Low-grade myofibroblastic sarcoma: A population-based study.

OBJECTIVES/HYPOTHESIS: Low-grade myofibroblastic sarcoma (LGMS) is a rare entity that is described as having a predilection for occurring in the head and neck region. Here we analyze its demographics, clinic-pathologic, and survival characteristics. STUDY DESIGN: Retrospective database analysis. METHODS: A cohort from the Surveillance, Epidemiology, and End Results Program database of cases with LGMS between 2001 and 2012. RESULTS: There were 49 cases with a 5-year overall survival of 71.6% and disease- specific survival of 76.3%. The majority of cases were in patients <60 years old, female, and white ethnicity. The most common sites were the extremities in 40.8% of cases followed by the head and neck region with 26.5% of cases. Multivariate analysis showed that only older age was significantly associated with worse survival (P < .05). CONCLUSIONS: LGMS is uncommon in the United States and occurs most commonly in the extremities followed by the head and neck region, despite an existing characterization of a predilection for the head and neck region. Treatment most commonly involves surgery, but the optimal surgical extent and/or radiotherapy needs to be further investigated. LEVEL OF EVIDENCE: 2c Laryngoscope, 127:116-121, 2017.

[Resection and reconstruction in cases of musculosceletal soft tissue sarcomas]. / Sebészi radikalitás és rekonstrukciós lehetõségek végtagi lágyrészsarcomáknál.

Soft tissue sarcomas are rare, reaching some 1.5% of all malignant tumors. While formerly the surgical management of sarcomas almost exclusively consisted of amputation, in the recent years limb saving surgery has become the first choice of therapy. Negative factors affecting the survival rate are: histologically high-grade tumor, size and localization of the tumor, vascular invasion, extensive tumor necrosis, certain subgroups, local recurrence and oncologically positive surgical margin at the resection. Many modern reconstruction possibilities are essential for the safe limb saving surgery with wide surgical margins, such as bone allograft implantation, tumor endoprostheses reconstruction, vascular grafting and plastic surgery. There should always be an attempt to perform limb saving surgery, however life quality, life expectancy and survival are more important considerations influencing essentially the surgical method of choice. In our follow-up study no significant difference in recurrence rate was found between the group of patients with sarcomas requiring a complex reconstruction procedure and the group of those treated by only resection methods (32% versus 47%).

Carcinosarcoma ex non-recurrent pleomorphic adenoma composed of TTF-1 positive large cell neuroendocrine carcinoma and myofibrosarcoma: apropos a rare Case.

We present a carcinosarcoma ex non-recurrent pleomorphic adenoma composed of a large cell neuroendocrine carcinomatous component and a spindle cell sarcoma with myofibroblastic differentiation. The tumor contained a hyalinized transition zone where the classical PA appeared to acquire two different histopathological patterns of malignant transformation of the epithelial component. The carcinomatous component was strongly and diffusely positive for low-molecular weight cytokeratins (AE1-3), synaptophysin, thyroid transcription factor-1 and focally positive for chromogranin A. All these markers were negative in the sarcomatous component. The sarcomatous component displayed immunoreactivity for smooth muscle actin with a predominantly linear, subplasmalemmal pattern. No expression of CD31, S100 protein, h-caldesmon, desmin, CD34, p63, myogenin, Myo D1 and c-kit was detected. Strong immunohistochemical expression of p53 was documented in both the carcinomatous and sarcomatous components as well as in the atypical epithelial component in the transition zone associated with the hyalinized pleomorphic adenoma.

Primary high-grade myofibroblastic sarcoma arising from the pericardium.

Primary pericardial sarcomas are very rare. A 62-year-old Japanese man presented with cardiac tamponade. Echocardiography, computed tomography and magnetic resonance imaging revealed massive pericardial effusion and a large tumor in the pericardial cavity, attached to the pericardium of the left ventricular posterolateral free wall. Surgical excision of the tumor was performed and histopathological and immunohistochemical examinations identified high-grade myofibroblastic sarcoma. Because of local recurrence soon after surgery, the patient received adjuvant chemotherapy, including doxorubicin and ifosfamide, and subsequent radiotherapy. As of 6 months after completing radiotherapy, the patient was alive and no disease progression or distant metastases were evident. This may be the first report of primary high-grade myofibroblastic sarcoma arising from the pericardium.

