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1.
Cancer Radiother ; 18(7): 666-71, 2014 Nov.
Article in French | MEDLINE | ID: mdl-24981411

ABSTRACT

PURPOSE: To assess microscopic extensions of head and neck squamous cell carcinomas aiming at a proposal for target volumes of radiation therapy. MATERIALS AND METHODS: Surgical specimens were prospectively analysed macroscopically and microscopically. Tumour borders were identified per macroscopic visual examination and inked on stained slides. Then microscopic implants (perineural or lymphatic involvement, or in situ carcinomas) were looked for with an optic microscope in the macroscopic healthy tissue surrounding the tumour. The maximal length from tumour border was correlated with the maximal length of macroscopically healthy tissues assessable. RESULTS: Twenty-one specimens were analysed and 12 were locally advanced tumours. Mean and median maximal microscopic extensions were 2.9 and 1.0mm (0-15mm), respectively. The 90th and 95th percentiles were 5 and 11mm, respectively. The ratio between healthy tissue length and maximal microscopic tumour extension was 10%. No correlation was found with tumour grade or volume. CONCLUSION: The presence of microscopic tumour was unlikely after 5mm from macroscopic tumour (≤5% of patients in this series) but should be assessed along with other histoclinical factors and particularities of tumour behaviour by anatomic site. A rigorous terminology should authorize a relevant appreciation of local risk of recurrence, particularly in adjuvant setting or for clinical target volume definition. Larger and more homogenous confirmatory series are needed.


Subject(s)
Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/radiotherapy , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/radiotherapy , Radiotherapy Planning, Computer-Assisted/methods , Adult , Aged , Carcinoma, Squamous Cell/surgery , Female , Head and Neck Neoplasms/surgery , Humans , Male , Microscopy , Middle Aged , Neoplasm Invasiveness , Prospective Studies , Radiotherapy, Conformal , Staining and Labeling
2.
Orthop Traumatol Surg Res ; 99(6 Suppl): S285-95, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23978711

ABSTRACT

INTRODUCTION: Medium-term results for total ankle replacement (TAR) are in general satisfactory, but there is a high redo rate for periprosthetic osteolysis associated with the AES implant. HYPOTHESIS: Comparing radioclinical findings and histologic analysis of implant revision procedure specimens can account for the elevated rate of osteolysis associated with the AES TAR implant. MATERIAL AND METHOD: In a prospective series of 84 AES TAR implants (2003-2008), 25 underwent revision for osteolysis (including three undergoing revision twice) at a mean 59.8 months. Eight patients had hydroxyapatite (HA) coated models and the others had titanium-hydroxyapatite (Ti-HA) coatings. Radiographs were systematically analyzed on Besse's protocol and evolution was monitored on AOFAS scores. The 94 specimens taken for histologic analysis during revision were re-examined, focusing specifically on foreign bodies. RESULTS: Macroscopically, no metallosis or polyethylene wear was found at revision. AOFAS global and pain scores fell respectively from 89.7/100 at 1 year postoperatively to 72.9 before revision and from 32.5/40 to 20.6/40, although global scores were unchanged in 25% of patients. Radiologically, all patients showed tibial and talar osteolytic lesions, 45% showed cortical lysis and in 25% the implant had collapsed into the cysts. All specimens showed macrophagic granulomatous inflammatory reactions in contact with a foreign body; the cysts showed necrotic remodeling. Some of the foreign bodies could be identified on optical histologic examination with polyethylene in 95% of the specimens and metal in 60% (100% of HA-coated models and 33.3% of Ti-HA-coated models). Unidentifiable material was associated: a brownish pigment in Ti-HA-coated models (33.3%) and flakey bodies in 44.4% of the HA-coated models and 18.2% of the Ti-HA-coated models. DISCUSSION: The phenomenon of periprosthetic osteolysis is still poorly understood, although implant wear debris seems to be implicated. All the patients with HA-coated implants with modular tibial stem had metal particles in the tissue around the implant, although their exact nature could not be determined. The double-layer Ti-HA coating may induce delamination by fretting while the biological bone anchorage is forming. LEVEL OF EVIDENCE: Prospective cohort study - Level IV.


