Primary or secondary clear cell sarcoma of the pancreas is an exceedingly rare and aggressive disease.In addition to pathology,molecular analysis is pivotal in differential diagnosis,especially with malignant melanoma...Primary or secondary clear cell sarcoma of the pancreas is an exceedingly rare and aggressive disease.In addition to pathology,molecular analysis is pivotal in differential diagnosis,especially with malignant melanoma.A key aspect in identifying clear cell sarcoma is specific genetic alterations,notably the translocation of t(12;22)(q13;q13),a diagnostic hallmark of this sarcoma subtype,which is absent in malignant melanoma.Treatment of primary clear cell sarcoma of the pancreas is the same as that for adenocarcinoma.展开更多
BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone an...BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone and brain;however,pancreatic metastasis is relatively rare.CASE SUMMARY We report on a rare case of CCS with pancreatic metastasis in a 47-year-old man.The patient had a relevant medical history 3 years ago,with abdominal pain as the main clinical manifestation.No abnormalities were observed on physical examination and the tumor was found on abdominal computed tomography.Based on the medical history and postoperative pathology,the patient was diagnosed with CCS with pancreatic metastasis.The patient was successfully treated with surgical interventions,including distal pancreatectomy and sple-nectomy.CONCLUSION This report summarizes the available treatment modalities for CCS and the importance of regular postoperative follow-up for patients with CCS.展开更多
This article presents a comprehensive case report on an uncommon instance of metastatic clear cell sarcoma(CCS)originating from the pancreas.The high mortality rate of pancreatic carcinoma underscores the importance o...This article presents a comprehensive case report on an uncommon instance of metastatic clear cell sarcoma(CCS)originating from the pancreas.The high mortality rate of pancreatic carcinoma underscores the importance of precise diagnosis and early detection.The authors report a novel case of CCS with pancreatic metastasis,detailing successful surgical intervention through distal pancreatectomy and splenectomy,resulting in favourable outcomes.This study highlights the standard role of surgery in treating advanced CCS and emphasizes preoperative imaging and thorough patient history assessment.This article also underscores the necessity for long-term surveillance due to the potential for recurrence or metastasis.Despite the favourable recovery postsurgery,the absence of subsequent follow-up evaluation prompts consideration of the need for extended monitoring.This article raises questions about the nature of the pancreatic lesion and suggests the possibility of a primary lesion.Further evidence is crucial to establish the correlation between the features related to the development of the patient's primary and metastatic tumours.In conclusion,this study offers valuable insights into metastatic CCS of the pancreas,highlighting the importance of regular postoperative follow-up for improved outcomes through early detection and intervention.展开更多
In this editorial based on a case report,we delve into a seldom-seen occurrence of clear cell sarcoma featuring pancreatic metastasis in a 47-year-old male patient.Recognized for its typical tendency to metastasize to...In this editorial based on a case report,we delve into a seldom-seen occurrence of clear cell sarcoma featuring pancreatic metastasis in a 47-year-old male patient.Recognized for its typical tendency to metastasize to the lungs,bones,and brain,clear cell sarcoma rarely extends its reach to the pancreas.Despite the initial absence of discernible abnormalities during the patient's physical examination,the manifestation of abdominal pain prompted further investigation.Subsequent abdominal computed tomography brought to light the presence of a pancreatic tumor,culminating in the definitive diagnosis of clear cell sarcoma with pancreatic metastasis.The successful management of this atypical presentation involved a series of surgical interventions,including distal pancreatectomy and splenectomy.This report not only sheds light on the infrequent manifestation of clear cell sarcoma within the pancreas but also underscores the pivotal role of vigilant postoperative follow-up in addressing this rare sarcoma.The emphasis on postoperative care serves as a crucial aspect of the broader narrative,acknowledging the need for ongoing monitoring and management to ensure a comprehensive and successful treatment trajectory for patients with this unique presentation of clear cell sarcoma.展开更多
