Primary Histiocytic Sarcoma, an Extremely Rare Neoplasm: Report of a Case Presenting as a Skin Lesion

: Histiocytic sarcoma (HS) is a very rare neoplasm of hematopoietic origin characterized by the proliferation of malignant cells that have the morphological and immunohistochemical features of mature tissue histiocytes, with only a few cases reported. Most patients with symptoms of the unilateral or multichannel disease are more involved with the intestines, skin, and soft tissues, palpable mass lesions, and compressions of adjacent organs, such as intestinal obstruction, or constitutional symptoms (e.g., fever and weight loss). In this study, we reported a 56-year-old man with a six-month history of a cutaneous plaque lesion on the left arm’s posterior surface. He underwent skin lesion biopsy, histopathologic examination, and immunohistochemistry that was compatible with histiocytic sarcoma. Since surgical resection not deemed appropriate, our patient underwent aggressive multiagent chemotherapy with six cycles of ICE (ifosfamide, mesna, carboplatin, and etoposide) regimen and radiotherapy. After the completion of chemoradiotherapy, the skin lesion was completely disappeared. The patient is currently coming to us for the follow-up without any recurrence of the disease.

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Symptomatic Heterotopic Gastric Mucosa in Distal Esophagus

Journal of Health and Allied Sciences NU ◽

10.1055/s-0041-1731141 ◽

2021 ◽

Author(s):

Avnish Kumar Seth ◽

Mahesh Kumar Gupta ◽

Gursimran Kaur ◽

Priti Jain ◽

Rinkesh Kumar Bansal

Keyword(s):

Gastric Mucosa ◽

Squamous Epithelium ◽

Narrow Band Imaging ◽

Distal Esophagus ◽

Heterotopic Gastric Mucosa ◽

Retrosternal Pain ◽

Gastric Type ◽

History Of ◽

Mass Lesions

Abstract Introduction Heterotopic gastric mucosa (HGM) in esophagus is commonly noted as an inlet patch at endoscopy. We describe a rare patient with symptomatic distal esophageal HGM. Case Report A 40-year-old male presented with retrosternal pain and marked odynophagia for the last 4 weeks without any history of ingestion of antibiotics, foreign body, or corrosive. Endoscopy showed abrupt circumferential transition to salmon pink mucosa at 35 cm from incisors. From 35 to 41 cm, there were areas of polypoid edematous thickening with few superficial ulcers of 1 to 3 mm. Squamous epithelium was visualized at narrow band imaging from 41 cm to the Z-line at 43 cm with no hiatus hernia. Biopsy showed gastric-type mucosa with parietal cells without dysplasia. Serology for cytomegalovirus and human immunodeficiency virus was negative. He was managed with proton pump inhibitors (PPIs) and prokinetics and improved symptomatically. Follow-up endoscopy at 3 months demonstrated healing of ulcers with persistence of HGM and pseudopolyps. He remains well on maintenance with PPI at 1-year follow-up. Conclusion Symptomatic HGM in distal esophagus is rare and can be differentiated from Barrett’s esophagus histologically and by presence of squamous epithelium between HGM and stomach. Inflammatory mass lesions may develop and mimic esophageal malignancy. Symptoms are largely due to acid production and usually respond to PPI.

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Primary orbital extraskeletal osteosarcoma and review of literature

BMC Ophthalmology ◽

10.1186/s12886-020-01690-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jingwen Hui ◽

Yun Zhao ◽

Lei Zhang ◽

Jinyong Lin ◽

Hong Zhao

Keyword(s):

Soft Tissues ◽

Malignant Tumour ◽

Extraskeletal Osteosarcoma ◽

Complete Excision ◽

Case Presentation ◽

Left Orbit ◽

Orbital Wall ◽

Previous Trauma ◽

History Of

Abstract Background Extraskeletal osteosarcoma is a malignant tumour composed of an osteoid and/or cartilaginous matrix; it arises in soft tissues without connection to the skeleton, and to our knowledge, this type of tumour is extremely rare. Case presentation The present study reports a 57-year-old man with primary orbital extraskeletal osteosarcoma who presented with a history of painful swelling in the left orbit that had occurred for 11 months. Imaging of the orbit showed an atypical, well-defined heterogeneous mass attached to the posterior globe of the left orbit. The patient underwent an anterior orbitotomy and complete excision of the tumour. The mass was originated from neither the globe nor the bony orbital wall but from the soft tissue. Histopathology demonstrated an extraskeletal osteosarcoma. After 13 months of follow-up, there was apparent recurrence of the tumour. The medical history showed no complaints of previous trauma or radiotherapy. Conclusions ESOS is a highly malignant tumour. Immunosuppression, trauma and adjuvant radiotherapy are possible predisposing factors in the development of this tumour. Prompt recognition and thorough treatment are essential for preventing orbital lesions and presence of metastasis from other organs.

