1
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Dashti NK, Jebastin Thangaiah J, Gliem T, Knutson D, Kloft-Nelson S, Armstrong SM, Bakhshwin A, Greipp P, Fritchie KJ. MDM2 Amplification Status in a Cohort of Well-Characterized Myxofibrosarcoma: A Clinicopathologic Analysis of 22 Tumors. Int J Surg Pathol 2024; 32:478-485. [PMID: 37501528 DOI: 10.1177/10668969231186930] [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] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Myxofibrosarcomas (MFS) present as slowly enlarging superficial masses in elderly patients. Even though these tumors fail to exhibit a distinct immunophenotype, diagnosis is straightforward when they present in subcutaneous tissue. Intramuscular MFS, however, are more challenging to diagnose as the differential also includes dedifferentiated liposarcoma with myxoid features. The vast majority of dedifferentiated liposarcomas show MDM2 amplification, whereas limited data exists as to the MDM2 status of MFS. We sought to explore the rate of MDM2 amplification in cases of classic MFS. Our archives were searched for MFS; only subcutaneous well-sampled resections were included. FISH for MDM2 amplification was performed on each tumor. A cohort of myxoid dedifferentiated liposarcoma resections was studied for comparison. Twenty-two MFS arose in patients aged 44 to 85 years. All tumors contained an infiltrative population of atypical cells embedded in a myxoid stroma with curvilinear blood vessels. MDM2 amplification by FISH was identified in 3 (of 22; 14%) tumors. Available follow up on 17 patients (range 1-96 months; median 13 months) revealed 6 patients with local recurrence and 1 with distant metastasis. Of 3 patients with MDM2- amplified MFS, 1 experienced recurrence and died of unrelated causes, while the second was alive without disease 12 months after diagnosis. Even though the rate of MDM2 amplification by FISH in MFS appears to be low, a subset of cases may show this genetic alteration, which pathologists should be aware of to avoid misclassification as myxoid dedifferentiated liposarcomas. Further studies are necessary to determine if amplification status adds prognostic value.
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Affiliation(s)
- Nooshin K Dashti
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Troy Gliem
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Darlene Knutson
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Sara Kloft-Nelson
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Susan M Armstrong
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmed Bakhshwin
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Patricia Greipp
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Karen J Fritchie
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
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2
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Ranji P, Jonasson E, Andersson L, Filges S, Luna Santamaría M, Vannas C, Dolatabadi S, Gustafsson A, Myklebost O, Håkansson J, Fagman H, Landberg G, Åman P, Ståhlberg A. Deciphering the role of FUS::DDIT3 expression and tumor microenvironment in myxoid liposarcoma development. J Transl Med 2024; 22:389. [PMID: 38671504 PMCID: PMC11046918 DOI: 10.1186/s12967-024-05211-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Myxoid liposarcoma (MLS) displays a distinctive tumor microenvironment and is characterized by the FUS::DDIT3 fusion oncogene, however, the precise functional contributions of these two elements remain enigmatic in tumor development. METHODS To study the cell-free microenvironment in MLS, we developed an experimental model system based on decellularized patient-derived xenograft tumors. We characterized the cell-free scaffold using mass spectrometry. Subsequently, scaffolds were repopulated using sarcoma cells with or without FUS::DDIT3 expression that were analyzed with histology and RNA sequencing. RESULTS Characterization of cell-free MLS scaffolds revealed intact structure and a large variation of protein types remaining after decellularization. We demonstrated an optimal culture time of 3 weeks and showed that FUS::DDIT3 expression decreased cell proliferation and scaffold invasiveness. The cell-free MLS microenvironment and FUS::DDIT3 expression both induced biological processes related to cell-to-cell and cell-to-extracellular matrix interactions, as well as chromatin remodeling, immune response, and metabolism. Data indicated that FUS::DDIT3 expression more than the microenvironment determined the pre-adipocytic phenotype that is typical for MLS. CONCLUSIONS Our experimental approach opens new means to study the tumor microenvironment in detail and our findings suggest that FUS::DDIT3-expressing tumor cells can create their own extracellular niche.
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Affiliation(s)
- Parmida Ranji
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Emma Jonasson
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Lisa Andersson
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Stefan Filges
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Manuel Luna Santamaría
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Christoffer Vannas
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Soheila Dolatabadi
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Anna Gustafsson
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ola Myklebost
- Department of Tumor Biology, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Science, University of Bergen, Bergen, Norway
| | - Joakim Håkansson
- RISE Unit of Biological Function, Division Materials and Production, RISE Research Institutes of Sweden, Borås, Sweden
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Chemistry and Molecular Biology, Faculty of Science at University of Gothenburg, Gothenburg, Sweden
| | - Henrik Fagman
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Göran Landberg
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pierre Åman
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Anders Ståhlberg
- Sahlgrenska Center for Cancer Research, Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
- Department of Clinical Genetics and Genomics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
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3
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Shen Y, Zhao L, Li A, Peng Q, Liu Q, Wang L, Liu Z. Rare myxoid pleomorphic liposarcoma: a case report and literature review. J Clin Pathol 2024; 77:358-362. [PMID: 38123348 DOI: 10.1136/jcp-2023-209223] [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] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
We report a case of a middle-aged woman with a rapidly growing abdominal mass that was diagnosed as myxoid pleomorphic liposarcoma, a recently recognised, rare and aggressive subtype of liposarcoma. The tumour exhibits a combination of histological features from both myxoid liposarcoma and pleomorphic liposarcoma. Genetic analysis revealed mutations in TP53 and RB1, along with widespread loss of heterozygosity. However, no DDIT3 gene translocation or MDM2/CDK4 gene amplification was detected. These genetic characteristics can be used to distinguish this type of liposarcoma from others. Two unusual gene fusion/rearrangements, CREB5::TERT fusion and ETV1::LFNG rearrangement, were identified. The patient underwent complete removal of the tumour without the use of radiotherapy or chemotherapy. No recurrence was observed during the follow-up period of 18 months.
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Affiliation(s)
- Yanying Shen
- Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Zhao
- Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anqi Li
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Peng
- Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Liu
- Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lisha Wang
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Zebing Liu
- Department of Pathology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Panther EJ, Lyons H, Shychuk AJ. Dedifferentiated liposarcoma of the spermatic cord. BMJ Case Rep 2024; 17:e258954. [PMID: 38627046 PMCID: PMC11029294 DOI: 10.1136/bcr-2023-258954] [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] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
A man in his 60s presented to an outside hospital with persistent groin pain and a scrotal mass which was thought to be a recurrent hernia. Three months after initial presentation, the patient was found to have dedifferentiated liposarcoma (LPS) of the spermatic cord. LPS of the spermatic cord is a rare entity; however, clinicians should have LPS on the differential diagnosis especially in men with recurrent scrotal pain and mass. If unrecognised, LPS is associated with a high degree of morbidity and mortality. LPS can be subdivided into well-differentiated LPS, dedifferentiated LPS, myxoid LPS and pleomorphic LPS. In patients with advanced or metastatic LPS, chemotherapy consisting of Adriamycin, ifosfamide and mesna is used despite LPS being relatively chemoresistant. Therapies inhibiting mouse double minute 2 homologue, an oncoprotein that is a negative regulator of the tumour suppressor p53, appear to be promising in preclinical trials.
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Affiliation(s)
- Eric James Panther
- Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Hannah Lyons
- Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Andrew Jacob Shychuk
- Internal Medicine, University of Florida, Gainesville, Florida, USA
- Internal Medicine, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida, USA
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5
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Diaz-Perez JA, Kerr DA. Gene of the month: DDIT3. J Clin Pathol 2024; 77:211-216. [PMID: 38053287 DOI: 10.1136/jcp-2023-208963] [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] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
DNA damage-inducible transcript 3 (DDIT3) gene, mapped to the human chromosome 12q13.3, encodes a protein that belongs to the CCAAT/enhancer-binding protein family of transcription factors. DDIT3 is involved in the proliferative control that responds to endoplasmic reticulum stress in normal conditions, dimerising other transcription factors with basic leucine zipper (bZIP) structural motifs. DDIT3 plays a significant role during cell differentiation, especially adipogenesis, arresting the maturation of adipoblasts. In disease, FUS/EWSR1::DDIT3 fusion is the pathogenic event that drives the development of myxoid liposarcoma. The amplification of DDIT3 in other adipocytic neoplasms mediates the presence of adipoblast-like elements. Another fusion, GLI1::DDIT3, has rarely been documented in other tumours. This paper reviews the structure and function of DDIT3, its role in disease-particularly cancer-and its use and pitfalls in diagnostic testing, including immunohistochemistry as a tissue-based marker.
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Affiliation(s)
- Julio A Diaz-Perez
- Department of Pathology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Darcy A Kerr
- Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Masunaga T, Tsukamoto S, Nitta Y, Honoki K, Fujii H, Akahane M, Takeda M, Tanaka Y, Mavrogenis AF, Errani C, Kawai A. Is perioperative chemotherapy effective in patients with localized myxoid liposarcoma? Jpn J Clin Oncol 2024; 54:297-304. [PMID: 38134204 DOI: 10.1093/jjco/hyad179] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND This study aimed to compare the local recurrence, distant metastasis and disease-specific survival rates of patients with localized myxoid liposarcoma in the surgery and adjuvant chemotherapy group versus the surgery alone group. METHODS A total of 456 patients in the Japanese National Bone and Soft Tissue Tumour Registry database who had localized myxoid liposarcoma and underwent surgery and adjuvant chemotherapy or surgery alone between 2001 and 2019 were included in this retrospective study. The study adjusted for background differences between patients who underwent surgery and adjuvant chemotherapy (n = 228) or surgery alone (n = 228) using propensity score matching. RESULTS Univariate analysis showed no significant difference in local recurrence rate between the two groups (5-year local recurrence-free survival: 98.6% [95% confidence interval: 95.9-99.6] vs. 94.0% [95% confidence interval: 89.7-96.6], P = 0.052). Univariate analysis showed no difference in the incidence of distant metastases between the two groups (5-year distant metastasis-free survival: 80.5% [95% confidence interval: 73.9-85.8] vs. 75.1% [95% confidence interval: 67.7-81.2], P = 0.508). Univariate analysis showed no difference in disease-specific survival between the two groups (5-year disease-specific survival: 92.6% [95% confidence interval: 86.1-96.2] vs. 93.2% [95% confidence interval: 87.6-96.4], P = 0.804). In the high-risk group (n = 203) with high-grade tumours and tumour size ≥10 cm, there were no significant differences in the local recurrence, distant metastasis and disease-specific survival rates between the surgery and adjuvant chemotherapy group and the surgery alone group. CONCLUSION The effect of adjuvant chemotherapy on localized myxoid liposarcoma appears to be limited.
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Affiliation(s)
- Tomoya Masunaga
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Shinji Tsukamoto
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Yuji Nitta
- Department of Diagnostic Pathology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Kanya Honoki
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Hiromasa Fujii
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Manabu Akahane
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama 351-0197, Japan
| | - Masayuki Takeda
- Department of Cancer Genomics and Medical Oncology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Street, Holargos, Athens 15562, Greece
| | - Costantino Errani
- Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna 40136, Italy
| | - Akira Kawai
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
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7
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Xue S, Liu QY, Gou XN, Zhao YW, Cheng Q, Kong LF. [Well-differentiated/dedifferentiated liposarcoma associated with myxoid-like morphology: a clinicopathological and molecular genetic characteristics analysis of 34 cases]. Zhonghua Bing Li Xue Za Zhi 2024; 53:168-173. [PMID: 38281785 DOI: 10.3760/cma.j.cn112151-20231025-00302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Objective: To investigate the clinicopathological and molecular genetic characteristics of well-differentiated/dedifferentiated liposarcoma (WDLPS/DDLPS) with myxoid-like morphology, and to distinguish them from myxofibrosarcoma (MFS) with similar morphology. Methods: Twenty-nine cases of myxoid-like liposarcoma and 5 cases of MFS were collected from Henan Provincial People's Hospital, Zhengzhou, China and the First Medical Center of PLA General Hospital, Beijing, China from January 2015 to March 2023. Relevant markers were detected using immunohistochemistry and fluorescence in situ hybridization (FISH). The literature was also reviewed. Results: There were 24 males and 10 females, with ages ranging from 41 to 73 years. The tumor sites included retroperitoneum (n=17), abdomen (n=9), lower limbs (n=5), scrotum (n=1), upper limb (n=1) and axilla (n=1). WDLPS was commonly seen as lipomatoid type (12 cases), while the dedifferentiated components of DDLPS included low-grade (13 cases) and high-grade (2 cases) morphology, with low-high grade myxofibrosarcoma, dermatofibrosarcoma protuberans, and low-grade fibrosarcoma structures. Twenty-nine liposarcomas had various proportions of myxoid-like morphology, while 16 showed various degrees of tumor necrosis. The myxoid-like component showed myxoid pleomorphic liposarcoma (MLPS)-like morphology, lobulated growth, characteristic slender, ramified capillary network,"chicken claw-like"morphology, mucus-rich stroma and lung edema-like morphology. Tumor cells were spindle and oval, with many variable vacuolar lipoblasts. MDM2 gene amplification was detected using FISH and present in all tested cases (29/29). DDIT3 break-apart mutation was not detected, but its cluster amplification was present (24/29). Among the MFS cases, one showed cluster amplification (1/5), but no cases showed break-apart or amplification of MDM2 gene. Conclusions: WDLPS/DDLPS with myxoid-like morphology is most commonly seen in the retroperitoneum and abdominal cavity and mostly harbors DDIT3 break-apart probe amplification, while this amplification is not specific to liposarcoma. For core biopsy specimens or very rare tumors in the limbs, when histology has mucinous stroma and MLPS-like morphology, misdiagnosis of MLPS or other non-lipomatous neoplasms with myxoid morphology should be avoided.
