Malignant Soft Tumors Research Articles

A review of primary malignant cutaneous soft tissue tumors seen in a tertiary institution

Introduction: The baseline data of primary malignant cutaneous soft tissue tumors in this environment had been determined. It is important that as the years roll by, data collection and analyses are indispensable to determine the current trend of this tumor on one hand and compare it with the baseline data from previous studies on the other hand. The aim of this study is therefore to determine the frequency and the histopathological types of primary malignant cutaneous soft tissue tumors at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria. Methodology: This was a retrospective study of all primary malignant cutaneous soft tissue tumors that were histologically diagnosed from 1st of January 2004 to 31st of December 2013 in the Department of Morbid Anatomy, UBTH. Data were obtained from departmental archives. Data analysis was done using the SPSS statistical package version 16 (V.16.0). Results: A total of 187 malignant cutaneous tumors were diagnosed over the study period, and 87 (46.52%) of these cases were primary malignant cutaneous soft tissue tumors. Their mean age was in the fourth decade of life. Females were slightly more affected with a male:female ratio of 1:1.2. The histopathological types were angiosarcomas (2.3%), dermatofibrosarcoma protuberance (10.3%), and Kaposi's sarcoma (87.4%) in increasing order of frequency. Conclusion: The earlier determined reference point data of primary cutaneous soft tissue tumors in our environment were updated to include cutaneous angiosarcoma, thus bringing this rare tumor to the attention of both the pathologist and dermatologist. An increase in the frequency of dermatofibrosarcoma protuberance and Kaposi's sarcoma was also noted.

Histopathology of soft tissue tumors in association with immunohistochemistry

Aim: To study the histopathological pattern for understanding the classification and type of soft tissue tumors. To find out the relative incidence of benign and malignant soft tissue tumors and to classify the soft tissue tumours on basis of age, sex, site, types and benign and malignant behaviour. Material and Methods: The test population comprised of patients with soft tissue lesions, between July 2014 to July 2016, evaluated by light microscopy and Immunohistochemistry. Results: Painless mass was the most common presenting symptom in our study. Benign soft tissue tumors (89.7%) outnumbered malignant tumors (9.2%) by a ratio of 9.7:1. In our study, Male: Female ratio-1.16:1. In benign soft tissue tumor, Male: Female ratio -1.1:1 and in malignant soft tissue tumor, Male: Female - 0.9:1 in our study. First most common soft tissue tumors are Lipomatous tumors among the all soft tissue tumor. Benign lipomatous tumors are the most common tumors in present study. Most common site soft tissue tumor found is upper limb with chest in present study. Most common age of soft tissue tumor is in 2 nd and 3 rd decade of life. Malignant tumors are 9.2% reported; most common tumors are skeletal muscle tumors 100% followed by stromal tumor (80%). Second most common tumor is capillary lobular haemangioma which are of vascular origin. In the present study 3 cases of intermediate type of soft tissue tumor 2 of haemangiopericytoma and 1 of fibromatosis are found, which are rarely found. IHC markers were applied in 25 cases where microscopy was inconclusive to arrive at a definite diagnosis. Conclusion: A good clinical acumen, through description and grossing of specimen, and microscopic evaluation of hematoxylin and eosin stained sections are fundamental aspects in diagnosis of soft tissue tumors. Majority of tumors diagnosed by hematoxylin and eosin stained sections. Immunohistochemistry was done wherever light microscopy was inconclusive.

Application of time intensity curve of contrast enhanced ultrasound in the discrimination of benign and malignant soft tissue tumors

Objective To study the value of time intensity curve of contrast enhanced ultrasound in the discrimination of benign and malignant soft tissue tumors. Methods Thirty-seven cases of soft tissue tumors were carried out contrast-enhanced ultrasound examination. The region of interest in the dynamic images were chosen to carry out Gamma-Variate curve fitting through Q-LAB software and made a quantitative analysis. Then they were compared with pathological diagnosis to analyze the ultrasound imaging performance of benign and malignant tumors and their characteristics of micro-irrigation. Results Thirty-seven cases of soft tissue tumors were pathologically diagnosed 21 cases of benign and malignant in 16 cases. The perfusion of benign tumors were mainly uniformity (19/21) or potentialization (2/21). The perfusion of malignant tumors were mainly uniformity (10/16) or nonuniformity (6/16). There were no significant differences in time to peak(TTP) and arrival time of contrast agent(AT) between benign and malignant tumors( P ＞0.05). The upslope rate(A) and the derived peak intensity(DPI) in benign group were significantly less than malignant group ( P ＜0.05). Conclusions Time-intensity curve analysis of contrast-enhanced ultrasound showed that benign and malignant soft tissue tumors were different in perfusion,and it will be of a certain value for the clinical differential diagnosis. Key words: Ultrasonography; Microbubbles; Soft tissue neoplasms

The comparative study of MR diffusion-weighted imaging and MR perfusion-weighted imaging in diagnosing soft tissue tumors

