Sarcoma

Leiomyosarcoma of the parapharyngeal space: A very rare entity

July 13, 2014     Haim Gavriel, MD; Eyal Yeheskeli, MD; Gratiana Hermann, MD; Ephraim Eviatar, MD
article

Abstract

Leiomyosarcoma of the head and neck is very rare, as only about 100 cases have been reported; of these, only 3 cases have been previously reported in the parapharyngeal space. We report the fourth such case, and we review the features of this entity. The patient was an 84-year-old woman who presented to the emergency department for treatment of an 18-month history of right-sided headache, a 6-month history of right-sided hearing loss and nasal obstruction, and a 2-month history of dysphagia. Physical examination revealed a bulge in the right side of the soft palate and the right lateral nasopharyngeal wall and complete obstruction of the right eustachian tube. Indirect laryngoscopy detected a bulge in the right lateral hypopharyngeal wall. Otoscopy revealed otitis media with effusion in the right ear. Imaging demonstrated a space-occupying lesion in the right parapharyngeal space that extended from the base of the skull to the level of the hypopharynx. Biopsy and histology identified the mass as a leiomyosarcoma. Metastasis to the brain was discovered shortly thereafter, and the patient died 10 months later. The unusual presentation of head and neck leiomyosarcoma requires a high index of suspicion and appropriate diagnostic imaging. Surgical excision is the recommended treatment when feasible; chemoradiotherapy does not appear to affect disease progression.

Pediatric rhabdomyosarcoma

July 13, 2014     Rosemary Ojo, MD; Si Chen, MD; Liset Pelaez, MD; Ramzi Younis, MD
article

All children with rhabdomyosarcoma require multimodality therapy to maximize local tumor control. This can involve different combinations of chemotherapy, surgery, and radiation therapy.

Rhabdomyosarcoma of the supraglottis in an adult

June 8, 2014     Alex Fernandez, MS; Reena Gupta, MD; Hootan Zandifar, MD
article

Primary laryngeal rhabdomyosarcoma is an extremely uncommon malignant neoplasm in adults, accounting for relatively few documented cases compared with squamous cell carcinoma.

Conservative cricoid surgery for chondrosarcoma: A case report

February 12, 2014     Elena Gaio, MD; Giandomenico Maggiore, MD; Alessandra Canesso, MD; and Riccardo Artico, MD
article

Abstract

We present the case of a 39-year-old man who presented with hoarseness and progressively worsening dyspnea. Findings on laryngoscopy and computed tomography strongly suggested the presence of a chondrosarcoma. The patient underwent open surgery for removal of the lesion with wide margins. Reconstruction was carried out with two segments of costal cartilage. Laryngeal chondrosarcomas are rare, malignant, usually well-differentiated neoplasms that should be treated with conservative surgery. Recurrences should be treated more aggressively.

Synovial sarcoma of the parapharyngeal space

December 20, 2013     Jagdeep Singh Virk, MA, MRCS; Dhafir Al-Okati, FRCPath; Hesham Kaddour, FRCS ORL-HNS
article

Osteosarcoma

July 21, 2013     Lester D.R. Thompson, MD
article

Osteosarcoma affects the mandible and the maxilla differently, with mandibular tumors tending to arise from the body of the mandible while maxillary tumors arise from the alveolar ridge and sinus.

Tonsillar Kaposi sarcoma in a patient with membranous glomerulonephritis on immunosuppressive therapy

July 21, 2013     Nabeel Al-Brahim, FRCPC; Ashraf H. Zaki, MD; Khaled El-Merhi, MD; Mahmoud S. Ahmad, MD
article

Abstract

Kaposi sarcoma is a malignant vascular neoplasm uncommonly seen in immunosuppressed patients. Herein we report an unusual case of tonsillar Kaposi sarcoma in a patient with membranous glomerulonephritis treated with prednisolone and cyclosporine. The patient presented after 10 months of starting the treatment with a tonsillar mass. Histological examination was typical of monomorphic spindle cell proliferation with slit-like vascular channels. The tumor cells expressed CD34, D2-40 and positive nuclear stain for HHV-8. Kaposi sarcoma is associated with immunosuppression and rarely occurs in the tonsil. Clinicians should be aware of this rare presentation of Kaposi sarcoma.

