Variety Of Soft Tissue Lesions Research Articles

The contribution of Juan Rosai to the pathology of soft tissue tumors.

SummaryThe conceptual evolution in the field of soft tissue tumor pathology has been mostly driven by a relatively small group of individuals that includes giants of the past and the present such as James Ewing, Raffaele Lattes, Arthur Purdy Stout, Franz Enzinger, Sharon Weiss, Lennart Angervall, Harry Evans, Marku Miettinen, and Christopher Fletcher. Juan Rosai, not only exerted an immense impact on surgical pathology in general, but in consideration of his unique talent in identifying novel clinicopathologic entities, has also contributed remarkably to current understanding of mesenchymal neoplasms. The creation of desmoplastic small round cell tumor certainly ranks among his most relevant efforts, although he actually put his mark on a broad variety of soft tissue lesions, including vascular neoplasms. It would be impossible to include in a single article all the entities that he created or contributed to refine; therefore, this review is limited to a selection of what we believe represent true milestones.

Is shear wave elastography relevant in the diagnosis of polycystic ovarian syndrome?

The aim of this study was to determine the contribution of Shear Wave Elastography (SWE) to the diagnosis of polycysticovarian syndrome (PCOS). Thirty-seven patients with PCOS diagnosis criteria were includedin the study. Sixteen volunteer patients without hormonal disturbances and with normal menstrual cycles were evaluated as thecontrol group. Gray scale ultrasonography (US) and SWE measurements in both ovaries were performed by a single radiologistwho was blinded to the clinical and laboratory results. The SWE measurements in PCOS group were 8.4±2.0 kPafor the right ovary and 9.4±3.9 kPa for the left ovary and in the control group 7.8±4.1 for the right ovary and 8.6±2.5 kPa forthe left ovary. There was no statistically significant difference between the PCOS and the control group according to the SWEresults (for right ovary p=0.356, for left ovary p=0.258, and total ovary p=0.293). The ovarian morphology isstill the most reliable imaging finding in the diagnosis of PCOS, although it is controversial especially among adolescents.Although the diagnostic efficacy of SWE is demonstrated in a variety of soft tissue lesions, we did not find any significantcontribution of SWE to the diagnosis PCOS. Therefore, the promising value of elastography is yet to be defined for the diagnosisof PCOS.

Prevalence of Oral Mucosal Lesions in a Tertiary Care Dental Hospital of Kathmandu

Oral mucosa can be affected by a variety of soft tissue lesions and conditions. Benign as well as malignant lesions of oral cavity are common. Squamous cell carcinoma is one of the commonest malignancies. The present retrospective study was undertaken to study the prevalence of various oral mucosal lesions in a tertiary care dental hospital of Kathmandu. This retrospective study was carried out in the Department of Oral and Maxillofacial Pathology at Kantipur Dental College and Teaching hospital from January 2015 to January 2017. The study included biopsy specimen from the oral cavity. The parameters included in the study were age, gender, site of the lesion and histopathological diagnosis. The data collected was statistically analyzed. A total of 111 biopsy cases were included in the present study. Out of which, there were 16 (14.4%) cases of non-neoplastic and 16 (14.4%) cases of benign pathology. The oral cavity lesions were commonly seen in age range between 6-74 years where males 59 (53.2%) were mostly affected. The most common site for oral lesion was buccal mucosa 23 (20.7%) and anterior gingiva 23 (20.7%). Total 15 (13.5%) cases of oral squamous cell carcinoma were seen as the predominant malignancy affecting in the vestibular region 8 (7.2%). The present study shows benign as well as the non-neoplastic lesions were more prevalent in oral mucosa with the buccal mucosa and anterior gingiva as the commonest site of occurrence.

Endoscopic Removal of Benign Forehead Tumors: Patient Satisfaction With Decision Making and Scar Outcomes

The endoscopic approach is an alternative treatment to direct excision of benign forehead tumors. Prior publications describe the technique and outcomes. Our study assumes a quality improvement perspective, focusing on patient satisfaction with decision making and scar outcomes. This is a retrospective case series study of adult patients who underwent endoscopic removal of benign forehead tumors at Kaiser Permanente Oakland from 2006 to 2016. Data were collected pertaining to surgical outcomes, patient satisfaction using validated instruments. Thirty adult patients were included. Mean operating time was 60 minutes. Forehead tumors included osteomas and a variety of soft tissue lesions. Transient complications included hypoesthesia, seroma, and frontalis weakness. A recurrence of an epidermal inclusion cyst occurred. Patients reported nearly complete satisfaction with decision making and scar outcomes. Endoscopic removal of benign forehead tumors is a safe and effective treatment. Patient satisfaction with decision making and the scar is excellent. Further studies are needed to compare the endoscopic approach to direct excision. The surgeon should offer the endoscopic approach and appropriate counseling to the patient with a benign forehead tumor.

