Soft tissue sarcomas harboring EWSR1::PATZ1 are a recently recognized entity with variable morphology and a heterogeneous immunohistochemical profile. We studied 17 such tumors. The tumors occurred in 12 men and 5 women (median age, 50 years; range, 15-71 years), involved the thoracoabdominal soft tissues (14 cases; 82%), lower extremities (2 cases; 12%), and tongue (1 case; 6%), and ranged from 0.7 to 11.3 cm (median, 4.7 cm). All but 1 patient received complete surgical resection; 7 were also treated with neoadjuvant chemo/radiotherapy. All cases showed typical features of EWSR1::PATZ1 sarcoma, including uniform round to spindled cells, fibromyxoid matrix, fibrous bands, hyalinized vessels, and pseudoalveolar/microcystic spaces. Unusual features, seen in a subset of cases, included degenerative-appearing nuclear atypia, epithelioid cytomorphology, mature fat, abundant rhabdomyoblasts, high mitotic activity, and foci with increased cellularity and nuclear atypia. Positive immunohistochemical results were desmin (16/17, 94%), MyoD1 (13/14, 93%), myogenin (6/14, 43%), GFAP (10/10, 100%), S100 protein (15/17, 88%), SOX10 (7/13, 54%), keratin (10/17, 59%), CD99 (4/11, 36%), H3K27me3 (retained expression 9/9, 100%), p16 (absent expression 1/4, 25%), and p53 (wild type 3/3, 100%). Fusion events included EWSR1 exon 8::PATZ1 exon 1 (14/17, 82%), EWSR1 exon 9::PATZ1 exon 1 (2/17, 12%), and EWSR1 exon 7::PATZ1 exon 1 (1/17, 6%). No evaluated tumor had alterations of CDKN2A/B and/or TP53, or MDM2 amplification. Clinical follow-up (16 patients: median, 13.5 months; range, 1-77 months) showed distant metastases in 3 patients (1/3 at time of presentation) and no local recurrences. At the time of last follow-up, 14 patients were disease free, 1 was alive with disease, 1 was dead of disease (at 13 months), and 1 had an indeterminant pulmonary nodule. We conclude that the morphologic spectrum of EWSR1::PATZ1 is broader than has been previously appreciated. Although more long-term follow-up is needed, the prognosis of these very rare sarcomas may be more favorable than previously reported.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádorové biomarkery genetika MeSH
- nádory měkkých tkání * genetika terapie patologie MeSH
- prognóza MeSH
- protein EWS vázající RNA genetika MeSH
- proteiny S100 MeSH
- represorové proteiny genetika MeSH
- sarkom * genetika terapie patologie MeSH
- transkripční faktory Krüppel-like MeSH
- transkripční faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- lidé MeSH
- nádory dělohy * terapie MeSH
- sarkom * terapie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- směrnice pro lékařskou praxi MeSH
- MeSH
- lidé MeSH
- nádory dělohy * diagnóza patofyziologie terapie MeSH
- sarkom * diagnóza patofyziologie terapie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
PURPOSE: The CD47 molecule, often referred to as the "do not eat me" signal, is frequently overexpressed in tumor cells. This signaling pathway limits phagocytosis by macrophages. Our objective was to determine CD47 abundance in various soft tissue sarcomas (STS) to investigate whether it could serve as a potential evasion mechanism for tumor cells. Additionally, we aimed to assess the prognostic value of CD47 expression by examining its association with different clinicopathological factors. This study aimed to elucidate the significance of CD47 in the context of emerging anti-tumor targeting approaches. METHODS: In this retrospective study, formalin-fixed paraffine-embedded (FFPE) tumor tissues of 55 treatment-naïve patients were evaluated by immunohistochemistry for the abundance of CD47 molecule on tumor cells. The categorization of CD47 positivity was as follows: 0 (no staining of tumor cells), 1 + (less than 1/3 of tumor area positive), 2 + (between 1/3 and 2/3 of tumor area positive), and 3 + (more than 2/3 of tumor area positive for CD47). Next, we compared CD47 abundance between different tumor grades (G1-3). We used Kaplan-Meier survival curves with log-rank test to analyze the differences in survival between patients with different CD47 expression. Moreover, we performed Cox proportional hazards regression model to evaluate the clinical significance of CD47. RESULTS: CD47 is widely prevalent across distinct STS subtypes. More than 80% of high grade undifferentiated pleiomorphic sarcoma (UPS), 70% of myxofibrosarcoma (MFS) and more than 60% of liposarcoma (LPS) samples displayed a pattern of moderate-to-diffuse positivity. This phenomenon remains consistent regardless of the tumor grade. However, there was a tendency for higher CD47 expression levels in the G3 group compared to the combined G1 + G2 groups when all LPS, MFS, and UPS were analyzed together. No significant associations were observed between CD47 abundance, death, and metastatic status. Additionally, high CD47 expression was associated with a statistically significant increase in progression-free survival in the studied cohort of patients. CONCLUSION: This study highlights the potential of the CD47 molecule as a promising immunotherapeutic target in STS, particularly given its elevated expression levels in diverse sarcoma types. Our data showed a notable trend linking CD47 expression to tumor grade, while also suggesting an interesting correlation between enhanced abundance of CD47 expression and a reduced hazard risk of disease progression. Although these findings shed light on different roles of CD47 in STS, further research is crucial to assess its potential in clinical settings.
