Malignant Soft Tissue Tumors Research Articles

Incidence and risk of infection in malignant soft tissue tumor resection: Data from the nationwide soft tissue tumor registry

BackgroundPostoperative infection is a devastating complication in limb salvage surgery for malignant soft tissue tumors. The low absolute case numbers of these rare cancers represent a bottleneck for data collection and analysis. The administration of nationwide registry data is a practical option for the accumulation of cases. MethodsData on malignant soft tissue tumor resection were extracted from the Bone and Soft Tissue Tumor Registry in Japan. The incidence of postoperative infection and its risk factors were analyzed. ResultsA total of 14,460 cases were included. The incidence of infection was 2.6%. Significant risks for infection were male sex, lower extremity or trunk location, tumor diameter of over 10 cm, trans-compartmental invasion, high grade, autologous bone graft, myocutaneous flap, vascular reconstruction, reconstruction by prosthesis, postoperative radiotherapy, and delayed wound healing. ConclusionsThe incidence was lower than those in the previous studies, perhaps because of less frequent radiotherapy application. Some of the significant risk factors represented local invasiveness of the tumor, suggesting the importance of the preservation of soft tissue for infection prevention. The administration of nationwide registry data was informative for the analysis of infection in malignant soft tissue tumor resection.

Giant Intramuscular Thigh Lipoma

Lipomas are the most frequent benign tumors in practice. The absence of specific clinical symptomatology is frequent allows the lipoma to grow silently, until it reaches a large size before the diagnosis and the doctor must include malignant soft tissue tumors in the differential diagnosis. We report the observation of a 40-year-old patient, who presented a painless swelling of the left thigh evolving for 13 years gradually increasing in volume. All evolving in a context of conservation of the general condition. A lipoma has been mentioned, but a liposarcoma still remains to be eliminated. The MRI did not find signs of malignancy, it made it possible to confirm the fatty nature of the tumor. an anterior ultrasound biopsy centered on the tumor, confirmed the result of the MRI. The excision of the tumor in its entirety was carried out by taking away the scar from the biopsy and respecting all the anatomical elements of the thigh. The pathological-anatomical analysis confirmed the diagnosis of lipoma. A step back of 2 years, the patient is asymptomatic, and the MRI showed no recurrence or malignant degeneration.

Expression of PD-L1 in malignant soft tissue neoplasm and their correlation with clinicopathological parameters

Objectives: Programmed death ligand-1 (PD-L1) expression in malignant epithelial neoplasms has been the subject of numerous studies; however, less data on its application to sarcomas are available. This research focused on the expression of PD-L1 and how it correlated with clinicopathological characteristics in soft tissue sarcomas. Materials and Methods: The anti-PD-L1 antibody and Ki-67 were stained in 50 cases of sarcoma that had been confirmed by biopsy and immunohistochemistry. The tumor cell percentage with complete or incomplete membrane staining was calculated. Sarcomas were categorized as positive (>1% of tumor cells with complete or incomplete membrane staining) or negative (≤1% of tumor cells with complete or incomplete membrane staining). The data were analyzed using Statistical Package for Social Sciences version 21.0. Statistical Analysis: Data were analyzed using Statistical Package for Social Sciences (SPSS, IBM Inc., United States), version 21.0. The independent sample t-test for continuous variables and the chi-square test for discrete variables were used to investigate the relationships between PD-L1 expression and clinicopathologic factors. A p-value less than 0.05 was considered statistically significant. Results: The soft tissue sarcomas showing marked pleomorphic morphology were significantly linked to positive PD-L1 expression than other subtypes of sarcomas (p = 0.042). Proliferation index grade III accounts for 62.5% of cases with positive PD-L1 expression, followed by proliferation index grade II with 25% cases and grade I with 12.5% cases. On comparing statistically, this difference was found to be significant (p = 0.013). A significant association was found between PD-L1 expression and the poor outcome of follow-up (p = 0.024). Conclusions: Our study showed a significant relationship between malignant soft tissue tumor positivity for PD-L1 and pleomorphic morphology, a higher proliferation index grade, and a poorer prognosis.

Progress in muscle strength of the reconstructed knee and quality of life of the patient after knee rotationplasty: A case report.

