Idiopathic and radiation-induced myxofibrosarcoma in the head and neck—case report and literature review

Abstract Background Myxofibrosarcoma (MFS), especially radiation-Induced MFS (RIMFS) in the head and neck, is an extremely rare malignant fibroblastic tumor. The diagnosis and treatment of MFS remain great challenges. In the present study, we presented one case of RIMFS. Combined with previous literature, the clinical features, essentials of diagnosis, and treatment modalities of MFS in the head and neck were reviewed to better understand this rare entity. Case presentation We reported a case of RIMFS under the left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006. A total tumor resection was performed with preservation of the overlying scalp the underlying bone, and no adjuvant therapy was administered after the first operation. The postoperative pathological diagnosis was high-grade MFS. The tumor relapsed 6 months later, and then, a planned extensive resection with negative surgical margins was carried out, followed by radiotherapy. No relapse occurred in a 12-month postoperative follow-up. Conclusions Planned gross total resection (GTR) with negative margins is the reasonable choice and footstone of other treatments for MFS. Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck, so adjuvant radiotherapy and chemotherapy seem more necessary for these lesions.

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Idiopathic and Radiation-Induced Myxofibrosarcoma In Head And Neck-Case Report And Literature Review

10.21203/rs.3.rs-538444/v1 ◽

2021 ◽

Author(s):

Bin Zhang ◽

Miao Bai ◽

Runfa Tian ◽

shuyu hao

Keyword(s):

Head And Neck ◽

Frozen Section ◽

Tumor Resection ◽

Surgical Margin ◽

Diagnosis And Treatment ◽

Treatment Modalities ◽

Total Resection ◽

Extensive Resection ◽

Radiation Induced ◽

Reasonable Choice

Abstract BackgroundMyxofibrosarcoma (MFS) is a rare malignant fibroblastic tumor that primarily occurred in proximal extremities of older people. However, MFS, especially radiation-Induced MFS is extremely rare in the head and neck. Local recurrence is very common, the diagnosis and treatment of MFS is always a great challenge. We presented one case of radiation-induced MFS, combined with previous literature, the clinical features, essentials of diagnosis and treatment modalities of MFS in head and neck were reviewed to better understand this rare entity.Case presentationHere, we reported a case of radiation-Induced MFS under left occipital scalp in a 20-year-old girl with a history of medulloblastoma surgery and radiotherapy in 2006. A total tumor resection was performed with preservation of the overlying scalp the underlying bone, and no adjuvant therapy was administered after surgery. Post-operative pathological diagnosis was high-grade MFS. Unfortunately, the tumor relapsed six month later. Then a planned extensive resection was carried out, followed by radiotherapy. In addition, intra-operative frozen section was sent to confirm negative surgical margin. No relapse occurred in 12-month postoperative follow-up.ConclusionsPlanned gross total resection (GTR) with negative margins is the reasonable choice and footstone of other treatments for MFS. Ill-defined infiltrated borders and the complicated structures make it a great trouble to achieve total resection of MFS in the head and neck. Therefore, adjuvant radiotherapy and chemotherapy seem more necessary for these lesions. Further studies are needed to confirm the efficacy of radio-chemotherapy for head and neck MFS.

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Intracranial solitary fibrous tumor/hemangiopericytoma – A case series

Surgical Neurology International ◽

10.25259/sni_490_2020 ◽

2020 ◽

Vol 11 ◽

pp. 414

Author(s):

Chi-Man Yip ◽

Shu-Shong Hsu ◽

Wei-Chuan Liao ◽

Szu-Hao Liu ◽

Yung-Shang Lin ◽

...

