Epitheloid Sarcoma Research Articles

Detection of Cardiac Metastasis by Positron-Emission Tomography–Computed Tomography

A 59-year-old woman was referred for staging of breast cancer with known hepatic metastases before inclusion in a chemotherapy trial. She had undergone breast-conserving surgery and adjuvant radiotherapy 8 years earlier at primary diagnosis. On a routine CT scan, a right atrial mass measuring 25×22 mm was detected (see Figure 2). The polyp-like pedunculated appearance and the location at the crista terminalis were suggestive of a myxoma. At the time of diagnosis, the ECG was unremarkable and …

Reconstructive Treatment following Resection of High-Grade Soft-Tissue Sarcomas of the Lower Limb

To review the role of free tissue transfer in reconstructive surgery following resection of high-grade soft-tissue sarcomas of the lower limb. Medical records of all consecutive patients with high-grade soft-tissue sarcomas of the lower limbs between August 1997 and September 2003 were reviewed. Of 8 patients (6 women and 2 men) aged between 19 and 65 years, 4 had malignant fibrous histiocytoma, one had malignant peripheral nerve sheath tumour, one had synovial sarcoma, one had recurrent liposarcoma, and one had epitheloid sarcoma. The tumour sizes ranged from 132 cm(2) to 483 cm(2). The soft-tissue defects following tumour extirpation ranged from 153 cm(2) to 896 cm(2). The flaps used were 3 free latissimus dorsi flaps, 2 free osteoseptocutaneous fibula flaps (one vascularised fibula flap and one 'double barrel' fibula flap), one free rectus abdominis flap, 2 free mini-transverse rectus abdominis flaps, and one pedicled rectus abdominis flap. Five patients did not have local recurrence and systemic metastases. Tissue transfer allows early adjuvant therapy facilitating the multimodal approach for the high-grade soft-tissue sarcomas of the lower extremity.

The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection

BackgroundAn understanding of the biology of bone and soft-tissue sarcomas, knowledge of adjuvant therapies and refinement in techniques of reconstructive surgery have allowed limb-sparing and limb salvage surgery to become a reality in the management of malignant tumors of the extremities. Functional limb salvage following radical resection has become a possibility in many resectable tumors by the use of alloplastic prostheses, homograft or autogenous bone for skeletal reconstitution combined with vascularized soft tissue coverage. Although the free fibula flap has been well described for reconstructions of the mandible and oral cavity, it has not been widely presented as an ideal tool to preserve extremities and to circumvent amputation.Patients and methodsWe describe the complex surgical reconstruction in four patients with primary sarcomas of the extremities. The sarcomas (Ewing's sarcoma, osteosarcoma and epitheloid sarcoma) were resected radically and the massive bone and soft tissue defect was replaced by vascularized free fibula transfer.ResultsWe present our experience with versatility of this osteocutaneous flap to allow reconstruction and salvage of extremitity sarcomas. There were no operative or postoperative complication and all the four patients had good limb function. The flap was found to be versatile as it could be used for either upper limb or lower limb and for large defects. The results were better in upper limb than in lower limb.ConclusionsFree fibular graft was found to be effective for salvaging limb function where a massive bone defect resulted from wide tumor resection in the extremities.

Dupuytren's disease in children—differential diagnosis

Background/Purpose: Dupuytren's disease in children is uncommon; only a few histologically confirmed diagnoses are found in literature. In its early, proliferative phase with many fibroblasts, it can resemble the early stadium of an epitheloid sarcoma, which also is a rare tumor. The purpose of this report is to show pediatric surgeons and pathologists the importance of differential diagnosis of nodules and fibrotic bands in children's hands, especially to exclude a malignancy. Methods: Between 1998 and 2000, 3 children at ages of 2½ years, 9 years, and 10 years, respectively, presented with the clinical signs of Dupuytren's disease of the hand. Each of them had fibrous bands with a flexion contracture of the fingers. All of them underwent fasciectomy. Results: In patient 1, a 10° extension lag of the index finger resulted after 3 operations. Histology findings showed the typical features of Dupuytren's disease. In patient 2, histology findings showed a recurring digital fibroma of childhood. After consultation with the pathologist and reevaluation of the slides, the histologic diagnosis was corrected to Dupuytren's disease. Full extension and thumb abduction has been achieved. In patient 3, histology of the first and second operation was misdiagnosed as Dupuytren's disease. In the third operation 2½ years later, the histologic diagnosis of epitheloid sarcoma was made. Amputation of the forearm was necessary. Conclusions: Exact anamnesis, location of the lesion, and suspicious diagnosis must be mentioned to the pathologist in the case of biopsy or excision of Dupuytrenlike lesions in children's hands. Awareness of the possibility of the epitheloid sarcoma may help prevent misdiagnosis. J Pediatr Surg 37:E7. Copyright 2002, Elsevier Science (USA). All rights reserved.