Objective To evaluate MR diffusion-weighted imaging (DWI)and MR perfusion-weighted imaging(PWI) in differentiating benign from malignant soft tissue tumors by comparing the related parameters. Methods Fifty patients with soft tissue tumors verified by pathology( benign 24, malignant 26) underwent DWI and dynamic contrast-enhanced T2 * -weighted PWI. DWI and PWI data of benign and malignant soft tissue tumors were acquired at the workstation and their difference was analyzed with t-test. The diagnostic accordance rate was verified with x2-test. Subjective overall performance of two techniques were evaluated with receiver operating characteristic (ROC) analysis. Results ADC values of benign and malignant tumors were (2. 03±0. 36) × 10-3 mm2/s, ( 1.52±0. 39) × 10-3 mm2/s,respectively. The signal intensity decrease of them during the first-pass perfusion (SIdecrease ) were ( 13.54 ± 3.37 )%, (47. 57 ± 5. 21 ) % ,respectively. The maximum linearity slope rate of TIC ( SSmax ) of them were ( 5.51 ± 2. 54 ) %, (7.94 ± 3. 33) %, respectively. There were significant differences between benign and malignant tumors of ADC value and SIdecrease ( t = 2. 515,2. 938 ;P 0. 05). When the threshold of ADC value was 1. 866 × mm2/s, sensitivity and specificity for determining malignant tumors were 84. 6% (22/26)and 83.3% (20/24). When the threshold of SIdecrease was 40. 33% ,sensitivity and specificity for determining malignant tumors were 88. 5% (23/26)and 75.0% (18/24). In type Ⅰa of TIC,the proportion of benign soft tissue tumor was 3/24 and malignant tumor was 20/26. In type Ⅰb , benign tumor was 14/24 and malignant tumor was 3/26. In type Ⅰc, malignant tumor was 3/26. In type Ⅱ ,benign tumor was 7/24. The diagnostic accordance rate of DWI and PWI were 84. 0% (42/50) and 82. 0% (41/50), respectively. There was no significant difference between them ( x2 = 0. 8, P >0. 05). The accuracies of them were 81.7% , 83. 6% respectively by the area under the ROC curve (AUC). The sensitivity of PWI in diagnosing malignant soft tissue tumors was higher. Conclusions ADC value and SIdecrease are Valllable diagnostic parameters in differentiating benign and malignant soft tissue tumors. The threshold of these parameters for diagnosing malignant soft tissue tumors are 1. 866 × 10-3 mm2/s and 40. 33%, respectively. The type of TIC can help to distinguish malignant tumors from benign tumors, while the SSmax can not. The accuracies of DWI and PWI in the diagnosis of malignant soft tissue tumors are moderate. Compared with DWI, PWI should be selected firstly because of its higher sensitivity in diagnosing malignant tumors. Key words: Soft tissue neoplasm; Magnetic resonance imaging

Approach to the Management of Soft Tissue Tumors of the Foot and Ankle

To properly treat soft tissue tumors, the foot and ankle surgeon must start with an adequate fund of knowledge and follow a systematic approach. Some malignant soft tumors have a predilection for the foot and ankle, and they may mimic common musculoskeletal conditions, leading to a trap for the unwary clinician. This review will familiarize the practitioner with the common soft tissue tumors that occur in the foot and ankle along with their presentations. A systematic approach to the workup is outlined, which is designed to establish the diagnosis with a significant degree of certainty before the surgical treatment of the tumor is planned. A practical and reliable method of distinguishing benign tumors from those that are potentially malignant is presented. Finally, the techniques for surgical management of the common soft tissue tumors are summarized.

Soft tissue tumours in childhood.

The spectrum of soft tissue tumours in young adults is very similar to that in more mature individuals, while those in childhood form a distinct group rarely seen outside the first decade. The majority of these are benign vascular or fibroblastic proliferations; in young children they may be highly cellular and mitotically active, but malignancy should be diagnosed with caution. Congenital soft tissue tumours constitute a special group in which the clinical outcome may be particularly difficult to predict from the histological appearances. This review focuses on those malignant soft tumours which are either peculiar to childhood or which manifest special features in childhood. Some recently recognized benign soft tissue tumours which occur mainly in childhood are also described. The fibromatoses are not discussed. As a guide to the appropriate treatment regime, the main histological distinctions to be drawn are between: 1 tumours of neuroectodermal origin (Ewing's sarcoma and primitive neuroectodermal tumour); 2 other sarcomas; and 3 the fibromatoses and other benign and potentially locally aggressive lesions requiring local excision. Immunohistochemical staining may be of considerable help in achieving the correct diagnosis, but it is vital that a panel of antibodies be applied and the results critically assessed. Cytogenetic analysis is also of growing importance, characteristic karyotypic abnormalities having been demonstrated in Ewing's sarcoma/primitive neuroectodermal tumour, alveolar rhabdomyosarcoma and synovial sarcoma.

Malignant soft tissue tumors of the lower extremities; a radical-conservative technique of wide excision and skin grafting without amputation; report of five cases.

Malignant soft tissue tumors of the lower extremities; a radical-conservative technique of wide excision and skin grafting without amputation; report of five cases.