Osteosarcoma Components Research Articles

MNG-2 AN ANAPLASTIC MENINGIOMA WITH THE DIFFERENTIATION INTO OSTEOSARCOMA TISSUE

Abstract Eighty-two year old woman developed motor aphasia. A brain MRI revealed an (1) extramedullary tumor adhering to the dura mater which enhanced almost uniformly and (2) an intramedullary tumor in the left frontal lobe. She underwent surgery in which we removed both tumors. Pathological examination revealed that (1) was meningothelial meningioma, WHO grade 1, without malignant findings. (2) had a high cell density, many mitosis (about 15 in 10 high-power fields), and a high MIB-1 index, leading to atypical meningioma, WHO grade 2. In addition, osteosarcoma component was found in part of (2), MIB-1 was further elevated, and the same site was diagnosed as anaplastic meningioma, equivalent to WHO garde 3. As a result of genetic analysis,tumor (1) had hemi-deletion and tumor (2) had homozygous deletion of the CDKN2A/2B gene. A case of anaplastic meningioma with osteosarcoma tissue has not been reported in the past as far as we could find, and it seems to be an extremely rare case. In this case, it is presumed that the other allele was deleted in the CDKN2A/2B hemi-deficient cells with benign morphology, and the homozygous deletion cells transformed into malignant transformation.

Reliability study of radiology interpretation in osteosarcoma

Introduction: Radiography interpretation of osteosarcoma is almost similar with the benign and other malignant bone tumors. The radiologists’ ability to accurately diagnose osteosarcoma will determine the therapy and diagnostic consistency. Currently, there is lack of evidence on radiography interpretation reliability of osteosarcoma performed by radiologists. This study aimed to evaluate the interobserver and intraobserver radiologists’ compatibility to confirm the diagnosis of osteosarcoma and explore the interpretation variability of radiological description.Methods: This was an interobserver and intraobserver reliability study for osteosarcoma radiograph interpretation. The osteosarcoma radiographs, which have been histopathologically diagnosed, were evaluated retrospectively by two observers and twice by one observer in a different timeline. The components of osteosarcoma identified through the radiographs are bone destruction and its pattern, zone of transition, type of periosteal reaction, type of matrix calcification, skip metastasis, and soft tissue mass. The data analyzed with reliability testing through agreement analysis and Kappa value.Results: After evaluation of 30 radiographs of osteosarcoma, substantial reliability score for periosteal reaction (Kappa 0.79) to almost perfect for bone destruction, types of bone destruction, transitional zone, types of periosteal reaction, calcification matrix, and presence of soft tissue mass (Kappa 0.84-1) were found. There is a strong level of agreement (96.7%) found for skip metastasis. Intraobserver reliability also showed substantial value for the presence of soft tissue mass (Kappa 0.78) and almost perfect for other characteristics of osteosarcoma (0.84-0.93).Conclusion: Intraobserver and interobserver reliability of osteosarcoma radiograph interpretation was substantial and almost perfect.

Ovarian Cystadenocarcinoma with an Osteosarcoma Component

Novel Approaches in Cancer Study Ovarian Cystadenocarcinoma with an Osteosarcoma Component Selma Sakhri* Head of medical oncology department, Algeria *Corresponding author:Selma Sakhri, Head of medical oncology department, Laghouat, Algeria Submission: July 01, 2021 Published: August 16, 2021 DOI: 10.31031/NACS.2021.06.000633 ISSN:2637-773XVolume6 Issue2

Ovarian Cystadenocarcinoma with an Osteosarcoma Component

Ovarian cystadenocarcinoma with an osteosarcoma component, is a very rare tumor. We aimed to describe a case of an osteosarcoma arising in an ovarian squamous cell carcinoma.

