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Prasad AS, Shanbhogue KP, Ramani NS, Balasubramanya R, Surabhi VR. Non-gastrointestinal stromal tumor, mesenchymal neoplasms of the gastrointestinal tract: a review of tumor genetics, pathology, and cross-sectional imaging findings. Abdom Radiol (NY) 2024:10.1007/s00261-024-04329-1. [PMID: 38691132 DOI: 10.1007/s00261-024-04329-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 05/03/2024]
Abstract
There is a diverse group of non-gastrointestinal stromal tumor (GIST), mesenchymal neoplasms of the gastrointestinal (GI) tract that demonstrate characteristic pathology and histogenesis as well as variable imaging findings and biological behavior. Recent advancements in tumor genetics have unveiled specific abnormalities associated with certain tumors, influencing their molecular pathogenesis, biology, response to treatment, and prognosis. Notably, giant fibrovascular polyps of the esophagus, identified through MDM2 gene amplifications, are now classified as liposarcomas. Some tumors exhibit distinctive patterns of disease distribution. Glomus tumors and plexiform fibromyxomas exhibit a pronounced affinity for the gastric antrum. In contrast, smooth muscle tumors within the GI tract are predominantly found in the esophagus and colorectum, surpassing the incidence of GISTs in these locations. Surgical resection suffices for symptomatic benign tumors; multimodality treatment may be necessary for frank sarcomas. This article aims to elucidate the cross-sectional imaging findings associated with a wide spectrum of these tumors, providing insights that align with their histopathological features.
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Affiliation(s)
| | | | - Nisha S Ramani
- Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, USA
| | | | - Venkateswar R Surabhi
- Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX, 77030, USA.
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2
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Cantú-Soriano GN, Padilla-Rodríguez ÁL. [Intestinal calcifying fibrous tumor: case report]. Rev Esp Patol 2024; 57:137-140. [PMID: 38599735 DOI: 10.1016/j.patol.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 04/12/2024]
Abstract
Calcifying fibrous tumor (CFT) is a rare benign lesion of mesenchymal origin that may present similar characteristics to other more common tumors. We present the case of a 36-year-old woman with a tumor in the proximal jejunum, initially suspected to be a gastrointestinal stromal tumor (GIST). Surgical resection was performed, revealing a well-demarcated nodule at the anti-mesenteric border with microscopic features typical of a calcifying fibrous tumor. The tumor cells were positive for CD34 and negative for other markers, differentiating it from other neoplasms. Calcifying fibrous tumors can be confused with more common tumors because of its appearance, but an accurate diagnosis supported by immunohistochemistry is essential. Complete surgical excision is usually curative.
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Affiliation(s)
- Gonzalo Nathaniel Cantú-Soriano
- DIGIPATH (Digital Pathology Laboratory), Escuela de Medicina Universidad Panamericana, Campus Ciudad de México, Ciudad de México, México
| | - Álvaro Lezid Padilla-Rodríguez
- DIGIPATH (Digital Pathology Laboratory), Escuela de Medicina Universidad Panamericana, Campus Ciudad de México, Escuela de Medicina Instituto Tecnológico y de Estudios Superiores de Monterrey, Campus Ciudad de México, Ciudad de México, México.
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3
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Ramalhosa F, Pezzuto F, Fortarezza F, Canu G, Biondini D, Faccioli E, Polverosi R, Giraudo C, Calabrese F. Endobronchial solitary fibrous tumors: An enigma for diagnosis. Pathol Res Pract 2024; 256:155240. [PMID: 38492357 DOI: 10.1016/j.prp.2024.155240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms constituting less than 2% of all soft tissue tumors. They typically originate in the thoracic cavity, mainly in the pleura, but can also occur in other various sites such as lung parenchyma, pericardium, and bronchus. In this study, a 49-year-old non-smoking female with a history of allergies presented to our pulmonary clinic with a chronic cough. An explorative bronchoscopy revealed an intrabronchial mass in the left superior bronchi, and a 68 Ga-DOTATOC positron emission computed tomography suggested a carcinoid tumor. Subsequent pulmonary segmentectomy unveiled a well-circumscribed polypoid lesion diagnosed as a low-grade bronchus SFT through histopathological and immunohistochemical assessments. The patient was asymptomatic after surgical excision and showed no other lesion during the 6-month follow-up. The endobronchial location of SFT is uncommon, with only a few reported cases in the literature, underscoring the necessity of considering various differential diagnoses, including carcinoid, mucoepidermoid carcinoma, endobronchial pleomorphic adenoma, hamartoma, leiomyoma, and metastasis, depending on location and imaging features. This report underscores the importance of careful histological and immunohistochemical evaluation in understanding and appropriately stratifying the risk associated with polypoid lesions.