Keyword(s):

Solitary Fibrous Tumor ◽

Adjuvant Radiotherapy ◽

Tumor Resection ◽

Case Series ◽

Extent Of Resection ◽

Treatment Modalities ◽

Total Resection ◽

Initial Surgery ◽

Fibrous Tumor

Background: Intracranial solitary fibrous tumor/hemangiopericytoma (HPC) is a rare and aggressive tumor. We conducted this retrospective study to investigate the outcome of patients after treatment, the efficacy of postoperative adjuvant radiotherapy, and the factors not conducive to total resection. Methods: We conducted a retrospective review of the medical records of patients harboring fresh intracranial solitary fibrous tumor/HPC treated from January 2009 to December 2019 in our hospital. We reviewed their clinical presentations, radiologic appearances, tumor size and location, extent of resection, estimate intraoperative blood loss, treatment modalities and results, and duration of follow-up. Results: There were seven consecutive patients (three males and four females). The ages of the patients at the time of diagnosis ranged from 35 to 77 years (mean: 52.86 years). Five patients (71.43%) got tumor bigger than 5 cm in dimension and only 1 patient (14.29%) underwent gross total tumor resection in the first operation without complication. Five patients (71.43%) underwent postoperative adjuvant radiotherapy. Follow-up period ranged from 4.24 to 123.55 months and the median follow-up period was 91.36 months. Three patients had favorable outcome with Glasgow Outcome Scale (GOS) equal to 4; four patients had unfavorable outcome with GOS equal to 2 or 3. No mortality was happened. Conclusion: Gross total tumor resection in the initial surgery is very important to achieve a better outcome. Massive intraoperative bleeding and venous sinus or major vessels adjoining are factors not conducive to total resection. Radiotherapy can be administered as adjuvant therapy for cases showing an aggressive phenotype or not treated with gross total resection.

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RONC-19. TWO CASES OF RE-IRRADIATION FOR LATE RECURRENT OR RADIATION-INDUCED TUMOR AFTER RADIATION THERAPY FOR PEDIATRIC BRAIN TUMORS

Neuro-Oncology ◽

10.1093/neuonc/noaa222.788 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii459-iii459

Author(s):

Takashi Mori ◽

Shigeru Yamaguchi ◽

Rikiya Onimaru ◽

Takayuki Hashimoto ◽

Hidefumi Aoyama

Keyword(s):

Radiation Therapy ◽

Brain Tumors ◽

Tumor Resection ◽

Intensity Modulated Radiation Therapy ◽

Late Recurrence ◽

Pediatric Brain Tumors ◽

Suprasellar Region ◽

Radiation Induced ◽

Pediatric Brain

Abstract BACKGROUND As the outcome of pediatric brain tumors improves, late recurrence and radiation-induced tumor cases are more likely to occur, and the number of cases requiring re-irradiation is expected to increase. Here we report two cases performed intracranial re-irradiation after radiotherapy for pediatric brain tumors. CASE 1: 21-year-old male. He was diagnosed with craniopharyngioma at eight years old and underwent a tumor resection. At 10 years old, the local recurrence of suprasellar region was treated with 50.4 Gy/28 fr of stereotactic radiotherapy (SRT). After that, other recurrent lesions appeared in the left cerebellopontine angle, and he received surgery three times. The tumor was gross totally resected and re-irradiation with 40 Gy/20 fr of SRT was performed. We have found no recurrence or late effects during the one year follow-up. CASE 2: 15-year-old female. At three years old, she received 18 Gy/10 fr of craniospinal irradiation and 36 Gy/20 fr of boost to the posterior fossa as postoperative irradiation for anaplastic ependymoma and cured. However, a anaplastic meningioma appeared on the left side of the skull base at the age of 15, and 50 Gy/25 fr of postoperative intensity-modulated radiation therapy was performed. Two years later, another meningioma developed in the right cerebellar tent, and 54 Gy/27 fr of SRT was performed. Thirty-three months after re-irradiation, MRI showed a slight increase of the lesion, but no late toxicities are observed. CONCLUSION The follow-up periods are short, however intracranial re-irradiation after radiotherapy for pediatric brain tumors were feasible and effective.