Subject(s)
Arthroplasty, Replacement, Ankle , Osteolysis/pathology , Postoperative Complications/pathology , Biopsy , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Male , Osteolysis/diagnostic imaging , Osteolysis/etiology , Postoperative Complications/diagnostic imaging , Postoperative Complications/etiology , Radiography , Retrospective Studies
3.
Rev Stomatol Chir Maxillofac Chir Orale ; 114(6): 366-71, 2013 Dec.
Article in French | MEDLINE | ID: mdl-23871565

ABSTRACT

Solitary fibrous tumor (SFT) is a rare etiology of progressive unilateral exophthalmia. The tumor is of mesenchymal origin and it is usually well defined. But recurrences can occur despite of complete surgical resection. Metastases have been observed. Tumors of the SFT spectrum are considered as benign or low-grade malignant. Histological features do not currently allow any prognosis. The most important prognostic factor is complete surgical resection. Craniofacial approaches provide a good view of the tumor extensions and orbital contents. Recurrent tumors must be surgically removed when possible. Complementary treatments have not proved effective. A very long-term follow-up is mandatory.


Subject(s)
Neoplasm Recurrence, Local , Orbital Neoplasms , Solitary Fibrous Tumors , Diagnosis, Differential , Diagnostic Imaging , Exophthalmos/diagnosis , Exophthalmos/etiology , Exophthalmos/therapy , Humans , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/therapy , Orbital Neoplasms/diagnosis , Orbital Neoplasms/epidemiology , Orbital Neoplasms/pathology , Orbital Neoplasms/therapy , Prognosis , Solitary Fibrous Tumors/diagnosis , Solitary Fibrous Tumors/epidemiology , Solitary Fibrous Tumors/pathology , Solitary Fibrous Tumors/therapy
4.
Eur Ann Otorhinolaryngol Head Neck Dis ; 129(6): 327-30, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22819223

ABSTRACT

OBJECTIVE: The present study describes the clinical, radiological and histological features of pharyngeal synovial sarcoma, on the basis of one clinical case, and discusses management. CASE STUDY: A male patient, aged 27 years, presented with synovial sarcoma of the lateral pharyngeal wall, revealed by pharyngeal discomfort and bloody sputum. CT and MRI showed a partially necrotic tumoral process centered on the upper half of the piriform sinus. Pathologic analysis found a malignant biphasic tumor, suggestive of synovial sarcoma. Partial pharyngolaryngectomy was performed on a lateral approach, with associated radiotherapy. DISCUSSION: Synovial sarcoma raises diagnostic and therapeutic issues. Prognostic factors are not clearly established. CONCLUSION: Pharyngeal synovial sarcoma is a rare tumor. Treatment is essentially surgical, requiring wide margins; radiotherapy is usually associated. The value of chemotherapy has yet to be assessed.


Subject(s)
Pharyngeal Neoplasms/diagnosis , Sarcoma, Synovial/diagnosis , Adult , Humans , Male
5.
Eur Ann Otorhinolaryngol Head Neck Dis ; 129(3): 160-2, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22475977

ABSTRACT

OBJECTIVES: To illustrate, via a case report, how a differential diagnosis of amyloidosis is to be suspected in case of a nasopharyngeal mass. CASE REPORT: A 59-year-old woman presented with bilateral nasal obstruction with associated episodic tubal dysfunction. Physical examination found a mass occupying the entire nasopharynx, initially suggestive of tumor. DISCUSSION: Amyloidosis was diagnosed on histopathologic study of the biopsy and surgical specimens. Exploration for systemic disease proved negative. The localized amyloidosis was managed conservatively. At 9 months' follow-up, there was no recurrence. CONCLUSION: Localized amyloidosis, however rare, should be considered as differential diagnosis in any case of nasal obstruction with tubal dysfunction, even if bilateral. ENT physicians need to recognize and understand this pathology for adapted diagnostic and treatment planning.


Subject(s)
Amyloidosis/diagnosis , Nasopharyngeal Diseases/diagnosis , Amyloidosis/pathology , Amyloidosis/surgery , Biopsy , Contrast Media/administration & dosage , Diagnosis, Differential , Female , Gadolinium , Humans , Magnetic Resonance Imaging , Middle Aged , Nasopharyngeal Diseases/pathology , Nasopharyngeal Diseases/surgery , Nasopharyngeal Neoplasms/diagnosis , Nasopharyngeal Neoplasms/pathology , Nasopharyngeal Neoplasms/surgery , Nasopharynx/pathology , Nasopharynx/surgery , Tomography, X-Ray Computed
6.
Clin Res Hepatol Gastroenterol ; 35(8-9): 586-9, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21397584

ABSTRACT

Pancreatic metastases from colorectal cancer are extremely rare. We report the case of a 74-years-old patient presented with a metachronous pancreatic metastasis, which was treated by segmental pancreatectomy. After reviewing literature, diagnosis and management of pancreatic metastasis from colorectal carcinoma are discussed.


