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1.
Anticancer Res ; 39(10): 5605-5610, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570456

RESUMO

BACKGROUND/AIM: We analyzed the process of healing at osteotomy sites and timing of achievement of full weight-bearing in sarcoma patients who underwent hemicortical or intercalary reconstruction using the extracorporeal irradiated autologous bone graft technique. PATIENTS AND METHODS: We studied 10 patients who had undergone tumor resection and reconstruction with hemicortical extracorporeal irradiated autologous bone graft at mid-shaft femur or tibia. The control group consisted of 30 patients who received the reconstruction using intercalary bone graft. RESULTS: Full weight-bearing was achieved in all 10 patients at a median time of 4.8 months. Function was excellent in all patients. When comparing the clinical outcome among the patients who received intercalary and hemicortical grafts, the duration to full weight-bearing achievement in patients who received hemicortical graft was shorter than that in those with intercalary graft. CONCLUSION: Early full weight-bearing may be achieved in patients undergoing hemicortical resection and reconstruction using extracorporeal irradiated autologous bone graft.


Assuntos
Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Sarcoma/patologia , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Transplante Ósseo/métodos , Osso e Ossos/patologia , Osso e Ossos/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia , Transplante Autólogo/métodos , Resultado do Tratamento
2.
Br J Radiol ; 92(1103): 20190158, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31509443

RESUMO

OBJECTIVE: To analyze patterns of response in soft tissue sarcomas exposed to pazopanib using CT-morphologic and textural features and their suitability for evaluating therapeutic response. METHODS: Retrospective evaluation of CT response and texture patterns in 33 patients (23 female; mean age: 61.2 years, range, 30-85 years) with soft tissue sarcomas treated with pazopanib from October 2008 to July 2017. Response evaluation was based on modified (m)CHOI-criteria and RECISTv.1.1 and classified as partial response (PR), stable disease (SD), progressive disease (PD). The following CT-texture (CTTA)-parameters were calculated: mean, entropy and uniformity of intensity/average/skewness/entropy of co-occurrence matrix and contrast of neighboring-gray-level-dependence-matrix. RESULTS: Following mCHOI-criteria, 12 patients achieved PR, 7 SD and 14 PD. As per RECISTv.1.1 9 patients obtained PR, 9 SD and 15 PD. Frequent patterns of response were tumor liquefaction and necrosis (n=4/33, 12.1% each). Further patterns included shrinkage and cavitation (n=2/33, 6.1% each). In responders, differences in mean heterogeneity (p=0.01), intensity (p=0.03), average (p=0.03) and entropy of skewness (p=0.01) were found at follow-up whereas in non-responders, CTTA-parameters did not change significantly. Baseline-CTTA-features differed between responders and non-responders in terms of uniformity of skewness (p=0.045). Baseline-CTTA-parameters did not correlate with any morphologic response pattern. CONCLUSION: Most frequent patterns of response to pazopanib were tumor liquefaction and necrosis. Single CT-textural features show strong association with the response to pazopanib-although limited in relation to specific response patterns. ADVANCES IN KNOWLEDGE: Tumor liquefication and necrosis are important patterns of response to pazopanib. CT-texture analysis has limited associations with specific response patterns.


Assuntos
Antineoplásicos/uso terapêutico , Pirimidinas/uso terapêutico , Sarcoma/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico , Sulfonamidas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoma/diagnóstico por imagem , Sarcoma/patologia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
3.
Medicine (Baltimore) ; 98(37): e16986, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517817

RESUMO

RATIONALE: Cavernous hemangiomas referred to as venous malformations (VMs), are not true vascular tumors. The treatment of cavernous hemangiomas is controversial. PATIENT CONCERNS: A five-year-old girl with a cavernous hemangioma on her right buttock had undergone surgery but recurred 1 month after the operation. DIAGNOSES: Cavernous hemangioma was diagnosed on the basis of physical examination, magnetic resonance imaging (MRI) and postoperative pathologic examination. INTERVENTIONS: We treated her with intralesional injection of triamcinolone acetonide (TCA) for 8 times. OUTCOMES: She was cured and had no recurrence during the 3-month follow-up. LESSONS: This prompts that TCA may provide a more effective and safer choice for the treatment of cavernous hemangiomas.