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Affiliation(s)
- Fátima Ramalhosa
- Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra 3004-561, Portugal
| | - Federica Pezzuto
- Department of Cardia, Thoracic, Vascular Science, and Public Health, University of Padova, Padova 35121, Italy
| | | | - Gianluca Canu
- Department of Cardia, Thoracic, Vascular Science, and Public Health, University of Padova, Padova 35121, Italy
| | - Davide Biondini
- Department of Cardia, Thoracic, Vascular Science, and Public Health, University of Padova, Padova 35121, Italy
| | - Eleonora Faccioli
- Department of Cardia, Thoracic, Vascular Science, and Public Health, University of Padova, Padova 35121, Italy
| | | | - Chiara Giraudo
- Department of Cardia, Thoracic, Vascular Science, and Public Health, University of Padova, Padova 35121, Italy
| | - Fiorella Calabrese
- Department of Cardia, Thoracic, Vascular Science, and Public Health, University of Padova, Padova 35121, Italy.
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4
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Kašpar L, Balko J, Strnadová M, Krsková L, Máška D, Zámečník J. Mazabraud's syndrome: A case report supported by molecular studies and review of the literature. Bone Rep 2023; 18:101685. [PMID: 37250204 PMCID: PMC10220459 DOI: 10.1016/j.bonr.2023.101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Mazabraud's syndrome represents rare benign disorder characterized by simultaneous occurrence of fibrous dysplasia of bone and intramuscular myxomas within surrounding soft tissue. Mutations of GNAS1 gene were proven to be causative for this condition. Here, we present a case report of a patient with unusual manifestation of this disease, who developed a pathological fracture of the femur in the setting of monostotic fibrous dysplasia. The intramuscular myxoma of the thigh was discovered during the following orthopedic operation, where the intraoperative diagnosis became a pitfall of the case, as the intramuscular myxoma was initially diagnosed as a low-grade sarcoma from the frozen section. Apart from clinical findings, the diagnosis of Mazabraud's syndrome was further proven by histopathological evaluation and molecular studies of GNAS1 gene. This case raises awareness of such condition as it can easily become a diagnostic pitfall.
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Affiliation(s)
- Ludvík Kašpar
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Jan Balko
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Martina Strnadová
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Lenka Krsková
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague, Czech Republic
| | - David Máška
- Department of Adult and Pediatric Orthopaedic Surgery and Traumatology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague, Czech Republic
| | - Josef Zámečník
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University and Motol University Hospital, V Úvalu 84, 150 06 Prague, Czech Republic
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Sánchez Fernández C, García Lagarto E, Rodríguez-Arias CA. Recurrent meningeal malignant tumor: Assessment of differences in the solitary fibrous tumor/hemangiopericytoma spectrum through a case report. Neurocirugia (Astur : Engl Ed) 2022; 33:371-376. [PMID: 36333095 DOI: 10.1016/j.neucie.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/14/2021] [Indexed: 06/16/2023]
Abstract
Solitary fibrous tumors (SFTs) are neoplasms that grow from mesenchymal fusiform cells. In the central nervous system, meninges are the common origin of these neoplasms. Although literature reports mostly SFT as benign neoplasm, malignancy data have been described in recurrences or metastatic lesions. Definitive diagnosis includes immunohistochemical profiles assessing cellular positivity for CD34, vimentin, CD99 and Bcl-2. Recent studies have demonstrated NAB2-STAT6 gene fusion as a distinct molecular feature of SFT with overexpression of the fusion protein NAB2-STAT6 in nuclei of these cells. Since several years, pathologists have grouped SFT and hemangiopericytomas (HPC) as different phenotypes of the same entity although both neoplasms do not share numerous features. This article, based on a case of a recurrent malignant SFT, aims to emphasize differences in the SFT/HPC spectrum due to the diagnostic, therapeutic and prognostic implications.
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Affiliation(s)
| | - Elena García Lagarto
- Department of Pathology, University Clinical Hospital of Valladolid, Valladolid, Spain
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Xie GY, Zhu HB, Jin Y, Li BZ, Yu YQ, Li JT. Solitary fibrous tumor of the liver: A case report and review of the literature. World J Clin Cases 2022; 10:7097-7104. [PMID: 36051139 PMCID: PMC9297403 DOI: 10.12998/wjcc.v10.i20.7097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/30/2022] [Accepted: 05/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatic solitary fibrous tumor (SFT) is a rare neoplasm. Up to now, only 90 cases have been reported in the English language literature. This report describes a case of SFT of the liver misdiagnosed as hepatocellular carcinoma.
