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Geng J, Chen D, Wang L, Liu X, Chen W, Gao H, Xiao S. Infantile fibrosarcoma of the perineum with dorsal metastasis in a neonate: a case report original. BMC Pediatr 2023; 23:327. [PMID: 37386422 PMCID: PMC10308727 DOI: 10.1186/s12887-023-04129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/12/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Infantile fibrosarcoma is a rare pediatric soft tissue tumor and usually appears in children before one year of age. Distal extremities constitute the most frequently affected locations, and other tissues such as the trunk, head and neck, gut, sacrococcygeal region, and viscera are uncommon sites. CASE PRESENTATION We describe a rare case of infantile fibrosarcoma arising from the perineum. First, a cystic mass was detected using prenatal ultrasonography, and then an echo was changed in serial ultrasound examinations. A solid cystic lesion was found at term; a hypoechoic lesion occurred in the back. The tumor became so large that massive bleeding occurred, which then underwent surgical resection. Pathological examination confirmed infantile fibrosarcoma. CONCLUSION Our report demonstrates not all ultrasonographic findings in cases of infantile fibrosarcoma exhibit a solid mass during the initial examination - an early-stage lesion may reveal a cystic echo. Infantile fibrosarcoma has a good prognosis and surgery constitute the main treatment, with adjuvant chemotherapy being received if necessary.
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Affiliation(s)
- Juan Geng
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Dan Chen
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Limin Wang
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiangjiao Liu
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Wenjing Chen
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Hongyi Gao
- Department of Pathology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Shangjie Xiao
- Department of Neonatal Surgery, Guangdong Women and Children Hospital, Guangzhou, China.
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2
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Levin LE, Kinariwalla N, Behr GG, Morel KD, Lauren CT, Garzon MC. Lumps and bumps: What not to miss. Pediatr Dermatol 2022; 39:679-688. [PMID: 35918890 DOI: 10.1111/pde.15084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
The evaluation of pediatric patients with subcutaneous nodules remains a diagnostic challenge. Pediatric dermatologists are regularly confronted with patients who have a nonspecific nodule. Though most masses that require evaluation are ultimately benign, the possibility of a more aggressive process, including borderline or malignant neoplasms, underscores the pivotal role of the pediatric dermatologist in recognizing these lesions. The aim of this review is to provide an overview of lumps and bumps that are important to recognize to prevent delay in diagnosis or treatment of a serious underlying condition. Clinical clues that may lead the pediatric dermatologist to have a higher index of suspicion for more aggressive lesions are reviewed. Suggestions for evaluation and workup, as well as tips for the difficult to discern lesion, are proposed.
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Affiliation(s)
- Laura E Levin
- Department of Dermatology, Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA
| | - Neha Kinariwalla
- Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA
| | - Gerald G Behr
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Kimberly D Morel
- Department of Dermatology, Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA.,Department of Pediatrics, Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA
| | - Christine T Lauren
- Department of Dermatology, Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA.,Department of Pediatrics, Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA
| | - Maria C Garzon
- Department of Dermatology, Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA.,Department of Pediatrics, Columbia University Vagelos College of Physicians & Surgeons, New York City, New York, USA
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3
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Huerta CT, Quinn K, Saberi RA, Rao KA, Quiroz HJ, Brady AC, Thorson CM, Sola JE, Perez EA. Radical Resection of Pediatric Fibrosarcoma Is Not Associated With Survival Benefit: A Nationwide Database Analysis. J Surg Res 2022; 279:639-647. [PMID: 35930817 DOI: 10.1016/j.jss.2022.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Fibrosarcoma is one of the most common nonrhabdomyosarcoma soft tissue sarcomas in the pediatric population. Surgical resection is the cornerstone of treatment; however, optimal factors regarding the extent of fibrosarcoma resection in localized versus regional disease is poorly understood. METHODS The Surveillance, Epidemiology, and End Results database was queried for patients who are 19 y old or younger with a diagnosis of fibrosarcoma from 1975 to 2016. Kaplan-Meier analyses were performed for disease-specific survival on clinical and pathologic variables. Multivariate analysis was performed based on significant predictors of disease-specific survival. RESULTS There were 1290 patients (median age 13 [7-17] y) identified with fibrosarcoma. The overall survival rate at 20 y was 93%. Radical resection was performed on 22%, 40%, and 52% of patients with localized, regional, and distant Surveillance, Epidemiology, and End Results disease stage, respectively. Chemotherapy (P < 0.001), radiation (P < 0.001), histology (P < 0.001), and stage (P = 0.004) were significant predictors of increased mortality using univariate Kaplan-Meier analysis. Most patients (86%) with localized or regional stage who underwent radiation had fibrosarcomas of nondermatofibrosarcoma histology (P < 0.001). Dermatofibrosarcoma subtype comprised most radical resections (41%). Excluding distant stage, nondermatofibroma histology (hazard ratio 16.94, 95% confidence interval 3.77-76.01) and regional stage (hazard ratio 8.15, 95% confidence interval 2.93-22.69) were independent prognostic factors of mortality (both P < 0.001). Radical resection was not a significant independent prognostic indicator of survival. CONCLUSIONS Nondermatofibrosarcoma subtype is independently associated with increased mortality. Although surgery remains the mainstay of treatment, the extent of resection is not a predictor of survival for patients with the localized and regional stage of disease.
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Affiliation(s)
- Carlos Theodore Huerta
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Kirby Quinn
- University of Miami Miller School of Medicine, Miami, Florida
| | - Rebecca A Saberi
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Krishnamurti A Rao
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Hallie J Quiroz
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Ann-Christina Brady
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Chad M Thorson
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Juan E Sola
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Eduardo A Perez
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida.
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Eleti S, Meshaka R, McHugh K, Sebire N, Tahir N. Imaging characteristics of infantile fibrosarcoma. Clin Radiol 2022; 77:e532-e539. [DOI: 10.1016/j.crad.2022.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/31/2022] [Indexed: 11/03/2022]
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Han Y, Lian K, Zhang D. Treatment of infantile fibrosarcoma: A tertiary care center experience. Front Pediatr 2022; 10:1015185. [PMID: 36389393 PMCID: PMC9663799 DOI: 10.3389/fped.2022.1015185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/13/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Infantile fibrosarcoma (IFS) is a highly locally aggressive nonrhabdomyosarcomatous soft tissue sarcoma that most commonly occurs in young infants. There exists no standard treatment this lesion due to its rarity. We shared our treatment experience for IFS in this study. METHODS Patients' record between January 2013 and December 2018 were reviewed and patients with newly diagnosed IFS were included. The clinical characteristics, treatment strategy, treatment-related toxicities and clinical outcome were retrospectively analyzed. RESULTS Eleven patients were admitted in our center, including 4 girls and 7 boys, and the median age at diagnosis was 5 months (range 1-23 months). Ten patients achieved complete remission (CR) after the completion of initial treatment. The main short-term adverse effects was myelosuppression. Three patients experienced relapse, including two patients with local progression and one patient with distant metastasis. After a median follow-up of 3.5 years (range 1.5-7 years), 9 patients were alive and 2 patients died. The 3-year overall survival (OS) rate was 93.5% (95% CI 83.7-98.2). CONCLUSION We formulated the treatment strategy according to group grade and the experience from previous studies, which may be effective and feasible for the treatment of IFS.