The role of myostatin and bone morphogenetic proteins in muscular disorders.

Skeletal muscle is the largest organ in the human body, and plays an important role in body movement and metabolism. Skeletal muscle mass is lost in genetic disorders such as muscular dystrophy, muscle wasting and ageing. Chemicals and proteins that restore muscle mass and function are potential drugs that can improve human health and could be used in the clinic. Myostatin is a muscle-specific member of the transforming growth factor (TGF)-beta superfamily that plays an essential role in the negative regulation of muscle growth. Inhibition of myostatin activity is a promising therapeutic method for restoring muscle mass and strength. Potential inhibitors of myostatin include follistatin domain-containing proteins, myostatin propeptide, myostatin antibodies and chemical compounds. These inhibitors could be beneficial for the development of clinical drugs for the treatment of muscular disorders. Bone morphogenetic protein (BMP) plays a significant role in the development of neuromuscular architecture and its proper functions. Modulation of BMP activity could be beneficial for muscle function in muscular disorders. This review will describe the current progress in therapy for muscular disorders, emphasising the importance of myostatin as a drug target.

Characteristics and outcome of children with primary soft tissue sarcomas of extremities.

OBJECTIVES: To determine the characteristics and outcome or patients with primary soft tissue sarcomas of extremities in children. MATERIAL AND METHODS: Thirty-six patients treated for soft tissues sarcomas were enrolled into the study. Features analysed: the incidence of soft tissues sarcoma of extremities, the time from first clinical symptoms to making the diagnosis, the primary site of tumour; histopathologic type of tumour, stage of disease, methods and results of the treatment. RESULTS: The time From first symptoms to making the diagnosis was 5.4 months (mean). The site of the tumour was the femur in 6 patients, arm in 3, knee in 1. Histopathologic types: synovial sarcoma in 4 patients, malignant haemangiopericytoma in 2, rhabdomyosarcoma in 2, sarcoma myogenes in 1, primitive neuroectodermal tumour in l. Stage of disease: III deg. -- 8 patients, IV deg. -- 2. Patients underwent treatment according to the soft tissue sarcoma protocols. Results of treatment: first complete remission was observed in 7 patients; second complete remission in 1, one patient is on postoperative treatment. One patient died. CONCLUSIONS: 1. Combined treatment achieves full remission in the majority of patients with soft tissues sarcomas localized within the limbs. 2. In patients with large tumours (>5 cm) the treatment should to be started with inductive chemotherapy, and the surgery should be postponed. 3. Early excision of the tumour should be considered in cases of small tumours (< 5 cm), when resection with wide margin of healthy tissues is possible, without deteriorating the function of the limb or cosmetic damage.

[Acute renal failure as complication of neoplastic disease in children]. / Ostra niewydolnosc nerek jako powiklanie choroby nowotworowej u dzieci.

Three cases of acute renal failure (ARF) requiring renal replacement therapy (RRT) in the course of neoplastic disease were presented. 7.5-yr-old girl admitted with postrenal failure during palliative radiotherapy had metastases in retroperitoneal space. Improvement followed percutaneous placement of nephrostomy catheters. 16-yr-old boy with acute myeloid leukemia was effectively treated with hemodialysis for prerenal and renal ARF mediated by vasomotor, infectious and toxic factors. In 11-yr-old boy ARF was the first clinical presentation of non-Hodgkin's lymphoma. Chemotherapy brought restoration of renal function. As a conclusion we emphasize complex etiology of ARF in such patients as well as the necessity of early introduction of RRT and thorough diagnosis and proper management of the causes of impaired renal function.

Cancer of the endometrium and corpus uteri.

Uterine cancer is often diagnosed at an early stage and is therefore considered one of the most curable gynecologic malignancies. Despite this, a substantial number of women who present at more advanced stage or with unfavorable histologies suffer significant morbidity and death from this disease. Research continues along several fronts in an attempt to improve the prognosis for this group of women. Basic scientific research has continued to evaluate mechanisms of carcinogenesis in the hope that better targets for treatment and prevention of disease will be found. Epidemiologic studies have attempted to further define risk factors as well as elucidate risk in those patients receiving combination estrogen and progestin hormone replacement therapy. Clinical studies have further defined prognostic factors, and examined new surgical staging techniques and the need for adjuvant therapy after primary surgery. However, treatment options for advanced and recurrent disease remain limited.

