MyMedR

Fulltext Giant gluteal lipoma-like liposarcoma: a case report

Sultan M, Burezq H, Bang RL, El-Kabany M, Eskaf W

World J Surg Oncol, 2008;6:81.

PMID: 18664291 DOI: 10.1186/1477-7819-6-81

Liposarcoma is the second most common soft tissue sarcoma in adults with a peak incidence between the 4th and 6th decade of life and slight preponderance to the male gender. It originates from multipotential primitive mesenchymal cells, rather than mature adipose tissue.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*

Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma - a rare vascular neoplasm with deceptive morphology and distinctive immunophenotype

Cheo FF, Sittampalam K

Malays J Pathol, 2017 Dec;39(3):305-309.

PMID: 29279595

Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma is a rare, low grade vascular (endothelial) neoplasm typically presenting as multicentric, superficial to deep nodules in extremities with a slight tendency of affecting young adult males. We report a case of pseudomyogenic hemangioendothelioma in a 15-year-old boy presenting initially with a 1 cm right thigh painless cutaneous lump. The lump was excised with the clinical impression of a sebaceous cyst. On microscopy, a poorly circumscribed, mild to moderately atypical spindle cell lesion in fascicular and storiform patterns with strikingly myoid-like eosinophilic cytoplasm was identified. The spindle cells were highlighted by pancytokeratin AE1/AE3, CD31, and ERG with retained INI-1, while being negative for MNF116, S100, CD34, EMA, desmin, SMA, caldesmon, myogenin, MyoD1, HHV-8 and CD163. Following the first diagnostic report, a positron emission tomography-computed tomography (PET-CT) scan revealed another 4 cm ill-defined nodule accompanied by a smaller adjacent 0.7 cm ipsilateral satellite nodule within the right psoas muscle that displayed similar morphology and immunophenotype as the cutaneous lump, supporting the multicentric feature of this unique entity. It is an uncommon yet increasingly recognised neoplasm of endothelial origin possessing a misleading myoid morphology and distinctive immunophenotype worth notifying.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*

Fulltext Small cell variant of anaplastic large cell lymphoma with positive immunoreactivity for CD99

Shiran MS, Tan GC, Sabariah AR, Chye PC, Pathmanathan R

Med J Malaysia, 2008 Jun;63(2):150-1.

PMID: 18942305 MyJurnal

A 13 year old boy presented with a huge mass on his right arm of 6 months duration. Histopathological examination revealed sheets of malignant small round blue cells with immunopositivity for LCA, CD43, CD45Ro, CD30, EMA, ALK-1 and CD99, and negativity for CD20, TdT, myogenin, myoD1, NSE, bcl-6, bcl-2 and CD10. Fluorescent In-Situ Hybridization (FISH) testing excluded the diagnosis of Ewing's sarcoma/PNET. Pathologists need to be aware of the diagnosis of a small cell variant of ALCL, as well as of the fact that CD99 expression commonly occurs in cases of ALK-positive ALCL, in order to distinguish this entity from Ewing's sarcoma/PNET.

Matched MeSH terms: Soft Tissue Neoplasms/pathology

Malignant peripheral nerve sheath tumour with perineurial differentiation and hyaline eosinophilic globules (thanatosomes): A rare tumour

Abdelzaher E, Elwany A, Amr SA

Malays J Pathol, 2018 Dec;40(3):355-358.

PMID: 30580369

Malignant peripheral nerve sheath tumour (MPNST) with perineurial differentiation is a rare variant of MPNST. The pathological features and clinical significance of this variant remain to be characterised. We reported the clinicoradiological and pathological features of a case of recurrent right arm mass related to the ulnar nerve in a 42-year-old female patient. On pathological examination, the tumour showed dual features of conventional and perineurial MPNST which was proven by positive immunostaining for S-100 and EMA. The pathological diagnosis was MPNST with perineurial differentiation. In addition, a peculiar and rare finding of intracytoplasmic eosinophilic hyaline globules (thanatosomes) within tumour cells is reported. We document a rare tumour with hybrid features between conventional and perineurial MPNSTs. Further studies are needed to establish its biological behaviour.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*

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/pathology

Extensive left ventricular, pulmonary artery, and pericardial metastasis from myxoid liposarcoma 16 years after the initial detection of the primary tumour: a case report and review of the literature

Motevalli D, Tavangar SM

Malays J Pathol, 2017 Aug;39(2):201-205.

