1
|
Li Y, Zhou S, Wan Y, Xu L, Wu S, Zhang Y, Liu ET. Multimodal imaging of perivascular epithelioid cell tumors in the pericardium. J Nucl Cardiol 2023; 30:2194-2197. [PMID: 35915326 DOI: 10.1007/s12350-022-03057-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Yingwen Li
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shuqin Zhou
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yun Wan
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Li Xu
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine & Guangdong Provincial Hospital of Chinese Medicine, Guangdong Province, 111 Da De Lu, Guangzhou, 510120, People's Republic of China.
| | - Shanshan Wu
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ying Zhang
- Department of Radiology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - En-Tao Liu
- WeiLun PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| |
Collapse
|
2
|
Mirmomen SM, Matthew TL, Arai AE, Sirajuddin A. Pericardial Perivascular Epithelioid Cell Neoplasm. Radiol Cardiothorac Imaging 2021; 3:e200532. [PMID: 33969310 DOI: 10.1148/ryct.2021200532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/18/2020] [Accepted: 01/04/2021] [Indexed: 11/11/2022]
Abstract
Supplemental material is available for this article.
Collapse
Affiliation(s)
- S Mojdeh Mirmomen
- National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Dr, Building 10, Room B1D416, Bethesda, MD 20814 (S.M.M., A.E.A., A.S.); and Department of Cardiac Surgery, Suburban Hospital, Bethesda, Md (T.L.M.)
| | - Thomas L Matthew
- National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Dr, Building 10, Room B1D416, Bethesda, MD 20814 (S.M.M., A.E.A., A.S.); and Department of Cardiac Surgery, Suburban Hospital, Bethesda, Md (T.L.M.)
| | - Andrew E Arai
- National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Dr, Building 10, Room B1D416, Bethesda, MD 20814 (S.M.M., A.E.A., A.S.); and Department of Cardiac Surgery, Suburban Hospital, Bethesda, Md (T.L.M.)
| | - Arlene Sirajuddin
- National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Dr, Building 10, Room B1D416, Bethesda, MD 20814 (S.M.M., A.E.A., A.S.); and Department of Cardiac Surgery, Suburban Hospital, Bethesda, Md (T.L.M.)
| |
Collapse
|
3
|
Ghanem S, Granina E, Hevroni G, Schrem E, Lin B, Chiu E. Metastatic cardiac PEComa presenting as a hemorrhagic pleural effusion: Case presentation and review of literature. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2021. [DOI: 10.1016/j.cpccr.2021.100053] [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
|
4
|
Daimon M, Kanki S, Ozawa H, Katsumata T. A surgical case of primary perivascular epithelioid cell tumor of the heart. J Card Surg 2020; 35:1732-1735. [PMID: 32484981 DOI: 10.1111/jocs.14676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND We encountered an extremely rare case of perivascular epithelioid cell tumor (PEComa) of the heart. CASE REPORT A 54-year-old woman was admitted to our hospital because a solid mass developing in the left atrioventricular groove by computed tomography scans of the chest. Histologic examination of the resected tumor revealed that the tumor had proliferating fusiform or spheroid cells with clear cytoplasm. Immunostaining showed positive results for α-smooth muscle actin, a myogenic marker, and human melanin black-45 (HMB-45), leading to a diagnosis of PEComa. The patient was discharged uneventfully, and there was no recurrence for the last thirteen years postoperatively. CONCLUSIONS We experienced a surgical case of PEComa primarily occurring in the heart. Although no sign of a recurrence is observed to date, we consider it necessary to follow up the case carefully.
Collapse
Affiliation(s)
- Masahiro Daimon
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Sachiko Kanki
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Hideki Ozawa
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takahiro Katsumata
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| |
Collapse
|
5
|
Ruptured pericardial perivascular epithelioid cell tumor (PEComa) leading to sudden death: an autopsy case report and review of the literature. Cardiovasc Pathol 2015; 25:63-6. [PMID: 26386746 DOI: 10.1016/j.carpath.2015.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/15/2015] [Accepted: 08/20/2015] [Indexed: 11/20/2022] Open
Abstract
A 30-year-old man with past medical history of atrial fibrillation/flutter passed away after presenting with sudden-onset cardiac dysfunction. The postmortem examination revealed cardiac tamponade secondary to rupture of a 7.2-cm pericardial perivascular epithelioid cell tumor (PEComa). The tumor grossly appeared to arise from the transverse pericardial sinus and focally penetrated the epicardium of the right atrium. Microscopically, it was composed of predominately spindle cells with low nuclear grade, no pleomorphism, or readily apparent mitoses. Immunohistochemistry revealed cytoplasmic reactivity for HMB-45, desmin, and smooth muscle actin. Electron microscopic findings were characterized by melanosome-like structures intermixed with intermediate filaments and abundant stacked endoplasmic reticulum. The present case is unique among previously reported pericardial/myocardial PEComas as a first example resulting in unexpected cardiac tamponade and sudden cardiac death.