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Affiliation(s)
- Yidi Han
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Kai Lian
- Department of Orthopedics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Dongdong Zhang
- Department of Oncology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China.,Department of Pediatric Hematology/Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kotb M, Aboelela A, Eshiba A, Sheta E, Abdallah D. Jejunal infantile fibrosarcoma: An unusual cause of neonatal intestinal obstruction. Congenit Anom (Kyoto) 2021; 61:199-201. [PMID: 34125974 DOI: 10.1111/cga.12433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/18/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Mostafa Kotb
- Faculty of Medicine, Pediatric Surgery Department, Alexandria University, Alexandria, Egypt
| | - Ahmed Aboelela
- Faculty of Medicine, Pediatric Surgery Department, Alexandria University, Alexandria, Egypt
| | - Ahmed Eshiba
- Faculty of Medicine, Pediatric Surgery Department, Alexandria University, Alexandria, Egypt
| | - Eman Sheta
- Faculty of Medicine, Pathology Department, Alexandria University, Alexandria, Egypt
| | - Dina Abdallah
- Faculty of Medicine, Pathology Department, Alexandria University, Alexandria, Egypt
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Rashid T, Noyd DH, Iranzad N, Davis JT, Deel MD. Advances in the Diagnosis and Management of Neonatal Sarcomas. Clin Perinatol 2021; 48:117-145. [PMID: 33583500 DOI: 10.1016/j.clp.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Neonatal sarcomas comprise a heterogeneous group of rare soft tissue neoplasms that present unique diagnostic and therapeutic challenges. Recent advances in molecular profiling have improved diagnostic capabilities and reveal novel therapeutic targets. Clinical trials demonstrate differences in behavior between sarcoma subtypes that allow for better clinical management. Surgical resection has been replaced with a multimodal approach that includes chemotherapy and radiotherapy. Despite these advances, neonates with sarcoma continue to fare worse than histologically similar sarcomas in older children, likely reflecting differences in tumor biology and the complexities of neonatal medicine. This review focuses on recent advances in managing neonatal sarcomas.
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Affiliation(s)
- Tooba Rashid
- Pediatric Hematology/Oncology, Duke University School of Medicine, DUMC, Box 102382, Durham, NC 27710, USA
| | - David H Noyd
- Pediatric Hematology/Oncology, Duke University School of Medicine, DUMC, Box 102382, Durham, NC 27710, USA
| | - Natasha Iranzad
- Pediatric Hematology/Oncology, Duke University School of Medicine, DUMC, Box 3712, Durham, NC 27710, USA
| | - Joseph T Davis
- Pediatric Hematology/Oncology, Duke University School of Medicine, DUMC, Box 3808, Durham, NC 27710, USA
| | - Michael D Deel
- Pediatric Hematology/Oncology, Duke University School of Medicine, DUMC, Box 102382, Durham, NC 27710, USA.
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8
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Congenital infantile fibrosarcoma of the abdominal wall: A case report. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2020.101758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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Unusual Case of Concurrent Retroperitoneal Congenital Infantile Fibrosarcoma and Cellular Type Congenital Mesoblastic Nephroma. J Pediatr Hematol Oncol 2020; 42:e801-e806. [PMID: 31343481 DOI: 10.1097/mph.0000000000001567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although congenital infantile fibrosarcoma (cIFS) is a rare soft tissue sarcoma among children, it constitutes one of the most common soft tissue sarcomas during the first year of life. Congenital mesoblastic nephroma (CMN) is the most common benign renal tumor usually developing during the first 3 months of life. cIFS and cellular type CMN (cCMN) share not only similar histopathologic features but identical molecular genetic abnormality including the ETV6/NTRK3 fusion gene. Here, we report an unusual case of cIFS occurring with cCMN. CASE PRESENTATION An 18-month-old girl presented with a 1-month history of abdominal distension and a few days' history of a palpable abdominal mass. A large heterogenous mass sized 9.0×11.2×11.6 cm on the right side of the abdomen and an isolated heterogenous lesion sized 4×4.5 cm within the right kidney were noted from the imaging study. Pathologic findings were consistent with cIFS and cCMN of the right kidney. In addition, both pathologic specimens contained the ETV6/NTRK3 fusion gene. CONCLUSION Although cIFS and cCMN share similar histopathologic features and molecular genetic abnormality, simultaneous occurrence of these 2 types of tumor is exceedingly rare. To our knowledge, this is the first unusual case report of concurrent cIFS and cCMN.
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10
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Sparber-Sauer M, Vokuhl C, Seitz G, Stegmaier S, Hallmen E, von Kalle T, Scheer M, Münter M, Bielack SS, Ladenstein R, Niggli F, Ljungman G, Fuchs J, Klingebiel T, Koscielniak E. The impact of local control in the treatment of children with advanced infantile and adult-type fibrosarcoma: Experience of the cooperative weichteilsarkom studiengruppe (CWS). J Pediatr Surg 2020; 55:1740-1747. [PMID: 31753608 DOI: 10.1016/j.jpedsurg.2019.10.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES This study aims at examining the potential survival benefits of primary versus secondary surgery of children diagnosed with advanced infantile (iFS) and adult-type fibrosarcoma (aFS). METHODS Treatment and outcome of 89 children with FS treated within prospective Cooperative Studiengruppe (CWS) trials (1981-2016) were analyzed retrospectively. RESULTS Localized disease (LD) was diagnosed in 87 patients: 64/66 patients with iFS (≤2 years) and 23 with aFS (>2 ≤ 18 years). Two patients (iFS) had metastatic disease. Resection was the mainstay of therapy of patients with LD resulting in microscopically complete (R0, IRS group I) (n = 29/87, 33%), microscopically incomplete (R1, IRS group II) (n = 17/87, 20%) and macroscopically incomplete (R2, IRS group III) (n = 41/87, 47%). Advanced LD (IRS group III) was present in 32/64 (50%) patients with iFS and in 9/23 (39%) with aFS. Chemotherapy was added predominantly in patients with advanced disease and an assessable objective response to CHT was seen in 71% iFS and 75% aFS. The 5-year event-free survival (EFS) of patients with iFS and aFS was 81% (±10, 95% CI) and 70% (±19, 95% CI) (p = 0.24); the 5-year overall survival (OS) was 98% (±3, 95% CI) and 82% (±16, 95% CI) (p = 0.02). Primary resection was no prognostic factor. Secondary R0/ R1 resection in patients with advanced disease improved 5-year EFS and OS in aFS (p = 0.002 and p = 0.000) but not in infants. CONCLUSIONS Secondary resection improves outcome in advanced aFS but not in infants. Mutilating surgery in infants should be avoided. TYPE OF STUDY AND LEVEL OF EVIDENCE Treatment study: patients were enrolled in five prospective studies and one registry, prognosis study: retrospective study. LEVEL OF EVIDENCE II/ III. MINI-ABSTRACT Fibrosarcoma is a very rare malignant tumor. Little is known about differences of local treatment of advanced infantile and adult-type. Data of 89 patients registered in five prospective trials and one registry of the Cooperative Weichteilsarkom Studiengruppe (CWS) (1981-2016) were analyzed.
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Affiliation(s)
- Monika Sparber-Sauer
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany.
| | - Christian Vokuhl
- Kiel Pediatric Tumor Registry, Section of Pediatric Pathology Department of Pathology, Kiel, Germany
| | - Guido Seitz
- University Children's Hospital Marburg, Department of Pediatric Surgery, Marburg, Germany
| | - Sabine Stegmaier
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany
| | - Erika Hallmen
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany
| | - Thekla von Kalle
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital, Institute of Radiology, Stuttgart, Germany
| | - Monika Scheer
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany
| | - Marc Münter
- Klinikum Stuttgart, Institute of Radiotherapy, Stuttgart, Germany
| | - Stefan S Bielack
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany; University of Muenster, Department of Pediatric Hematology and Oncology, Muenster, Germany
| | | | - Felix Niggli
- Department of Pediatric Oncology, University of Zurich, Zurich, Switzerland
| | - Gustaf Ljungman
- University of Uppsala, Children's University Hospital, Department of Women's and Children's Health, Uppsala, Sweden
| | - Joerg Fuchs
- University Children's Hospital, Department of Pediatric Surgery and Urology, Tuebingen, Germany
| | - Thomas Klingebiel
- University of Frankfurt, Department for Children and Adolescents, Goethe University, Frankfurt/M., Germany
| | - Ewa Koscielniak
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pediatrics 5 (Oncology, Hematology, Immunology), Stuttgart, Germany; Children's Hospital, Department of Pediatric Hematology and Oncology, Tuebingen, Germany
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Soft Tissue Special Issue: Fibroblastic and Myofibroblastic Neoplasms of the Head and Neck. Head Neck Pathol 2020; 14:43-58. [PMID: 31950474 PMCID: PMC7021862 DOI: 10.1007/s12105-019-01104-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022]
Abstract
Fibroblastic and myofibroblastic neoplasms of the head and neck encompass a group of rare tumor types with often overlapping clinicopathologic features that range in biologic potential from benign to overtly malignant. Even neoplasms with no metastatic potential may provide significant therapeutic challenges in this region due to the unique anatomy of the head and neck. This review will cover the following entities, highlighting important clinical aspects of each neoplasm and then focusing on their characteristic histomorphology, immunophenotype, and molecular alterations: nodular and cranial fasciitis, fibrous hamartoma of infancy, nasopharyngeal angiofibroma, nuchal-type and Gardner fibromas, desmoid fibromatosis, dermatofibrosarcoma protuberans and giant cell fibroblastoma, solitary fibrous tumor, inflammatory myofibroblastic tumor, low-grade myofibroblastic sarcoma, infantile fibrosarcoma, low-grade fibromyxoid sarcoma, and sclerosing epithelioid fibrosarcoma. While some of these neoplasms characteristically arise in the head and neck, others are rarely described in this anatomic region and may therefore be particularly difficult to recognize. Distinction between these entities, however, is crucial, particularly as the molecular pathogenetic basis for these neoplasms are being rapidly elucidated, in some instances allowing for targeted therapeutic approaches.
