Oral contraceptive use, parity, and constitutional characteristics in soft tissue sarcoma: a Swedish population-based case-control study 1988-2009.

PURPOSE: The study was designed to investigate the influence of surrogate factors associated with sex (SH) and growth hormones (GH) on the risk of developing soft tissue sarcomas (STS). BACKGROUND AND METHODS: The etiology of soft tissue sarcoma is largely unknown. We have studied the effect of hormone related factors on STS in the Swedish population between 1988 and 2009 using a population-based matched case-control design. RESULTS: Our study is the largest on this topic to date, including 634 cases in a primary matched analysis and 855 cases in an unmatched sensitivity analysis. We identified protective effects connected to constitutional characteristics, hormonal and reproductive factors. Being shorter than your peers at age 11 was associated with an odds ratio (OR) of 0.51 (0.36-0.74). Having used oral contraceptives (OC), OR 0.75 (0.49-1.15), and high parity, OR 0.16 (0.04-0.63), comparing three or more children to two or less, also appeared to reduce the risk of STS. The risk was further reduced with the duration of OC use (p = 0.01), comparing use for 11 years or more to use for 3 years or less yielded an OR of 0.10 (0.02-0.41). No effect was observed for ever having had perimenopausal hormone therapy OR 1.02 (0.70-1.47). The effect of BMI varied significantly with subtype (p = 0.03) and tumor location (p < 0.001). CONCLUSIONS: We observed surrogates of SH, GH, and insulin-like growth factor 1 to be associated with STS development. These findings are important as they may connect STSs to the group of hormone-dependent tumors, potentially revealing common treatment and prevention targets.

Multinucleate cell angiohistiocytoma: an uncommon mucosal tumour.

Multinucleate cell angiohistiocytoma (MCAH) is an uncommon benign soft-tissue lesion with characteristic histological and immunohistochemical features. It is unclear if it represents a benign neoplasm or a reactive/inflammatory process. The overwhelming majority of these tumors have been described on cutaneous surfaces. One case has been reported on the skin of the lip. This is the first documentation of MCAH within the oral cavity. The clinical presentation, histopathological features and immunohistochemical reactivity pattern are described. Because of the benign nature of this lesion, a conservative approach is recommended in its management. Surgical excision appears to be curative.

2-Deoxy-2-[F-18]fluoro-D-glucose positron emission tomography illustrates two visceral tumors in a post kidney transplant patient with multiple cutaneous malignancies.

The success of renal transplantation brings with it the dilemma of managing patients with complications from lifelong immunosuppressive therapy. Immunosuppressed transplant recipients are a special population with significantly increased risk for development of skin cancers. Because malignant tumors are increasing as demonstrated on 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) positron emission tomography (PET) image, we report the unusual coincidence of multiple cutaneous cancers and two visceral malignancies 20 years after renal transplantation. The malignancies include basal cell and squamous cell carcinomas and malignant fibrous histiocytoma. FDG-PET images show, in this case, visceral masses with increased metabolism: one in the left upper lung and one in the abdomen, corresponding to individual mass lesions observed on computed tomography (CT) images of the chest and abdomen. A fine-needle biopsy of the nodule of the left upper lung lobe yielded a diagnosis of a sarcoma. The mass lesion of the abdomen had caused bowel obstruction, requiring exploratory laparotomy; histopathological findings from the resected mass from the abdomen confirmed the diagnosis malignant fibrous histiocytoma. This long-term immune suppressed transplant recipient developed viscerally located malignant lesions demonstrated by FDG-PET imaging and three types of cutaneous malignancies (skin cancers).