Ekfors, T. O., Kulju, T., Aaltonen, M. & Kallajoki, M. Ossifying fibromyxoid tumour of soft parts: report of four cases including one mediastinal and one infantile. APMIS 106: 1124-1 130, 1998.Four cases of ossifying fibromyxoid tumour of soft parts are described. One of them was in the mediastinum, a hitherto unreported location of this rare neoplasm. Another was removed from the subcutaneous tissue of the head of a two-year-old girl, the youngest patient so far described. A peculiar feature of this tumour was haphazard spindle cell groups showing smooth muscle differentiation. One tumour was remarkably proliferative with 20 mitotic figures per 10 high power fields and 50% of cells positive for Ki-67 antigen. Immunohistochemical analysis revealed that all the tumows were diffusely positive for vimentin, and focally for S-100-protein. In addition to this the infantile tumour expressed focal a-smooth muscle actin, desmin and glial fibrillary acidic protein, while the mediastinal tumour expressed only a-smooth muscle actin and the highly proliferative one expressed none of these antigens. Background cells, including histiocytes, lymphocytes and mast cells were numerous. DNA cytometry analysis using both static and flow methods showed that the mediastinal tumour contained two cell clones, while the others were diploid. The proliferative fraction of cells (S plus G2 phases) was prominent in the proliferative and infantile tumours.

ObjectivesNeurostimulation has offered new treatment options in refractory epilepsy, first with vagus nerve stimulation (VNS) and more recently with deep brain stimulation (DBS). There is a lack of previous detailed data assessing the relationship between VNS and ANT‐DBS. The aim of this study was to investigate the potential correlation between therapeutic responses to VNS and ANT‐DBS.Materials and MethodsA total of 11 patients with previous VNS therapy underwent ANT‐DBS implantation. Monthly seizure counts starting from baseline before VNS extending to long‐term DBS treatment were analyzed. The reasons for VNS discontinuation were assessed.ResultsAltogether in 10 of 11 patients, the response to VNS seemed to be similar to the response to DBS therapy. Progressive response to VNS was likely to correlate with a progressive response to DBS in three of three patients. Partial response to VNS was associated with a fluctuating response pattern to DBS in two patients. Five of six nonresponders to VNS were also nonresponders to DBS. One of the VNS nonresponders obtained progressive response to DBS.ConclusionsThis is the first study to evaluate in detail the effect of both VNS and ANT‐DBS in refractory epilepsy patients. There is a putative association between VNS and DBS responses suggesting the need for further studies.

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