Cartilage and bone containing benign mesenchymoma of the thigh and popliteal fossa.
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We report a case of a large cartilage and bone containing mesenchymoma of the thigh and popliteal fossa in a 56-year-old man. Mesenchymomas are rare tumors with a histologically benign pattern. They may be associated with morbidity as a result of local infiltrative growth. (+info)
Ultrasonographically guided needle biopsy of benign and malignant soft tissue and bone tumors.
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In 65 patients an ultrasonographically guided needle biopsy was performed for histologic diagnosis of benign and malignant soft tissue and bone tumors. On the basis of the histopathologic findings, a final diagnosis could be made in 54 cases after sonographically guided needle biopsy of the soft tissue tumor component. In addition, tumor grouping was possible in seven cases; however, due to the small volume of the biopsy specimen, further tumor differentiation proved to be unsuccessful. A definite diagnosis was not possible in four patients, who had mainly cystoid tumors; however, malignancy could be ruled out in three of these cases. The decisive advantage of the ultrasonographically guided needle biopsy procedure over what is known as a blind tumor biopsy is that the biopsy needle can be positioned exactly by means of imaging control. The ultrasound screen enables the user to monitor the biopsy procedure; multiple biopsies of different parts of the tumor soft tissue component can be performed using a single needle tract. No complications occurred in our study. Because of the far-reaching consequences of ultrasonographically guided needle biopsy, this type of procedure should be performed only at tumor centers. (+info)
Soft-tissue sarcoma and non-Hodgkin's lymphoma clusters around a municipal solid waste incinerator with high dioxin emission levels.
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Overall evidence from epidemiologic studies in the workplace suggests that dioxin is a human carcinogen, but whether low doses affect the general population remains to be determined. The authors examined the spatial distribution of soft-tissue sarcomas and non-Hodgkin's lymphomas around a French municipal solid waste incinerator with high emission levels of dioxin (16.3 ng international toxic equivalency factor/m3). Not consistently associated with dioxin exposure,-Hodgkin's disease served as the control cancer category. Clusters were identified from 1980 to 1995 in the area ("departement') of Doubs by applying a spatial scan statistic to 26 electoral wards. The most likely and highly significant clusters found were identical for soft-tissue sarcomas and non-Hodgkin's lymphomas and included the area around the municipal solid waste incinerator; standardized incidence ratios were 1.44 (observed number of cases = 45, focused test p value = 0.004) and 1.27 (observed number of cases = 286, focused test p value = 0.00003), respectively. Conversely, Hodgkin's disease exhibited no specific spatial distribution. Confounding by socioeconomic status, urbanization, or patterns of medical referral seemed unlikely to explain the clusters. Although consistent, these findings should be confirmed by further investigation (e.g., a case-control study in which dioxins are measured in biologic tissues) before clusters of soft-tissue sarcoma and non-Hodgkin's lymphoma are ascribed to dioxin released by the municipal solid waste incinerator. (+info)
Prognostic significance of apoptosis in synovial sarcoma: correlation with clinicopathologic parameters, cell proliferative activity, and expression of apoptosis-related proteins.
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bcl-2 overexpression in synovial sarcomas has been recently reported. Although it is widely known that bcl-2 suppresses apoptosis in various cells, there are no studies that have examined the significance of apoptosis in synovial sarcoma. In the present study, we visualized apoptotic tumor cells by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate in situ nick end-labeling (TUNEL) method in 49 cases of primary synovial sarcoma. The degree of apoptosis was analyzed in relation to several clinicopathologic parameters, cell proliferative activity, and immunohistochemical expression of apoptosis-related proteins, including bcl-2, bax, bcl-x, bak, p53, p21 (WAF1/CIP1), Fas, and Fas ligand. TUNEL index (TUNEL-I) significantly correlated with the mitotic index (MI) (n = 0.60, P < .0001) and Ki-67 labeling index (MIB1-I) (n = 0.52, P = 0.0005). There was a highly significant association between high TUNEL-I value (>.8%) and poor prognosis (log-rank test; P < .0001). Many synovial sarcomas were diffusely positive for bcl-2 family proteins (bcl-2, bax, bcl-x, and bak) and were negative or only sporadically positive for Fas, Fas ligand, p53, and p21 (WAF1/CIP1) proteins. The results indicated that increased rate of apoptosis in primary synovial sarcoma was considered to be an indicator of poor prognosis. In addition, apoptosis in synovial sarcoma may be controlled by multiple apoptosis-regulating mechanisms, including the bcl-2 family. (+info)
p27(kip1) protein expression correlates with survival in myxoid and round-cell liposarcoma.
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PURPOSE: The p27(kip1) protein (p27) is a cyclin-dependent kinase inhibitor that has been shown to be an independent prognostic factor in a variety of human neoplasms. Low expression of p27 tends to occur in more aggressive neoplasms. The role of p27 as an independent prognostic factor in the spectrum of myxoid and round-cell liposarcomas has not been examined. MATERIALS AND METHODS: Forty-seven cases of myxoid and round-cell liposarcomas were examined. Clinicopathologic features and immunohistochemical expression of p27 and Ki-67 antigen were studied in all cases. Survival analysis was performed using the log-rank test and the Cox multivariate regression model. RESULTS: The male:female ratio was 1. 4:1, and the mean age at diagnosis was 45 years. The tumors were located in the lower extremities (94%) and retroperitoneum (6%). The median tumor size was 13.5 cm. The median follow-up was 6.3 years, and the overall 5- and 10-year survival rates were 76% and 67%, respectively. Low expression of p27 was identified in 34 cases (72%) and correlated with decreased metastasis-free (P =.026) and overall survival (P =.008). In a multivariate analysis, only round-cell differentiation and low expression of p27 independently predicted decreased metastasis-free and overall survival. CONCLUSION: p27 expression predicts the clinical behavior of myxoid and round-cell liposarcomas, even in neoplasms with few or no round-cell differentiation. (+info)
Expression of bone morphogenetic protein and its receptors in osteosarcoma and malignant fibrous histiocytoma.
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BACKGROUND: Bone morphogenetic protein (BMP) activity has been found in cases of malignant fibrous histiocytoma (MFH) and osteosarcoma but only tumors in the latter category show evidence of ossification. The aim of this study was to try to understand this difference by examination of the distribution of BMP and its receptors (BMPR) for this bone inducing protein in these tumors. METHODS: Sections of 11 osteosarcoma and 10 MFH were analyzed immunohistochemically for BMP and BMPRs by use of the avidin-biotin peroxidase method. RESULTS: Nine out of 11 osteosarcoma cases (80.1%) showed positive staining for both BMP and BMPRs. Two cases of chondroblastic type osteosarcoma did not show any significant staining for BMP and BMPRs. In eight out of 10 MFH cases (80%) there was positive staining for BMP. No immunoreactivity for BMPRs was found in any case of MFH. CONCLUSIONS: MFH does not express BMPRs and this may be the reason why-MFH tumors do not ossify, even in the presence of BMP. (+info)
Extraskeletal myxoid chondrosarcoma: a clinicopathologic, immunohistochemical, and ploidy analysis of 23 cases.
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Twenty-three cases of extraskeletal myxoid chondrosarcoma, evaluated at the Mayo Clinic between 1968 and 1996, were studied for clinicopathologic features, immunohistochemical profile, Ki-67 activity, and ploidy status to identify adverse prognostic factors. Females and males were equally affected, and the median age at diagnosis was 50 years. The tumors were located mainly in the lower extremities (83%), and the median tumor size was 9.5 cm. Sixteen tumors showed low cellularity (70%), and eight tumors had high mitotic activity (more than two per 10 high-power fields). The tumors were immunoreactive for vimentin (89%), synaptophysin (72%), epithelial membrane antigen (28%), and S-100 protein (17%). Nine tumors were diploid, three aneuploid, and one tetraploid. Mean Ki-67 activity was 11% (range, 1 to 45%). The 10-year overall survival rate was 78%. On univariate analysis, tumor size > or = 10 cm, high cellularity, presence of anaplasia or rhabdoid features, mitotic activity more than two per 10 high-power fields, Ki-67 > or = 10%, and Ki-67 "hot spot" > or = 25% were associated with decreased metastasis-free or overall survival. Ploidy status was not associated with any adverse outcome. The presence of any of these adverse prognostic factors can indicate the possibility of a more aggressive behavior in extraskeletal myxoid chondrosarcoma, and a closer follow-up is suggested. (+info)
Glucose metabolic analysis of musculoskeletal tumours using 18fluorine-FDG PET as an aid to preoperative planning.
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We performed positron emission tomography (PET) with 18 fluorine-fluoro-2-deoxy-D-glucose (FDG) on 55 patients with tumours involving the musculoskeletal system in order to evaluate its role in operative planning. The standardised uptake value (SUV) of FDG was calculated and, to distinguish malignancies from benign lesions, the cases were divided into high (> or =1.9) and low (< 1.9) SUV groups. The sensitivity of PET for correctly diagnosing malignancy was 100% with a specificity of 76.9% and an overall accuracy of 83.0%. The mean SUV for metastatic lesions was twice that for primary sarcomas (p < 0.0015). Our results suggest that the SUV may be useful in differentiating malignant tumours from benign lesions. However, some of the latter, such as schwannomas, had high SUVs so that biopsy or wide resection was selected as the first operation. Thus, some other quantitative analysis may be required for preoperative planning in cases of high-SUV neurogenic benign tumours. The reverse transcription-polymerase chain reaction revealed that the RNA message of a key enzyme in glucose metabolism, phosphohexose isomerase (PHI)/autocrine motility factor, was augmented in only high FDG-uptake lesions, suggesting that a high expression of the PHI message may be associated with accumulation of FDG in musculoskeletal tumours. (+info)