Purpose: Development of sarcoma is a known late rare negative side effect of radiotherapy. We add two cases to emphasize the need for open-end follow-up and critical evaluation to avoid misinterpretation. Patients, Me...Purpose: Development of sarcoma is a known late rare negative side effect of radiotherapy. We add two cases to emphasize the need for open-end follow-up and critical evaluation to avoid misinterpretation. Patients, Methods, and Results: Two patients developed osteosarcoma as a second malignancy in the humerus after adjuvant radiotherapy of a primary tumor not directly involving the later affected bone. The first patient had a Ewing sarcoma of the scapula at age 13 years. Though after neoadjuvant chemotherapy the resected specimen showed only fibrotic necrotic areas within clear resection margins, the study group indicated adjuvant radiotherapy in a field including the shoulder joint. At age 24 years she developed an osteosarcoma of the humeral head, which was resected and reconstructed with a proximal humerus endoprosthesis. She is alive without disease at age 32 years. The second patient presented with an osteosarcoma of the proximal humerus 29 years after irradiation for breast cancer including the shoulder joint. The sarcoma was misinterpreted as radiation-induced necrosis and the patient was treated with a reverse shoulder endoprosthesis. Pathologic examination of the resected humeral head then showed a typical osteosarcoma. Two years later the humeral reverse shoulder implant was resected and a proximal humerus tumor prosthesis implanted leaving the original glenosphere. Conclusions: In both cases radiation-induced osteosarcoma developed in bone not affected by the primary cancer. Protecting uninvolved structures must be warranted in the planning of radiotherapy. The long latency between the primary and second cancer mandates long-term—best indefinite—follow-up, as with appropriate treatment of a radiation-induced osteosarcoma good healing rates comparable to those of primary osteosarcoma can still be achieved.展开更多
Liposarcoma of the breast is a very rare malignant tumor. It can clinically manifest as a palpable breast mass and mimic primary breast cancer. We report an unusual case of a 51-year-old female who presented with an a...Liposarcoma of the breast is a very rare malignant tumor. It can clinically manifest as a palpable breast mass and mimic primary breast cancer. We report an unusual case of a 51-year-old female who presented with an asymptomatic right breast mass, which was histologically diagnosed as well differentiated liposarcoma arisen within malignant phyllodes tumor. The patient underwent breast conserving surgery, received no adjuvant treatment and is disease-free after 2 years. Radiological and histopathological features are presented and described in detail. Data from the literature are presented and therapy recommendations discussed.展开更多
OBJECTIVE To investigate the clinical and pathologicalcharacteristics, diagnosis and treatment of stromal sarcoma ofthe breast (SSB). Methods: The clinical and pathological dataof 6 patients with SSB treated between 1...OBJECTIVE To investigate the clinical and pathologicalcharacteristics, diagnosis and treatment of stromal sarcoma ofthe breast (SSB). Methods: The clinical and pathological dataof 6 patients with SSB treated between 1954 and 2007 wereretrospectively analyzed.METHODS The clinical and pathological data of 6 patients withSSB treated between 1954 and 2007 were retrospectively analyzed.RESULTS All patients were female and one was menopausal.The median age of the patients was 39 years old (range, 20-55).All cases had a history of a palpable mass. The tumor rapidlyaugmented in a short time period in 3 patients. One patient haddiscontinuous pain and 3 patients had masses located in the upperouter quadrant of the breast. The median tumor radius was 6.0cm (range, 3-15 cm). According to the AJCC breast cancer stagingstandard (6th edition), 1 case was of stage ⅡA, 2 cases were ofstage ⅡB, 2 cases were of stage ⅢB and one case couldn't bestaged. Four patients were initially treated by excising the tumorand then undergoing mastectomy or modified radical mastectomyafter recurrence. Radical mastectomy was suitable for those withpectoralis major muscle involvement. Two patients receivedsimple mastectomy, 2 patients underwent radical