Assuntos
Antineoplásicos/administração & dosagem , Hemangioma Cavernoso/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico , Triancinolona Acetonida/administração & dosagem , Nádegas , Pré-Escolar , Feminino , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/cirurgia , Humanos , Injeções Intralesionais , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia
5.
J Surg Oncol ; 120(4): 740-745, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31309561

RESUMO

BACKGROUND AND OBJECTIVE: This is the first study to compare the safety and efficacy of vacuum-assisted biopsy (VAB) using a self-contained hand-held system compared to those of ultrasound-guided and computed tomography-guided core needle biopsy (US-CNB and CT-CNB) and to incisional biopsy (IB). METHODS: VAB was performed in an outpatient setting under local anesthesia. Safety, diagnostic accuracy, time, and cost expenditures of biopsy were compared between VAB, US-CNB, CT-CNB, and IB in 211 consecutive patients. RESULTS: VAB was applied in 78 patients, US-CNB in 51, CT-CNB in 45, and IB in 37. Patient characteristics did not differ between groups. Sample volume of VAB was 392.5 mm3 , 4062 mm 3 for IB, and 25.1 to 34.5 mm 3 for CNB, P < .001. VAB discriminated between malignant and benign lesions with the highest accuracy of 96% and determined sarcoma grading accurately in 95%. VAB and CNB had no complications vs 5% for IB. Duration of VAB was 5 ± 2 minutes, equal to US-CNB and shorter than CT-CNB and IB. Expenditures for VAB were higher than for US-CNB and lower than CT-CNB and IB. CONCLUSION: VAB is an accurate, safe, cost-effective, and time-saving outpatient diagnostic procedure for patients with soft-tissue tumors and presents a viable alternative to IB.


Assuntos
Biópsia Guiada por Imagem/métodos , Biópsia Guiada por Imagem/estatística & dados numéricos , Medição de Risco/métodos , Neoplasias de Tecidos Moles/patologia , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Vácuo , Adulto Jovem
6.
Medicine (Baltimore) ; 98(27): e16346, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277190

RESUMO

Time resolved magnetic resonance angiography with interleaved stochastic trajectories (TWIST) allows for identification of tumor feeding arteries and arteriovenous shunt (AVS). We used TWIST to obtain number of feeding arteries (NFA) and detect AVS for 43 cases of pathology-confirmed soft tissue tumors. We compared normalized number of feeding arteries (nNFA) and AVS between malignant and benign tumors, and found nNFA was significantly greater in malignant tumors versus benign tumors (2.1 vs 1.3, P < .05). The incidence of AVS was significantly higher in malignant tumors versus benign tumors (87.5% vs 10.5%, P < .05). TWIST derived nNFA and AVS could be useful in the discrimination of benign and malignant soft tissue tumors.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Neoplasias de Tecidos Moles/irrigação sanguínea , Neoplasias de Tecidos Moles/diagnóstico por imagem , Adulto , Idoso , Diagnóstico Diferencial , Estudos de Viabilidade , Feminino , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Neoplasias de Tecidos Moles/patologia , Processos Estocásticos , Adulto Jovem
7.
Cesk Patol ; 55(2): 92-95, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181941

RESUMO

Nowadays, FNAC is an important diagnostic tool of soft tissue tumors in southeast Asia and India. We can also appreciate recent monographies on this topic authored by Swedish and American cytopathologists. They constantly stress the importance of clinical information and imaging studies. A cytology report should determine the morphological type of tumoral cell population, tumor grade (in two-tiered system) and conclusion providing at least some probable diagnostic options. This approach is documented in two case reports on pleiomorphic liposarcoma and giant cell tumor of tendo sheet.