BACKGROUND Clear cell sarcoma(CCS)is a rare and highly malignant soft tissue tumor,usually occurring in the deep soft tissues of the distal tendons and aponeurosis of the extremities,especially the feet and knees.CCS ...BACKGROUND Clear cell sarcoma(CCS)is a rare and highly malignant soft tissue tumor,usually occurring in the deep soft tissues of the distal tendons and aponeurosis of the extremities,especially the feet and knees.CCS originating in the head and neck is extremely rare.The clinical manifestations of CCS in the head and neck are not typical,and the imaging manifestations have certain characteristics,but the diagnosis still depends on pathological examination and genetic testing.CASE SUMMARY A 33-year-old male patient had paroxysmal headache for more than 4 years,accompanied by nausea and vomiting,which could be relieved after rest.Computed tomography angiography showed a left paraspinal soft tissue mass.Contrast-enhanced imaging showed obvious uneven enhancement with adjacent bone lytic destruction.Magnetic resonance imaging examination showed isosignal on T_(1)-weighted images,slightly high signal on T_(2)-weighted images(T_(2)WI),high signal on Tirm fat suppression sequence,significantly high signal on diffusion weighted imaging,and obvious and uneven enhancement.The lesion invaded the anterior medulla oblongata through the left atlantoaxial foramen and compressed the cervical spinal cord on T_(2)WI.Primary CCS of soft tissue was diagnosed by pathology and genetic examination.CONCLUSION CCS should be considered in the differential diagnosis of soft tissue tumors of the head and neck,and their diagnosis depends on pathological examination and genetic testing.展开更多
BACKGROUND Transcatheter arterial chemoembolization(TACE)is a common treatment for inoperable malignant renal tumors.However,a series of complications may follow the TACE treatment.Spinal cord injury caused by the emb...BACKGROUND Transcatheter arterial chemoembolization(TACE)is a common treatment for inoperable malignant renal tumors.However,a series of complications may follow the TACE treatment.Spinal cord injury caused by the embolization of intercostal or lumbar arteries is extremely rare.CASE SUMMARY We describe a case with quite uncommon spinal cord injury after TACE in a 3-year-old child with clear cell sarcoma of the kidney.Sensory impairment beneath the T10 dermatomes and paraplegia on the day after TACE were found in this patient.Unfortunately,sustained paraplegia still existed for more than 2 mo after TACE despite the large dose of steroids and supportive therapy.CONCLUSION We should draw attention to an uncommon complication of paraplegia after TACE treatment in malignant renal tumors.Although it is rare,the result is disastrous.展开更多
Clear Cell Sarcoma (CCS) is a rare soft tissue sarcoma that corresponds <span style="font-family:Verdana;">to </span><span style="font-family:Verdana;">a less than 1% of all sarco...Clear Cell Sarcoma (CCS) is a rare soft tissue sarcoma that corresponds <span style="font-family:Verdana;">to </span><span style="font-family:Verdana;">a less than 1% of all sarcomas</span><span style="font-family:Verdana;"> and</span><span style="font-family:Verdana;"> is a high degree neoplasm with propensity to disseminate to regional lymph nodes. Regional lymphadenectomies have </span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">controversial impact on sarcomas treatment and survival, even though those patients have higher local recurrence and lower survival. So, sentinel lymph