Curent Concepts in Pathology of Soft Tissue Sarcoma

Husain, Nuzhat; Verma, Nidhi

doi:10.1007/s13193-012-0134-6

Cited by 21 publications

(17 citation statements)

References 18 publications

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“…Such discordance arises as certain small round cell tumors, like synovial sarcoma-round cell variant have a spindle cell component, thus leading to cytological error. Monophasic synovial sarcoma consists predominantly of spindle cells and thus resembles a hemangiopericytoma, a fibrosarcoma, and other spindle cell tumors on histopathology [16]. The poorly differentiated variant of the same closely resembles a round blue cell tumor, as its tumor cells may appear spindly, large, small, or clear, thus creating confusion on pathological evaluation.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal Tumor: A Silent Trespasser – Role of Image-Guided Fine-Needle Aspiration Cytology with Histopathological Correlation in Early Diagnosis

et al. 2019

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Objective: Retroperitoneal lesions present a great diagnostic challenge. Here we analyze the spectrum of retroperitoneal lesions and the utility of cytohistopathological correlation in early diagnosis. Study Design: This 7-year study was undertaken in 338 patients with a retroperitoneal mass (kidney/adrenal/ pancreas/retroperitoneal lymph node, or soft tissue origin). In a prospective analysis, 81 patients underwent image-guided fine-needle aspiration cytology (FNAC) and 70 of the 81 underwent Tru-cut biopsy/histopathological evaluation. Clinical, radiological, and pathological details of 257 patients were retrieved from institutional records for retrospective analysis. A total of 119 patients, i.e., 70 in the prospective analysis and 49 in the retrospective analysis, had cytohistopathological correlation. Results: Of the 338 cases, 88.4% were malignant (n = 274), 2.6% were benign (n = 8), 9% were nonneoplastic (n = 28), and 9% were inadequate (n = 28). Most were renal in origin (n = 106; 34.2%), followed by retroperitoneal soft tissue (n = 96; 31%). The most common nonneoplastic lesion was tubercular lymphadenitis (42.85%) and the most common benign lesion was paraganglioma (42.85%). The most common malignancy was renal cell carcinoma (21.16%), followed by Wilms’ tumor (13.86%). In infancy and early childhood, Wilms’ tumor, neuroblastoma, and germ cell tumor were the most common malignancies, while in middle age it was renal cell carcinoma, followed by pancreatic adenocarcinoma, and in the elderly age group it was metastatic carcinoma. Most malignancies were noted in the 5th to 6th decades. The overall sensitivity, specificity, and diagnostic accuracy of image-guided FNAC was 98.02, 72.22, and 94.12%, respectively. Conclusion: Image-guided FNAC is highly sensitive and specific for early diagnosis of an otherwise silent retroperitoneal mass. It saves patient from meticulous surgical procedures for diagnostic reasons and allows more rational planning of management. Knowledge of the distribution of tumors by age group helps to narrow down differential diagnoses.

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Section: Discussionmentioning

confidence: 99%

Retroperitoneal Tumor: A Silent Trespasser – Role of Image-Guided Fine-Needle Aspiration Cytology with Histopathological Correlation in Early Diagnosis

et al. 2019

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“…There is no consensus on the role of lymph node dissection, adjuvant radiotherapy or chemotherapy. Local recurrence of sarcomas is common 1 and patients require regular follow-up to monitor for recurrence.…”

Section: Discussionmentioning

confidence: 99%

The rarest form of Paratesticular Leiomyosarcoma – a case report

Cobley

Mahmalji

2018

JOMH

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Paratesticular tumours make up less than 5% of intra-scrotal tumours and of these, approximately 30% are malignant tumours with sarcomas accounting for the majority.Leiomyosarcoma is a malignant tumour arising from soft tissues containing smooth muscle. They are reported as comprising between 5-30% of paratesticular sarcomas.1,2 It is extremely rare that they arise from tissue other than the spermatic cord or epididymis.The authors describe such a case of paratesticular leiomyosarcoma in a 54-year-old man who presented with a six-month history of a painful testis and who subsequently underwent radical inguinal orchidectomy and high ligation. CASE REPORTA 54-year-old man presented to his doctor with a 6-month history of a painful left testis and was referred to urology. On examination the left testis was palpable anterior to the scrotum with a hard, craggy mass felt posteriorly.Scrotal ultrasound described a 5.9 mm left upper pole mass of mixed echogenicity and increased blood flow from the left testis. Tumour markers were normal.Following multidisciplinary team discussion, a repeat ultrasound was performed by a consultant radiologist with urology expertise. The results indicated a large extratesticular mass likely arising from scrotal layers of uncertain nature but soft tissue sarcoma not ruled out.Computed tomography of the thorax, abdomen, and pelvis showed no evidence of metastasis or lymphadenopathy.After a multidisciplinary team assessment, the patient was counselled for a left radical inguinal orchidectomy. Intra-operatively the tumour was intra-tunical and appeared closely adherent to the testis and spermatic cord which made for a more challenging orchidectomy but the patient made an uneventful recovery and was discharged on post-operative on day 1.Macroscopically, there was a firm, white lobulated tumour measuring 72 × 50 × 50 mm, compressing the testis which measured 40 × 10 mm.Histopathological assessment identified a malignant tumour of the paratesticular region with no connection seen to the testis, rete testis, epididymis, or spermatic cord.Morphological features included plump, spindleshaped cells arranged in fascicular, storiform, and whorled architectural patterns. The nuclei showed coarse chromatin with moderate eosinophilic cytoplasm and exhibited moderate to marked atypia with foci of moderate to severe pleomorphism with multinucleate and large pleomorphic tumour cells. Numerous

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“…Certain reactive processes can mimic sarcoma , and it is not always possible to diagnose or classify STS based on cytology or core biopsy Therefore, STS diagnosis is often based on open biopsy or following tumour resection . Core biopsies, even under ultrasound guidance, can result in inappropriate sampling, with for example a high‐grade STS being misdiagnosed as low‐grade.…”

Section: Pathologymentioning

confidence: 99%

“…The role of frozen section is useful in ensuring that there is viable tissue for resection margin evaluation thought it is often difficult to make a formal diagnosis. Immunohistochemistry is used to assess both diagnosis and prognosis of STS and is useful to exclude a non‐mesenchymal tumour . Figure shows the histopathological features of some soft tissue head and neck sarcomas.…”

Section: Pathologymentioning

confidence: 99%

Current update on the diagnosis and management of head and neck soft tissue sarcomas

Tudor-Green

Fonseca

Gomez

et al. 2017

J Oral Pathology Medicine

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Head and neck soft tissue sarcomas are a group of rare heterogeneous tumours arising from embryonic mesoderm. They comprise <1% of all head and neck malignancies and 5-15% of all sarcomas with most head and neck sarcomas arising from soft tissues. Although rare, they are associated with both high recurrence and mortality rates. We review the current management of head and neck soft tissue sarcomas.

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Curent Concepts in Pathology of Soft Tissue Sarcoma

Cited by 21 publications

References 18 publications

Retroperitoneal Tumor: A Silent Trespasser – Role of Image-Guided Fine-Needle Aspiration Cytology with Histopathological Correlation in Early Diagnosis

Retroperitoneal Tumor: A Silent Trespasser – Role of Image-Guided Fine-Needle Aspiration Cytology with Histopathological Correlation in Early Diagnosis

The rarest form of Paratesticular Leiomyosarcoma – a case report

Current update on the diagnosis and management of head and neck soft tissue sarcomas

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