Assuntos
Neoplasias de Tecidos Moles , Biópsia por Agulha Fina , Humanos , Neoplasias de Tecidos Moles/patologia
8.
Ann R Coll Surg Engl ; 101(6): 405-410, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31155889

RESUMO

INTRODUCTION: The aims of this study were to report the presenting characteristics and identify how best to distinguish bone and soft-tissue infections that mimic sarcomas. MATERIALS AND METHODS: A total of 238 (211 osteomyelitis and 27 soft-tissue infections) patients referred to a tertiary sarcoma multidisciplinary team with suspected sarcoma who were ultimately diagnosed with a bone or soft tissue infection were included. Data from a prospectively collated database was analysed retrospectively. RESULTS: Of all possible bone and soft-tissue sarcoma referrals, a diagnosis of infection was made in 2.1% and 0.7%, respectively. Median age was 18 years in the osteomyelitis group and 46 years in the soft-tissue infection group. In the osteomyelitis group, the most common presenting features were pain (85.8%) and swelling (32.7%). In the soft-tissue infection group, the most common clinical features were swelling (96.3%) and pain (70.4%). Those in the soft-tissue group were more likely to have raised inflammatory markers. Radiological investigations were unable to discern between tumour or infection in 59.7% of osteomyelitis and 81.5% of soft-tissue infection cases. No organism was identified in 64.9% of those who had a percutaneous biopsy culture. CONCLUSIONS: This study has highlighted that infection is frequently clinically indistinguishable from sarcoma and remains a principle non-neoplastic differential diagnosis. When patients are investigated for suspected sarcoma, infections can be missed due to falsely negative radiological investigations and percutaneous biopsy. As no single clinical, biochemical or radiological feature or investigation can be relied upon for diagnosis, clinicians should have a low threshold for tissue biopsy and discussion in a sarcoma multidisciplinary team meeting.


Assuntos
Neoplasias Ósseas/diagnóstico , Comunicação Interdisciplinar , Osteomielite/diagnóstico , Equipe de Assistência ao Paciente , Sarcoma/diagnóstico , Infecções dos Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Biópsia , Neoplasias Ósseas/patologia , Osso e Ossos/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/patologia , Estudos Retrospectivos , Sarcoma/patologia , Infecções dos Tecidos Moles/patologia , Neoplasias de Tecidos Moles/patologia
9.
Pan Afr Med J ; 32: 75, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223366

RESUMO

Extra-osseous chondroma is a benign and rare tumor. It usually sits at the extremities, we report an exceptional case of a chondroma of the soft parts of the shoulder in a 28 year old woman who manifested by a painless swelling of the left shoulder. The histology confirmed the diagnosis on the excision piece. Clinical and radiological follow-up after a 24-month follow-up did not show a sign of recurrence.


Assuntos
Condroma/diagnóstico , Ombro/patologia , Neoplasias de Tecidos Moles/diagnóstico , Adulto , Condroma/patologia , Condroma/cirurgia , Feminino , Seguimentos , Humanos , Ombro/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia
10.
Pathologe ; 40(4): 353-365, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31168638

RESUMO

Soft tissue neoplasms with myxoid features are collectively not uncommon. Their often complex differential diagnosis makes them significantly over-represented among consultation cases. This applies not only to sarcomas but in particular to benign lesions as well. Generally, myxoid soft tissue lesions are divided into two major groups: (1) myxoid lesions by definition (which can however rarely be non-myxoid) and (2) rare myxoid variants of otherwise non-myxoid entities.Four major diagnostic challenges are responsible for the complexity of myxoid soft tissue neoplasms: (1) Diagnosis of malignancy in many cases is not based on conventional malignancy criteria but is defined by the entity itself, making under-diagnosis of malignancy likely in entities such as low-grade fibromyxoid sarcoma. (2) On the other hand, harmless myxoid lesions with features of high proliferation, e.g. nodular and proliferative fasciitis, tend to be over-diagnosed as malignant by the unworried. (3) The necessity to assess not only cellular morphology/differentiation, but also the stromal, vascular and architectural characteristics adds to the complexity of the differential diagnostic algorithm. (4) Last but not least, recognition of unexpected myxoid variants of non-myxoid entities is basically impossible if focal conventional areas are absent, underlining the need for high suspicion index and sufficient sampling.This review illuminates the various aspects related to the differential diagnostic workup of these challenging entities.


