scholarly journals Difficulties in the diagnosis of soft tissue sarcomas

1970 ◽  
Vol 32 (2) ◽  
pp. 26-29
Author(s):  
R Jha
Keyword(s):  
Soft Tissue ◽  
Age Distribution ◽  
Age Groups ◽  
Soft Tissue Sarcomas ◽  
Vascular Tumor ◽  
University Teaching ◽  
Institute Of Medicine ◽  
Diagnostic Challenge ◽  
Study Results ◽  
Common Diagnosis

Introduction: Soft tissue tumors represent diagnostic challenge to general practicing pathologists because of overlap in morphologic features. The usual approach is to diagnose by presumed cell lineage. A major utility of immunohistochemistry is to identify a tumor being mesenchymal or nonmesenchymal and once mesenchymal lineage has been confirmed, histologic sub typing according to specific lineage may be achieved with help of lineage specific markers. Methods: The objective of this study was to analyse different types of soft tissue malignancies according to their type, site and age distribution, discuss the difficulties faced during morphologic examination and review the literature for role of ancillary techniques, particularly immunohistochemistry in diagnosing soft tissue sarcomas.All soft tissue malignancies reported from Tribhuvan University Teaching Hospital in three years period from April 2008 to March 2010 were included in the study. Results: Total 87 soft tissue malignancies were reported during study period. Most of these patients (58.6%) were male and the rest were female. These malignancies were found in all age groups. Youngest patient was newborn who was born with tongue mass and biopsy was performed on 13th day of life. However maximum numbers of tumors (41.4%) were seen in first two decades of life. Head and neck was the most common site .Rhabdomyosarcoma was the most common diagnosis. In 20 cases (23%) a definite opinion was not possible and vague terms like sarcoma, small round cell tumor, spindle cell malignancy, vascular tumor “likely” were used. Immunohistochemistry was advised in these cases. Conclusions: Only light microscopic examination of hematoxylin and eosin stained slide not sufficient at all times because there is morphologic overlap of soft tissue sarcomas with each other and with carcinomas and melanomas. Though immunohistochemistry is not a substitute for skilled interpretation of routinely stained slides but prove helpful to reach a more definite diagnosis. Keywords: Immunohistichemistry; sarcoma; soft tissue DOI: http://dx.doi.org/10.3126/joim.v32i2.4941 Journal of Institute of Medicine, August, 2010; 32: 26-29

scholarly journals Epidemiology of Primary Malignant Bone Tumors in Isfahan Province, Iran

2019 ◽  
Vol 6 (4) ◽  
pp. 7-12
Author(s):  
Hossein Akbari Aghdam ◽  
◽  
Azin Mohammad-Salehi ◽  
Hamed i Zandi-esfahan ◽  
Mohsen Heidari ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Age Groups ◽  
Soft Tissue Tumors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Isfahan Province ◽  
Medical Centers ◽  
Study Results ◽  
Epidemiological Characteristics

Background: Primary malignant tumors, including rare tumors of the skeleton, are of concern. However, the unpredictable prognosis, morbidity, and mortality of these tumors have raised them as one of the health problems. Objectives: This study was designed to evaluate the epidemiological characteristics of these tumors in Isfahan province, Iran. Methods: In this cross-sectional study, 489 patients with malignant bone and soft tissue tumors were enrolled from 2006 to 2016. Their data were available in Isfahan medical centers, and their diagnostic biopsies from their hospitals’ records were examined. The data were statistically analyzed using SPSS. Results: The most common tumors were in the descending order: Osteosarcoma (15.1%), Ewing sarcoma (13.7%), chondrosarcoma (13.1%), fibrosarcoma and neurofibrosarcoma (10.8%), malignant fibrous histiocytoma (7.8%), synovial sarcoma (6.7%), liposarcoma (6.5%), dermatofibrosarcoma (3.3%), rhabdomyosarcoma (3.1%), and leiomyosarcoma (3.1%). Other sarcomas comprised 16.8%. The highest prevalence of tumors was in Isfahan city. Conclusion: This study was conducted for the first time in Isfahan Province to evaluate the epidemiological characteristics of malignant bone and soft tissue tumors. Our study results were similar to most studies conducted in different regions of the world. Considering the relatively high prevalence of malignant bone and soft tissue tumors in lower age groups, we recommend further studies in this area to manage this problem.