Knee rotationplasty (KRP) is a function-preserving surgery that serves as an alternative to above-knee amputation in patients diagnosed with malignant bone and soft tissue tumors around the knee joint. However, the short-term progress of the reconstructed knee in terms of muscle strength is unclear after KRP. This case report describes the progress of a 37-year-old man diagnosed with synovial sarcoma in the distal femur, 1 year after undergoing KRP. Changes in muscle strength of the reconstructed knee and physical function are reported. Physical therapy was started on postoperative day 1 after the KRP, and mobilization proceeded step-by-step with sitting, wheelchair transfer, and crutch walking. Active and passive range-of-motion exercises of the reconstructed knee were started on postoperative day 5. The isometric reconstructed knee extension strength, 10-m walk test, timed up and go test, Musculoskeletal Tumor Society score, Toronto Extremity Salvage Score, and quality of life (QOL) were evaluated. One month postoperatively, muscle strength had increased, and at 6 and 12 months postoperatively, isometric knee extension strength and physical function had improved. Furthermore, activities of daily living and QOL gradually improved over the course of the 12 months. Our case shows the previously unknown course of reconstructed knee muscle strength in the early post-KRP period, with corresponding improvements in physical function, activities of daily living, and QOL.

Mast Cell and VEGF Profile in Canine Soft Tissue Tumors

Canine soft tissue sarcomas are a complex group that is difficult to treat with high invasion and metastasis characteristics. These tumors are divided into a wide variety of subtypes, but due to their general mesenchymal characteristics and morphological similarities, they are under a single group called soft tissue tumors together with benign ones. Tumor microenvironment including mast cells promotes tumor angiogenesis, proliferation, invasion, and metastasis, as well as mediating the mechanism of therapeutic resistance. In this study, the presence and relationships of mast cells with VEGF in benign and malignant soft tissue tumors were evaluated. As a result, mast cells showed a significant increase in malignant tumors compared to benign ones. In the VEGF analyzes performed for interpreting of angiogenesis, the immunostaining scores were also higher in malignant tumors. To the authors' knowledge, there is no previous study investigating mast cells and angiogenesis in canine soft tissue tumors. This study revealed that mast cell and VEGF scores are higher in malignant tumors compared to benign ones and can be considered as a prognostic marker. However, any correlation between mast cells and VEGF immune expressions could not be detected.

Consensus recommendations in the management of Ewing sarcoma from the National Ewing Sarcoma Tumor Board.

Ewing sarcoma (ES) is a malignant tumor of bone and soft tissue that most often occurs in adolescents and young adults. Despite an international coordinated approach, several nuances, discrepancies, and debates remain in defining the standard of care for treating ES. In this review, the authors leverage the expertise assembled by formation of the National Ewing Sarcoma Tumor Board, a multi-institution, multidisciplinary virtual tumor board that meets monthly to discuss complicated and challenging cases of ES. This report is focused on select topics that apply to the management of patients with newly diagnosed ES. The specific topics covered include indications for bone marrow aspirate and biopsy for initial evaluation compared with fluorodeoxyglucose-positron emission tomography, the role of interval compressed chemotherapy in patients aged 18years and older, the role of adding ifosfamide/etoposide to vincristine/doxorubicin/cyclophosphamide for patients with metastatic disease, the data on and role of high-dose chemotherapy with autologous stem cell transplantation, maintenance therapy, and whole-lung irradiation. The data referenced are often limited to subgroup analyses and/or compiled from multiple sources. Although not intended to replace the clinical judgement of treating physicians, the guidelines are intended to provide clarity and recommendations for the upfront management of patients with ES. PLAIN LANGUAGE SUMMARY: Ewing sarcoma is a malignant tumor of bone and soft tissue that most often occurs in adolescents and young adults. For this review, the authors used the experience of the National Ewing Sarcoma Tumor Board, a multi-institution, multidisciplinary virtual tumor board that meets monthly to discuss complicated and challenging cases of Ewing sarcoma. Although not intended to replace the clinical judgement of treating physicians, the guidelines will focus on the development of consensus statements for the upfront management of patients with Ewing sarcoma.

Diagnosis of Local Recurrence of Malignant Soft Tissue Tumors after Reconstructive Surgery on MRI.