CASE SUMMARY A 42-year-old male had a two-year history of a gradually enlarging intrahepatic nodule. The preoperative imaging revealed a mass with a size of 2.7 cm × 2.3 cm located in the segment IV of the liver. The patient was subjected to the resection of the segment IV, such as the medial segment of the left lobe of the liver. The histological examination of the mass showed various spindled cells irregularly arranged in the stroma. The immunohistochemistry of this mass revealed a positive staining for CD34 and STAT6. The history of intracranial tumor and postoperative pathological results led to the diagnosis of SFT of the liver (SFTL) due to a metastasis from the brain.
CONCLUSION SFTL is an uncommon mesenchymal neoplasm that can be easily overlooked or misdiagnosed. The best treatment choice is the complete surgical resection of the mass. A regular follow-up after the surgery should be performed due to the poor prognosis of metastatic or recurrent SFT.
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Affiliation(s)
- Guang-Yuan Xie
- Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Huan-Bing Zhu
- Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Yun Jin
- Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Bai-Zhou Li
- Department of Pathology, The Second Affiliated Hospital, Zhejiang University School of Medicine, HangZhou 310000, Zhejiang Province, China
| | - Yuan-Quan Yu
- Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Jiang-Tao Li
- Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
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Pantoja Pachajoa DA, Palacios Huatuco RM, Sambuelli G, Viscido GR, Doniquian AM, Mandojana FI. Surgical resection of a presacral solitary fibrous tumor with extension to iliac vessels using Karakousis's abdominoinguinal approach: Report of a rare case. Int J Surg Case Rep 2021; 83:106011. [PMID: 34062355 PMCID: PMC8178095 DOI: 10.1016/j.ijscr.2021.106011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction and importance The solitary fibrous tumor (SFT) is a rare tumor of mesenchymal origin, with a reported incidence of 2.8 cases per 100,000 tumors and with distinctive histopathological and immunohistochemical characteristics. It was initially described as a pleural lesion and subsequently, it was found in different organs and tissues. The abdominoinguinal incision described by Karakousis allows a safe and radical approach for lower quadrants abdominopelvic tumors. Case presentation A 47-year-old man was referred to us with a 5-months history of lower backache radiating to the left lower limb. MRI and CT revealed a retroperitoneal mass of 10 cm extending to left iliac vessels. The initial diagnosis corresponded to a sarcomatous retroperitoneal tumor. It was decided to perform an abdominal exploration using Karakousis's approach for surgical resection. The immunohistochemistry and histopathological study revealed neoplasia compatible with a SFT. It was categorized as low risk for developing metastasis and death from disease, according to the new malignancy criteria. Currently, the patient is asymptomatic and disease-free at 19 months after surgery. Clinical discussion Most patients with SFTs present symptoms derived from the tumor growth and the compression on adjacent structures with clinical manifestations that are frequently insidious and precede the tumor discovery. The diagnosis is based on histopathological studies. Nonetheless, when they present an extrathoracic location, they represent a diagnostic challenge, due to their variable histological characteristics. Conclusion Presacral SFT is a rare entity, with a scant incidence reported regarding this location and long-term treatment. Surgical resection is needed as the immediate treatment. A solitary fibrous tumor (SFT) is a rare tumor of mesenchymal origin. SFT requires immediate treatment with surgical resection. The Karakousis abdominoinguinal incision allows a safe and radical approach. The presacral SFT with extension to iliac vessels benefits from the Karakouis approach.
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Affiliation(s)
- Diana A Pantoja Pachajoa
- Oncology Surgery Sector, General Surgery Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
| | - René M Palacios Huatuco
- Oncology Surgery Sector, General Surgery Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina.
| | - Gabriela Sambuelli
- Pathological Anatomy Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
| | - Germán R Viscido
- Oncology Surgery Sector, General Surgery Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
| | - Alejandro M Doniquian
- Oncology Surgery Sector, General Surgery Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
| | - Facundo I Mandojana
- Oncology Surgery Sector, General Surgery Service, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
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8
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Alonso Batanero S, Garrosa Muñoz S, Iglesias Iglesias MJ, Muñoz-Bellvís L. A giant solitary fibrous tumor arising from the hepatic round ligament. Dig Liver Dis 2021; 53:379-380. [PMID: 32601031 DOI: 10.1016/j.dld.2020.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 12/11/2022]
Affiliation(s)
- S Alonso Batanero
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Salamanca, Spain.
