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[腹膜后骨外黏液样软骨肉瘤]

[Retroperitoneal extraskeletal myxoid chondrosarcoma].

作者信息

Fornari A

机构信息

Dipartimento di Scienze Biomediche ed Oncologia Umana, Università di Torino, Italy.

出版信息

Pathologica. 2006 Aug;98(4):234-8.

Abstract

INTRODUCTION

Extraskeletal myxoid chondrosarcoma is a rare soft tissue tumor included by WHO in the group of tumors of uncertain differentiation because well formed cartilage is rarely seen in its setting; moreover some of the immunophenotype features of the tumor are still controversial. The reciprocal translocation t(9;22)(q22;q12) has recently been identified in many cases, and this chromosomal aberration is currently considered high specific of this tumor.

CASE REPORT

We report the case of a 75-year-old female submitted to radical nephrectomy for a voluminous kidney tumor with radiological evidence of extrarenal extension.

RESULTS

Grossly the lesion was set in the perirenal fat tissue. Histological examination revealed a malignant mesenchimal tumor with myxoid f eatures and areas of chondroid differentiation consistent with the diagnosis of extraskeletal myxoid chondrosarcoma. According with the diagnosis the tumor showed focal positivity to NSE by immunohistochemistry.

DISCUSSION

Differentiated cartilage is seen in extraskeletal myxoid chondrosarcoma in about 30% of the cases. Our case is then interesting not only for the rare site of tumor location but also for the extension of chondroid differentiation areas found on histologic examination in the tumor setting. Moreover immunohistochemistry showed focal positivity of the neoplastic cells for NSE, according with recent studies demonstrating expression of some neural/neuroendocrine markers in extrascheletal myxoid chondrosarcoma.

摘要

引言

骨外黏液样软骨肉瘤是一种罕见的软组织肿瘤,世界卫生组织将其归入分化不确定的肿瘤组,因为在其病变中很少见到成熟的软骨;此外,该肿瘤的一些免疫表型特征仍存在争议。最近在许多病例中发现了相互易位t(9;22)(q22;q12),这种染色体畸变目前被认为是该肿瘤的高度特异性特征。

病例报告

我们报告了一例75岁女性,因巨大肾肿瘤接受根治性肾切除术,影像学检查显示肿瘤已侵犯肾外组织。

结果

大体上,病变位于肾周脂肪组织中。组织学检查显示为恶性间叶性肿瘤,具有黏液样特征和软骨样分化区域,符合骨外黏液样软骨肉瘤的诊断。根据诊断,肿瘤免疫组化显示NSE局灶阳性。

讨论

在约30%的骨外黏液样软骨肉瘤病例中可见分化的软骨。我们的病例不仅因其罕见的肿瘤位置,还因其在肿瘤组织学检查中发现的软骨样分化区域的范围而具有意义。此外,免疫组化显示肿瘤细胞NSE局灶阳性,与最近的研究结果一致,这些研究表明在骨外黏液样软骨肉瘤中存在一些神经/神经内分泌标志物的表达。

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