Assuntos
Fibrossarcoma , Sarcoma , Neoplasias de Tecidos Moles , Algoritmos , Diagnóstico Diferencial , Fibrossarcoma/diagnóstico , Humanos , Sarcoma/diagnóstico , Sarcoma/patologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia
11.
Pathologe ; 40(4): 339-352, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31240452

RESUMO

More than 20% of soft-tissue tumors belong to the group of adipocytic neoplasms. Difficulties may occur in the differential diagnosis of lipomas versus atypical lipomatous tumors/well-differentiated liposarcomas, in the distinction of dedifferentiated liposarcomas from other soft-tissue sarcoma entities and in the detailed subtyping of liposarcomas. Especially in biopsies, the correct diagnosis and grading may be hampered due to limited tissue. Because of the ever-increasing molecular-pathological knowledge of soft-tissue tumors and the rising distribution of molecular diagnostic assays in institutes of pathology, differential diagnosis has been facilitated, as more than 90% of adipocytic tumors carry more or less specific genomic alterations. In the following, the most important subtypes of adipocytic tumors are described morphologically and genomically.


Assuntos
Lipoma , Lipossarcoma , Neoplasias Lipomatosas , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Lipoma/diagnóstico , Lipoma/patologia , Lipossarcoma/diagnóstico , Lipossarcoma/patologia , Neoplasias Lipomatosas/diagnóstico , Neoplasias Lipomatosas/patologia , Sarcoma/diagnóstico , Sarcoma/patologia , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/patologia
12.
Pathologe ; 40(4): 393-411, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31243551

RESUMO

Epithelioid soft tissue tumors consist exclusively of epithelioid tumor cells. Biphasic tumors are composed of both a spindle-cell and an epithelioid component. The rare mixed tumors of soft tissue show a broader variety of cellular and stromal differentiation but also include at least one, possibly several, epithelioid portions.The close morphological similarity of some of these entities with each other, as well as with the more frequent soft tissue metastases of carcinomas, carcinosarcomas, and melanomas, to malignant mesothelioma and certain lymphomas, can often make the correct diagnosis extremely difficult. Recent advances in the detection of certain molecular alterations (mostly chromosomal translocations) have contributed to changes in tumor classification but also to improved pathological diagnostics (e.g. through the development of potent diagnostic antibodies) and biological understanding.The present overview should help the pathologist in the diagnosis of these rare tumors through the classical approach of morphological pattern recognition. The most important entities are discussed and illustrated in more detail, with the incorporation of the latest immunohistochemical and molecular aspects and the differential diagnosis of similar tumors.


Assuntos
Mesotelioma , Sarcoma , Neoplasias de Tecidos Moles , Biomarcadores Tumorais , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Mesotelioma/diagnóstico , Mesotelioma/patologia , Sarcoma/patologia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia
13.
Medicine (Baltimore) ; 98(18): e15150, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045758

RESUMO

RATIONALE: Deep benign fibrous histiocytoma (BFH) is relatively rare in contrast to superficial BFH involving the skin. Moreover, it was extremely rare for deep BFH occurring in the solid organ. To our knowledge, so far, only one case of deep BFH of the kidney was reported in English literature. PATIENT CONCERNS: Herein, we report another case of deep BFH located in the kidney in a 88-year-old female. She was referred to our hospital for a severe pain in the right upper abdomen. Computed tomography revealed a round low-density shadow measuring 6 cm in the kidney. DIAGNOSIS: The lesion was diagnosed as a deep BFH of the kidney, as the tumor was histologically predominately composed of bland ovoid cells arranged in a storiform pattern. INTERVENTION: The patient underwent the total resection of the right kidney with the tumor in our hospital. OUTCOMES: The postoperative course was uneventful. The patient was alive with no tumor recurrence or metastasis within 6 months of follow-up. LESSONS: We present another case of deep BFH of the kidney. Because of the rarity, the tumor may be poorly recognized. The typical storiform pattern in histology may be helpful for diagnosis. This report serves to remind that deep BFH is also a differential diagnosis for a tumor with storiform pattern in the kidney.