Magnetic resonance imaging (MRI) is useful in the diagnosis of local recurrence, but few studies have explored recurrence in MRI in patients after reconstructive surgery. The purpose of this study was to analyze MRI findings of locoregional recurrence following reconstructive surgery after malignant soft tissue tumor resection. Fifty-three postoperative MRIs from 37 patients who underwent reconstructive surgery after malignant soft tissue tumor resection were retrospectively reviewed. A total of 76 enhancing lesions, including 40 locoregional recurrences and 36 postoperative changes, were analyzed regarding morphology (location on the transplanted tissue, border, and shape) and the signals on T1- and T2-weighted imaging (T1WI, T2WI), fat-suppressed (FS) T2WI, and contrast-enhanced FS T1WI. Diffusion-weighted imaging with an apparent diffusion coefficient was assessed. A chi-squared test and Fisher's exact test were used for statistical analysis. The most common site of recurrent tumors and postoperative changes was the peripheral margin on transplanted tissue (63% and 61%, respectively p = 0.907). Recurrent tumors commonly appeared with well-defined borders (75%) as well as nodular appearance (98%), hyperintensity on T2WI (85%) and FS-T2WI (95%), isointensity on T1WI (65%), impeded water diffusion (55%), and intense (50%) or moderate (45%) enhancement. Postoperative changes showed ill-defined borders (75%), nodular appearance (56%), facilitated water diffusion (69%), and moderate (86%) enhancement, which were significantly different from those of recurrent tumors (p ≤ 0.020). Common and partitioning MRI features of locoregional recurrence were well-defined borders, nodular shape, impeded water diffusion, and intense enhancement. Peripheral margins on transplanted tissue were common sites in both recurrent tumors and postoperative changes.

Pericapsular nerve group (PENG) block as a sole anesthetic method for malignant soft tissue excision

Since its first description by Philippe WH Peng in 2018, the Pericapsular Nerve Group (PENG) block, a novel regional anesthetic procedure, has been gaining in popularity. In order to provide appropriate analgesia, an ultrasound-guided local anesthetic injection around the hip joint is performed.We presented, in this case, the successful management of the PENG block for surgical anesthesia in the excision of a malignant soft tissue tumor in the proximal tibia of a 73-year-old female patient. Adequate sensory and motor blocks were obtained, allowing a 70-minute surgery without using additional analgesics. Postoperative pain scores were low, and the patient was discharged without complications.

Neutrophil-, Monocyte- and Platelet-to-Lymphocyte Ratios, and Absolute Lymphocyte Count for Diagnosis of Malignant Soft-tissue Tumors.

Soft-tissue tumors are difficult to differentiate as benign or malignant. Immune markers, such as the neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and absolute lymphocyte count (ALC) in serum, have been reported to be useful in the diagnosis and predicting prognosis of several malignancies. We investigated the diagnostic value of these immune markers in differentiating soft-tissue tumors. A total of 692 patients who underwent biopsy or surgery of soft-tissue tumors were included and divided into benign tumor, low-grade malignancy, or high-grade malignancy groups. Immune markers were calculated from the preoperative blood tests and compared between the groups. A receiver operating curve (ROC) analysis was conducted between the benign disease group and a combination of the groups with malignancy to determine which immune marker had the most diagnostic value. NLR and MLR were significantly different between the three groups with benign disease having the lowest value and high-grade malignancies the highest. Benign disease was also associated with lower PLR and higher ALC. There was no difference between the low- and high-grade malignancies in PLR and ALC. From the ROC analysis, NLR had the highest area under the curve (AUC) value of 0.773 out of the four markers. When limited to small tumors (≤30 mm), NLR had the highest AUC value of 0.729. The NLR showed the highest diagnostic value, although the diagnostic ability was not adequately high to differentiate benign and malignant soft-tissue tumors alone. NLR may serve as diagnostic support in combination with clinical history, physical findings, and tumor-imaging results.