node biopsy must be one option for better regional staging to STS with higher propensity to lymph node commitment. The authors demonstrate two cases of CCS submitted to surgery through compartmental resection associated </span><span style="font-family:Verdana;">with</span><span style="font-family:Verdana;"> the sentinel lymph node biopsy. A literature review about soft tissue sarcoma and lymph node sentinel biopsy </span><span style="font-family:Verdana;">is</span><span style="font-family:Verdana;"> show</span><span style="font-family:Verdana;">n </span><span style="font-family:Verdana;">as an initial experience of two cases.</span>展开更多
Clear cell sarcoma of the kidney (CCSK) is a rare and highly malignant tumor which is usually confused with other kidney tumors. We experienced such a patient and present report this. Case Report A 9-year old girl was...Clear cell sarcoma of the kidney (CCSK) is a rare and highly malignant tumor which is usually confused with other kidney tumors. We experienced such a patient and present report this. Case Report A 9-year old girl was admitted to a local hospital because of fever and a pain in her right abdomen. The computerized tomography showed:展开更多
BACKGROUND Clear cell sarcoma(CCS)of soft tissue is a rare malignant soft tissue sarcoma usually reported to locate at distal end of extremities and rarely at trunk.Herein,we report a case of CCS in pleural cavity.CAS...BACKGROUND Clear cell sarcoma(CCS)of soft tissue is a rare malignant soft tissue sarcoma usually reported to locate at distal end of extremities and rarely at trunk.Herein,we report a case of CCS in pleural cavity.CASE SUMMARY A 31-year-old male was admitted for an uncertain mass in left pleural cavity in routine physical examination without any symptoms.A VATS surgery was performed to remove the tumor.The pathological finding displayed a cystic mass with 6.5 cm at the longest diameter,dark red in section and cysts could be found locally.A strong expression of S-100,HMB45 and Vimentin was detected in immunohistochemical staining,which was inclined to the diagnosis of the CCS of soft tissue.The patient refused chemotherapy,radiotherapy and targeted therapy because of the personal financial situation.Follow-up computed tomography scans were done at the 90th postoperative day and the 180th postoperative day,and no obvious sign of recurrence was found till now.CONCLUSION CCS of soft tissue also can be found in pleural cavity although in an extremely rare incidence.Radical resection is useful to improve the prognosis.展开更多
BACKGROUND Clear cell sarcoma is an aggressive rare malignant neoplasm with morphologic and immunohistochemical similarities to malignant melanoma.Both disease entities display melanin pigment and melanocytic markers,...BACKGROUND Clear cell sarcoma is an aggressive rare malignant neoplasm with morphologic and immunohistochemical similarities to malignant melanoma.Both disease entities display melanin pigment and melanocytic markers,making differentiation between the two difficult.Although clear cell sarcoma cases in the literature have mainly involved deep soft tissues of the extremities,trunk or limb girdles,we report here two cases of primary clear cell sarcoma in unusual sites and describe their clinicopathologic findings.CASE SUMMARY The first case involves a 37-year-old female,who presented with jaw pain and a submandibular mass.The second case involves a 33-year-old male,who presented with back pain and a thoracic spine tumor.Both cases showed tumors with diffuse infiltration of neoplastic cells that were positive for melanocytic markers,and in both cases this finding led to an initial diagnosis of metastatic melanoma.However,further analysis by fluorescence in situ hybridization(commonly known as FISH)showed a rearrangement of the EWS RNA binding protein 1(EWSR1)gene on chromosome 22q12 in both patients,confirming the diagnosis of clear cell sarcoma.CONCLUSION Distinction between clear cell sarcoma and malignant melanoma can be made by FISH,particularly in cases of unusual tumor sites.展开更多