scholarly journals Pediatric Discharges Against Medical Advice: A Review of Cases in Ado-Ekiti, Nigeria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Adefunke Olarinre Babatola ◽  
Oladele Simeon Olatunya ◽  
Ezra Olatunde Ogundare ◽  
Ayotunde Emmanuel Ajibola ◽  
Temitope Olumuyiwa Ojo ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Age Groups ◽  
Complete Information ◽  
Relevant Information ◽  
Medical Advice ◽  
University Teaching ◽  
State University ◽  
Cross Sectional ◽  
Against Medical Advice ◽  
Common Diagnosis

Background: Knowledge of the profile of pediatric discharge against medical advice (DAMA) may help design interventions to reduce its prevalence. Objectives: This study aimed to assess the profile of pediatric DAMA at Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Ekiti State, Nigeria. Methods: This retrospective cross-sectional descriptive study included all pediatric cases of DAMA from January 2012 to December 2018. Relevant information was extracted from the patients’ case notes. Data was analyzed using the statistical package for social sciences (SPSS) version 23. Results: The overall prevalence of pediatric DAMA was 3.8%. Of the 233 pediatric DAMA with complete information, 127 (54.5%) were males. Severe malaria (27.3%) was the most common diagnosis among DAMA cases at the children emergency ward (CEW), while severe perinatal asphyxia (25.0%) and neonatal sepsis (25.0%) were the most common at the special care baby unit (SCBU). Only 1 (0.4%) patient was enrolled in the National Health Insurance Scheme (NHIS). Moreover, 43 (18.5%) parents took DAMA due to financial constraints, and 55% of the patients had their DAMA form signed by their fathers. In addition, among the patients who referred for follow-up, 11 (4.7%) patients fully recovered, 2 (0.8%) recovered with disability, 1 (0.4%) was readmitted, and 1 (0.4%) died. The highest and lowest DAMA rates were in the months of May and December, respectively. Patients aged under five years old who took DAMA significantly had infectious diseases compared to older age groups (P

Histological types of soft-tissue sarcomas at the lagos university teaching hospital

2017 ◽  
Vol 24 (4) ◽  
pp. 205 ◽  
Author(s):  
NzechukwuZimudo Ikeri ◽  
AndreaOludolapo Akinjo ◽  
OlugbendeO Ajayi ◽  
AdekunbiolaAina Fehintola Banjo
Keyword(s):  
Soft Tissue ◽  
Teaching Hospital ◽  
Soft Tissue Sarcomas ◽  
University Teaching ◽  
Histological Types

Descriptive Epidemiology and Outcomes of Soft Tissue Sarcomas in Adolescent and Young Adult Patients in Japan

2020 ◽  
Author(s):  
Takashi Fukushima ◽  
Koichi Ogura ◽  
Toru Akiyama ◽  
Katsushi Takeshita ◽  
Akira Kawai
Keyword(s):  
Multivariate Analysis ◽  
Young Adult ◽  
Prognostic Factor ◽  
Soft Tissue ◽  
Cancer Survival ◽  
Survival Rates ◽  
Age Groups ◽  
Soft Tissue Sarcomas ◽  
Adolescent And Young Adult ◽  
Peripheral Nerve Sheath Tumors

Abstract Background: Compared to young children or older adults, the prognoses of adolescent and young adult (AYA) patients with cancer, i.e., those aged from 15 to 39 years, have not improved. In this study, we focused on soft tissue sarcoma (STS) in AYA patients and aimed to determine whether there is a correlation between the AYA age group and overall poor cancer survival in STS. We further aimed to determine which histologic subtypes are more common in AYA patients and investigate the cause of poor outcomes in this group.Methods: The medical records of 5853 Japanese patients diagnosed with STS between 2006 and 2013 were accessed from the Bone and Soft Tissue Tumor registry (BSTT). We analyzed and compared the epidemiological features of AYA patients with those of other age groups. The cancer survival rates were calculated using the Kaplan-Meier method. Cox proportional hazards models were used to analyze the prognostic factors for cancer survival. The primary endpoint for prognosis was the occurrence of tumor-related death.Results: On multivariate analysis, age was not a prognostic factor for poor cancer survival among these patients. Compared to the same categories in other age groups, the proportions of myxoid/round cell liposarcomas, synovial sarcomas, malignant peripheral nerve sheath tumors (MPNST), primitive neuroectodermal tumor, and rhabdomyosarcoma in AYA patients were the highest, but none of the categories were significantly more prevalent in AYA patients. The cancer survival rates of AYA patients with MPNST were poorer than those of the other age groups; however, AYA age was not a prognostic factor on multivariate analysis in MPNST patients.Conclusions: Our study is the first to investigate STS in AYA patients using the nationwide BSTT registry. Our findings demonstrate that AYA age is not a prognostic factor for poor cancer survival among those with STS in Japan.