Left Hindquarter Amputation due to High-Grade Pleomorphic Sarcoma of the Groin: A Case Report

Introduction:Hindquarter amputation or known as hemipelvectomy is a surgical technique that is primarily used for the eradication of malignant primary soft tissue and bone tumors of the pelvis, hip, and upper thigh regions. Occasionally, hindquarter amputation has been employed in the treatment of severe trauma, metastases, and infection. This case report aims to give a lesson in the case of the High-Grade Pleomorphic Sarcoma of the Groin because this is a very rare case and most patients are not willing to undergo amputation.Case Presentation: A 54-year-old male patient came with a complaint of a lump in the thigh. Initially, the lump was as big as a marble and has been getting bigger since last year. The size of the lump was approximately 30 x 30 x 30 cmConclusions: The most common indications for amputation in patients with the primary localized disease were extensive involvement of the limb-girdle, multiple muscle compartment involvement, multifocality, and unsuitability for limb-sparing surgery, typically due to lack of a salvage option. Hindquarter amputation was used as a treatment for 13% of all pelvic bone sarcomas where there is a realistic chance of control of symptoms or long-term survival.comas.

Pleomorphic rhabdomyosarcoma of lumbar region: A case report

Rhabdomyosarcoma is a malignant mesenchymal soft tissue tumour with tendency towards skeletal muscle differentiation. It is commonly seen in children and adolescents but is exceedingly rare in adults. The most common site in adults is the extremities. Less common locations include pelvis and thorax. The tumour is diagnosed by the morphologic presence of scattered pleomorphic rhabdomyoblasts and immunohistochemistry (with evidence of at least one skeletal muscle-specific marker). The outcome of tumour in adults is very poor, especially when compared to outcomes in children in whom significant improvements with treatment have been achieved. We present a case of Pleomorphic Rhabdomyosarcoma at the lumbar region which was clinically thought as a dermoid cyst. This case is reported because of rare location. The diagnosis was made on histopathology and immunohistochemistry. The tumour was diffusely positive for vimentin and desmin and focally positive for myogenin & MyoD1.

Asuhan gizi pada pasien malignant neoplasma di RSD dr. Soebandi Jember

Background: tumor disease is a deadly disease in the world. It is estimated that around 1,300 people die each year from bone tumors. Bone tumors occur due to abnormal growth of mesenchymal cells in bones, which can be malignant/cancerous. Malignant soft tissue tumors can affect anyone, especially the elderly. In developing bone tumor malignancy, it is necessary to have nutritional service assistance that can support the nutritional adequacy of sufferers.Purpose: to determine the effect of nutritional care process on the development of the malignant neoplasma patient's condition.Methods: this study used the case study design. Management of nutrition care which was carried out for three consecutive days from 17 to 19 November 2022 to a patients with malignant neoplasma at RSD dr. Soebandi. The data collection process was carried out by interviews, anthropometric measurements, observe the medical records and survey consumption using 24-hour food recall method.Results: during monitoring the patient is included in a normal nutritional state and does not experience changes; physical and clinical evaluation showed that there were still complaints of weakness after the chemotherapy process; monitoring and analysis of intake show that the average intake of energy, protein and carbohydrates meets the target requirement of 89.13%, 81.93%, 89.2% (80-110% of requirement) and fat intake exceeds the target requirement of 126 .6% (80-110% of requirement); as well as the results of diet education and counseling show that patients understand the diet that must be followed and apply it to the recommended food ingredients, but are less compliant with the heavy food given.Conclusion: overall the NCP (Nutrition Care Process) carried out a positive impact to patient with malignant neoplasma patien’s developmet.

Primary leiomyosarcoma of the thyroid with concurrent papillary thyroid cancer: a rare case report and a review of literature

BackgroundLeiomyosarcoma (LMS) is a soft tissue malignant tumor that has a predilection to the abdominopelvic and limb smooth muscles. LMS of the thyroid is exceptionally rare. Papillary thyroid cancer (PTC) is the most common thyroid malignancy and originates from the thyroid epithelial layer. To our knowledge, the presence of both tumors in the same patient has not been reported previously.Case presentation & literature reviewA 42-year-old woman presented with a progressively enlarging neck mass for a few months. She underwent left thyroid lobectomy, and the histology showed high-grade primary LMS of the thyroid. She subsequently underwent a complete thyroidectomy, which identified a classical PTC on her right lobe.Our comprehensive literature review identified 39 published cases of primary LMS of the thyroid. The average tumor size was 5.88 cm and occurred more in women. The most common presentation was neck mass, followed by compressive symptoms. Recurrence and metastasis were uncommon at 15% and 10–25%, respectively.ConclusionThyroid LMS is a rare malignancy with a worse prognosis than PTC. A thorough workup must be done to rule out metastasis before labeling it as primary thyroid cancer.

