Epidemiology, clinical features, and histopathology of sarcomas managed in a Haitian cancer clinic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23515-e23515
Author(s):  
Joseph Bernard ◽  
Thierry Alcindor ◽  
Lynn Gabrielle Alexis ◽  
Doukens Patrick Gilbert ◽  
Vincent DeGennaro
Keyword(s):  
Overall Survival ◽  
Mortality Rate ◽  
Head And Neck ◽  
Clinical Features ◽  
Soft Tissues ◽  
Soft Tissue Sarcomas ◽  
Presentation Rate ◽  
Dermatofibrosarcoma Protuberans ◽  
Lower Limbs ◽  
Anatomical Site

e23515 Background: Sarcomas are among the least described cancers diagnosed in Haiti. Suboptimal surgery and the unavailability of radiation therapy make their management challenging. The main objective of this study was to present the epidemiology, clinical features and histopathology of sarcomas in the Haitian setting. Methods: A seven-year retrospective study was conducted in the cancer program of Innovating Health International (IHI). We included all patients with clinical or histological diagnosis of sarcoma enrolled from January 1, 2014 to December 31, 2020. Date of first visit, age, gender, stage, anatomical site, histology, outcome as of December 31, 2020 and date of death were the main variables selected for this chart review. Mortality rate and overall survival were also evaluated. Results: One hundred and twenty-two (122) patients with sarcomas were diagnosed and treated during the study period. Their mean age was 43.3 years [range: 15-88] and the sample was 62.3% women and 37.7% men. 49.2% of the patients were less than 40 years of age. Among the cases of sarcomas, 86.9% were soft tissue sarcomas and 13.1% bone sarcomas. The lower limbs (36.9%), abdomen (14.8%), head and neck (13.1%), upper limbs (12.3%) and breasts (7.4%) were the most common locations of the sarcomas. 81% of abdominal/pelvic sarcoma cases (n=21) were in women. The most common histological types (n=94) were fibrosarcoma (15.2%), liposarcoma (10.9%), dermatofibrosarcoma protuberans (8.7%), malignant histiocytofibroma (6.5%), rhabdomyosarcoma (5.4%) and gastrointestinal stromal tumor (5.4%). 19.6% of the patients had metastatic disease. The mortality rate for the study period was 53.3% and 17.2% of the patients were lost to follow-up. The median overall survival was 7.2 months for the cohort and 18.4 months for the treated patients (n=70). Conclusions: The sarcomas seen in this Haitian medical clinic mainly affect the soft tissues of limbs, abdomen and head and neck. There is a strong predominance of female patients and about half of the patients are aged less than 40. Despite a low metastatic presentation rate, the prognosis is poor, likely reflecting both the aggressiveness of this group of diseases and the disparities of outcomes between high-income and low-and-middle-income countries.

Clinical features and outcomes of young patients with head and neck non-rhabdomyosarcoma soft tissue sarcomas

Head & Neck ◽  
2014 ◽  
Vol 37 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Sara M. Federico ◽  
David Gilpin ◽  
Sandeep Samant ◽  
Catherine A. Billups ◽  
Sheri L. Spunt
Keyword(s):  
Soft Tissue ◽  
Head And Neck ◽  
Clinical Features ◽  
Young Patients ◽  
Soft Tissue Sarcomas

scholarly journals Mucosal Melanoma in the Head and Neck Region: Different Clinical Features and Same Outcome to Cutaneous Melanoma

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Faruk Tas ◽  
Serkan Keskin
Keyword(s):  
Overall Survival ◽  
Oral Cavity ◽  
Head And Neck ◽  
Clinical Features ◽  
Cutaneous Melanoma ◽  
Regional Lymph Node ◽  
Survival Rates ◽  
Mucosal Melanoma ◽  
Significant Prognostic Factor ◽  
Overall Survival Rates

Mucosal melanoma (MM) in the head and neck (H&N) is relatively rare and behaves in distinct pattern from cutaneous melanoma (CM). We performed this study to define clinical characteristics and outcomes of patients and emphasize MM differences from CM. Forty-one patients with MM located in H&N were assessed. 94 CM patients originated from H&N region were also used for comparison. Patients had oral cavity (51%) and sinonasal location (49%).The median age was 60 years and gender distribution was equal. Thirty-two (78%) patients had localized stage, four (10%) patients had regional lymph node metastasis, and five (12%) patients had distant metastasis. The 1- and 5-year overall survival rates were 81% and 58%, respectively. Outcomes were similar between sinonasal and oral cavity patients (). Advanced disease was the significant prognostic factor for outcome (). MM patients are older () and more diagnosed as a localized disease patients at presentation than those with CM (). Overall survival rates were identical in patients with MM and CM (). In conclusion, despite different clinical features, outcome was identical in patients with MM and CM located in the H&N region.

