scholarly journals Elastofibroma dorsi: The clunking tumour that need not cause alarm

2016 ◽  
Vol 98 (03) ◽  
pp. 208-211 ◽  
Author(s):  
HG Smith ◽  
JAF Hannay ◽  
K Thway ◽  
C Messiou ◽  
MJF Smith ◽  
...  

Introduction Elastofibromas are rare, pseudo-tumours arising at the inferior pole of the scapula that have a characteristic presentation. Due to their tissue of origin and size, they may often be mistaken for soft tissue sarcomas. We present the management of patients diagnosed with elastofibroma at a single institution. Methods Patients diagnosed with elastofibroma between January 1995 and January 2015 were identified from a prospectively maintained histopathology database. Electronic patient records, imaging and pathology reports were retrieved and reviewed. Results Thirty seven patients were identified, with a median age of 66 years and a male-to-female ratio of 1:1.6. All tumours occurred in the characteristic subscapular location. The median maximum tumour diameter was 8.2cm. A synchronous contralateral lesion (15.8%) was found in six patients. Cross-sectional imaging was performed in 29 patients, with magnetic resonance imaging the most common modality (59.5%). Diagnosis was confirmed with percutaneous biopsy in all but one patient, who proceeded directly to surgery. Eighteen patients were managed non-operatively; 19 opted for surgical excision due to significant symptoms. Excision was performed in a marginal fashion and, at a median follow-up of 5 months, no functional impairment or local recurrences were observed. Conclusions Soft tissue masses greater than 5cm in diameter should prompt the clinician to exclude soft tissue sarcoma. The diagnosis of elastofibroma may be alluded to by its typical presentation and can be confirmed by percutaneous biopsy. After excluding malignancy, these lesions can be safely managed non-operatively, with surgery reserved for symptomatic patients.

Author(s):  
Kunhi Mohammed K. P. ◽  
Snehasis Pradhan ◽  
Supratim Bhattacharyya ◽  
Prafulla Kumar Das ◽  
Muhammed Navas N. K.

Background: Soft tissue sarcomas are a rare and heterogeneous group of malignant tumors of mesenchymal origin that comprise less than 1 percent of all adult malignancies. Although they occur anywhere in the body, they involve most commonly in extremities, trunk, retroperitoneum and head and neck. The aim of the study was to analyze clinical and histopathological features of various soft tissue sarcomas.Methods: This was a retrospective study, conducted in tertiary cancer centre in Odisha during the period 2015 to 2018. We collected clinical parameters like age, sex, site of swelling, any associated pain and biopsy reports and these variables were correlated with final histopathology reports.Results: A total of 107 patients were included in the study, with male to female ratio of 2:1(71 and 36) and average age of 43.45 years. All of them presented with a swelling. The lower extremities were the most common sites i.e. 44.62%. Pleomorphic sarcoma was the most frequent histologic variety comprising 43% and less frequent variety were angiosarcoma, and myxoid sarcoma.Conclusions: Soft tissue sarcoma are predominant in males and middle aged population are frequently affected. Most common affected site is lower extremity and pleomorphic sarcoma is the prominent histologic type.


Author(s):  
Sumer N. Shikhare ◽  
Wilfred C. G. Peh

Chapter 88 outlines the key radiologic features of soft tissue infections and the diagnostic value of the different imaging modalities such as conventional radiography, US, CT, and MRI. Soft tissue infections present in various forms that involve varying depths from skin to deeper tissues. Early diagnosis may be challenging because of nonspecific clinical presentations, resulting in delay in management. The advent of cross-sectional imaging has improved diagnostic capabilities dramatically, with US, CT, and particularly MRI being the pillars of evaluation. Prompt and appropriate imaging workup of the various MSK soft tissue infections aids early diagnosis and in demonstrating the extent of the disease process, as treatment delay significantly reduces the cure rate and increases the risk of complications.