Clear cell sarcoma is usually described as a malignant melanoma of the soft tissues. The overall prognosis is poor because of delay in diagnosis and vague clinical symptoms. It is rarely involved in the gastrointestin...Clear cell sarcoma is usually described as a malignant melanoma of the soft tissues. The overall prognosis is poor because of delay in diagnosis and vague clinical symptoms. It is rarely involved in the gastrointestinal tract, and its diagnosis is often missed secondary to infrequent occurrence and histological resemblance to melanoma. We present two cases of primary CCS of the jejunum whose clinical presentations were complicated by lymph node involvement. Prompt diagnosis and potential aggressive surgical intervention may improve overall survival.展开更多
Introduction: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are one spectrum of rare cutaneous neoplasms that typically arise in sun-exposed skin of older population. AFX/PDS is essentially diagnos...Introduction: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are one spectrum of rare cutaneous neoplasms that typically arise in sun-exposed skin of older population. AFX/PDS is essentially diagnosis of exclusion requiring Immunohistochemical work-up to exclude other types of tumors. Case Report: We present a case involving an ulcerated solitary lesion on the scalp of an elderly man. Histological examination revealed that the dermal tumor was composed of large pleomorphic, epithelioid, and spindle cells with clear cytoplasm. These cells were negative for cytokeratins, melanocytes and smooth muscle markers, but positive for CD10. These findings are consistent with a diagnosis of clear cell (CC) PDS. Conclusion: PDS is a low-grade malignancy that can recur locally and metastasize, which is distinguished from AFX by its larger size and the presence of aggressive histopathologic features including deeper invasion into the subcutaneous tissue, tumor necrosis, and lymphovascular and/or perineural involvement. Among several histopathologic variants, the CC variant is extremely rare with only two cases of PDS reported in the literature to date.展开更多
We report here the case of a young patient with metastatic clear-cell sarcoma of the kidney resistant to standard chemotherapy, and with complete response under sorafenib treatment. The remarkable response of her tumo...We report here the case of a young patient with metastatic clear-cell sarcoma of the kidney resistant to standard chemotherapy, and with complete response under sorafenib treatment. The remarkable response of her tumor to sorafenib led us to study sorafenib molecular targets in the metastatic tissue. Background: Biomarkers predicting response to anti-angiogenic tyrosine kinase inhibitors remain to be identified. Methods and Findings: In this paper, we studied the molecular targets of sorafenib in the lung metastasis of a kidney clear-cell sarcoma. In a patient with complete response under sorafenib treatment, we showed high VEGFR2 expression by tumor endothelial cells from the lung metastasis. Conclusion: The original mechanistic results that we obtained using immunostainings and quantitative RT-PCR on laser-microdissected tumor endothelial cells have a direct application in daily clinical practice: metastatic tumors with a large angiogenic component should be tested for VEGFRs expression to consider anti-angiogenic tyrosine kinase inhibitor treatments.展开更多
Clear-cell sarcoma is a rare, malignant soft tissue tumor that displays melanocytic differentiation with a distinct molecular profile. It is rarely localized in the gastrointestinal tract. Herein we reported a case of...Clear-cell sarcoma is a rare, malignant soft tissue tumor that displays melanocytic differentiation with a distinct molecular profile. It is rarely localized in the gastrointestinal tract. Herein we reported a case of multiple synchronous clear-cell sarcomas of the gastrointestinal tract with parotid gland metastasis. A 51-year-old male patient presented with a growing painless mass under the right ear. A preoperative positron emission tomography/computed tomography showed multiple intestinal masses and a mass in the right parotid with increased glucose uptake, and he underwent operative treatment with resection of three tumors in the jejunum and ileum and then received a right parotidectomy. Postoperative pathological examination showed that cells in the intestinal tumor were consistent with clear-cell sarcoma of the gastrointestinal tract, and the malignant cells in the parotid gland were similar to the intestinal tumor. Immunohistochemical studies revealed positive expression of HMB-45, Melan-A, and S-100. EWSR1 gene fusion transcripts were undetectable by fluorescence in situ hybridization.展开更多
