Cases reported "Soft Tissue Neoplasms"

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1/126. 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.
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2/126. Tumor-induced osteomalacia and symptomatic looser zones secondary to mesenchymal chondrosarcoma.

    Tumor-induced osteomalacia is a rare clinical entity that is associated with soft-tissue or skeletal tumors. We present a case report of a patient with a chest wall mesenchymal chondrosarcoma who presented with bone pain. The patient had skeletal changes in the femoral neck and fibula consistent with osteomalacia and laboratory values suggesting phosphate diabetes. The patient was treated with tumor resection and phosphate supplementation with reversal of the signs and symptoms of osteomalacia. Tumor-induced osteomalacia is vitamin-D-resistant and often reversed by complete removal of the tumor. Most commonly, the causative tumors are of vascular, mesenchymal, or fibrous origin. The osteomalacia is associated with bone pain, muscle weakness, and radiographic changes. Tumor-induced humoral factors have been implicated in causing the osteomalacia, but the definite etiology has yet to be determined. Current treatment includes complete tumor resection and electrolyte supplementation.
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3/126. dermatofibrosarcoma protuberans. A rare case involving the pediatric foot.

    dermatofibrosarcoma protuberans is a rare, slow-growing, locally destructive, intermediate-grade malignancy that originates in the dermal layer of the skin. dermatofibrosarcoma protuberans rarely metastasizes and has a marked tendency to recur following local surgical excision. The lesion is found most commonly on the trunk, on the proximal aspect of both the lower and upper extremities, and in the head and neck region. dermatofibrosarcoma protuberans occurs most commonly in people between the ages of 20 and 50. This article describes the clinical and pathologic features of this rare, malignant neoplasm and describes a rare case of dermatofibrosarcoma protuberans involving the pediatric foot.
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4/126. Benign recurring lipoblastoma in an adult versus well differentiated subcutaneous myxoid liposarcoma: clinicopathologic, immunohistochemical and molecular analysis of a unique case.

    Subcutaneous myxoid liposarcoma (ML) is exceedingly rare, with only two or three cases having been reported. lipoblastoma (LB), a rare fatty tumor that arises in infants and children, is unknown after adolescence. In contrast to ML, LB is often superficial. The two tumors can be difficult to distinguish due to many histologic similarities. We examined a 0.9 cm superficial subcutaneous nodule from the dorsal neck of a 48 year old man that had been growing slowly. Three and one half years later, a 0.4 cm palpable recurrent nodule was excised from the scar. The patient is now free of disease at 7.5 years. Because of these unusual features, we performed clinicopathologic, immunohistochemical and molecular analysis of this unusual tumor to decide if this represented a rare cutaneous ML or an unprecedented example of LB in an adult. The primary featured a thick fibrous pseudocapsule with foci of lymphocytes and infiltrating nests of semi-mature fetal-appearing adipocytic tissue. This surrounded a more immature cellular-but-cytologically-bland myxoid tissue featuring stellate cells and signet lipoblasts. There were fibrous sep at the periphery and the vasculature was rather inconspicuous. The 0.4 cm diameter recurrence was distinctly lobular and had minute satellite nodules. It was composed of uniform fetal-appearing bland myxoid lipoblastic tissue featuring signet ring lipoblasts surrounded by a few spindle cells. In both tumors, lipoblasts expressed S-100 protein. In the primary, 5% of the lesional cells were FXIIIa dendritic stromal histiocytes while in the recurrence, 15% of the lesional cells were FXIIIa dendritic cells. CD34 stained only scattered small capillaries. The Ki67 proliferation index was 1% in the primary and 3% in the recurrence. RT-PCR assay for TLS/FUS-CHOP fusion transcripts was negative despite three repeat tests performed on paraffin sections of the primary tumor in the presence of good m-rna internal controls. We reviewed the clinicopathologic and cytogenetic features of ML and LB. Based on this review and on the growth pattern, anatomic features and molecular data from the present case, we conclude that this tumor may represent the first reported case of adult LB.
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5/126. Nuchal fibroma: a clinicopathological review.