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12
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Zouhair N, Chaouki A, Ballage A, Abada RE, Rouadi S, Roubal M, Mahtar M. Fibrosarcoma of the ethmoid sinus: A rare entity. Int J Surg Case Rep 2019; 59:136-139. [PMID: 31136873 PMCID: PMC6536737 DOI: 10.1016/j.ijscr.2019.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 11/25/2022] Open
Abstract
Ethmoidal fibrosarcoma is an extremely rare tumor. Mostly misdiagnosed because of none specifics symptoms, in this case patient didn’t complaint any nasal symptom. Treatment is not codified and prognosis is unknown.
Introduction Ethmoidal fibrosarcoma is an extremely rare tumor which represent less than one percent of all malignancies in this anatomical area, the case of a 13-year-old is reported here. Presentation of case A 13-year-old boy, his medical history was marked exclusively before presented to our hospital by an exophthalmia. Rhinoscopic examination showed well-defined pink mass at the level of ethmoid. Computed tomography was performed to showed local and regional extension. Treatment was an endoscopic excision of the tumor using a navigation system. The final diagnosis was made on pathologic examination. Radiotherapy was recommended by multidisciplinary staff but the patient refused. Discussion These tumors occur in extremities most frequently and Ethmoidal localization is extremely rare and have no specifics symptoms, so the rhinoscopic examination is necessary for any chronic nasal symptom. Its treatment is not codified because of its rarity and its prognosis is unknown. Conclusion It’s important knowledge about this pathology because of its rarity and its therapeutic and prognostic difficulties.
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Affiliation(s)
- Najib Zouhair
- Department of Otorhinolaryngology, Hospital of 20 August, University of Hassan II, Casablanca, Morocco.
| | - Anass Chaouki
- Department of Otorhinolaryngology, Hospital of 20 August, University of Hassan II, Casablanca, Morocco
| | - Amine Ballage
- Department of Otorhinolaryngology, Hospital of 20 August, University of Hassan II, Casablanca, Morocco
| | - Redalah Elarabi Abada
- Department of Otorhinolaryngology, Hospital of 20 August, University of Hassan II, Casablanca, Morocco
| | - Sami Rouadi
- Department of Otorhinolaryngology, Hospital of 20 August, University of Hassan II, Casablanca, Morocco
| | - Mohamed Roubal
- Department of Otorhinolaryngology, Hospital of 20 August, University of Hassan II, Casablanca, Morocco
| | - Mohamed Mahtar
- Department of Otorhinolaryngology, Hospital of 20 August, University of Hassan II, Casablanca, Morocco
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13
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Vokuhl C. [Pediatric tumors with spindle cell morphology]. DER PATHOLOGE 2019; 40:381-392. [PMID: 31049678 DOI: 10.1007/s00292-019-0602-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Spindle cell tumors in childhood are rare lesions with a heterogeneous morphological picture and clinical course, ranging from benign lesions to fully malignant tumors. The clinical assessment of these tumors is often challenging since some of them show fast growth dynamics but are utterly benign, while a subset of slow-growing tumors can represent malignant entities. Due to the rarity of these tumors as well as the overlapping morphology and the often uncharacteristic immunohistochemical profiles, the pathologic diagnosis is often also difficult. This review gives an overview of some of the more common pediatric spindle cell tumors. In addition to the morphological features and immunohistochemical aspects, specific molecular changes are discussed. Here, some of the newly described translocations that may imply therapeutic options, are presented.
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Affiliation(s)
- C Vokuhl
- Kindertumorregister der GPOH, Sektion Kinderpathologie, Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 10/Haus 4, 24105, Kiel, Deutschland.
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14
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Bender J, Anderson B, Bloom DA, Rabah R, McDougall R, Vats P, Mody R. Refractory and metastatic infantile fibrosarcoma harboring LMNA-NTRK1 fusion shows complete and durable response to crizotinib. Cold Spring Harb Mol Case Stud 2019; 5:mcs.a003376. [PMID: 30709876 PMCID: PMC6371745 DOI: 10.1101/mcs.a003376] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/14/2018] [Indexed: 01/12/2023] Open
Abstract
Infantile fibrosarcoma (IFS) is a rare soft-tissue sarcoma, which classically presents as an aggressive and rapidly enlarging tumor over the distal extremities of children in their first year of life. The presence of ETV6 and NTRK3 gene rearrangement is characteristic of IFS, which can be detected on routine fluorescence in situ hybridization (FISH) testing. Patients with IFS typically respond well to surgical resection and chemotherapy and have an overall survival of ∼90%. In this report, we outline the use of integrative clinical sequencing (ICS) including RNA-seq in a patient with refractory, metastatic IFS to reveal an unusual fusion (LMNA-NTRK1), not detected by routine FISH testing, which was treated with oral crizotinib and resulted in a complete and durable long-term response. This study highlights the utility of ICS in identifying cryptic gene fusions, especially in refractory malignancies, and demonstrates how such information can be used to select targeted therapies in patients with actionable molecular alterations.
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Affiliation(s)
- Jonathan Bender
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Bailey Anderson
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - David A Bloom
- Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Raja Rabah
- Department of Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Rhonda McDougall
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Pankaj Vats
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Rajen Mody
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan 48109, USA.,Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, Michigan 48109, USA.,Comprehensive Cancer Center, University of Michigan, Ann Arbor, Michigan 48109, USA
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15
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Alias H, Abdul Rashid AH, Lau SCD, Loh CK, Sapuan J, Ibrahim S, Md Zin RR, Chow YP, Kanegane H, Eguchi M. Early Surgery Is Feasible for a Very Large Congenital Infantile Fibrosarcoma Associated With Life Threatening Coagulopathy: A Case Report and Literature Review. Front Pediatr 2019; 7:529. [PMID: 31956645 PMCID: PMC6951396 DOI: 10.3389/fped.2019.00529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/05/2019] [Indexed: 01/03/2023] Open
Abstract
Background: Congenital infantile fibrosarcoma (CIF) is a rare malignant soft tissue tumor that predominantly occurs in children under 1 year of age. CIF is frequently misdiagnosed with other conditions like hemangioma of infancy, infantile fibromatosis, or kaposiform hemangioendothelioma. Disseminated intravascular coagulopathy (DIVC) is rarely reported to be associated with CIF. Case presentation: We describe an infant who presented with a large mass over the right arm. She was initially treated conservatively as hemangioma but was later confirmed by tissue histopathological examination to have CIF as the mass rapidly increased in size. She developed massive intra-tumoral bleed with DIVC whilst receiving neoadjuvant chemotherapy requiring multiple blood products transfusion. An urgent near-total resection of the tumor was performed in view of life threatening bleeding despite multiple blood transfusions. Post-operatively, she received further adjuvant chemotherapy. Subsequently, she remained in complete remission 32 months off-treatment and has full function of the affected limb. Conclusions: CIF is an important condition to be considered in infant who has large mass over the extremity. DIVC could be associated with large CIF and when it occurs can be life-threatening. Whenever feasible early surgery should be performed in very young patients with large CIF to prevent mortality from bleeding.
