• Title/Summary/Keyword: Soft tissue sarcoma

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Surgical Resection and Polypropylene Mesh Reconstruction for Canine Chest Wall Soft Tissue Sarcoma

  • Youngsoo Hong;Youngrok Song;Woojin Song;Myung-Chul Kim;Joo-Myoung Lee;Hyunjung Park;Jiwhan Moon;Jongtae Cheong
    • Journal of Veterinary Clinics
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    • v.41 no.1
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    • pp.24-29
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    • 2024
  • A 6-year-old spayed female French Bulldog presented with a left-sided chest wall tumor. Physical examination revealed that the tumor was firmly adhered to the chest wall. A preoperative punch biopsy of the tumor revealed a grade 2 soft tissue sarcoma (STS). On computed tomography, the tumor's dimensions were assessed as 6.5 × 5.7 × 3.5 cm, and it exhibited invasiveness near the tissue surrounding the ninth rib. The tumor size was large in comparison to the dog's chest wall area. Hence, if the traditional wide-margin resection surgery were to be performed, primary wound closure seemed impractical and could potentially result in respiratory function complications. Therefore, considering the extent of tumor invasion and grade, deep margins were established to include the removal of the eighth to tenth ribs, and a 1-cm lateral margin was designated to enable primary wound closure. To reconstruct the chest wall, polypropylene mesh was attached to the adjacent ribs and the remaining muscles were sutured and covered over the mesh. The dog exhibited a rapid recovery beginning the day after the operation. Postoperative biopsy confirmed that the tumor was a grade 2 STS, and the surgical margins were evaluated as incomplete. The owner chose to pursue follow-up observation instead of chemotherapy. In this study, the surgical approach was chosen based on the importance of functional recovery after surgery. Recent research indicates that the tumor grade is more critical for postoperative prognosis than the extent of surgical margins when removing an STS.

Limb-salvage Operations for Sarcomas of the Extremities Involving Critical Artery (주요 혈관을 침범한 연부조직 종양의 사지구제술 - 치험 3례 보고 -)

  • Kim, Jae-Do;Choi, Sung-Woon;Park, Jung-Ho;Son, Young-Chan;Hong, Young-Gi;Son, Jeong-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.105-112
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    • 1995
  • Soft tissue sarcomas are malignant tumors that arise in the extraskeletal connective tissues of the body. And the clinical behavior of soft tissue sarcomas is characterized by a tendency to extensively invade surrounding soft tissues as well as early metastatic dissemination. Difficulties were encounted when soft tissue sarcomas invade the major vessels. There are a few reprots about the reconstruction of the major vessels after resection of soft tissue sarcomas. We have treated 3 cases of the soft tissue sarcomas involving the major artery. After marginal excision of the tumor mass, the involved major artery was reconstructed with Gortex artificial vessel graft and we could salvage the patient's extremity.

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Diagnosis of Residual Tumors after Unplanned Excision of Soft-Tissue Sarcomas: Conventional MRI Features and Added Value of Diffusion-Weighted Imaging

  • Jin, Kiok;Lee, Min Hee;Yoon, Min A;Kim, Hwa Jung;Kim, Wanlim;Chee, Choong Geun;Chung, Hye Won;Lee, Sang Hoon;Shin, Myung Jin
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.20-31
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    • 2022
  • Purpose: To assess conventional MRI features associated with residual soft-tissue sarcomas following unplanned excision (UPE), and to compare the diagnostic performance of conventional MRI only with that of MRI including diffusion-weighted imaging (DWI) for residual tumors after UPE. Materials and Methods: We included 103 consecutive patients who had received UPE of a soft-tissue sarcoma with wide excision of the tumor bed between December 2013 and December 2019 and who also underwent conventional MRI and DWI in this retrospective study. The presence of focal enhancement, soft-tissue edema, fascial enhancement, fluid collections, and hematoma on MRI including DWI was reviewed by two musculoskeletal radiologists. We used classification and regression tree (CART) analysis to identify the most significant MRI features. We compared the diagnostic performances of conventional MRI and added DWI using the McNemar test. Results: Residual tumors were present in 69 (66.9%) of 103 patients, whereas no tumors were found in 34 (33.1%) patients. CART showed focal enhancement to be the most significant predictor of residual tumors and correctly predicted residual tumors in 81.6% (84/103) and 78.6% (81/103) of patients for Reader 1 and Reader 2, respectively. Compared with conventional MRI only, the addition of DWI for Reader 1 improved specificity (32.8% vs. 56%, 33.3% vs. 63.0%, P < 0.05), decreased sensitivity (96.8% vs. 84.1%, 98.7% vs. 76.7%, P < 0.05), without a difference in diagnostic accuracy (76.7% vs. 74.8%, 72.9% vs. 71.4%) in total and in subgroups. For Reader 2, diagnostic performance was not significantly different between the sets of MRI (P > 0.05). Conclusion: After UPE of a soft-tissue sarcoma, the presence or absence of a focal enhancement was the most significant MRI finding predicting residual tumors. MRI provided good diagnostic accuracy for detecting residual tumors, and the addition of DWI to conventional MRI may increase specificity.