- MeSH
- antigeny CD47 metabolismus MeSH
- dospělí MeSH
- lidé MeSH
- lipopolysacharidy MeSH
- makrofágy patologie MeSH
- nádory měkkých tkání * patologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- sarkom * terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- akutní lymfatická leukemie diagnóza farmakoterapie MeSH
- diferenciální diagnóza MeSH
- dítě * MeSH
- germinální a embryonální nádory diagnóza terapie MeSH
- hepatoblastom chirurgie diagnóza terapie MeSH
- lidé MeSH
- lymfom diagnóza farmakoterapie terapie MeSH
- nádory centrálního nervového systému chirurgie diagnóza terapie MeSH
- nádory * chirurgie diagnóza terapie MeSH
- neuroblastom diagnóza terapie MeSH
- sarkom chirurgie diagnóza terapie MeSH
- Wilmsův nádor diagnóza terapie MeSH
- Check Tag
- dítě * MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
PURPOSE: Sarcomas are rare cancers with many subtypes in soft tissues, bone and cartilage. International survival trends in these cancers are not well known. We present 50-year survival trends for soft tissue sarcoma (STS) and bone sarcoma (BS) in Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE). METHODS: Relative 1-, 5/1 conditional- and 5-year survival data were obtained from the NORDCAN database for years 1971-20. We additionally estimated annual changes in survival rates and determined significant break points. RESULTS: In the last period, 2016-20, 5-year survival in STS was best for NO men (74.6%) and FI women (71.1%). For the rarer BS, survival rates for SE men (72.0%) and DK women (71.1%) were best. Survival in BS was lower than that in STS in 1971-75 and the difference remained in 2016-20 for men, but for women the rates were almost equal. Sex- and country-specific differences in survival in STS were small. The 50-year improvement in 5-year survival in STS was highest in NO men, 34.0 % units and FI women, 30.0 % units. The highest improvements in BS were in SE men 26.2 % units and in FI women 29.2 % units. CONCLUSIONS: The steady development in survival over the half century suggests contribution by stepwise improvements in diagnostics, treatment and care. The 10-15% mortality in the first year probably indicates diagnostic delays which could be improved by organizing patient pathways for aggressive rare diseases. Early diagnosis would also reduce metastatic disease and breakthroughs in treatment are a current challenge.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory kostí * mortalita epidemiologie patologie MeSH
- nádory měkkých tkání mortalita epidemiologie patologie MeSH
- osteosarkom mortalita epidemiologie patologie terapie MeSH
- registrace MeSH
- sarkom * mortalita epidemiologie patologie terapie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Finsko MeSH
- Skandinávie a severské státy MeSH
Desmoplastický tumor z malých okrouhlých buněk je podskupinou měkkotkáňových sarkomů. Jedná se o raritní onemocnění, kdy od jeho objevení v roce 1989 byly v literatuře popsány jenom stovky případů. Vzhledem k ojedinělé incidenci tumoru zůstává toto onemocnění neznámým v běžné praxi. Vyskytuje se nejčastěji u mužů v mladém věku. Jeho prognóza je závažná a průměrné přežití pacientů se pohybuje od 1,5 do 2,5 roku. Možností léčení je chirurgická resekce, chemo-, radio- a cílená terapie. Naše práce prezentuje kazuistiku 40letého pacienta, u kterého byla první manifestací onemocnění uskřinutá epigastrická kýla, jejímž obsahem bylo omentum s metastázou sarkomu. Byla provedena resekce uskřinuté části omenta s metastázou a biopsie z dalšího ložiska intraabdominálně. Vzorky z biopsie byly odeslány k histopatologickému hodnocení. Pro generalizaci onemocnění nebyl další chirurgický výkon indikován a byla zvolena systémová paliativní chemoterapie v režimu VDC-IE. V čase odevzdání rukopisu přežívá pacient 6 měsíců od operace.