Genitourinary embryonal rhabdomyosarcoma clinicopathologic determinants of clinical outcomes: Analysis of a pooled database.

e23536 Background: Embryonal rhabdomyosarcoma (ERS) refers to malignant soft tissue tumors with phenotypical, histological features of primitive skeletal muscle. ERS commonly involves the head and neck region and genitourinary system. Genitourinary embryonal rhabdomyosarcoma (GUERS) is considered an entity similar to other ERS based on Intergroup Rhabdomyosarcoma Study Group (IRSG) with non-prostate GUERS considered low risk. This study seeks to define other high-risk subtypes in this population. Methods: To study the demographic and molecular characteristics, therapeutic interventions, survival, and prognostic factors, we compiled a pooled database of 137 cases of GUERS. Kaplan-Meier survival curves, Cox proportional-hazards model and Log-rank tests were used to assess the influence of demographic and clinicopathologic factors on overall survival (OS) and disease-free survival (DFS). Results: 137 patients with confirmed GUERS were identified: median age was 16 and F:M ratio of 1.6. Female reproductive organs (49%), renal and urinary tract (24%), male reproductive organs (23%), and abdomino-pelvis (4%) were involved. Lymph node involvement and metastasis occurred in 11% and 13%, respectively. Staging consisted of stage I (65%), stage II (15%), stage III (8%), and stage IV (12%). Rhabdomyosarcoma clinical groups were mostly IA (41%), IIIA (31%) and IV (13%). Risk groups consisted of low (71%), intermediate (17%), and high (13%). Median OS and DFS were 96 and 42 months, respectively. The primary site of involvement impacted OS, with urinary tract organ involvement having the best median OS, compared to female reproductive organs, male reproductive organs, and abdomino-pelvis involvement (p = 0.01). While primary pelvic disease (p = 0.03), prostate (p = 0.008), and lymph node involvement (p = 0.001) were associated with worse OS, cervix/vaginal involvement tended to have better OS (p = 0.06). Constitutional symptoms (p = 0.0007), obstruction (p = 0.047) and metastases (p = 0.02) were associated with worse OS. Clinical staging system (p = 0.0008), risk groupings (p = 0.06) correlated with OS, but not clinical groupings (p = 0.26). GUERS with vimentin+, CD99- and SMA+ had worse survival (only the latter was statistically significant). Compared to no treatment, RT, CT+/-RT, S+CT+RT were superior with mOS of 2, 6, NR, 96 months, respectively (p < 0.0001). Achieving CR had superior OS (p < 0.0001). OS was not impacted by age, sex, or extent of surgery. Conclusions: Genitourinary embryonal rhabdomyosarcoma is a distinct clinical entity with outcomes worse than other forms of ERS defined by the Clinical Groups of IRSG. Prostate, primary pelvic and obstructive symptoms have worse OS compared to bladder and cervical involvement and we propose their inclusion in the current Clinical Group. This study presents updated clinicopathologic data from a pooled cohort of patients with GUERS.

Results from phase I/II study of NY-ESO-1-specific TCR gene-transduced T cell therapy (TBI-1301, mipetresgene autoleucel) in patients with advanced synovial sarcoma.

