scholarly journals Soft Tissue Sarcomas - Series of Cases in One Surgical Department

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 50
Author(s):  
R.V. Costea ◽  
N. Zărnescu ◽  
A. Chirca ◽  
O. Rusu ◽  
S. Neagu
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Soft Tissue Sarcomas ◽  
Operative Therapy ◽  
Predictive Biomarkers ◽  
Tumor Type ◽  
Total Excision ◽  
Surgical Department ◽  
Safety Margins

Abstract Introduction. Soft tissue sarcomas (STS) are a heterogeneous group of tumors with over 80 different subtypes that account for approximately 1-2% of adult malignancies. Primary sarcomas arise from a variety of soft tissues and bone, and include fibrous connective, fat, and smooth, or striated muscle, vascular, peripheral neural and visceral tissue. With difficulties in establishing cell origin and pathogenesis, this condition lacks an effective and durable therapy with no predictive biomarkers and rapid diagnosis. Materials and methods. We reviewed the cases of 21 patients treated in our clinic for soft tissue sarcoma over a 20-year period (1999-2018). We extracted the following information from each patient’s medical record: disease status at presentation, histological diagnosis, American Joint Committee on Cancer staging, surgical procedure, oncological outcome, length of hospitalization, and follow-up information. Results. All 21 patients (14 males and 7 females, aged between 19 and 88 years) underwent surgery and total excision with safety margins was performed with histopathological confirmation stating the tumor type and subtype. Some samples required immunohistochemistry for subtype differentiation. Chondrosarcoma and myosarcoma were the most common (5 patients). 8 patients presented local recurrence and metastatic disease with 6 cases receiving adjuvant chemotherapy. Only one patient presented for the 5-year follow-up. Conclusions. STS are a rare group of tumors with poor outcome with surgical treatment being represented by total excision. We chose to present our clinic’s experience to highlight the need for post-operative therapy advancements and to raise awareness on the difficulties in managing these cases.

scholarly journals Popliteal Fossa Sarcomas

2021 ◽  
Author(s):  
Ozgur Erdogan ◽  
Aykut Çelik ◽  
Ertuğrul Tekçe ◽  
Güray Altun ◽  
Korhan Ozkan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
Popliteal Fossa ◽  
Tumor Type ◽  
Fusiform Cell ◽  
Positive Margins ◽  
Large Patient ◽  
The Mean

Abstract Background and Aim: Soft tissue sarcomas of the popliteal fossa are extremely rare tumors of mesenchymal origin accounting for 3%–5% of all extremity sarcomas. However, data regarding the tumor type, neurovascular involvement, and administration of radiation therapy before or after resection are limited. This study aimed to report on popliteal fossa sarcomas analyzing data from two institutions based on a relatively large patient sample.Materials and Method: Twenty-four patients (80%; 9 men and 15 women) with a popliteal fossa soft tissue sarcoma were included in this study. The reviewed patient data included sex, age, duration of complaints, interval to diagnosis, radiology, pre- and postoperative biopsy, tumor histology, surgery type, complications, and pre- and postoperative oncologic and functional outcomes.Results: The mean age of the patients was 48 ± 21.23 (range 3–72) years at the time of diagnosis. The most common histological diagnoses were synovial sarcoma (6 patients), hemangiopericytoma (2 patients), soft tissue osteosarcoma (2 patients), fusiform cell sarcoma (2 patients), and myxofibrosarcoma (2 patients). Local recurrence after limb salvage was observed in six patients (25%). At the latest follow-up, 2 patients died of the disease, 2 patients were still alive with progressive lung disease and soft tissue metastasis, and the remaining 20 patients were free from the disease.Conclusions: Microscopically positive margins may not be an absolute indication for amputation. Also, negative margins do not provide a guarantee that local recurrence will not occur. Lymph node or distant metastasis may be predictive factors for local recurrence rather than positive margins.

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.