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Laryngeal Chondroma: A Rare Diagnosis in This Localization

Case Reports in Pathology ◽

10.1155/2011/852396 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Ebru Tastekin ◽

Semsi Altaner ◽

Cem Uzun ◽

Ahmet R. Karasalihoglu ◽

Cigdem Ozdemir ◽

...

Keyword(s):

Local Recurrence ◽

Male Patient ◽

Cricoid Cartilage ◽

Histopathologic Examination ◽

Posterior Surface ◽

Laryngeal Tumors ◽

History Of ◽

Rare Diagnosis

Primary chondroid tumors of the larynx represent less than 1% of all laryngeal tumors. Most of them are chondromas and they often involve to the cricoid cartilage. A 31-year-old male patient applied to the oto-laryngology service with a history of dysphonia and dyspnea. Microlaryngoscopy revealed 2 cm sized, ill-defined, covered with regular mucosa, porous, and hard mass on posterior surface of crycoid cartilage in subglottic area. Following the excision of the lesion, histopathologic examination revealed as chondroma. Two years later, local recurrence was detected and the diagnosis was again chondroma. There was no complaint of the patient in last 3 and half years of follow-up. Chondroma should carefully be differentiated from chondrosarcoma and the patients should be followed for possible recurrences.

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Giant lung metastasis of NRAS-mutant melanoma in a 24-year-old patient with a history of BRAF-mutant conventional melanoma harboring Spitzoid morphology: a case report

Diagnostic Pathology ◽

10.1186/s13000-020-01046-3 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Jiri Vachtenheim ◽

Roman Kodet ◽

Ondrej Fischer ◽

Vitezslav Kolek ◽

Zuzana Strizova ◽

...

Keyword(s):

Case Report ◽

Skin Lesion ◽

Molecular Characterization ◽

Lung Metastasis ◽

Skin Lesions ◽

Lung Tumour ◽

Spitz Nevus ◽

History Of ◽

Braf Mutant

Abstract Background Spitzoid melanocytic lesions represent a heterogeneous group of proliferations with ambiguous and overlapping terminology. The exact distinction of a Spitz nevus from a Spitzoid melanoma can be very difficult or, in some cases, impossible. Among the Spitzoid lesions, there is a lesion termed an atypical Spitz tumour (AST) that has intermediate histopathologic features between those of a Spitz nevus and a Spitzoid melanoma and thus uncertain malignant potential. There are several rare cases of patients with a Spitzoid melanoma initially misdiagnosed as a Spitz nevus or an AST with fatal consequences. It is, therefore, advised to perform a molecular characterization in cases where uncertain skin lesions are presented, as it may provide extended set of information with a possible impact on the treatment options. Furthermore, preventive measures, such as regular physical and skin examinations, as well as thorough scheduling of individual follow-up visits, are essential in patients with potentially malignant skin nevi. Case report We report a case of a young adult female with a history of AST excision with a negative sentinel lymph node biopsy (SLNB) and insufficient follow-up. Four years after the primary dermatological diagnosis, she presented with a giant tumour in the right hemithorax. Radical en bloc resection of the tumour with right pneumonectomy and resection of the pericardium with reconstruction of the pericardium using mesh was performed. A definitive histopathological examination revealed a metastatic melanoma. The association of the previously diagnosed AST and subsequent appearance of melanoma metastases led to a retrospective re-evaluation of the initial lesion. The suspected diagnosis of Spitzoid melanoma, however, was not confirmed. Moreover, the molecular examination revealed a major discordance between the initial lesion and the lung tumour, which most likely excluded the possible association of the lung metastasis with the initial skin lesion. The initial skin lesion was a BRAF-mutant melanoma with Spitzoid features and termed as AST, while the giant lung metastasis was NRAS-mutant melanoma. The subsequent postoperative course was complicated by the appearance of brain metastases that were stereotactically irradiated. Nevertheless, despite complex specialised medical care, the patient’s clinical condition rapidly deteriorated. By this time, no active oncological treatment was possible. The patient was delegated to local hospice for palliative care six months after the surgery and died three weeks later. Conclusions Our patient was surgically treated at the age of 20 for AST and died four years later of metastatic NRAS-mutant melanoma most likely of different occult origin. Molecular characterization, as well as the close clinical follow-up should be always precisely performed in patients with uncertain skin lesions, such as AST.