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Affiliation(s)
- Hamidah Alias
- Department of Pediatrics, The National University of Malaysia, Kuala Lumpur, Malaysia.,UKM Medical Molecular Biology Institute, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Abdul Halim Abdul Rashid
- Department of Orthopedic and Traumatology, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Sie Chong Doris Lau
- Department of Pediatrics, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - C-Khai Loh
- Department of Pediatrics, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Jamari Sapuan
- Department of Orthopedic and Traumatology, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Sharaf Ibrahim
- Department of Orthopedic and Traumatology, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Reena R Md Zin
- Department of Pathology, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Yock Ping Chow
- UKM Medical Molecular Biology Institute, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Hirokazu Kanegane
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mariko Eguchi
- Department of Pediatrics, Graduate School of Medicine, Ehime University, Toon, Japan
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16
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Yang T, Zou Y, Li J, Yang J, Tan T, Pan J, Hu C. Infantile fibrosarcoma associated with giant congenital melanocytic nevus. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Abstract
BACKGROUND Soft tissue sarcomas are challenging to oncologists due to their unique character, the infrequency of their occurrence, and the difficulties in predicting outcomes. Advances in imaging, as well as improvements in surgical techniques and adjunctive treatment methods, have improved care for patients with these unusual disorders. METHODS The various types of soft tissue tumors are defined, and the statistics for the Orthopaedic Oncology Group in relation to them are reviewed and compared with literature references. RESULTS The overall survival rate for 1,220 tumors treated at our institute from June 1972 to June of 2001 was 72%, with a wide range. Patients with leiomyosarcomas, clear cell sarcomas, and malignant fibrous histiocytomas had a poorer survival rate, while those with fibrosarcomas, liposarcomas, and neurofibrosarcomas fared better. Outcome was affected by patient age, tumor anatomic site, tumor stage, and a history of recurrence. CONCLUSIONS Competent imaging, predictive immunological and genetic studies, improved surgery, and newer methods of adjunctive and neoadjunctive treatment should result in improvements in outcomes for patients with these tumors.
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18
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Abstract
Masses in the pediatric foot are relatively uncommon and can present a diagnostic challenge. The literature lacks a comprehensive overview of these types of lesions. Most are benign soft-tissue lesions that can be diagnosed on the basis of history and physical examination. However, some rare malignant neoplasms can mimic benign masses. It is imperative to recognize these lesions because the consequences of a delayed or missed diagnosis can be substantial. A thorough history and physical examination of all pediatric patients with foot lesions are crucial to ensure that any lesion not readily identified as benign is appropriately managed.
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19
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Chemotherapy and Multidisciplinary Approaches to Pediatric Sarcomas. Sarcoma 2017. [DOI: 10.1007/978-3-319-43121-5_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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20
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Ivanov A, Valyi-Nagy T, Nikas D. Extracalvarial Composite Infantile Myofibromatosis: Case Report and Literature Review. European J Pediatr Surg Rep 2016; 4:22-25. [PMID: 28018804 PMCID: PMC5177563 DOI: 10.1055/s-0036-1580704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/14/2016] [Indexed: 11/03/2022] Open
Abstract
Infantile soft tissue tumors of the head are very rare and the majority of them are myofibromas. The authors present the case of a 1-day-old boy with a scalp tumor with several distinct histopathological features including myofibroma, hemangiopericytoma, and fibrosarcoma consistent with the diagnosis of composite infantile myofibromatosis. Genetic testing was negative for trisomy 17, translocation (12; 15), FUS, and ETV6 translocations. Despite the ominous histopathological features, the clinical course was benign. The authors review here available literature concerning current concepts of making the diagnosis of composite infantile myofibromatosis and discuss treatment options.
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Affiliation(s)
- Alexander Ivanov
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Tibor Valyi-Nagy
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Dimitrios Nikas
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, United States
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21
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Orbach D, Brennan B, De Paoli A, Gallego S, Mudry P, Francotte N, van Noesel M, Kelsey A, Alaggio R, Ranchère D, De Salvo GL, Casanova M, Bergeron C, Merks JHM, Jenney M, Stevens MCG, Bisogno G, Ferrari A. Conservative strategy in infantile fibrosarcoma is possible: The European paediatric Soft tissue sarcoma Study Group experience. Eur J Cancer 2016; 57:1-9. [PMID: 26849118 DOI: 10.1016/j.ejca.2015.12.028] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/29/2015] [Accepted: 12/31/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Infantile fibrosarcoma (IFS) is a very rare disease occurring in young infants characterised by a high local aggressiveness but overall with a favourable survival. To try to reduce the total burden of therapy, the European pediatric Soft tissue sarcoma Study Group has developed conservative therapeutic recommendations according to initial resectability. MATERIAL AND METHODS Between 2005 and 2012, children with localised IFS were prospectively registered. Initial surgery was suggested only if possible without mutilation. Patients with initial complete (IRS-group I/R0) or microscopic incomplete (group II/R1) resection had no further therapy. Patients with initial inoperable tumour (group III/R2) received first-line vincristine-actinomycin-D chemotherapy (VA). Delayed conservative surgery was planned after tumour reduction. Aggressive local therapy (mutilating surgery or external radiotherapy) was discouraged. RESULTS A total of 50 infants (median age 1.4 months), were included in the study. ETV6-NTRK3 transcript was present in 87.2% of patients where investigation was performed. According to initial surgery, 11 patients were classified as group I, 8 as group II and 31 as group III. VA chemotherapy was first delivered to 25 children with IRS-III/R2 and one with IRS-II/R1 disease. Response rate to VA was 68.0%. Mutilating surgery was only performed in three cases. After a median follow-up of 4.7 years (range 1.9-9.0), 3-year event-free survival and overall survival were respectively 84.0% (95% confidence interval [CI] 70.5-91.7) and 94.0% (95% CI 82.5-98.0). CONCLUSIONS Conservative therapy is possible in IFS as only three children required mutilating surgery, and alkylating or anthracycline based chemotherapy was avoided in 71.0% of patients needing chemotherapy. VA regimen should be first line therapy in order to reduce long term effects.
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Affiliation(s)
- Daniel Orbach
- Department of Pediatric, Adolescent and Young Adult Oncology, Institut Curie, Paris, France.
| | - Bernadette Brennan
- Department of Pediatric Oncology, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Angela De Paoli
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Soledad Gallego
- Paediatric Oncology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Peter Mudry
- Department of Pediatric Oncology, University Children's Hospital, Brno, Czech Republic
| | - Nadine Francotte
- Department of Pediatrics, CHC-Clinique Esperance, Montegnée, Belgium
| | - Max van Noesel
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Anna Kelsey
- Department of Diagnostic Paediatric Histopathology, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Rita Alaggio
- Pathology Department, Padova University, Padova, Italy
| | - Dominique Ranchère
- Pathology Department, Institut d'Hematologie et d'Oncologie Pediatrique, Centre Léon Bérard, Lyon, France
| | - Gian Luca De Salvo
- Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Christophe Bergeron
- Department of Pediatric Oncology, Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Johannes H M Merks
- Department of Pediatric Oncology, Emma Children's Hospital-Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Meriel Jenney
- Department of Pediatric Oncology, Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom
| | - Michael C G Stevens
- Department of Pediatric Oncology, Royal Hospital for Children, University of Bristol, United Kingdom
| | - Gianni Bisogno
- Pediatric Hematology and Oncology Division, Padova University, Padova, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
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22
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Geramizadeh B, Khademi B, Karimi M, Shekarkhar G. Infantile fibrosarcoma of ethmoid sinus, misdiagnosed as an adenoid in a 5-year-old child. J Oral Maxillofac Pathol 2015; 19:271. [PMID: 26604519 PMCID: PMC4611951 DOI: 10.4103/0973-029x.164567] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Infantile fibrosarcoma of head and neck is rare and the presence of this tumor in ethmoid sinus is even more uncommon. To the best of our knowledge, <5 cases have been reported in the last 20 years in the English literature, so far, only one of which has been infantile type in a 15 months old girl. In this case report, we will explain our experience with a rare case of infantile fibrosarcoma originating from ethmoid sinus in a 5-year-old boy who presented with dyspnea and epistaxis. After biopsy, it was diagnosed as fibrosarcoma of sinus origin.
