Primary stromal sarcoma of breast: A case report and literature review

2021 ◽  
pp. 1-7
Author(s):  
Mohammad Al-Wiswasy ◽  
Mahmoud Al-Balas ◽  
Raith Al-Saffar ◽  
Hamzeh Al-Balas
Keyword(s):  
Malignant Tumors ◽  
Histopathological Examination ◽  
Prognostic Significance ◽  
Total Duration ◽  
Young Patients ◽  
Soft Tissue Sarcomas ◽  
Breast Mass ◽  
Resection Margins ◽  
Stromal Sarcoma ◽  
First Case

INTRODUCTION: Primary breast sarcoma (PBS) was first described in 1887 as a rare heterogeneous neoplasm arising from the mesenchymal tissue of the mammary gland accounting for less than 5% of all body soft-tissue sarcomas and less than 0.1% of all malignant tumors of the breast. CASE PRESENTATION: A 31-year old lady presented with left breast mass which she felt four years before during which the mass increased in size from 1 to 6 cm in the largest diameter, diagnosed clinically as a benign fibroadenoma without any further cytological or histopathological confirmation. Histopathological examination of the excised breast mass reveals undifferentiated, primary stromal sarcoma of the breast (PSSB), which was followed by mastectomy three weeks later with reconstructive breast surgery with a total duration of follow-up of 3 years thereafter. This is the first case of PSSB reported in Jordan. DISCUSSION/CONCLUSION: PSSB is the generic term given to malignant breast tumors thought to arise from the specialized mesenchymal stroma of the breast but lacking an epithelial component with a phylloides pattern. PSSB is difficult to diagnose preoperatively due to its rarity and inadequate imaging methods to establish an exact diagnosis. The histology of the patient mass may be the leading factor for the management of these tumors. Even in very young patients, a progressively growing breast mass should alert the clinician to investigate for malignancy and verify the results by biopsy. Surgery with adequate resection margins represents the only potentially curative modality with prognostic significance. Adjuvant chemotherapy and radiotherapy are not very beneficial. The prognosis is dismal for patients with lymph node involvement and the size of the tumor has a lesser bearing on the outcome.

scholarly journals Endometrial Stromal Nodule: A Rarity and a Pathological Challenge

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Camilla Skovvang Borg ◽  
Peter Humaidan ◽  
Hanne Noer ◽  
Huda Galib Majeed
Keyword(s):  
Malignant Tumors ◽  
Histopathological Examination ◽  
Pathological Examination ◽  
Diagnostic Tools ◽  
Stromal Tumors ◽  
Tumor Margins ◽  
Stromal Sarcoma ◽  
Preoperative Diagnostic ◽  
Endometrial Sarcoma ◽  
Endometrial Stromal Tumors

Endometrial stromal tumors are rare, and endometrial stromal nodule is the least common. In the region of Middle Jutland, Denmark, only two cases are reported since 1995. The nodules are benign; nevertheless, hysterectomy is the treatment of choice. Tumor margins are required for diagnosis and essential to differentiate it from an invasive stromal sarcoma whose prognosis is very different. We report a rare case of a 38-year-old woman, with presurgical diagnosis of a uterine tumor/polyp. She presented with nausea and changes in bleeding pattern and initially had a transcervical polyp resection performed. Histopathological examination showed the presence of an endometrial stromal tumor with unclear margins, and an invasive malignant endometrial sarcoma could not be excluded. Pathological examination revealed an endometrial stromal nodule with invasion, not exceeding three mm. Endometrial stromal tumors are interesting due to their rare existence and difficulties in establishing a histological diagnosis. Although endometrial stromal nodules are benign entities, they must be differentiated from the other invasive malignant stromal tumors, which may change the final prognosis. No preoperative diagnostic tools are at hand, and benign as well as malignant tumors are treated with hysterectomy.

scholarly journals Tumor Associated Macrophages-Friends Turned Foe? A Case Report and Review of Literature

2012 ◽  
Vol 11 (2) ◽  
pp. 139-142
Author(s):  
Zeeba Shamim Jairajpuri ◽  
Usha Agarwal
Keyword(s):  
Breast Carcinoma ◽  
Malignant Tumors ◽  
Medical Science ◽  
Prognostic Significance ◽  
Inflammatory Cells ◽  
Tumor Associated Macrophages ◽  
First Case ◽  
Large Numbers ◽  
Tertiary Center ◽  
Pathological Evaluation