目的探讨分析儿童肾透明细胞肉瘤(clear cell sarcom a of the kidney,CCSK)的影像学特征,以提高对本病的认识。方法选取经手术病理证实的13例CCSK患儿的临床及影像学资料。采用CT、超声检查,将所得图像传入后处理工作站行冠状位及矢状...目的探讨分析儿童肾透明细胞肉瘤(clear cell sarcom a of the kidney,CCSK)的影像学特征,以提高对本病的认识。方法选取经手术病理证实的13例CCSK患儿的临床及影像学资料。采用CT、超声检查,将所得图像传入后处理工作站行冠状位及矢状位等平面重建。重点观察病灶的侧别、部位(皮质、髓质)、大小(最大横截面长径)、形态、边缘等。结果13例患儿均单侧发病,肿瘤均位于肾髓质区。肿瘤平均长径10.87 cm,边界清楚,9例(69.2%)轮廓光整,4例(30.8%)呈分叶状。CT平扫肿瘤密度不均,13例病灶内均出现囊变坏死,6例(46.2%)钙化,3例(23.1%)出血,11例(84.6%)肿瘤实性成分呈等低密度,1例呈稍高密度,1例呈等密度。行CT增强扫描,12例(92.3%)中度强化,1例轻度强化,10例(76.9%)增强皮质期肿瘤内可见多发细小肿瘤血管影,肿瘤内无强化的囊变坏死区与肿瘤实性成分相间呈虎斑条纹样改变。肿瘤灰阶超声表现均为肾内不均质肿块,彩色多普勒超声显示肿瘤内部均可见血流信号。9例(69.2%)无转移,4例(30.8%)出现其他部位多处转移。结论儿童CCSK CT及超声表现具有一定的特征性,联合CT和超声检查有助于提高该病的诊断准确率。展开更多
文摘Primary or secondary clear cell sarcoma of the pancreas is an exceedingly rare and aggressive disease.In addition to pathology,molecular analysis is pivotal in differential diagnosis,especially with malignant melanoma.A key aspect in identifying clear cell sarcoma is specific genetic alterations,notably the translocation of t(12;22)(q13;q13),a diagnostic hallmark of this sarcoma subtype,which is absent in malignant melanoma.Treatment of primary clear cell sarcoma of the pancreas is the same as that for adenocarcinoma.
文摘BACKGROUND Clear cell sarcoma(CCS)is a rare soft-tissue sarcoma.The most common metastatic sites for CCS are the lungs,bones and brain.CCS is highly invasive and mainly metastasizes to the lung,followed by the bone and brain;however,pancreatic metastasis is relatively rare.CASE SUMMARY We report on a rare case of CCS with pancreatic metastasis in a 47-year-old man.The patient had a relevant medical history 3 years ago,with abdominal pain as the main clinical manifestation.No abnormalities were observed on physical examination and the tumor was found on abdominal computed tomography.Based on the medical history and postoperative pathology,the patient was diagnosed with CCS with pancreatic metastasis.The patient was successfully treated with surgical interventions,including distal pancreatectomy and sple-nectomy.CONCLUSION This report summarizes the available treatment modalities for CCS and the importance of regular postoperative follow-up for patients with CCS.
文摘This article presents a comprehensive case report on an uncommon instance of metastatic clear cell sarcoma(CCS)originating from the pancreas.The high mortality rate of pancreatic carcinoma underscores the importance of precise diagnosis and early detection.The authors report a novel case of CCS with pancreatic metastasis,detailing successful surgical intervention through distal pancreatectomy and splenectomy,resulting in favourable outcomes.This study highlights the standard role of surgery in treating advanced CCS and emphasizes preoperative imaging and thorough patient history assessment.This article also underscores the necessity for long-term surveillance due to the potential for recurrence or metastasis.Despite the favourable recovery postsurgery,the absence of subsequent follow-up evaluation prompts consideration of the need for extended monitoring.This article raises questions about the nature of the pancreatic lesion and suggests the possibility of a primary lesion.Further evidence is crucial to establish the correlation between the features related to the development of the patient's primary and metastatic tumours.In conclusion,this study offers valuable insights into metastatic CCS of the pancreas,highlighting the importance of regular postoperative follow-up for improved outcomes through early detection and intervention.