Treatment of human clonogenic tumor cells and bone marrow progenitor cells with bleomycin and peplomycin under 40.5 degrees C hyperthermia in vitro.

Tumor cells derived from 13 different individual human tumors were plated in a colony forming monolayer assay. The effect of bleomycin and peplomycin on colony formation was assessed in normothermic conditions and after a hyperthermic treatment at 40.5 degrees C for 2 h at the beginning of the culture. In three out of the 13 tumor samples (two colon carcinomas, one malignant melanoma), hyperthermic incubation resulted in a thermal enhancement of the effects of bleomycin and peplomycin. In addition, human bone marrow progenitor cells (CFU-C) were subjected to the same procedure. Peplomycin proved to be less toxic to CFU-C than bleomycin. In samples from eight different donors, homogeneous dose-response curves were observed. There was no difference between normo- and hyperthermic incubation.

[Anti-tumor effect and mechanism of action of the tumor necrosis factor (TNF)].

TNF is cytokine derived from macrophages and shows much promise for use in cancer therapy because of its marked antitumor effects and its high specificity to tumors. The clinical application (Phase I-II) of TNF has been started because human recombinant TNF (rH-TNF) can be produced on a large scale. In spite of notable antitumor effects, little is known concerning the mechanism of its cytotoxic action. In this article, the antitumor effects of rH-TNF against human and murine tumors, the mechanism of its action and the synergistic effects of rH-TNF in combination with IFN-gamma, various anticancer drugs or with hyperthermia are reviewed.

Characterization of a monoclonal antibody directed to a T cell suppressor factor.

A monoclonal antibody raised by fusion of immune BALB/c splenocytes with NS1 cells is described. BALB/c mice were immunized with a T suppressor factor (TsF) raised in DBA/2 mice with specificity for the P815 tumor. The TsF had been purified by affinity chromatography before its use as an immunogen. The monoclonal antibody (B16G) was shown to affect the course of P815 growth in DBA/2 mice if administered i.v. on days -2 to 0 before tumor cell inoculation. Mice treated with B16G demonstrated slower tumor development and growth than controls, and a small number of animals (about 10%) did not develop tumors; all controls did. It was also shown that B16G did not exhibit total specificity for the P815 tumor in that it had similar effects on the growth of an unrelated myosarcoma (M-1) of DBA/2 mice. The general immunopotentiating effect of the B16G monoclonal was demonstrated by the fact that spleen cells of DBA/2 mice that had received B16G showed significantly higher MLC than did equivalent controls. When spleen cells of DBA/2 mice were depleted of B16G-reactive cells by panning in vitro, it was also found that cells so treated gave rise to elevated MLC reactions in comparison to appropriate controls. When an immunoadsorbent was prepared with B16G and cell lysates from splenocytes of immunosuppressed mice were passed over it, the immunosuppressive properties of the lysate in MLC were eliminated. The conclusion that the B16G recognizes a marker common to a group of regulatory T cells in DBA/2 mice is discussed.

Myosarcomas of the bladder and prostate.

Of 32 patients seen in Memorial Center since 1920 with myosarcomas of the bladder or prostate 26 were male and six were female. The tumors arose in the bladder in 20, in the prostate in 11 and in one patient both organs were involved. Sarcomas of the bladder account for two or three of every thousand bladder cancers and for one of every thousand prostate cancers. Seventy-six patients, or approximately 10% of reported cases, have survived 3 years or more from diagnosis. Forty-five of those 76 sarcomas were reported as specific myosarcomas, i.e., embryonal rhabdomyosarcoma, adult rhabdomyosarcoma, leiomyosarcoma or combinations of those three. Thirty-six arose in the bladder, nine arose in the prostate. The most successful methods of treatment have been cystectomy for embryonal rhabdomyosarcoma of the bladder and segmental resection for leiomyosarcoma of the bladder. Rhabdomyosarcoma of the bladder and prostate has seldom been managed successfully, so that no particular treatment can be unconditionally recommended. Embryonal rhabdomyosarcoma of the prostate is as yet an incurable condition.