Assuntos
Dor Abdominal/etiologia , Histiocitoma Fibroso Benigno/patologia , Rim/patologia , Dor Abdominal/diagnóstico , Assistência ao Convalescente , Idoso de 80 Anos ou mais , Feminino , Histiocitoma Fibroso Benigno/diagnóstico por imagem , Histiocitoma Fibroso Benigno/cirurgia , Histiocitoma Fibroso Benigno/ultraestrutura , Humanos , Rim/diagnóstico por imagem , Rim/cirurgia , Neoplasias de Tecidos Moles/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
14.
Expert Opin Pharmacother ; 20(12): 1503-1515, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31136210

RESUMO

Introduction: Liposarcomas are a heterogeneous group of soft tissue tumors that arise from adipose tissue and are one of the most common soft tissue sarcomas found in adults. Liposarcomas are subclassified into four subtypes with distinct histologic and biologic features that influence their treatment and management. Areas covered: This manuscript reviews the key clinicopathologic and cytogenic characteristics of the liposarcoma histologic subtypes and summarizes the results of recent clinical trials, treatment options, and future directions in the pharmacotherapy for the management of liposarcoma. Expert opinion: Despite significant advancements in the management of this disease, the treatment of liposarcoma continues to be a challenge. Surgical resection remains the mainstay of treatment for localized disease; however, use of systemic therapies in conjunction with surgery may be considered in patients where tumor shrinkage could reduce surgical morbidity and in patients with high-risk of micrometastatic disease. Anthracycline-based chemotherapy regimens remain the standard first-line treatment for unresectable/metastatic liposarcoma. Trabectedin and eribulin are currently the two most promising and evidenced-based second-line treatment options for liposarcomas. However, multiple clinical trials dedicated to patients with liposarcoma evaluating novel targeted agents are ongoing. Every effort should be made to enroll patients with liposarcoma into histotype-specific clinical trials.


Assuntos
Antineoplásicos/classificação , Antineoplásicos/uso terapêutico , Drogas em Investigação/uso terapêutico , Lipossarcoma/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico , Adulto , Antraciclinas/uso terapêutico , Descoberta de Drogas/métodos , Descoberta de Drogas/tendências , Furanos/uso terapêutico , Humanos , Cetonas/uso terapêutico , Lipossarcoma/epidemiologia , Lipossarcoma/patologia , Sarcoma/tratamento farmacológico , Sarcoma/epidemiologia , Sarcoma/patologia , Neoplasias de Tecidos Moles/epidemiologia , Neoplasias de Tecidos Moles/patologia , Trabectedina/uso terapêutico
15.
Medicine (Baltimore) ; 98(19): e15587, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083243

RESUMO

RATIONALE: Chondroid lipoma (CL) is a rare benign tumor. No relevant epidemiological reports have been published on CL, and there is a lack of uniform diagnostic and treatment criteria for the tumor. PATIENT CONCERNS: Here, we report a case of CL with a mass on the left buttock for 2 weeks, and further illuminate its diagnosis and treatment. DIAGNOSIS: The diagnosis of CL was rendered according to the pathological indices. INTERVENTIONS: The tumor was resected completely under spinal anesthesia. OUTCOMES: The patient was followed-up for 6 months and showed no tumor recurrence or metastasis and there was resolution of the patient's lower-limb numbness and pain. LESSONS: The case study presented here provides evidence that CL could be effectively diagnosed by using ultrasound, puncture or biopsy, and/or magnetic resonance imaging. Furthermore, the patient recovered without any complications after completely resecting the tumor.


