11/60. hemangiopericytoma. An analysis of 106 cases.A series of 106 cases of hemangiopericytoma was analyzed. The neoplasms occurred principally in adults (median age, 45 years), were deep seated, and were most common in the thigh (27 cases) and the pelvic retroperitoneum (26 cases). A painless mass was the first symptom in 96 of the patients. The median size of the excised tumors was 6.5 cm. Surgical removal of the tumor was often complicated by hemorrhage because of marked dilatation of the vascular bed in the vicinity of the neoplasm, probably as the result of rapid exchange of blood from the arterial to the venous circulation within the tumor. Microscopically, benign and malignant forms could be distinguished. The latter were characterized by increased cellularity, prominent mitotic activity, and foci of necrosis or hemorrhage. Follow-up information was obtained in 93 cases. Seventy-one of the 93 patients were living (two with recurrence and four with metastasis), and 22 had died (13 as the result of recurrence or metastasis in more than two-thirds of the related causes). recurrence preceded metastasis in more than two-thirds of the patients with evidence of metastasis. The 10 year survival rate was 70 per cent. The morphologic differences from other mesenchymal tumors showing a hemangiopericytoma-like vascular pattern are discussed, and the close resemblance of hemangiopericytoma to richly vascular forms of fibrous histiocytomas and synovial sarcoma is emphasized. Congenital or infantile hemangiopericytoma is described as a separate entity having a distinctive microscopic pattern and behavior.- - - - - - - - - - ranking = 1keywords = histiocytoma (Clic here for more details about this article) |
12/60. A case of disseminated hemangiomatosis with cutaneous, hepatic and skeletal manifestations and increased urinary excretion of glycosaminoglycans.A case of disseminated hemangiomatosis with cutaneous hepatic and extensive skeletal manifestations is reported. The diagnosis was established by means of bone X-ray, hepatic angiography, and skin and bone biopsies. A moderately increased urinary excretion of glycosaminoglycans (GAG) was found. The main GAG fraction excreted was tentatively identified as a heparan sulphate.- - - - - - - - - - ranking = 0.0030199346239441keywords = hemangioma (Clic here for more details about this article) |
13/60. Case report: recurrence of soft tissue MFH in bone due to minute intravenous tumor emboli detected by MRI.We recently encountered a case with local recurrence of malignant fibrous histiocytoma (MFH) in the bone after wide resection, caused by minute intravenous tumor emboli which were retrospectively detected in MR imaging. The patient was a 69-year-old woman who initially noticed a mass in her left thigh. The tumor was diagnosed to be MFH, therefore a wide resection was performed; although the tumor was closely attached to the periosteum, it was not difficult to dissect the tumor subperiosteally from the cortex of the femur. The patient received postoperative brachytherapy, but no chemotherapy. Two years later, the tumor recurred with bony destruction of the femur. We reviewed the pre-operative films obtained by various imaging modalities, as well as the histology of the primary tumor, and found minute intravenous tumor emboli in the MR imaging obtained before surgery. Tumor emboli were also observed histologically in the small vessels of the surgically resected tumor. Such intravenous tumor emboli have recently been implicated in the development of regional bone metastasis near the site of the primary lesion in cases of malignant soft tissue tumors. Therefore, we concluded that the tumor recurrence in our case was caused by small tumor emboli invading the perforating veins of the femur. It is therefore emphasized that MR images should be carefully reviewed for the presence of such intravenous tumor emboli before surgery in cases of high-grade malignant sarcomas. As at the time of writing, our patient remains alive and disease-free, with no evidence of any local recurrence or distant metastasis after wide tumor resection for the recurrent tumor.- - - - - - - - - - ranking = 1keywords = histiocytoma (Clic here for more details about this article) |
14/60. Angiomatoid metastatic melanoma.Two patients with metastatic melanoma, both with the same bizarre morphology and an unusual, comparatively benign course, are described: a 50-year-old female who more than 20 years after a primary melanoma on the right upper arm, Clark level III, maximum tumor thickness of 1.1 mm, developed multiple metastases in the deep soft tissue and a 62-year-old male with an acrolentiginous melanoma, Clark level III, maximum tumor thickness of 0.55 mm, who 6 months after the excision of the primary tumor developed metastasis in regional lymph nodes. histology of all metastases revealed extensive central necrosis and hemorrhage with a demarcating granulomatous reaction imitating angiomatoid malignant fibrous histiocytoma but no obvious melanoma tissue. Although extensive immunohistochemistry and ultrastructural examination failed to solve the quandary, careful macroscopy revealed tiny foci of remnants from melanoma in the granulation center. The female developed multiple soft tissue metastases managed by surgery, immunochemotherapy, and autologous vaccination. Both patients are well without internal manifestations 9 and 5 years, respectively, after the first metastatic episode.- - - - - - - - - - ranking = 1keywords = histiocytoma (Clic here for more details about this article) |