Subject(s)
Adenocarcinoma/pathology , Colonic Neoplasms/pathology , Pancreatic Neoplasms/secondary , Aged , Humans , Male
7.
Article in English | MEDLINE | ID: mdl-20822751

ABSTRACT

OBJECTIVE: To describe diagnostic and therapeutic management of a rare parotid lesion: sclerosing polycystic adenosis. PATIENT AND METHOD: We report a case of persistent right intraparotid tumefaction. RESULTS: A 68-year-old man was referred with a right parotid nodule of 2 years' evolution. Cytology diagnosed pleomorphic adenoma, verified on MRI. Conservative subtotal parotidectomy diagnosed sclerosing polycystic adenosis. Over 1 year's regular follow-up, there were no signs of local recurrence. CONCLUSION: Sclerosing polycystic adenosis of the parotid gland is a rare and recently described entity presenting several analogies to the much more frequent cystic mastitis. Although benign and well-delimited, it requires complete exeresis of the parotid, due to a non-negligible risk of recurrence.


Subject(s)
Adenoma, Pleomorphic/diagnosis , Parotid Neoplasms/diagnosis , Adenoma, Pleomorphic/pathology , Adenoma, Pleomorphic/surgery , Aged , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Parotid Gland/pathology , Parotid Gland/surgery , Parotid Neoplasms/pathology , Parotid Neoplasms/surgery , Sclerosis
10.
J Hepatol ; 35(1): 120-6, 2001 Jul.
Article in English | MEDLINE | ID: mdl-11495029

ABSTRACT

BACKGROUND/AIMS: The aim of this study was to evaluate the changes in histological lesions and serum N-terminal peptide of type III procollagen (PIIINP) and hyaluronate (HA) levels in virologic non-responder patients treated by Interferon alpha (IFNalpha). METHODS: We enrolled 183 patients treated by IFNalpha and 56 controls, all with paired biopsy specimens. Yearly liver fibrosis progression was estimated before and during a follow-up of 1 year. RESULTS: By contrast to sustained responders, non-responders (n = 105) did not achieve improvement of histological scores after therapy. Their yearly fibrosis progression rate was similar before and during follow-up (0.18, 95%CI: 0.16-0.20, vs 0.26 (95%CI: 0.12-0.40) fibrosis units/year, NS), and was not different in controls (0.17, 95%CI: 0.06-0.27). The levels of PIIINP and hyaluronate (HA) remained unchanged during follow-up. Histological improvement was observed for the second biopsy in 25% of non-responders, but also in 23% of controls. This improvement was not correlated with decrease of ALT level, viral load, PIIINP, or HA. CONCLUSIONS: Our results suggest that IFNalpha therapy is unable to decrease PIIINP or HA levels and cannot improve the histological outcome in virologic non-responder patients. The histological improvement observed in a subset of patients may be linked to sample fluctuation or lack of reproducibility of histological scores.


Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C, Chronic/blood , Hepatitis C, Chronic/pathology , Hyaluronic Acid/blood , Interferon-alpha/therapeutic use , Peptide Fragments/blood , Procollagen/blood , Adult , Biomarkers/blood , Disease Progression , Female , Hepatitis C, Chronic/drug therapy , Humans , Male , Middle Aged , Treatment Failure
11.
Eur J Gastroenterol Hepatol ; 13(2): 207-11, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11246625

ABSTRACT

Loss of heterozygosity for polymorphic markers flanking the multiple endocrine neoplasia type 1 (MEN-1) gene in parathyroid and pancreatic islet tumours from subjects with MEN-1 has been well documented and has led to the hypothesis that the MEN-1 gene functions as a recessive tumour suppressor gene. We report a case of MEN-1 with duodeno-pancreatic gastrinoma, parathyroid hyperplasia, pituitary adenoma, adrenal adenoma, and lipomas, whose rare association with a malignant gastrointestinal stromal tumour (GIST) represents an undescribed combination. MEN-1 mutation in this family was shown as a frameshift (1607delA) in exon 10. To assess the role of the MEN-1 gene in the pathogenesis of tumours less commonly associated with MEN-1, we studied GIST DNA for loss of the unaffected MEN-1 gene allele. Stromal tumour and peripheral leucocyte DNAs from our patient were examined for loss of heterozygosity using the PYGM microsatellite polymorphism and an intragenic polymorphism (D418D in exon 9) in the MEN-1 gene. We showed no evidence for loss of the wild-type MEN-1 allele in GIST. The MEN-1 germline inactivating mutation 1607delA-ter558 in exon 10 was detected in the stromal tumour DNA, but no somatic mutation in the wild-type MEN-1 allele in GIST DNA was detected. Occurrence of GIST could be consistent with the possibility that this MEN-1-related uncommon neoplasm arose independently by a mechanism unrelated to the MEN-1 gene.


