Clinicopathological study of soft tissue sarcoma-retrospective study of tertiary cancer institute in eastern India

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.

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Giant Soft Tissue Sarcoma of Scalp with Skull and Cerebral Invasion

Nepal Medical College Journal ◽

10.3126/nmcj.v23i4.42269 ◽

2021 ◽

Vol 23 (4) ◽

pp. 357-359

Author(s):

Raghav Yelamanchi ◽

Parikshith Manjunath ◽

Nikhil Gupta ◽

CK Durga

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Malignant Tumors ◽

Soft Tissue Sarcomas ◽

Brain Parenchyma ◽

Clinical Image ◽

Tissue Mass ◽

Surgical Department ◽

Pleomorphic Sarcoma ◽

Multimodality Approach

Scalp soft tissue sarcomas (STS) are very rare accounting for less than 0.1% of all malignancies. We report a rare clinical image of advanced stage soft tissue sarcoma of the scalp. A 65 year woman had presented to the surgical department with complaints of a rapidly growing swelling over the scalp for three months. On examination there was huge 20 x 20 cm swelling over the scalp in the left temporoparietal region with variegated consistency. Computed tomography of head revealed a large soft tissue mass with necrosis invading the bone and underlying brain parenchyma. Histopathological finding from core needle biopsy revealed pleomorphic sarcoma. STS are highly malignant tumors which should be diagnosed and treated using multimodality approach. Recurrences are common even after complete resection and prognosis is poor.

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Histopathological study of soft tissue tumours in a tertiary health centre in southern part of Assam

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20214422 ◽

2021 ◽

Vol 9 (11) ◽

pp. 3391

Author(s):

Khadija S. Tapadar ◽

Manoj K. Deka ◽

R. N. Chaubey ◽

Shah A. Sheikh ◽

Gargi R. Choudhury ◽

...

Keyword(s):

Soft Tissue ◽

Malignant Tumors ◽

Soft Tissue Tumors ◽

The Body ◽

World Health ◽

Vascular Tumors ◽

Benign Tumors ◽

Peripheral Nerve Sheath Tumors ◽

Pleomorphic Sarcoma ◽

Younger Age

Background: Soft tissue tumors are defined as mesenchymal proliferations which occur in the extraskeletal non-epithelial tissues of the body, excluding the viscera, coverings of brain and lymphoreticular system. The objective of this study was to study the histopathological features of soft tissue tumors and to study the occurrence of soft tissue tumors in relation to age, sex and anatomical site.Methods: This study comprised of 89 cases studied over a period of two years. All soft tissue tumors, their gross features, microscopic findings were analysed in detail. Soft tissue tumors were divided into benign and malignant categories and further sub typing were done according to World Health Organization (WHO) classification. The distribution of soft tissue tumors according to the age, sex and site of occurrence was studied.Results: Out of 89 cases of soft tissue tumors, 76 cases were benign, 4 cases belonged to intermediate category and 9 cases were malignant. Adipocytic tumors formed the largest group constituting 39 cases. Vascular tumors were the second commonest (26 cases) followed by peripheral nerve sheath tumors (11 cases). The benign tumors were seen in younger age as compared to malignant tumors. Malignant soft tissue tumors was seen to be more common in male than female and pleomorphic sarcoma and liposarcoma was commonest (3 cases each).Conclusions: Benign tumors were more common than malignant. The most common benign tumors were lipoma followed by hemangioma and schwannoma. The most common malignant tumor was pleomorphic sarcoma. The benign tumors were seen in younger age as compared to malignant tumors.

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Article Commentary: Soft Tissue Sarcoma of the Extremity and Trunk: Issues for the General Surgeon

The American Surgeon ◽

10.1177/000313480607200802 ◽

2006 ◽

Vol 72 (8) ◽

pp. 665-671

Author(s):

Gerame Wells ◽

Robert C.G. Martin ◽

Kelly M. Mcmasters ◽

Charles R. Scoggins

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Current Literature ◽

Medical Literature ◽

Malignant Tumors ◽

Soft Tissue Sarcomas ◽

Heterogeneous Group ◽

General Surgeon ◽

Academic Interest ◽

General Surgeons

Soft tissue sarcomas represent a heterogeneous group of malignant tumors that arise from mesenchymal tissues. The majority of these tumors arise on the extremity or trunk. Despite their rarity, soft tissue sarcomas continue to generate vigorous academic interest, and as a result, the ever-expanding medical literature dealing with sarcomas continues to grow. Many general surgeons will see few of these tumors during their careers, and a review of the current literature and how it applies to patients afflicted with soft tissue sarcoma of the extremity or trunk is warranted.

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Combination chemotherapy using adriamycin, DTIC, cyclophosphamide, and actinomycin D for advanced soft tissue sarcomas: a randomized comparative trial. A phase III, Southwest Oncology Group Study (7613).