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Bilateral spontaneous chylothorax presenting as a left-sided neck mass

BMJ Case Reports ◽

10.1136/bcr-2020-240320 ◽

2021 ◽

Vol 14 (4) ◽

pp. e240320

Author(s):

Sarah Akbar ◽

Rajeev Advani ◽

Rohini Aggarwal

Keyword(s):

Soft Tissues ◽

Anterior Chest Wall ◽

Neck Mass ◽

Ct Scans ◽

X Ray ◽

Low Fat Diet ◽

History Of ◽

Chest X Ray ◽

Inflammatory Changes

A previously well 36-year-old woman presented with a 2-day history of a tender left-sided neck mass associated with left-sided otalgia and odynophagia. On examination, there was a diffuse, tender swelling of the left anterior triangle of the neck with extension onto the anterior chest wall. Ultrasound and CT scans of the neck revealed extensive inflammatory changes in the soft tissues of the neck and a chest X-ray showed blunting of both costophrenic angles. A diagnostic pleural aspiration was subsequently performed and yielded chyle. The patient was commenced on total parenteral nutrition and placed on a low-fat diet; symptoms completely resolved within 5 days, and at follow-up at 6 weeks, there were no further episodes or complications. Bilateral spontaneous chylothorax is a rarely reported phenomenon in the literature; it has been reported in females following the possibility of minor physical exercise such as stretching or hyperextension of the neck.

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Rare case of cystic hygroma in the epidural space resulting in multilevel spinal cord compression

BMJ Case Reports ◽

10.1136/bcr-2019-230326 ◽

2019 ◽

Vol 12 (8) ◽

pp. e230326

Author(s):

Christopher Payne ◽

Michael J Gigliotti ◽

Alejandro Castellvi ◽

Alexander Yu

Keyword(s):

Epidural Space ◽

Lymphatic System ◽

Benign Lesion ◽

Cord Compression ◽

Cystic Hygroma ◽

Lymphatic Tissue ◽

Lower Extremity Weakness ◽

History Of ◽

Mass Lesions

Lymphangioma, or cystic hygroma, involving the epidural space and spinal soft tissue, is a rare benign lesion consisting of an abnormal collection of lymphatic tissue isolated from the normal lymphatic system. This case report is the most extensive case of cystic hygroma involving the spine reported in the literature. A 23-year-old man with a history of cystic hygromas of the neck and thorax presented with bilateral upper and lower extremity weakness that progressively worsened over 3 months. A left hemilaminectomy from C4 to T5 with endoscopic exploration and cyst drainage was performed. At last follow-up, the patient was ambulating and returned to work. Aggressive decompression of mass lesions resulting in myelopathy, such as the spinal cystic hygromas, resulted in improved motor function as well as overall function status.

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Subcutaneous Leiomyosarcoma of the Frenulum

The Scientific World JOURNAL ◽

10.1100/tsw.2005.76 ◽

2005 ◽

Vol 5 ◽

pp. 571-575 ◽

Cited By ~ 4

Author(s):

D. Mendis ◽

S. R. J. Bott ◽

J. H. Davies

Keyword(s):

Skin Lesion ◽

Resection Margin ◽

Disease Recurrence ◽

Local Resection ◽

Penile Skin ◽

History Of

Leiomyosarcomas of the penis are rare, with only 29 reported cases to date. We record the case of a patient who presented with a 2-year history of a seemingly indolent penile skin lesion. On histopathology of the local resection, a diagnosis of subcutaneous leiomyosarcoma was made. Specifically, leiomyosarcoma of the penile frenulum has not been clearly reported previously. The patient underwent a further excision to ensure an adequate resection margin and has had no disease recurrence at subsequent follow-up. Our case was of a lesion that, although clinically benign, was malignant and this possibility should be borne in mind when assessing patients.

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Cecal malakoplakia: A case report

Korean Journal of Clinical Oncology ◽

10.14216/kjco.21007 ◽

2021 ◽

Vol 17 (1) ◽

pp. 44-47

Author(s):

Jin Woon Jeong ◽

Ji Hyun Noh ◽

Jeong Hyun Kang ◽

Ji Hyun Park ◽

Joo Hyung Lee

Keyword(s):