Flap Reconstruction of Sarcoma Defects in the Setting of Neoadjuvant and Adjuvant Radiation

2018 ◽  
Vol 35 (04) ◽  
pp. 287-293 ◽  
Author(s):  
Rohini Kadle ◽  
Catherine Motosko ◽  
George Zakhem ◽  
John Stranix ◽  
Timothy Rapp ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Radiation Treatment ◽  
Soft Tissue Sarcomas ◽  
Adjuvant Radiation ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Fasciocutaneous Flaps ◽  
Musculoskeletal Tumor Society

Background Limb-sparing treatment of extremity soft tissue sarcomas requires wide resections and radiation therapy. The resulting complex composite defects necessitate reconstructions using either muscle or fasciocutaneous flaps, often in irradiated wound beds. Methods A retrospective chart review was performed of all limb-sparing soft tissue sarcoma resections requiring immediate flap reconstruction from 2012 through 2016. Results Forty-four patients with 51 flaps were identified: 25 fasciocutaneous and 26 muscle-based flaps. Mean defect size, radiation treatment, and follow-up length were similar between groups. More often, muscle-based flaps were performed in younger patients and in the lower extremity. Seventeen flaps were exposed to neoadjuvant radiation, 12 to adjuvant radiation, 5 to both, and 17 to no radiation therapy. Regardless of radiation treatment, complication rates were comparable, with 28% in fasciocutaneous and 31% in muscle-based groups (p < 0.775). Muscle-based flaps performed within 6 weeks of undergoing radiotherapy were less likely to result in complications than those performed after greater than 6 weeks (p < 0.048). At time of follow-up, Musculoskeletal Tumor Society scores for fasciocutaneous and muscle-based reconstructions, with or without radiation, showed no significant differences between groups (mean [SD]: 91% [8%] vs. 89% [13%]). Conclusion The similar complication rates and functional outcomes in this study support the safety and efficacy of both fasciocutaneous flaps and muscle-based flaps in reconstructing limb-sparing sarcoma resection defects, with or without radiotherapy.

scholarly journals How Can a Multidisciplinary Approach Improve Prognosis of Soft-Tissue Sarcomas of Extremities?

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Asmae Mazti ◽  
Mohamed El Idrissi ◽  
Abdelhalim El Ibrahimi ◽  
Mustapha El Maaroufi ◽  
Ghizlane El Koubaiti ◽  
...  
Keyword(s):  
Survival Rate ◽  
Soft Tissue ◽  
Malignant Tumors ◽  
Research Work ◽  
Soft Tissue Sarcomas ◽  
University Hospital ◽  
R0 Resection ◽  
Magnetic Resonance Imaging Scan ◽  
Tumor Type ◽  
Multidisciplinary Meeting

Soft-tissue sarcomas are malignant tumors that require good management within specialized centers. Our study aims to assess the benefit of handling these kinds of tumors using the Multidisciplinary Meeting (MDM) approach. The current paper details this approach through a prospective study that has lasted for 42 months in the HASSAN II University Hospital Center, Fez, Morocco. During this research work, 116 cases were selected with an average age of 53 years. In 95.7% of the cases, it was found that the lower limb was the most frequent tumor type (78.4%). Also, ninety-two (92) patients (79.3%) have had a prior biopsy. Ninety-nine (99) patients (85.3%) have received a magnetic resonance imaging scan (MRI) before surgery. Sixty-three (63) patients were operated on, including R0 resection used for 37 patients, R1 used for 21 patients, and R2 used for five patients. As a result, liposarcomas were the most frequent type (30.1%), followed by synovial sarcomas (14.6%), leiomyosarcomas (9.5%), ewing sarcoma (8.6), and undifferentiated pleomorphic sarcomas (7.7%). In addition, neoadjuvant chemotherapy was used for 36 patients. The other 22 patients received adjuvant chemotherapy and/or radiotherapy. The overall survival rate was 60.56 months, which proves a significant improvement, thanks to the multidisciplinary meeting approach. Conclusion. The conducted investigation has shown that using MDM for managing soft-tissue sarcomas of extremities improves the patients’ survival rate. Moreover, results have proven MDM might allow optimal treatment regarding less local recurrence and metastasis.

Perioperative blood transfusions are associated with increased rates of recurrence and decreased survival in patients with high-grade soft-tissue sarcomas of the extremities.

