Myofibroblastic sarcoma of mitral valve: A case report

Kolli, Swathy; Ziaee, Ali; Lee, Richard; Lim, Michael J.; Levy, Beth; Labovitz, Arthur J.

doi:10.1016/j.echo.2004.12.011

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…Since Mentzel et al[ 1 ] first defined a distinctive clinicopathological entity now known as low-grade myofibroblastic sarcoma in 1998, myofibroblastic sarcoma has been increasingly investigated, with most reports consisting of case reports or case series[ 2 , 3 , 6 - 11 ]. Although the World Health Organization (WHO) included low-grade myofibroblastic sarcoma, when characterized reproducibly, in the WHO Classification of Tumors in 2002[ 12 ], the definition of intermediate- and high-grade myofibroblastic sarcoma with less reproducible characteristics has not reached a consensus, even in the latest edition of the WHO Classification of Tumors of Soft Tissue and Bone[ 4 ].…”

Section: Discussionmentioning

confidence: 99%

High-grade myofibroblastic sarcoma in the liver: A case report

Wen

Zhao

et al. 2017

WJG

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Only two cases of myofibroblastic sarcoma in the liver have been reported in the literature. Here, we report the case of a male patient with high-grade myofibroblastic sarcoma mimicking echinococcosis in the liver. The 25-year-old male patient complained of right upper quadrant swelling pain for one week and was initially diagnosed with echinococcosis. He was then scheduled for an exploratory laparotomy. During the operation, a huge mass exceeding 16 cm in diameter was found to occupy nearly the entire right trisegment of the liver, with a clear boundary and a round shape, and the mass was resected by right hepatic trisegmentectomy. Immunohistochemical staining revealed that the tumor tissue was positive for desmin, α-smooth muscle actin, CD56, and vimentin and negative for ALK-1, myogenin, calponin, β-catenin, S100, and glypican-3, with a Ki-67 (MIB-1) index of approximately 20%. Based on the histological manifestations and immunohistochemical staining, a diagnosis of myofibroblastic sarcoma was established. The postoperative recovery was uneventful. There was no evidence of recurrence or metastasis through the last follow-up, 6 mo after surgery, despite a lack of postoperative chemotherapy or radiotherapy. To the best of our knowledge, the present case is the first reported case of high-grade myofibroblastic sarcoma in the liver, and it is also the first reported case in a male patient.

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Section: Discussionmentioning

confidence: 99%

High-grade myofibroblastic sarcoma in the liver: A case report

Wen

Zhao

et al. 2017

WJG

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“…Strong/ diffuse desmin staining will tend to suggest smooth-muscle differentiation and leiomyosarcoma, especially if (external) lamina, a characteristic feature of smooth-muscle cells but not myofibroblasts, is also reported (lamina is discussed further below). On this basis, therefore, some of the published desmin-positive cases of myofibrosarcoma 12,14,28-31 might be poorly differentiated leiomyosarcomas and electron microscopy could test this hypothesis. Two of our cases showed focal/weak desmin positivity and 1 case showed focal/weak staining with h-caldesmon, another good smooth-muscle marker.…”

Section: Discussionmentioning

confidence: 97%

Ultrastructurally Confirmed Myofibrosarcoma

et al. 2012

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Some view ultrastructure as key to myofibrosarcoma diagnosis, whereas others argue that electron microscopy is too little used in contemporary practice to be considered an important diagnostic tool. These views are discussed in the context of 10 ultrastructurally confirmed cases of myofibrosarcoma, some occurring at rare sites such as skin and penis. Patient age ranged from 21 to 83 years, with a 6:4 male to female ratio. Size ranged from 2 to 7.5 cm and all had infiltrative margins. Histologically, all consisted of variably cellular fascicles of spindle cells with mild to moderately pleomorphic nuclei, small punctate nucleoli, and eosinophilic cytoplasm. All cases showed α-smooth muscle actin positivity and 2 showed very focal weak positivity for desmin. Ultrastructurally, the tumor cells contained rough endoplasmic reticulum, mainly peripheral smooth-muscle myofilaments, and fibronectin fibrils or fibronexus junctions at the cell surface. The most confident diagnosis of myofibrosarcoma is provided by ultrastructural examination. However, given the right histological appearance, use of a panel of antibodies that includes α-smooth muscle actin, desmin, and h-caldesmon, serves as an acceptable practical way of diagnosing myofibrosarcoma.

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“…9 In humans, myofibroblastic sarcomas are considered to have a wide-ranging anatomic distribution with a predilection for the head and the neck, whereas cardiac occurrence is rare. 11,16 In a dog, a case of sarcoma partially composed of myofibroblasts was observed in the neck as a reaction to microchip implantation, 22 whereas, in the heart, no sarcomas with myofibroblastic component or true myofibroblastic sarcomas have been previously reported. To the authors' knowledge, this is the first description of a tumor presumptively totally composed of myofibroblasts in the heart of a dog.…”

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confidence: 99%

“…Ultrastructurally, myofibroblasts are differentiated from quiescent fibroblasts in tissues by intracytoplasmic bundles of contractile microfilaments, extensive cell-to-matrix attachment sites, and intercellular adherens and gap junctions 9 . In humans, myofibroblastic sarcomas are considered to have a wide-ranging anatomic distribution with a predilection for the head and the neck, whereas cardiac occurrence is rare 11,16 . In a dog, a case of sarcoma partially composed of myofibroblasts was observed in the neck as a reaction to microchip implantation, 22 whereas, in the heart, no sarcomas with myofibroblastic component or true myofibroblastic sarcomas have been previously reported.…”

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A Case of Two Different Tumors in the Heart of a Dog

et al. 2008

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A 9-year-old, spayed, female Maremmano shepherd had a bilateral mastectomy for multiple mammary adenocarcinomas 2 years previous and was referred to the Cardiology Service of the School of Veterinary Medicine of Milan after an acute episode of cardiogenic collapse. Because of severe cardiovascular symptoms and poor prognosis, the dog was euthanized. Necropsy examination revealed the presence of multiple firm grayish neoplastic nodules in the myocardium of the left ventricle and scattered in the pulmonary parenchyma. Neoplastic nodules were also detected in the spleen, pancreas, liver, kidneys, and omentum. Histological examination revealed the coexistence of tubular adenocarcinoma and an undifferentiated sarcoma in the myocardium. Immunohistochemical staining of the sarcoma cells was negative for cytokeratin, desmin, and smooth muscle myosin, thus excluding their epithelial or myoepithelial origin, as well as an origin from smooth muscles cells. These findings, together with the coexpression of vimentin and alpha-smooth muscle actin, suggested that the sarcoma was derived from myofibroblasts. To the authors' knowledge, this is the first report describing cardiac sarcoma of presumptive myofibroblastic origin in a dog with simultaneous occurrence of cardiac metastasis of mammary gland adenocarcinoma.

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Myofibroblastic sarcoma of mitral valve: A case report

Cited by 3 publications

References 6 publications

High-grade myofibroblastic sarcoma in the liver: A case report

High-grade myofibroblastic sarcoma in the liver: A case report

Ultrastructurally Confirmed Myofibrosarcoma

A Case of Two Different Tumors in the Heart of a Dog

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