Journal of Clinical Oncology ◽

10.1200/jco.1987.5.6.851 ◽

1987 ◽

Vol 5 (6) ◽

pp. 851-861 ◽

Cited By ~ 62

Author(s):

L H Baker ◽

J Frank ◽

G Fine ◽

S P Balcerzak ◽

R L Stephens ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Actinomycin D ◽

Malignant Tumors ◽

Soft Tissue Sarcomas ◽

Comparative Trial ◽

Phase Iii ◽

Oncology Group ◽

Southwest Oncology Group ◽

Significant Difference

The term soft tissue sarcoma refers to a large variety of malignant tumors arising in extraskeletal connective tissues that connect, support, and surround discrete anatomic structures. All visceral organs also contain a connective stroma that can undergo malignant transformation. Because of the histological similarities of this group of tumors and their relative rarity, treatment prescriptions for patients that have disseminated disease are most often uniform. In this study, we asked the question whether adding a third drug (cyclophosphamide or actinomycin D) to Adriamycin (Adr [Adria Laboratories, Columbus, OH])-(3,3-dimethyl-1-triazeno)- imidazole-4-carboxamide (DTIC) would improve the response rate and/or survival. A unique feature of this cooperative group clinical trial was the mandatory pathology review of the histological material. All patients of the Southwest Oncology Group between June 1, 1976, and November 17, 1979, who had a biopsy-confirmed diagnosis of a soft tissue sarcoma with convincing clinical or biopsy-documented evidence of metastatic disease were eligible for the study. Patients were randomized to receive (1) Adr, 60 mg/m2 intravenously, day 1, and DTIC, 250 mg/m2 every 3 weeks (104 patients); (2) Adr and DTIC as in (1) and cyclophosphamide, 500 mg/m2, day 1 (112 patients); or (3) Adr and DTIC as in (1) and actinomycin D, 1.2 mg/m2, day 1, (119 patients). There was no statistically significant difference in response rates (33%, 34%, and 24%) (P = .25). Median durations of response were 31 weeks in the Adr-DTIC arm, 26 weeks in the cyclophosphamide-DTIC-Adr arm, and 23 weeks in the Adr-DTIC-Actinomycin D arm (P = .78). Median durations of survival were 37, 42, and 50 weeks, respectively. Again, no statistically significant differences were observed (P = .59). Toxicities from each of these treatment arms were formidable and were equivalent. Prognostic factor analysis showed a prognosis based on bone marrow reserve, sex, and pathology subtype favorable to patients.

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MRI evaluation of soft tissue sarcomas

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e21523 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e21523-e21523

Author(s):

N. Faizi ◽

R. Sharma ◽

S. Sharma ◽

S. Chandrashekhara ◽

N. K. Shukla ◽

...

Keyword(s):

Soft Tissue ◽

Subcutaneous Tissue ◽

Demographic Data ◽

Soft Tissue Sarcomas ◽

The Body ◽

Preoperative Imaging ◽

Joint Involvement ◽

Muscle Involvement ◽

Female Ratio ◽

Histopathological Findings

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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Surgical Management of Extremity and Truncal Sarcoma

10.2310/7800.16098 ◽

2017 ◽

Author(s):

Christina L Roland ◽

Janice N Cormier

Keyword(s):

Radiation Therapy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Treatment Approach ◽

Multidisciplinary Treatment ◽

Survival Rates ◽

Soft Tissue Sarcomas ◽

The Body ◽

Wide Resection ◽

Staging Surgery

Soft tissue sarcomas are a heterogeneous group of neoplasms that arise throughout the body, but most commonly in the extremity and trunk. A multidisciplinary treatment approach has resulted in local control rates exceeding 90% and 5-year survival rates exceeding 70%. For patients with localized soft tissue sarcoma, limb-sparing surgical resection is the mainstay of therapy, with radiation therapy and chemotherapy used as adjuncts to reduce local and distant recurrences. Amputation is reserved for patients with primary or recurrent tumors that cannot be grossly resected with a limb-sparing procedure and preservation of function, which should occur in less than 5% of patients. Most patients who die of soft tissue sarcoma die of metastatic disease, which becomes evident within 2 to 3 years of initial diagnosis in 80% of cases, highlighting the need for improved systemic therapy options and optimal treatment at the time of diagnosis. This review contains 13 figures, 4 tables and 53 references Key words: amputation, multimodality, radiation therapy, soft tissue sarcoma, staging, surgery, treatment, wide resection

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A case of marantic endocarditis with systemic emboli in a patient with metastatic soft tissue sarcoma

Case Reports in Internal Medicine ◽

10.5430/crim.v6n3p6 ◽

2019 ◽

Vol 6 (3) ◽

pp. 6

Author(s):