11558 Background: Synovial sarcoma is one of malignant soft tissue tumors with a poor prognosis. A cancer-testis antigen NY-ESO-1 is expressed in the tumors of 50-80% synovial sarcoma patients. The purpose of this study was to evaluate the safety and the efficacy of gene engineered autologous T cell product with NY-ESO-1 siTCR retroviral vector which expressed affinity-enhanced NY-ESO-1-specific TCR and siRNA to silence endogenous TCR (TBI-1301). Methods: This was an open label phase I/II study to evaluate safety, appearance of replication competent retrovirus (RCR), appearance of clonality, in vivo cell kinetics and clinical responses. TBI-1301 were manufactured from each subject’s leucocytes stimulated with anti-CD3 antibody and Retronectin and transduced with NY-ESO-1 siTCR retroviral vector. TBI-1301 was infused at split dose of 5 x 109 cells following cyclophosphamide treatment at 750 mg/m2 for two days to HLA-A*02:01 or HLA-A*02:06 positive subjects with synovial sarcoma expressing NY-ESO-1, which were surgically unresectable and refractory to anthracycline therapy. Results: Eight subjects were enrolled and treated with TBI-1301. The objective response rate was 50.0% with best overall partial response in 4 of 8 subjects according to RECIST v1.1/irRECIST and the median overall survival was 650 days. Cytokine release syndrome (CRS) occurred in 50.0% (4/8) and consisted of 1 subject with grade 1 CRS and 3 subjects with grade 2 CRS. All subjects who developed CRS recovered with prespecified treatment, in which 2 subjects were treated with symptomatic therapy, 1 subject was treated with tocilizumab and 1 subject was treated with both tocilizumab and corticosteroid. No subjects had immune effector cell- associated neurotoxicity syndrome (ICANS). RCR and clonal dominance were not detected in any subjects throughout the study period. Conclusions: Adoptive immunotherapy with TBI-1301 to selectively target NY-ESO-1 positive tumors will become a promising treatment for advanced or recurrent synovial sarcoma with acceptable toxicity. Clinical trial information: NCT03250325 .

Differential overall survival and treatment for non-dedifferentiated liposarcoma in academic and non-academic facilities: An NCDB analysis.

e23556 Background: Liposarcoma is a malignant soft tissue tumor sarcoma which most commonly arises in subcutaneous fat of the limbs and abdomen. Previous studies found overall survival and treatments to vary between patients treated at academic and non-academic facilities. Methods: The National Cancer Database (NCDB) was used to identify patients diagnosed with non-dedifferentiated liposarcoma from 2004 to 2019 using the histology codes 8850, 8851, 8852, 8853, 8855, and 8857 as assigned by the Commission on Cancer Accreditation program. Kaplan-Meier, ANOVA, Chi-Square, and Cox Proportional Hazards tests were performed. Data was analyzed using SPSS version 27 and statistical significance was set at α = 0.05. Results: Of the 15,256 patients queried, 72% were treated at an academic/research facility (AF). Patients treated at an AF had an improved median survival compared to a non-academic facility (NA) (184 months versus 154 months; p < 0.001). After controlling for stage, income, and therapy type, treatment at an AF was associated with an independent decrease in hazard (HR = .824; p < 0.001). AF patients disproportionately came from a higher income bracket and were more likely to carry private insurance. Additionally, AF patients were more likely to receive surgery, have margins with complete tumor resection, and receive adjuvant chemotherapy (p < 0.001). There were no significant differences in stage or metastasis at presentation between the two groups. Conclusions: Patients with non-dedifferentiated liposarcoma treated at an academic/research facility had improved overall survival, higher rates of surgery, higher rates of chemotherapy, and better surgical margins compared to patients treated at a non-academic facility.

Ensemble learning-based radiomics with multi-sequence magnetic resonance imaging for benign and malignant soft tissue tumor differentiation.

Many previous studies focused on differentiating between benign and malignant soft tissue tumors using radiomics model based on various magnetic resonance imaging (MRI) sequences, but it is still unclear how to set up the input radiomic features from multiple MRI sequences. Here, we evaluated two types of radiomics models generated using different feature incorporation strategies. In order to differentiate between benign and malignant soft tissue tumors (STTs), we compared the diagnostic performance of an ensemble of random forest (R) models with single-sequence MRI inputs to R models with pooled multi-sequence MRI inputs. One-hundred twenty-five STT patients with preoperative MRI were retrospectively included and consisted of training (n = 100) and test (n = 25) sets. MRI included T1-weighted (T1-WI), T2-weighted (T2-WI), contrast-enhanced (CE)-T1-WI, diffusion-weighted images (DWIs, b = 800 sec/mm2) and apparent diffusion coefficient (ADC) maps. After tumor segmentation on each sequence, 100 original radiomic features were extracted from each sequence image and divided into three-feature sets: T features from T1- and T2-WI, CE features from CE-T1-WI, and D features from DWI and ADC maps. Four radiomics models were built using Lasso and R with four combinations of three-feature sets as inputs: T features (R-T), T+CE features (R-C), T+D features (R-D), and T+CE+D features (R-A) (Type-1 model). An ensemble model was built by soft voting of five, single-sequence-based R models (Type-2 model). AUC, sensitivity, specificity, and accuracy of each model was calculated with five-fold cross validation. In Type-1 model, AUC, sensitivity, specificity, and accuracy were 0.752, 71.8%, 61.1%, and 67.2% in R-T; 0.756, 76.1%, 70.4%, and 73.6% in R-C; 0.750, 77.5%, 63.0%, and 71.2% in R-D; and 0.749, 74.6%, 61.1%, and 68.8% R-A models, respectively. AUC, sensitivity, specificity, and accuracy of Type-2 model were 0.774, 76.1%, 68.5%, and 72.8%. In conclusion, an ensemble method is beneficial to incorporate features from multi-sequence MRI and showed diagnostic robustness for differentiating malignant STTs.