mastectomy andanother 2 patients received modified radical mastectomy. Aftersurgery, all patients were identified as SSB through pathology,with focal ossification in one case and mucinous degeneration inanother one case. Four patients who underwent axillary lymphnode dissection did not have lymph node metastases. Threepatients received chemotherapy after surgery. After a medianfollow-up time of 36.5 months (8-204 months), 4 patients hadrecurrence after local excision and 3 patients had recurrence morethan 2 times with a median time to recurrence of 2.5 months (1to 4 months) after surgery. One patient had lung metastases at 7months after the initial surgery and the other 5 patients were alivewithout disease at the end of the follow-up period.CONCLUSION SSB is difficult to diagnose preoperativelyand is characterized by its tendency to recur locally. To obtainnegative margins, wide local excision or mastectomy must beperformed. Axillary lymph node dissection is not mandatory. Theroles of adjuvant chemotherapy and radiotherapy have still beencontroversial.展开更多
Follicular dendritic cell sarcomas (FDC-Sarcoma) are a rare type of tumor. Although most cases (60%) originate in the cervical, abdominal, or axillary lymph nodes, extranodal origin from secondary lymphatic tissue suc...Follicular dendritic cell sarcomas (FDC-Sarcoma) are a rare type of tumor. Although most cases (60%) originate in the cervical, abdominal, or axillary lymph nodes, extranodal origin from secondary lymphatic tissue such as the tonsils, Waldeyer’s ring, or MALT is also prevalent (40%). We report a case of cervical FDCS in a 51-year-old female who developed invasive breast cancer during follow-up. We review the presentation and management of this disorder, emphasizing the differential diagnosis. The patient was continuously monitored and has been free of recurrences for ten years. For FDC Sarcoma of the head and neck, this case suggests surgical resection combined with chemotherapy and radiotherapy as a therapeutic option.展开更多
Endometrial Stromal Sarcoma (ESS) is a rare uterine malignancy. The annual incidence of ESS has been reported as 1 - 2 per million women. In the general population approximately 10 percent of cancer patients may devel...Endometrial Stromal Sarcoma (ESS) is a rare uterine malignancy. The annual incidence of ESS has been reported as 1 - 2 per million women. In the general population approximately 10 percent of cancer patients may develop a second primary cancer. Synchronous multiple primary tumors constitute only 20% of all multiple primary tumors, and by definition, occur within a period of two month. This case report is presented to document the occurrence of ESS as a “Synchronous Multiple Primary Tumor”, which is an extremely rare event. Previously only one case report has documented such an occurrence. The literature is also briefly reviewed. This case underlines the requirement of a thorough initial evaluation for a patient with a gynecological malignancy and a regular follow-up. Follow-up includes patient education regarding symptoms of any recurrence, physical examination repeated at 6 - 12 monthly interval, along with imaging studies when indicated.展开更多
目的：探讨乳腺间质肉瘤（Stromal sarcoma of the breast，SSB）的临床病理特征、诊治方法及预后。方法：对天津医科大学附属肿瘤医院1954年5月～2007年9月收治的6例SSB患者的临床病理资料进行回顾性分析。结果：患者均为女性，1例绝...目的：探讨乳腺间质肉瘤（Stromal sarcoma of the breast，SSB）的临床病理特征、诊治方法及预后。方法：对天津医科大学附属肿瘤医院1954年5月～2007年9月收治的6例SSB患者的临床病理资料进行回顾性分析。结果：患者均为女性，1例绝经。发病年龄20～55岁，中位年龄38岁。患者均以乳腺肿物为首发症状，3例位于乳腺外上象限，肿物中位最大直径6cm（3～15cm），3例有肿块短时间内迅速增大的病史，1例伴间断性疼痛。按美国肿瘤联合会（AJCC）制定的临床及病理分期（第六版）标准：ⅡA期1例，ⅡB期2例，ⅢB期2例，1例无法评估。4例患者首次治疗采用乳腺肿物局部切除术，复发后采用全乳切除或改良根治术，侵犯胸大肌者则行根治术。最终2例行全乳切除术，2例行乳腺根治术，2例行乳腺改良根治术。术后病理证实均为乳腺间质肉瘤，其中1例伴灶性骨化，1例伴粘液变性。4例患者首次行腋窝淋巴结清扫，均未见淋巴结转移。术后3例患者行辅助化疗，所有患者均未行放疗。术后中位随访36．5个月（8～204个月）间，4例行肿物局部切除术的患者均复发，其中3例患者2次以上复发，首次复发中位时间为2．5个月（1～4个月）。1例患者于术后7个月出现双肺转移，未治疗，余5例患者均无瘤生存。结论：乳腺间质肉瘤术前诊断困难，肿物局部切除术后易复发，保证切缘阴性的局部扩大切除术或全乳切除术是治疗乳腺间质肉瘤的合适手段，腋淋巴结清扫是不必要的。术后辅助化疗、放疗的疗效尚不明确。展开更多