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Affiliation(s)
- S Xue
- Department of Pathology, Henan Provincial People's Hospital, the People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Q Y Liu
- Department of Pathology, Henan Provincial People's Hospital, the People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - X N Gou
- Department of Pathology, the First Medical Center of People's Liberation Army General Hospital, Beijing 100853, China
| | - Y W Zhao
- Department of Pathology, Henan Provincial People's Hospital, the People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Q Cheng
- Department of Pathology, Henan Provincial People's Hospital, the People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - L F Kong
- Department of Pathology, Henan Provincial People's Hospital, the People's Hospital of Zhengzhou University, Zhengzhou 450003, China
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8
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Vierra BM, Saadat LV, Hornick JL, Jagannathan JP, Ferrone ML, Wagner AJ, Wang J, Baldini EH, Raut C, Fairweather M. Distribution and Rate of Myxoid Liposarcoma Spine Metastases: Impact on Surveillance Imaging. Ann Surg Oncol 2023; 30:8647-8652. [PMID: 37773566 DOI: 10.1245/s10434-023-14309-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/30/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Myxoid liposarcoma (LPS) has a unique tendency to spread to extrapulmonary sites, including osseous sites such as the spine, and adjacent sites such as the paraspinous tissue. No clear consensus exists to guide the approach to imaging in these patients. OBJECTIVE The aim of this study was to investigate the rate and distribution of spine metastases in patients with myxoid LPS and detection modality. METHODS Records of all patients with myxoid LPS evaluated at our sarcoma center were retrospectively reviewed. Disease patterns and imaging modality utilization were analyzed. RESULTS Between 2000 and 2020, 164 patients with myxoid LPS were identified. The majority (n = 148, 90%) presented with localized disease, with half (n = 82, 50%) of all patients developing metastases or recurrence during their disease course. With a median follow-up of 69.2 months, spine/paraspinous metastases developed in 38 patients (23%), of whom 35 (92%) already had synchronous, non-spine metastases. Spine disease was only visible on magnetic resonance imaging (MRI), as opposed to other imaging modalities, for over one-quarter of patients with spine metastases (n = 10). For patients with metastatic disease, spine metastases were associated with worse median overall survival (2.1 vs. 8.7 years, p < 0.001). CONCLUSION Spine metastases occurred in nearly one-quarter of patients with myxoid LPS and represented an advanced disease state, as they primarily presented in the setting of synchronous, non-spine metastases, and were associated with worse overall survival. Routine surveillance with spine MRI in patients with localized disease likely provides no benefit but may be considered in those with known metastatic disease.
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Affiliation(s)
- Benjamin M Vierra
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Lily V Saadat
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Marco L Ferrone
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Andrew J Wagner
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jiping Wang
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Elizabeth H Baldini
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
- Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Chandrajit Raut
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA
| | - Mark Fairweather
- Division of Surgical Oncology, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
- Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA.
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9
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Benavides-Huerto MA, Páramo-Figueroa L, Moreno-Páramo D, Lagunas-Rangel FA. Primary Orbital Myxoid Liposarcoma. Med Sci (Basel) 2023; 11:72. [PMID: 37987327 PMCID: PMC10660850 DOI: 10.3390/medsci11040072] [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] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023] Open
Abstract
Although liposarcoma is the most prevalent soft tissue sarcoma in adults, head and neck liposarcomas are rare and account for less than 5% of all liposarcomas. The primary orbital location is even more exceptional, with fewer than 100 cases documented in the medical literature. Given the scarcity of cases of orbital liposarcoma and the limited familiarity of physicians and pathologists with this pathology, there is an increased risk of non-diagnosis or misdiagnosis, which may lead to inappropriate patient management. To address these challenges, we present a case of primary orbital myxoid liposarcoma and subsequently discuss the primary findings of this case based on the evidence documented in the medical literature. This comprehensive text is designed to serve as a valuable resource for healthcare professionals and pathologists, with the goal of promoting both clinical suspicion and accurate diagnosis and treatment of this rare condition in future cases.
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Affiliation(s)
| | | | | | - Francisco Alejandro Lagunas-Rangel
- Department of Genetics and Molecular Biology, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City 07360, Mexico
- Department of Surgical Sciences, Uppsala University, 752 36 Uppsala, Sweden
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10
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Encinas Tobajas VM, Almeida González C, Marcilla D, Vallejo M, Cano Rodríguez A, Reina Sánchez de Movellán JI, Morales Pérez JM. Myxoid liposarcoma: MRI features with histological correlation. Radiologia (Engl Ed) 2023; 65 Suppl 2:S23-S32. [PMID: 37858349 DOI: 10.1016/j.rxeng.2021.01.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 01/30/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Myxoid liposarcoma is classified in the group of sarcomas with adipose differentiation, which is the second most common group of sarcomas. However, myxoid liposarcoma is not a homogeneous entity, because the behavior and clinical course of these tumours can vary widely. This study aimed to describe the magnetic resonance imaging (MRI) features of myxoid liposarcomas and to determine whether the MRI features are associated with the histologic grade and can differentiate between low-grade and high-grade tumours and thus help in clinical decision making. MATERIAL AND METHODS We studied 36 patients with myxoid liposarcomas treated at our centre between 2010 and 2018. We analysed clinical variables (age, sex, and tumour site) and MRI features (size, depth, borders, fatty component, myxoid component, non-fatty/non-myxoid component, apparent diffusion coefficient (ADC), and type of enhancement after the administration of intravenous contrast material). We correlated the MRI features with the histologic grade and the percentage of round cells. RESULTS In our series, patients with myxoid liposarcomas were mainly young adults (median age, 43 years). There were no differences between sexes; 97.2% were located in the lower limbs, 86.1% were deep, and 77.8% had well-defined borders. Of the 23 myxoid liposarcomas that contained no fat, 16 (69.6%) were high grade (p = 0.01). All the tumors with a myxoid component of less than 25% were high grade (p = 0.01); 83.3% of those with a non-fatty/non-myxoid component greater than 50% were high grade (p = 0.03) and 61.5% had more than 5% round cells (p = 0.01). Diffusion sequences were obtained in 14 of the 36 patients; ADC values were high (median, 2 × 10-3 mm2/s), although there were no significant associations between low-grade and high-grade tumours. Contrast-enhanced images were available for 30 (83.3%) patients; 83.3% of the tumours with heterogeneous enhancement were high grade (p = 0.01). CONCLUSIONS MRI can be useful for differentiating between high- and low-grade myxoid liposarcomas and can help in clinical decision making.
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Affiliation(s)
- V M Encinas Tobajas
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - C Almeida González
- Unidad de Bioestadística, Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - D Marcilla
- Unidad de Gestión Clínica de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Vallejo
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - A Cano Rodríguez
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - J M Morales Pérez
- Unidad de Gestión Clínica de Radiodiagnóstico, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Dewaguet J, Beaujot J, Leguillette C, Decanter G, Cordoba A, Penel N, Ceugnart L, Taieb S, Amor MBH. [Contribution of whole-body MRI to the initial assessment of myxoid liposarcoma]. Bull Cancer 2023; 110:1015-1026. [PMID: 37507239 DOI: 10.1016/j.bulcan.2023.05.009] [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] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Myxoid liposarcoma is a soft tissue sarcoma associated with multifocal metastases at diagnosis. These metastases are asymptomatic and occult on CT and FDG-PET and can alter the therapeutic management and prognosis. In this context, we evaluated the contribution of whole-body MRI to the initial workup of patients with myxoid liposarcoma. METHOD This retrospective study was conducted between January 2015 and December 2020 at the Oscar Lambret Center. We enrolled 22 patients who were diagnosed with myxoid liposarcoma and underwent whole-body MRI at diagnosis. The number of metastases at diagnosis, their location, and the visibility of these lesions on CT were evaluated. Associations between clinical features, presence of metastasis, and their impact on management were assessed. RESULTS Sixteen patients (72.7%) had non-metastatic disease at the initial diagnosis, and 15 of these patients were managed using local treatment. Six patients (27.3%) had metastases at multiple locations and received chemotherapy. The main locations were the bones (n=5) and lungs (n=3). In five patients with metastases, whole-body MRI demonstrated additional lesions that were not visible on CT (bone and soft tissue lesions). Only the presence of a round cell contingent (P=0.009) was found as a criterion associated with the presence of metastases. CONCLUSION The patients' young age, absence of reliable prognostic factors at diagnosis, asymptomatic nature of the lesions, and the benefits of early and targeted therapeutic management encourage the use of whole-body MRI as part of the initial work-up as it seems to provide a better initial staging compared with conventional imaging.
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Affiliation(s)
- Julie Dewaguet
- Centre Oscar-Lambret, département d'imagerie, 3, rue Combemale, 59020 Lille cedex, France.
| | - Juliette Beaujot
- Centre Oscar-Lambret, département d'anatomie et cytologie pathologique, 3, rue Combemale, 59020 Lille cedex, France
| | - Clémence Leguillette
- Centre Oscar-Lambret, unité de méthodologie et de biostatistiques, 3, rue Combemale, 59020 Lille cedex, France
| | - Gauthier Decanter
- Centre Oscar-Lambret, département de chirurgie, 3, rue Combemale, 59020 Lille cedex, France
| | - Abel Cordoba
- Centre Oscar-Lambret, département de radiothérapie, 3, rue Combemale, 59020 Lille cedex, France
| | - Nicolas Penel
- Centre Oscar-Lambret, Clinical Research and Innovation Department, Medical Oncology Department, 3, rue Combemale, 59020 Lille cedex, France; University Lille, CHU de Lille, ULR 2694 - Metrics : évaluation des technologies de santé et des pratiques médicales, 59000 Lille, France
| | - Luc Ceugnart
- Centre Oscar-Lambret, département d'imagerie, 3, rue Combemale, 59020 Lille cedex, France
| | - Sophie Taieb
- Centre Oscar-Lambret, département d'imagerie, 3, rue Combemale, 59020 Lille cedex, France
| | - Mariem Ben Haj Amor
- Centre Oscar-Lambret, département d'imagerie, 3, rue Combemale, 59020 Lille cedex, France
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Homsy P, Blomqvist C. ASO Author Reflections: Patterns of Metastatic Recurrence of Genetically Confirmed Myxoid Liposarcoma. Ann Surg Oncol 2023; 30:4498. [PMID: 36973565 PMCID: PMC10250443 DOI: 10.1245/s10434-023-13380-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Pauliina Homsy
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Homsy P, Böhling T, Seitsonen A, Sampo M, Tukiainen E, Blomqvist C. Patterns of Metastatic Recurrence of Genetically Confirmed Myxoid Liposarcoma. Ann Surg Oncol 2023; 30:4489-4497. [PMID: 36907960 PMCID: PMC10250512 DOI: 10.1245/s10434-023-13312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/16/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Most sarcomas metastasize predominantly to the lungs, and chest x-ray, or computed tomography, is the most commonly used staging investigation. Myxoid liposarcomas (MLSs) are rare tumors with a tendency to metastasize to extrapulmonary loci. The aim of this study was to assess the locations of the first metastases in MLS patients, to guide the design of effective staging and follow-up imaging protocols. METHODS Patients treated for MLS between 1987 and 2017 were identified in a prospectively maintained register. Histology of the tumors was reassessed. In addition, the presence of one of the pathognomonic gene translocations was confirmed, uniquely for a retrospective series. The surgical and oncological outcomes were reviewed. A comprehensive review of the literature was performed on the metastatic pattern of MLS, including series with 10 or more MLS patients with metastatic disease. RESULTS A total of 32 patients with genetically confirmed MLS were identified, with a median follow-up of 7.6 years. Seven patients (22%) developed metastatic disease, five initially intra-abdominally and only one to the lungs. The comprehensive review included 14 series with 1853 patients, 348 (19%) of whom had metastases. The location of the first metastases was soft tissues in 32% of patients, intra-abdominal in 26%, pulmonary in 24%, and bone in 17%. CONCLUSIONS MLSs metastasize often intra-abdominally and to extra-abdominal soft tissues. Thus, whole-body imaging may be indicated during the initial assessment and follow-up of these patients.