PMID: 28866706

Liposarcoma is regarded as the second most common soft tissue malignant tumour. Metastasis of liposarcoma to the heart is very rare, and to date, less than 40 cases have been reported in the literature. We report a 46 year-old male with myxoid liposarcoma of the lower extremity who developed extensive metastasis to the left ventricle, pulmonary artery, and pericardium. The patient presented with acute symptoms of dyspnea 16 years after surgical resection of the primary tumour, and his dyspnea progressed to cardio-respiratory arrest within the first few days of hospital admission.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*

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*

Histopathological diagnoses in soft tissue tumours: an experience from a tertiary centre in Malaysia

Jalaludin ND, Mohd Dusa N, Hassan MR, Abd Shukor N

Malays J Pathol, 2017 Dec;39(3):209-216.

PMID: 29279582 MyJurnal

Soft tissue tumours are a group of remarkably diverse neoplasms that frequently pose significant diagnostic challenges to general pathologists. This study aimed to compare the agreement of histopathological diagnoses between general pathologists from various referral institutes and the referred soft tissue pathologist in a tertiary centre. The common discrepancies and their causes are also presented here. A retrospective study was conducted on 243 cases of potential soft tissue tumours referred to Hospital Kuala Lumpur, Malaysia over a period of 5 years. Reports by the referring pathologists and the soft tissue pathologist were compared based on tumour classification and tumour behaviour. Overall, there was moderate agreement in soft tissue tumour diagnoses in both tumour classification (weighted κ = 0.423) and tumour behavior (weighted κ = 0.548). The highest agreement of tumour classification was seen in the adipocytic tumours (21/28 cases), Ewing sarcoma (5/7 cases) and smooth-muscle tumours (3/5 cases). The highest rates of discrepancies were the so-called fibrohistiocytic tumours (7/11 cases), vascular tumours (9/15 cases) and undifferentiated/ unclassified sarcomas (19/32 cases). Full agreement for tumour behaviour was seen in 178 cases and there were 21 cases of zero agreement. Liposarcoma, alveolar soft part sarcoma and benign fibrous histiocytoma were the most frequent benign/malignant diagnostic discrepancies. The most common causes of discrepancy were wrong morphological interpretation followed by insufficient immunohistochemical stains performed. In conclusion, review of diagnosis by a pathologist specialized in soft tissue improves the quality of diagnosis in these heterogenous and rare tumours. A good panel of immunohistochemical stains with additional molecular study is crucial in the general hospital laboratories practice.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*

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

Synchronous glomus tumors in a distal digit: a case report

Noor MA, Masbah O, Lumpur K

J Hand Surg Am, 1997 May;22(3):508-10.

PMID: 9195463

Glomus tumors occurring synchronously in the subungual region and the pulp of a fingertip are extremely uncommon. Awareness of this will lead to early diagnosis and treatment.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*

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*

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

Dendritic fibromyxolipoma: a variant of spindle cell lipoma with extensive myxoid change, with cytogenetic evidence

Wong YP, Chia WK, Low SF, Mohamed-Haflah NH, Sharifah NA

Pathol. Int., 2014 Jul;64(7):346-51.

PMID: 25047505 DOI: 10.1111/pin.12176

Dendritic fibromyxolipoma (DFML), a rare, recently described distinct benign soft tissue tumor, has many clinicopathological features reminiscent of spindle cell lipoma and solitary fibrous tumor with myxoid change. It is distinguished histologically from both entities by the presence of spindle and stellate cells with dendritic cytoplasmic prolongations, prominent myxoid stroma with abundant keloidal collagen and occasional small plexiform vascular proliferation. We describe a case of histologically confirmed DFML of the left shoulder in a 67-year-old male, in which subsequent cytogenetic analysis revealed deletion involving 13q14.3 region in all the tumor cells, typically detected in spindle cell lipoma. In the presence of many clinicopathological similarities between DFML and spindle cell lipoma including chromosomal abnormalities, we postulate that DFML is merely a rare variant of spindle cell lipoma with extensive myxoid degeneration, and may not be considered as a separate entity. The possible differential diagnosis and their distinguishing features are briefly discussed.

Matched MeSH terms: Soft Tissue Neoplasms/pathology*

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/pathology*

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