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Laryngeal cancer

InnovAiT Education and inspiration for general practice ◽

10.1177/17557380211010564 ◽

2021 ◽

pp. 175573802110105

Author(s):

Kelvin Miu

Keyword(s):

Head And Neck Cancer ◽

Early Diagnosis ◽

Head And Neck ◽

Patient Outcomes ◽

Laryngeal Cancer ◽

Neck Cancer ◽

Early Recognition ◽

Signs And Symptoms ◽

Diagnosis And Treatment

Laryngeal cancer is a common head and neck cancer and typically presents with voice hoarseness in patients older than 60 years. Early recognition of signs and symptoms of laryngeal cancer can lead to early diagnosis and treatment, therefore improving patient outcomes. This article aims to provide an overview of the anatomy of the larynx, presentation and management of laryngeal cancer, and common follow-up problems.

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Diffuse Pigmented Villonodular Synovitis Around the Ankle

Journal of the American Podiatric Medical Association ◽

10.7547/16-100 ◽

2018 ◽

Vol 108 (2) ◽

pp. 140-144 ◽

Cited By ~ 1

Author(s):

Keiichi Muramatsu ◽

Ryuta Iwanaga ◽

Yasuhiro Tominaga ◽

Takahiro Hashimoto ◽

Toshihiko Taguchi

Keyword(s):

Ankle Joint ◽

Tumor Resection ◽

Tumor Location ◽

Pigmented Villonodular Synovitis ◽

Growth Patterns ◽

Treatment Modalities ◽

Villonodular Synovitis ◽

Lateral Incision ◽

Pigmented Villonodular

Background: Pigmented villonodular synovitis (PVNS) is a rare disorder around the ankle joint. The optimal treatment for diffuse-type PVNS is still controversial because of the high incidence of recurrence. We present the clinical features of our patients and review the current diagnostic and treatment modalities. Methods: Five patients with PVNS located around the ankle were surgically treated. In three patients, diffuse PVNS arose from the ankle joint, and in the other two it arose from the calcaneocuboid and intercuneiform joints. The average follow-up time after surgery was 2.9 years (range, 2–4.6 years). Results: The average time between onset of pain and diagnosis of PVNS was 6.4 years (range, 4–10 years). Arthrotomic tumor resection was performed in all of the patients. In the three patients with ankle joint PVNS, both medial and lateral approaches were used. One patient experienced mild infection at the surgical site, but this healed conservatively. No tumor recurrences had occurred after minimum follow-up of 2 years, although mild pain persisted in the three patients with ankle PVNS. Conclusions: Diagnosis of diffuse PVNS is frequently delayed due to vague symptoms and variable growth patterns. Orthopedic clinicians should be aware of the existence of this lesion, and it should be suspected in patients with persistent ankle swelling. To prevent tumor recurrence, accurate evaluation of tumor location and careful operative planning are mandatory. A combined surgical approach involving medial and lateral incision is necessary to expose the entire joint cavity.

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Ten-Year Follow-Up of Desarthrodesis of the Knee Joint 41 Years after Original Arthrodesis for a Bone Tumor

Case Reports in Orthopedics ◽

10.1155/2015/308127 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6

Author(s):

Ahmed Hamed Kassem Abdelaal ◽

Norio Yamamoto ◽

Katsuhiro Hayashi ◽

Akihiko Takeuchi ◽

Shinji Miwa ◽

...

Keyword(s):

Knee Joint ◽

Giant Cell Tumor ◽

Giant Cell ◽

Tumor Resection ◽

Cell Tumor ◽

Joint Surface ◽

Knee Arthrodesis ◽

Extensive Resection ◽

Complication Risk

Introduction. The main indication for knee arthrodesis in tumor surgery is a tumor that requires an extensive resection in which the joint surface cannot be preserved. We report a patient that had knee desarthrodesis 41 years after giant cell tumor resection followed by a knee arthrodesis. This is the longest reported follow-up after desarthrodesis and conversion to total knee arthroplasty (TKA), almost ten years.Case Report. A 71-year-old man with a distal femoral giant cell tumor had undergone a resection of the distal femur and knee arthrodesis using Kuntscher nail in 1962. In July 2003 he experienced gradually increasing pain of his left knee. We performed a desarthrodesis and conversion to TKA in 2005. The postoperative period passed uneventfully as his pain and gait improved, with gradually increasing range of motion (ROM) and no infection. He now walks independently, with no brace or contractures.Conclusion. Desarthrodesis of the knee joint and conversion to TKA are a difficult surgical choice with a high complication risk. However, our patient’s life style has improved, he has no pain, and he can ascend and descend stairs more easily. The surgeon has to be very meticulous in selecting a patient for knee arthrodesis and counseling them to realize that their expectations may not be achievable.