Assuntos
Lipoma/diagnóstico , Lipoma/cirurgia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/cirurgia , Nádegas , Diagnóstico Diferencial , Humanos , Lipoma/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias de Tecidos Moles/patologia
16.
Crit Rev Oncol Hematol ; 138: 120-131, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31092367

RESUMO

Angiosarcomas are rare malignant tumors with a heterogeneous clinical presentation and generally poor prognosis. It has been difficult to establish consistent molecular characteristics and driver events in angiosarcoma development. Oncogenic and angiogenesis-related pathways have been investigated pre-clinically and clinically with varying results. A few promising responses to checkpoint inhibitors have been described, but immunological features require further elucidation. With this review we present an overview of the critical biological pathways and processes affected in angiosarcoma, and their potential role in novel, non-cytotoxic, systemic treatments.


Assuntos
Hemangiossarcoma/patologia , Hemangiossarcoma/terapia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/terapia , Feminino , Humanos , Masculino , Doenças Raras
17.
Int J Surg Oncol ; 2019: 2350157, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30956820

RESUMO

Objectives: This study aims to assess the impact of surgical margin and malignancy grade on overall survival (OS) and local recurrence free rate (LRFR) for soft tissue sarcomas (STS) of the thoracic wall. Methods: This retrospective cohort study identified 88 patients, diagnosed and treated surgically for a nonmetastatic STS located in the thoracic wall between 1995 and 2013, using the population based and validated Aarhus Sarcoma Registry and Danish Sarcoma Registry. The Kaplan-Meier method was used to estimate OS and LRFR. Multivariate Cox analyses were used to determine prognostic factors for OS and LRFR. Results: The 5-year OS was 55% (95% confidence interval (CI): 0.44-0.65) and 5-year LRFR was 77% (95% CI: 0.67-0.85). High malignancy grade and intralesional/marginal resection were identified as negative predictors for OS. High grade was the only prognostic factor associated with a lower LRFR. Conclusions: In this large, single institution, study tumor grade was the key predictor for OS and LRFR. Surgical margin only statistically significantly influenced mortality, not local recurrence.


Assuntos
Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Neoplasias Torácicas/cirurgia , Parede Torácica/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Prognóstico , Sistema de Registros , Estudos Retrospectivos , Sarcoma/mortalidade , Sarcoma/patologia , Neoplasias de Tecidos Moles/mortalidade , Neoplasias de Tecidos Moles/patologia , Análise de Sobrevida , Neoplasias Torácicas/mortalidade , Neoplasias Torácicas/patologia , Parede Torácica/patologia , Adulto Jovem
18.
Acta Orthop Traumatol Turc ; 53(3): 189-194, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30982757

RESUMO

OBJECTIVE: The aim of this study was to retrospectively evaluate the patients who were operated in our orthopedics and traumatology clinic with the suspection of bone and soft tissue tumors. METHODS: A total of 3133 patients (1146 (46.5%) female and 1318 (53.5%) male) who presented to our tertiary clinic from different regions of Turkey between January 2002 and July 2013 with the presumed diagnosis of bone and soft tissue tumors were analyzed according to age, gender, bone/soft tissue localization, tumoral localization, histopathological diagnosis, tumor size and incidence. RESULTS: Of all operated patients, 2464 (78%) were diagnosed with tumor, while non-tumoral causes were found in 669 (22%) patients. Of the cases diagnosed with tumor, 1139 were bone localized, 1004 soft tissue localized, and 321 metastasis. The most common benign bone tumors were osteochondroma (130, 20%), enchondroma (96, 15%), and simple bone cysts (90, 14%), while the most common malignant bone tumors were osteosarcoma (241, 44%), ewing's sarcoma (89, 16%), and chondrosarcoma (77, 14%); respectively. The most common benign soft tissue tumors were lipoma (141, 22%), giant cell tumors (108, 16%) and ganglion (107, 16%), while the most common malignant soft tissue tumors were liposarcoma (55, 16%), synovial sarcoma (53, 16%) and malignant mesenchymal tumors (45, 13%); respectively. CONCLUSION: Musculoskeletal tumors are rare, but descriptive data in any region are important in order to reduce mortality and improve treatment. No significant difference was found between the data of our hospital regarding epidemiology of the musculoskeletal system tumors and those from the other regions around the world. LEVEL OF EVIDENCE: Level IV, Therapeutic study.