| | - S Garrosa Muñoz
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Salamanca, Spain
| | - M J Iglesias Iglesias
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Salamanca, Spain
| | - L Muñoz-Bellvís
- Department of General and Gastrointestinal Surgery, Hospital Universitario de Salamanca, Salamanca, Spain; Institute for Biomedical Research of Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
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Kaur K, Rajeshwari M, Gurung N, Kumar H, Sharma MC, Yadav R, Kumar S, Manchanda S, Singhal S, Mathur SR. Uterine tumor resembling ovarian sex cord tumor: A series of six cases displaying varied histopathological patterns and clinical profiles. INDIAN J PATHOL MICR 2020; 63:S81-S86. [PMID: 32108635 DOI: 10.4103/ijpm.ijpm_340_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Uterine tumors resembling ovarian sex cord tumor (UTROSCT) are a unique group of neoplasms with diverse morphology and immunophenotypic characteristics, coexpressing sex cord, epithelial, and smooth-muscle markers. To date, less than 100 cases have been reported and there is paucity of data concerning their clinical behavior. Materials and Methods All cases of uterine body tumors diagnosed over a period of two and a half years (2016-2018) were retrieved. Histopathological features were reviewed and extended panel of immunohistochemistry was performed to identify cases of UTROSCTs. Results Six cases of UTROSCTs were identified with a median age of 46.5 years. Four of them presented with menorrhagia, while two with postmenopausal bleeding including one with a history of carcinoma breast. Three of these cases were initially misdiagnosed as endometrial stromal sarcoma and adenocarcinomas. They all underwent hysterectomy with bilateral salpingo-oophorectomy. Conclusion It is considered a tumor with low malignant potential; however, one out of six cases (16.7%) in our study showed metastasis, within 1 year of diagnosis. It is important to recognize this entity as it mimics a wide range of both benign and malignant tumors. Molecular pathogenesis and exact management protocols remain elusive due to rarity,hence, multi-institutional studies are warranted.
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Affiliation(s)
- Kavneet Kaur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Madhu Rajeshwari
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Niteeka Gurung
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Hemanth Kumar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar C Sharma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajni Yadav
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sunesh Kumar
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Manchanda
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Singhal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep R Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Nova LM, Lopez P, Cerezo C, Llanos C, Amat I. Ileal Intussusception in an Adult Caused by a Locally Invasive Inflammatory Fibroid Polyp: A Case Report. Rev Esp Patol 2020; 54:65-69. [PMID: 33455696 DOI: 10.1016/j.patol.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/21/2020] [Accepted: 06/14/2020] [Indexed: 11/30/2022]
Abstract
Inflammatory fibroid polyps (IFPs) are rare mesenchymal neoplasms affecting the gastrointestinal tract which are considered benign and noninvasive. We present a case of an invasive IFP in a 46-year-old woman who presented with signs of intestinal obstruction due to ileal intussusception. A segment of the small intestine was resected and subsequently intestinal continuity was restored. A polypoid lesion was found obstructing the lumen. Histopathology revealed a mesenchymal proliferation of spindle and stellate cells, without cytological atypia, arranged in a fibromyxoid stroma. The tumor cells were located in the submucosa but also infiltrated the muscularis propria and the subserosa and were CD34 positive. The molecular study by PCR showed mutation in exon 12 of the PDGFRA gene. IFP is considered a true neoplasm and can also be considered as a potentially invasive lesion.
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Affiliation(s)
- Luiz M Nova
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
| | - Paul Lopez
- Department of Radiology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Clara Cerezo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Concepción Llanos
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Irene Amat
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
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11
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Suh YJ, Park JH, Jeon JH, Bilegsaikhan SE. Extrapleural solitary fibrous tumor of the thyroid gland: A case report and review of literature. World J Clin Cases 2020; 8:782-789. [PMID: 32149061 PMCID: PMC7052546 DOI: 10.12998/wjcc.v8.i4.782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/13/2020] [Accepted: 01/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm that arises from the pleura. A few SFTs have also been described in extrapleural sites. However, SFT of the thyroid gland is rare. Here, we report a case of extrapleural SFT on the thyroid gland, in addition to a literature review.
CASE SUMMARY A 59-year-old man visited our hospital in July 2017 complaining of a large mass in his neck. His thyroid function test results, including antibody levels, were within the normal limits. Ultrasonography showed a 4.7 cm × 4.0 cm × 3.2 cm solitary mass of intermediate suspicion in the left thyroid lobe. A fine-needle aspiration biopsy was subsequently performed. The pathologist reported a benign follicular lesion. However, the size of this nodule increased to 5.5 cm × 5.0 cm × 3.4 cm by April 2018. After a multidisciplinary discussion, a left lobectomy was performed in May 2018. The specimen showed a well-demarcated, partly encapsulated, soft nodule of whitish and tan/brown color on the cut surface. Light microscopy revealed high cellularity with moderate cytologic atypia. The mitotic count was 5/10 high-power fields. There was no tumor necrosis or lymphovascular invasion. The tumor was CD34-positive and signal transducer and activator of transcription 6-positive. Neither thyroid transcription factor-1 nor cytokeratin expression was detected. The Ki-67 showed intermediate proliferative activity. The final diagnosis was extrapleural SFT of the thyroid gland with a clear resection margin. The patient was discharged without complication three days after the surgery.