文摘In this editorial based on a case report,we delve into a seldom-seen occurrence of clear cell sarcoma featuring pancreatic metastasis in a 47-year-old male patient.Recognized for its typical tendency to metastasize to the lungs,bones,and brain,clear cell sarcoma rarely extends its reach to the pancreas.Despite the initial absence of discernible abnormalities during the patient's physical examination,the manifestation of abdominal pain prompted further investigation.Subsequent abdominal computed tomography brought to light the presence of a pancreatic tumor,culminating in the definitive diagnosis of clear cell sarcoma with pancreatic metastasis.The successful management of this atypical presentation involved a series of surgical interventions,including distal pancreatectomy and splenectomy.This report not only sheds light on the infrequent manifestation of clear cell sarcoma within the pancreas but also underscores the pivotal role of vigilant postoperative follow-up in addressing this rare sarcoma.The emphasis on postoperative care serves as a crucial aspect of the broader narrative,acknowledging the need for ongoing monitoring and management to ensure a comprehensive and successful treatment trajectory for patients with this unique presentation of clear cell sarcoma.
文摘BACKGROUND Clear cell sarcoma(CCS)is a rare and highly malignant soft tissue tumor,usually occurring in the deep soft tissues of the distal tendons and aponeurosis of the extremities,especially the feet and knees.CCS originating in the head and neck is extremely rare.The clinical manifestations of CCS in the head and neck are not typical,and the imaging manifestations have certain characteristics,but the diagnosis still depends on pathological examination and genetic testing.CASE SUMMARY A 33-year-old male patient had paroxysmal headache for more than 4 years,accompanied by nausea and vomiting,which could be relieved after rest.Computed tomography angiography showed a left paraspinal soft tissue mass.Contrast-enhanced imaging showed obvious uneven enhancement with adjacent bone lytic destruction.Magnetic resonance imaging examination showed isosignal on T_(1)-weighted images,slightly high signal on T_(2)-weighted images(T_(2)WI),high signal on Tirm fat suppression sequence,significantly high signal on diffusion weighted imaging,and obvious and uneven enhancement.The lesion invaded the anterior medulla oblongata through the left atlantoaxial foramen and compressed the cervical spinal cord on T_(2)WI.Primary CCS of soft tissue was diagnosed by pathology and genetic examination.CONCLUSION CCS should be considered in the differential diagnosis of soft tissue tumors of the head and neck,and their diagnosis depends on pathological examination and genetic testing.
基金Supported by the National Natural Science Foundation of China,No.81801939Scientific Research Project of Zhejiang Education Department,No.N20140124+1 种基金Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2019KY093Science Technology Research Program of Zhejiang Province,No.2017C33047.
文摘BACKGROUND Transcatheter arterial chemoembolization(TACE)is a common treatment for inoperable malignant renal tumors.However,a series of complications may follow the TACE treatment.Spinal cord injury caused by the embolization of intercostal or lumbar arteries is extremely rare.CASE SUMMARY We describe a case with quite uncommon spinal cord injury after TACE in a 3-year-old child with clear cell sarcoma of the kidney.Sensory impairment beneath the T10 dermatomes and paraplegia on the day after TACE were found in this patient.Unfortunately,sustained paraplegia still existed for more than 2 mo after TACE despite the large dose of steroids and supportive therapy.CONCLUSION We should draw attention to an uncommon complication of paraplegia after TACE treatment in malignant renal tumors.Although it is rare,the result is disastrous.