Prognostic implications of the immunohistochemical expression of perilipin 1 and adipophilin in high-grade liposarcoma

AimsLiposarcoma is a malignant soft tissue tumour with adipocytic differentiation. Dedifferentiated liposarcoma (DDLS) and myxoid liposarcoma (MLS) are classified as high-grade liposarcomas. Lipid droplet-associated protein (also known as perilipin 1...

Extraskeletal mesenchymal chondrosarcoma of the abdomen: A rare clinical presentation

Extraskeletal mesenchymal chondrosarcoma (EMCS) is a rare malignant soft tissue tumor of chondroprogenitor cell origin. Originally, it was restricted to the bone only but that is no longer the case. Recent literature reports that 20–33% of these tumors occur at the extraskeletal sites. We report one such case, in which the tumor involved the anterior abdominal wall muscles and also had a large intra- abdominal mass that covered a large part of the peritoneal cavity. The clinical features and computed tomography findings suggested the diagnosis of a malignant desmoid tumor with intra-abdominal extension; however, the histopathological examination and the immunohistochemistry proved the tumor to be EMCS. The case is reported due to the dilemma in diagnosis, its rarity, large size, parietal, and intra-abdominal extension with multiple site involvement.

Feasibility and Safety of Diffusing Alpha-Emitter Radiation Therapy for Recurrent or Unresectable Skin Cancers

Patients with recurrent or unresectable skin cancers have limited treatment options. Diffusing alpha-emitter radiation therapy (DaRT), a novel solid tumor management strategy using alpha-particle interstitial brachytherapy, may address this challenge. To evaluate the feasibility and safety of using DaRT to manage recurrent or unresectable skin cancers. This prospective cohort study of patients who received a 2-week to 3-week treatment course and were followed up for 24 weeks after treatment during 2021 and 2022 at 2 sites in the US. Patients with malignant skin tumors or soft tissue tumors were recruited if they had limited treatment options for tumors recurrent after prior surgery or external beam radiotherapy or unresectable tumors. Patients underwent DaRT to deliver a physical dose of 10 Gy (equivalent weighted dose of 200 CGE) to the tumor. Feasibility of the DaRT procedure was evaluated based on the ability of investigators to successfully deliver radiation to the tumor. Patients were followed up for adverse events (AEs) for 24 weeks and for tumor response by physicians' physical examination and imaging 12 weeks after device removal. This study included 10 participants with recurrent or unresectable skin cancer (median [IQR] age, 72 [68-75] years; 6 males [60%]; 4 females [40%]). Six patients (60%) had recurrent disease, and 4 (40%) had tumors that were deemed unresectable. Tumors were located on the nose, chin, eyelid, scalp, neck, trunk, and extremities. Median (range) tumor volume before treatment was 2.1 cm3 (0.65-12.65 cm3). The mean (SD) prescription dose coverage of the gross tumor volume was 91% (2.8%) with all tumors having coverage of 85% or more. No device-related grade 3 AEs were noted. Common AEs were grade 1 to 2 erythema, edema, and pruritus. At 12 weeks following treatment, there was a 100% complete response rate. Nine of 10 complete responses (90%) were confirmed by CT imaging. This cohort study suggests the feasibility and preliminary safety of DaRT in the management of recurrent or unresectable skin cancers. The favorable safety profile and high response rates are promising. A US trial for marketing approval based on this pilot study is under way. ClinicalTrials.gov Identifier: NCT04377360.