2013 ◽  
Vol 7 (9-10) ◽  
pp. 651 ◽  
Author(s):  
Gabriele Guglielmetti ◽  
Paolo De Angelis ◽  
Paolo Mondino ◽  
Carlo Terrone ◽  
Alessandro Volpe

Perivascular Epithelioid Cell tumour (PEComa) is rare. We describe a 39-year-old man who underwent a left radical orchidectomy and adjuvant radiation therapy for a stage IA classical testicular seminoma. He was diagnosed with a mass lateral to the right common iliac artery that was considered suspicious for late lymph node relapse after 3 years of follow-up. Due to the unusual location of the mass and the equivocal findings of percutaneous biopsy, a laparoscopic pelvic lymphadenectomy was performed. Final pathology revealed PEComa of soft tissue. The patient is disease free after 38 months of follow-up without adjuvant treatment. The presence of rare soft-tissue neoplasm should be considered in differential diagnosis of retroperitoneal masses during follow-up of germ cell tumours. Suspicious isolated recurrences of these neoplasms in unusual locations can require surgical excision to confirm diagnosis and avoid inappropriate treatment.


2016 ◽  
Vol 9 (3) ◽  
pp. 655-660 ◽  
Author(s):  
Marco Rastrelli ◽  
Saveria Tropea ◽  
Romina Spina ◽  
Alessandra Costa ◽  
Roberto Stramare ◽  
...  

Sarcomas arising from the chest wall account for less than 20% of all soft tissue sarcomas, and at this site, primitive tumors are the most frequent to occur. Leiomyosarcoma is a malignant smooth muscle tumor and the best outcomes are achieved with wide surgical excision. Although advancements have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcoma to treat. Currently, general local control is obtained with surgical treatment with wide negative margins. We describe the case of a 50-year-old man who underwent a chest wall resection involving a wide portion of the pectoralis major and minor muscle, the serratus and part of the second, third and fourth ribs of the left side. The full-thickness chest wall defect of 10 × 8 cm was closed using a non-cross-linked acellular dermal matrix (Egis®) placed in two layers, beneath the rib plane and over it. A successful repair was achieved with no incisional herniation and with complete tissue regeneration, allowing natural respiratory movements. No complications were observed in the postoperative course. Biological non-cross-linked matrix, derived from porcine dermis, behaves like a scaffold supporting tissue regeneration; it can be successfully used as an alternative to synthetic mesh for chest wall reconstruction.


2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Amjad Soltany ◽  
Ghazal Asaad ◽  
Rami Daher ◽  
Mouhannad Dayoub ◽  
Ali Khalil ◽  
...  

Abstract Ameloblastic fibrosarcoma (AFS) is a rare, aggressive malignant odontogenic tumor. AFS is seen most frequently in second and third decades of life. We are reporting a case of a low grade AFS in a 21-year-old male complaining of a painless swelling in the right side of the maxilla. The patient was treated with surgical excision followed by radiotherapy, which is considered the most effective approach for most of soft tissue sarcomas. AFS has a high-reported recurrence rate (up to 37%); therefore, long-term surveillance for recurrence is crucial.


2003 ◽  
Vol 21 (4) ◽  
pp. 722-727 ◽  
Author(s):  
Andre M. Oliveira ◽  
Scott H. Okuno ◽  
Antonio G. Nascimento ◽  
Ricardo V. Lloyd

Background: p45 S phase kinase-associated protein-2 (p45skp2), a member of the F-box family of proteins, is an important component of the Skp1-Cullin-F-box protein (SCF) ubiquitin-ligase complex (SCFskp2). The latter has been implicated in the ubiquitination and degradation of p27kip1 (p27) and G1-S cell cycle progression. The expression and prognostic role of Skp2 in a large series of soft tissue sarcomas has not been previously investigated. Methods: Clinicopathologic features and immunohistochemical expression of Skp2, p27, and Ki-67 proteins were studied in 182 cases of soft tissue sarcomas (American Joint Committee on Cancer stages II and III). Survival analyses were performed using the Kaplan-Meier method and the Cox regression model. Results: The male to female ratio was 1.2:1, and the median age at the diagnosis was 53 years. The tumors were predominantly located in the lower extremities (n = 163; 90%) and had a median size of 9 cm. High Skp2 expression (≥ 10% of the cells) was identified in 68 tumors (37%), and was correlated with high grade histology (P = .002) and Ki-67 proliferative index (r = 0.44; P < .0001), but not with p27 expression (r = −0.02; P = .80). By univariate analysis, high Skp2 expression was associated with decreased metastasis-free, disease-free, and overall survival. In a multivariate model, high Skp2 expression was an independent predictor for decreased local recurrence-free, disease-free, and overall survival. Conclusion: These results indicate that Skp2 expression is associated with cell proliferation and a worse prognosis in soft tissue sarcomas. The lack of an inverse correlation between Skp2 and p27 suggests that additional molecular events associated with either Skp2 expression or p27 proteolysis may be operating in these tumors.