Daniel Alexander Reikher ◽

Mark Feldman

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Malignant Tumors ◽

Tissue Injury ◽

Clinical Manifestations ◽

Soft Tissue Sarcomas ◽

Mass Effect ◽

Metastatic Soft Tissue Sarcoma ◽

Rare Group ◽

Marantic Endocarditis

Clinical manifestations of cancer can be categorized as resulting from direct tissue injury from the primary tumor, distant metastatic spread, or aberrant biological activity, also known as a paraneoplastic syndrome. Soft tissue sarcomas are a rare group of malignant tumors of mesenchymal origin which typically present with direct tissue injury, exerting their harmful potential by compression and mass effect. We describe a rare case of an occult retroperitoneal soft tissue sarcoma presenting with marantic endocarditis. To date, there is a paucity of available medical literature relating sarcoma to marantic endocarditis.

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Surgical Management of Extremity and Truncal Sarcoma

10.2310/cgso.16098 ◽

2017 ◽

Author(s):

Christina L Roland ◽

Janice N Cormier

Keyword(s):

Radiation Therapy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Treatment Approach ◽

Multidisciplinary Treatment ◽

Survival Rates ◽

Soft Tissue Sarcomas ◽

The Body ◽

Wide Resection ◽

Staging Surgery

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Real-world data of a cohort of patients with soft tissue sarcoma in a single institution of Colombia.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e19259 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e19259-e19259

Author(s):

Luis Eduardo Pino ◽

Ivan Camilo Triana ◽

Aylen Vanessa Ospina Serrano ◽

Javier Segovia ◽

Diana Carolina Hennessey

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Real World ◽

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Soft Tissue Sarcomas ◽

Stage Iv ◽

University Hospital ◽

Single Institution ◽

Pleomorphic Sarcoma

e19259 Background: Soft Tissue Sarcomas (STS) are a group of neoplasm with huge histological diversity and biological behaviors. They have a low prevalence and lack of data, especially in Colombia where there is no specific report of this disease. The objective of this study is to describe clinical characteristics and outcomes of patients with soft tissue sarcoma at Fundación Santafe, a university hospital located in Bogotá. Methods: This is an observational study of a cohort of soft tissue sarcoma patients treated at a single institution with a follow-up of 4 years (2015 - 2019). Clinical, molecular and epidemiological variables were registered, and overall survival was calculated for stage IV sarcomas. For the survival analysis a Kaplan Meier model was used. Results: Twenty-four patients were included. The histologies reported were: Pleomorphic sarcoma 25.0%, Ewing's sarcoma 20.8%, liposarcoma 16.7%, chondrosarcoma 8.3%, leiomiosarcoma 8.3%, synovial sarcoma 8.3%, soft part alveolar sarcoma 8.3%, and dermatofibrosarcoma protuberans 4.3%. OSm for the whole stage IV group was: 30.22m, according to subtypes OSm was: Ewing's sarcoma 37.13 OSm, liposarcoma 11 OSm, chondrosarcoma 12.3 OSm. Only 3 of the cases (2 Ewing's sarcoma and 1 alveolar sarcoma) had multigenic platform information. In these cases, main mutations in BCL2, SOX9, SATB2 and TFE3 were described. In two of the cases PDL1 expression was done with a negative result ( < 1%) (pleomorphic sarcoma and Ewing's sarcoma). Ifosfamide and anthracyclines was the most frequent chemotherapy regimen used, but in two of the cases checkpoint inhibitors were initiated. Conclusions: This real-world cohort of STS have a similar clinical and epidemiological distribution to historic cohorts, but our OSm for Ewing's sarcoma stage IV is longer than reported, even with a case of complete remission after consolidation with autologous bone marrow transplant. Other histologies had a worse prognosis with a less than 12 m OSm. Genomic data were scarce and useless for directed therapies or immunotherapy as usual in STS. [Table: see text]

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Soft Tissue Sarcoma

10.1093/oso/9780190238667.003.0043 ◽

2017 ◽

Author(s):

Marianne Berwick ◽

Charles Wiggins

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Soft Tissue Sarcomas ◽

Relative Survival ◽

Major Complication ◽

The United States ◽

The Body ◽

Molecular Characteristics ◽

Relative Survival Rate ◽

Head Neck

Soft tissue sarcoma (STS) is a rare tumor, occurring in approximately one to four of every 100,000 individuals worldwide. Soft tissue sarcomas can form anywhere in the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissues around joints. They are most common in the head, neck, arms, legs, trunk, and abdomen. Prognosis is generally poor, with a relative survival rate of approximately 65% at five years, with little difference by race. Approximately 11,930 cases and 4,870 deaths from STS occurred in the United States in 2015. The etiology of STS is still poorly understood, which makes prevention of this relatively rare cancer difficult. A major complication in studying STS is the histologic diversity —more than 100 subtypes. Newer investigations are evaluating molecular characteristics and prognostic factors but continue to be hampered by a lack of standardized histology.

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