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RADI-24. VENTRICULOMEGALY AFTER STEREOTACTIC RADIOSURGERY (SRS) FOR BRAIN METASTASES (BM): A PILOT ANALYSIS OF TWO INSTITUTIONAL EXPERIENCES

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz014.116 ◽

2019 ◽

Vol 1 (Supplement_1) ◽

pp. i26-i26

Author(s):

Ali Alattar ◽

Jiri Bartek ◽

Brian HIrshman ◽

Clark Chen

Keyword(s):

Stereotactic Radiosurgery ◽

Cerebral Atrophy ◽

White Matter Injury ◽

Whole Brain Radiation ◽

History Of ◽

Radiation Induced ◽

A Prospective Study ◽

The University ◽

Brain Radiation

Abstract INTRODUCTION: Ventriculomegaly, or dilatation of the cerebrospinal fluid (CSF) space, occurs after whole-brain radiation (WBRT) of brain metastasis (BM) patients due to either 1) hydrocephalus or 2) cerebral atrophy from radiation-induced white matter injury. In this study, we examined whether cumulative radiation from repeat stereotactic radiosurgery (SRS) increases the risk of ventriculomegaly. METHODS: Patients were included if they underwent SRS of BM from 2007–2017 and had imaging follow-up. We examined a cohort of 214 patients treated at the University of California San Diego (1,106 BM) and a second cohort of 148 patients (1,760 BM) treated at Karolinska Institutet. Ventriculomegaly was defined according to established morphometric criteria. Patients were grouped according to the development of new ventriculomegaly at last follow-up. Demographic, clinical, and dosimetric factors were compared between groups using univariable and multivariable logistic regressions. RESULTS: In the UCSD cohort, 63 patients (29%) presented with ventriculomegaly before SRS. Of 151 remaining patients with normal ventricular size before first SRS, 30 (20%) developed new ventriculomegaly. The odds of developing ventriculomegaly increased with history of WBRT (OR 5.247, p< 0.001) and trended toward significance with a greater number of SRS treatments (OR 1.296, p=0.075). In the Karolinska cohort, the odds of developing new ventriculomegaly trended towards significance with a greater number of SRS treatments (OR 1.605, p=0.26). To test whether this trend would achieve significance in a larger sample, we repeated the analysis in the combined cohort of 362 patients. The association between number of SRS treatments and developing ventriculomegaly reached significance (OR 1.254, p=0.049). CONCLUSIONS: These pilot findings suggest that cumulative radiation from repeat stereotactic radiosurgery (SRS) potentially increases the risk of ventriculomegaly. Based on our study, a prospective study of >350 patients will be needed to further test this hypothesis.

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Intraarterial Thrombolysis with r-tPA for Treatment of Anterior Circulation Acute Ischemic Stroke

Interventional Neuroradiology ◽

10.1177/159101990300900306 ◽

2003 ◽

Vol 9 (3) ◽

pp. 273-282

Author(s):

F. Baltacioğlu ◽

N. Afşar ◽

G. Ekinci ◽

N. Tuncer-Elmaci ◽

N Çagatay Çimşit ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Recombinant Tissue Plasminogen Activator ◽