scholarly journals Testicular, Spermatic Cord, and Scrotal Soft Tissue Sarcomas: Treatment Outcomes and Patterns of Failure

Sarcoma ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Varun K. Chowdhry ◽  
John M. Kane ◽  
Katy Wang ◽  
Daniel Joyce ◽  
Anne Grand’Maison ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Metastatic Disease ◽  
Spermatic Cord ◽  
Preoperative Radiotherapy ◽  
Specific Treatment ◽  
Soft Tissue Sarcomas ◽  
Treatment Patterns ◽  
Study Results ◽  
Localized Disease

Introduction. Paratesticular sarcomas are defined as tumors that arise within the scrotum and include the subsites of epididymis, spermatic cord, and tunica vaginalis and represent the most common type of GU sarcoma. The mainstay of treatment is often surgical resection, combined with histology specific chemotherapy and radiotherapy. Due to the rare nature of the disease, there are limited data to guide management. We present our single-institution retrospective experience regarding the management and treatment of paratesticular sarcomas. Materials and Methods. We queried our oncology registry database for patients treated for testicular, spermatic cord, and scrotal soft tissue sarcomas between 1971 and 2017. Patients in this series had pathological confirmation of a sarcoma diagnosis by a sarcoma-specialized pathologist. Only patients with localized disease were included in this analysis with the exception of patients with a diagnosis of rhabdomyosarcoma where patients with both localized and metastatic disease were included on this study. Results. A total of 34 patients were included in this retrospective analysis. The median was 24 (range, 5–78), and the median tumor size was 6.25 cm. Twenty-six patients had localized disease (76.6%) at the time of diagnosis. A predominance of patients had tumors involving the spermatic cord (45.5%), and the most common histology was rhabdomyosarcoma (35.3%), leiomyosarcoma (26.5%), and well-differentiated liposarcoma (23.5%). The median follow-up was 71.0 months (range, 2.5–534.4 months). A total of 7 patients experienced an isolated local failure (20.6%), four patients developed distant metastatic disease (11.8%), and one patient (2.9%) with synovial sarcoma of the spermatic cord experienced a regional recurrence. The median progression-free survival (PFS) was 99.6 months, 95% CI (45.8–534.3 months), with a three-year PFS rate of 71%, 95% CI (53%–83%), and a 5-year PFS rate of 64% (range, 46%–78%). We did not find any statistically significant associations based on surgery type ( p = 0.15 ), the use of chemotherapy, ( p = 0.36 ), or final margin status ( p = 0.21 ). Two patients who were treated with preoperative radiotherapy had significant wound healing complication with chronic sinus tracts, though these patients did not experience a local recurrence. Conclusions. We provide a characterization of the natural history and treatment patterns of paratesticular sarcomas. While effective at reducing a local recurrence, preoperative radiotherapy was associated with significant toxicity. As a result, we prefer the use of postoperative radiotherapy in patients as clinically indicated. We did not find any specific treatment patterns associated with an improvement in clinical outcomes.

scholarly journals Fine needle aspiration cytology of cystic lesions of head and neck

2018 ◽  
Vol 8 (2) ◽  
pp. 1360-1364 ◽  
Author(s):  
Narendra Bhattarai ◽  
Akanksha Kushwah
Keyword(s):  
Head And Neck ◽  
Cost Effective ◽  
Needle Aspiration ◽  
University Teaching ◽  
Epidermal Cyst ◽  
Anatomical Site ◽  
Tuberculous Lymphadenitis ◽  
Cystic Lesions ◽  
Institute Of Medicine ◽  
Common Diagnosis