CONCLUSION In the literature, extrapleural SFT of the thyroid gland has been reported to behave indolently with the capacity for recurrence and rare metastasis, although surgical resection is the treatment of choice. Understanding this disease entity is important for accurate diagnosis and proper management.
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Affiliation(s)
- Yong Joon Suh
- Department of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Gyeonggi-do 14068, South Korea
| | - Jung Ho Park
- Department of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, Gyeonggi-do 14068, South Korea
| | - Jae Hyeon Jeon
- Department of Biomedical Science, Hallym University, Chuncheon 24252, South Korea
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Ronchi A, La Mantia E, Gigantino V, Perdonà S, De Sio M, Facchini G, Franco R, De Chiara A. A rare case of malignant solitary fibrous tumor in prostate with review of the literature. Diagn Pathol 2017; 12:50. [PMID: 28687087 PMCID: PMC5501453 DOI: 10.1186/s13000-017-0640-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/29/2017] [Indexed: 12/18/2022] Open
Abstract
Background Solitary fibrous tumor is an uncommon soft tissue neoplasm with intermediate biological behavior, which rarely metastasizes. Malignant solitary fibrous tumor, although not clearly defined, is rarely described in the prostate. The present case is characterized by some peculiarities if compared with previously reported cases of prostatic malignant solitary fibrous tumor. Firstly, it does not show a homogeneous morphology: part of the neoplasm (about 50%) showed the features of a conventional solitary fibrous tumor, while the remaining part showed the features of a malignant solitary fibrous tumor. In addition, the case is the first malignant solitary fibrous tumor reaching a huge diameter of 20 cm and replacing all prostatic parenchyma. Interestingly, normal prostatic parenchyma was observed on left-lobe trans-rectal needle-core biopsies, but was totally absent in surgical specimen. Since radical prostatectomy was carried out about 4 months after the biopsies, such discordant data may suggest exceedingly rapid growth of the neoplasm. Case presentation We report a case of a 62-year-old male, presented at medical observation for urinary retention, constipation and an enlarged prostate gland. A trans-rectal prostatic biopsy showed a low-grade spindle cell neoplasm. Histopathological examination of the prostatectomy specimen showed patternless architecture with hypocellular and hypercellular areas and hemangiopericytoma-like vessels. In some fields the neoplasm was characterized by a high mitotic index and evident cellular atypia. Immunohistochemically, neoplastic cells were positive for CD34, bcl2, CD99, STAT6 and partially for PgR. The neoplasm was diagnosed as a malignant solitary fibrous tumor. Conclusions The differential diagnosis of spindle cells tumors arising in the prostrate is broad and includes lesions of epithelial and mesenchymal origin, primary prostatic lesions such as stromal tumors of uncertain malignant potential and stromal sarcoma, as well as anatomically ubiquitous soft tissue neoplasms. Solitary fibrous tumors should be considered in cases of prostatic tumors with a spindled morphology, but malignancy in such tumors is extremely rare in the prostate. A review of literature showed only four additional cases. Because of the unpredictable biological behavior and the possibility of recurrence, a long-term clinical and instrumental follow-up is recommended.
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Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Università della Campania "L. Vanvitelli", Via Luciano Armanni, 80138, Naples, Italy
| | - Elvira La Mantia
- Pathology Unit, Università della Campania "L. Vanvitelli", Via Luciano Armanni, 80138, Naples, Italy
| | - Vincenzo Gigantino
- Pathology Unit, Istituto Nazionale Tumori I. R. C. C. S. "Fondazione Pascale", Naples, Italy
| | - Sisto Perdonà
- Division of Urology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori I. R. C. C. S. "Fondazione Pascale", Naples, Italy
| | - Marco De Sio
- Division of Urology, Università della Campania "L. Vanvitelli", Naples, Italy
| | - Gaetano Facchini
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori I. R. C. C. S. "Fondazione Pascale", Naples, Italy
| | - Renato Franco
- Pathology Unit, Università della Campania "L. Vanvitelli", Via Luciano Armanni, 80138, Naples, Italy.
