MyMedR

Cytologic features and differential diagnosis in chondroma of the breast: a case report

Sivakumar S, Kaur G

Acta Cytol., 2009 May-Jun;53(3):303-5.

PMID: 19534271 DOI: 10.1159/000325312

BACKGROUND: Extraskeletal (soft tissue) chondromas are rare neoplasms. They are seen most frequently in the soft tissues of hands and feet. A chondroma occurring in the breast is exceedingly uncommon. We present a case of pure chondroma of the breast in a young woman in whom fine needle aspiration (FNA) cytologic features suggested a cartilaginous neoplasm.

CASE: A 28-year-old woman presented with a mobile lump in the left breast. Mammography showed a high-density nodule without microcalcifications. A clinical diagnosis of fibroadenoma was made. A differential diagnosis was obtained on FNA. Excisional biopsy of the lump showed the histopathologic features of chondroma. There was no recurrence or appearance of new lesion during 13 months of follow-up.

CONCLUSION: Chondroma of the breast shows FNA cytologic features of cartilaginous tumor, but specific tumor typing may not be possible. This case highlights the difficulties that may arise in FNA diagnosis of cartilaginous tumor especially when it occurs at an unusual site. Awareness of the cytologic features combined with clinical and radiologic findings should guide the cytopathologist to make correct diagnosis of this neoplasm.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*; Soft Tissue Neoplasms/surgery

Fulltext Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients

Dhanoa A, Yong TL, Yeap SJ, Lee IS, Singh VA

BMC Complement Altern Med, 2014;14:404.

PMID: 25324121 DOI: 10.1186/1472-6882-14-404

Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients.

Matched MeSH terms: Soft Tissue Neoplasms/psychology; Soft Tissue Neoplasms/therapy*

Fulltext Does lightning strike twice?

Qi Qi C, Ajit Singh V

BMJ Case Rep, 2012;2012.

PMID: 22892228 DOI: 10.1136/bcr.01.2012.5518

The authors present an interesting case under our follow-up who has had five different forms of tumours with different pathologies throughout his lifetime. He started off with hepatoma, followed by pleomorphic sarcoma of the thigh, adenocarcinoma of the prostate, meningioma and finally schwanoma. He is still alive to this date.

Matched MeSH terms: Soft Tissue Neoplasms/diagnosis; Soft Tissue Neoplasms/pathology*; Soft Tissue Neoplasms/therapy

Fulltext Cutaneous mycobacterial spindle cell pseudotumour

Tan GC, Yap YP, Shiran MS, Sabariah AR, Pathmanathan R

BMJ Case Rep, 2009;2009.

PMID: 21686408 DOI: 10.1136/bcr.11.2008.1221

Mycobacterial spindle cell pseudotumour (MSCP) has been reported in various sites, including skin, lymph nodes, bone marrow, lung and spleen. Cutaneous lesions are extremely rare and the differential diagnoses include various spindle cell lesions. Literature review shows that this lesion has preponderance for upper limb involvement and occurs largely in immunosuppressed individuals. We report a case of MSCP of the skin due to atypical mycobacterium and discuss the risk of misdiagnosis as a sarcoma.

Matched MeSH terms: Soft Tissue Neoplasms

Fulltext Can a chronic expanding haematoma mimic a soft tissue sarcoma?

Muniandy M, Singh VA

BMJ Case Rep, 2009;2009.

PMID: 21686602 DOI: 10.1136/bcr.09.2008.0846

A 68-year-old woman presented with a gradually increasing left gluteal swelling that she had first noted 2 years previously. The results of both clinical and radiological examinations were consistent with soft tissue sarcoma, but the final diagnosis after resection was haematoma.

Matched MeSH terms: Soft Tissue Neoplasms

Fulltext Monophasic spindle cell myxoid synovial sarcoma of the hand: promising results with marginal resection

Vijayan S, Mohammed AP, Kulkarni MS, Rao SK

BMJ Case Rep, 2021 Jan 28;14(1).

PMID: 33509874 DOI: 10.1136/bcr-2020-238366

Synovial sarcomas are deep-seated, genetically distinct, malignant neoplasms seen in young adults, with a male preponderance. They have unusual clinical and pathological presentation and mimic many other sarcomas and carcinomas, making the diagnosis quite challenging. Although four variants are identified, occurrence in the hand is extremely rare and leads to significant morbidity. There is a high incidence of local recurrence and distant metastasis within the first 2 years. We report the case of an elderly woman with monophasic spindle cell synovial sarcoma who presented with painless swelling in her palm and underwent local excision of the neoplasm. At 2-year follow-up, she remains totally asymptomatic with normal function of the hand. We also attempt to give an overview about monophasic spindle cell synovial sarcoma with the differentials, which would help surgeons in prompt diagnosis and appropriate management.

