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1.
Cancers (Basel) ; 13(9)2021 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-34066400

RESUMO

In locally advanced dermatofibrosarcoma protuberans (DFSP), imatinib mesylate has been described as an efficient neoadjuvant therapy. This retrospective study included patients with locally advanced DFSP who received neoadjuvant TKI (imatinib or pazopanib) from 2007 to 2017 at Saint Louis Hospital, Paris. The primary endpoint was the evaluation of the long-term status. A total of 27 patients were included, of whom nine had fibrosarcomatous transformation. The median duration of treatment was 7 months. The best response to TKI treatment before surgery, evaluated according to RECIST1.1 on MRI, consisted of complete/partial response (38.5%) or stability (46.2%). DFSP was surgically removed in 24 (89%) patients. A total of 23 patients (85%) were disease-free after 64.8 months of median follow-up (95% confidence interval 47.8; 109.3). One patient developed distant metastases 37 months after surgical tumor resection and finally died. Two patients (7%) did not get surgery because of metastatic progression during TKI treatment, and one patient refused surgery even though the tumor decreased by 30%. Treatment-related adverse events (AE) occurred in 23 patients (85%). Only four patients (imatinib: n = 3, pazopanib: n = 1) had grade ≥3 AE requiring temporary treatment disruption. Neoadjuvant TKI followed by complete surgery with micrographic analysis is an effective strategy for locally advanced and unresectable DFSP, with durable local recurrence disease-free survival.

2.
J Cutan Pathol ; 48(7): 896-901, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33241586

RESUMO

Recently, a novel group of CD34+ and S100+ spindle cell tumors with distinctive stromal and perivascular hyalinization showing recurrent gene fusions involving RAF1, BRAF, NTRK1/2/3, and RET has been identified. ALK rearrangements have been rarely reported in this group of tumors. We report a 24-year-old woman with a 1.5-cm pink mass of the scalp. The tumor was made of spindle cells organized in fascicles or haphazardly arranged in a patternless architecture, with areas of stromal and perivascular hyalinization. The tumor cells diffusely expressed CD34 and S100, without SOX-10 expression. The tumor showed diffuse immunopositivity for ALK. RNA sequencing using next-generation sequencing (NGS) detected an EML4-ALK fusion. This case extends the spectrum of this newly described group of CD34+/S100+ spindle cell tumors at the molecular-genetic level. Dermatopathologists should be aware of this recent entity, as it may fall in the differential diagnosis of many other spindle cell tumors with CD34 expression. NGS-based techniques should be performed when facing spindle cell tumors with similar morphology and immunophenotype. Identification of kinase fusions is essential for the precise classification and better knowledge of these tumors, and for targeted therapy in rare aggressive cases.


Assuntos
Antígenos CD34/metabolismo , Proteínas S100/metabolismo , Neoplasias de Tecidos Moles/metabolismo , Neoplasias de Tecidos Moles/patologia , Vasos Sanguíneos/metabolismo , Vasos Sanguíneos/patologia , Diagnóstico Diferencial , Feminino , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Hialina/metabolismo , Imuno-Histoquímica/métodos , Proteínas de Fusão Oncogênica , Análise de Sequência de RNA/métodos , Neoplasias de Tecidos Moles/diagnóstico , Células Estromais/metabolismo , Células Estromais/patologia , Recusa do Paciente ao Tratamento , Adulto Jovem
4.
Melanoma Res ; 20(3): 247-50, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20216240

RESUMO

Anecdotal cases of partial or complete responses have been reported after ipilimumab therapy for stage IV melanoma with brain metastasis treated earlier by surgery or radiosurgery. We report the first case of ipilimumab monotherapy resulting in durable complete remission of untreated, progressive brain metastases in a patient with stage IV melanoma. This case and earlier reports provide support for the further evaluation of ipilimumab in melanoma patients with brain metastasis.


Assuntos
Anticorpos Monoclonais/farmacologia , Antineoplásicos/farmacologia , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/secundário , Melanoma/tratamento farmacológico , Melanoma/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Idoso , Neoplasias Encefálicas/patologia , Humanos , Ipilimumab , Masculino , Metástase Neoplásica , Análise de Regressão , Indução de Remissão , Resultado do Tratamento
5.
AJR Am J Roentgenol ; 193(2): W144-8, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19620417

RESUMO

OBJECTIVE: We describe a coaxial introducer provided with an additional blunt-tip stylet that allows safe access to difficult-to-reach lymph nodes in the chest, abdomen, and pelvis under CT control. CONCLUSION: Once the thoracic, abdominal, or pelvic wall is crossed by the introducer fitted with the sharp-tip stylet, the blunt-tip stylet replaces the sharp stylet for further progression in the fat toward the target. The soft-tip stylet carries a smaller risk of inadvertent perforation displacing vital structures.


Assuntos
Biópsia/instrumentação , Linfonodos/patologia , Linfoma/patologia , Neoplasias/patologia , Abdome , Adulto , Idoso , Idoso de 80 Anos ou mais , Amiloidose/patologia , Biópsia/métodos , Desenho de Equipamento , Feminino , Humanos , Linfonodos/diagnóstico por imagem , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Pelve/diagnóstico por imagem , Radiografia Abdominal , Radiografia Torácica , Fibrose Retroperitoneal/patologia , Espaço Retroperitoneal/diagnóstico por imagem , Estudos Retrospectivos , Sarcoidose/patologia , Tórax , Tomografia Computadorizada por Raios X/métodos , Tuberculose/patologia
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