| | - Annarosaria De Chiara
- Pathology Unit, Istituto Nazionale Tumori I. R. C. C. S. "Fondazione Pascale", Naples, Italy
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13
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Wang XT, Xia QY, Ni H, Ye SB, Li R, Wang X, Shi SS, Zhou XJ, Rao Q. SFPQ/PSF-TFE3 renal cell carcinoma: a clinicopathologic study emphasizing extended morphology and reviewing the differences between SFPQ-TFE3 RCC and the corresponding mesenchymal neoplasm despite an identical gene fusion. Hum Pathol 2017; 63:190-200. [PMID: 28315422 DOI: 10.1016/j.humpath.2017.02.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/06/2017] [Accepted: 02/24/2017] [Indexed: 01/22/2023]
Abstract
Xp11 translocation renal cell carcinoma (RCC) with SFPQ/PSF-TFE3 gene fusion is a rare epithelial tumor. Of note, the appearance of the gene fusion does not necessarily mean that it is renal cell carcinoma. The corresponding mesenchymal neoplasms, including Xp11 neoplasm with melanocytic differentiation, TFE3 rearrangement-associated perivascular epithelioid cell tumor (PEComa) and melanotic Xp11 translocation renal cancer, can also harbor the identical gene fusion. However, the differences between Xp11 translocation RCC and the corresponding mesenchymal neoplasm have only recently been described. Herein, we examined 5 additional cases of SFPQ-TFE3 RCCs using clinicopathologic, immunohistochemical, and molecular analyses. One tumor had the typical morphologic features of SFPQ-TFE3 RCC, whereas other 3 cases demonstrated the unusual morphologic features associated with pseudorosettes formation or clusters of smaller cells, mimicking TFEB RCC. The remaining one showed branching tubules and papillary structure composed of clear and eosinophilic tumor cells. Immunohistochemically, all 5 cases demonstrated moderate (2+) or strong (3+) positive staining for TFE3, PAX-8 and CD10, whereas no cases demonstrated TFEB, Cathepsin K, CA-IX, CK7, Melan-A, or HMB-45 expression. Genetically, the fusion transcripts were identified in 3 cases by reverse-transcription polymerase chain reaction (RT-PCR). On the basis of fluorescence in situ hybridization (FISH) analysis, all the cases were detected with SFPQ-TFE3 gene fusion. Clinical follow-up data were available for all the patients, and no one developed tumor recurrence, progression, or metastasis. We also review the differences between SFPQ-TFE3 RCC and the corresponding mesenchymal neoplasm despite the identical gene fusion. The presence of pseudorosettes also expands the known histological features of SFPQ-TFE3 RCC.
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MESH Headings
- Adult
- Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/genetics
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biopsy
- Carcinoma, Renal Cell/chemistry
- Carcinoma, Renal Cell/genetics
- Carcinoma, Renal Cell/pathology
- Chromosomes, Human, Pair 11
- Diagnosis, Differential
- Female
- Gene Fusion
- Genetic Predisposition to Disease
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Male
- Middle Aged
- PTB-Associated Splicing Factor/genetics
- Phenotype
- Predictive Value of Tests
- Retrospective Studies
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic
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Affiliation(s)
- Xiao-Tong Wang
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China; Department of Pathology, Jinling Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiu-Yuan Xia
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Hao Ni
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China; Department of Pathology, Jinling Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Sheng-Bing Ye
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Rui Li
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Xuan Wang
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Shan-Shan Shi
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China
| | - Xiao-Jun Zhou
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China; Department of Pathology, Jinling Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiu Rao
- Department of Pathology, Nanjing Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu, China; Department of Pathology, Jinling Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
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14
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Abstract
The discovery of a tumor as a primary schwannoma in the thyroid gland is rare (Andrion et al. in Virchows Arch 413:367-372, 1988). It represents less than 1 % of mesenchymal neoplasms of this gland. Therefore, few cases of this type are described in medical literature (Aron et al. in Cytopathology 16:206-209, 2005; Cashman et al. in Medscape J Med 10(8):201, 2008; Coleman et al. in AJR Am J Roentgenol 140:383-7, 1983). In this article, we introduce the clinical case of a 27-year-old female patient, who presented a nodular mass located in the neck region. This mass was not associated with other symptoms and during the imagistic investigation it appeared to be a thyroglossal duct cyst. A fine needle aspiration biopsy was performed which revealed benign mesenchymal cells. After a pathology study of the piece resected through a thyroidectomy, it was confirmed that the tumor had neural characteristics, the final diagnosis being a primary schwannoma. The importance of a cytology study is emphasized, since in this case, it made it possible to accurately diagnose a mesenchymal tumor, despite their low frequency. It constitutes a highly useful tool for diagnosing non-epithelial neoplasia of the thyroid gland.