文摘Purpose: Development of sarcoma is a known late rare negative side effect of radiotherapy. We add two cases to emphasize the need for open-end follow-up and critical evaluation to avoid misinterpretation. Patients, Methods, and Results: Two patients developed osteosarcoma as a second malignancy in the humerus after adjuvant radiotherapy of a primary tumor not directly involving the later affected bone. The first patient had a Ewing sarcoma of the scapula at age 13 years. Though after neoadjuvant chemotherapy the resected specimen showed only fibrotic necrotic areas within clear resection margins, the study group indicated adjuvant radiotherapy in a field including the shoulder joint. At age 24 years she developed an osteosarcoma of the humeral head, which was resected and reconstructed with a proximal humerus endoprosthesis. She is alive without disease at age 32 years. The second patient presented with an osteosarcoma of the proximal humerus 29 years after irradiation for breast cancer including the shoulder joint. The sarcoma was misinterpreted as radiation-induced necrosis and the patient was treated with a reverse shoulder endoprosthesis. Pathologic examination of the resected humeral head then showed a typical osteosarcoma. Two years later the humeral reverse shoulder implant was resected and a proximal humerus tumor prosthesis implanted leaving the original glenosphere. Conclusions: In both cases radiation-induced osteosarcoma developed in bone not affected by the primary cancer. Protecting uninvolved structures must be warranted in the planning of radiotherapy. The long latency between the primary and second cancer mandates long-term—best indefinite—follow-up, as with appropriate treatment of a radiation-induced osteosarcoma good healing rates comparable to those of primary osteosarcoma can still be achieved.
文摘Liposarcoma of the breast is a very rare malignant tumor. It can clinically manifest as a palpable breast mass and mimic primary breast cancer. We report an unusual case of a 51-year-old female who presented with an asymptomatic right breast mass, which was histologically diagnosed as well differentiated liposarcoma arisen within malignant phyllodes tumor. The patient underwent breast conserving surgery, received no adjuvant treatment and is disease-free after 2 years. Radiological and histopathological features are presented and described in detail. Data from the literature are presented and therapy recommendations discussed.
文摘OBJECTIVE To investigate the clinical and pathologicalcharacteristics, diagnosis and treatment of stromal sarcoma ofthe breast (SSB). Methods: The clinical and pathological dataof 6 patients with SSB treated between 1954 and 2007 wereretrospectively analyzed.METHODS The clinical and pathological data of 6 patients withSSB treated between 1954 and 2007 were retrospectively analyzed.RESULTS All patients were female and one was menopausal.The median age of the patients was 39 years old (range, 20-55).All cases had a history of a palpable mass. The tumor rapidlyaugmented in a short time period in 3 patients. One patient haddiscontinuous pain and 3 patients had masses located in the upperouter quadrant of the breast. The median tumor radius was 6.0cm (range, 3-15 cm). According to the AJCC breast cancer stagingstandard (6th edition), 1 case was of stage ⅡA, 2 cases were ofstage ⅡB, 2 cases were of stage ⅢB and one case couldn't bestaged. Four patients were initially treated by excising the tumorand then undergoing mastectomy or modified radical mastectomyafter recurrence. Radical mastectomy was suitable for those withpectoralis major muscle involvement. Two patients receivedsimple mastectomy, 2 patients underwent radical mastectomy andanother 2 patients received modified radical mastectomy. Aftersurgery, all patients were identified as SSB through pathology,with focal ossification in one case and mucinous degeneration inanother one case. Four patients who underwent axillary lymphnode dissection did not have lymph node metastases. Threepatients received chemotherapy after surgery. After a medianfollow-up time of 36.5 months (8-204 months), 4 patients hadrecurrence after local excision and 3 patients had recurrence morethan 2 times with a median time to recurrence of 2.5 months (1to 4 months) after surgery. One patient had lung metastases at 7months after the initial surgery and the other 5 patients were alivewithout disease at the end of the follow-up period.CONCLUSION SSB is difficult to diagnose preoperativelyand is characterized by its tendency to recur locally. To obtainnegative margins, wide local excision or mastectomy must beperformed. Axillary lymph node dissection is not mandatory. Theroles of adjuvant chemotherapy and radiotherapy have still beencontroversial.