Background: Many non-neoplastic and neoplastic lesions are encountered as cystic lesions of head and neck depending on the patient’s age and anatomical site. Value of FNAC in preoperative diagnosis of these lesions has been established in various study.Materials and Methods: The study was performed in 333 patients that presented as cystic lesions of head and neck at Department of Pathology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal from July 2013 to June 2014.RESULTS: Cystic lesions in head and neck accounted for 11.35% of all FNACs. The median age of the patients was 31 years and the majority of the patients were in the age group of 21-30 years with slight female predilection. Lateral neck was the most common site with lymph node (31.9%) the most common organ of involvement. Tuberculous lymphadenitis was the most common diagnosis with 21% of cases, followed by colloid goiter with cystic change and epidermal cyst. Pus was the most common aspiration finding. Sensitivity and specificity of FNAC in diagnosing malignancy was 83.3% and 100% respectivelyCONCLUSION: A significant number and wide variety of lesions present as cystic lesions of head and neck. FNAC is useful and cost effective tool to classify, diagnose and rule out malignancy in these cases.

scholarly journals 1352. Pediatric azithromycin prescriptions in a healthcare system from 2016-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S686-S687
Author(s):  
Skylar Petrone ◽  
Lisa Garavaglia ◽  
Shipra Gupta
Keyword(s):  
Otitis Media ◽  
Treatment Guidelines ◽  
Age Distribution ◽  
Age Groups ◽  
Acute Otitis Media ◽  
Urgent Care ◽  
Outpatient Clinics ◽  
Age Group ◽  
Common Diagnosis ◽  
History Of

Abstract Background In 2017, the Centers for Disease Control and Prevention (CDC) estimated that 30% of all antibiotics prescribed in outpatient clinics are unnecessary, with children receiving more antibiotics than any other age group. Among those antibiotics being prescribed, azithromycin is one of the most commonly prescribed antibiotics. Methods We reviewed antimicrobial prescribing data of children 0 to 19 years of age who visited West Virginia University (WVU) Health system which is the flagship institution for the state. We reviewed information of patients who were prescribed azithromycin by healthcare providers between January 2016 and December 2018. We included prescribing data from urgent care centers, outpatient clinics and emergency departments. The primary visit diagnosis associated with the visit was reviewed. Results During the study period there were 29,983 visits identified during which antibiotics were prescribed and azithromycin was prescribed in 40.6% of those visits. The majority of visits occurred between the months of October through February (54.4%), with December having the most visits. There were 11,934 unique patients identified and only 26.5% of these patients were marked as allergic to penicillin (PCN) or amoxicillin. The distribution of the age groups for azithromycin prescriptions is shown in figure 1. The age group of 11-19 years had the highest azithromycin prescription rate (38.7%) and the most common diagnosis for this group was pharyngitis. The distribution of the common diagnoses associated with azithromycin prescriptions can be seen in figure 2 and acute otitis media (AOM) was the most common diagnosis (23.6%). Figure 1- Age distribution of children who received azithromycin prescriptions during the study period Figure 2- Distribution of diagnoses associated with azithromycin prescriptions Conclusion Acute otitis media and pharyngitis accounted for almost half of the diagnoses associated with azithromycin prescriptions. Treatment guidelines for both conditions recommend PCN-based therapy as first-line treatment unless there is a history of PCN allergy. Only a quarter of the patients had allergy documented to PCN or amoxicillin and, therefore, azithromycin would be considered a suboptimal antimicrobial choice. These results provide us with a stewardship opportunity to nudge providers to select appropriate antimicrobial based on diagnosis and history of allergy. Disclosures All Authors: No reported disclosures

Evaluation of Myogenin and MyoD1 as Immunohistochemical Markers of Canine Rhabdomyosarcoma

2021 ◽  
Vol 58 (3) ◽  
pp. 516-526
Author(s):  
Joanne L. Tuohy ◽  
Brittney J. Byer ◽  
Suzanne Royer ◽  
Charles Keller ◽  
Margaret A. Nagai-Singer ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Soft Tissue ◽  
Clinical Outcomes ◽  
Soft Tissue Sarcomas ◽  
Biological Behavior ◽  
Diagnostic Challenge ◽  
Histological Features ◽  
Immunohistochemical Markers ◽  
Ihc Markers