文摘Clear Cell Sarcoma (CCS) is a rare soft tissue sarcoma that corresponds <span style="font-family:Verdana;">to </span><span style="font-family:Verdana;">a less than 1% of all sarcomas</span><span style="font-family:Verdana;"> and</span><span style="font-family:Verdana;"> is a high degree neoplasm with propensity to disseminate to regional lymph nodes. Regional lymphadenectomies have </span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">controversial impact on sarcomas treatment and survival, even though those patients have higher local recurrence and lower survival. So, sentinel lymph node biopsy must be one option for better regional staging to STS with higher propensity to lymph node commitment. The authors demonstrate two cases of CCS submitted to surgery through compartmental resection associated </span><span style="font-family:Verdana;">with</span><span style="font-family:Verdana;"> the sentinel lymph node biopsy. A literature review about soft tissue sarcoma and lymph node sentinel biopsy </span><span style="font-family:Verdana;">is</span><span style="font-family:Verdana;"> show</span><span style="font-family:Verdana;">n </span><span style="font-family:Verdana;">as an initial experience of two cases.</span>
文摘Clear cell sarcoma of the kidney (CCSK) is a rare and highly malignant tumor which is usually confused with other kidney tumors. We experienced such a patient and present report this. Case Report A 9-year old girl was admitted to a local hospital because of fever and a pain in her right abdomen. The computerized tomography showed:
文摘BACKGROUND Clear cell sarcoma(CCS)of soft tissue is a rare malignant soft tissue sarcoma usually reported to locate at distal end of extremities and rarely at trunk.Herein,we report a case of CCS in pleural cavity.CASE SUMMARY A 31-year-old male was admitted for an uncertain mass in left pleural cavity in routine physical examination without any symptoms.A VATS surgery was performed to remove the tumor.The pathological finding displayed a cystic mass with 6.5 cm at the longest diameter,dark red in section and cysts could be found locally.A strong expression of S-100,HMB45 and Vimentin was detected in immunohistochemical staining,which was inclined to the diagnosis of the CCS of soft tissue.The patient refused chemotherapy,radiotherapy and targeted therapy because of the personal financial situation.Follow-up computed tomography scans were done at the 90th postoperative day and the 180th postoperative day,and no obvious sign of recurrence was found till now.CONCLUSION CCS of soft tissue also can be found in pleural cavity although in an extremely rare incidence.Radical resection is useful to improve the prognosis.
文摘BACKGROUND Clear cell sarcoma is an aggressive rare malignant neoplasm with morphologic and immunohistochemical similarities to malignant melanoma.Both disease entities display melanin pigment and melanocytic markers,making differentiation between the two difficult.Although clear cell sarcoma cases in the literature have mainly involved deep soft tissues of the extremities,trunk or limb girdles,we report here two cases of primary clear cell sarcoma in unusual sites and describe their clinicopathologic findings.CASE SUMMARY The first case involves a 37-year-old female,who presented with jaw pain and a submandibular mass.The second case involves a 33-year-old male,who presented with back pain and a thoracic spine tumor.Both cases showed tumors with diffuse infiltration of neoplastic cells that were positive for melanocytic markers,and in both cases this finding led to an initial diagnosis of metastatic melanoma.However,further analysis by fluorescence in situ hybridization(commonly known as FISH)showed a rearrangement of the EWS RNA binding protein 1(EWSR1)gene on chromosome 22q12 in both patients,confirming the diagnosis of clear cell sarcoma.CONCLUSION Distinction between clear cell sarcoma and malignant melanoma can be made by FISH,particularly in cases of unusual tumor sites.
文摘Clear cell sarcoma is usually described as a malignant melanoma of the soft tissues. The overall prognosis is poor because of delay in diagnosis and vague clinical symptoms. It is rarely involved in the gastrointestinal tract, and its diagnosis is often missed secondary to infrequent occurrence and histological resemblance to melanoma. We present two cases of primary CCS of the jejunum whose clinical presentations were complicated by lymph node involvement. Prompt diagnosis and potential aggressive surgical intervention may improve overall survival.
文摘Introduction: Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are one spectrum of rare cutaneous neoplasms that typically arise in sun-exposed skin of older population. AFX/PDS is essentially diagnosis of exclusion requiring Immunohistochemical work-up to exclude other types of tumors. Case Report: We present a case involving an ulcerated solitary lesion on the scalp of an elderly man. Histological examination revealed that the dermal tumor was composed of large pleomorphic, epithelioid, and spindle cells with clear cytoplasm. These cells were negative for cytokeratins, melanocytes and smooth muscle markers, but positive for CD10. These findings are consistent with a diagnosis of clear cell (CC) PDS. Conclusion: PDS is a low-grade malignancy that can recur locally and metastasize, which is distinguished from AFX by its larger size and the presence of aggressive histopathologic features including deeper invasion into the subcutaneous tissue, tumor necrosis, and lymphovascular and/or perineural involvement. Among several histopathologic variants, the CC variant is extremely rare with only two cases of PDS reported in the literature to date.