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Affiliation(s)
- Pauliina Homsy
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Tom Böhling
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anne Seitsonen
- HUS Diagnostic Center, Helsinki University Hospital, Helsinki, Finland
| | - Mika Sampo
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Erkki Tukiainen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Abstract
RATIONALE Myxoid pleomorphic liposarcoma (MPL) is a rare aggressive adipocytic tumor that mainly presents in children and adolescents. It is most frequently observed in the mediastinum and rarely in the head and neck, perineal region, or back. Herein, we report the first published case of MPL of the teres minor muscle. PATIENT CONCERNS A 24-years-old woman presented with a painless palpable mass in her right shoulder. DIAGNOSES Magnetic resonance imaging identified a 9.0 × 7.0 × 4.0 cm mass suspected to be a sarcoma in the teres minor muscle. Positron emission tomography/computed tomography revealed no evidence of distant metastasis. Histopathological examination revealed the mass to be an MPL, which was assigned a histologic grade of 3 according to the French Federation of Cancer Centers Sarcoma Group system. No tumor cells were observed along the resected margins. INTERVENTIONS Under general anesthesia, the right teres minor muscle containing the mass was excised en bloc and frozen biopsy confirmed that the tumor cells did not invade the surrounding tissues. OUTCOMES The patient underwent radiotherapy and was followed up for 6 months without complications. LESSONS Although MPL in the teres minor muscle is rare, it should be considered in the differential diagnosis in patients with a mass in the teres minor muscle due to its poor prognosis.
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Affiliation(s)
- Jun Ho Choi
- Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Hyuk Lee
- Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Kwang Seog Kim
- Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
- * Correspondence: Kwang Seog Kim, Professor, Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea (e-mail: )
| | - Yoo Duk Choi
- Department of Pathology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Ha Hwang
- Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sam Yong Lee
- Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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15
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Zhao L, Shi J, Yang Q. Metastatic pericardial myxoid liposarcoma: A case report. Asian J Surg 2022; 46:1884-1885. [PMID: 36411168 DOI: 10.1016/j.asjsur.2022.10.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/31/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Lei Zhao
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, China
| | - Jiangong Shi
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, China
| | - Qing Yang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, China.
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Dermawan JK, Hwang S, Wexler L, Tap WD, Singer S, Vanderbilt CM, Antonescu CR. Myxoid pleomorphic liposarcoma is distinguished from other liposarcomas by widespread loss of heterozygosity and significantly worse overall survival: a genomic and clinicopathologic study. Mod Pathol 2022; 35:1644-1655. [PMID: 35672466 PMCID: PMC9613513 DOI: 10.1038/s41379-022-01107-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 12/21/2022]
Abstract
Myxoid pleomorphic liposarcoma (MPLPS) is a recently described and extremely rare subtype of liposarcoma with a predilection for the mediastinum. However, the genomic features of MPLPS remain poorly understood. We performed comprehensive genomic profiling of MPLPS in comparison with pleomorphic liposarcoma (PLPS) and myxoid/round cell liposarcoma (MRLPS). Of the 8 patients with MPLPS, 5 were female and 3 were male, with a median age of 32 years old (range 10-68). All except one were located in the mediastinum, with invasion of surrounding anatomic structures, including chest wall, pleura, spine, and large vessels. All cases showed an admixture of morphologies reminiscent of PLPS and MRLPS, including myxoid areas with plexiform vasculature admixed with uni- and/or multivacuolated pleomorphic lipoblasts. Less common features included well-differentiated liposarcoma-like areas, and in one case fascicular spindle cell sarcoma reminiscent of dedifferentiated LPS. Clinically, 4 experienced local recurrence, 4 had distant metastases and 5 died of disease. Compared to PLPS and MRLPS, patients with MPLPS had worse overall and progression-free survival. Recurrent TP53 mutations were present in all 8 MPLPS cases. In contrast, in PLPS, which also showed recurrent TP53 mutations (83%), RB1 and ATRX losses were more common. MRLPS was highly enriched in TERT promoter mutations (88%) and PI3K/AKT pathway mutations. Copy number profiling in MPLPS revealed multiple chromosomal gains with recurrent amplifications of chromosomes 1, 19 and 21. Importantly, allele-specific copy number analysis revealed widespread loss of heterozygosity (80% of the genome on average) in MPLPS, but not in PLPS or MRLPS. Our findings revealed genome-wide loss of heterozygosity co-existing with TP53 mutations as a characteristic genomic signature distinct from other liposarcoma subtypes, which supports the current classification of MPLPS as a stand-alone pathologic entity. These results further expand the clinicopathologic features of MPLPS, including older age, extra-mediastinal sites, and a highly aggressive outcome.
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Affiliation(s)
- Josephine K Dermawan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sinchun Hwang
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Leonard Wexler
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William D Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Samuel Singer
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chad M Vanderbilt
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cristina R Antonescu
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Kuczkiewicz-Siemion O, Wiśniewski P, Dansonka-Mieszkowska A, Grabowska-Kierył M, Olszewska K, Goryń T, Prochorec-Sobieszek M, Rutkowski P, Szumera-Ciećkiewicz A. The utility of fluorescence in situ hybridization (FISH) in determining DNA damage-inducible transcript 3 (DDIT3) amplification in dedifferentiated liposarcomas - an important diagnostic pitfall. Pathol Res Pract 2021; 225:153555. [PMID: 34325315 DOI: 10.1016/j.prp.2021.153555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/28/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Dedifferentiated liposarcoma (DDLPS) is characterized by non-lipogenic sarcoma fields coexisting with adipocyte-rich well-differentiated areas. Amplification of the 12q13-15 region includes the MDM2 and DDIT3 genes. MDM2 amplification is considered a genetic hallmark of DDLPS, while DDIT3 is typically rearranged in myxoid liposarcoma. Recent studies showed that DDIT3 amplification is associated with myxoid liposarcoma-like (LPS-like) morphology in DDLPS. Our study aimed to evaluate the status of MDM2 and DDIT3 by FISH in DDLPS and correlate it with MLPS-like features. MATERIAL AND METHODS Six patients with MLPS-like morphology DDLPS were investigated pathologically, immunohistochemically, and genetically. The control groups of patients with classical DDLPS morphology and well-differentiated liposarcoma (WDLPS) were established and molecularly assessed as well. Fluorescence in situ hybridization (FISH) used in routine diagnostics was performed to determine the status of MDM2 and DDIT3 genes. RESULTS The patient's mean age was 64 (range from 43 to 85 years) with a 5:4 male to female ratio. Tumors were localized retroperitoneally (15) and extra-retroperitoneally (3). All cases demonstrated amplification of the 12q15 region containing MDM2 gene and co-amplification of the 5' DDIT3 FISH Probe representing DDIT3 telomeric tag. However, we did not find the relation of myxoid LPS-like morphology with DDIT3 amplification as previously reported. CONCLUSIONS The biopsy material from DDLPS with myxoid areas can be misclassified as myxoid liposarcoma. Indeed, according to the histological image, DDIT3 status may be evaluated first. In these cases, we show that the DDIT3 telomeric tag amplification assessed by FISH, is a common, nonspecific feature, which is also found in classical DDLPS and WDLPS. Therefore, we believe that co-amplification of DDIT3 and MDM2 may be considered a spectrum of the 12q13-15 region amplification due to the specification of FISH methodology.
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Affiliation(s)
- Olga Kuczkiewicz-Siemion
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Pathology and Laboratory Diagnostics, Warsaw, Poland; Institute of Hematology and Transfusion Medicine, Diagnostic Hematology Department, Warsaw, Poland
| | - Piotr Wiśniewski
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Pathology and Laboratory Diagnostics, Warsaw, Poland
| | - Agnieszka Dansonka-Mieszkowska
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Pathology and Laboratory Diagnostics, Warsaw, Poland
| | - Magdalena Grabowska-Kierył
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Pathology and Laboratory Diagnostics, Warsaw, Poland
| | - Katarzyna Olszewska
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Pathology and Laboratory Diagnostics, Warsaw, Poland
| | - Tomasz Goryń
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland
| | - Monika Prochorec-Sobieszek
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Pathology and Laboratory Diagnostics, Warsaw, Poland; Institute of Hematology and Transfusion Medicine, Diagnostic Hematology Department, Warsaw, Poland
| | - Piotr Rutkowski
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Soft Tissue/Bone Sarcoma and Melanoma, Warsaw, Poland
| | - Anna Szumera-Ciećkiewicz
- Maria Skłodowska-Curie National Research Institute of Oncology, Department of Pathology and Laboratory Diagnostics, Warsaw, Poland; Institute of Hematology and Transfusion Medicine, Diagnostic Hematology Department, Warsaw, Poland.
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18
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Özütemiz C, Krystosek LA, Church AL, Chauhan A, Ellermann JM, Domingo-Musibay E, Steinberger D. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncologic Patients. Radiology 2021; 300:E296-E300. [PMID: 33625300 DOI: 10.1148/radiol.202121027511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Five cases of axillary lymphadenopathy are presented, which occurred after COVID-19 vaccination and mimicked metastasis in a vulnerable oncologic patient group. Initial radiologic diagnosis raised concerns for metastasis. However, further investigation revealed that patients received COVID-19 vaccinations in the ipsilateral arm prior to imaging. In two cases, lymph node biopsy results confirmed vaccination-related reactive lymphadenopathy. Ipsilateral axillary swelling or lymphadenopathy was reported based on symptoms and physical examination in COVID-19 vaccine trials. Knowledge of the potential for COVID-19 vaccine-related ipsilateral adenopathy is necessary to avoid unnecessary biopsy and change in therapy. © RSNA, 2021.
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Affiliation(s)
- Can Özütemiz
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Luke A Krystosek
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - An L Church
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Anil Chauhan
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Jutta M Ellermann
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Evidio Domingo-Musibay
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Daniel Steinberger
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
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19
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Bonvalot S, Wunder J, Gronchi A, Broto JM, Turcotte R, Rastrelli M, Papai Z, Radaelli S, Lindner LH, Shumelinsky F, Cubillo A, Rutkowski P, Demaire C, Strens D, Nalbantov G. Complete pathological response to neoadjuvant treatment is associated with better survival outcomes in patients with soft tissue sarcoma: Results of a retrospective multicenter study. Eur J Surg Oncol 2021; 47:2166-2172. [PMID: 33676792 DOI: 10.1016/j.ejso.2021.02.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/21/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Locally advanced soft tissue sarcoma (STS) management may include neoadjuvant or adjuvant treatment by radiotherapy (RT), chemotherapy (CT) or chemoradiotherapy (CRT) followed by wide surgical excision. While pathological complete response (pCR) to preoperative treatment is prognostic for survival in osteosarcomas, its significance for STS is unclear. We aimed to evaluate the prognostic significance of pCR to pre-operative treatment on 3-year disease-free survival (3y-DFS) in STS patients. METHODS This is an observational, retrospective, international, study of adult patients with primary non-metastatic STS of the extremities and trunk wall, any grade, diagnosed between 2008 and 2012, treated with at least neoadjuvant treatment and surgical resection and observed for a minimum of 3 years after diagnosis. The primary objective was to evaluate the effect of pCR. (≤5% viable tumor cells or ≥95% necrosis/fibrosis) on 3y-DFS. Effect on local recurrence-free survival (LRFS), distant recurrence-free survival (MFS) overall survival (OS) at 3 years was also analyzed. Statistical univariate analysis utilized chi-square independence test and odds ratio confidence interval (CI) estimate, multivariate analysis was performed using LASSO. RESULTS A total of 330 patients (median age 56 years old, range:19-95) treated by preoperative RT (67%), CT (15%) or CRT (18%) followed by surgery were included. pCR was achieved in 74/330 (22%) of patients, of which 56/74 (76%) had received RT. 3-yr DFS was observed in 76% of patients with pCR vs 61% without pCR (p < 0.001). Multivariate analysis showed that pCR is statistically associated with better MFS (95% CI, 1.054-3.417; p = 0.033), LRFS (95% CI, 1.226-5.916; p = 0.014), DFS (95% CI, 1.165-4.040; p = 0.015) and OS at 3 years (95% CI, 1.072-5.210; p = 0.033). CONCLUSIONS In a wide, heterogeneous STS population we showed that pCR to preoperative treatment is prognostic for survival.
