• Title/Summary/Keyword: Sarcomas

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Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas (악성 연부조직 종양에 대한 무계획적 절제술 후 잔여 종양의 영상학적 진단의 정확성과 임상적 위험인자)

  • Oh, Eunsun;Seo, Sung Wook;Jeong, Jeonghwan
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.150-156
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    • 2019
  • Purpose: This study examined the diagnostic accuracy of an imaging study to find the factors that affect the presence of residual tumors after an unplanned excision of sarcomas. Materials and Methods: Ninety-eight patients, who underwent a re-excision after unplanned surgery between January 2008 and December 2014, were enrolled in this study. Magnetic resonance imaging (MRI) was performed before reoperation in all patients. Positron emission tomography (PET)-computed tomography was performed on 54 patients. A wide re-excision and histology diagnosis were performed in all cases. The clinical variables were evaluated using univariate logistic regression and multivariate logistic regression. Results: The presence of a deep-seated tumor increases the risk of remnant tumors (odds ratio: 3.21, p=0.02, 95% confidence interval: 1.25-8.30). The sensitivity for detecting residual tumors is high in MRI (sensitivity 0.79). Conclusion: Deep-seated tumors have a significantly higher risk of remnant tumors. Because the negative predictive value of MRI and PET scans is very low, reoperation should be performed regardless of a negative result.

Diagnosis of Residual Tumors after Unplanned Excision of Soft-Tissue Sarcomas: Conventional MRI Features and Added Value of Diffusion-Weighted Imaging

  • Jin, Kiok;Lee, Min Hee;Yoon, Min A;Kim, Hwa Jung;Kim, Wanlim;Chee, Choong Geun;Chung, Hye Won;Lee, Sang Hoon;Shin, Myung Jin
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.20-31
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    • 2022
  • Purpose: To assess conventional MRI features associated with residual soft-tissue sarcomas following unplanned excision (UPE), and to compare the diagnostic performance of conventional MRI only with that of MRI including diffusion-weighted imaging (DWI) for residual tumors after UPE. Materials and Methods: We included 103 consecutive patients who had received UPE of a soft-tissue sarcoma with wide excision of the tumor bed between December 2013 and December 2019 and who also underwent conventional MRI and DWI in this retrospective study. The presence of focal enhancement, soft-tissue edema, fascial enhancement, fluid collections, and hematoma on MRI including DWI was reviewed by two musculoskeletal radiologists. We used classification and regression tree (CART) analysis to identify the most significant MRI features. We compared the diagnostic performances of conventional MRI and added DWI using the McNemar test. Results: Residual tumors were present in 69 (66.9%) of 103 patients, whereas no tumors were found in 34 (33.1%) patients. CART showed focal enhancement to be the most significant predictor of residual tumors and correctly predicted residual tumors in 81.6% (84/103) and 78.6% (81/103) of patients for Reader 1 and Reader 2, respectively. Compared with conventional MRI only, the addition of DWI for Reader 1 improved specificity (32.8% vs. 56%, 33.3% vs. 63.0%, P < 0.05), decreased sensitivity (96.8% vs. 84.1%, 98.7% vs. 76.7%, P < 0.05), without a difference in diagnostic accuracy (76.7% vs. 74.8%, 72.9% vs. 71.4%) in total and in subgroups. For Reader 2, diagnostic performance was not significantly different between the sets of MRI (P > 0.05). Conclusion: After UPE of a soft-tissue sarcoma, the presence or absence of a focal enhancement was the most significant MRI finding predicting residual tumors. MRI provided good diagnostic accuracy for detecting residual tumors, and the addition of DWI to conventional MRI may increase specificity.

Differentiating Uterine Sarcoma From Atypical Leiomyoma on Preoperative Magnetic Resonance Imaging Using Logistic Regression Classifier: Added Value of Diffusion-Weighted Imaging-Based Quantitative Parameters

  • Hokun Kim;Sung Eun Rha;Yu Ri Shin;Eu Hyun Kim;Soo Youn Park;Su-Lim Lee;Ahwon Lee;Mee-Ran Kim
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.43-54
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    • 2024
  • Objective: To evaluate the added value of diffusion-weighted imaging (DWI)-based quantitative parameters to distinguish uterine sarcomas from atypical leiomyomas on preoperative magnetic resonance imaging (MRI). Materials and Methods: A total of 138 patients (age, 43.7 ± 10.3 years) with uterine sarcoma (n = 44) and atypical leiomyoma (n = 94) were retrospectively collected from four institutions. The cohort was randomly divided into training (84/138, 60.0%) and validation (54/138, 40.0%) sets. Two independent readers evaluated six qualitative MRI features and two DWI-based quantitative parameters for each index tumor. Multivariable logistic regression was used to identify the relevant qualitative MRI features. Diagnostic classifiers based on qualitative MRI features alone and in combination with DWI-based quantitative parameters were developed using a logistic regression algorithm. The diagnostic performance of the classifiers was evaluated using a cross-table analysis and calculation of the area under the receiver operating characteristic curve (AUC). Results: Mean apparent diffusion coefficient value of uterine sarcoma was lower than that of atypical leiomyoma (mean ± standard deviation, 0.94 ± 0.30 10-3 mm2/s vs. 1.23 ± 0.25 10-3 mm2/s; P < 0.001), and the relative contrast ratio was higher in the uterine sarcoma (8.16 ± 2.94 vs. 4.19 ± 2.66; P < 0.001). Selected qualitative MRI features included ill-defined margin (adjusted odds ratio [aOR], 17.9; 95% confidence interval [CI], 1.41-503, P = 0.040), intratumoral hemorrhage (aOR, 27.3; 95% CI, 3.74-596, P = 0.006), and absence of T2 dark area (aOR, 83.5; 95% CI, 12.4-1916, P < 0.001). The classifier that combined qualitative MRI features and DWI-based quantitative parameters showed significantly better performance than without DWI-based parameters in the validation set (AUC, 0.92 vs. 0.78; P < 0.001). Conclusion: The addition of DWI-based quantitative parameters to qualitative MRI features improved the diagnostic performance of the logistic regression classifier in differentiating uterine sarcomas from atypical leiomyomas on preoperative MRI.

Primary leiomyosarcoma of the chest wall in a child : a case report (소아의 흉벽에서 진단된 평활근육종 1례)

  • Choi, Jae Hyuk;Chung, David Chanwook;Lee, Mee Jeong
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.98-101
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    • 2008
  • Leiomyosarcoma is an uncommon soft tissue sarcoma of mesenchymal cell origin, which shows smooth muscle differentiation. Leiomyosarcoma is seldom found in the pediatric population, and accounts for fewer than 2% of all soft tissue sarcomas. Leiomyosarcoma of the chest wall is extremely rare in children. We report here a case of an 8-year-old boy with a primary leiomyosarcoma that was incidentally found as a rib mass. The patient underwent a complete resection for a suspected osteochondroma diagnosed by a three-dimensional chest computed tomography examination. Pathological findings of the mass revealed intersecting fascicles of spindle cells showing cigar-shaped nuclei, inconspicuous nuclear pleomorphism and occasional mitotic figures in the background of a suspected osteochondroma of the rib. This report documents the first description of a leiomyosarcoma possibly arising in an osteochondroma of the rib in a child.

A Case of Primary Unclassified Spindle Cell Sarcoma of the Left Atrium (좌심방에 발생한 원발성 미분류 방추세포 육종 1례)

  • Cho, Jeong-Hwan;Hong, Geu-Ru;Song, In-Wook;Son, Chang-Woo;Jung, Sun-Young;Nam, Jong-Ho;Kim, Mi-Jin
    • Journal of Yeungnam Medical Science
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    • v.26 no.2
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    • pp.108-113
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    • 2009
  • Primary cardiac tumors are very uncommon. Seventy five percent of them are benign tumors and these are mostly myxomas. The malignant cardiac tumors, the majority of which are undifferentiated sarcomas, comprise up to 25% of all cardiac tumors. A primary malignant sarcoma of the myocardium is exceedingly rare. Thus, there have been very few such cases reported in the literature. We present here a case of a 15 year old man who had complaints of orthopnea and increasing exercise intolerance over a one month period. Transthoracic echocardiography demonstrated a well demarcated huge mass with left ventricular inflow obstruction on the posterior wall of the left atrium. The patient's symptoms were relieved by surgery. The histological diagnosis was an unclassified spindle cell sarcoma.

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Isolated Recurrence of Intracranial Granulocytic Sarcoma Mimicking a Falx Meningioma in Acute Myeloblastic Leukemia

  • Cho, Won-Ho;Choi, Young-Jin;Choi, Byung-Kwan;Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.385-388
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    • 2010
  • Intracranial granulocytic sarcomas are rare tumors, which are composed of immature granulocytic cells. Although it has been well known that these tumors are associated with acute myeloblastic leukemia (AML), they have been almost always related to bone marrow relapse. However, isolated recurrence of granulocytic sarcoma following complete remission from prior AML is extremely rare, especially in the central nervous system. A 44-year-old male presented with isolated recurrence of granulocytic sarcoma mimicking a falx meningioma two years after complete remission by allogenic peripheral blood stem cell transfusion (PBSCT) in the acute myelomonoblastic leukemia (FAB, M4). Because of depressed mental state and mass effect, total surgical resection was performed. Pathological findings were compatible with the granulocytic sarcoma. There was no evidence of leukemic relapse in the peripheral blood. We suggest that this phenomenon can be explained by the hypothesis that a certain barrier effect such as blood brain barrier might lead to the proliferation of intracranial leukemic cells which metastasized before PBSCT.