Subject(s)
Gastrinoma/pathology , Gastrointestinal Neoplasms/pathology , Multiple Endocrine Neoplasia Type 1/pathology , Neoplasms, Multiple Primary/pathology , Adult , Chromosomes, Human, Pair 11 , DNA, Neoplasm/analysis , Gastrinoma/genetics , Gastrointestinal Neoplasms/genetics , Genes, Tumor Suppressor , Humans , Loss of Heterozygosity , Male , Multiple Endocrine Neoplasia Type 1/genetics , Neoplasms, Multiple Primary/genetics , Polymorphism, Genetic
12.
Rev Med Interne ; 21(10): 889-92, 2000 Oct.
Article in French | MEDLINE | ID: mdl-11075397

ABSTRACT

INTRODUCTION: Inflammatory pseudo-tumors (IPT) are benign neoplasms associated with local or general manifestations. Renal localization seems exceptional, and no case of fever of unknown origin caused by renal inflammatory pseudo-tumors have been reported. EXEGESIS: The authors report the case of a man presenting fever of unknown origin and inflammatory syndrome. Computerized tomography showed a renal mass. Nephrectomy was performed, and renal inflammatory pseudo-tumor was diagnosed. After surgical exeresis, the clinical and biological abnormalities vanished. CONCLUSION: This rare diagnosis must be considered in these situations. The outcome is excellent.


Subject(s)
Fever of Unknown Origin/etiology , Granuloma, Plasma Cell/complications , Granuloma, Plasma Cell/diagnosis , Kidney Diseases/complications , Kidney Diseases/diagnosis , Biopsy, Needle , Blood Sedimentation , Diagnosis, Differential , Granuloma, Plasma Cell/blood , Granuloma, Plasma Cell/surgery , Humans , Immunohistochemistry , Kidney Diseases/blood , Kidney Diseases/surgery , Male , Middle Aged , Nephrectomy , Tomography, X-Ray Computed
13.
Ann Chir ; 125(4): 376-9, 2000 May.
Article in French | MEDLINE | ID: mdl-10900741

ABSTRACT

The shortage of organ donors has led to progressive softening of selection criteria for organ donation. We report on hepatic transplantation in a 55-year-old woman with primary biliary cirrhosis, whose donor was a 50-year-old heart transplant recipient who became brain stem dead, due to cerebral bleeding 8 months after transplantation. An orthotopic liver transplantation was performed. The postoperative course was uneventful and the recipient was alive and had normal liver function after a 42-month follow-up. Analysis of the literature included ethical consideration, potential hepatotoxic effects of immunosuppressive drugs and modification of the graft immunogenicity. It confirms that transplanted patients should not be a priori excluded from organ donation.


Subject(s)
Brain Death , Heart Transplantation , Liver Transplantation , Cerebral Hemorrhage/complications , Ethics, Medical , Female , Follow-Up Studies , Humans , Immunosuppressive Agents/therapeutic use , Liver Cirrhosis, Biliary/surgery , Middle Aged , Tissue Donors
14.
Am J Surg Pathol ; 24(6): 830-6, 2000 Jun.
Article in English | MEDLINE | ID: mdl-10843285

ABSTRACT

Desmoplastic small round cell tumors (DSRCTs) present a reciprocal chromosomal translocation, t(11;22)(p13;q12), that results in fusion of Ewing's sarcoma and Wilms' tumor (WT1) genes. The authors evaluated 15 DSRCTs and 71 other tumors often considered in the differential diagnosis for immunoreactivity using a polyclonal antibody directed against the WT1 part of the chimeric protein resulting from this translocation. WT1 immunostaining was performed on paraffin material using the WT(C-19) antibody after heat-antigen retrieval. All the DSRCTs (15 of 15, 100%) demonstrated strong WT1 nuclear immunoreactivity. Ten of 14 nephroblastomas (71%) disclosed WT1-positive nuclei in accordance with the staining reported by others, and rare and focal nuclear positivity was detected in two of 17 rhabdomyosarcomas. WT1 immunoreactivity was not observed in Ewing's sarcoma/primitive neuroectodermal tumors (zero of 21, 0%), neuroblastomas (zero of 17, 0%), or rhabdoid tumors of the kidney (zero of two, 0%). In nephroblastoma, differential diagnosis with DSRCT was not difficult: Clinical and morphologic data are not similar for these two entities. The current study validates WT1 immunoreactivity as a useful marker to separate DSRCT from other small round cell tumors.