Desmoplastic small round cell tumor belongs to a group of soft tissue sarcomas. It is a rare disease, since its discovery in 1989, only hundreds of cases have been described in the literature. Due to the rare incidence of the tumor, this disease remains unknown in common medical practice. It occurs most often in men at young age. Its prognosis is serious and the average survival of patients ranges from 1.5 to 2.5 years. Treatment options include surgical resection, chemo-, radio- and targeted therapy. Our work presents a case report of a 40 year-old patient sufferred from this sarcoma. The first manifestation of the disease was an incarcerated epigastric hernia with omentum and sarcoma metastasis. A resection of the incarcerated part of the omentum was performed with a biopsy from another intra-abdominal lesion. Biopsy specimens were sent for histopathological evaluation. For the generalization of the disease, further surgery was not indicated and systemic palliative chemotherapy in the VDC-IE regimen was chosen. At the time of submitting the manuscript, the patient has survived 6 months since the surgical procedure.
- MeSH
- desmoplastický nádor z malých kulatých buněk * diagnóza komplikace terapie MeSH
- dospělí MeSH
- hernie etiologie MeSH
- lidé MeSH
- metastázy nádorů MeSH
- operace kýly MeSH
- protokoly protinádorové léčby MeSH
- sarkom diagnóza terapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- práce podpořená grantem MeSH
- MeSH
- lidé MeSH
- sarkom * epidemiologie prevence a kontrola terapie MeSH
- sekundární prevence * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- diferenciální diagnóza MeSH
- gastrointestinální stromální tumory chirurgie diagnóza terapie MeSH
- lidé MeSH
- nádory měkkých tkání chirurgie diagnóza terapie MeSH
- osteosarkom chirurgie diagnóza terapie MeSH
- sarkom * chirurgie diagnóza terapie MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Primární synoviální sarkom srdce je mimořádně vzácným nádorem s vyšším výskytem u mladých mužů. Průměrný věk výskytu je 32 let. Synoviální sarkomy jsou nádory s vysokou agresivitou, rychle proliferují a metastazují do regionálních i vzdálených mízních uzlin či okolních orgánů. Typická lokalizace synoviálního sarkomu srdce je síňové a komorové septum. Jeho velikost, stupeň infiltrace okolních tkání a přítomnost metastáz mají vliv na klinické příznaky, které jsou velmi nespecifické. Nízká specifita příznaků ztěžuje klinickou diagnózu a ve většině případech k jeho odhalení dojde při jeho progresi nebo v rámci jiného vyšetření. Stanovení konečné diagnózy je na podkladě histologického vyšetření. Prvotní a jedinou metodou léčby je operační řešení se snahou o kompletní resekci nádoru, poté navazující agresivní paliativní chemoterapie.
Primary cardiac synovial sarcoma is an extremely rare tumor with a higher incidence in young men. The mean age of occurrence is 32 years. Synovial sarcomas are tumors with high aggressiveness, proliferate rapidly and metastasize to regional and distant lymph nodes or surrounding organs. The typical location of synovial sarcoma of the heart is the atrial and ventricular septum. Its size, the degree of infiltration of the surrounding tissues and the presence of metastases influence clinical symptoms, which are very non-specific. The low specificity of the symptoms complicates the clinical diagnosis and in most cases the tumor is detected during its progression or incidentally. The final diagnosis is based on histological examination. The primary and only method of treatment is a surgical solution with an effort to completely resect the tumor, followed by aggressive palliative chemotherapy. In the following paper, we present a case report of a 32-year-old man who was diagnosed with synovial cardiac sarcoma only on the basis of exacerbation of non-specific subjective complaints due to the complication in the form of of aneurysmal bleeding of the tumor mass.
- MeSH
- chybná diagnóza MeSH
- COVID-19 komplikace MeSH
- dospělí MeSH
- lidé MeSH
- nádory srdce * chirurgie diagnóza farmakoterapie MeSH
- protokoly antitumorózní kombinované chemoterapie MeSH
- sarkom chirurgie diagnóza terapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH