1/472. Papillary endothelial hyperplasia presenting as a chest wall neoplasm.Soft tissue hematomas generally resolve but may persist and develop into slow-growing, organized masses. These chronic expanding hematomas are characterized by a pseudocapsule and a predominantly necrotic central cavity, with foci of newly formed capillaries. These have been called chronic expanding hematomas or Masson's papillary endothelial hyperplasia. These lesions can mimic vascular neoplasms and must be considered in the evaluation of expanding soft tissue vascular malformations.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
2/472. Soft tissue masses of the chest wall and axilla: has metastatic melanoma been considered?Isolated axillary and chest wall soft tissue masses are an uncommon presentation of metastatic cancer. The authors present three patients in whom malignant melanomas metastatic to these sites had been misdiagnosed, leading to inappropriate oncologic treatment planning in all three cases. The presumed diagnoses, even after fine-needle aspiration or trucut biopsies, were soft-tissue sarcoma (n = 2) and undifferentiated breast cancer (n = 1). The combination of taking a thorough history and performing proper immunohistochemical analysis of the biopsy material would have suggested the presence of malignant melanoma in all cases. As the disease appeared locoregionally limited in all patients, radical surgical resection with extended lymphadenectomy was performed without significant dysfunction of the upper extremity. One patient agreed to postoperative immunotherapy with interferon-alpha. Two patients are currently alive 17 and 14 months after operation. One patient was found to have systemic recurrence at 5 months, one experienced two isolated local recurrences in a prior operative site that were amenable to reresection and presently has no evidence of disease 12 months after resection, and one patient remains free of disease at 14 months. Clinical presentation, suggested diagnostic workup, and therapeutic implications are discussed to avoid misdiagnoses in this setting of possible clinical presentations of metastatic melanoma.- - - - - - - - - - ranking = 0.005898678757063keywords = cancer (Clic here for more details about this article) |
3/472. Molecular assessment of clonality leads to the identification of a new germ line TP53 mutation associated with malignant cystosarcoma phyllodes and soft tissue sarcoma.Cystosarcoma phyllodes (CSP) is a rare breast neoplasm composed of stromal and epithelial elements. It usually runs a benign course but it may metastasize. In a 31-year-old patient with recurring CSP, a mesenchymal tumor in the leg developed. The question arose whether the latter tumor could be a metastasis from the CSP, which would have major treatment consequences. The problem was addressed using molecular methods, i.e., comparison of the pattern of polymorphic repeat markers on chromosome 17p as well as single strand conformation polymorphism analysis and sequencing of exons 5 to 8 of the TP53 gene in both tumor and normal tissue. An identical pattern of loss of heterozygosity in both breast tumors was demonstrated, but a different pattern was shown in the tumor in the leg. This led to the conclusion that the latter tumor had to be a new primary tumor. A mutation in codon 162 of the TP53 gene was found in the tumor tissue as well as in the normal tissue of this patient. This germ line mutation leads to the replacement of isoleucine by asparagine and most likely has functional consequences. In all four examined tumors of this patient, the normal TP53 allele was lost. This is strong evidence that this germ line TP53 mutation causes the genesis of these two rare primary mesenchymal tumors in this young patient. The current study exemplifies the power of molecular diagnostic methods in investigating the specific clinical problem of clonal relation between two separate tumors. The germ line mutation found in codon 162 of the TP53 gene and the association with cystosarcoma phyllodes have not been described previously.- - - - - - - - - - ranking = 0.2keywords = neoplasm (Clic here for more details about this article) |
4/472. Histopathologic diagnosis of superficial soft tissue tumors, related lesions, and simulators: an algorithmic approach based on colors.An algorithmic approach based on colors for histopathologic diagnosis of soft tissue tumors and their simulators is proposed. At scanning magnification, in specimens stained with H&E, mesenchymal tumors can be classified according to their color. The color of a tumor is basically determined by density, morphology and distribution of neoplastic cells, and by density and quantity of the stroma. The basic colors that can be observed by neoplasms stained with H&E are white, pink, red, and blue. Colors may be used as a first step to choose the algorithm for specific diagnosis of a given mesenchymal neoplasm. Furthermore, colors may be helpful in understanding the histogenesis of a tumor and this is especially important in soft tissue pathology, because criteria for benignancy and malignancy vary according to the nature of the neoplasm.- - - - - - - - - - ranking = 0.6keywords = neoplasm (Clic here for more details about this article) |
5/472. Low grade fibromyxoid sarcoma: fine-needle aspiration cytology with histologic, cytogenetic, immunohistochemical, and ultrastructural correlation.BACKGROUND: Although the histologic features of the recently described low grade fibromyxoid sarcoma are well established, to the authors' knowledge there are no reports in the literature describing the cytologic features of this tumor by fine-needle aspiration. Recognition of this lesion is important because of its indolent but metastasizing nature. methods: The authors retrospectively reviewed their surgical pathology files for cases of low grade fibromyxoid sarcoma with a preoperative fine-needle aspiration biopsy (FNAB); three such cases were found. Immunohistochemical studies were performed in all three tumors, ultrastructural examination was performed in two tumors, and fresh tissue for cytogenetic analysis was obtained in one tumor. RESULTS: All FNABs showed similar features. The aspirates were relatively hypocellular with an abundant myxoid background; the neoplastic cells contained oval to spindle shaped nuclei with minimal pleomorphism. No capillaries or areas of fibrous tissue were identified. Cytogenetic study of one case revealed no chromosomal abnormalities. The histologic findings were characteristic for this lesion. By immunohistochemistry the tumor cells showed diffuse and strong reactivity for vimentin only; at the ultrastructural level the neoplastic spindle cells had characteristics of fibroblasts. CONCLUSIONS: The cytologic features of low grade fibromyxoid sarcoma are not specific enough for a definitive diagnosis based on FNAB alone; however, correlating the cytologic and clinical findings can narrow the range of diagnosis. The differential diagnosis includes other myxoid lesions, in particular superficial or intramuscular myxoma and myxofibrosarcoma. In addition, the immunohistochemical and ultrastructural findings support a fibroblastic origin for this neoplasm.- - - - - - - - - - ranking = 0.2keywords = neoplasm (Clic here for more details about this article) |