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Affiliation(s)
- Bita Geramizadeh
- Department of Pathology and Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bijan Khademi
- Department of ENT, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Karimi
- Pediatric and Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golsa Shekarkhar
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
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23
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Hiradfar A, Pourlak T, Badebarin D. Primary Pulmonary Fibrosarcoma With Bone Metastasis: a Successful Treatment With Post-Operation Adjuvant Chemotherapy. IRANIAN JOURNAL OF CANCER PREVENTION 2015; 8:e2328. [PMID: 26413248 PMCID: PMC4581369 DOI: 10.17795/ijcp2328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 11/05/2014] [Indexed: 11/25/2022]
Abstract
Introduction: Pulmonary fibrosarcoma has been an extremely rare tumor in children. Wide surgical resection of infantile fibrosarcoma would be the treatment of choice. Case Presentation: Post-operative chemotherapy has shown the benefit in the cases of residual disease after initial surgery and metastatic disease in the literature. We have presented the case of a 70-days old male child with primary infantile fibrosarcoma of the left lung and distant metastasis of skull. Conclusions: The aim of this publication was to highlight the role of adjuvant chemotherapy to improve outcome of infantile fibrosarcoma with residual tumor and / or metastatic disease.
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Affiliation(s)
- Amirataollah Hiradfar
- Pediatric Health Research Center, Tabriz University of Medical sciences, Tabriz, IR Iran
| | - Tala Pourlak
- Pathology Department, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Davoud Badebarin
- Pediatric Surgery Department, Tabriz University of Medical Sciences, Tabriz, IR Iran
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24
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Ainsworth KE, Chavhan GB, Gupta AA, Hopyan S, Taylor G. Congenital infantile fibrosarcoma: review of imaging features. Pediatr Radiol 2014; 44:1124-9. [PMID: 24706181 DOI: 10.1007/s00247-014-2957-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 02/26/2014] [Accepted: 02/26/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Fibrosarcoma is a rare tumor in children with limited information on imaging features of these tumors in the literature. OBJECTIVE To retrospectively review the imaging features of histologically proven congenital infantile fibrosarcoma. MATERIALS AND METHODS The list of histologically confirmed congenital infantile fibrosarcomas between November 1999 and June 2013 was obtained from the oncology-pathology database. Imaging features and pathology reports of these tumors were reviewed. Patient charts were reviewed and clinical features, management and outcomes were recorded. RESULTS During the study period, 13 children (9 girls and 4 boys; age range: 0 day-16 months, median age: 2.5 months) with congenital infantile fibrosarcomas were available for complete radiological review. The translocation (t[12;15]) was present in 11/13 (84.6%) and absent in 2/13. Eight/thirteen (61.5%) tumors were located in extremities (5 in lower and 3 in upper), 3/13 in thoracolumbar paraspinal regions, and one each in abdomen and sternocleidomastoid muscle. Imaging features included iso- to hyperintensity on T1-W, hyperintensity on T2-W as compared to skeletal muscles and heterogeneous enhancement. Six (37.5%) tumors showed hemorrhagic components and 2 (15.4%) showed low intensity foci. None of the patients had evidence of regional or distant metastases at diagnosis. Management included surgical resection only (1/13) and combined surgery and chemotherapy (10/13). Overall survival was 100% with a median follow-up of 49.3 months. CONCLUSION Congenital infantile fibrosarcoma has nonspecific imaging characteristics but should be high on the differential diagnosis in a soft-tissue tumor presenting in infancy, located in an extremity and showing tumoral hemorrhage. Patients have a favorable outcome.
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Affiliation(s)
- Kelly E Ainsworth
- Department of Diagnostic Imaging, McMaster University Medical Centre and McMaster University, Hamilton, ON, Canada
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25
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Sulkowski JP, Nicol K, Raval MV, Yeager N, Setty B, Groner JI, Aldrink JH. Infantile fibrosarcoma of the intestine: A report of two cases and literature review. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2014. [DOI: 10.1016/j.epsc.2014.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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26
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Swain N, Kumar SV, Dhariwal R, Routray S. Primary fibrosarcoma of maxilla in an 8-year-old child: A rare entity. J Oral Maxillofac Pathol 2014; 17:478. [PMID: 24574679 PMCID: PMC3927362 DOI: 10.4103/0973-029x.125226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fibrosarcoma (FS) is a malignant mesenchymal neoplasm of the fibroblasts that is uncommon in the head and neck and constitutes less than 1% of malignancies and approximately 6% of the soft tissue sarcomas. FSs rarely occur before the third decade except infantile type. This condition primarily affects long bones, and its occurrence in the cranium is rare (15%), with the mandible being the most commonly involved cranial site. Here a case of primary FS in anterior maxilla of an 8-year-old male child is reported. This article is presented to document the rarity of FSs in the jaws of children with review of literature.
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Affiliation(s)
- Niharika Swain
- Department of Oral Pathology, Mahatma Gandhi Mission Dental College and Hospital, Kamothe, Navi, Mumbai, Maharashtra, India
| | - Shwetha V Kumar
- Department of Oral Pathology, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India
| | - Richa Dhariwal
- Department of Oral Pathology, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India
| | - Samapika Routray
- Department of Oral Pathology, Institute of Dental Sciences, Bhubaneswar, Odisha, India
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27
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Ferrari A, Casanova M. New concepts for the treatment of pediatric nonrhabdomyosarcoma soft tissue sarcomas. Expert Rev Anticancer Ther 2014; 5:307-18. [PMID: 15877527 DOI: 10.1586/14737140.5.2.307] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nonrhabdomyosarcoma soft tissue sarcomas form a group of rare tumors with a different biology and clinical behavior. The recently established European Pediatric Soft Tissue Sarcoma Study Group is organizing a new study devoted specifically to these tumors that were formerly treated according to the principles derived from experience with rhabdomyosarcoma, which is a clearly distinct entity. The new study includes two prospective trials, one for synovial sarcoma and the other for adult-type nonrhabdomyosarcoma soft tissue sarcomas. While surgery remains the mainstay of treatment, the role of adjuvant therapy is not yet clear and our understanding of the biology and natural history of nonrhabdomyosarcoma soft tissue sarcomas is still incomplete. This review presents the latest data on nonrhabdomyosarcoma soft tissue sarcoma treatment and outcome, and the rationale behind a risk-adapted treatment program that investigates the role of full-dose ifosfamide-doxorubicin chemotherapy in improving the response rate of patients with unresectable disease, the chances of avoiding adjuvant chemotherapy in low-risk synovial sarcomas, and the possible role of chemotherapy in high-risk adult-type soft tissue sarcomas.
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Affiliation(s)
- Andrea Ferrari
- Istituto Nazionale Tumori, Via G.Venezian, 1-20133 Milan, Italy.
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28
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Salman M, Khoury NJ, Khalifeh I, Abbas HA, Majdalani M, Abboud M, Muwakkit S, Solh HE, Saab R. Congenital infantile fibrosarcoma: Association with bleeding diathesis. AMERICAN JOURNAL OF CASE REPORTS 2013; 14:481-5. [PMID: 24265847 PMCID: PMC3835170 DOI: 10.12659/ajcr.889489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 07/26/2013] [Indexed: 11/09/2022]
Abstract
PATIENT Male, 2 month FINAL DIAGNOSIS Congenital infantile fibrosarcoma Symptoms: Bleeding Medication: Vincristine • actinomycin • cyclophosphamide Clinical Procedure: Surgical resection Specialty: Pediatric Oncology. OBJECTIVE Diagnostic/therapeutic accidents. BACKGROUND Congenital infantile fibrosarcoma (CIF) is a soft-tissue tumor occurring during the first 2 years of life, most commonly in the extremities. CIF is frequently initially misdiagnosed as a vascular tumor, but its association with bleeding and coagulopathy has not been well characterized. CASE REPORTS We describe 2 infants with CIF presenting with bleeding and coagulopathy, requiring urgent intervention. Both patients did well; one underwent partial resection followed by chemotherapy, and the other received 2 cycles of chemotherapy followed by gross total resection. We also provide a review of all reported cases of coagulopathy in the setting of CIF in the English literature, uncovering an association that seems to be more prevalent in patients diagnosed in the neonatal period, with associated anemia and thrombocytopenia, and a significant mortality rate. CONCLUSIONS CIF needs to be considered in the differential diagnosis of vascular congenital tumors, especially when there is evidence of bleeding, anemia, or thrombocytopenia.