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Affiliation(s)
- G Vázquez-Benítez
- Department of Pathology, Hospital Universitario 12 de Octubre, Avda. de Córdoba s/n, 28041, Madrid, Spain.
| | - A Pérez-Campos
- Department of Pathology, Hospital Universitario 12 de Octubre, Avda. de Córdoba s/n, 28041, Madrid, Spain
| | - N Alberti Masgrau
- Department of Pathology, Hospital Universitario 12 de Octubre, Avda. de Córdoba s/n, 28041, Madrid, Spain
| | - A Pérez-Barrios
- Department of Pathology, Hospital Universitario 12 de Octubre, Avda. de Córdoba s/n, 28041, Madrid, Spain
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15
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Telugu RB, Pushparaj M, Masih D, Pulimood A. Synchronous Appearance of Adenocarcinoma and Gastrointestinal Stromal Tumour (GIST) of the Stomach: A Case Report. J Clin Diagn Res 2016; 10:ED16-8. [PMID: 27042477 DOI: 10.7860/jcdr/2016/17636.7289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 12/11/2015] [Indexed: 12/23/2022]
Abstract
Adenocarcinoma is the most common histological type of gastric tumour, accounting for approximately 95% of all gastric carcinomas. Gastrointestinal stromal tumours (GISTs) are rare mesenchymal neoplasms of the digestive tract. Synchronous adenocarcinoma and gastrointestinal stromal tumour (GIST) occurring in the stomach is rare and very few cases have been reported in literature. Synchronous tumours in the stomach are rarely diagnosed preoperatively. A 63-year-old gentleman was diagnosed with a gastric adenocarcinoma on endoscopic biopsy and underwent surgery. Postoperative histopathologic examination revealed 2 synchronous tumours with both adenocarcinoma and GIST. The adenocarcinoma was determined to be the aggressive tumour based on histologic features. GIST was categorized as a very low risk of malignancy, based on its size and mitosis. The patient underwent chemotherapy for adenocarcinoma. He is under follow up and is currently disease free. Careful histopathologic evaluation is required to detect co-existing rare synchronous tumours. Presence of the second tumour may require additional procedures or protocols.
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Affiliation(s)
- Ramesh Babu Telugu
- Assistant Professor, Department of General Pathology, Christian Medical College , Vellore, Tamilnadu, India
| | - Magesh Pushparaj
- PG Registrar, Department of General Pathology, Christian Medical College , Vellore, Tamilnadu, India
| | - Dipti Masih
- Associate Professor, Department of General Pathology, Christian Medical College , Vellore, Tamilnadu, India
| | - Anna Pulimood
- Professor, Department of General Pathology, Christian Medical College , Vellore, Tamilnadu, India
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16
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Abstract
Plexiform fibromyxoma (PF) of the stomach is a recently described rare mesenchymal neoplasm of the gastrointestinal tract. Its main clinical features include a peculiar plexiform pattern, bland spindle cells and a myxoid stroma rich in arborizing blood vessels. However, the epidemiology, etiology, pathogenesis, diagnosis and treatment of PF are still not very clear. Here we report a case of plexiform fibromyxoma of the stomach, and we also performed a literature review.
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17
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Traboulsi SL, Wazzan W, Abou Ghaida RR. Renal Angiomyxolipoma: Its First Appearance! Urol Case Rep 2014; 2:89-92. [PMID: 26955555 PMCID: PMC4733029 DOI: 10.1016/j.eucr.2014.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 03/12/2014] [Indexed: 11/25/2022] Open
Abstract
Angiomyxolipoma is considered a very rare subtype of lipoma, with the latter being the most common type of mesenchymal neoplasm. Only 17 cases have been described in English medical literature. Angiomyxolipomas have been described in many locations, mostly in the subcutaneous tissue. In this report, we present the first case of renal angiomyxolipoma ever encountered. Diagnosis was made after many differential diagnoses had been ruled out. Subsequent management and follow-up are illustrated along with a discussion and review of literature.