Subject(s)
Abdominal Neoplasms/pathology , Genes, Wilms Tumor/genetics , Kidney Neoplasms/pathology , Neuroblastoma/pathology , Pelvic Neoplasms/pathology , Rhabdomyosarcoma/pathology , Wilms Tumor/pathology , Abdominal Neoplasms/diagnosis , Abdominal Neoplasms/genetics , Adolescent , Adult , Artificial Gene Fusion , Child , Diagnosis, Differential , Female , Humans , Immunohistochemistry , Kidney/pathology , Kidney Neoplasms/diagnosis , Kidney Neoplasms/genetics , Liver Neoplasms/diagnosis , Liver Neoplasms/pathology , Liver Neoplasms/secondary , Male , Middle Aged , Neuroblastoma/diagnosis , Neuroblastoma/genetics , Pelvic Neoplasms/diagnosis , Pelvic Neoplasms/genetics , Rhabdomyosarcoma/diagnosis , Rhabdomyosarcoma/genetics , Sarcoma, Ewing/genetics , Terminology as Topic , Wilms Tumor/diagnosis , Wilms Tumor/genetics
16.
Pathol Res Pract ; 194(10): 693-700, 1998.
Article in English | MEDLINE | ID: mdl-9820865

ABSTRACT

Desmoplastic small round cell tumor is an aggressive neoplasm first described in 1991. Recently, a reciprocal translocation t(11;22)(p13;q12) has been characterized by conventional cytogenetic studies and molecular analysis. This translocation involves the Ewing's sarcoma gene on chromosome 22 and the Wilms' tumor gene WT1 on chromosome 11. The chimeric transcript corresponding to the fusion gene could be detected by the reverse transcriptase-polymerase chain reaction (RT-PCR). Using an anti-WT1 antibody, the WT1 part of the putative chimeric protein could be recognized by immunohistochemistry. We describe two well-characterized cases of intraabdominal desmoplastic small round cell tumor in two male patients aged 14 and 28 with both RT-PCR analysis and immunostaining for WT1. In this report, we insist on the necessity to increase the RT-PCR analysis in DSRCT in order to obtain a precise differential diagnosis. In addition, WT1 immunostaining may serve as a useful diagnostic marker for DSRCT.


Subject(s)
Abdominal Neoplasms/genetics , Carcinoma, Small Cell/genetics , DNA-Binding Proteins/metabolism , Desmin/metabolism , Genes, Wilms Tumor/genetics , Transcription Factors/metabolism , Abdominal Neoplasms/metabolism , Abdominal Neoplasms/pathology , Adolescent , Adult , Carcinoma, Small Cell/metabolism , Carcinoma, Small Cell/pathology , DNA Primers/chemistry , DNA, Neoplasm/analysis , Fatal Outcome , Humans , Immunoenzyme Techniques , Karyotyping , Male , Reverse Transcriptase Polymerase Chain Reaction , WT1 Proteins
17.
Hepatology ; 27(3): 862-7, 1998 Mar.
Article in English | MEDLINE | ID: mdl-9500719