Canine rhabdomyosarcoma (RMS) presents a diagnostic challenge due to its overlapping histologic features with other soft tissue sarcomas. The diagnosis of RMS currently relies on positive immunohistochemical (IHC) labeling for desmin; however, desmin expression is also observed in non-RMS tumors. Myogenin and MyoD1 are transcription factors reported to be sensitive and specific IHC markers for human RMS, but they are not widely used in veterinary oncology. The goals of this study were to develop an IHC protocol for myogenin and MyoD1, evaluate myogenin and MyoD1 labeling in canine RMS, and report clinical outcomes. Sixteen cases of possible RMS were retrospectively evaluated. A diagnosis of RMS was confirmed in 13 cases based on histological features and immunolabeling for myogenin and MyoD1, with the aid of electron microscopy in 2 cases. Desmin was negative in 3 cases of RMS. Two cases were of the sclerosing variant. The median age of dogs with RMS was 7.2 years. Anatomic tumor locations included previously reported sites such as bladder, larynx, heart, and orbit, as well as other locations typical of soft tissue sarcomas. Survival ranged from 47 to 1480 days for 5 dogs with available data. This study demonstrated that MyoD1 and myogenin should be included with desmin as part of a diagnostic IHC panel for canine RMS. Utilization of these antibodies to improve the accuracy of canine RMS diagnosis will ultimately allow for better characterization of the biological behavior and clinical outcomes of this disease, providing the groundwork for future comparative investigations in canine RMS.

scholarly journals Soft tissue leiomyosarcoma—diagnostics, management, and prognosis: Data of the registry cancer of the center of Tunisia

Rare Tumors ◽  
2019 ◽  
Vol 11 ◽  
pp. 203636131882017 ◽  
Author(s):  
Sarra Mestiri ◽  
Mohamed Amine Elghali ◽  
Rym Bourigua ◽  
Nihed Abdessayed ◽  
Salsabil Nasri ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
Lower Limbs ◽  
University Hospital ◽  
Treatment Modalities ◽  
Male Predominance ◽  
Pathologic Features ◽  
Study Results ◽  
Average Size

Background: Soft tissue leiomyosarcomas are rare, accounting for almost 5%–10% of all soft tissue sarcomas; they account for almost 1% of all sarcomas. They are aggressive tumors where location, size, and management require a multidisciplinary approach. Since there are few series published, we here analyze epidemiological pattern, clinical and pathologic features of soft tissue leiomyosarcomas. Methods: We conducted a retrospective study of 29 consecutive cases of histologically proven soft tissue leiomyosarcoma extracted from the database of the Cancer Registry of the Center of Tunisia and the Department of Pathology of Farhat Hached University Hospital of Sousse of Tunisia, during a 10-year period (from January 1996 to December 2005). Epidemiologic details, clinico-pathological features, and treatment modalities were assessed with focus on patients’ 5-year overall survival, tumor relapse, and metastases. Results: Soft tissue leiomyosarcoma accounted for 17.5% of all soft tissue sarcomas diagnosed at our pathology department. Most of patients were of advanced age (median: 52 years), with extremes ranging from 12 and 87 years. There was a slight male predominance (sex-ratio = 1.07). Tumors were located mostly in the lower limbs (45%). Deep sites as retroperitoneum was found only in two cases. Tumor size was more than 5 cm in 83% of cases (average size = 9.4 cm). Five cases had metastasis on initial staging. For 24 patients, the disease was locally limited at the moment of diagnosis. Palliative chemotherapy was indicated for four patients and surgery was performed for 20 patients. Local recurrence occurred in 11 patients (55% of operated patients) and metastasis in 6 patients. Overall, 5-year survival was about 24%. Conclusion: Our study results highlight the scarcity of soft tissue leiomyosarcoma. Unfortunately, unusual tumor sites, disease’s advanced stages, and intralesional resection made the prognosis poorer than in other series. Clinical course of soft tissue leiomyosarcoma was highly marked by local recurrence and metastasis.

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