15/60. Giant cell malignant fibrous histiocytoma of the breast: a case report.A case of primary malignant fibrous histiocytoma of the breast is reported. The patient was a 48-yr-old woman with a huge tumor involving almost the entire left breast. The central portion of her left breast was already rotted by extensive necrosis and inflammation. She was treated by radical mastectomy and axillary lymphadenectomy to level I. Pathologic examination supported by an immunohistochemical staining confirmed the tumor as malignant fibrous histiocytoma of giant cell type. Axillary lymph nodes were free from tumor metastasis. She had not taken any postoperative adjuvant therapy. The metastasis to lungs was found 2 months after the operation, and she died within 6 months.- - - - - - - - - - ranking = 6keywords = histiocytoma (Clic here for more details about this article) |
16/60. Localized cutaneous metastases from an atypical fibroxanthoma.BACKGROUND: Atypical fibroxanthoma is a rare cutaneous spindle cell neoplasm typically found on the sun-exposed areas of the head or neck of the elderly. OBJECTIVE: We report a case of localized cutaneous metastases attributed to an atypical fibroxanthoma. methods: A case report and a review of the literature of metastasizing atypical fibroxanthoma are given. RESULTS: Mohs micrographic surgery was used to treat all skin lesions and currently the patient has no suspicious lesions. CONCLUSION: Metastases attributed to atypical fibroxanthoma are rare, and many prior reports may have actually been malignant fibrous histiocytoma, spindle cell melanoma, or spindle cell squamous carcinoma. Tumor depth, vascular invasion, and cutaneous tumor recurrence appear to increase risk for metastasis.- - - - - - - - - - ranking = 1keywords = histiocytoma (Clic here for more details about this article) |
17/60. Metastasizing atypical fibroxanthoma (cutaneous malignant histiocytoma): report of five cases.BACKGROUND: Atypical fibroxanthoma (AFX) is an unusual malignant fibrohistiocytic tumor of sun-damaged skin. When first described, it was felt to be a reactive tumor of low malignant potential. More recently, it has been shown to be a tumor of intermediate malignant potential. OBJECTIVE: To describe five cases of metastatic AFX. RESULTS: Five patients ranging in age from 65 to 85 years old presented with metastatic AFX. Three of the five cases presented with regional lymph node disease. Also, three of the five cases had other aggressive cutaneous malignancies. LN-2 (CD74) staining was positive in three of five primary tumors and two of five metastatic tumors. CONCLUSION: The metastatic potential of AFX may be underestimated. LN-2 staining may be a useful marker in identifying more aggressive tumor behavior.- - - - - - - - - - ranking = 4keywords = histiocytoma (Clic here for more details about this article) |
18/60. Malignant fibrous histiocytoma.Two patients are presented who had malignant fibrous histiocytomas of the skin and soft tissue. These tumors characteristically consist of a solitary mass, 0.5 cm to 12.0 cm, which has skin fixation, is circumscribed and firm. Microscopically, there is a pattern of histiocytes and bizarre histiocytic giant cells intermingled in a fibrous stroma with fibroblasts arranged in a whirling pattern. The lesion is treated with wide excision and skin grafting. Local recurrence is common. Metastasis is less common, but with metastasis the prognosis is poor.- - - - - - - - - - ranking = 5keywords = histiocytoma (Clic here for more details about this article) |
19/60. Multifocal malignant histiocytoma.The pathology of malignant histiocytoma has recently been defined and its malignancy confirmed beyond doubt. A unique example of this tumour is described, a search of the literature having failed to find a previously recorded case with a multifocal origin.- - - - - - - - - - ranking = 5keywords = histiocytoma (Clic here for more details about this article) |
20/60. Inflammatory fibrous histiocytoma. An aggressive and lethal lesion.During an investigation of soft tissue fibrohistiocytic tumors, seven cases were found which we believe represent a new and specific diagnostic subgroup of fibrous histiocytomas. All patients were adults (mean 52.6 years), only one of whom was younger than age 40. There were four females and three males; all were Caucasian. The tumors which occurred in the retroperitoneum, anterior chest wall, anterior abdominal wall, femoral area, and oral cavity, were large, averaging 8.5 cm., and although appearing encapsulated, were microscopically infiltrative. The common histologic feature of all cases was a diffuse and at times intense neutrophilic infiltrate unassociated with tissue necrosis, in combination with bland and anaplastic appearing histiocytes. The presence of this acute exudative reaction is a unique feature of these lesions, and was present not only in the original tumors, but in recurrences and metastatic foci as well. Other cell types including foam cells, lymphocytes, plasma cells, eosinophils, Reed-Sternberg-like and ganglion-like cells were commonly present. A storiform fibrous pattern, a hallmark of the fibrous histiocytomas was seen at some time in all but one case. The treacherous aspect of these lesions was their bland initial histologic appearance. The foci of foam cells associated with the inflammatory elements often led to a diagnosis of a benign inflammatory reaction or xanthogranuloma. However, follow-up has confirmed the aggressive and neoplastic nature of these lesions. The clinical course was usually protracted with multiple recurrences and eventual metastases. All patients died of their tumor, the average survival being 53 months; four patients survived over 5 years. At this time, we propose the term inflammatory fibrous histiocytoma to designate these lesions.- - - - - - - - - - ranking = 7keywords = histiocytoma (Clic here for more details about this article) |
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