A Case of Primary Hemangiopericytoma of the Lung (폐의 원발성 혈관주위세포종 1예)

  • Kim, Dae-Young;Lee, Dong-Lyeol;Lee, Kyu-Hwan;Jo, Jin-Hoon;Kim, Kang-Hee;Kim, Ho-Kyun;Kim, Hye-Suk;Yoon, Sun-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.111-116
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    • 1999
  • Primary hemangiopericytomas of the lung are uncommon sarcomas that arise from pericytes that surround the basement membrane of capillaries and small venules within the lung parenchyma. The presenting symptoms and signs depend on the location of the tumor and radiologic features are not diagnostic. The behavior of pulmonary hemangiopericytomas is difficult to predict and all tumors should be considered potentially malignant. Wide surgical excision remains the mainstay of treatment. We report a case of primary hemangiopericytoma of the lung with a brief review of literature.

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Von Recklinghausen's disease involving the chest -Two cases report- (흉부질환을 병발한 Von Recklinghausen's disease -2예 보고-)

  • Kim, Chi-Kyung;Park, Jae-gil;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.149-153
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    • 1980
  • Von Recklinghausen's disease is a systemic hereditary disorder with varied manifestations in bone, soft tissue, nervous system, and skin, the most common of which is the developement of multiple, small, cutaneous tumors with a characteristic histologic picture. Tumors develop after birth and before puberty in most cases, and they increase in number until old age. Malignant neoplasms that complicate multiple neurofibromatosis include gliomas of the optic nerve, astrocytomaas of the cerebral and cerebellar hemispheres, and sarcomas of peripheral nerves (femoral, tibial and intercostal nerves) and somatic soft tissues. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochrocytoma, meningocele or, less commonly parenchymal pulmonary neurofibromas. Author have experienced 2 cases of Von Recklinghausen's disease. One case developed a hyge malignant Schwannoma in the parietal pleura of left 4th intercostal space and multiple benign neurofibromas (two in intercostal spacees and one in the neck) , and the other has several episodes of pneumothorax resulting from diffuse cystic lung disease which required closed thoracotomy drainage.

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Fine Needle Aspiration Cytology of Biphasic Synovial Sarcoma - A Case Report - (이중상 활막육종의 세침흡인 세포학적 소견 -1예 보고-)

  • Kim, Hee-Kyung;Jin, So-Young;Lee, Dong-Wha
    • The Korean Journal of Cytopathology
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    • v.14 no.2
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    • pp.96-101
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    • 2003
  • Synovial sarcoma is a rare soft tissue tumor accounting for 5-10% of soft tissue sarcomas. Most arise in the extremities and trunk, and a small proportion occur in the abdominal wall, head and neck legion, and mediastinum. It manifests different phenotypic subtypes that render their cytologic evaluation challenging. Moreover, cytomorphologic description of the epithelial component of synovial sarcoma is rare in Korea. We report a case of biphasic synovial sarcoma on the right lower extremity in a 49-year-old woman diagnosed by fine needle aspiration cytology. The aspirate was moderately cellular and composed of a mixture of tissue fragments and dissociated cells with bland chromatin, inconspicuous nucleoli, and oval to spindle-shaped cytoplasm. Mitosis was rare. A monolayer sheet of epithelial component was seen. The cells in this monolayer sheet had more abundant distinct cytoplasm, round nuclei, and prominent micronucleoli. Histologic examination showed a biphasic pattern consisting of mostly sarcomatous stroma and a few small glandular areas at the periphery of the tumor.

Roles of Galectin-7 in Cancer

  • Kaur, Manpreet;Kaur, Tarnjeet;Kamboj, Sukhdev Singh;Singh, Jatinder
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.455-461
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    • 2016
  • Galectins are ${\beta}$-galactoside binding lectins that contain one or more carbohydrate recognition domains. As a consequence of sugar-binding properties, galectins exhibit a variety of interactions with glycoproteins, thus playing important roles in various pathological processes. A number of studies have shown roles of galectins in cancer. Galectin-7 is a prototype member of the galectin family implicated in epithelial stratification and cell migration. It can act as a potent dual regulator in different types of cancer. Galectin-7 may contribute either to neoplastic transformation and tumour progression through regulation of cell growth, cell cycle, angiogenesis, apoptosis and cell migration or may have a protective effect in cancer depending on the tissue type. A perusal of the literature indicates particular roles of galectin-7 in carcinomas and melanomas, while contributions await greater exploration in other types of cancers including sarcomas and leukemia. This review collectively summarizes available literature on expression and roles of galectin-7 in different cancers.