Dedifferentiated soft tissue leiomyosarcoma with heterologous osteosarcoma component: case report and review of the literature

BackgroundSoft tissue dedifferentiated leiomyosarcoma with heterologous osteosarcomatous component is an extremely rare entity described in only few cases in the literature.Case presentationWe report the case of a 65-year-old male patient who, after initial inadequate surgery of a tumor of the left forearm, developed local recurrence that was treated with neoadjuvant chemotherapy, surgery and postoperative radiation therapy. Histologically the tumor showed an abrupt separation of two different patterns. One component consisted of interlacing fascicles of spindle cells with cigar-shaped nuclei strongly positive for smooth muscle actin, desmin and H-caldesmon. The other component consisted of a high-grade pleomorphic sarcoma with osteoid and chondroid matrix production, which positive for SATB2. Thus, a final diagnosis of dedifferentiated leiomyosarcoma was rendered. Fifteen months after treatment, the patient presented further local and distant relapse with pulmonary metastases and died 23 months after the first presentation.Discussion and conclusionsDedifferentiated leiomyosarcoma is a highly malignant neoplasm with a poor outcome. Extensive sampling of soft tissue leiomyosarcomas is recommended to detect possible dedifferentiated areas as they represent a crucial prognostic parameter.

Carcinosarcoma ex Pleomorphic Adenoma of the Submandibular Gland in a 64-Year-Old Man: A Case Report

Carcinosarcoma (CS) is a rare tumor, consisting of both carcinomatous and sarcomatous components. In this paper, we present a case of CS arising from a pleomorphic adenoma (PA) of the submandibular gland. A 64-year-old Japanese man presented with a left submandibular mass that had developed for 20 years with complaints of pain for the last 3 months. Magnetic resonance imaging showed a lesion involving the left submandibular gland. The patient underwent total dissection of the left submandibular gland and left cervical lymph nodes. Upon gross examination, the mass appeared completely covered by fibroadipose tissue measuring 46×42×45 mm; sectioning revealed a solid-white nodule with central bleeding and necrosis, invading into the surrounding adipose tissue. Microscopically, the presence of carcinomatous and sarcomatous components in the fibro-myxomatous stroma was detected, suggestive of pre-existing PA. The carcinoma component was diagnostic of salivary adenocarcinoma, not otherwise specified, whereas the sarcomatous component exhibited features of osteosarcoma characterized by formation of osteoid. As the border between the carcinomatous and sarcomatous components was not evident, CS may have occurred via transformation of the carcinoma into sarcoma. Tumor metastasis was detected in the cervical lymph nodes. Immunohistochemically, AE1/AE3 expression was noted in the carcinomatous component, but not in the osteosarcoma component. Both components were diffusely positive for vimentin. Four months after the operation, the patient developed a metastatic CS lesion in the lung, suggesting tumor aggression.

The contribution of immune infiltrates and the local microenvironment in the pathogenesis of osteosarcoma

Osteosarcoma is a rare primary bone cancer characterized by cancer cells producing calcified osteoid extracellular matrix and inducing lung metastases with a high frequency. The local microenvironment defined several tumor niches controlling the tumor growth and cell extravasation. The immune infiltrate composes one of these niches. The immune environment of osteosarcoma is mainly composed by T-lymphocytes and macrophages but also contains other subpopulations including B-lymphocytes and mast cells. Osteosarcoma cells control the recruitment and differentiation of immune infiltrating cells and establish a local immune tolerant environment favorable to the tumor growth, drug resistance and the occurrence of metastases. Osteosarcoma cells are able to affect the balance between M1 and M2 macrophage subtypes and so could control the T-lymphocyte responses via the PD-1/PDL-1 system. In addition, mesenchymal stem cells may also contribute to this immune tolerance and strengthen the immune evasion. The present review gives a brief overview of the immune components of osteosarcoma and their most recent therapeutic interests.

Epithelioid Osteosarcoma with Pseudo-Glandular Structures: A Case Report and Review of the Literature

Epithelioid osteosarcoma is an uncommon subtype of conventional osteosarcoma that comprised of both typical osteosarcoma component and epithelioid cells. It often occurs in adolescent and children. In here, we report a case of epithelioid osteosarcoma of a 12-year-old Chinese boy. Microscopically, the tumor contains large epithelioid cell with abundant cytoplasm and osteoid forming malignant cells, and partially, the tumor cells arranged in pseudoglandular structures. To our knowledge, it is the first report of epithelioid osteosarcoma with pseudo-glandular structure. The epithelioid cells expressed vimentin and epithelial membrane antigen but did not expressed cytokeratin.

Inhibition of hypoxia-inducible factor-1 alpha radiosensitized MG-63 human osteosarcoma cells in vitro.

Hypoxia is a fundamental microenvironmental component of osteosarcoma which induces activation of the hypoxia-inducible factor-1 (HIF-1) pathway. Overexpression of HIF-1α has been linked to tumor resistance to radio- or chemotherapy. However, little is known about the effects of HIF-1α inhibition on hypoxic radioresistance of human osteosarcoma cells. Here, we investigated the effects of HIF-1α inhibition on cell survival and radiosensitivity in the MG-63 human osteosarcoma cell line. HIF-1α inhibition was achieved by small interfering RNA (siRNA) targeting of HIF-1α or via chetomin. Inhibition of the HIF-1 pathway was determined by monitoring the expression levels of HIF-1α, carbonic anhydrase 9 (CA9) and vascular endothelial growth factor (VEGF) using quantitative real-time PCR and Western blot analyses. Clonogenic assay was performed after irradiation (2-10 Gy) to investigate the effect of HIF-1α inhibition on the radiosensitivity of human osteosarcoma cells under normoxic and hypoxic conditions. Compared to the control groups, treatment with HIF-1α siRNA or chetomin significantly reduced the hypoxia-inducible radioresistance of MG-63 cells. However, siRNA and chetomin showed different effects on the radiosensitivity under normoxic conditions. Our results indicate that inhibition of HIF-1α effectively decreases hypoxia-induced transcription and radiosensitizes hypoxic MG-63 human osteosarcoma cells in vitro.

β-catenin is a valuable marker for differential diagnosis of osteoblastoma and osteosarcoma.

Osteoblastoma (OB) and osteosarcoma (OS) are 2 bone tumors that predominantly affect young adults. The clinical management of OS differs significantly from that of OB, and thus, accurate diagnosis of OB and OS is critical in determining appropriate treatment modality. However, in certain cases, OS significantly overlaps with OB in clinical and radiographic characteristics, and therefore, the differential diagnosis of OB and OS can be difficult, especially when biopsy material is insufficient. To date, there have been few reports on markers for differential diagnosis of OB and OS. We have previously shown that the Wnt/β-catenin pathway is inactivated in OS. In this study, we aimed to investigate whether the cellular distribution pattern of β-catenin is a potential marker for the differential diagnosis of OB and OS. Immunohistochemical staining was studied in 17 OB samples (21 biopsies; 17 primary and 4 recurrent) and 37 OS samples with complete follow-up information. Moderate-to-strong nuclear β-catenin staining was found in all OB specimens (17/17). In contrast, positive staining of β-catenin was found in the cytoplasm and/or membrane but not the nucleus in all 32 cases of nonchondroblastic OS (32/32) and the classic OS component in chondroblastic OS (5/5). The only positive nuclear β-catenin staining detected in OS biopsies was in chondroblastic OS cells (5/5). In summary, our results indicate that, in addition to conventional histopathologic evaluation, cellular distribution of β-catenin may be used as a valuable marker in the differential diagnosis of OB and OS. Nuclear β-catenin staining strongly suggests OB, whereas cytoplasmic/membranous staining of β-catenin suggests OS.

高分化型脂肪肉腫と低悪性度骨肉腫とが併存した5.5kgの腹膜外腫瘍の1例

高分化型脂肪肉腫と低悪性度骨肉腫とが併存した5.5kgの腹膜外腫瘍の1例

Metaplastic carcinoma of the breast with transformation from adenosquamous carcinoma to osteosarcomatoid and spindle cell morphology