Most malignant tumors are infiltrated by inflammatory cells and it has long been considered that such infiltrates may be evidence of a host response to the tumor. Although lymphocytes are prominent in the inflammatory infiltrate, macrophages are also present, often in considerable numbers. Breast carcinoma is one such tumor where tumor associated macrophages (TAM) have been reported to be widespread, more so in Western literature. There is paucity of information about the biological and prognostic significance of this phenomenon in India. Ours is a tertiary center which receives approximately100 to120cases of breast carcinoma for pathological evaluation annually. Here we report the first case in our experience which showed large numbers of macrophages infiltrating the stroma around the tumor cells.DOI: http://dx.doi.org/10.3329/bjms.v11i2.8928 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 139-142

The First Case Report of a Metastatic Myxoid Liposarcoma Invading the Left Atrial Cavity and Pulmonary Vein

2011 ◽  
Vol 14 (4) ◽  
pp. 261 ◽  
Author(s):  
Umuttan Dogan ◽  
Adil Zamani ◽  
Niyazi Gormus ◽  
Yahya Paksoy ◽  
Mustafa Cihat Avunduk ◽  
...  
Keyword(s):  
Left Atrium ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Histopathological Examination ◽  
Soft Tissue Sarcomas ◽  
Myxoid Liposarcoma ◽  
Surrounding Tissue ◽  
Cardiac Metastasis ◽  
First Case ◽  
Patient Reported

Myxoid liposarcoma (MLS) is the most commonly encountered liposarcoma subgroup, accounting for about 50% of all cases. Metastatic MLS of the heart is extremely rare. Herein we describe for the first time metastasis of MLS to the left atrium and left upper pulmonary vein in a 54-year-old woman who was admitted with shortness of breath and cough persisting for 2 weeks. The patient reported that a total surgical excision of MLS of the left thigh followed by radiotherapy was performed 4 years ago. An emergency operation was performed due to rapidly progressive worsening of clinical condition and echocardiographic determination of left atrial mass protruding into the left ventricle and obstructing the mitral inflow throughout the diastole. The mass could not be totally excised because it was tightly adhered to the surrounding tissue. Postoperative magnetic resonance imaging (MRI) showed a 5 � 3 cm residual tumor deforming the posterior wall of the left atrium entirely and extending into the left upper pulmonary vein. Histopathological examination was consistent with MLS. In conclusion, considering probable cardiac metastasis in patients presenting with respiratory symptoms with medical history of soft tissue sarcomas would be life saving. The case is discussed, and a review of the literature in relation to the metastatic involvement of the heart by MLS is presented.

scholarly journals Synchronous Primary Ovarian and Endometrial Carcinomas in a Young PatientCase report and literature review

2020 ◽  
Vol 70 (12) ◽  
pp. 4360-4365
Keyword(s):  
Malignant Tumors ◽  
Histopathological Examination ◽  
Young Patients ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Abnormal Uterine Bleeding ◽  
Serum Levels ◽  
Cystic Tumors ◽  
Endometrioid Ovarian Carcinoma ◽  
Endometrial Carcinomas

Synchronous primary ovarian and endometrial carcinomas is a rare condition encountured in clinical practice, especially in young patients with history of endometriosis. The most frequent histopatological subtype is endometrioid carcinoma. We present a case of a 36-years old patient admitted in the Emergency Department for lower abdominal pain and abnormal uterine bleeding. The clinical and ultrasound examination diagnosed bilateral ovarian cystic tumors, a normal uterine structure and no abdominal fluid colection. Serum levels of ROMA score was performed with normal value. The International Ovarian Tumor Analysis (IOTA) criteria used for ovarian tumors scoring diagnosed a 55% probability for malignant tumors. Laparotomy was performed with prelevation of peritoneal fluid for citology. After right anexectomy was performed, the intraoperative histopathological examination diagnosed endometrioid ovarian carcinoma. Left anexectomy and total hysterectomy with omentectomy and multiple peritoneal biopsy was further performed. The final histopathological examination confirmed endometroid carcinoma in both ovaries and endometrial tissue. Keywords: synchronous genital carcinomas, endometrioid subtype, endometriosis

scholarly journals Preoperative Diagnosis Failure for a Rare Gastric Collision Tumor: A Case Report