Matched MeSH terms: Soft Tissue Neoplasms/pathology; Soft Tissue Neoplasms/surgery*

Fulltext An Aggressive growth of cranial sarcoma

Thiagarajah R, Sellamuthu P, Bharmjit Singh SS, Muniandy RK

BMJ Case Rep, 2021 Aug 09;14(8).

PMID: 34373248 DOI: 10.1136/bcr-2021-242276

Sarcomas are a group of rare malignant tumours of the connective tissues. They can occur in almost any location, but more frequently in the extremities. The occurrence of sarcomas in the head and neck region is less than 1%. We are presenting a case report of a very large cranial sarcoma. Gross total tumour excision was done with pedicle skin graft and titanium mesh cranioplasty. The excised tumour weighed approximately 1.1 kg. Histopathological examination showed primitive intermediate-sized tumour cells arranged in sheets, nests and cords with focal palisading. Postoperative MRI done 2 weeks post surgery showed no evidence of residual tumour.

Matched MeSH terms: Soft Tissue Neoplasms*

Li-Fraumeni syndrome in a Malaysian kindred

Ariffin H, Martel-Planche G, Daud SS, Ibrahim K, Hainaut P

Cancer Genet. Cytogenet., 2008 Oct;186(1):49-53.

PMID: 18786442 DOI: 10.1016/j.cancergencyto.2008.06.004

We report on a Malaysian kindred with Li-Fraumeni syndrome. The proband was an 8-year-old girl who presented with embryonal rhabdomyosarcoma of the trunk at the age of 8 months and developed a brain recurrence at the age of 7 years, which was 5 years after remission. A younger sister later developed adrenocortical carcinoma at the age of 6 months. Their mother and maternal grandmother were diagnosed with breast cancer at the ages of 26 and 38 years, respectively. TP53 mutation detection in this family revealed a duplication of a GGCGTG motif starting at nucleotide 17579 in exon 10, resulting in an in-frame insertion of two amino acids between residues 334 and 336 in the tetramerization domain of the p53 protein. This mutation was found in the proband and her affected sister as well as her mother. In addition, the mutation was detected in two other siblings (a brother aged 3 years and a sister aged 18 months) who have not yet developed any malignancy. Sequencing of TP53 in the father and two other asymptomatic siblings revealed wild-type TP53. To our knowledge, this is a first report of a Li-Fraumeni syndrome family in Southeast Asia.

Matched MeSH terms: Soft Tissue Neoplasms/genetics

Fulltext Rapidly Growing Huge Lower Back Malignant Peripheral Nerve Sheath Tumour

Abuzarifa N, Al-Chalabi MMM, Wan Sulaiman WA

Cureus, 2021 Mar 05;13(3):e13712.

PMID: 33842103 DOI: 10.7759/cureus.13712

Malignant peripheral nerve sheath tumours (also called neurofibrosarcomas) are a rare, highly aggressive soft tissue sarcomas that arise from the peripheral nerves or cells associated with the nerve sheath, such as Schwann cells, peri-neural cells and fibroblasts. It is representing 10% of all soft tissue sarcomas in which it is considered as an extremely rare malignancy, especially in patients with neurofibromatosis type I. In the general population, it affects approximately 1 in 100,000 people. This article is reporting a 56-year-old Malay female patient who is a known case of neurofibromatosis type I for 20 years, presented with a lower back, pruritic, gradually increasing swelling during the last five months. Last month before the presentation, the lesion rapidly grows, reaching a size of (15×15 cm), accompanied by foul-smelling discharge and pain exacerbated with movement. Although no history of preceding trauma or accident, the mass bleeds within contact. In conclusion, only a few cases of giant malignant peripheral nerve sheath tumours reported in the literature describing its location and growth progression. We present a massive, extremely rapid growth of cutaneous exophytic malignant peripheral nerve sheath tumours over the lower back.