文摘We report here the case of a young patient with metastatic clear-cell sarcoma of the kidney resistant to standard chemotherapy, and with complete response under sorafenib treatment. The remarkable response of her tumor to sorafenib led us to study sorafenib molecular targets in the metastatic tissue. Background: Biomarkers predicting response to anti-angiogenic tyrosine kinase inhibitors remain to be identified. Methods and Findings: In this paper, we studied the molecular targets of sorafenib in the lung metastasis of a kidney clear-cell sarcoma. In a patient with complete response under sorafenib treatment, we showed high VEGFR2 expression by tumor endothelial cells from the lung metastasis. Conclusion: The original mechanistic results that we obtained using immunostainings and quantitative RT-PCR on laser-microdissected tumor endothelial cells have a direct application in daily clinical practice: metastatic tumors with a large angiogenic component should be tested for VEGFRs expression to consider anti-angiogenic tyrosine kinase inhibitor treatments.
基金Supported by Basic Scientific Research Business of Chinese Academy of Medical Sciences,No.2016ZX310020
文摘Clear-cell sarcoma is a rare, malignant soft tissue tumor that displays melanocytic differentiation with a distinct molecular profile. It is rarely localized in the gastrointestinal tract. Herein we reported a case of multiple synchronous clear-cell sarcomas of the gastrointestinal tract with parotid gland metastasis. A 51-year-old male patient presented with a growing painless mass under the right ear. A preoperative positron emission tomography/computed tomography showed multiple intestinal masses and a mass in the right parotid with increased glucose uptake, and he underwent operative treatment with resection of three tumors in the jejunum and ileum and then received a right parotidectomy. Postoperative pathological examination showed that cells in the intestinal tumor were consistent with clear-cell sarcoma of the gastrointestinal tract, and the malignant cells in the parotid gland were similar to the intestinal tumor. Immunohistochemical studies revealed positive expression of HMB-45, Melan-A, and S-100. EWSR1 gene fusion transcripts were undetectable by fluorescence in situ hybridization.
文摘目的探讨分析儿童肾透明细胞肉瘤(clear cell sarcom a of the kidney,CCSK)的影像学特征,以提高对本病的认识。方法选取经手术病理证实的13例CCSK患儿的临床及影像学资料。采用CT、超声检查,将所得图像传入后处理工作站行冠状位及矢状位等平面重建。重点观察病灶的侧别、部位(皮质、髓质)、大小(最大横截面长径)、形态、边缘等。结果13例患儿均单侧发病,肿瘤均位于肾髓质区。肿瘤平均长径10.87 cm,边界清楚,9例(69.2%)轮廓光整,4例(30.8%)呈分叶状。CT平扫肿瘤密度不均,13例病灶内均出现囊变坏死,6例(46.2%)钙化,3例(23.1%)出血,11例(84.6%)肿瘤实性成分呈等低密度,1例呈稍高密度,1例呈等密度。行CT增强扫描,12例(92.3%)中度强化,1例轻度强化,10例(76.9%)增强皮质期肿瘤内可见多发细小肿瘤血管影,肿瘤内无强化的囊变坏死区与肿瘤实性成分相间呈虎斑条纹样改变。肿瘤灰阶超声表现均为肾内不均质肿块,彩色多普勒超声显示肿瘤内部均可见血流信号。9例(69.2%)无转移,4例(30.8%)出现其他部位多处转移。结论儿童CCSK CT及超声表现具有一定的特征性,联合CT和超声检查有助于提高该病的诊断准确率。