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Affiliation(s)
- Sylvie Bonvalot
- Department of Surgery, Institut Curie, Paris University, Paris, France.
| | - Jay Wunder
- Department of Surgery, Sinai Health System, Toronto, Ontario, Canada
| | - Alessandro Gronchi
- Department of Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Javier Martin Broto
- Department of Medical Oncology, Hospital Virgen Del Rocio, And Institute of Biomedicine of Sevilla (IBIS) (HUVR, CSIC, University of Sevilla), Sevilla, Spain
| | - Robert Turcotte
- Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Marco Rastrelli
- Department of Surgical Oncology, Istituto Oncologico Veneto, Padova, Italy
| | - Zsuzsanna Papai
- Department of Oncology, Honved Hospital - Hungarian Defence Forces Military Hospital, Budapest, Hungary
| | - Stefano Radaelli
- Department of Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Lars H Lindner
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Felix Shumelinsky
- Department of Surgery - Bone and Connective Tissue Tumour Surgery, Jules Bordet Institute, Brussels, Belgium
| | - Antonio Cubillo
- Department of Medical Oncology, Hospital Universitario Sanchinarro, Centro Integral Oncológico Clara Campal HM CIOCC, Madrid, Spain
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Clémentine Demaire
- Health Economics & Outcome Research Team, Monitor Deloitte, Zaventem, Belgium
| | - Daniëlle Strens
- Health Economics & Outcome Research Team, Monitor Deloitte, Zaventem, Belgium
| | - Georgi Nalbantov
- Health Economics & Outcome Research Team, Monitor Deloitte, Zaventem, Belgium
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20
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Crombe A, Sitbon M, Stoeckle E, Italiano A, Buy X, Le Loarer F, Kind M. Magnetic resonance imaging assessment of chemotherapy-related adipocytic maturation in myxoid/round cell liposarcomas: specificity and prognostic value. Br J Radiol 2020; 93:20190794. [PMID: 32105502 PMCID: PMC10993228 DOI: 10.1259/bjr.20190794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/09/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the specificity, clinical implication and prognostic value of MRI adipocytic maturation (MAM) in myxoid/round cells liposarcomas (MRC-LPS) treated with neoadjuvant chemotherapy (NAC). METHODS Of the 89 patients diagnosed with MRC-LPS at our sarcoma reference center between 2008 and 2018, 28 were included as they were treated with NAC, surgery and radiotherapy. All patients underwent contrast-enhanced MRIs at baseline and late evaluation. A control cohort of 13 high-grade pleomorphic and dedifferentiated LPS with same inclusion criteria was used to evaluate the specificity of MAM in MRC-LPS. Two radiologists analyzed the occurrence of MAM, changes in the tumor architecture, shape and surrounding tissues during NAC. Pathological features of tumor samples were reviewed and correlated with MRI. Metastatic relapse-free survival was estimated with Kaplan-Meier curves and Cox models. Associations between prognostic T1-based delta-radiomics features and MAM were investigated with Student t-test. RESULTS MAM was more frequent in MRC-LPS (p = 0.045) and not specific of any type of chemotherapy (p = 0.7). Regarding MRC-LPS, 14 out of 28 patients (50%) demonstrated MAM. Eight patients showed metastatic relapses. MAM was not associated with metastatic relapse-free survival (p = 0.9). MAM correlated strongly with the percentage of histological adipocytic differentiation on surgical specimen (p < 0.001), which still expressed the tumor marker NY-ESO-1. None of the prognostic T1-based delta-radiomics features was associated with MAM. CONCLUSION MAM seems a neutral event during NAC. ADVANCES IN KNOWLEDGE MAM predominated in MRC-LPS and was not specific of a type of chemotherapy. Occurrence of MAM was not associated with better patients' metastasis free survival.
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Affiliation(s)
- Amandine Crombe
- Department of Radiology, Institut Bergonie,
F-33000, Bordeaux,
France
- University of Bordeaux, F-33000,
Bordeaux, France
- Modelisation in Oncology (MOnc) Team, INRIA Bordeaux-Sud-Ouest,
CNRS UMR 5251 & Université de Bordeaux,
F-33405, Talence,
France
| | - Maxime Sitbon
- Department of Radiology, Institut Bergonie,
F-33000, Bordeaux,
France
| | | | - Antoine Italiano
- Department of Medical Oncology, Institut Bergonie,
F-33000, Bordeaux,
France
| | - Xavier Buy
- Department of Radiology, Institut Bergonie,
F-33000, Bordeaux,
France
| | - François Le Loarer
- University of Bordeaux, F-33000,
Bordeaux, France
- Department of Pathology, Institut Bergonie,
F-33000, Bordeaux,
France
| | - Michèle Kind
- Department of Radiology, Institut Bergonie,
F-33000, Bordeaux,
France
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21
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Sato MP, Saito K, Fujita T, Seo T, Doi K. Primary Liposarcoma with Cholesteatoma in Mastoid. J Int Adv Otol 2020; 16:134-137. [PMID: 31257194 PMCID: PMC7224421 DOI: 10.5152/iao.2019.6709] [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] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/03/2019] [Accepted: 04/09/2019] [Indexed: 11/22/2022] Open
Abstract
Liposarcoma is a soft tissue neoplasm that commonly develops in the lower extremities and rarely in the head and neck region. Herein, we report the case of a patient with primary liposarcoma that was detected in the mastoid antrum during staged tympanoplasty for cholesteatoma. The tumor adjacent to the attic cholesteatoma was resected completely, and the pathological diagnosis was that of myxoid-type liposarcoma. Because positron emission tomography after the surgery showed no signs of tumor remnants or systemic metastasis, a second-stage surgery was performed 8 months after the first surgery. After confirming that there was no recurrence, tympanoplasty type III with interposition between the stapes and malleus and canal reconstruction was performed. No recurrence was observed for 5 years, and to date, good hearing has been maintained. This is the first report on long-term follow-up of a patient with liposarcoma in the mastoid antrum.
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Affiliation(s)
- Mitsuo P Sato
- Department of Otorhinolaryngology, Kindai University School of Medicine, Osaka, Japan
| | - Kazuya Saito
- Department of Otorhinolaryngology, Kindai University School of Medicine, Osaka, Japan
| | - Takeshi Fujita
- Department of Otorhinolaryngology, Kindai University School of Medicine, Osaka, Japan
| | - Toru Seo
- Department of Otorhinolaryngology, Kindai University School of Medicine, Osaka, Japan
| | - Katsumi Doi
- Department of Otorhinolaryngology, Kindai University School of Medicine, Osaka, Japan
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22
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Özşen M, Yalçınkaya U, Yazıcı Z, Sarısözen MB. Lipomatous Tumors in Pediatric Patients: A Retrospective Analysis of 50 cases. Turk Patoloji Derg 2020; 36:1-10. [PMID: 31282548 PMCID: PMC10512668 DOI: 10.5146/tjpath.2019.01464] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/01/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Although lipomatous tumors are the most common type of mesenchymal tumors in adults, they account for less than 10% of all soft tissue lesions in pediatric patients. In this descriptive study, we aim to present our series of pediatric lipomatous tumors consisting of lipoma, neural fibrolipoma, lipoblastoma, atypical lipomatous tumor, myxoid liposarcoma and pleomorphic liposarcoma, and to evaluate the clinicopathological characteristics of these tumors in reference to the literature. MATERIAL AND METHOD In this study, pediatric lipomatous tumor cases diagnosed between 2002 and 2018 were screened from pathological archives and retrospectively evaluated. RESULTS A total of 50 cases were diagnosed with lipomatous tumor within the mentioned period. Of the total cases, 24 were female (48%) and 26 were male (52%), with age distribution ranging from 1 to 204 months. Histopathological examination revealed lipoma in 26 cases (52%), lipoblastoma in 19 (38%), atypical lipomatous tumor in 2 (4%), myxoid liposarcoma in 2 (4%), and pleomorphic liposarcoma in 1 case (2%). CONCLUSION Although lipomatous tumors are the most common type of mesenchymal tumors; they rarely occur in children. Since there is a limited number of studies on pediatric lipomatous tumors in the literature, there is insufficient data on the prevalence and incidence of these tumors. These tumors may slowly enlarge to greater sizes, especially those localized in deep tissues, and may cause various clinical symptoms by compressing surrounding tissues. Local recurrences may occur, even after total excision, and require close monitoring.
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Affiliation(s)
- Mine Özşen
- Department of Pathology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Ulviye Yalçınkaya
- Department of Pathology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Zeynep Yazıcı
- Department of Radiology, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Bartu Sarısözen
- Department of Orthopedics and Traumatology, Uludag University Faculty of Medicine, Bursa, Turkey
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23
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Gouin F, Renault A, Bertrand-Vasseur A, Bouilleau L, Crenn V, Rosset P, Tallegas M, Samargandi R, Le Nail LR. Early detection of multiple bone and extra-skeletal metastases by body magnetic resonance imaging (BMRI) after treatment of Myxoid/Round-Cell Liposarcoma (MRCLS). Eur J Surg Oncol 2019; 45:2431-2436. [PMID: 31447287 DOI: 10.1016/j.ejso.2019.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/28/2019] [Accepted: 08/12/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Myxoid Round cell containing myxoid liposarcomas (MRCLS) have a high propensity to metastasize to soft tissue and bone. Whole Body Magnetic Resonance Imaging (BMRI) has been reported as a critical modality to early detect disease spreading in asymptomatic patients. The purpose of this study is to describe metastatic patterns and outcomes in patients through annual BMRI surveillance after diagnosis of MRCLS of the extremities and trunk. MATERIEL AND PATIENTS This retrospective study included patients with histology confirmed MRCLS. Initial BMRI were done within 6 months following the first line treatment then once a year. RESULTS Forty-five out of 51 consecutive MRCLS patients were included. At the last follow-up 10 patients (22.2%) had an extra-pulmonary soft-tissue or/and bone metastasis detected in a median delay of 22.7±16 months [0-49] from the diagnosis of the MRCLS. Nine patients were asymptomatic. Finally, 5-years metastatic free survival was 72±8%. All metastatic patients had multiple lesion within the year following the first lesion diagnosis. CONCLUSION Systematic BMRI in MRCLS patients following treatment frequently identify extra-pulmonary metastasis in asymptomatic patients within the first 5 years of follow-up. Despite a long survival can be expected after diagnosis, extra-skeletal metastasis was a signal of disseminated disease.