Matched MeSH terms: Soft Tissue Neoplasms

Fulltext Blockade of c-Met-Mediated Signaling Pathways by E7050 Suppresses Growth and Promotes Apoptosis in Multidrug-Resistant Human Uterine Sarcoma Cells

Huang TT, Chen CM, Lan YW, Lin SS, Choo KB, Chong KY

Int J Mol Sci, 2022 Nov 28;23(23).

PMID: 36499211 DOI: 10.3390/ijms232314884

E7050 is a potent inhibitor of c-Met receptor tyrosine kinase and has potential for cancer therapy. However, the underlying molecular mechanism involved in the anti-cancer property of E7050 has not been fully elucidated. The main objective of this study was to investigate the anti-tumor activity of E7050 in multidrug-resistant human uterine sarcoma MES-SA/Dx5 cells in vitro and in vivo, and to define its mechanisms. Our results revealed that E7050 reduced cell viability of MES-SA/Dx5 cells, which was associated with the induction of apoptosis and S phase cell cycle arrest. Additionally, E7050 treatment significantly upregulated the expression of Bax, cleaved PARP, cleaved caspase-3, p21, p53 and cyclin D1, while it downregulated the expression of survivin and cyclin A. On the other hand, the mechanistic study demonstrated that E7050 inhibited the phosphorylation of c-Met, Src, Akt and p38 in HGF-stimulated MES-SA/Dx5 cells. Further in vivo experiments showed that treatment of athymic nude mice carrying MES-SA/Dx5 xenograft tumors with E7050 remarkably suppressed tumor growth. E7050 treatment also decreased the expression of Ki-67 and p-Met, and increased the expression of cleaved caspase-3 in MES-SA/Dx5 tumor sections. Therefore, E7050 is a promising drug that can be developed for the treatment of multidrug-resistant uterine sarcoma.

Matched MeSH terms: Soft Tissue Neoplasms*

Fulltext Oncogenic osteomalacia, you say? better start looking then - a case report

Vijay, A.P., Tan, A.T.B., Suhaida, A.M., Chan, S.P.

JUMMEC, 2010;13(1):63-68.

MyJurnal

Tumour-induced or oncogenic osteomalacia (OOM) is a rare paraneoplastic syndrome characterized by bone pain and muscle weakness. A biochemical profile consisting of normocalcaemia, hypophosphataemia, phosphaturia, increased serum alkaline phosphatase and inappropriately low serum levels of 1, 25-dihydroxyvitamin-D is diagnostic. OOM is usually caused by an osseous or soft-tissue tumour of mesenchymal origin that secretes phosphaturic substances leading to increased urinary phosphate wasting. These tumours are small and slow growing. The diagnosis continues to be easily missed and when eventually made, localization of the tumour can be difficult. We describe the case of a young man who presented with severe generalized pain associated with muscle weakness. He was extensively investigated and eventually diagnosed to have OOM 3 years after initial presentation. Specialized investigations were necessary to localize the offending tumour.

Matched MeSH terms: Soft Tissue Neoplasms

Extraskeletal myxoid chondrosarcoma of the thigh in a child: a case report

Ibrahim ZA, Chan WH, Wong SL, Ong EJ, Narihan MZ

J Orthop Surg (Hong Kong), 2014 Dec;22(3):423-6.

PMID: 25550031

Extraskeletal myxoid chondrosarcoma (EMC) is aggressive in children. The condition in children differs to that in adults and to skeletal myxoid chondrosarcoma. We report on a 9-year-old girl with EMC in her left thigh. She underwent above-knee amputation. Five months later, a small mass was noted at the right lower lobe of the lung. The patient underwent one course of ifosfamide, carboplatin, and etoposide chemotherapy, followed by resection of the mass and 8 more courses of chemotherapy. At the 2-year follow-up, she was in remission radiologically.

Matched MeSH terms: Soft Tissue Neoplasms/pathology; Soft Tissue Neoplasms/surgery*

Preoperative lymphocyte count in relation to sarcoma prognosis

Teck Seo S, Singh VA, Yasin NF

J Orthop Surg (Hong Kong), 2019 6 22;27(2):2309499019854957.

PMID: 31221016 DOI: 10.1177/2309499019854957

PURPOSE: Inflammation plays a major role in tumour development, progression and metastasis. Multiple inflammatory markers such as absolute lymphocyte count, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio have been discovered as prognostic markers for various malignancies. We investigate preoperative lymphocyte count and other cell count ratios and their relation to survival and prognosis of sarcoma patients after surgery.