Metastatic Giant Pulmonary Soft Tissue Sarcomas (Hemangiopericytoma, Synovial Sarcoma) -Two Case Report- (폐에 전이된 거대 연조직 육종(혈관외피세포종, 활막육종) -수술치험 2례-)

  • Kim, Gil-Dong;Jeong, Gyeong-Yeong;Sin, Dong-Hwan
    • Journal of Chest Surgery
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    • v.27 no.1
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    • pp.63-67
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    • 1994
  • We report two cases of giant soft tissue sarcomas metastatic to the lung from lower extremities. The lung metastasis occurred 2 years later from original diagnosis in 27-year-old woman with hemangiopericytoma and 8 years later in 54-year-old woman with synovial sarcomtt. We had performed pleuropneumonectomies with partial resection of pericardium involved. The postoperative courses were uneventful and postoperative adjuvant therapy was begun.

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Extraskeletal Ewing Sarcoma - Report of Four Cases - (골격외 Ewing 육종 - 4예 보고 -)

  • Rhee, Seung-Koo;Kang, Yong-Koo;Song, Seok-Whan;Park, Won-Jong;Ihm, Il-Jae
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.63-69
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    • 1999
  • Recently we experienced four cases of soft tissue Ewing sarcoma, developed in the calf muscles in two cases, and one case each in the foot and suprascapular region. We also found that the clinical course in all cases was rather rapid, because of local recurrence and metastatic lesions developing within a few months, followed by the patients' death in about 2 years after the primary tumor was excised. These cases were improperly treated initially as some kind of benign soft tissue tumor. The delay led to missed early accurate diagnosis and was thought to be one of the main causes for the rapid local recurrence and metastasis after tumor excision. The pulmonary metastasis was the most common cause of death.

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Treatment of Synovial Sarcoma in Popliteal Fossa Adjacent to Tibia - A Case Report - (경골과 접한 슬와부 활막육종의 치료 - 증례 보고 -)

  • Shin, Duk-Seop;Kwack, Byung-Hoon;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.201-206
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    • 2007
  • It is a well-accepted tenet that wide surgical margins are necessary for the treatment of soft-tissue sarcomas, and it is still true that the rate of recurrence depends on the adequacy of the surgical margins. Sarcomas that rest directly against bone pose a dilemma for the surgeon. A wide margin is not possible in the literal sense without excision of the bone. Whereas reconstruction of skeletal defects is possible, it adds to the complexity of the surgery and increases potential complications. We report the experience of treatment in a case of synovial sarcoma which located at popliteal fossa adjacent to proximal tibia.

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Clear Cell Sarcoma of the Upper Thoracic Back Muscle

  • Kim, Dae-Hyun;Choi, Ki-Hwan;Cho, Young-Dae
    • Journal of Korean Neurosurgical Society
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    • v.45 no.2
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    • pp.112-114
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    • 2009
  • Clear cell sarcoma (CCS), also called malignant melanoma of soft parts, is a rare malignant soft tissue tumor and is often associated with tendons or aponeuroses. Most of CCS involve extremities, especially lower extremities, but a tumor occurring in the trunk is rare. We report an extremely rare case of CCS originated in the upper thoracic back muscle. To our knowledge, this case is the second report of CCS of the back muscle.

Alveolar Soft Part Sarcoma of The Lung Diagnosed by Fine Needle Aspiration Cytology - A Case Report - (세침흡인 세포검사로 진단한 폐의 포상 연부육종 - 1예 보고 -)