6/472. Carcinoma of the uterine cervix metastatic to behind the zygomatic arch: a case report.PURPOSE: We propose to present a novel case of a genital malignancy metastatic to the head and neck. Carcinoma of the uterine cervix is the third most frequent malignancy of the female genital tract. Early detection and improved radiation and surgical techniques have resulted in better control of the pelvic tumor and a greater incidence of distant metastasis. Metastases to the soft tissue of the head and neck region have not been reported. methods: We present the first known case of a 35-year-old woman with cancer of the uterine cervix who presented with metastasis to the soft tissue behind the zygomatic arch. RESULTS: The patient received radiation therapy to the zygomatic region and cisplatin therapy with a near-complete remission. CONCLUSION: This case shows that not all squamous cell cancers detected above the clavicles are from a thoracic or a head and neck primary tumor. The atypical location should alert the physician to suspect distant metastasis, rather than locoregional disease.- - - - - - - - - - ranking = 0.005898678757063keywords = cancer (Clic here for more details about this article) |
7/472. Gingival metastasis from a prostate adenocarcinoma: report of a case.prostate cancer is the cause of 10% of cancer-related deaths in males in the united states. Metastases are found late in the course of the disease. Metastatic tumors of the oral cavity are rare, representing about 1% of oral tumors and affect jaws much more frequently than soft tissues. Metastatic prostate cancer tends to involve the bones of the axial skeleton. In a recent review, 22 cases of metastases to the jawbones from prostate cancer were found in 390 cases. On the other hand, only 1 case of a metastasis to the oral soft tissues was reported. The authors describe the second case of oral soft tissue metastasis from a prostate cancer. The metastatic lesion was located in the gingiva. Clinicians should be aware of oral soft tissue metastases since they can be the first sign of a not yet diagnosed malignant tumor and they can be very easily confused with several different benign lesions.- - - - - - - - - - ranking = 0.014746696892658keywords = cancer (Clic here for more details about this article) |
8/472. Solitary fibrous tumor of the oral cavity: an uncommon location for a ubiquitous neoplasm.Solitary fibrous tumor is an uncommon soft tissue tumor initially reported in the pleura but recently described in other sites of the body. To date, only 5 examples of oral solitary fibrous tumor have been reported. Here, we describe 2 additional cases of this tumor in the oral cavity. The tumors were composed of small to medium-sized spindle cells with bland cytologic features; these cells were haphazardly arranged in highly cellular sheets or ill-formed fascicles as well as in hypocellular areas with hyalinized blood vessels. Both tumors contained blood vessels with a hemangiopericytomalike appearance and expressed vimentin, CD34, and CD99. One case was also strongly positive for bcl-2. The diagnosis of solitary fibrous tumor may be difficult inasmuch as it shares a number of histologic features with other soft tissue tumors. awareness of its occurrence in the oral cavity is important so that confusion with other spindle cell neoplasms can be avoided.- - - - - - - - - - ranking = 1keywords = neoplasm (Clic here for more details about this article) |
9/472. Fine needle aspiration cytology and core biopsy in the diagnosis of alveolar soft part sarcoma presenting with lung metastases. A case report.BACKGROUND: Alveolar soft part sarcoma is a rare soft tissue tumor of uncertain origin usually affecting young adults. This neoplasm has early metastatic potential. Its cytologic features, particularly when presenting with metastases, have rarely been described. CASE: A 23-year-old male presented with shortness of breath and scapular pain. Routine chest roentgenograms revealed multiple lung nodules. Malignancy was established by percutaneous fluoroscopically guided fine needle aspiration on a lung nodule. Possible metastatic alveolar soft part sarcoma was suggested by cytology among few considerations in the differential diagnosis. Alveolar soft part sarcoma was confirmed by lung core biopsy and further supported by immunohistochemistry and electron microscopy. Tumor cells expressed muscle-specific actin and myoglobin, and contained diastase-resistant inclusions with periodic acid-Schiff stain. Ultrastructurally, peculiar, elongated intracytoplasmic crystalline bodies typical of this neoplasm were identified. A meticulous clinical search led to finding the primary tumor deeply located in the right posterior thigh. CONCLUSION: Aspiration cytology is a reliable, cost-efficient technique in the diagnostic workup of masses suspicious for malignancy.- - - - - - - - - - ranking = 0.4keywords = neoplasm (Clic here for more details about this article) |
10/472. Pleomorphic hyalinized angiectatic tumor of soft parts.Pleomorphic hyalinized angiectatic tumor of soft parts is a recently described neoplasm that most commonly affects the lower extremities. It is locally aggressive but has not been known to metastasize. This article presents a case of a softball-sized tumor on the dorsum of the foot that was identified as pleomorphic hyalinized angiectatic tumor of soft parts. Previously, it would have been misdiagnosed and treated as either a neurilemoma or a malignant fibrous histiocytoma.- - - - - - - - - - ranking = 0.2keywords = neoplasm (Clic here for more details about this article) |
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