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Affiliation(s)
- Francois Gouin
- Clinique Chirurgicale Orthopédique, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, France; INSERM UMR1238. Bone Sarcoma and Remodeling of Calcified Tissues. Faculté de Médecine de Nantes, France.
| | - Arthur Renault
- Service de Radiologie, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, France
| | | | - Loic Bouilleau
- Service de Radiologie, Hôpital Trousseau, CHRU de Tours, France Faculté de Médecine, Université de Tours, France
| | - Vincent Crenn
- Service de Radiologie, Hôtel-Dieu, Centre Hospitalier Universitaire de Nantes, France; INSERM UMR1238. Bone Sarcoma and Remodeling of Calcified Tissues. Faculté de Médecine de Nantes, France
| | - Philippe Rosset
- Service de Chirurgie Orthopédique 1&2, Hôpital Trousseau, CHRU de Tours, France Faculté de Médecine, Université de Tours, France; INSERM UMR1238. Bone Sarcoma and Remodeling of Calcified Tissues. Faculté de Médecine de Nantes, France
| | - Matthias Tallegas
- Service d'Anatomie-Pathologique, Hôpital Trousseau, CHRU de Tours, France, Faculté de Médecine, Université de Tours, France
| | - Rami Samargandi
- Service de Chirurgie Orthopédique 1&2, Hôpital Trousseau, CHRU de Tours, France Faculté de Médecine, Université de Tours, France
| | - Louis-Romée Le Nail
- Service de Chirurgie Orthopédique 1&2, Hôpital Trousseau, CHRU de Tours, France Faculté de Médecine, Université de Tours, France; INSERM UMR1238. Bone Sarcoma and Remodeling of Calcified Tissues. Faculté de Médecine de Nantes, France
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24
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Zhang S, Kohli K, Black RG, Yao L, Spadinger SM, He Q, Pillarisetty VG, Cranmer LD, Van Tine BA, Yee C, Pierce RH, Riddell SR, Jones RL, Pollack SM. Systemic Interferon-γ Increases MHC Class I Expression and T-cell Infiltration in Cold Tumors: Results of a Phase 0 Clinical Trial. Cancer Immunol Res 2019; 7:1237-1243. [PMID: 31171504 DOI: 10.1158/2326-6066.cir-18-0940] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/09/2019] [Accepted: 06/03/2019] [Indexed: 12/15/2022]
Abstract
Interferon-γ (IFNγ) has been studied as a cancer treatment with limited evidence of clinical benefit. However, it could play a role in cancer immunotherapy combination treatments. Despite high expression of immunogenic cancer-testis antigens, synovial sarcoma (SS) and myxoid/round cell liposarcoma (MRCL) have a cold tumor microenvironment (TME), with few infiltrating T cells and low expression of major histocompatibility complex class I (MHC-I). We hypothesized that IFNγ treatment could drive inflammation in a cold TME, facilitating further immunotherapy. We conducted a phase 0 clinical trial treating 8 SS or MRCL patients with weekly systemic IFNγ. We performed pre- and posttreatment biopsies. IFNγ changed the SS and MRCL TME, inducing tumor-surface MHC-I expression and significant T-cell infiltration (P < 0.05). Gene-expression analysis suggested increased tumor antigen presentation and less exhausted phenotypes of the tumor-infiltrating T cells. Newly emergent antigen-specific humoral and/or T-cell responses were found in 3 of 7 evaluable patients. However, increased expression of PD-L1 was observed on tumor-infiltrating myeloid cells and in some cases tumor cells. These findings suggest that systemic IFNγ used to convert SS and MRCL into "hot" tumors will work in concert with anti-PD-1 therapy to provide patient benefit.
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MESH Headings
- Adult
- Aged
- Antigens, Neoplasm/immunology
- Biomarkers
- Biopsy
- Cytokines
- Female
- Histocompatibility Antigens Class I/genetics
- Histocompatibility Antigens Class I/immunology
- Humans
- Immunophenotyping
- Interferon-gamma/metabolism
- Liposarcoma, Myxoid/etiology
- Liposarcoma, Myxoid/immunology
- Liposarcoma, Myxoid/pathology
- Liposarcoma, Myxoid/therapy
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/metabolism
- Lymphocytes, Tumor-Infiltrating/pathology
- Male
- Middle Aged
- Sarcoma, Synovial/etiology
- Sarcoma, Synovial/immunology
- Sarcoma, Synovial/pathology
- Sarcoma, Synovial/therapy
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Young Adult
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Affiliation(s)
- Shihong Zhang
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Karan Kohli
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - R Graeme Black
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Lu Yao
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Sydney M Spadinger
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Qianchuan He
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Lee D Cranmer
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Division of Medical Oncology, University of Washington, Seattle, Washington
| | - Brian A Van Tine
- Division of Oncology, Washington University in St. Louis, St. Louis, Missouri
| | - Cassian Yee
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Robert H Pierce
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Stanley R Riddell
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Division of Medical Oncology, University of Washington, Seattle, Washington
| | - Robin L Jones
- Sarcoma Unit, Royal Marsden Hospital and Institute of Cancer Research, London, UK
| | - Seth M Pollack
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
- Division of Medical Oncology, University of Washington, Seattle, Washington
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25
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Iwanaga J, Puffer RC, Watanabe K, Spinner RJ, Tubbs RS. Division of Sacrospinous and Sacrotuberous Ligaments Expands Access Through Greater Sciatic Foramen: Anatomic Study with Application to Resection of Greater Sciatic Foramen Tumors. World Neurosurg 2019; 128:e970-e974. [PMID: 31100516 DOI: 10.1016/j.wneu.2019.05.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Tumors of the greater sciatic foramen remain difficult to treat. They often have both intrapelvic and extrapelvic components that may limit visualization and make safe resection of the tumor difficult. Therefore the goal of the present anatomic study was to quantitate how much additional surgical working space could be gained by transection of the sacrospinous and sacrotuberous ligaments. METHODS Sixteen sides from 9 fresh-frozen Caucasian cadaveric torsos underwent transgluteal dissection and exposure of the greater sciatic foramen and associated liagments. With the piriformis in place, the vertical and horizontal diameters of the greater sciatic foramen were measured. Next, the sacrotuberous and sacrospinous ligaments were cut at their ischial attachments. The vertical diameter of the now confluent greater and lesser sciatic foramina (V2) was measured. RESULTS The mean vertical diameter of the greater sciatic foramen (V1) was 54.8 ± 9.7 mm. The horizontal diameter of the greater sciatic foramen had a mean of 44.3 ± 6.1 mm with a range of 30-52 mm. After transection of the sacrotuberous and sacrospinous ligaments, the vertical distance of the greater and lesser sciatic foramina (V2) had a mean of 74.8 ± 6.8 mm with a range of 60.1-90 mm. The mean ratio of V2 to V1 was 1.40. CONCLUSIONS The vertical length of the greater sciatic foramen increased, on average, 40% after resection of the sacrotuberous and sacrospinous ligaments. The results of this study support an alternative technique for resecting large intrapelvic tumors via a transgluteal approach.
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Affiliation(s)
- Joe Iwanaga
- Seattle Science Foundation, Seattle, Washington, USA; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Ross C Puffer
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Koichi Watanabe
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Robert J Spinner
- Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
| | - R Shane Tubbs
- Seattle Science Foundation, Seattle, Washington, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada
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26
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Trautmann M, Cheng YY, Jensen P, Azoitei N, Brunner I, Hüllein J, Slabicki M, Isfort I, Cyra M, Berthold R, Wardelmann E, Huss S, Altvater B, Rossig C, Hafner S, Simmet T, Ståhlberg A, Åman P, Zenz T, Lange U, Kindler T, Scholl C, Hartmann W, Fröhling S. Requirement for YAP1 signaling in myxoid liposarcoma. EMBO Mol Med 2019; 11:e9889. [PMID: 30898787 PMCID: PMC6505681 DOI: 10.15252/emmm.201809889] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 12/25/2022] Open
Abstract
Myxoid liposarcomas (MLS), malignant tumors of adipocyte origin, are driven by the FUS-DDIT3 fusion gene encoding an aberrant transcription factor. The mechanisms whereby FUS-DDIT3 mediates sarcomagenesis are incompletely understood, and strategies to selectively target MLS cells remain elusive. Here we show, using an unbiased functional genomic approach, that FUS-DDIT3-expressing mesenchymal stem cells and MLS cell lines are dependent on YAP1, a transcriptional co-activator and central effector of the Hippo pathway involved in tissue growth and tumorigenesis, and that increased YAP1 activity is a hallmark of human MLS Mechanistically, FUS-DDIT3 promotes YAP1 expression, nuclear localization, and transcriptional activity and physically associates with YAP1 in the nucleus of MLS cells. Pharmacologic inhibition of YAP1 activity impairs the growth of MLS cells in vitro and in vivo These findings identify overactive YAP1 signaling as unifying feature of MLS development that could represent a novel target for therapeutic intervention.
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Affiliation(s)
- Marcel Trautmann
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Ya-Yun Cheng
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Patrizia Jensen
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Ninel Azoitei
- Department of Internal Medicine I, Ulm University Hospital, Ulm, Germany
| | - Ines Brunner
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jennifer Hüllein
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mikolaj Slabicki
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ilka Isfort
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Magdalene Cyra
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Ruth Berthold
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Eva Wardelmann
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Sebastian Huss
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Bianca Altvater
- Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
| | - Claudia Rossig
- Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
- Cells in Motion Cluster of Excellence, University of Münster, Münster, Germany
| | - Susanne Hafner
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University Hospital, Ulm, Germany
| | - Thomas Simmet
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University Hospital, Ulm, Germany
| | - Anders Ståhlberg
- Department of Pathology and Genetics, Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pierre Åman
- Department of Pathology and Genetics, Sahlgrenska Cancer Center, Institute of Biomedicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Thorsten Zenz
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Hematology, Zurich University Hospital and University of Zurich, Zürich, Switzerland
| | - Undine Lange
- Department of Hematology, Medical Oncology and Pneumology, University Medical Center of Mainz, Mainz, Germany
| | - Thomas Kindler
- Department of Hematology, Medical Oncology and Pneumology, University Medical Center of Mainz, Mainz, Germany
- German Cancer Consortium, Heidelberg (Frankfurt/Mainz), Germany
| | - Claudia Scholl
- German Cancer Consortium, Heidelberg (Frankfurt/Mainz), Germany
- Division of Applied Functional Genomics, DKFZ, Heidelberg, Germany
| | - Wolfgang Hartmann
- Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
- Division of Translational Pathology, Gerhard-Domagk-Institute of Pathology, Münster University Hospital, Münster, Germany
| | - Stefan Fröhling
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium, Heidelberg (Frankfurt/Mainz), Germany
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27
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Wang D, Wu J, Yu J, Zhang H, Liu H. Solitary pancreatic metastasis of extremity myxoid liposarcoma: a case report and literature review. BMC Cancer 2018; 18:1121. [PMID: 30445938 PMCID: PMC6240240 DOI: 10.1186/s12885-018-5059-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 11/07/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Myxoid liposarcoma has a distinct migration aptitude; however, pancreatic metastasis is rare. CASE PRESENTATION We report on the case of a 40-year-old female patient who suffered solitary pancreatic metastasis of myxoid liposarcoma and had a right thigh myxoid liposarcoma radical resection 5 years ago. The patient underwent a medial pancreatectomy and pancreaticojejunostomy for solitary pancreatic metastasis of myxoid liposarcoma. After 12 months of disease-free survival, the patient underwent an extended radical resection for the recurrence of the right thigh primary myxoid liposarcoma and received postoperative radiotherapy. Currently, the disease-free survival time after the last operation has been 22 months. CONCLUSIONS We reviewed the relevant literature and suggest that radical surgery might result in a good prognosis for patients with solitary pancreatic metastasis of myxoid liposarcoma.
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Affiliation(s)
- Dingding Wang
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Jie Wu
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, 266003 Shandong China
| | - Jian Yu
- Department of Oncology, Rizhao Central Hospital, Rizhao, 276800 Shandong China
| | - Hong Zhang
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - Honggang Liu
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
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28
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Abstract
RATIONALE Computed tomography (CT) and magnetic resonance imaging (MRI) are conventional used to evaluate liver tumors. Detection of fat component is considered an important clue to the imaging diagnosis of hepatic myxoid liposarcoma. However, the positron emission tomography (PET)/CT report of hepatic myxoid liposarcoma is scarce, and the metabolic characteristics of primary hepatic myxoid liposarcoma are still unknown. PATIENT CONCERNS In this report, we report the PET/CT manifestations of a rare case of primary hepatic myxoid liposarcoma that was confirmed by pathologic examination. A 29-year-old male patient presented with a nodule adjacent to the umbilicus that had been present for 2 weeks. PET/CT showed a hypoattenuating mass with moderate uptake (maximum standardized uptake value [SUVmax] 1.9), except for a slightly hyperattenuating focal area with intense uptake (SUVmax 3.1). DIAGNOSES The final pathologic diagnosis was confirmed, by means of laparotomy, to be a primary hepatic myxoid liposarcoma with multiple extrahepatic metastases. INTERVENTIONS The lesions in the left liver and periumbilical abdominal wall were punctured. During the laparotomy, hepatic malignant tumors were confirmed and metastasized widely in the abdominal cavity. OUTCOMES An abdominal CT performed 4 months after initial presentation showed extensive metastasis. LESSONS Primary hepatic myxoid liposarcoma may manifest as moderate metabolism with less fat on PET/CT. PET/CT is not only valuable in reflecting the round cell component of hepatic myxoid liposarcoma, but also in estimating its origin.
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Affiliation(s)
- Weihai Liu
- Department of Radiology, Beilun Branch Hospital of the First Affiliated Hospital, College of Medicine, Zhejiang University, the People's Hospital of Beilun District, Ningbo, Zhejiang
| | - Wenjie Liang
- Department of Radiology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang Province, China
| | - Zhiyi Peng
- Department of Radiology, First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang Province, China
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Pilotti S, Lavarino C, Mezzelani A, Della Torre C, Minoletti F, Sozzi G, Azzarelli A, Rilke F, Pierotti MA. Limited Role of TP53 and TP53-Related Genes in Myxoid Liposarcoma. Tumori 2018; 84:571-7. [PMID: 9862519 DOI: 10.1177/030089169808400512] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims Circumstantial evidence suggests that genetic changes may lead to tumor progression within the myxoid liposarcoma tumors (MLTs) carrying non-random chromosomal translocation t(12;16). Methods To address this subject an immunophenotypic analysis, applying antibodies against proteins encoded by TP53, MDM2 and CDK4 genes, complemented by molecular analysis of eight suitable cases, was performed on 104 consecutive cases. Chromosomal translocations were assessed either by cytogenetic analysis or by RT-PCR in 9 suitable cases and chimeric transcripts were found in all cases but two pleomorphic liposarcomas. Results Based on immunophenotyping and tumor site, the case material consisted of three groups. The first one was made up of 92 non-retroperitoneal cases carrying a null p53, mdm2, cdk4 immunophenotype, which remained unchanged over the time of recurrences and along the gamut of histologic subtypes. The second group was represented by five p53+, mdm2-, cdk4- non-retroperitoneal cases, 4 of which were further analysed by PCR-SSCP for p53 mutation. The im-munophenotipic profile of these cases, complemented by the molecular findings, supported a role of TP53 in tumor progression in three high-grade MLTs. The third group, consisting of 7 retroperitoneal cases, showed a heterogeneous immunophenotype, sharing immunophenotypic and molecular features with the well-differentiated/evoluted (dedifferentiated) liposarcoma group. Conclusions TP53 mutations seem to play a role in tumor progression in a few cases of MLTs (2.8%) showing more aggressive histologic characteristics. The unexpected finding that a number of retroperitoneal LMTs display the immunophenotypic profile of the well differentiated/evoluted (dedifferentiated) liposarcomas, deserves further investigation.
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Affiliation(s)
- S Pilotti
- Division of Anatomic Pathology and Cytopathology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
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30
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Abstract
Retroperitoneal sarcomas are rare and heterogeneous tumors. We here report two cases of liposarcoma in the renal compartment with a literature review in order to emphasize on the anatomical and surgical features of this tumor location and on its possible prognostic implications. The first reported case was a 45-year old female patient with liposarcoma at the level of the left renal compartment. The diagnosis of myxoid liposarcoma was based on anatomo-pathological examination of the surgical specimen. The second reported case was a 70-year old man with liposarcoma at the level of the right renal compartment. The diagnosis of dedifferentiated liposarcoma was based on anatomo-pathological examination of the surgical specimen. Retroperitoneal sarcomas are often diagnosed with a palpable mass. The gold standard treatment is complete tumor resection with healthy resection margins and without damage or rupture. For this purpose resection involving adjacent organs is recommended by some authors. However the anatomical constraints of tretroperitoneal compartment and the often important tumor volume limit the possibilities to achieve a satisfactory resection. CT scan and MRI are very useful imaging techniques. Histological diagnosis poses some problems; therefore immunohistochemistry and sometimes molecular biology are significantly helpful. Patient evolution is marked by the frequent occurrence of recurrences. A specialized multidisciplinary management of these rare and very varied tumors is recommended in order to optimize therapeutic outcomes.
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Affiliation(s)
- Rajae Tahri
- Centre Hospitalo-universitaire Ibn Sina, Faculté de Médecine et de Pharmacie, Rabat, Maroc
| | - Lamiaa Gamra
- Centre Hospitalo-universitaire Ibn Sina, Faculté de Médecine et de Pharmacie, Rabat, Maroc
| | - Azzedine El Otmany
- Centre Hospitalo-universitaire Ibn Sina, Faculté de Médecine et de Pharmacie, Rabat, Maroc
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31
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Rosato L, Panier Suffat L, Bertotti L, Perino P, Comello E, Mondini G. Retroperitoneal or mesenteric primary liposarcoma: clinical and prognostic evaluations on five cases. G Chir 2018; 39:57-62. [PMID: 29549683 PMCID: PMC5902147 DOI: 10.11138/gchir/2018.39.1.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Retroperitoneal or mesenteric primary liposarcoma is a malignant neoplasia whose prognosis depends on the biological variants, the radical resection surgery and the histological subtypes, as well as on local and remote recurrences. Liposarcoma is the most common variant of this tumour among tumours of soft retroperitoneal tissue. The purpose of this study is to evaluate whether the treatment of this disease, carried out at the Ivrea Hospital for urgent reasons, may be considered in line with the experience of high-volume Centres. PATIENTS AND METHODS Between 1982 and 2016 five patients were hospitalized with a diagnosis of acute abdomen due to retroperitoneal or mesenteric primary liposarcoma: one myxoid of the mesentery, one well-differentiated of lesser epiploon, one well-differentiated of mesentery, and two dedifferentiates of the retroperitoneum. RESULTS The five patients, all males, had a average age of 59 years (range 48-86) and were all subjected to general anaesthesia and open technique for total tumour removal. Only the patient with the myxoid liposarcoma had two recurrences. All are alive and healthy after a follow-up of 177 months (range 9-420). CONCLUSION These tumours should be removed radically, if necessary in conjunction with contiguous organs. Rarity and therapeutic complexity require a treatment, sometimes even multimodal, in highvolume centres. Patients admitted in General Surgery Unit for unpostponable urgency should be operated by surgeons experienced in the treatment of abdominal disease to achieve survival results in line to those achievable in Hub Centres.
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32
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Tornin J, Hermida-Prado F, Padda RS, Gonzalez MV, Alvarez-Fernandez C, Rey V, Martinez-Cruzado L, Estupiñan O, Menendez ST, Fernandez-Nevado L, Astudillo A, Rodrigo JP, Lucien F, Kim Y, Leong HS, Garcia-Pedrero JM, Rodriguez R. FUS-CHOP Promotes Invasion in Myxoid Liposarcoma through a SRC/FAK/RHO/ROCK-Dependent Pathway. Neoplasia 2017; 20:44-56. [PMID: 29190494 PMCID: PMC5747526 DOI: 10.1016/j.neo.2017.11.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 01/13/2023] Open
Abstract
Deregulated SRC/FAK signaling leads to enhanced migration and invasion in many types of tumors. In myxoid and round cell liposarcoma (MRCLS), an adipocytic tumor characterized by the expression of the fusion oncogene FUS-CHOP, SRC have been found as one of the most activated kinases. Here we used a cell-of-origin model of MRCLS and an MRCLS cell line to thoroughly characterize the mechanisms of cell invasion induced by FUS-CHOP using in vitro (3D spheroid invasion assays) and in vivo (chicken chorioallantoic membrane model) approaches. FUS-CHOP expression activated SRC-FAK signaling and increased the invasive ability of MRCLS cells. In addition, FAK expression was found to significantly correlate with tumor aggressiveness in sarcoma patient samples. The involvement of SRC/FAK activation in FUS-CHOP-mediated invasion was further confirmed using the SRC inhibitor dasatinib, the specific FAK inhibitor PF-573228, and FAK siRNA. Notably, dasatinib and PF573228 could also efficiently block the invasion of cancer stem cell subpopulations. Downstream of SRC/FAK signaling, we found that FUS-CHOP expression increases the levels of the RHO/ROCK downstream effector phospho-MLC2 (T18/S19) and that this activation was prevented by dasatinib or PF573228. Moreover, the ROCK inhibitor RKI-1447 was able to completely abolish invasion in FUS-CHOP-expressing cells. These data uncover the involvement of SRC/FAK/RHO/ROCK signaling axis in FUS-CHOP-mediated invasion, thus providing a rationale for testing inhibitors of this pathway as potential novel antimetastatic agents for MRCLS treatment.
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Affiliation(s)
- Juan Tornin
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Francisco Hermida-Prado
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain; CIBER de Cáncer (CIBERONC), Madrid, Spain
| | - Ranjit Singh Padda
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Translational Prostate Cancer Research Laboratory, Lawson Health Research Institute, London, ON, Canada
| | - M Victoria Gonzalez
- CIBER de Cáncer (CIBERONC), Madrid, Spain; Departamento de Cirugía, Universidad de Oviedo and Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | - Veronica Rey
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Lucia Martinez-Cruzado
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Oscar Estupiñan
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Sofia T Menendez
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain; CIBER de Cáncer (CIBERONC), Madrid, Spain
| | - Lucia Fernandez-Nevado
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | - Aurora Astudillo
- Servicio de Anatomía Patológica, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Juan P Rodrigo
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain; CIBER de Cáncer (CIBERONC), Madrid, Spain
| | | | - Yohan Kim
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Translational Prostate Cancer Research Laboratory, Lawson Health Research Institute, London, ON, Canada; Department of Urology, Mayo Clinic, Rochester, MN
| | - Hon S Leong
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Translational Prostate Cancer Research Laboratory, Lawson Health Research Institute, London, ON, Canada; Department of Urology, Mayo Clinic, Rochester, MN
| | - Juana Maria Garcia-Pedrero
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain; CIBER de Cáncer (CIBERONC), Madrid, Spain.
| | - Rene Rodriguez
- Hospital Universitario Central de Asturias-Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain; CIBER de Cáncer (CIBERONC), Madrid, Spain.
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Takahashi M, Takahashi S, Araki N, Sugiura H, Ueda T, Yonemoto T, Morioka H, Hiraga H, Hiruma T, Kunisada T, Matsumine A, Shimura M, Kawai A. Efficacy of Trabectedin in Patients with Advanced Translocation-Related Sarcomas: Pooled Analysis of Two Phase II Studies. Oncologist 2017; 22:979-988. [PMID: 28526720 PMCID: PMC5553952 DOI: 10.1634/theoncologist.2016-0064] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 02/06/2017] [Indexed: 11/26/2022] Open
Abstract
This analysis updates the results of two phase II studies of translocation‐related sarcomas to evaluate the efficacy of trabectedin against histological subtype and analyze overall survival. Background. Trabectedin is reported as effective, especially against translocation‐related sarcomas (TRSs) after failure of or intolerance to standard chemotherapy. We conducted two phase II studies of TRS, confirming high efficacy of 1.2 mg/m2 trabectedin. The updated data of 66 patients in these studies was integrated to evaluate the efficacy of trabectedin against each histological subtype, and analyze final overall survival (OS). Methods. Trabectedin was administered on day one of a 21‐day cycle. Efficacy was assessed using progression‐free survival (PFS), OS, and best overall response. An analysis of OS and PFS was performed for subgroups divided by baseline lymphocyte count (<1,000/μL, ≥1,000/μL) or number of previous chemotherapy regimens (0, 1, 2, ≥3 regimens), and a Weibull parametric model was used to estimate the numerical relationship between lymphocyte count and PFS and OS. Results. Median PFS and OS in overall patients were 5.6 (95% confidence interval [CI]: 4.1–7.3) and 17.5 months (95% CI: 12.6–23.6), respectively. PFS in the myxoid and round‐cell liposarcoma (MRCL) group (7.4 months [95% CI: 5.6–11.1]) was longer than in the other subtypes. The response rate was also highest in the MRCL group. Median OS was longer in patients with baseline lymphocyte counts ≥1,000/μL than in those with counts of <1,000/μL, but median PFS was not different between the two subgroups. Conclusion. Our updated and pooled data showed that trabectedin exerted prolonged disease control and antitumor effects in patients with advanced TRS, especially in MRCL. We consider that the subgroup analyses also provide important information for trabectedin treatment in patients with TRS. Implications for Practice. The progression‐free survival (PFS) for the integrated data of 66 patients with translocation‐related sarcomas (TRSs) in two phase II studies of trabectedin 1.2 mg/m2 was 5.6 months (95% confidence interval: 4.1–7.3). PFS and response rate in myxoid/round‐cell liposarcoma was longer than that of other subtypes. The overall survival (OS) in all TRS subtypes was similar to previous data of TRS patients. In subgroup analysis, the patients with baseline lymphocyte count ≥1,000/μL exhibited better OS, although PFS was not different by baseline lymphocyte count. Our data are considered important information for trabectedin treatment in TRS patients.