METHODS: A total of 142 patients from the Orthopaedics Oncology Database were included into this retrospective study. Kaplan-Meier curve and multivariate Cox proportional models were used to calculate the overall survival of patients with sarcoma who underwent radical excision surgery.

RESULTS: High preoperative LMR is significantly associated with better overall survival and prognosis in sarcoma patients, whereas high preoperative NLR is significantly associated with shorter overall survival and poorer prognosis. Multivariate analysis shows that LMR and NLR are good predictors for overall survival at 3 and 5 years after surgery, respectively. Patients with high preoperative lymphocytes count are associated with longer overall survival, but this association is not statistically significant. Our findings suggest that preoperative NLR and LMR are good predictive markers for survival of sarcoma patients.

CONCLUSION: LMR and NLR can be used to identify patients at risk for poor clinical outcome, so that a more aggressive course of treatment can be applied to improve outcome. These are cost-effective prognostic tools as they are calculated from routine preoperative peripheral blood counts. In conclusion, preoperative NLR and LMR are good prognostic markers for predicting the clinical outcome of patients with sarcoma.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*; Soft Tissue Neoplasms/surgery

Giant cell tumor of the tendon sheath in the knee of an 11-year-old girl

Abdullah A, Abdullah S, Haflah NH, Ibrahim S

J Chin Med Assoc, 2010 Jan;73(1):47-51.

PMID: 20103492

Giant cell tumors are commonly found over the flexor tendon sheath of the hand and wrist. However, giant cell tumors in the knee joint are rare, especially in children. We report an interesting case of an 11-year-old girl who presented with a painful lump on her right knee that enlarged over time. Clinically, she had fullness over the anterolateral part of her knee. Magnetic resonance imaging revealed an encapsulated mass inferior to the patella. The tumor measured 3 x 3.5 x 1.5 cm. Histopathological findings confirmed that it was a tenosynovial giant cell tumor. Because of initial mild symptoms, there was a delay of 2 years from the initial symptoms until tumor excision. Her follow-up period was 35 months, and her health to date is excellent with no recurrence. We believe that reporting this rare case will help clinicians update their knowledge on possible causes of lumps in the knee, and avoid diagnostic delay. It could also prove to be beneficial in arriving at a diagnosis in future cases.

Matched MeSH terms: Soft Tissue Neoplasms/diagnosis*; Soft Tissue Neoplasms/pathology; Soft Tissue Neoplasms/surgery

Epithelioid sarcoma and concurrent Volkman ischaemic contracture: a case report

Suria-Hayati MP, Siti-Aishah MA, Eshagroni A, Jamari S, Abdolvahab F, Yazmin Y, et al.

Clin Ter, 2012;163(3):215-7.

PMID: 22964694

Epithelioid sarcoma is a very infrequent soft tissue sarcoma involving predominantly distal extremities of adolescent and young adult. We hereby report a case of epithelioid sarcoma in a 34-year-old young adult who presented with 1-year history of a painful left upper limb associated subsequently with warm left forearm swelling and a Volkman contracture. He was treated as an inflamed soft tissue condition of the left upper limb. A computed tomography study showed presence of multiple hypodense lesions mainly in the flexor compartment of the left arm as well at the subcutaneous tissue, which measured 1 to 1.7 cm in diameter. Histological examination of the left upper limb mass showed nodular proliferation of epithelioid tumour cells and some with rhabdoid features surrounding a central zone of necrosis and was diagnosed as epithelioid sarcoma. Concurrent presence of epithelioid sarcoma and Volkman ischaemic contracture are rarely seen in clinical practice. The present case highlights the importance of the histology which can be confused with other types of sarcoma or chronic granuloma and even missed at times thereby causing diagnostic problems.

Matched MeSH terms: Soft Tissue Neoplasms/complications*

Fulltext Central airway obstruction tumour debulking using rigid bronchoscopy and cryotherapy: a case report

Wai Heng Chew, Abdul Aziz Marwan, Ummi Nadira Daut, Rosmadi Ismail, Mona Zaria Nasaruddin, Jamalul Azizi Abdul Rahman

Malaysian Journal of Medicine and Health Sciences, 2020;16(108):75-77.