文摘Follicular dendritic cell sarcomas (FDC-Sarcoma) are a rare type of tumor. Although most cases (60%) originate in the cervical, abdominal, or axillary lymph nodes, extranodal origin from secondary lymphatic tissue such as the tonsils, Waldeyer’s ring, or MALT is also prevalent (40%). We report a case of cervical FDCS in a 51-year-old female who developed invasive breast cancer during follow-up. We review the presentation and management of this disorder, emphasizing the differential diagnosis. The patient was continuously monitored and has been free of recurrences for ten years. For FDC Sarcoma of the head and neck, this case suggests surgical resection combined with chemotherapy and radiotherapy as a therapeutic option.
文摘Endometrial Stromal Sarcoma (ESS) is a rare uterine malignancy. The annual incidence of ESS has been reported as 1 - 2 per million women. In the general population approximately 10 percent of cancer patients may develop a second primary cancer. Synchronous multiple primary tumors constitute only 20% of all multiple primary tumors, and by definition, occur within a period of two month. This case report is presented to document the occurrence of ESS as a “Synchronous Multiple Primary Tumor”, which is an extremely rare event. Previously only one case report has documented such an occurrence. The literature is also briefly reviewed. This case underlines the requirement of a thorough initial evaluation for a patient with a gynecological malignancy and a regular follow-up. Follow-up includes patient education regarding symptoms of any recurrence, physical examination repeated at 6 - 12 monthly interval, along with imaging studies when indicated.
文摘目的：探讨乳腺间质肉瘤（Stromal sarcoma of the breast，SSB）的临床病理特征、诊治方法及预后。方法：对天津医科大学附属肿瘤医院1954年5月～2007年9月收治的6例SSB患者的临床病理资料进行回顾性分析。结果：患者均为女性，1例绝经。发病年龄20～55岁，中位年龄38岁。患者均以乳腺肿物为首发症状，3例位于乳腺外上象限，肿物中位最大直径6cm（3～15cm），3例有肿块短时间内迅速增大的病史，1例伴间断性疼痛。按美国肿瘤联合会（AJCC）制定的临床及病理分期（第六版）标准：ⅡA期1例，ⅡB期2例，ⅢB期2例，1例无法评估。4例患者首次治疗采用乳腺肿物局部切除术，复发后采用全乳切除或改良根治术，侵犯胸大肌者则行根治术。最终2例行全乳切除术，2例行乳腺根治术，2例行乳腺改良根治术。术后病理证实均为乳腺间质肉瘤，其中1例伴灶性骨化，1例伴粘液变性。4例患者首次行腋窝淋巴结清扫，均未见淋巴结转移。术后3例患者行辅助化疗，所有患者均未行放疗。术后中位随访36．5个月（8～204个月）间，4例行肿物局部切除术的患者均复发，其中3例患者2次以上复发，首次复发中位时间为2．5个月（1～4个月）。1例患者于术后7个月出现双肺转移，未治疗，余5例患者均无瘤生存。结论：乳腺间质肉瘤术前诊断困难，肿物局部切除术后易复发，保证切缘阴性的局部扩大切除术或全乳切除术是治疗乳腺间质肉瘤的合适手段，腋淋巴结清扫是不必要的。术后辅助化疗、放疗的疗效尚不明确。