Synovial sarcoma of the larynx treated by supraglottic laryngectomy: Case report and literature review

July 21, 2013     Kuauhyama Luna-Ortiz, MD; Ana Maria Cano-Valdez, MD; Isabela Werneck da Cunha, MD; Adalberto Mosqueda-Taylor, DDS
article

Abstract

We describe a case of synovial sarcoma of the larynx, and we discuss the use of fluorescence in situ hybridization (FISH) in confirming the diagnosis. The patient was a 21-year-old woman who presented with a recurrence of a previously resected supraglottic tumor of the aryepiglottic folds. A horizontal supraglottic laryngectomy was performed, and the 0.5-cm tumor was resected. Histopathologic study suggested that it was a biphasic malignant tumor compatible with a synovial sarcoma. The diagnosis of synovial sarcoma was confirmed by FISH immunohistochemistry with the use of an SYT break-apart probe. The patient recovered satisfactorily, but at follow-up 5 years and 4 months later, tumoral activity was evident in the left side of the neck. A biopsy found that 5 lymph nodes contained a metastasis of the synovial sarcoma. Again, a bilateral neck dissection was performed, and it revealed that 16 of 16 right-side nodes and 36 of 36 left-side nodes were negative. Two months later, the patient received 46 Gy of radiotherapy in 23 sessions. She remained free of disease during 2 more years of follow-up. Synovial sarcoma of the larynx is a rare entity. Organ preservation seems to be indicated in these cases. The histologic diagnosis may be difficult. In this case, the identification of a genetic mutation corroborated the diagnosis.

Extraosseous Ewing sarcoma and peripheral primitive neuroectodermal tumor of the thyroid gland: Case report and review

April 17, 2013     Magdalena Chirila, MD, PhD; Mihaela Muresan, MD; Elisabeta Ciuleanu, MD, PhD; and Marcel Cosgarea, MD, PhD
article

Abstract

The Ewing family of tumors and peripheral primitive neuroectodermal tumor (pPNET) represent different manifestations of the same entity. Immunohistochemical and cytogenetic studies suggest that these tumors have a common origin. Ewing sarcoma is more common in bone, while pPNET is more common in soft tissues. Extraosseous Ewing sarcoma (EoES) is rare. We present the case of a 48-year-old man who presented with acute obstructive respiratory failure secondary to a large thyroid swelling. The patient was initially diagnosed with giant B-cell non-Hodgkin lymphoma and treated with chemotherapy. However, subsequent immunohistochemical staining of biopsy specimens revealed that the patient actually had EoES/pPNET of the thyroid gland. We performed a nearly complete surgical resection of the tumor plus a total laryngectomy and resection of five tracheal rings. However, the patient died of a cerebral metastasis 1 month later after he had completed one cycle of postoperative chemotherapy.

Adult case of large sinonasal embryonal rhabdomyosarcoma with intracranial extension

April 17, 2013     Enrique Palacios, MD; Alexander Quiroz-Casian, MD; Lorena Garza Garcia, MD; Philip J. Daroca, MD; Harold R. Neitzschman, MD
article

Rhabdomyosarcomas often present with nonspecific symptoms such as headache, nasal congestion, proptosis, epistaxis, and cranial nerve palsies, reflecting extension to the base of the skull.

Radiation-induced osteosarcoma of the larynx: Case report and literature review

October 8, 2012     Murat Ulusan, MD; Rasim Yilmazer, MD; Yasemin Ozluk, MD; Murat Enoz, MD; Yusufhan Suoglu, MD
article

Abstract

Laryngeal osteosarcoma is an extremely rare disease. Only 23 cases have been published in the literature. Radiation-induced laryngeal osteosarcoma is even rarer; this is only the third such case to be reported. A 59-year-old man underwent radiotherapy for an in situ laryngeal squamous cell carcinoma at another institution. Five years later he developed a laryngeal osteosarcoma, and a total laryngectomy was performed. Although previous reports showed a poor prognosis, our patient was without disease at the 8-year follow-up. To the best of our knowledge, this is the longest disease-free follow-up to be reported in the literature. We also present a review of the world’s literature.

Unusual maxillary chondrosarcoma

September 7, 2012     Daniel O. Rosenblatt, MD; Rosa B. Lipin, MD; Enrique Palacios, MD, FACR; Paul Friedlander, MD; Harold Neitzschman, MD, FACR
article

Chondrosarcomas can be distinguished from osteosarcomas because they have the distinction of producing chondroid (cartilaginous matrix) but not osteoid. When they occur in the head and neck, they usually are found in the anterior maxilla and sinonasal structures 

Page
of 5Next