• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.212-218
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• 2021

Ewing sarcomas constitute a group of small, round, blue cell tumors of the bone and soft tissue. Extraskeletal Ewing sarcoma (EES) is a rare malignant neoplasm that arises from soft tissues, and it usually affects children and young adults. EES of the thoracopulmonary region commonly presents with a palpable mass or pain. Although rarely reported, EES affecting the anterior chest wall may present as a breast mass. We report a case of EES arising from the chest wall and manifesting as a palpable breast mass in a 22-year-old woman. The large mass was initially misdiagnosed as a breast origin mass on ultrasonography, but subsequent CT and MRI showed that the mass originated from the chest wall. Radiologists should be aware of the imaging findings of EES, and they should understand that chest wall lesions may be clinically confused as breast lesions.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.327-330
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• 2014

Background: Ewing sarcoma is a small round cell tumor arising from soft tissue and bone that predominantly affects children and adolescents. The most unfavorable prognostic factor is the presence of distant metastasis at the time of diagnosis. Materials and Methods: The records of 26 Ewing sarcoma patients (14 male, 12 female) were re-evaluated retrospectively. Results: The median age was 26.5 (19-42) years. Eight patients (31%) showed a primary tumor in their extremities, 8 (31%) in the thorax, 4 (15%) at the vertebra, 4 (15%) in the head and neck, and 2 (8%) in the abdomen. Five patients (19%) had distant metastasis at diagnosis. The median progression-free survival was 72 months and 10 months in localized and metastatic disease, respectively (p=0.005). The overall survival rate was 19 months in metastatic disease, and the 5-year overall survival rate was 64% in localized disease (p=0.006). Patients who had localized disease in the extremities and were under age 30 had a favorable prognosis. Conclusions: Although Ewing sarcoma is a tumor affecting children and adolescents, it may be seen in adults, where the prognosis is generally worse. Although it is a highly malignant tumor, it is possible to achieve improved survival with combined modality treatments.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.729-732
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• 1997

A case of chest wall malignant peripheral nerve sheath tumor(MPNST) was reported in the U.S.A by Mark and coworkers6)(1991), but none in korea. MPNST accounts for approximately 10% of all soft tissue sarcoma, mostly in patients between 20 and 50 years of age. MPNST arises in association with a major nerve trunk, including the sciatic nerve, brachial plexus, and sacral plexus and the most common anatomical site is the proximal portion of the upper and lower extremity and trunk. Surgical treatment is local excision of mass in low grade sarcoma but unblock resection is necessary in high grade sarcoma. We experienced multiple huge low grade MPNST on left chest wall of a 50 years old man. The tumor and invalved chest wall were removed, and the chest wall defect(15$\times$8 cm) was reconstructed with Teflon. Postoperative course was unevenful.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.3
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• pp.223-227
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• 2004

A malignant sarcoma of soft tissue that arises near but not in a joint, most often in an adolescent or young adult, is typically slowgrowing, and may escapes notice until it causes pain. The diagnosis of this tumor can be suspected by X-ray or imaging, made by biopsy, and confirmed by chromosome studies. Cytogenic studies reveal a translocation between the X chromosome and chromosome 18 in the tumor cells. The most common treatment for the tumor is surgery to remove the entire tumor, nearby muscle, and lymph nodes. Synovial sarcoma tends to recur locally and to involve regional lymph nodes. Distant metastasis occurs in half cases. The well-documented and adequately followed cases are currently lacking and this report described an instance of Synovial sarcoma good result after treatment and review of literature.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.485-495
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• 1998

Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.261-266
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• 1992

We analyzed retrospectively the patients of granulocytic sarcoma treated with radiotherapy at the Department of Radiation Oncology, Yonsei University College of Medicine from Mar 1987 to Mar.1992 in an attempt to review our experience with irradiation of granulocytic sarcoma and to evaluate the treatment results for the radiation dose response. Fourteen lesions of granulocytic sarcoma in 9 patients were developed in variable clinical settings such as AML, CML and without leukemia. The involved lesions were bone, lymph node, soft tissue and skin in descending order of occurrence. All of the lesions in 9 patients were treated with external beam radiotherapy (Co-60 or electron beam). Both age distribution and clinical settings did not show any correlation with the response to treatment. The response to treatment seemed to be better for lesions in the bone than in other involved lesions. The majority received local irradiation of a total dose of more than 2000 cGy. Radiation dose of more than 2000 cGy showed excellent local control of $100\%$, (11/11), while local control decreased to $33\%$(1/3) with total dose less than 2000 cGy. In conclusion, local radiotherapy seems to be very effective for palliative or curative aim of granulocytic sarcoma, and a radiation dose more than 2000 cGy is highly recommended.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.2
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• pp.549-559
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• 1999

Leiomyosarcoma is extremely rare in the oral cavity and especially in the mandible. At first. the case of this report was diagnosed as odontogenic fibroma but after approximately 3.5 years. it was diagnosed as leiomyosarcoma. Conventional radiograph of the first time showed an ill-defined radiolucent lesion in the mandible. After local recurrence. CT images showed a large irregular soft tissue mass with some necrotic areas. These findings were not specific for leiomyosarcoma, but they suggested that this lesion was a recurrent soft tissue sarcoma. Histopathological examinations using H & E staining, immunohistochemical staining and Masson's trichrome staining confirmed this case as leiomyosarcoma. Deciding its malignancy or benignancy, defining the tumor extent and its relationship to the surrounding anatomic structures, and evaluating the distant metastasis are more important roles of radiographic examination than finding out the name of disease.

• 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.

• Journal of Veterinary Clinics
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• v.22 no.4
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• pp.444-449
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• 2005

An 11-year-old female, Golden retriever dog with a history of solid mass on the chest wall was referred to Veterinary Medical Teaching Hospital, Seoul National University. The mass was firm on palpation. A soft tissue opacity mass with calcified foci around the right 7th rib and extrapleural patterns around the right 5th rib and 7th rib was shown on thoracic radiographs. The mass of the 7th rib has a mixed-echo pattern with a strong acoustic shadowing and internal vascular signals on ultrasonography. On CT scan, the mass showed contrast enhancement effect, expansive pattern of intrathoracic and extrathoracic legion around costochondral junction. The 7th rib appeared mildly lytic. The mass of the 5th rib had a soft tissue swelling without bone lysis. The mass was diagnosed as a sarcoma by fine needle biopsy. Therefore, the mass was surgically removed. Subsequent histopathological study found the mass was chondrosarcoma.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.505-507
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• 2011

Purpose: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. Methods: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. Results: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. Conclusion: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.