Radiation-induced sarcoma presenting as a gluteal abscess: a diagnostic and therapeutic challenge

Sarcomas are a rare and fatal treatment complication following radiotherapy. Radiation-induced sarcomas (RISs) presenting as a gluteal abscess is a rarity, accounting for its varied presentation. We present a case of a middle-aged woman, post-chemo-radiation for carcinoma cervix 5 years ago, who presented with gluteal abscess. Achieving haemostasis post incision and drainage under anaesthesia was a challenge. On further evaluation, she was diagnosed with radiation-induced gluteal soft tissue sarcoma. Haemostasis was achieved after radiation following failed attempts of surgical and radiological interventions. She is currently planned for chemotherapy. Cancer survivors have an increased risk of developing a second malignancy following radiation treatment. RISs are highly aggressive, exhibit a varied clinical presentation and pose a challenge in early diagnosis; thus, have a poor outcome. RISs pose a diagnostic challenge; any dubious lesion in the previously irradiated field should raise suspicion and prompt aggressive management.

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Melanoacanthoma on the nipple of a middle-aged woman: A diagnostic challenge

JAAD Case Reports ◽

10.1016/j.jdcr.2021.01.026 ◽

2021 ◽

Vol 9 ◽

pp. 93-96

Author(s):

Maria Fernanda Hunziker ◽

Gianine Rigoni Guaraldo ◽

Nilceo Schwery Michalany ◽

Alexandre Michalany ◽

Antonio Carlos Herrmann de Andrade ◽

...

Keyword(s):

Middle Aged ◽

Diagnostic Challenge ◽

Aged Woman ◽

Middle Aged Woman

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Solitary neurofibroma of the larynx: a diagnostic challenge

BMJ Case Reports ◽

10.1136/bcr-2020-236682 ◽

2021 ◽

Vol 14 (1) ◽

pp. e236682

Author(s):

Bruno Cunha ◽

Ricardo Pacheco ◽

Isabel Fonseca ◽

Alexandra Borges

Keyword(s):

Differential Diagnosis ◽

Tumour Size ◽

Negative Consequences ◽

Diagnostic Challenge ◽

Presenting Symptoms ◽

Aged Woman ◽

Complete Surgical Resection ◽

Long Term Follow Up ◽

Middle Aged Woman ◽

Benign Nature

Solitary neurofibromas of the larynx are extremely rare, with a total of 15 cases described in the literature. Nonetheless, acquaintance with this diagnosis is important, as misdiagnoses can have negative consequences. Presenting symptoms are non-specific and depend on tumour size and location. As well-defined submucosal masses with a broad differential diagnosis, they remain a clinical and radiological challenge. While some characteristics might favour a benign nature and subtle signs might help narrow the differential diagnosis, imaging alone is not sufficient for differentiation and definitive diagnosis requires a biopsy. Complete surgical resection and long-term follow-up is indicated. We share our experience on a case of a solitary laryngeal neurofibroma in a middle-aged woman, presenting with a large well-defined paraglottic lesion.

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Yap activation in irradiated parotid salivary glands is regulated by ROCK activity

PLoS ONE ◽

10.1371/journal.pone.0232921 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0232921 ◽

Cited By ~ 1

Author(s):

Wen Yu Wong ◽

Kristy Gilman ◽

Kirsten H. Limesand

Keyword(s):

Salivary Glands ◽

Radiation Treatment ◽

Acinar Cells ◽

Transcriptional Targets ◽

Increased Risk ◽

Salivary Function ◽

Radiation Induced ◽

Injury Models ◽

Rock Activity

Radiotherapy plays a major role in the curative treatment of head and neck cancer, either as a single modality therapy, or in combination with surgery or chemotherapy, or both. Despite advances to limit radiation-induced side-effects, the major salivary glands are often affected. This frequently leads to hyposalivation which causes an increased risk for xerostomia, dental caries, mucositis, and malnutrition culminating in a significant impact on patients’ quality of life. Previous research demonstrated that loss of salivary function is associated with a decrease in polarity regulators and an increase in nuclear Yap localization in a putative stem and progenitor cell (SPC) population. Yap activation has been shown to be essential for regeneration in intestinal injury models; however, the highest levels of nuclear Yap are observed in irradiated salivary SPCs that do not regenerate the gland. Thus, elucidating the inputs that regulate nuclear Yap localization and determining the role that Yap plays within the entire tissue following radiation damage and during regeneration is critical. In this study, we demonstrate that radiation treatment increases nuclear Yap localization in acinar cells and Yap-regulated genes in parotid salivary tissues. Conversely, administration of insulin-like growth factor 1 (IGF1), known to restore salivary function in mouse models, reduces nuclear Yap localization and Yap transcriptional targets to levels similar to untreated tissues. Activation of Rho-associated protein kinase (ROCK) using calpeptin results in increased Yap-regulated genes in primary acinar cells while inhibition of ROCK activity (Y-27632) leads to decreased Yap transcriptional targets. These results suggest that Yap activity is dependent on ROCK activity and provides new mechanistic insights into the regulation of radiation-induced hyposalivation.

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Erdheim-Chester Disease with a Posterior Fossa Tumour Mimicking Neurosarcoidosis: A Case Report.

10.21203/rs.3.rs-246426/v1 ◽

2021 ◽

Author(s):

Laura Parrado-Sánchez ◽

Verónica Alzate-Carvajal ◽

Luis Alberto Escobar Florez ◽

Ana María Granados-Sánchez ◽

Javier Lobato-Polo

Keyword(s):

Middle Aged ◽

Diagnostic Challenge ◽

Male Population ◽

Fibrotic Tissue ◽

Erdheim Chester Disease ◽

Aged Woman ◽

Middle Aged Woman ◽

Mass Lesions ◽

Erdheim Chester ◽

Chester Disease

Abstract Erdheim-Chester disease (ECD) is a rare non-Langerhans'cell histiocytosisdescribed in 1930 by Jakob Erdheim and William Chester, it can present as a multisystemic entity that forms xanthogranulomas which are foamy histiocytes surrounded by fibrotic tissue. Lesions are commonly located in long bones, central nervous system (CNS), cardiovascular system, lungs, kidneys and skin. The CNS is involved in approximately 50% of cases and can compromise both extra or intra-axial structures and therefore can mimic schwannomas or meningiomas, amongst other mass lesions [2, 9]. Clinical presentation will differ from patient to patient thus diagnosis depends greatly in imaging, immunohistochemistry and genetic findings within the pathology analysis [4]. The pathogenesis of this disease remains unknown. It is most commonly found in the middle-aged male population [1, 8]. Here, we present a case of a middle-aged woman with an extra-axial lesion that was initially considered to be neurosarcoidosis proving the diagnostic challenge this entity implies.

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