  • Kim, Dae-Su;Oh, Young-Lyun;Ko, Young-Hyeh
    • The Korean Journal of Cytopathology
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    • v.9 no.2
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    • pp.187-191
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    • 1998
  • Alveolar soft part sarcoma(ASPS) is a rare malignant neoplasm with a distinct clinicopathologic entity of which fine needle aspiration(FNA) cytologic findings have been described in only a few reports. Although patients usually present with an isolated soft-tissue mass in the extremity, metastasis can occur in about 13 % of total cases and the most frequent metastatic site is the lung. We have recently experienced a FNA cytologic case of ASPS in the lung. A 23-year-old female patient was admitted to this hospital due to 2-month-history of cough She had been good in health before the visit. Chest computed tomography revealed multiple, variable sized, bilateral pulmonary nodules. Physical examination and other staging work up revealed no other lesions except for pulmonary nodules. A percutaneous transthoracic FNA was performed from the pulmonary nodules. The smear was cellular and most cells were arranged singly. In addition, a few clusters lined by thin-walled vasculature with a pseudoalveolar pattern were present. Some of the tumor cells were large and polygonal lo oval with abundant granular or vacuolated cytoplasm. Most cells were naked nuclei showing finely granular chromatin pattern with prominent central nucleoli.

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Efficacy of adjuvant radiotherapy in non-extremity soft tissue sarcoma with moderate chemosensitivity

  • Lee, Eun Mi;Kim, Dong Hyun;Kim, Do Young;Seol, Young Mi;Choi, Young Jin;Kim, Hyojeong
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.325-331
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    • 2018
  • Purpose: Soft tissue sarcoma (STS) is a rare and heterogeneous cancer with over 50 known subtypes. It is difficult to understand the role of adjuvant treatment in STS. We aimed to determine the benefits of adjuvant treatment for a rare STS subset: non-extremity STS with moderate chemosensitivity. Materials and Methods: We reviewed medical records from Pusan National University Hospital and Kosin University Gospel Hospital, which had detailed pathological reports on patients diagnosed between 2006 and 2016. The most important inclusion criterion was resection with curative intent. We grouped STS by chemosensitivity based on reported data and analyzed non-extremity STS with moderate chemosensitivity. Results: We investigated 142 patients with 20 pathological subtypes of STS. Eighty-six patients had extremity STS and 56 had non-extremity STS. Thirty-eight of 56 patients were categorized as having moderate chemosensitivity. Seventeen of 38 patients (44.7%) received adjuvant radiotherapy and 14 (36.8%) received adjuvant chemotherapy. A log-rank test showed longer disease-free survival (DFS) in the adjuvant radiotherapy group than in the group treated without adjuvant radiotherapy (not reached vs. 1.468 years, p = 0.037). Multivariate Cox proportional hazard analysis, with covariates including age, stage, resection margin, adjuvant chemotherapy, and adjuvant radiotherapy, revealed that adjuvant radiotherapy was associated with longer DFS (odds ratio = 0.369, p = 0.045). Overall survival was not correlated with adjuvant radiotherapy. Conclusion: Adjuvant radiotherapy may be associated with longer DFS in patients with non-extremity STS with moderate chemosensitivity.

Prognostic Factors of Soft Tissue Sarcomas - analysis of 205 cases - (연부 육종의 예후 인자 - 205례 분석 -)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Lee, Soo-Yong;Kim, Sug-Jun;Jung, Dong-Whan;Park, Hyun-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.89-97
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    • 1997
  • Twenty hundred and five out of 266 patients who were registered in Korea Cancer Center Hospital from Mar. 1985 to Jan. 1994, were analyzed in the aspect of survival and local recurrence. Fifty one patients were excluded due to inadequate data and follow up. Prognostic factors for survival were evaluated statistically. One hundred and four cases were male, 101 female. Average age was 39.7(range 1 to 77) year with a peak incidence around 4th decade. The most frequent diagnosis was malignant fibrous histiocytoma(MFH)(24.1%). Liposarcoma, synovial sarcoma, rhabdomyosarcoma, malignant peripheral nerve sheath tumor and fibrosarcoma were relatively common diagnostic entities, in decreasing order. In location, extremity was 179(87.3%) and trunk 26(12.7%). Average follow up period was 7.5 years(6 months to 10 years). Actuarial 5 years and 10 years survival rate were 64.0% and 40.8% respectively. In univariate analysis with log-lank test, significant differences in survival rate were noted in histopathological diagnosis, size(10 cm), stage and metastasis. Age, sex, tumor location, tumor depth and local recurrence didn't affect the survival rate. Adjuvant chemotherapy and/or radiotherapy did not affect overall survival rate, but lowered the local recurrence rate when compared with surgery only. Surgical margin did not affect the survival rate, but local recurrence rate was different according to each margin; 5.7% in more than wide; 39.5% in marginal; and 60.0% in intralesional excision. In multivariate analysis for results of univariate analysis with Cox's propotional model, metastasis was a meaningful factor for survival of soft tissue sarcoma.

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