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Affiliation(s)
- Samer L Traboulsi
- Division of Urology, Department of Surgery, American University of Beirut, Beirut, Lebanon
| | - Wassim Wazzan
- Division of Urology, Department of Surgery, American University of Beirut, Beirut, Lebanon
| | - Rami R Abou Ghaida
- Division of Urology, Department of Surgery, American University of Beirut, Beirut, Lebanon
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18
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Jakob M, Schneider M, Hoeller I, Laffer U, Kaderli R. Malignant solitary fibrous tumor involving the liver. World J Gastroenterol 2013; 19:3354-3357. [PMID: 23745040 PMCID: PMC3671090 DOI: 10.3748/wjg.v19.i21.3354] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/30/2013] [Accepted: 04/28/2013] [Indexed: 02/06/2023] Open
Abstract
Solitary fibrous tumors are predominantly benign and are most commonly found in the thoracic cavity and pleura; while reports exist in the literature of malignant solitary fibrous tumors and those located in extrathoracic organs, these cases are considered extremely rare. Herein, a case is reported of a malignant solitary fibrous tumor involving the liver that was diagnosed and treated in a 62-year-old woman. The patient presented with complaints of upper abdominal pain and unintentional weight loss. Computed tomography scan of the abdomen revealed a remarkably large mass, measuring 15 cm × 10 cm × 20 cm, which appeared to be unrelated to any particular organ. The intraoperative finding of a wide communication with the left liver suggested hepatic origin, and served as an indicator for tumor resection via left hemihepatectomy. The diagnosis of solitary fibrous tumor and its malignant nature was confirmed by histological and immunohistochemical examination of the resected tissues. Hepatic solitary fibrous tumor is very rare, and surgery remains the mainstay of treatment. Due to limited reports of such tumors in the literature, little can be said about the benefit of adjuvant therapy and prognosis for the rare cases with malignant histological findings.
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19
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Abstract
Plexiform fibrohistiocytic tumor (PFHT) is a rare mesenchymal neoplasm of intermediate malignancy, first reported by Enzinger and Zhang in 1988 [1]. It mainly affects children and young adults and preferentially involves the upper extremity [1, 2].We report a rare case in the submandibular region which was diagnosed on histopathology.
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Affiliation(s)
- Ruma Pahwa
- Department of Pathology, Dr Baba Saheb Ambedkar Hospital, Delhi, India
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20
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Abstract
Pure mesenchymal tumors may occur anywhere in the female genital tract, but they are most common in the uterine corpus, leiomyoma being by far the most prevalent. These tumors, and other uncommon mesenchymal lesions within the uterine corpus and elsewhere in the female genital tract, may result in several diagnostic problems. Morphology remains paramount and, in most cases, an unequivocal diagnosis can be made based on examination of the hematoxylin and eosin stained sections, combined with an appreciation of the clinical and gross pathologic features. In difficult cases, immunohistochemistry can significantly contribute to the final diagnosis. In this article, the immunohistochemistry of neoplastic and nonneoplastic mesenchymal lesions of the female genital tract is discussed site by site, concentrating on markers that are of value in diagnosis and in differential diagnosis. The immunophenotype of mixed epithelial and mesenchymal neoplasms and pure epithelial neoplasms with a component of spindle cells is discussed, where appropriate, because these can enter into the differential diagnosis of a pure mesenchymal lesion.
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Affiliation(s)
- W Glenn McCluggage
- Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BA, Northern Ireland, UK.
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21
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Vimi S, Punnya VA, Kaveri H, Rekha K. An aggressive solitary fibrous tumor with evidence of malignancy: a rare case report. Head Neck Pathol 2008; 2:236-41. [PMID: 20614322 PMCID: PMC2807562 DOI: 10.1007/s12105-008-0073-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 07/16/2008] [Indexed: 10/21/2022]
Abstract
Solitary fibrous tumor (SFT) is rare mesenchymal neoplasm that has been originally and most often documented in the pleura. Recently, the ubiquitous nature of the SFT has been recognized with reports of involvement of numerous sites all over the body, i.e, upper respiratory tract, breast, somatic tissue, mediastinum, head, and neck, etc. The diagnosis of SFT still remains an enigma in our field. Furthermore, malignant SFT is extremely rare and only two cases have been reported in the oral cavity till date. Here, we present a rare case report of an aggressive solitary fibrous tumor which presented as a palatal mass and extended throughout the middle cranial fossa and exhibited features of malignancy.
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Affiliation(s)
- S. Vimi
- Department of Oral and Maxillofacial Pathology, S.D.M. College of Dental Sciences and Hospital, Dharwad, Karnataka 580009 India
| | - V. A. Punnya
- Department of Oral and Maxillofacial Pathology, S.D.M. College of Dental Sciences and Hospital, Dharwad, Karnataka 580009 India
| | - H. Kaveri
- Department of Oral and Maxillofacial Pathology, S.D.M. College of Dental Sciences and Hospital, Dharwad, Karnataka 580009 India
| | - K. Rekha
- Department of Oral and Maxillofacial Pathology, S.D.M. College of Dental Sciences and Hospital, Dharwad, Karnataka 580009 India
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