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Affiliation(s)
- Mayssaa Salman
- Department of Pediatric and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
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29
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Sulkowski JP, Raval MV, Browne M. Margin status and multimodal therapy in infantile fibrosarcoma. Pediatr Surg Int 2013; 29:771-6. [PMID: 23765394 DOI: 10.1007/s00383-013-3318-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2013] [Indexed: 12/11/2022]
Abstract
PURPOSE The rarity of infantile fibrosarcoma (IF) has precluded comprehensive treatment evaluation. The purpose of this study was to better define the extent of surgical resection required and the role of chemotherapy. METHODS Patients (0-2 years) with IF were evaluated from the National Cancer Data Base (1985-2007). Survival was estimated using the Kaplan-Meier method stratifying patients by margin status and treatment with or without chemotherapy. RESULTS Of the 224 patients, 171 (76.3 %) were <1 year of age. Of the 64 (28.6 %) with positive margins, 36 (56.3 %) had microscopic disease, 12 (18.8 %) had macroscopic disease, and 16 (25 %) had unknown margin status; none were found to have metastases. Most were managed with surgical resection (171, 76.4 %). The proportion treated with both surgery and chemotherapy increased over time (18-40 %, p = 0.025). Disease-free survival was 90.6 %. No significant survival difference was noted in this retrospective, non-randomized cohort based on margin status, nodal involvement, tumor size, or treatment modality. CONCLUSIONS The use of multimodal therapy has increased over time. There was a small increase in survival associated with negative margins and the use of multimodal therapy, however, neither result reached significance. Future studies investigating tumor biology and chemosensitivity will likely determine the optimal management of IF.
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Affiliation(s)
- Jason P Sulkowski
- Division of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH 43205, USA
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30
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Clinical management of infantile fibrosarcoma: a retrospective single-institution review. Pediatr Surg Int 2013; 29:703-8. [PMID: 23708972 PMCID: PMC4825685 DOI: 10.1007/s00383-013-3326-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Infantile fibrosarcoma (IFS) is an uncommon soft-tissue sarcoma. Here we review our experience treating this tumor. PATIENTS AND METHODS We retrospectively reviewed records of patients with IFS treated at St. Jude Children's Research Hospital between 1980 and 2009. RESULTS We identified 15 patients, 8 girls and 7 boys; 13 white and 2 black. Median age at diagnosis was 3 months. Primary sites included the leg (n = 3), chest wall (n = 2), foot (n = 2), and one each in the tongue, occipital region, axilla, parascapular region, arm, forearm, retroperitoneum, and thigh. All patients underwent resection; 11 upfront surgery, and 4 delayed. Complications included loss of the posterior tibial nerve and artery, axillary vein, biceps, pectoralis major, gallbladder, and transverse/sigmoid sinus. Eight received chemotherapy and three radiotherapy. Seven experienced local recurrence and three lung metastasis. Median follow-up was 65 months. At the time of the review, 12 patients were alive and 3 had died. All deaths were in patients older than 1 year at diagnosis with an axial primary site. CONCLUSIONS Non-mutilating surgery should be the primary treatment for IFS. Neoadjuvant chemotherapy is indicated when upfront resection is unfeasible. Patients with positive surgical margins should receive adjuvant chemotherapy. Radiotherapy is indicated for axial primary sites where complete resection is impossible.
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31
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He H, Zang LH, Feng YS, Wang J, Liu WW, Chen LX, Kang N, Tashiro SI, Onodera S, Qiu F, Ikejima T. Physalin A induces apoptotic cell death and protective autophagy in HT1080 human fibrosarcoma cells. JOURNAL OF NATURAL PRODUCTS 2013; 76:880-888. [PMID: 23647462 DOI: 10.1021/np400017k] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Physalin A (1) is a withanolide isolated from Physalis alkekengi var. franchetii. In this study, the selective growth inhibitory effects on tumor cells induced by 1 were screened, and the mechanism was investigated on 1-induced growth inhibition, including apoptosis and autophagy, in human fibrosarcoma HT1080 cells. Apoptosis induced by 1 in HT1080 cells was associated with up-regulation of caspase-3 and caspase-8 expression. However, there were no significant changes in caspase-9, Bid, Bax, and Bcl-2 expression, indicating that 1-induced apoptosis in HT1080 cells occurs mainly through activation of the death receptor-associated extrinsic apoptotic pathways. Autophagy induced by 1 was found to antagonize apoptosis in HT1080 cells. This effect was enhanced by rapamycin and suppressed by the autophagy inhibitor 3-methyladenine (3MA). Loss of beclin 1 (as an autophagic regulator) function led to similar results to 3MA. However, 1 did not show inhibitory effects on normal human cells (human peripheral blood mononuclear cells). Taken together, these results suggest that 1 may be a promising agent for the treatment of cancer.
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Affiliation(s)
- Hao He
- Department of Natural Products Chemistry, School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, People's Republic of China
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32
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Emergency surgical treatment of an ulcerative and hemorrhagic congenital/infantile fibrosarcoma of the lower leg: case report and literature review. J Pediatr Orthop B 2013; 22:228-32. [PMID: 22568962 DOI: 10.1097/bpb.0b013e3283536908] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fibrosarcomas are rare malignant soft-tissue tumors occurring mostly in infants younger than 1 year of age. Fibrosarcomas can ulcerate and cause various complications, which could threaten a fetus in utero or a child in the early neonatal period. We report a unique case of congenital infantile fibrosarcoma of the lower leg, its treatment and pathology. The large expansive and destructive lesion was not appreciated on routine prenatal ultrasound exams at 20 and 33 weeks gestation. The newborn required immediate emergency surgical intervention after delivery to prevent death by hemorrhagic shock. Initial debulking of the tumor was performed and hemostasis was attained on the day of birth. The child was resuscitated and definitive treatment of the leg was deferred until a pathologic diagnosis was obtained. Given the extent of the fibrosarcoma, the lower leg was not salvageable and the patient received a through-the-knee amputation in the neonatal period. The patient is free of disease at 2 years of age.
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Ortega-García JA, Soldin OP, López-Hernández FA, Trasande L, Ferrís-Tortajada J. Congenital fibrosarcoma and history of prenatal exposure to petroleum derivatives. Pediatrics 2012; 130:e1019-25. [PMID: 22945410 PMCID: PMC3457614 DOI: 10.1542/peds.2011-1307] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Congenital fibrosarcoma (CFS) is a rare fibrous tissue malignancy that usually presents in the first few years of life. It is unique among human sarcomas in that it has an excellent prognosis. We describe a temporal clustering of a number of cases of CFS and investigate the possible associated prenatal risk factors. The Pediatric Environmental History, a questionnaire developed in our clinic that is instrumental in determining environmental risk factors for tumor-related disease, was essential in documenting the presence or absence of risk factors considered as human carcinogens. We found a history of exposure to petroleum products in four cases of CFS that occurred at a greater than expected rate in a short time frame-an apparent cancer cluster. We call attention to the possibility that exposure to petroleum products raises the risk of developing CFS. While future studies should focus on systematic investigation of CFS and its underlying mechanisms, this report suggests the need for proactive measures to avoid exposure to solvents and petroleum products during pregnancy.