Sarcoma

2021 ◽  
pp. 95-104
Author(s):  
Ian M. Smith ◽  
Vinay Itte
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Multidisciplinary Team ◽  
Systematic Approach ◽  
Soft Tissues ◽  
Soft Tissue Sarcomas ◽  
Malignant Tumours ◽  
Staging Classification

Sarcomas are malignant tumours of the soft tissues or bone. Epidemiology, aetiology, pathology, clinical features, investigations, diagnosis, staging, classification, and management of soft tissue sarcomas are described in this chapter. These tumours are relatively uncommon but require a systematic approach to treatment involving a multidisciplinary team.

scholarly journals Worldwide Prevalence and Clinical Characteristics of RAS Mutations in Head and Neck Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Ofra Novoplansky ◽  
Sankar Jagadeeshan ◽  
Ohad Regev ◽  
Idan Menashe ◽  
Moshe Elkabets
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Clinical Features ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Anatomical Site ◽  
Cochrane Central Register ◽  
Kras Mutations ◽  
Ras Mutations ◽  
Hpv Status

Importance: There is considerable variation among different studies for the prevalence of RAS mutations in head and neck cancer (HNC) patients. In light of the development of RAS inhibitors, a reliable assessment of the prevalence of RAS mutations and their correlation with the clinical features of patients with HNC is crucially needed. Objective: To assess the worldwide prevalence of HRAS, KRAS, and NRAS mutations in HNC in the relation to geographical region, anatomical site(s) of the tumor(s) and clinical features. Data Sources: A systematic search of the PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials databases was performed to identify studies published since January 2000. Data were analyzed between June and September 2021. Study Selection: Studies that included mutational analyses of at least one of the target genes and reported the prevalence and frequency of mutations as an outcome measure were included. Studies including less than ten patients or were conducted before year 2000 were excluded. Data Extraction and Synthesis: Two researchers independently reviewed the literature according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Random-effects models were applied to results with high heterogeneity. Otherwise, fixed-effects models were used for the analyses. Dichotomous variables were pooled as odds ratios (OR). Main Outcome(s) and Measure(s): The primary outcome was mutation prevalence. Secondary outcomes included the location of the mutated codon and amino acid substitution. Results: The estimated mutation rate is highest for HRAS (7%), followed by KRAS (2.89%) and NRAS (2.20%). HRAS prevalence in South Asia (15.28%) is twice as high as the global estimate. HRAS mutations are more prevalent in oral cavity and salivary gland tumors. In contrast, KRAS mutations are found more frequently in sinonasal tumors, and NRAS mutations are found chiefly in tumors of the nasopharynx. OR analyses show a significant association between HRAS mutations and a high tumor stage (OR=3.63). In addition, there is a significant association between HPV-positive status and KRAS mutations (OR=2.09). Conclusions and Relevance: RAS mutations occur in a subset of HNC patients and their prevalence varies according to geography, tumors anatomical site, stage, and HPV status. This meta-analysis provides support for their potential as viable therapeutic targets in HNC patients.

scholarly journals Adult Head and Neck Soft Tissue Sarcomas: Treatment and Outcome

Sarcoma ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Rabindra P. Singh ◽  
Robert J. Grimer ◽  
Nabina Bhujel ◽  
Simon R. Carter ◽  
Roger M. Tillman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Head And Neck ◽  
Metastatic Disease ◽  
Tumour Size ◽  
Soft Tissue Sarcomas ◽  
Histological Subtypes ◽  
Median Size ◽  
Adult Head