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 633
Author(s):  
Rabie E. Elshaer ◽  
Eid R. Elgammal ◽  
Amr M. Elmistekawy ◽  
Walaa A. Ghannam ◽  
Ahmed E. Elshamy ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Malignant Tumors ◽  
Epigastric Pain ◽  
Benign Lesion ◽  
Partial Gastrectomy ◽  
Collision Tumor ◽  
Wide Resection ◽  
Resection Margins ◽  
Mesenchymal Tumors ◽  
First Case

Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors of the gastrointestinal tract (GIT), usually occur as a solitary neoplasm. Inflammatory florid polyp (IFP) is a solitary rare benign lesion of the gastrointestinal tract, mainly occur in the gastric antrum, whose atypical presentation can mimic GISTs or other malignant tumors, therefore the synchronous occurrence of GISTs and IFP is extremely rare. We had a case of a 58-year-old man that was presented with recurrent epigastric pain and recurrent melena. Upper endoscopic examination revealed a large polypoid antrum polyp measured 7 cm at greatest dimension with focal ulceration. Clinical and radiological features did not reach the definite diagnosis until histopathological evaluation with immunohistochemical analysis was performed. Surgical intervention is recommended and partial gastrectomy was done with wide resection margins. Histological examination revealed two distinct GISTs and IFP parts presenting a collision tumor that showed spindle and epitheloid cells consistent with GISTs with histological features of florid polyp showed a characteristic perivascular onion-skin arrangement of spindle cells with dense chronic inflammatory infiltrate including eosinophils and lymphocytes. Immunohistochemical studies have been done and revealed an association between GISTs and IFP. To the best of our knowledge, this is the first case of a collision tumor consisting of a GIST and an IFP arising in the stomach. In conclusion, the gastrointestinal stromal tumor is the comments mesenchymal tumor of GIT and IFP is a rare benign lesion of GIT therefore association between GIST and IFP as a collision tumor is extremely rare.

scholarly journals The changing paradigm of resection margins in sarcoma resection

2017 ◽  
Vol 2 (4) ◽  
pp. 165-170 ◽  
Author(s):  
Kamran Harati ◽  
Marcus Lehnhardt
Keyword(s):  
Surgical Resection ◽  
Strong Association ◽  
Locally Advanced ◽  
Prognostic Significance ◽  
Soft Tissue Sarcomas ◽  
The Body ◽  
Surgical Margins ◽  
Resection Margins ◽  
Prognostic Impact ◽  
Mesenchymal Tumors

AbstractSoft tissue sarcomas (STS) are a heterogeneous group of rare mesenchymal tumors that account for approximately 1% of all adult malignancies. They can arise throughout the body due to their mesenchymal origin, although 60% of all STS occur in the extremities. Locally advanced STS can lead to significant functional morbidity and tend to local recurrences despite surgical resection. About 30% of all STS patients develop distant metastases with a median overall survival of less than 15 months. The treatment of choice in patients with localized disease is still surgical resection with negative margins. However, there has been a paradigm shift in the last few decades. Large retrospective analyses could not establish a strong association between radical resections and improved local control or survival. Previous radical concepts in STS surgery have been gradually replaced by more moderate approaches with function- and limb-sparing resections combined with radiotherapy. Here, the margin status appears to be of prognostic significance. However, several large retrospective analyses have presented inconsistent results, questioning the independent prognostic impact of surgical margins. This article reviews the literature critically, focusing on the changing role of surgical margins in STS surgery.

Intestinal Heterotopic Pancreas Involved by Simultaneous PanIN-2 Lesion and Endocrine Microadenoma: a Unique Case

2017 ◽  
Vol 26 (2) ◽  
pp. 199-202
Author(s):  
Remus Cornea ◽  
Sorina Taban ◽  
Cristian Suciu ◽  
Codruta Lazureanu ◽  
Alis Dema
Keyword(s):  
Histopathological Examination ◽  
Intraepithelial Neoplasia ◽  
Heterotopic Pancreas ◽  
Pancreatic Intraepithelial Neoplasia ◽  
Unique Case ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Pancreatic Endocrine Neoplasm ◽  
First Case ◽  
Mucinous Neoplasms

