High-dose-rate interstitial brachytherapy (HDR-ISBT) has recently come to be considered one of the most effective treatments for oral cancer. On the other hand, it is important to note that radiation therapy has some side effects. Especially, radiation-induced malignancy is probably the most serious complication affecting long-term survivors. We report a case of a radiation-induced undifferentiated spindle cell sarcoma that developed following HDR-ISBT for tongue squamous cell carcinoma (SCC). A 39-year-old woman with right tongue SCC underwent HDR-ISBT (60 Gy, 10 fractions, 8 days) treatment. Five years and one month later, a tumor had developed at the primary site. Surgery was performed for the tumor, which was histopathologically diagnosed as an undifferentiated spindle cell sarcoma. That was distinct from the squamous cell origin of the primary cancer. According to recently established criteria for radiation-induced malignancy, this case was classified as a radiation-induced sarcoma. A search of the literature revealed no previous report of radiation-induced malignancy following HDR-ISBT for tongue cancer.
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http://dx.doi.org/10.5114/jcb.2022.116149 | DOI Listing |
J Cutan Pathol
January 2025
Department of Anatomical Pathology, Dorevitch Pathology, Heidelberg, Victoria, Australia.
Melanomas show a wide spectrum of clinical, morphological, immunohistochemical, and molecular features, which can impact treatment and prognosis. Dedifferentiated and transdifferentiated melanomas (DTM) are defined as melanomas which have lost conventional melanocytic morphologic and immunohistochemical features, showing sarcomatous morphology and/or immunohistochemical staining of other cell lineages, and as such, can be mistaken for other entities such as collision tumors and undifferentiated spindle cell tumors. In this series, we highlight the utility of preferentially expressed antigen in melanomas (PRAME) in diagnosing undifferentiated/dedifferentiated melanomas.
View Article and Find Full Text PDFInt J Surg Pathol
December 2024
Department of Medical Oncology, All Indian Institute of Medical Sciences (A.I.I.M.S), New Delhi, India.
fusion-positive sarcomas constitute an emerging subtype of undifferentiated sarcomas, histopathologically composed of epithelioid and spindle cells. We describe two fusion-positive sarcomas occurring in the occipital region of a 53-year-old female patient and the left shoulder of a 25-year-old male patient. Histopathologically, the former tumor comprised spindle and polygonal-shaped/epithelioid cells, while the latter comprised epithelioid cells.
View Article and Find Full Text PDFNeuropathology
December 2024
Department of Pathology and Laboratory Medicine, UT Health-McGovern Medical School, Houston, Texas, USA.
Solitary fibrous tumors (SFTs) of the central nervous system (CNS) are rare mesenchymal tumors characterized by a fusion of the NGFI-A-binding protein 2 (NAB2) gene and the signal transducer and activator of transcription 6 (STAT6) gene, immunohistochemically resulting in nuclear expression of STAT6 - an immunohistochemical hallmark essential for diagnosis, as outlined in the fifth edition of the World Health Organization Classification of Tumors. Dedifferentiation, where low-grade tumors transform into high-grade forms, has been observed in SFTs, with documented cases involving sarcomatous or rarely epithelial transformations. We report the first case of a CNS SFT exhibiting "transdedifferentiation" into epithelioid neuroendocrine differentiation.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Gastroenterological Surgery, National Hospital Organization Higashihiroshima Medical Center, 739-0041, 513, Jike, Saijocho, Higashihiroshima, Hiroshima, Japan.
Introduction: Spindle cell sarcoma (SCS) is a sarcoma subtype rarely described in the abdominal cavity, and with a worse prognosis compared with that at other sites. We report a case of SCS occurring at the anastomosis after ileal resection for colorectal cancer.
Presentation Of Case: An 86-year-old woman with a chief complaint of abdominal pain had undergone ileal resection, D2 dissection, and hand-sewn anastomosis in 2011 to treat papillary stage I adenocarcinoma.
Int J Surg Pathol
November 2024
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
() amplification via fluorescence in-situ hybridization (FISH) is the gold standard test used for confirming the diagnosis of atypical lipomatous tumor/well differentiated liposarcoma and dedifferentiated liposarcoma. It is also used as a screening test in high grade spindle cell or pleomorphic neoplasms. FISH is considered positive for amplification when the /CEP12 ratio is greater than 2; however, a ratio between 2 and 3 is considered a "low-level" amplification and raises the possibility of a false positive result; thus, posing a diagnostic dilemma.
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