Diagnostic Differences in Expert Second-Opinion Consultation Cases at a Tertiary Sarcoma Center

Soft tissue tumors are diagnostically challenging, and it is recommended that these are reported or reviewed by specialist soft tissue pathologists. We present our experience with second-opinion (consultation) cases in a specialist tertiary sarcoma center. The aim of this study was to determine areas of diagnostic difficulty in soft tissue pathology. We assessed 581 second-opinion cases which were reviewed by two experienced pathologists in a period of one year. There was 62% concordance between the original and the second-opinion diagnosis, with diagnostic discrepancy in 38%. The largest group of soft tissue neoplasms received for second opinion was fibroblastic/myofibroblastic tumors, and most major diagnostic problems were encountered in adipocytic and so-called “fibrohistiocytic” tumors. Major diagnostic errors impacting management were found in 148 cases (25%). Morphologic assessment of tumors, judicious use of molecular techniques, newer immunostains and their interpretation, along with importance of knowledge of rarer entities were found to be most useful in avoiding errors.

Download Full-text

Grading and characterization of soft tissue tumors on magnetic resonance imaging: the value of an expert second opinion report

Insights into Imaging ◽

10.1007/s13244-012-0151-6 ◽

2012 ◽

Vol 3 (2) ◽

pp. 131-138 ◽

Cited By ~ 11

Author(s):

F. M. Vanhoenacker ◽

K. Van Looveren ◽

K. Trap ◽

J. Desimpelaere ◽

K. Wouters ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Soft Tissue ◽

Soft Tissue Tumors ◽

Second Opinion ◽

Resonance Imaging

Download Full-text

Vulvar soft tissue tumors

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200401000-00012 ◽

2004 ◽

Vol 14 (1) ◽

pp. 94-99

Author(s):

K. A. Behranwala ◽

B. Latifaj ◽

P. Blake ◽

D. P. J. Barton ◽

J. H. Shepherd ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Surgical Excision ◽

Primary Treatment ◽

Soft Tissue Tumors ◽

Soft Tissue Neoplasms ◽

Low Grade ◽

Aggressive Angiomyxoma ◽

Royal Marsden Hospital ◽

Histologic Types

ObjectiveTo report our incidence of soft tissue tumors at this site and to discuss various prognostic factors.MethodsAll patients with a diagnosis of vulvar soft tissue neoplasms were studied from a prospective database at the Royal Marsden Hospital between January 1985 and July 2001.ResultsSeventeen vulvar soft tissue neoplasms (11 malignant and six benign) were treated during this period. Leiomyosarcoma (n = 5) and aggressive angiomyxoma (n = 4) were the most frequent histologic types. According to the grade, there were four G3, three G2, three G1 and could not be assessed in one patient. Local recurrence occurred in six patients with sarcoma (three with high grade and one each with intermediate, low, and undetermined grade). In this group, five patients had negative microscopic margins and one patient had positive microscopic margins on excision. All three women with low-grade sarcomas are alive without evidence of disease. Three patients with aggressive angiomyxoma also had a local recurrence.ConclusionSurgical excision is the primary treatment where possible. The grade of the tumor is an important predictor for local recurrence and outcome. Aggressive angiomyxoma is a local problem. Leiomyosarcoma and aggressive angiomyxoma are the most frequent histologic types.

Download Full-text

Transplacental Melanoma–One-Year Survival

PEDIATRICS ◽

10.1542/peds.57.6.978 ◽

1976 ◽

Vol 57 (6) ◽

pp. 978-979

Author(s):

Bertil Cavell

Keyword(s):

Malignant Melanoma ◽

Soft Tissue ◽

Neonatal Period ◽

Metastatic Malignant Melanoma ◽

Soft Tissue Tumors ◽

Metastatic Lesions ◽

One Year ◽

Uneventful Pregnancy

I would like to add another case of transplacental metastatic malignant melanoma to those reported in the article by Dr. Trozak et al.1 The details of the case were reported in 1963.2 The patient, who was born six weeks before term after an uneventful pregnancy, is now 14 years old. Her mother died of widespread malignant melanoma four days after delivery of the girl who seemed well during the neonatal period. At 2 months of age, however, the baby displayed soft tissue tumors in her legs and pulmonary metastatic lesions.

Download Full-text

Advanced Cutaneous Leiomyosarcoma of the Forearm

Dermatopathology ◽

10.3390/dermatopathology8010008 ◽

2021 ◽

Vol 8 (1) ◽

pp. 40-44

Author(s):

Gerardo Cazzato ◽

Maria Chiara Sergi ◽

Sara Sablone ◽

Anna Colagrande ◽

Teresa Lettini ◽

...

Keyword(s):

Smooth Muscle ◽

Adjuvant Chemotherapy ◽

Soft Tissue ◽

Rare Case ◽

Soft Tissue Neoplasms ◽

Good Shape ◽

Smooth Muscle Neoplasm ◽

One Year ◽

The Right ◽

Considerable Size

Leiomyosarcoma is a malignant smooth muscle neoplasm, which is traditionally divided into superficial and deep tumors. Superficial leiomyosarcomas are quite rare entities, accounting for approximately 7% of soft tissue neoplasms and 0.04% of all cancers. Here we describe a rare case of advanced primary cutaneous leiomyosarcoma (PCL) in a 93-year-old woman, highlighting the considerable size of the lesion and the correct surgical and oncological management. The clinical story began about 4 years ago, and the neoplasia was treated only with local radiotherapy, but the patient suffered from a dramatic volumetric increase of the right arm sarcoma one year ago. Then, an amputation of the limb was performed without following adjuvant chemotherapy. Currently, she does not show signs of recurrence and is in good shape.

Download Full-text

Localization of Gallium-67 in Peritoneal Cells by Electron Microscopic Autoradiography

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100072460 ◽

1973 ◽

Vol 31 ◽

pp. 404-405

Author(s):

D. C. Swartzendruber ◽

Norma L. Idoyaga-Vargas

Keyword(s):

Clinical Trials ◽

Soft Tissue ◽

Tumor Tissue ◽

Soft Tissue Tumors ◽

Clinical Usefulness ◽

Electron Microscopic ◽

Normal Cells ◽

Electron Microscopic Autoradiography ◽

Peritoneal Cells ◽

Gallium 67

The radionuclide gallium-67 (67Ga) localizes preferentially but not specifically in many human and experimental soft-tissue tumors. Because of this localization, 67Ga is used in clinical trials to detect humar. cancers by external scintiscanning methods. However, the fact that 67Ga does not localize specifically in tumors requires for its eventual clinical usefulness a fuller understanding of the mechanisms that control its deposition in both malignant and normal cells. We have previously reported that 67Ga localizes in lysosomal-like bodies, notably, although not exclusively, in macrophages of the spocytaneous AKR thymoma. Further studies on the uptake of 67Ga by macrophages are needed to determine whether there are factors related to malignancy that might alter the localization of 67Ga in these cells and thus provide clues to discovering the mechanism of 67Ga localization in tumor tissue.

Download Full-text

Benign Skin and Soft-Tissue Tumors of the Hand

Clinics in Plastic Surgery ◽

10.1016/s0094-1298(20)30610-6 ◽

1987 ◽

Vol 14 (2) ◽

pp. 403-412

Author(s):

Saleh M. Shenaq

Keyword(s):

Soft Tissue ◽

Soft Tissue Tumors ◽

Tumors Of The Hand

Download Full-text

Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0040-1717113 ◽

2020 ◽

Vol 24 (06) ◽

pp. 667-675

Author(s):

Violeta Vasilevska Nikodinovska ◽

Slavcho Ivanoski ◽

Milan Samardziski ◽

Vesna Janevska

Keyword(s):

Soft Tissue ◽

Complication Rate ◽

Core Needle Biopsy ◽

Multidisciplinary Team ◽

Gold Standard ◽

Needle Biopsy ◽

Soft Tissue Tumors ◽

Open Biopsy ◽

Core Needle ◽

Similar Accuracy

AbstractBone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

Download Full-text