We have retrospectively analysed the experience of a musculoskeletal oncological unit in the management of adult head and neck soft tissue sarcomas from 1990 to 2005. Thirty-six patients were seen, of whom 24 were treated at this unit, the remainder only receiving advice. The median age of the patients was 46 years. Most of the sarcomas were deep and of high or intermediate grade with a median size of 5.5 cm. Eleven different histological subtypes were identified. Wide excision was possible only in 21% of the cases. 42% of the patients developed local recurrence and 42% developed metastatic disease usually in the lungs. Overall survival was 49% at 5 years. Tumour size was the most important prognostic factor. Adult head and neck soft tissue sarcomas have a high mortality rate with a high risk of local recurrence and metastatic disease. The rarity of the disease would suggest that centralisation of care could lead to increased expertise and better outcomes.

scholarly journals Leiomyosarcoma of the extremity deep soft tissues: analysis of factors predictive of survival and imaging features

2020 ◽  
Vol 7 (9) ◽  
pp. 647-651
Author(s):  
Osman Ciloglu ◽  
Rana Kapukaya
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Soft Tissues ◽  
Soft Tissue Sarcomas ◽  
Disease Free Survival ◽  
Magnetic Resonance Images ◽  
Tumor Type ◽  
Imaging Features

Objective:  This study aimed to report the visual outcomes of deeply located Leiomyosarcoma (LMS) in the extremities and treatment results. Methods: The histological diagnosis of each case was confirmed by the pathology council and only cases with LMS localized in the deep soft tissue of the limb were included in this study. Treatment-related factors such as all the visual features of the tumor, type of therapy, local and distant recurrence, follow-up time, and outcome were analyzed. Overall survival time was determined. Results: Evaluation was made of 17 patients, comprising 11 females and 6 males with a mean age of 64.35 years (range, 52-75 years). The localization of the primary lesion was the lower extremity in 14 patients (82.34%), and the upper extremity in 3 (17.34%). The average size of the lesions was 8.23 cm (range, 3-22 cm). All lesions were staged according to the TNM Classification of soft tissue sarcomas, as 3 (17.64%) patients in stage IIA, 9 (52.94%) in stage IIB, and 5 (29.41%) in stage IV. In the radiological features of the lesions, only two patients had scattered calcification and osseous pathology in the tumor tissue. The signal properties obtained in other soft tissue sarcomas on magnetic resonance images (MRI) were also present in these lesions. Neoadjuvant chemotherapy was applied to 5 of 17 patients, and surgical and adjuvant radiotherapy was applied to the remaining 12 patients. These patients were followed up for an average of 66 (23-111) months. Local recurrence occurred in 3 patients. The five-year disease-free survival rate was 58.8%, and the disease-survival rate was 64.7%. Conclusion: The most important result of this study was that the only effective factor on overall survival is tumor size (p <0.001). Neoadjuvant chemotherapy was not seen to have any significant effect on this disease.

scholarly journals Injury patterns of South African provincial cricket players over two seasons

2009 ◽  
Vol 21 (4) ◽  
Author(s):  
RA Stretch ◽  
RP Raffan ◽  
N Allan
Keyword(s):  
Soft Tissues ◽  
Lower Limbs ◽  
Acute Injury ◽  
Anatomical Site ◽  
Injury Incidence ◽  
Training Time ◽  
Acute Injuries ◽  
Gradual Onset ◽  
Fast Bowler ◽  
Fitness Training