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Affiliation(s)
- Juan A. Ortega-García
- Pediatric Environmental Health Specialty Unit, Department of Pediatrics, University Hospital Virgen of Arrixaca, Murcia, Spain
| | - Offie P. Soldin
- Network PregnaTox, Department of Medicine, Oncology, Obstetrics & Gynecology, Pharmacology & Physiology, Georgetown University Medical Center, Washington DC
| | | | - Leonardo Trasande
- Department of Pediatrics and Environmental Medicine, New York University School of Medicine, New York University Wagner School of Public Service, New York, New York; and
| | - Josep Ferrís-Tortajada
- Pediatric Environmental Health Specialty Unit, Oncology Section, Department of Pediatrics, Children’s University Hospital La Fe, Valencia, Spain
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Shah NN, Price MR, Loeb DM. Cardiac metastasis and hypertrophic osteoarthropathy in recurrent infantile fibrosarcoma. Pediatr Blood Cancer 2012; 59:179-81. [PMID: 21853519 PMCID: PMC4273568 DOI: 10.1002/pbc.23321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 07/19/2011] [Indexed: 11/08/2022]
Abstract
Cardiac metastasis and hypertrophic osteoarthropathy are both quite rare. We describe a patient presenting with hypertrophic osteoarthropathy as the first symptom of recurrent infantile fibrosarcoma (IF). During surgical resection of lung metastasis, the patient suffered sudden cardiac arrest. Autopsy demonstrated a metastatic lesion in the intraventricular septum of the heart, which is previously undescribed in the literature. This case demonstrates that IF can be aggressive despite its more typical benign course.
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Affiliation(s)
- Nirali N. Shah
- Division of Pediatric Oncology, Department of Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Mitchell R. Price
- Division of Pediatric Surgery, University of Illinois Medical Center, Chicago, Illinois
| | - David M. Loeb
- Division of Pediatric Oncology, Department of Oncology, Johns Hopkins University, Baltimore, Maryland,Correspondence to: David M. Loeb, MD, PhD, Division of Pediatric Oncology, Department of Oncology, Johns Hopkins University, 600 N. Wolfe Street, CMSC 800, Baltimore, Maryland 21287.
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Abstract
Congenital fibrosarcomas are malignant tumors that arise in soft tissues. In infants this unique tumor does not commonly metastasize, even though there may be local recurrences. We report here a boy who had congenital fibrosarcoma in his right foot, which was completely excised at the age of 3 days. Four months later, a solitary encapsulated metastasis emerged in thoracic chest wall, which was operated. During adjuvant chemotherapy he developed histologically confirmed fibrosarcoma metastases in the heart. After extended treatment with cyclophosphamide/topotecan and gemcitabine/docetaxel, the heart tumors disappeared and he has been in complete remission for 3 years.
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Abstract
Fibroblastic and myofibroblastic tumors in children and adolescents are a relatively common group of soft tissue proliferations that range from reactive to hamartomatous to neoplastic, with a full spectrum of benign, intermediate, and malignant neoplasms. These lesions are diagnostically challenging because of morphologic and immunohistochemical overlap, despite significant clinical, genetic, and prognostic differences. The fibromatoses are a major subgroup, and all types of fibromatoses can occur in the 1st 2 decades of life. Intermediate and malignant fibroblastic-myofibroblastic tumors are an important group that includes variants of fibrosarcoma and other tumors with recurrent cytogenetic or molecular genetic abnormalities and low metastatic potential. Pathologic examination is enhanced by adjunct techniques, such as immunohistochemistry, cytogenetics, and molecular genetics, although morphology provides the ultimate criteria for a specific diagnosis. This article reviews the clinicopathologic features of fibroblastic and myofibroblastic tumors with an emphasis on the unique aspects of these neoplasms in children and adolescents, the use of diagnostic adjuncts, and differential diagnoses.
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Affiliation(s)
- Cheryl M Coffin
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA.
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Abstract
Fibrosarcomas (FS) are rare malignant tumors in pediatrics, classified in the heterogeneous non-rhabdomyosarcomas group of malignant mesenchymal tumors. Infantile FS are found typically in children less than 2 years of age, and include congenital FS usually occurring in infants in the first 3 months of life. Histological diagnosis can be difficult; and confirmed with detection by molecular biology of the ETV6-NTRK3 fusion protein. FS is most often a localized disease at diagnosis, with involvement of an extremity. The management of these patients must be multidisciplinary, to define the different phases of treatment and avoid mutilating surgery. Cellular or atypical mesoblastic nephroma (MN) is a subtype of malignant pediatric renal tumors, most often present in children of less than 3 months. Histopathological characteristics of the cellular MN are very close to the congenital FS due to a fusion transcript common to both diseases. Treatment schedule is defined by initial local stage of the disease. FS called "adult-type" found exceptionally in childhood occur most often after 10 years old. Adult FS differ from infantile FS in their clinical presentation because of a strong local aggressiveness and problematic appearance of metastasis in 50% of cases, sometimes late. These three diseases present therefore histological similarities. Both have a common name but different clinical presentation and outcome: infantile FS and adult FS. Two have different names and initial location but similar histology, chromosomal rearrangement, sensitivity to chemotherapy and outcome: the congenital FS and cellular mesoblatic nephroma. Authors present a review of the literature of these entities.
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Abstract
After a brief discussion of the rarity of soft tissue sarcomas in children and of the limited ability of magnetic resonance imaging to provide a tissue diagnosis, this article discusses the incidence, presentation, treatment, prognosis, and imaging characteristics of the more common and unusual pediatric soft tissue sarcomas. It begins with extensive discussion of rhabdomyosarcoma, synovial sarcoma, and congenital/infantile fibrosarcoma. It then presents a more abbreviated discussion of uncommon tumors such as alveolar soft part sarcoma, epithelioid sarcoma, extraosseous Ewing's sarcoma, granulocytic sarcoma, hemangiopericytoma, liposarcoma, malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, and undifferentiated sarcoma.
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Affiliation(s)
- Rebecca Stein-Wexler
- Department of Radiology, University of California at Davis, Sacramento, CA 95817, USA.
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Dumont C, Monforte M, Flandrin A, Couture A, Tichit R, Boulot P. Prenatal management of congenital infantile fibrosarcoma: unexpected outcome. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 37:733-735. [PMID: 21618315 DOI: 10.1002/uog.8878] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report the case of a large leg tumor in a fetus at 36 weeks of gestation. The tumor's location, ultrasound characteristics and magnetic resonance imaging (MRI) findings enabled a prenatal diagnosis of congenital fibrosarcoma and allowed us to establish the prognosis. After multidisciplinary discussion, it was decided that the pregnancy should continue to 38 weeks, with surgery or neo-adjuvant chemotherapy scheduled after delivery. Unfortunately, the tumor unexpectedly burst in utero and the newborn died of the consequences of hemorrhagic shock, despite rapid amputation. Histological examination confirmed the nature of the tumor. The prognosis of congenital fibrosarcoma is generally good when there are no metastases. MRI is key to establishing a prenatal diagnosis. However, rupture of the tumor can result in fatal hemorrhaging and the pregnancy should be monitored closely before scheduled delivery.
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Affiliation(s)
- C Dumont
- Department of Obstetrics and Gynaecology, CHU Arnaud de Villeneuve, Montpellier, France.