MyJurnal

Sarcomas usually frequented in the head and neck region of young adults. Trachea is a rare site, and due to scarce clinical data, its clinical outcome is unclear. We reported a case of 60-year old patient presented with progressive worsening shortness of breath, cough, and progressive worsening dysphagia. Computer tomography scan revealed extensive 2 lobulated soft tissue lesions within and surrounding the trachea at the T4 level. Rigid bronchoscopy with mass cryo-debulking was performed and ultimately synovial sarcoma was diagnosed. Shortness of breath was com- pletely relieved post-procedure.

Matched MeSH terms: Soft Tissue Neoplasms

Fulltext Solitary fibrous tumour of the submandibular region: a rare entity

Noor Liza Ishak, Primuharsa Putra Sabir Athar Husin, Suria Hayati Md Pauzi, Isa Mohd Rose, Mohd Razif Mohamad Yunus

Malaysian Journal of Medicine and Health Sciences, 2016;12(2):53-55.

MyJurnal

Solitary fibrous tumours of the head and neck region are
extremely rare. The clinical diagnosis is often difficult to
establish, and this lesion may be indistinguishable from other
soft tissue neoplasms. An 18-year old Chinese gentleman
presented with a painless right submandibular swelling which
was increasing in size for eight months. A computed
tomography scan showed a well-defined solid mass measuring
about 2.0 x 2.96 cm in the submandibular region. The tumour
was resected and was confined within its capsule.
Immunohistochemical staining was strongly positive for CD34,
CD 99, and vimentin and negative for desmin, smooth muscle
actin (SMA), cytokeratin, S100 and CD68. The microscopic and
immunohistochemical profile were compatible with solitary
fibrous tumour. Distinguishing solitary fibrous tumours from
various spindle neoplasms can be difficult. In view of the
resemblance, immunohistochemical staining can help
differentiate solitary fibrous tumour from spindle neoplasm.

Matched MeSH terms: Soft Tissue Neoplasms

Fulltext Radical resection of primary leiomyosarcoma of inferior vena cava

Ikhwan Sani Mohamad, Sivabalan Nadarajan, Azim Idris, Hairol Othman, Affirul Chairil, Razman Jarmin

Malaysian Journal of Medicine and Health Sciences, 2018;14(1):61-64.

MyJurnal

Leiomyosarcoma of the Inferior Vena Cava (IVC) is a rare soft tissue tumour which accounts for only 0.5% of all soft tissue sarcomas. The patients usually presented with non specific clinical signs and often diagnosed at advanced stage. We reported a case of a 58-year-old lady who presented with right sided abdominal pain for 6 months. CT scan showed large Level 2 IVC tumour which encased the right renal vein and had no clear plane of demarcation with the caudate lobe of the liver. She underwent radical resection of the IVC tumour with the right kidney removed en bloc. Vascular reconstruction was not performed as established collateral veins present. She was nursed in Intensive Care Unit for 2 days and discharged well at day 5 post operatively. Histopathological examination results revealed leiomyosarcoma of IVC.

Matched MeSH terms: Soft Tissue Neoplasms

Fulltext Aural polyp with facial asymmetry in an unfortunate infant

Zubir FS, Saniasiaya J, Abdul Gani H

Malays Fam Physician, 2021 Mar 25;16(1):133-135.

PMID: 33948154 DOI: 10.51866/cr1070

Temporal bone rhabdomyosarcoma is an aggressive entity that simulates chronic otitis ear infection. It is the most common soft tissue sarcoma amongst pediatric patients. Herein, we would like to report a case of temporal bone rhabdomyosarcoma involving a 2-year-old boy who presented with a one-month history of otorrhea with facial asymmetry. Early treatment led to remission of this severe neoplasm.

Matched MeSH terms: Soft Tissue Neoplasms

Fulltext Giant epidermoid cyst of the thigh

Mohamed Haflah N, Mohd Kassim A, Hassan Shukur M

Malays Orthop J, 2011 Nov;5(3):17-9.

PMID: 25279030 MyJurnal DOI: 10.5704/MOJ.1111.001

Epidermoid cyst is a common benign cutaneous swelling frequently encountered in surgical practice. It usually presents as a painless lump frequently occurring in hairbearing areas of the body particularly the scalp, scrotum, neck, shoulder and back. Giant epidermoid cysts commonly occur in hairy areas such as the scalp. We present here the case of a rare occurrence of a giant epidermoid cyst in the less hairy area of the right upper thigh mimicking a soft tissue sarcoma. Steps are highlighted for the management of this unusual cyst.

Matched MeSH terms: Soft Tissue Neoplasms

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