    Nuchal fibroma, or collagenosis nuchae, is a benign soft tissue tumor that arises from the posterior cervical subcutaneous tissue, with a predilection for the interscapular and paraspinal regions. Because of its benign clinical course and its close histopathologic similarity to other benign head and neck lesions, this lesion may be misdiagnosed and underreported. The purpose of this paper is to review the histopathologic and radiologic findings unique to nuchal fibroma, and compare and contrast it to the other soft tissue neoplasms within the clinical differential diagnosis. These include several benign (elastofibroma, lipoma, fibrolipoma, nodular fasciitis) and rare malignant entities (fibrosarcoma, liposarcoma, fibromatosis).
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6/126. Elastofibroma of the neck.

    Elastofibromas are benign lesions of the chest wall. We describe the first reported case of elastofibroma in the neck. Imaging features as well as location of the lesion were atypical. On computed tomography and magnetic resonance imaging the lesion contained a marked preponderance of fat, because the lesion arose within fat.
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7/126. Infiltrating angiolipoma of the M. temporalis.

    Angiolipomas are rare benign mesenchymal tumours that are distinguished from common lipomas by a marked degree of vascularisation. They are differentiated into non-infiltrating and the even less frequent infiltrating angiolipomas. The present case is the 9th report of an infiltrating angiolipoma of the head and neck. The patient was a 63-year-old man with an infiltrating angiolipoma of the left M. temporalis. Microscopic examination showed univacuolated adipose cells mixed with capillaries invading skeletal muscle. The patient has been free of recurrence since excision of the tumor.
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8/126. Intravascular occlusive therapy: use of interventional radiology in cancer patients.

    Selective transcatheter intravascular occlusion in the treatment of cancer patients is a valuable extension of interventional diagnostic radiology. Intra-arterial embolization may be performed with various substances, including autologous clot, autologous subcutaneous tissue, Gelfoam, and stainless steel coil. Clinical applications in cancer patients include control of gastrointestinal and genitourinary hemorrhage, preoperative reduction of tumor vascularity, control of local symptoms, and therapeutic reduction of tumor bulk. The technique has been used for preoperative and palliative treatment of neoplasms of the head and neck, kidney, liver, spleen, and soft tissue and bone. Transcatheter intravascular occlusion should be performed only by radiologists experienced in angiographic techniques. Inadvertent occlusion of a normal vessel and thromboembolism are possible complications.
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9/126. Ectopic hamartomatous thymoma: a case study and review of the literature.

    Ectopic hamartomatous thymoma is a rare and distinctive tumor found in the deep soft tissues of the neck, which is characterized histopathologically by a mixture of spindle, epithelial, and adipose cell elements. We present a case of this lesion occurring in a 39-year-old male. The characteristic histochemical and immunohistochemical findings of these tumors are demonstrated. In addition, review of the reported histological, immunohistochemical and ultrastructural findings is presented together with a table of clinical findings in the tumors so far described. A brief discussion of theories of histogenesis and possible differential diagnosis is included.
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10/126. The contralateral bilobed trapezius myocutaneous flap for closure of large defects of the dorsal neck permitting primary donor site closure.

    BACKGROUND: Various reliable local flaps can be used to cover soft tissue defects of the posterior neck. Among others, the (either vertical or transverse) trapezius myocutaneous flap is a reliable option in this context. However, for defects with a diameter larger than 15 cm, these flaps require skin grafting of the donor site. methods: To prevent this additional morbidity we describe a contralaterally based bilobed trapezius musculocutaneous flap successfully applied in two elderly patients with large tumors of the posterior neck in palliative situations. RESULTS: This novel approach makes use of a standard vertical skin paddle to cover the neck, together with a transverse cervical flap in a bilobed design to primarily close the paravertebral donor site. CONCLUSIONS: The bilobed technique allows the primary closure of massive soft tissue neck wounds. Preservation of the accessory nerve to the superior fibers of the trapezius muscle permitted normal arm elevation in our patients.
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