Hemipelvectomy: Report of 12 cases, review of the literature, and therapeutic implications

Between 1988 and 1995, hemipelvectomy was performed in 12 patients with malignant neoplasms; there were three standard, five conservative, and four extended hemipelvectomies. At the time of the operation, two patients had inguinal lymph node metastases of an epitheloid sarcoma and three patients had pulmonary metastases. Three of seven patients showing no metastases at the time of operation, and both patients with lymph node metastases, have been continuously free of disease at a mean follow-up of 53 months (range, 23-85 months). The three patients with primary pulmonary metastases, and four patients who developed distant metastases after the operation, died after an average time of 20 months (range, 8-35 months). In three patients (two with extended hemipelvectomies, one with standard hemipelvectomy) there was necrosis of the dorsal skin flap, and in one patient with conservative hemipelvectomy, a deep infection developed, without necrosis of the skin flap. The quality of rehabilitation was more influenced by the individual attitude of the patient than by the extent of the surgical procedure, and it was excellent in four patients, good in five patients, and poor in three patients. Despite the increasing number of limb-salvage procedures indicated, hemipelvectomy continues to be an important and useful surgical procedure in musculoskeletal tumor surgery in selected patients with malignant pelvic tumors.

Reconstruction des pertes de substance des parties molles du membre supérieur après résection tumorale par lambeaux vascularisés libres ou en îlot: A propos d'une série de 16 cas

We have reviewed 16 cases of soft tissue sarcomas of the upper limb treated with wide excision of the tumour and immediate soft tissue reconstruction by means of a microvascular flap. 9 patients were males, 7 females; age ranged from 12 to 74 years. All the patients had been referred to us after previous failed or inadequate excisions. All the tumours were high-grade malignancies in an extracompartmental location (stade IIB according to Enneking). Histopathologic diagnosis was: synovial-sarcoma in 11 cases; fibrosarcoma in 2 cases; malignant fibrous histiocytoma in 1 case, soft tissue osteosarcoma in 1 case, epitheloid sarcoma in 1 case. The site of the tumour was the hand in 2 cases, the wrist in 6 cases, the forearm in 5 cases and the elbow in 3 cases. The free flaps used for soft tissue reconstructions were the latissimus dorsi in 6 cases, the dorsalis pedis in 2 cases, the lateral arm flap in 2 cases, the serratus in 1 case, the gracilis in 1 case. The island flaps were the radial forearm flap in 1 case, the posterior interosseous flap in 1 case, the cubital flap in 1 case. 14 cases required immediate associated reconstructive procedures such as tendon transfers or grafts (5 cases), vascularized or non vascularized bone grafts (4 cases), articular allografts (1 case), ligament reconstruction (1 case), nerve grafts (2 cases). Brachytherapy was associated to microsurgical reconstruction in the last 6 cases of this group. The catheters were charged with the radioisotope 5 days after surgery. No complications were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Epitheloid sarcoma originating on the back

Epitheloid sarcoma originating on the back

Epitheloid sarcoma: A case report

Epitheloid sarcoma of the pulp of the thumb followed repeated penetrating injuries to the digit. It was treated aggressively and successfully to date, nearly 5 years later. In some respects this case report parallels those animal experiments in which foreign body tumorigenesis has been demonstrated, and one might entertain a correlation.

Epitheloid sarcoma masquerading as Peyronie's disease.

A 23-year-old man presented witha firm plague-like penile mass with pain and deviationon erection, suggesting Peyronie's disease. Biopsy was erroneously interpreted asconformatory. Irradiation was the one mode of therapy which gave temporary subjective relief. Extension of the mass and focal gangrene led to rebiopsy 6 years later. Epithelioid sarcoma was present microscopically, and was also found on re-examination of theoriginal biopsy. Partial penectomy was performed, but pulmonary metastasis had alreadyoccurred. He was treated with chemotherapy and radiotherapy and is now alive with disease 2 years later. The diagnosis of possible penile sarcoma, although rare, must be considered in patients with symptons suggesting Peyronie's disease, especially if the lesion continues to enlarge.

Epithelioid sarcoma: A clinical and pathologic study of nine cases

This is a report of nine cases of epitheloid sarcoma, a term introduced recently to designate a special variant of malignant soft tissue tumor generally involving tendons, aponeuroses, and more superficial tissues of the extremities. The histologic features of this tumor, which consists of a mixture of polygonal epithelioid cells and elongated fibroblastic cells with necrotizing foci, have often misled the pathologist into diagnoses of necrotizing granuloma, malignant melanoma, angiosarcoma, or metastatic carcinoma. The tumor is definitely malignant, is difficult to eradicate by local surgical excision, and often metastasizes to lymph nodes and via the blood. The histogenesis of this tumor is still controversial, but some light and electron microscopic features suggest a possible synovial origin.

Two types of soft tissue sarcoma of uncertain histogenesis.

A brief account is given of two types of rare soft tissue sarcoma of uncertain histogenesis. The danger of mistaking the epitheloid sarcoma for a benign lesion is emphasized.