Collapse
|
6
|
PEComa: morphology and genetics of a complex tumor family. Ann Diagn Pathol 2015; 19:359-68. [PMID: 26144278 DOI: 10.1016/j.anndiagpath.2015.06.003] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 06/04/2015] [Indexed: 12/20/2022]
Abstract
Perivascular epithelioid cell tumors, or PEComas, are mesenchymal neoplasms composed of histologically and immunohistochemically distinctive epithelioid or spindle cells, which are immunoreactive for both smooth muscle and melanocytic markers. The cells in PEComas are typically arranged around blood vessels and appear to form the vessel wall, often infiltrating the smooth muscle of small- to medium-sized vessels. Periluminal cells are usually epithelioid and the more peripheral cells are spindle shaped. The cells have small, round to oval nuclei, sometimes with focal nuclear atypia, and clear to eosinophilic cytoplasm, and no counterpart normal cell has been identified. The PEComa "family" now includes angiomyolipoma, pulmonary clear cell "sugar" tumor and lymphangioleiomyomatosis, primary extrapulmonary sugar tumor, clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres, abdominopelvic sarcoma of perivascular epithelioid cells, and other tumors with similar features at various sites that are simply termed PEComa. Some PEComas occur in patients with tuberous sclerosis complex and share the genetic abnormalities. There is a behavioral spectrum from benign to frankly malignant, and histologic criteria have been proposed for assessing malignant potential. The differential diagnosis can include carcinomas, smooth muscle tumors, other clear cell neoplasms, and adipocytic tumors. PEComas constitute a genetically diverse group that includes neoplasms harboring TFE3 gene rearrangements and those with TSC2 mutations, indicating alternative tumorigenic pathways. Recent advances in therapy of malignant PEComas relate to increased knowledge of specific genetic changes and their effects on metabolic pathways that are susceptible to specific interventions. We review PEComas, emphasizing the diagnostic spectrum and recent immunohistochemical and genetic findings.
Collapse
|
7
|
"Malignant" perivascular epithelioid cell neoplasm: risk stratification and treatment strategies. Sarcoma 2012; 2012:541626. [PMID: 22619565 PMCID: PMC3350998 DOI: 10.1155/2012/541626] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 02/08/2012] [Indexed: 02/07/2023] Open
Abstract
Purpose. Perivascular epithelioid cell tumors (PEComas) are a rare collection of tumors characterized by a myomelanocytic phenotype, and PEComas occurring in “nonclassic” anatomic distributions are known as perivascular epithelioid cell tumor not otherwise specified (PEComa-NOS). This review aims to compile and analyze cases of PEComa-NOS in an effort to better define their natural history.
Design. We evaluated all 234 cases of PEComa-NOS reported in the English literature, extracting information regarding diagnostic features, treatment approaches, and outcomes. Multivariate analysis of a number of variables evaluable on pathologic review was performed to refine preexisting risk stratification criteria. Outcomes for patients receiving nonsurgical treatment are also reported.
Results. Primary tumor size ≥5 cm (P = 0.02) and a high (1/50 HPF) mitotic rate (P < 0.0001) were the only factors significantly associated with recurrence following surgical resection. Cytotoxic chemotherapy and radiation therapy have shown little benefit in treating PEComa-NOS; mTOR inhibition is emerging as a treatment option.
Conclusion. Progress has been made in understanding the natural history and molecular biology of PEComa-NOS. This review further clarifies risk of recurrence in this disease, allowing clinicians to better risk stratify patients. Further work should focus on applying this knowledge to making treatment decisions for patients with this disease.
Collapse
|
8
|
Bleeker JS, Quevedo JF, Folpe AL. Malignant perivascular epithelioid cell tumor of the uterus. Rare Tumors 2012; 4:e14. [PMID: 22532912 PMCID: PMC3325741 DOI: 10.4081/rt.2012.e14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 01/03/2012] [Accepted: 01/06/2012] [Indexed: 01/04/2023] Open
Abstract
Perivascular epithelioid cell tumors (PEComas) are a rare collection of tumors arising in a wide array of anatomic locations and characterized by a myomelanocytic phenotype. PEComas which occur in non-classic anatomic distributions are known as perivascular epithelioid cell tumor-not otherwise specified (PEComa-NOS), and one of the most common primary sites for PEComa-NOS is the uterus. The risk of aggressive behavior of these tumors has been linked to a number of factors evaluable on pathologic review following initial surgical resection. We report a case of PEComa-NOS of the uterus with multiple high-risk features, including frank vascular invasion, with no evidence of recurrent disease 18 months following initial surgical resection.
Collapse
|