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Affiliation(s)
- Mitsuru Takahashi
- Division of Orthopaedic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Nobuhito Araki
- Department of Orthopaedic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Hideshi Sugiura
- Department of Physical Therapy, Nagoya University School of Health Sciences, Nagoya, Japan
| | - Takafumi Ueda
- Department of Orthopaedic Surgery, Osaka National Hospital, Osaka, Japan
| | - Tsukasa Yonemoto
- Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan
| | - Hideo Morioka
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroaki Hiraga
- Department of Orthopaedic Surgery, Hokkaido Cancer Center, Hokkaido, Japan
| | - Toru Hiruma
- Department of Musculoskeletal Tumor Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Toshiyuki Kunisada
- Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Akihiko Matsumine
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masashi Shimura
- Data Science Department, Taiho Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
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34
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Khan MH, Kashif R, Rahim Khan HA, Fatimi SH. Myxoid Liposarcoma Originating In The Anterior Mediastinum. J Ayub Med Coll Abbottabad 2016; 28:818-820. [PMID: 28828769] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Myxoid liposarcomas of the head and neck are mostly metastatic in nature, with the primary lesion usually in lower extremities or retroperitoneum. Primary mediastinal liposarcomas are even rarer. Although there have been previous cases reporting their incidence, there is no evidence of any case comprising of both the neck and the mediastinal region yet. We here present a case of a 43 year old male with a primary liposarcoma of the myxoid subtype originating in the anterior mediastinum. This is the first time such a case has presented in literature. The patient presented with a right sided neck swelling associated with pain and shortness of breath upon lying down. CT neck revealed an enhancing mass extending from right cervical region to axilla and encasing the subclavian artery and involving a portion of the right lung. The patient underwent wide local excision of the mass along with chemoradiotherapy to prevent recurrence.
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Affiliation(s)
| | - Ramsha Kashif
- Department of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan
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35
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Åman P, Dolatabadi S, Svec D, Jonasson E, Safavi S, Andersson D, Grundevik P, Thomsen C, Ståhlberg A. Regulatory mechanisms, expression levels and proliferation effects of the FUS-DDIT3 fusion oncogene in liposarcoma. J Pathol 2016; 238:689-99. [PMID: 26865464 DOI: 10.1002/path.4700] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/06/2016] [Accepted: 02/01/2016] [Indexed: 12/28/2022]
Abstract
Fusion oncogenes are among the most common types of oncogene in human cancers. The gene rearrangements result in new combinations of regulatory elements and functional protein domains. Here we studied a subgroup of sarcomas and leukaemias characterized by the FET (FUS, EWSR1, TAF15) family of fusion oncogenes, including FUS-DDIT3 in myxoid liposarcoma (MLS). We investigated the regulatory mechanisms, expression levels and effects of FUS-DDIT3 in detail. FUS-DDIT3 showed a lower expression than normal FUS at both the mRNA and protein levels, and single-cell analysis revealed a lack of correlation between FUS-DDIT3 and FUS expression. FUS-DDIT3 transcription was regulated by the FUS promotor, while its mRNA stability depended on the DDIT3 sequence. FUS-DDIT3 protein stability was regulated by protein interactions through the FUS part, rather than the leucine zipper containing DDIT3 part. In addition, in vitro as well as in vivo FUS-DDIT3 protein expression data displayed highly variable expression levels between individual MLS cells. Combined mRNA and protein analyses at the single-cell level showed that FUS-DDIT3 protein expression was inversely correlated to the expression of cell proliferation-associated genes. We concluded that FUS-DDIT3 is uniquely regulated at the transcriptional as well as the post-translational level and that its expression level is important for MLS tumour development. The FET fusion oncogenes are potentially powerful drug targets and detailed knowledge about their regulation and functions may help in the development of novel treatments.
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MESH Headings
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Cell Line, Tumor
- Cell Proliferation
- Gene Expression Regulation, Neoplastic
- Half-Life
- Humans
- Liposarcoma, Myxoid/genetics
- Liposarcoma, Myxoid/metabolism
- Liposarcoma, Myxoid/pathology
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Promoter Regions, Genetic
- Protein Binding
- Protein Processing, Post-Translational
- Protein Stability
- RNA Stability
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Signal Transduction
- Time Factors
- Transcription, Genetic
- Transfection
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Affiliation(s)
- Pierre Åman
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
| | - Soheila Dolatabadi
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
| | - David Svec
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
- Institute of Biotechnology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Emma Jonasson
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
| | - Setareh Safavi
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
| | - Daniel Andersson
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
| | - Pernilla Grundevik
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
| | - Christer Thomsen
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
| | - Anders Ståhlberg
- Sahlgrenska Cancer Centre, Department of Pathology, Institute of Biomedicine, University of Gothenburg, Sweden
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36
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Abstract
A 5-year-old, female, Japanese Macaque ( Macaca fuscata) was diagnosed with round cell variant of myxoid liposarcoma. At necropsy, multifocal to coalescing, reddish tan to white nodules, ranging from 0.5 to 1 cm in diameter, were noted throughout the omentum and retroperitoneum. Similar neoplastic nodules were also present in diaphragm, abdominal wall, and on hepatic capsule. Microscopically, neoplastic masses consisted of round to polyhedral cells, which had round, often eccentric nuclei and abundant eosinophilic granular and microvacuolated cytoplasm; Oil red O staining demonstrated large numbers of lipid droplets in the cytoplasm. Ultrastructurally, the cytoplasm of the tumor cells was packed with occasional lipid vacuoles and numerous enlarged mitochondria. Immunohistochemistry revealed tumor cells were positive for vimentin, while negative to cytokeratin, actin, and Factor VIII-related antigen. To the authors' knowledge, this is the first report of round-cell variant of myxoid liposarcoma in nonhuman primate.
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Affiliation(s)
- H-J Kwon
- Department of Veterinary Pathology, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Korea.
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37
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38
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Yuen NK, Li CS, Monjazeb AM, Borys D, Bold RJ, Canter RJ. Older Age Modifies Oncologic Outcome Following Radiotherapy in Soft-tissue Sarcoma: A Subtype-specific SEER Analysis. Anticancer Res 2016; 36:1745-1750. [PMID: 27069154] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Given the immune-mediated mechanisms of radiotherapy (RT), we hypothesized that age would affect response to RT in patients with soft-tissue sarcoma (STS) undergoing surgery. MATERIALS AND METHODS Using the Surveillance, Epidemiology, and End Results Program (1990-2011), we identified 15,380 patients with non-metastatic STS. Stratified by age (≥65 years) and histological subtype, we assessed predictors of overall (OS) and disease-specific survival (DSS). RESULTS Treatment with RT was associated with improved OS and DSS compared to surgery alone (p<0.05). Multivariate analysis also demonstrated that older patients obtained significant improvements in OS following RT, while younger patients did not. Results for DSS were similar, with older patients with leiomyosarcoma, sarcoma not otherwise specified, and myxoid liposarcoma, in particular, showing greater improvements in DSS after RT than younger patients (p<0.05). Interaction testing demonstrated an impact of year of diagnosis on outcomes but not receipt of RT. CONCLUSION Among patients with STS undergoing surgery, age appears to impact oncological outcomes after RT.
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Affiliation(s)
- Noah K Yuen
- Department of Surgery, UC Davis School of Medicine, Sacramento, CA, U.S.A
| | - Chin-Shang Li
- Division of Biostatistics, Department of Public Health Sciences, UC Davis School of Medicine, Sacramento, CA, U.S.A
| | - Arta M Monjazeb
- Department of Radiation Oncology UC Davis School of Medicine, Sacramento, CA, U.S.A
| | - Dariusz Borys
- Department of Pathology, Stritch School of Medicine, Loyola University, Maywood, IL, U.S.A
| | - Richard J Bold
- Department of Surgery, UC Davis School of Medicine, Sacramento, CA, U.S.A
| | - Robert J Canter
- Department of Surgery, UC Davis School of Medicine, Sacramento, CA, U.S.A.
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39
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Steinmann S, Gali-Muhtasib H, Huebner K, Al-Halabi R, Abou Merhi R, Aman P, Agaimy A, Haller F, Schneider-Stock R. Hsp90 inhibition by AUY922 as an effective treatment strategy against myxoid liposarcoma. Cancer Lett 2015. [PMID: 26225840 DOI: 10.1016/j.canlet.2015.07.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Liposarcoma is one of the most common soft tissue sarcomas in adults. Recognized histological subtypes include well differentiated/dedifferentiated liposarcoma (WD/DDLS), myxoid liposarcoma (MLS) and pleomorphic liposarcoma. Currently, there are no proper subtype-specific treatments due to the genetic, histological and clinical heterogeneity of the liposarcoma subentities. In the past decade, the rising understanding of the various genetic and molecular aberrations in liposarcoma led to the development of novel alternative therapeutic strategies. One such therapy is the inhibition of the heat shock protein 90 (Hsp90) which is overexpressed in liposarcomas. In this study, we dissect the functional role of a novel potent Hsp90 inhibitor NVP-AUY922 (AUY922) in different cell lines of myxoid (MLS402, MLS1765) and undifferentiated (SW872) liposarcomas. We show that compared with 17-AAG treatment, lower concentrations of AUY922 achieve markedly cytotoxic effects on tumor cell viability. Combination treatment of AUY922 (20 nM) with Doxorubicin (300 nM) yielded a further reduction in cell viability in comparison to Doxorubicin alone. In vivo, we document an inhibition of tumor growth after AUY922 treatment. Further analyses revealed that Hsp90-inhibition induces apoptotic cell death and cell cycle arrest. In addition, we report striking perturbations of subtype-specific pattern in Raf/MEK/ERK and PI3K signaling after AUY922 application. In conclusion, our results provide evidence that Hsp90-inhibition by AUY922 may be a promising alternative therapeutic strategy for myxoid liposarcoma patients.
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Affiliation(s)
- Sara Steinmann
- Experimental Tumor Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Universitaetsstrasse 22, 91054 Erlangen, Germany; Institute of Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054 Erlangen, Germany
| | | | - Kerstin Huebner
- Experimental Tumor Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Universitaetsstrasse 22, 91054 Erlangen, Germany; Institute of Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054 Erlangen, Germany
| | - Racha Al-Halabi
- Genomic and Health Laboratory, Faculty of Sciences, R. Hariri Campus, Lebanese University, Hadath, Lebanon
| | - Raghida Abou Merhi
- Genomic and Health Laboratory, Faculty of Sciences, R. Hariri Campus, Lebanese University, Hadath, Lebanon
| | - Pierre Aman
- Sahlgrenska Cancer Center, Department of Pathology, Institute of Biomedicine, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054 Erlangen, Germany
| | - Florian Haller
- Institute of Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054 Erlangen, Germany
| | - Regine Schneider-Stock
- Experimental Tumor Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Universitaetsstrasse 22, 91054 Erlangen, Germany; Institute of Pathology, University Hospital Erlangen of Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054 Erlangen, Germany.
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Tajima S, Koda K. Paratesticular dedifferentiated liposarcoma with prominent myxoid stroma: report of a case and review of the literature. Med Mol Morphol 2015; 50:112-116. [PMID: 25986682 DOI: 10.1007/s00795-015-0108-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 05/08/2015] [Indexed: 11/27/2022]
Abstract
Paratesticular sarcoma is rare, but liposarcoma is its most common type. Paratesticular liposarcoma sometimes presents as dedifferentiated liposarcoma. Both high-grade and low-grade dedifferentiation have been reported. Herein, we presented a unique case of a 64-year-old man with low-grade dedifferentiated liposarcoma with prominent myxoid stroma. Well-differentiated liposarcoma components extended along the spermatic cord. The constituent cells of the dedifferentiated component were peculiar in that, they were relatively uniform cells with atypia and did not have pleomorphism to such an extent that it mimicked myxofibrosarcoma. This myxoid component was confidently differentiated from myxoid liposarcoma with the help of immunohistochemical analysis using CDK4 and MDM2. These two markers were also expressed in the well-differentiated component. It could therefore be confirmed that this sarcoma is dedifferentiated liposarcoma but is not mixed-type liposarcoma comprising well-differentiated liposarcoma and myxoid liposarcoma.
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Affiliation(s)
- Shogo Tajima
- Department of Pathology, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka, 422-8021, Japan.
| | - Kenji Koda
- Department of Pathology, Fujieda Municipal General Hospital, Shizuoka, Japan
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Creytens D, van Gorp J, Ferdinande L, Van Roy N, Libbrecht L. Array-based comparative genomic hybridization analysis of a pleomorphic myxoid liposarcoma. J Clin Pathol 2014; 67:834-5. [PMID: 24970901 DOI: 10.1136/jclinpath-2014-202420] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ma Y, Wei S, Peker D. An extremely rare primary gallbladder myxoid liposarcoma associated with amplification of DDIT3 gene. J Gastrointestin Liver Dis 2014; 23:460-461. [PMID: 25532011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Yihong Ma
- Department of Pathology, University of Alabama at Birmingham,Birmingham Al 35249, USA.