1985 ◽  
Vol 3 (5) ◽  
pp. 698-709 ◽  
Author(s):  
S A Rosenberg ◽  
C A Seipp ◽  
D E White ◽  
R Wesley
Keyword(s):  
Soft Tissue ◽  
Tumor Recurrence ◽  
Soft Tissue Sarcomas ◽  
Primary Lesion ◽  
Blood Transfusions ◽  
Tumor Type ◽  
High Grade ◽  
Anatomic Site ◽  
The Impact ◽  
Disease Free

One hundred fifty-six patients with high-grade soft-tissue sarcomas of the extremities treated on prospective randomized trials were analyzed to determine the impact of perioperative blood transfusions on tumor recurrence and patient survival. A significant increase in the incidence of tumor recurrence and decrease in survival were associated with the receipt of blood transfusions at the time of definitive surgical therapy of the sarcoma. Actuarial 5-year continuous disease-free survival was 70% in patients who had not been transfused compared to 48% in patients who received one or more transfusions (P = .007). Overall 5-year survival was also substantially decreased in patients receiving transfusions (85% compared to 63%; P = .0035). A direct relationship existed between the number of transfusions administered and the decrease in disease-free and overall survival; the larger the number of transfusions the worse the prognosis (P less than .0001 and P = .0001, respectively). A large number of other prognostic factors were included in the analysis including the age, sex, race of the patient, histology of the primary lesion, anatomic site of the primary lesion, final surgical margins, size of the tumor, type of surgery required, the use of chemotherapy, actual time in the operating room under anesthesia, the exact anesthetic agent used, and the individual surgeon who performed the operation. Accounting for all of these factors a strong association continued to exist between the receipt of blood transfusion and poor patient prognosis. We have previously shown that adjuvant chemotherapy is of benefit to patients with high-grade extremity sarcomas, and 132 (84.6%) of 156 patients in this series received chemotherapy. In patients receiving chemotherapy, blood transfusions were associated with increased recurrence (P less than .0001) and decreased survival (P = .0001). The only other significant independent prognostic variable in these patients was the size of the primary tumor. An analysis of all patients, stratified for tumor size, revealed an impact of transfusions on increasing recurrence (P = .007) and decreasing survival (P = .016). An analysis of the subpopulation of patients with large tumors (greater than 150 mL) gave the same results (P = .03 and .015, respectively). It thus appears that the receipt of blood transfusions is associated with increased tumor recurrence and decreased survival in patients with high-grade soft-tissue sarcomas of the extremities.(ABSTRACT TRUNCATED AT 400 WORDS)

scholarly journals PEComa of soft tissues can mimick lymph node relapse in patients with history of testicular seminoma

2013 ◽  
Vol 7 (9-10) ◽  
pp. 651 ◽  
Author(s):  
Gabriele Guglielmetti ◽  
Paolo De Angelis ◽  
Paolo Mondino ◽  
Carlo Terrone ◽  
Alessandro Volpe
Keyword(s):  
Lymph Node ◽  
Soft Tissue ◽  
Soft Tissues ◽  
Percutaneous Biopsy ◽  
Surgical Excision ◽  
Pelvic Lymphadenectomy ◽  
Adjuvant Radiation ◽  
Soft Tissue Neoplasm ◽  
Testicular Seminoma

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.

scholarly journals A rare case of paratesticular leiomyosarcoma

2012 ◽  
Vol 2 (1) ◽  
pp. 29 ◽  
Author(s):  
James Moloney ◽  
John Drumm ◽  
Deirdre M. Fanning
Keyword(s):  
Soft Tissue ◽  
Adjuvant Radiotherapy ◽  
Spermatic Cord ◽  
Soft Tissue Sarcomas ◽  
Solid Mass ◽  
Urological Malignancies ◽  
History Of ◽  
To Receive ◽  
Groin Swelling

Soft-tissue sarcomas of the genitourinary tract account for only 1-2% of urological malignancies and 2.1% of soft-tissue sarcomas in general. A 69-year-old male complained of a 4 month history of a painless right groin swelling during routine urological review for prostate cancer follow-up. Clinical examination revealed a non-tender, firm right inguinoscrotal mass. There was no discernible cough impulse. Computed tomography of abdomen and pelvis showed a non-obstructed right inguinal hernia. During elective hernia repair a solid mass involving the spermatic cord and extending into the proximal scrotum was seen. The mass was widely resected and a right orchidectomy was performed. Pathology revealed a paratesticular sarcoma. He proceeded to receive adjuvant radiotherapy. Only around 110 cases of leiomyosarcoma of the spermatic cord have been described in the literature. They commonly present as painless swellings in the groin. The majority of diagnoses are made on histology.

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