2018 ◽  
Vol 7 (5) ◽  
pp. 205846011877648 ◽  
Author(s):  
Olivia Francies ◽  
Levan Makalanda ◽  
Dimitris Paraskevopolous ◽  
Ashok Adams

The anterior skull base (ASB) is intimately associated with the unique soft tissue subtypes of the nasal cavity, paranasal sinuses, orbits, and intracranial compartment. Pathology involving the ASB is rare but the causes are manifold and can be broadly subdivided into those intrinsic to the skull base and processes extending from below or above. Sinonasal pathology is the most commonly encountered and poses significant management challenges that rely heavily on accurate interpretation of the radiological findings. We illustrate the normal anatomy of the ASB and present a cross-sectional imaging review of the pathological entities that may be encountered, focusing on the specific features that will impact on clinical and surgical management.


2019 ◽  
Vol 6 (6) ◽  
pp. 2522
Author(s):  
Monali Madhukar Patole

Background: Pediatric solid tumors include a heterogeneous group of tumors, and the burden of these tumors, especially from resource-challenged countries, is not well described. The aim of this study was to describe the distribution of solid tumors in children in an Indian tertiary cancer center.Methods: All patients under 12 years of age with histologically confirmed tumors presenting at a tertiary cancer center from January 2014 to January 2019 were identified from the hospital database. Patients with lymphomas, bone, and central nervous tumors were excluded. The demographic profile including age, sex distribution, and the treatment received were recorded for all patients. Results: The mean age of the eligible 153 patients was 5.7 years with majority (57.3%) in the 0-5 years age group. The male-to-female ratio was 1.6:1 with a male predominance in all tumors except germ cell tumors. Renal tumors were the most common tumors followed by neuroblastoma and soft tissue sarcoma, whereas germ cell and gonadal tumors formed only 8.49% of all tumors.Conclusions: Extracranial and extraosseous pediatric solid tumors include a wide range of tumors with a predilection for male sex and children below 4 years of age. Wilms tumors, neuroblastoma, and soft tissue sarcomas tumors are the most common tumors.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e21523-e21523
Author(s):  
N. Faizi ◽  
R. Sharma ◽  
S. Sharma ◽  
S. Chandrashekhara ◽  
N. K. Shukla ◽  
...  

e21523 Background: Althouth soft tissue constitute large part of the body, STS are rare (1% of all neoplasms) and can arise anywhere in the body. Imaging is require to confirm the diagnosis and for staging. We conducted a prospective study to evaluate the role of MRI scan in characterization and staging of the tumor. Methods: This study between 2006 and 2008 included 20 patients with histologically proven soft tissue sarcoma in whom preoperative MRI of the local site was performed and the findings were correlated with the surgical and histopathological findings. Only those patients in whom surgical and histopathological findings were available were included in the study. All MRI were performed on 1.5 T MRI using body and appropriate surface coil. T1W, T2W, and STIR sequences were acquired in axial, coronal, and sagittal planes. Contrast enhanced MRI was performed in four patients. Surgical findings were recorded by the operating surgeon and resected specimens were analyzed by pathologist for assessing extent and histologic typing. All demographic data of the patient, the clinical features, preoperative imaging analysis, operative and histopathological findings were tabulated as per the given proforma. Results: Age of the patients was 16 - 72 years (mean age 44.4 years). Male female ratio was 2.3:1 . Eleven cases were recurrent. Most common histologic type was MFH (30%) while synovial sarcoma was second most common (20%) type of the STS in our study. Eighteen of 20 soft tissue sarcomas were of high grade. Average size on MRI was 9.25 cm (range) and operative size was 9.8 cm (range). Statistically significant agreement existed between MR and operative size. The sensitivity of MRI for individual muscle involvement was 92.3% and specificity was 96.5%. MRI had a sensitivity of 93% and specificity of 100% in predicting fascial involvement. MRI had 100% sensitivity and specificity in showing skin and subcutaneous tissue involvement. MRI had 100% negative predictive value in predicting NV bundle involvement. None of the patients had bone or joint involvement. No distant parenchymal metastases were seen. Specific diagnosis based on MRI image characteristics was suggested in 35% patients. Conclusions: Overall staging accuracy of MRI was 75% in staging of STS when correlated with surgical and histopathological MSKCC staging. No significant financial relationships to disclose.


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