Neurological Status ◽

Treatment Modalities ◽

Anterior Circulation ◽

Main Trunk ◽

History Of ◽

The Right

To investigate factors effecting the safety and recanalization efficacy of local intraarterial (IA) recombinant tissue plasminogen activator (r-tPA) delivery in patients with acute ischemic stroke. Eleven patients with anterior circulation acute ischemic stroke were treated. The neurological status of the patients were graded with the Glasgow Coma Scale (GCS) and National Institute of Health Stroke Scale (NIHSS). All patients underwent a computed tomography (CT) examination at admission. In addition four patients had diffusion-weighted and one patient had a perfusion magnetic resonance (MR) examinations. Patients were treated within six hours from stroke onset. Immediate, six hours, and 24 hours follow-up CT examinations were performed in order to evaluate the haemorrhagic complications and the extent of the ischemic area. The Rankin Scale (RS) was used as an outcome measure. Two of the 11 patients had carotid “T” occlusion (CTO), nine had middle cerebral artery (MCA) main trunk occlusion. Four patients had symptomatic haemorrhage with a large haematoma rupturing into the ventricles and subarachnoid space. Of these, three patients died within 24 hours. The remaining seven patients had asymptomatic haematomas that were smaller compared to symptomatic ones, and showed regression in size and density on follow-up CTs. At third month five patients had a good outcome and three patients had a poor outcome. In acute ischemic stroke, local IA thrombolysis is a feasible treatment when you select the right patient. Haemorrhage rate does not seem to exceed that occuring in the natural history of the disease and in other treatment modalities.

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Thoracoscopic surgical resection of thoracic neurogenic tumors

Neurosurgical FOCUS ◽

10.3171/foc.1999.7.5.4 ◽

1999 ◽

Vol 7 (5) ◽

pp. E3 ◽

Cited By ~ 4

Author(s):

Patrick P. Han ◽

Curtis A. Dickman

Keyword(s):

Tumor Resection ◽

Open Thoracotomy ◽

Total Resection ◽

Thoracic Sympathectomy ◽

Neurogenic Tumors ◽

Normal Tissues ◽

Intercostal Neuralgia ◽

The Mean ◽

Intraspinal Extension

Five patients who harbored large intrathoracic paraspinal neurogenic tumors were treated using thoracoscopic techniques to achieve gross-total tumor resection. All tumors were entirely intrathoracic except one that had an intraspinal extension, and all tumors were treated entirely thoracoscopically except for this one. Gross-total resection was achieved in all cases. The mean clinical follow-up period was 6.8 months. Postoperatively, one patient developed Horner's syndrome. The only other complication was transient intercostal neuralgia (two patients), which has resolved in both patient. No evidence of disease was demonstrated clinically or on follow-up imaging in any patient. Thoracoscopy is an excellent modality with which to treat these tumors, in part because it is associated with significantly less morbidity than open thoracotomy and costotransversectomy procedures. Endoscopic transthoracic approaches reduce the approach-related soft-tissue morbidity by preserving the normal tissues of the chest wall, avoiding rib retraction and muscle transection, reducing postoperative pain, and facilitating recovery. This technique has become the senior author's (C.A.D.'s) surgical approach of choice for the removal of intrathoracic benign paraspinal neurogenic tumors. It has also become the preferred method by which to perform thoracic sympathectomy and remove central, herniated thoracic discs.

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Calcified Right Ventricular Fibroma in an Adult: A Case Report

10.22541/au.162281012.24531442/v1 ◽

2021 ◽

Author(s):

Huanhuan Gao ◽

Shuai Yuan ◽

Zhiqiang Hu ◽

Zhelan Zheng ◽

Shengjun Wu

Keyword(s):

Right Ventricular ◽

Histopathological Examination ◽

Tumor Resection ◽

Anterior Wall ◽

Benign Tumors ◽

Troublesome Symptom ◽

History Of ◽

The Right ◽

Operative Recovery

Background: Cardiac fibromas are rare benign tumors of the heart composed of fibroblasts and collagen. They are common among children and adolescents but are rarely present in adults. Case presentation: We here report the case of a fifty-seven-year-old man who complaining of a 2-year history of chest tightness at rest. Transthoracic echocardiography detected a severe calcified mass protruding outside the right ventricular anterior wall near the apex. The patient was referred for tumor resection. The calcified mass was determined to be a cardiac fibroma with postoperative histopathological examination. The patient experienced an unremarkable post-operative recovery and was discharged 8 days later. Subsequent follow-up has shown complete freedom from his troublesome symptom. Conclusions: Preoperative diagnosis with various imaging modalities and early surgery are the keys to improve prognosis of patients with cardiac fibromas.

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