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McGowan J, Smith CD, Maize J, Cook J. Giant fibrous hamartoma of infancy: A report of two cases and review of the literature. J Am Acad Dermatol 2011; 64:579-86. [DOI: 10.1016/j.jaad.2009.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 09/05/2009] [Accepted: 09/17/2009] [Indexed: 10/19/2022]
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Behnke NM, Patel M, Davidson T, Arkader A. Orthopaedic case of the month: Rapidly progressive shoulder soft tissue mass in an 8-week-old girl. Clin Orthop Relat Res 2011; 469:624-9. [PMID: 21128034 PMCID: PMC3018191 DOI: 10.1007/s11999-010-1710-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 11/17/2010] [Indexed: 01/31/2023]
Affiliation(s)
- Nicole Marie Behnke
- Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA USA
| | - Moneil Patel
- Department of Pathology, Keck School of Medicine, University of Southern California, Children’s Hospital of Los Angeles, Los Angeles, CA USA
| | - Tom Davidson
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Children’s Hospital of Los Angeles, Los Angeles, CA USA
| | - Alexandre Arkader
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Children’s Hospital of Los Angeles, 4650 W Sunset Boulevard, Mailstop #69, Los Angeles, CA 90027 USA
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Lagree M, Toutain F, Revillon Y, Gaussin G, Marie-Cardine A, Lemoine F, Vannier JP. [Recurrent and metastatic infantile fibrosarcoma: a case report]. Arch Pediatr 2010; 18:28-32. [PMID: 21084177 DOI: 10.1016/j.arcped.2010.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 03/14/2010] [Accepted: 10/05/2010] [Indexed: 01/08/2023]
Abstract
Infantile fibrosarcoma is a rare malignant tumor that usually occurs during the 1st year of life. It accounts for approximately 5-10% of all sarcomas in infants younger than 1 year of age. It usually has indolent progression and metastatic spread is rare. We report the case of a patient who had infantile fibrosarcoma of the trunk. At birth, the baby presented a soft tissue mass of the scapulothoracic region. Histopathological examination after complete surgical resection at first suggested an angioma. Reanalysis of the histology after a metastatic relapse resulted in the diagnosis of infantile fibrosarcoma, which was confirmed by the presence of the specific translocation seen in infantile fibrosarcoma (ETV6/NTRK3). This patient's progression was uncommon because he developed 3 metastatic relapses. The treatment consisted of surgery, chemotherapy, and radiation therapy. The patient is alive with persistent complete remission. We discuss the diagnostic and therapeutic issues of infantile fibrosarcoma. There is a risk of erroneous diagnosis in newborn infants between benign angiomatous tumor and infantile fibrosarcoma. The fusion transcript ETV6-NTRK3 resulting from the specific chromosomal translocation t(12;15)(p13;q25) is now a useful diagnostic tool for infantile fibrosarcoma. Surgery with wide resection is the mainstay of treatment. However, infantile fibrosarcoma is a chemosensitive tumor. If initial surgery cannot be done without mutilation or is impossible, preoperative chemotherapy should be given. The role of radiation therapy is still debated.
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Affiliation(s)
- M Lagree
- Service d'hémato-oncologie pédiatrique, CHU Charles-Nicolle, 1 rue de Germont, Rouen cedex, France
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Pediatric extremity soft-tissue sarcomas: from diagnosis to surgical treatment. CURRENT ORTHOPAEDIC PRACTICE 2010. [DOI: 10.1097/bco.0b013e3181e575bf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Demir HA, Akyüz C, Varan A, Ergen FB, Büyükpamukçu M. Right foot congenital infantile fibrosarcoma treated only with chemotherapy. Pediatr Blood Cancer 2010; 54:618-20. [PMID: 19998472 DOI: 10.1002/pbc.22389] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Congenital infantile fibrosarcoma (CIF) is a rare tumor in childhood. The 5-year survival rate for CIFs is high and has been reported between 84% and 93%, but limb-amputation/disarticulation is still a major problem. We report the case of a male newborn with a mass in his right foot. X-ray and MRI revealed a mass destroying all tarsal, metatarsal, and phalangeal bones. The patient was treated only with VAC chemotherapy and is able to walk normally.
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Affiliation(s)
- Haci Ahmet Demir
- Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey.
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Nam SH, Cho MJ, Kim DY, Kim SC, Kim IK. Infantile Fibrosarcoma in Neonate. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2010. [DOI: 10.4174/jkss.2010.79.suppl1.s62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- So-Hyun Nam
- Department of Surgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Min-Jung Cho
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dae-Yeon Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong-Chul Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Koo Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Orbach D, Rey A, Cecchetto G, Oberlin O, Casanova M, Thebaud E, Scopinaro M, Bisogno G, Carli M, Ferrari A. Infantile fibrosarcoma: management based on the European experience. J Clin Oncol 2009; 28:318-23. [PMID: 19917847 DOI: 10.1200/jco.2009.21.9972] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To retrospectively analyze the clinical features and results of treatment in 56 infants with fibrosarcoma enrolled onto cooperative European protocols between 1979 and 2005 and treated with a combination of surgery and chemotherapy. PATIENTS AND METHODS We performed a retrospective case review of infants under the age of 2 years with fibrosarcoma treated between 1979 and 2005 in six European studies. Patients were staged according to the Intergroup Rhabdomyosarcoma Staging System international classification as a function of the type of initial surgery and the extent of disease and were treated with surgery and chemotherapy. Survival was calculated using the Kaplan-Meier method. RESULTS Primary tumor site was the limbs in 66% of patients; median tumor diameter was more than 5 cm in 63% of patients; and postoperative staging was as follows: group I, 22%; group II, 27%; group III, 47%; and group IV, 4%. Response rate to chemotherapy was 75%, and the specific response rate to vincristine-dactinomycin was 71%. Local control was obtained in 84% of patients. At the end of follow-up, 45% of survivors had been treated by surgery alone, 6% by chemotherapy alone, 46% by surgery and chemotherapy, and 2% by surgery, chemotherapy, and radiotherapy. The 5-year overall survival (OS) rate was 89%. The 5-year OS and event-free survival rates for localized patients were 89% and 81%, respectively. CONCLUSION Although complete resection is rarely feasible at diagnosis, conservative surgery remains the mainstay treatment for infantile fibrosarcoma. An alkylating agent-free and anthracycline-free regimen is usually effective and should be chosen as first-line chemotherapy for inoperable tumors. Overall prognosis is good, but progression or relapse, mainly local, remains possible.
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Affiliation(s)
- Daniel Orbach
- Département de Pédiatrie, Institut Curie, 26 rue d'Ulm, 75005 Paris, France.
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Abstract
The development of a new soft tissue lesion in an otherwise healthy child, adolescent, or young adult can present many challenges for pediatric or medical oncology teams. Although uncommon, the diagnosis of a soft tissue malignancy should always be considered in the differential diagnosis of persistent pain, even if no mass is palpable. The definitive diagnosis and treatment of a soft tissue mass is aided by timely scans, appropriate biopsy for anatomic and molecular pathology, and a treatment approach guided by the specific diagnosis. Because pediatric soft tissue sarcomas are rare, cooperative groups play a crucial role in defining the standard of care through retrospective series and well-designed prospective clinical trials. Enrollment of newly diagnosed patients in clinical studies should be encouraged in order to continue to improve outcomes and understanding of these rare tumors. This review focuses on the current recommendations for management of sarcomas that typically occur in the soft tissues of pediatric and young adult patients.
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Affiliation(s)
- Melinda S Merchant
- Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
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Canale S, Vanel D, Couanet D, Patte C, Caramella C, Dromain C. Infantile fibrosarcoma: Magnetic resonance imaging findings in six cases. Eur J Radiol 2009; 72:30-7. [DOI: 10.1016/j.ejrad.2009.05.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 05/04/2009] [Indexed: 10/20/2022]
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Abstract
Fibroblastic and myofibroblastic tumors in neonates, infants, and children provide a diagnostic dilemma in surgical pathology due to their relative rarity and similarity in appearances. These tumors may be congenital or occur early during the first years of life or later during the first and second decades of life. The morphologic, immunocytochemical, ultrastructural, cytogenetic, and molecular features of the more "common" pediatric fibroblastic and myofibroblastic tumors are reviewed. In addition, the importance of a multimodal approach to tumor diagnosis is emphasized, with correlation with treatment and outcome differences among these unique fibroblastic and myofibroblastic tumors. The importance of providing an accurate diagnosis with pediatric fibroblastic and myofibroblastic tumors cannot be overstated, because treatment, prognosis, follow-up, and outcome are based on the initial assessment of these fascinating, but oftentimes, perplexing tumors.
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MESH Headings
- Adolescent
- Child
- Child, Preschool
- Fibroblasts/classification
- Fibroblasts/pathology
- Fibroblasts/ultrastructure
- Fibroma/classification
- Fibroma/pathology
- Fibroma/ultrastructure
- Humans
- Infant
- Infant, Newborn
- Microscopy, Electron, Transmission
- Myofibroma/classification
- Myofibroma/pathology
- Myofibroma/ultrastructure
- Neoplasms, Fibrous Tissue/classification
- Neoplasms, Fibrous Tissue/pathology
- Neoplasms, Fibrous Tissue/ultrastructure
- Neoplasms, Muscle Tissue/classification
- Neoplasms, Muscle Tissue/pathology
- Neoplasms, Muscle Tissue/ultrastructure
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Affiliation(s)
- John Hicks
- Texas Children's Cancer Center Cytogenetics Laboratory, Texas Children's Hospital and Baylor College of Medicine, Department of Pathology, Houston, Texas 77030-2313, USA.
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