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, Birmingham Al 35249, USA
| | - Deniz Peker
- Department of Pathology, University of Alabama at Birmingham, Birmingham Al 35249, USA
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Guo L, Cao DB, Yan X, Zou YB, Ma HX. [Primary intracranial mxyoid liposarcoma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2013; 42:843-844. [PMID: 24507109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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44
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Davidović R, Sopta J, Mandušić V, Krajnović M, Stanojević M, Tulić G, Dimitrijević B. p14(ARF) methylation is a common event in the pathogenesis and progression of myxoid and pleomorphic liposarcoma. Med Oncol 2013; 30:682. [PMID: 23918242 DOI: 10.1007/s12032-013-0682-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 07/26/2013] [Indexed: 02/03/2023]
Abstract
Liposarcoma represents the most frequent group of soft tissue sarcomas. The group can be divided into three different classes: (1) differentiated/undifferentiated (WDLPS/DDLPS), (2) myxoid/round cell (MLPS/RCLPS) and (3) pleomorphic liposarcoma (PLS). It has become apparent that p53-p14 and Rb-p16 pathways play important roles in the pathogenesis of various sarcoma types. Molecular studies of the genes involved in these two pathways showed wide variations between the liposarcoma subtypes or even within the same subtype. We sought to examine mutational status of p53 and methylation status of p16 (INK4a) /p14 (ARF) genes in primary and recurrent liposarcoma tumors. There were twelve myxoid (12/18, 66.7 %) and six pleomorphic liposarcoma (6/18, 33.3 %) samples. Immunohistochemical analysis revealed that p53 protein was overexpressed in 3/12 MLPS (25 %) and 6/6 PLS (100 %). Mutational analysis showed that 2/11 MLPS (18.2 %) and 2/6 PLS (33.3 %) contained mutated p53 gene. On the other hand, 3/18 samples (16.7 %) had methylated p16 promoter. However, the frequencies of the p14 (ARF) gene methylation were 83.3 % (10/12) and 50 % (3/6) in myxoid and pleomorphic group, respectively. Overall, 15 out of 18 (83.3 %) samples had either p53 gene mutation or methylated p14 (ARF) promoter. The results from the current study suggest significant impact of the p14 (ARF) gene methylation on the pathogenesis and progression of myxoid and to a lesser extent pleomorphic liposarcoma. Despite the limited number of samples, our study points to necessity of further investigation of p53-p14 and Rb-p16 pathways in liposarcoma.
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Affiliation(s)
- Radoslav Davidović
- Department for Radiobiology and Molecular Genetics, Institute of Nuclear Sciences Vinča, University of Belgrade, Mike Alasa 12-14, 11000, Belgrade, Serbia.
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Saito T, Ryu M, Fukumura Y, Asahina M, Arakawa A, Nakai K, Miura H, Saito M, Yao T. A case of myxoid liposarcoma of the breast. Int J Clin Exp Pathol 2013; 6:1432-1436. [PMID: 23826427 PMCID: PMC3693211] [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] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 06/04/2013] [Indexed: 06/02/2023]
Abstract
A 70-year-old woman visited a local hospital complaining of a nodulein the right breast, present since 1 month. She was referred to our hospital for further evaluation. Following mammotome (MMT) biopsy, the nodule was diagnosed as myxoid/round cell liposarcoma. She underwent total mastectomy of the right breast. Histological analysis indicated that the tumor was almost entirely composed of proliferating small round mesenchymal cells in amyxoid matrix background with capillary-like vessels with partial necrosis (<10%). Immunohistochemically, p53 positive cells were seen focally (<1%) only, and the Ki-67 labeling index was approximately 20%. Since the surgical margin was histologically positive despite pathologic findings of high-grade malignancy, adjuvant treatment involving local radiation therapy (60Gy) was administered. The patient was free from any symptoms of local recurrence and metastases 1 year and 8 months after surgery.
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Affiliation(s)
- Tsuyoshi Saito
- Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan.
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Kimura H, Dobashi Y, Nojima T, Nakamura H, Yamamoto N, Tsuchiya H, Ikeda H, Sawada-Kitamura S, Oyama T, Ooi A. Utility of fluorescence in situ hybridization to detect MDM2 amplification in liposarcomas and their morphological mimics. Int J Clin Exp Pathol 2013; 6:1306-1316. [PMID: 23826411 PMCID: PMC3693195] [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] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 05/03/2013] [Indexed: 06/02/2023]
Abstract
The atypical lipomatous tumor (ALT)/well-differentiated liposarcoma (WDLS) and the de-differentiated liposarcoma (DDLS) represent the most common category of liposarcomas. ALT/WDLSs and DDLSs are often difficult to distinguish from other tumors with similar morphological characteristics. In this study, we investigated whether the detection of amplified or overexpressed murine double-minute 2 (MDM2) can be a useful diagnostic ancillary aid. We used fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) to detect MDM2 amplification and protein overexpression, respectively, in 49 WDLSs, 5 DDLSs, 23 myxoid liposarcomas, 25 benign lipomatous tumors, and 75 spindle and pleomorphic sarcomas. MDM2 amplification was detected in 48 of 49 WDLSs, 5 of 5 DDLSs, 2 of 9 malignant peripheral nerve sheath tumors, and 2 of 10 myxofibrosarcomas. We did not detect MDM2 amplification in any of the benign lipomatous tumors. FISH-mediated detection of MDM2 amplification was the most valuable diagnostic aid for ALT/WDLS, as determined by using the Fisher exact test to compare two different diagnoses of 19 biopsies. On the contrary, unequivocal nuclear overexpression of MDM2 was found in only 10 of 50 ALT/WDLSs. The sensitivity and specificity of MDM2 amplification in distinguishing a DDLS from spindle and pleomorphic sarcomas were 100% and 95%, respectively, while those of MDM2 overexpression were 100% and 87%, respectively. In conclusion, our results indicate that FISH-mediated detection of MDM2 amplification is the most useful adjunct in the diagnosis of both ALT/WDLS and DDLS. However, IHC-mediated detection of MDM2 protein is useful only for the diagnosis of DDLS.
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Affiliation(s)
- Hiroaki Kimura
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa UniversityKanazawa, Ishikawa, Japan
| | - Yoh Dobashi
- Department of Pathology, Saitama Medical Center, Jichi Medical UniversitySaitama, Japan
| | - Takayuki Nojima
- Department of Pathology and Laboratory Medicine, Kanazawa Medical UniversityUchinada, Ishikawa, Japan
| | - Hiroyuki Nakamura
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa UniversityKanazawa, Ishikawa, Japan
| | - Norio Yamamoto
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa UniversityKanazawa, Ishikawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa UniversityKanazawa, Ishikawa, Japan
| | - Hiroko Ikeda
- Section of Diagnostic Pathology, Kanazawa University HospitalKanazawa, Ishikawa, Japan
| | - Seiko Sawada-Kitamura
- Section of Diagnostic Pathology, Kanazawa University HospitalKanazawa, Ishikawa, Japan
| | - Takeru Oyama
- Department of Molecular and Cellular Pathology, Graduate School of Medical Science, Kanazawa UniversityKanazawa, Ishikawa, Japan
| | - Akishi Ooi
- Department of Molecular and Cellular Pathology, Graduate School of Medical Science, Kanazawa UniversityKanazawa, Ishikawa, Japan
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Krishnan J, Hathiramani V, Hastak M, Redkar RG. Myxoid lipoblastoma. Indian Pediatr 2013; 50:603-605. [PMID: 23942405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A rapidly growing soft tissue mass in the axilla of an infant raises the suspicion of a lipoblastoma or a liposarcoma. Excisional/incisional biopsy is vital in confirming the diagnosis and hence avoiding aggressive extirpation. This case report highlights the role of histopathology and immunohistochemistry as the gold standard in differentiating a lipoblastoma from a liposarcoma. In some cases where the histopathology is inconclusive, genetic rearrangement of the PLAG1 (pleomorphic adenoma gene 1) oncogene on chromosome 8q12 helps in confirming the diagnosis of lipoblastoma.
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Affiliation(s)
- Janani Krishnan
- Department of Pediatric Surgery, Lilavati Hospital and Research Centre, Mumbai, India.
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Bittner JG, Gershuni VM, Matthews BD, Moley JF, Brunt LM. Risk factors affecting operative approach, conversion, and morbidity for adrenalectomy: a single-institution series of 402 patients. Surg Endosc 2013; 27:2342-50. [PMID: 23404146 DOI: 10.1007/s00464-013-2789-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 12/31/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Risk factors for selecting patients for open adrenalectomy (OA) and for conversion are limited in most series. This study aimed to investigate variables that are important in selecting patients for OA, predict risk of conversion from laparoscopic adrenalectomy (LA), and impact 30-day outcomes of OA and LA. METHODS A retrospective cohort study of prospectively collected data was conducted. Patients (≥ 16 years old) who underwent adrenalectomy in the Division of General Surgery at Barnes-Jewish Hospital (1993-2010) were grouped by operative approach (LA vs. OA) and compared using nonparametric tests and regression analyses (α < 0.05). RESULTS In total, 402 patients underwent 422 adrenalectomies. Compared to LA patients, those in the OA group were older (p = 0.02), had higher ASA scores (p = 0.04), larger tumor size (p < 0.01), and fewer functioning lesions (p < 0.01). OA patients more often required concurrent procedures (p < 0.01), had a longer operative time (p = 0.04), more intraoperative complications (p = 0.02), higher estimated blood loss (EBL), and larger transfusion requirement. Preoperative factors that predicted selection for OA were higher patient age (p = 0.01), higher ASA score (p = 0.03), larger tumor size (p < 0.01), nonfunctioning lesion (p < 0.01), diagnosis of adrenocortical carcinoma (p < 0.01), and the need for concomitant procedures (p < 0.01). Conversion to open or hand-assisted approach occurred in 6.2 % of LA patients. Preoperative risks for conversion included large tumor size (>8 cm) and need for concomitant procedures (p < 0.01). Multivariate analysis revealed that large indeterminate adrenal mass, adrenocortical carcinoma, tumor size (>6 cm), an open operation, conversion, concomitant procedures, operative time >180 min, and EBL >200 mL were predictors of 30-day morbidity. CONCLUSIONS Adrenal tumor size and need for concurrent procedures significantly impact the selection of patients for OA, the likelihood of conversion, and perioperative morbidity. These metrics should be considered when assessing operative approach and risks for adrenalectomy.
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Affiliation(s)
- James G Bittner
- Section of Minimally Invasive Surgery, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, St. Louis, MO 63111, USA.
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Giuri S, Raica M, Munteanu M. Myxoid/round cell conjunctival liposarcoma. A case report. Rom J Morphol Embryol 2013; 54:655-658. [PMID: 24068420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To present a rare case of conjunctival myxoid liposarcoma, subtype round cells, that had a seven years follow up. CLINICAL OBSERVATION A 61-year-old female patient presents with a palpable, non-painful tumor, on the superior temporal bulbar conjunctiva of the right eye. The initial examination detects a fleshy tumor, orange in color, under the superior temporal bulbar conjunctiva, as well as two oval-shaped hyperpigmented conjunctival lesions, near the limbus at 10 o'clock, causing moderate blepharoptosis. Vision was normal, there was no diplopia, proptosis, afferent pupillary defect or lymphadenopathy; there was no orbital involvement in MRI. An isolated 15/15 mm tumor, with no connections with the eye socket, was excised. Histopathology revealed a poorly differentiated myxoid liposarcoma. Five recurrences occurred, of which four were treated by local excision and the last required exenteration. Repeat histopathology detects lipoblasts, small round cells, with immunohistochemistry positive for CD34, S100 and vimentin. The last two rapidly evolving and large recurrences, as well as pulmonary metastasis and finally death of the patient, underlined the aggressive character of round cell conjunctival liposarcoma. CONCLUSIONS Conjunctival myxoid liposarcoma is characterized by numerous local recurrences, but the speed of the succession and volume of the recurrences may suggest a change in the underlying histopathological aspect, that is definitory for the therapeutical and prognostic approach of the case.
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Affiliation(s)
- Stela Giuri
- Department of Ophthalmology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania;
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