Objective. To determine the incidence and nature of injury patternsin elite cricketers over two seasons.Methods. Physiotherapists and/or doctors working with 4 provincial teams completed a questionnaire for each cricketer who presented with an injury during the 2004 - 2005 (S1) and 2005 - 2006 (S2) cricket seasons. This was done to determine: (i) the anatomical site of injury; (ii) the month of injury during the season; (iii) the diagnosis using the OSCIS injury classification system; (iv) the mechanism of injury; (v) whether it was a recurrence of a previous injury; (vi) whether the injury had recurred again during the season; and (vii) biographical data.Results. The results showed that 180 injuries (S1 – 84; S2 – 96)were sustained. On average the teams spent 2 472 hours on matches, 4 148 on practices and 1 612 on fitness training during the two-season period. The injury prevalence was 8% per match, while the injury incidence was 30/10 000 hours of match, practice and training time, with the match incidence being 74 injuries/ 10 000 hours and the training incidence 15 injuries/10 000 hours. Bowling (29%), fielding and wicket-keeping (27%) and batting (19%) accounted for the majority of injuries. The occurrence of injuries was predominantly to the lower limbs (S1 – 45%; S2 – 42%),back and trunk (S1 – 19%; S2 – 19%), upper limbs (S1 – 19%; S2 – 22%), head and neck (S1 – 6%; S2 – 3%), and related to illnesses (S1 – 11%; S2 – 14%). The injuries occurred primarily during first-class matches (39%), limited-overs matches (22%), and practices (17%), and some were of gradual onset (20%). Acute injuries comprised 78% of injuries. The majority of injuries were first-time injuries (76%), with 11% and 14% recurrent injuries from the previous and current seasons, respectively. The major injuries during S1 were haematomas (19%), muscle strains(17%) and other trauma (14%), while during S2 the injuries were primarily muscle strains (16%), other trauma (20%), tendinopathy (16%) and acute sprains (15%). The primary mechanisms of injury occurred in the delivery stride when bowling (19%) and overbowling (7%), on impact by the ball when batting (11%), and on sliding to field the ball (6%).Conclusion. The results indicate a pattern of cause of injury, withthe fast bowler most likely to sustain an acute injury to the soft tissues of the lower limb while participating in matches and practices during the early part of the season.

Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. (Preprint)

2019 ◽  
Author(s):  
Waheed Atilade Adegbiji ◽  
Shuaib Kayode Aremu ◽  
AbdulAkeem Adebayo Aluko
Keyword(s):  
Foreign Body ◽  
Head And Neck ◽  
Clinical Features ◽  
University Teaching ◽  
Age Group ◽  
Geriatric Population ◽  
Female Ratio ◽  
Common Diagnosis ◽  
Foreign Body Impaction ◽  
Nose And Throat

BACKGROUND Issues of geriatric otolaryngologic emergency have not been widely applied despite increase in geriatric population. OBJECTIVE This study aimed at determining prevalence, sociodemographic features, aetiology, clinical features, Complications and sources ofreferral of geriatric otorhinolaryngological, head and neck emergency in our center. METHODS This was a prospective hospital based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat Department of Ekiti State University Teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using pretested interviewers questionnaire.All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts and pie charts. RESULTS Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60-64). There were 38.6% males with male to female ratio of 1:1.5. The main aetiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumour. Main anatomical distribution of geriatric otorhinolaryngology emergency were 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. Common diagnosis in this study were 15.9% sinonasal tumour, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (<13 weeks) occurred in 1 week in 74.2% and 2-13 weeks In 19.7%. Commonest time of presentation was daytime in 65.9%. Major sources of referral were 43.2% general practitioner and 31.1% casualty officers. Presentation of geriatric otorhinolaryngology emergency were mainly ear, nose and throat clinic in 59.8% with accident and emergency in 28.8%. Commonest associated comorbid illnesses among the geriatric patients were 18.2% hypertension, 14.4% arthritis and 9.8% diabetes mellitus. CONCLUSIONS Geriatric otorhinolaryngological emergency are common pathology with associated with comorbid illnesses. Detailed clinical assessment are mandatory for effective management outcome.

Gangrena de Fournier. Reporte de caso

2020 ◽  
Vol 63 (5) ◽  
pp. 26-30
Author(s):  
Paloma Pérez Ladrón de Guevara ◽  
Georgina Cornelio Rodríguez ◽  
Oscar Quiroz Castro
Keyword(s):  
Mortality Rate ◽  
Necrotizing Fasciitis ◽  
Broad Spectrum ◽  
Soft Tissues ◽  
Fournier’S Gangrene ◽  
Type Ii ◽  
Necrotic Tissue ◽  
Fournier's Gangrene ◽  
Necrotizing Fascitis ◽  
Key Words Fournier's Gangrene

Fournier’s Gangrene is a type II necrotizing fascitis that leads to thrombosis of small subcutaneous vessels and spreads through the perianal and genital regions and the skin of the perineal. Most cases have a perianal or colorectal focus and in a smaller proportion it originates from the urogenital tract. The mortality rate varies between 7.8 and 50%1-3, only timely diagnosis decreases the morbidity and mortality of this condition. Treatment includes surgical debridement of all necrotic tissue and the use of broad-spectrum antibiotics. Key words: Fournier’s gangrene; gangrene; necrotizing fasciitis; infectious necrotizing of soft tissues.

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