Assuntos
Neoplasias Ósseas/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Adulto , Neoplasias Ósseas/classificação , Neoplasias Ósseas/epidemiologia , Neoplasias Ósseas/patologia , Feminino , Humanos , Incidência , Masculino , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/estatística & dados numéricos , Estudos Retrospectivos , Neoplasias de Tecidos Moles/classificação , Neoplasias de Tecidos Moles/epidemiologia , Neoplasias de Tecidos Moles/patologia , Centros de Atenção Terciária/estatística & dados numéricos , Turquia/epidemiologia
19.
Medicine (Baltimore) ; 98(16): e15262, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31008967

RESUMO

RATIONALE: Fibroma of tendon sheath is a rare entity that is typically attached to the tendon sheath. PATIENT CONCERNS: A 43-year-old man presented with a painful mass in his right wrist, which was initially misdiagnosed as an enchondroma. DIAGNOSIS: Fibroma embedded into carpal bones, which exhibited lytic radiographic features similar to those of enchondroma. Excisional biopsy demonstrated spindle-shaped cells and collagen-like stroma. INTERVENTIONS: The patient underwent lesion resection surgery. OUTCOMES: The patient recovered well and showed no signs of recurrence at 6-month follow-up. LESSONS: This case provides valuable insights for hand surgeons. While radiograph is helpful in multiple diseases, histological examination is indispensable for establishment of final diagnosis.


Assuntos
Neoplasias Ósseas/diagnóstico , Ossos do Carpo/patologia , Condroma/diagnóstico , Fibroma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Tendões , Adulto , Ossos do Carpo/diagnóstico por imagem , Ossos do Carpo/cirurgia , Diagnóstico Diferencial , Erros de Diagnóstico , Fibroma/diagnóstico por imagem , Fibroma/patologia , Fibroma/cirurgia , Humanos , Masculino , Radiografia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Tendões/diagnóstico por imagem , Tendões/patologia , Tendões/cirurgia
20.
Acta Orthop Traumatol Turc ; 53(3): 195-198, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31031128

RESUMO

OBJECTIVE: The aim of this study was to determine the prevalence, demographic data of elastofibroma dorsi (ED) in adult population who had undergone chest CT examination and to discuss clinical, and radiological presentations, and treatment options of ED. METHODS: We retrospectively reviewed 4074 chest CT examinations for ED from July 2014 to April 2015. Lesion size, side, and patient demographics were analyzed for positive cases of ED. The initial radiology reports of patients with ED were also reviewed. RESULTS: Of the 4074 patients, 111 patients (2.73%) (77 women and 34 men; mean age: 68.2 years; range: 35-91 years) had a total of 168 ED. The females had a 1.96 -fold higher prevalence of ED than the males (OR, 1.96; 95% CI, 1.481-2.59). The mean lesion thickness was found to be significantly greater in the female patients compared with the male patients (p = 0.001). The prevalence of the disease was estimated to be 4.98 times higher in patients aged 65 years or older (CI 95%, 3.25-7.36). In 111 ED patients, the lesions were only noted in 9 patients' initial radiology report. CONCLUSION: Here, we present a prevalence study with the largest population in the literature concerning ED. Our study shows that ED is not as uncommon as previously thought and should be especially suspected in females and older age groups. LEVEL OF EVIDENCE: Level IV, Diagnostic Study.


Assuntos
Fibroma , Radiografia Torácica , Neoplasias de Tecidos Moles , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Idoso , Feminino , Fibroma/diagnóstico por imagem , Fibroma/epidemiologia , Fibroma/patologia , Fibroma/terapia , Humanos , Masculino , Administração dos Cuidados ao Paciente/métodos , Prevalência , Radiografia Torácica/métodos , Radiografia Torácica/estatística & dados numéricos , Estudos Retrospectivos , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/epidemiologia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/terapia , Turquia/epidemiologia
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