Schwannoma of the nasal cavity: A case report and a review

Nasal polyps constitute the clinical presentation of a variety of soft tissue lesions involving the nose. Benign nerve sheath tumors are rare lesions that can present in the nasal cavity. Herein, we present a rare case of nasal schwannoma, and we review the clinical and the radiological features of cases published as nasal cavity schwannoma in the English literature. Extensive PubMed search revealed only 17 cases of schwannoma of the nasal cavity reported during the period 2000-2013. The mean age of presentation was 39 years, and a female predilection was observed. The main radiological feature was a homogenous well circumscribed mass on plain radiography with intermediate intensity on T1-weighted and T2-weighted and homogenous enhancement on contrast magnetic resonance imaging. No invasive growth pattern or cranial extension was reported. The histological features of nasal cavity schwannomas were similar to their soft tissue counterparts. The literature shows that malignant cases are rare.

The hierarchy of approaches to tobacco control

Tobacco represents the single most preventable cause of disease and death in the world today. Of 260 million male deaths in the developed world between 1950 and 2000, it is estimated that 50 million will be due to smoking. In the oral and craniofacial region tobacco use has been associated with the occurrence of cleft palate, periodontal disease and tooth loss, and a variety of soft tissue lesions including oral cancer. For example, smoking is estimated to account for 92% of cancers of the lip, oral cavity and pharynx. Few studies have examined relative efficiency of the many different approaches to tobacco control but, in general, legislative approaches such as increasing tobacco taxes and prohibiting advertising are most effective and those based on printed educational materials and cessation groups, the least effective. In all cases, advice or intervention by health care professionals ranked among the most effective non-legislative approaches to control. A very wide range of professionally-based interventions have been described, including pharmacologic interventions, behavioral approaches and group counseling. The dental profession has a unique opportunity to influence tobacco use by their patients. Its use is almost always immediately evident to the dentist or dental assistant in terms of odor, staining, poor oral hygiene or obvious oral disease. There is also a tendency for the length of personal contact with the dentist to be greater than with a physician. Guidelines are now available that provide the dental professional with advice on the best approaches to tobacco control with their patients.

Magnetic Resonance Imaging of Soft Tissues of the Neck

Magnetic resonance imaging (MRI) has proven to be an ideal examination for evaluating a variety of soft tissue lesions in the extracranial head and neck. In this article we will describe the MRI characteristics of a variety of the soft tissue lesions found in the neck. Pathophysiology, clinical presentation, treatment, and prognosis are also discussed.

Gardner's syndrome: Six generations

A family of 68 members in six generations has been investigated, and thus far 23 of these have had colorectal polyposis, cancer, or both. Many of the 23 have had a variety of soft tissue lesions, occult osteomas of the mandible, and dental abnormalities. Six of nine siblings in the proband's immediate family had diffuse colorectal polyposis and soft tissue lesions, as have 4 of their 20 children. One of three members of the most recent generation has polyposis and skin lesions. Retrospectively, 2 of the proband's 18 maternal cousins had colorectal polyposis or cancer, as did five of six siblings in her mother's generation. Four of nine siblings in the previous generation died from colon cancer, and so did their father. In the first three generations cancer was prevented in only 1 of 10 patients. Two of 13 in the later three generations thus far have died from colorectal cancer. Both coloproctectomy and colectomy with preservation of the rectum have been utilized in the patients in this study. Lifelong follow up is underway for those whose rectum has not been removed.

Radionuclide imaging of soft tissue neoplasms

Two classes of radiopharmaceuticals may be used for imaging tumors of the musculoskeletal system. The first is comprised of soft tissue or tumor specific agents such as gallium-67, bleomycin, and radionuclide-labeled antibodies, which may be useful for detecting and localizing these tumors. The other class of tracer is comprised of those with avidity for bone. The 99mTc-labeled-phosphate skeletal imaging compounds have been found to localize in a variety of soft tissue lesions, including benign and malignant tumors. In 1972, Enneking began to include bone scans in the preoperative evaluation of soft tissue masses. Later, he and his associates reported that these scans were useful in planning operative treatment of sarcomas by detecting involvement of bone by the tumors. Nearly all malignant soft tissue tumors take up bone-seeking radiopharmaceuticals, and bone involvement was indicated in two-thirds of the scans we reviewed. About half of benign soft tissue lesions had normal scans, but the other half showed uptake within the lesion and a few also showed bone involvement. Careful, thorough imaging technique is essential to proper evaluation. Multiple, high-resolution static gamma camera images in different projections are necessary to adequately demonstrate the presence or absence of soft tissue abnormality and to define the precise relationship of the tumor to the adjacent bone.

Soft Tissue Reconstruction of Nasal Defects

SummaryA large variety of soft tissue lesions of the nose are presented. The different operative procedures used are discussed, and preference for a surgical procedure in a particular situation is indicated.