ABSTRACT

The purpose of this study is to compare a combination of interferon (IFN)-alpha2a (Roferon) + Tenoxicam with IFN-alpha2a alone in the treatment of chronic hepatitis C. This prospective, randomized double-blind study included 149 patients, all of whom were diagnosed with active chronic hepatitis C but non-cirrhotic (ALT > or = 1.5 upper limit of normal, anti-hepatitis C virus (HCV) positive by enzyme-linked immunosorbant assay2 and RIBA3). The patients were randomized in two groups, as follows: G1 (n = 76): IFNalpha2a 3 million units times per week during 6 months + placebo; and G2 (n = 73): IFNalpha2a 3 million units three times per week + Tenoxicam (20 mg/day) during 6 months. Alanine aminotransferase (ALT) and HCV RNA were determined before and at months 6 and 12 of treatment. 2'5' oligoadenylate synthetase activity (2'5' AS) was dosed in mononuclear cells before and at 3-month treatment intervals in 28 patients. Liver biopsy was performed before and 6 months after the end of therapy. Parameters were similar before therapy for both groups. Biochemical and virological responses were similar for both groups at month 6 (49.3% vs. 42.9% and 43.3% vs. 38.3%, respectively) and month 12 (28.3% vs. 23.8% and 17.2% vs. 17.5%, respectively). HCV RNA level significantly decreased in both groups at month 6, with no difference whatever the therapy; however, the HCV RNA level returned to initial values at month 12 and was the only significant prognostic factor of a sustained response. No peak of 2'5' AS activity was observed during treatment in patients with dual therapy. A histological improvement was also noted in both groups without difference, regardless of therapy. The percentage of adverse events was identical for both groups. Paracetamol intake, assessed in 80 patients, was 49.1 g per 6 months in the G1 group and 22.5 g per 6 months in the G2 group (not significant). In conclusion, the non-steroid anti-inflammatory drug, Tenoxicam, does not increase IFNalpha efficacy in the treatment of chronic hepatitis C. This combination is well tolerated and partially lowers Paracetamol intake, but not preexisting alpha-IFN adverse events.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Hepatitis C, Chronic/drug therapy , Interferon-alpha/administration & dosage , Piroxicam/analogs & derivatives , 2',5'-Oligoadenylate Synthetase/metabolism , Adult , Double-Blind Method , Drug Therapy, Combination , Female , Humans , Interferon alpha-2 , Interferon-alpha/adverse effects , Male , Middle Aged , Piroxicam/administration & dosage , Piroxicam/adverse effects , Recombinant Proteins
18.
Hum Pathol ; 29(1): 95-8, 1998 Jan.
Article in English | MEDLINE | ID: mdl-9445141

ABSTRACT

Infiltration of regional lymph nodes by macrophages has been shown after total joint arthroplasty. These pelvic lymph nodes were obtained most often from patients during staging procedures for carcinoma and may be a diagnostic pitfall in the frozen section diagnosis of nodal metastasis. We report an unusual case of association in the same lymph node between histiocytosis and prostatic carcinoma metastasis. Histiocytosis was caused by wear debris from two different prostheses. Inductively coupled plasma mass spectrometry verified this diagnosis.


Subject(s)
Adenocarcinoma/secondary , Foreign-Body Reaction/pathology , Hip Prosthesis/adverse effects , Histiocytosis/pathology , Lymphatic Metastasis/pathology , Aged , Foreign-Body Reaction/etiology , Histiocytosis/etiology , Humans , Lymph Nodes/chemistry , Lymph Nodes/pathology , Male , Mass Spectrometry , Metals/analysis , Prostatic Neoplasms/pathology
20.
Arch Anat Cytol Pathol ; 45(1): 28-36, 1997.
Article in French | MEDLINE | ID: mdl-9339001

ABSTRACT

We describe a primary leiomyosarcoma arising in the proximal part of the right tibia of a 38-year-old man. The diagnosis was confirmed by immunohistochemistry (positivity of tumor cells for alpha smooth muscle actin, HHF 35, desmin and vimentin). To the best of our knowledge, this is the 49th documented case of primary leiomyosarcoma of bone outside the facial skeleton. This exceptional tumor arises more commonly in adults (mean age: 53 years) and in the long bones of lower limbs, near the knee. The most frequent symptom is pain with or without swelling or fracture. Radiological findings invariably consist of a non specific osteolytic lesion. Although their histological appearance does not differ from that of extraosseous leiomyosarcomas, their diagnosis is difficult and often requires immunohistochemical and/or ultrastructural study. From a practical point of view, the diagnosis of primary leiomyosarcoma of bone also requires an intensive review of the case history and of previous pathology. This is necessary in order to eliminate an extraosseous primary site (mainly in uterus, gastrointestinal tract and soft tissues). As well as clinicopathological features, modes of treatment and results are also reviewed.


Subject(s)
Bone Neoplasms/pathology , Leiomyosarcoma/pathology , Tibia/pathology , Adult , Bone Neoplasms/metabolism , Bone Neoplasms/therapy , Humans , Immunohistochemistry , Leiomyosarcoma/metabolism , Leiomyosarcoma/therapy , Male
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