Metaplastic carcinoma of the breast refers to a heterogenous group of mammary carcinomas that contain a mixture of various cell types, including squamous cells, spindle cells and/or a mesenchymal component, such as bone or cartilage. To the best of our knowledge, the clinical course of a tumour that has undergone a transformation from one type of metaplastic carcinoma to another subtype has not previously been reported. The present study reports the five-year clinical and pathological course of a metaplastic breast carcinoma in a 55-year-old female, who was diagnosed with a sclerosing fibroadenomatous nodule with osseous metaplasia and focal atypia. A recurrent tumour was documented four years later, showing a predominant component of osteosarcoma with adenosquamous carcinoma. Upon pathological review of the initial mass, the diagnosis was changed to low-grade adenosquamous carcinoma. The patient was treated with breast conserving therapy. However, one year later, a recurrent metaplastic carcinoma with spindle cell morphology was documented and surgically removed by mastectomy. Subsequently, pulmonary invasion of the chest wall occurred and the patient eventually succumbed due to the invasive nature of the disease.

Autopsy: failed intubation – what was the cause?

Aim and Methods A 77-year-old man presented to the Emergency Department with profound shortness of breath. The intubation failed due to upper airway obstruction and subsequently he underwent cri-cothyroidotomy. He had a cardiac arrest for up to 20 minutes in the Emergency Department. He was transferred to the Intensive Care Unit. He showed evidence of global ischaemia of the brain and his life support equipment was stopped after 3 days. His past medical history included beta thalassaemia and C3 to C7 laminectomy for severe cervical myelopathy 4 months prior to his death. Results The autopsy revealed a polypoid laryngeal tumour 3.2 cm in maximum dimension arising from the right vocal cord. The tumour extended to the glottic and supraglottic spaces. The superior aspect of the tumour was visible behind the epiglottis. Histologically, the tumour was a carcinosarcoma with squamous cell carcinoma and osteosarcoma component with sarcomatous component overgrowth. Discussion Carcinosarcoma of the larynx is a very rare tumour predominantly occurring in elderly males. They are rapidly growing polypoid tumours which often present with acute airway obstruction. In this case, the retrospective review of the MRI performed 4 months ago for the cervical laminectomy showed a 0.7 cm nodule on the vocal cord.

Pulmonary carcinosarcoma with an osteosarcomatous component

Pulmonary carcinosarcoma is a rare disease entity defined as a neoplasm, which has biphasic features consisting of both epithelial and sarcomatous components. It has been reported that the most frequent epithelial component is squamous cell carcinoma, while the most frequent sarcomatous component is rhabdomyosarcoma. Pulmonary carcinosarcomas with osteosarcoma components are even rarer. We report a case of a potentially curative resection for carcinosarcoma with an osteosarcoma component. Thoracic surgeons should be aware of this rare tumor when lung tumors with ossification are encountered.

骨肉腫と平滑筋肉腫成分を認めた後腹膜脱分化型脂肪肉腫の1例

症例は50歳，男性．左側腹部痛を主訴に前医を受診し，同部に腫瘤を指摘され紹介となった．初診時に左下腹部に圧痛を伴う可動性不良な腫瘤を触知した．血液生化学検査では炎症反応の上昇と軽度貧血を認めた．CTでは下行結腸背側に手拳大の腫瘍を認め，内部は均一で一部に石灰化を伴っていた．MRIではT1強調・T2強調像で腫瘍は不均一な高信号を示した．後腹膜腫瘍と診断し，下行結腸と一塊に腫瘍を切除した．腫瘍は10.5×7.0×7.0cm，割面は充実性で白色調の部位と黄色調の部位が混在していた．病理組織学検査では紡錘形細胞が車軸状に増殖する像を認め，悪性線維組織球腫に類似した所見であった．CDK4およびMDM2が陽性で，腫瘍内には骨肉腫と平滑筋肉種の成分も認め，骨肉腫と平滑筋肉腫への分化を示す脱分極型脂肪肉腫と診断した．

Pemetrexed, a multitargeted antifolate drug, demonstrates lower efficacy in comparison to methotrexate against osteosarcoma cell lines

The folate inhibitor methotrexate (MTX) is an important component of osteosarcoma (OS) treatment regimens. New generation multitargeted antifolates, such as pemetrexed (PMX), have shown promise in the treatment of various solid tumors. In this study, the in vitro efficacy of MTX and PMX was compared in OS cell lines. MTX demonstrated a superior cytotoxic effect in comparison to PMX in all tested cell lines. Apoptosis assays revealed that both MTX and PMX induce apoptosis but MTX demonstrated superior efficacy. These in vitro results suggest that PMX as a single agent may not demonstrate improved efficacy compared to MTX in OS patients.