Cervical Cancer ◽

Rare Case ◽

Psoas Muscle ◽

Histopathologic Examination ◽

Operative Case ◽

Close Observation ◽

History Of ◽

The Right ◽

Made In

Malakoplakia is a rare chronic granulomatous disease found in the genitourinary tract, mainly. It is considered to be related to immunosuppression and/or infectious processes. We would like to present an operative case of cecal malakoplakia in a patient with a history of surgical resection and chemotherapy for cervical cancer. A 74-year-old female patient visited our hospital for 1-year follow-up after operation and chemo-radiotherapy for cervical cancer. An infiltrative mass of 6 cm, between the cecal base and the right psoas muscle, was observed on computed tomography. An ileocectomy was performed for diagnosis. Histopathologic examination revealed cecal malakoplakia. After surgery, based on previous reports, antibiotics therapy was added. Then the patient was discharged and treated in the outpatient clinic. To our knowledge, a rare case has been described of cecal malakoplakia during observation after surgery and chemo-radiotherapy for cervical cancer. Malakoplakia is known to be related to immunosuppressive condition. Therefore, our case suggests that close observation should be made in patients on immunosuppressive condition, such as chemotherapy.

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Ewing's sarcoma of soft tissues in childhood: a report from the Intergroup Rhabdomyosarcoma Study, 1972 to 1991.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.2.574 ◽

1997 ◽

Vol 15 (2) ◽

pp. 574-582 ◽

Cited By ~ 150

Author(s):

R B Raney ◽

L Asmar ◽

W A Newton ◽

C Bagwell ◽

J C Breneman ◽

...

Keyword(s):

Soft Tissues ◽

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Distant Metastases ◽

Residual Tumor ◽

Complete Response ◽

Left Behind ◽

Multiagent Chemotherapy ◽

Extraosseous Ewing’S Sarcoma

PURPOSE One hundred thirty of 2,792 patients (5%) registered on three Intergroup Rhabdomyosarcoma Study clinical trials (IRS-I, -II, and -III) from 1972 to 1991 had an extraosseous Ewing's sarcoma (EOE). We report here the results of multimodality therapy for this tumor. PATIENTS AND METHODS The 130 patients were less than 21 years of age; 70 (54%) were males. Primary tumor sites were on the trunk in 41 patients, an extremity in 34, the head/neck in 23, the retroperitoneum/pelvis in 21, and other sites in 11. One hundred fourteen patients had no metastases at diagnosis. In 21 patients, the tumor was completely resected; in 30, the localized or regional tumor was grossly resected, and in 63 patients, grossly visible sarcoma was left behind. Sixteen patients (12%) had distant metastases at diagnosis. All patients were given multiagent chemotherapy and most received irradiation (XRT); none were treated with bone marrow transplantation. RESULTS One hundred seven patients (82%) achieved a complete response. At 10 years, 62%, 61%, and 77% of the patients were alive after treatment on IRS-I, IRS-II, or IRS-III therapeutic protocols, respectively, similar to figures obtained in all IRS patients. At last follow-up evaluation, 42 patients had died of progressive tumor and one of infection. Survival at 10 years was most likely for patients with tumor that arose in the head and neck, extremities, and trunk, and for those who underwent grossly complete tumor removal before initiation of chemotherapy. For patients with localized, gross residual tumor, adding doxorubicin (DOX) to the combination of vincristine, dactinomycin, cyclophosphamide (VAC), and XRT did not significantly improve survival in 39 patients (62% alive at 10 years) compared with that of 24 patients treated with VAC and XRT without DOX (65% alive at 10 years, P = .93). CONCLUSION This series indicated that EOE in children is similar to rhabdomyosarcoma (RMS) in its response to multimodal treatment. No benefit was apparent from the addition of DOX to VAC chemotherapy in patients with gross residual EOE.

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Hemophagocytic histiocytic sarcoma in feline

Ciência Rural ◽

10.1590/s0103-84782012000400016 ◽

2012 ◽

Vol 42 (4) ◽

pp. 675-678 ◽

Cited By ~ 2

Author(s):

Luciele Varaschini Teixeira ◽

Danieli Brolo Martins ◽

Raqueli Teresinha França ◽

Anne Santos do Amaral ◽

Cínthia Melazzo Mazzanti ◽

...

Keyword(s):

Laboratory Tests ◽

Pleural Cavity ◽

Correct Diagnosis ◽

Subsequent Treatment ◽

Histiocytic Sarcoma ◽

Cytological Analysis ◽

Palpable Mass ◽

Rare Neoplasm

Cytological analysis of the pleural cavity becomes extremely important for the diagnosis of tumors that have no visible or palpable mass. The aim of this study is to report a case of hemophagocytic histiocytic sarcoma in a cat, a rare neoplasm, emphasizing the importance of laboratory tests, especially the analysis of effusions. This report discloses the usefulness of cytology in effusions directing the clinical veterinarian for the correct diagnosis and subsequent treatment.

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