We hereby present the case of a 58-year-old male who underwent a total gastrectomy for gastric neoplasm. During the surgery, a tumor mass in the jejunum was identified, considered as metastasis, and resected. The histopathological examination of the jejunal lesion showed ectopic pancreas. In this area, two pathological distinct lesions were identified, one histologically compatible with pancreatic intraepithelial neoplasia (PanIN) type 2 lesion and the other with morphologic criteria for endocrine microadenoma. To our knowledge, this is the first case that evidences the presence of a concomitant premalignant exocrine lesion and benign endocrine lesion in a heterotopic pancreas (HP).Abbreviations: HP: heterotopic pancreas; IPMN: Intraductal Papillary Mucinous Neoplasms; PanIN: Pancreatic Intraepithelial Neoplasia; PEN: pancreatic endocrine neoplasm.

TUMOR GANAS OVARIUM RESIDIF METASTASIS KARSINOMA MUSIN KE UMBILIKUS, PERITONEUM, DAN CAIRAN ASITES TANPA DITEMUKAN TANDA KEGANASAN PADA PEMERIKSAAN HISTOPATOLOGIS PASCA OPERATIF SEBELUMNYA

2019 ◽  
Vol 3 (2) ◽  
pp. 130-136
Author(s):  
Arif Fadillah ◽  
Andi Friadi
Keyword(s):  
Ovarian Carcinoma ◽  
Ovarian Tumor ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Ovarian Tumors ◽  
Postoperative Chemotherapy ◽  
Definitive Treatment ◽  
Malignant Ovarian Tumor ◽  
Patient Will ◽  
Optimal Debulking

Background : Malignant ovarian tumor are still the number one cause of death and the second most  of incidents for gynecological malignant tumors. The principles of management of ovarian cancer are the same as the principles of handling other malignant diseases, for the treatment of primary lesions operatively and the handling of potential sites of tumor metastases with chemotherapy. Histopathological examination is still considered a gold standard for diagnosis and definitive treatment of malignant ovarian tumors. If histopathologic results are obtained, then the patient will be planned to undergo postoperative chemotherapy. The mismatch between the preoperative and intraoperative clinical features, and the results of postoperative histopathological examination is a problem in managing cases of ovarian malignant tumors.Objective : Report a case of residive ovarian carcinoma with no appearance of malignancy marker in the previous postoperative histopathological examination.Method : Case reportCase : We report the case of a 45-year-old woman with a history of two previous laparotomy. The first operation was carried out in February 2014 on the indication of an extra ovarian cyst, resulting in the impression of a "Follicular Cysts" based on histopathological examination. The second operation was performed in March 2015, performed surgical staging tumors with an indication of malignant ovarian tumors with clinical metastases, but from histopathological examination it was found that "Cystadenoma Ovarii Muscinosum Multiloculare" and "no visible signs of malignancy", so the patient was not managed with postoperative chemotherapy. In April 2019 patients came with complaints of new mass growth, from CT-Scan and USG investigations there was a suspicious impression of a residive ovarian tumor with metastases into the omentum and massive ascites. On May 16, 2019 an optimal debulking was performed with the findings of residive mass, ascites, and mass metastases in the intra operative peritoneum. From the results of histopathological examination, it was found that "Muscinous Carcinoma with metastases to the umbilicus, peritoneum, and ascitic fluidKeywords: Malignant residive ovarian tumor, mucinous ovarian carcinoma

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

Methylene Blue Test in Assessing Disease Free Margins in Lingual Carcinoma Resection

2018 ◽  
Vol 68 (12) ◽  
pp. 2879-2880
Author(s):  
Razvan Hainarosie ◽  
Viorel Zainea ◽  
Mura Hainarosie ◽  
Catalina Pietrosanu ◽  
Irina Ionita ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Young Patients ◽  
Blue Staining ◽  
Resection Margins ◽  
Methylene Blue Test ◽  
Lingual Carcinoma ◽  
Disease Free

Lingual squamous cell carcinoma is one of the most frequent localization of the oral carcinomas. The tongue neoplasia represents nearly 40% of the oral carcinomas. Recent studies showed an increasing trend of lingual carcinoma in young patients. Several staining tests have been described to early detect the disease. After detection, disease free margins resection will increase the survival rate. This study aims to analyze the methylene blue staining test in achieving disease free resection margins in lingual squamous cell carcinoma.

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