Case of postradiation osteosarcoma with a short latency period of 3 years.

Osteosarcoma is one of the neoplasms that may occur following exposure to radiation. A case of osteosarcoma arising in the craniofacial bone with a short latency period of 3 years after radiotherapy for maxillary squamous cell carcinoma is described. A 64-year-old-man underwent right partial maxillectomy and chemoradiotherapy due to squamous cell carcinoma of his right maxillary sinus. Histologically, the tumor was composed of moderately differentiated squamous cell carcinoma with a component of spindle cell carcinoma. Three years later, osteosarcoma developed in the craniofacial bone within the irradiation field of the first tumor. Detailed histological examination demonstrated that there was no component of osteosarcoma in the first tumor or squamous cell carcinoma in the second tumor. Radiation-induced osteosarcoma usually occurs after a long latency period of more than 10 years after the radiotherapy. In this case, osteosarcoma was possibly a radiation-induced osteosarcoma with a short latency period of 3 years.

Laryngeal osteosarcoma: A clinicopathologic analysis of four cases and comparison with a carcinosarcoma

We report the clinicopathologic findings of four cases of laryngeal osteosarcoma and one of carcinosarcoma with osteosarcoma components. The tumors occurred in men ranging in age from 50 to 69 years within a median age of 63.3 years. The most common symptoms were hoarseness, dyspnea, and obstruction, or a combination of these. Biopsy material and intraoperative frozen sections usually showed a high-grade sarcoma, but the diagnosis of osteosarcoma was quite apparent on microscopic examination of the surgical specimen. The primary differential diagnosis is spindle cell carcinoma with osteoid formation. Pulmonary metastases and local recurrences were common. Surgery is the treatment of choice, followed by adjuvant chemotherapy. Whether to use radiotherapy or not should be decided on an individual basis.

Evaluation of osteonectin as a diagnostic marker of osteogenic bone tumors

Osteonectin (ON), a 32,000-kd glycoprotein involved in the early steps of mineralization of skeletal tissue, is a recognized differentiation marker of normal osteogenic cells. The expression of ON was evaluated in vitro and in tissue sections by the polyclonal antibody bON II. In different cell cultures immunocytochemistry and molecular biology displayed a nonspecific reaction for the antibody, which showed itself to be useless for the in vitro identification of cells of the osteoblastic lineage. The diagnostic use of bON II antibody was investigated by immunohistochemistry on a series of osteogenic and nonosteogenic bone tumors. A strongly positive stain of the entire neoplastic component of osteosarcoma and osteoblastoma and a weaker stain of the mononuclear component of giant cell tumor and chondroblastoma were observed. On the other hand, stains for chondrosarcoma, Ewing's sarcoma, fibrosarcoma, malignant fibrous histiocytoma, and brown tumor from hyperparathyroidism were entirely negative. Our results indicate that ON may be helpful in the histologic diagnosis of bone tumors, particularly in differentiating small cell osteosarcoma from other small round cell tumors.

True Carcinosarcoma of the Maxillary Sinus

A case of true carcinosarcoma primarily arising in the right maxillary sinus is reported in a 60-year-old male. His chief complaints were right nasal obstruction and bleeding. Histological findings of the biopsied primary tumor revealed two components of keratinizing squamous cell carcinoma and osteosarcoma which were intricately intermingled. Despite intensive irradiation and chemotherapy, and total maxillectomy, he finally died of rapid tumor recurrence and widely spreading metastases to lungs, pleurae and brain two months later. At autopsy the recurrent and metastatic tumors consisted entirely of the osteosarcoma component, suggesting the efficiency of the radiotherapy and chemotherapy against the carcinomatous component, but not against the sarcomatous one. As for histogenesis, this case was compatible with a combination tumor judging from histologic, immunohistochemical and electron microscopic findings.