Rodríguez-Velasco Alicia, Fermán-Cano Floribel, Cerecedo-Díaz Fernando
Pathology, Unidad Médica de Alta Especialidad, Pediatría, Centro Médico Nacional Siglo XXI, IMSS, Mexico.
Pediatr Dev Pathol. 2009 Mar-Apr;12(2):147-51. doi: 10.2350/07-07-0317.1. Epub 2008 Jul 16.
Alveolar soft part sarcoma (ASPS) is a rare, malignant tumor of uncertain histogenesis that has no benign counterpart. In some cases, a structural rearrangement of chromosome 17 involving band q25 has been reported. The neoplasm occurs most frequently in female adolescents and young adults, where it arises predominantly in the extremities. In contrast, the most common sites of occurrence in infants and children are the orbit (41%) and the tongue (25%). The primary therapeutic option is a complete surgical excision. Because of the indolent growth and lack of pain associated with the mass, 20% of patients have metastases at the time of initial diagnosis. Median survival time reported for all sites of the body is 79 months. When ASPS presents in the tongue region, however, the patients involved are usually children and have a better prognosis than patients affected in the extremities. The utility of adjuvant chemotherapy or radiation therapy in children is open to question. Because metastases may occur after several decades, children with ASPS should be followed throughout adolescence and well into adulthood. Only 10 cases of ASPS occurring in the tongues of children younger than 5 years of age were indexed by MEDLINE between 1952 and 2006. Here, we describe the 1st case consistent with typical ASPS of the tongue in 15 years at our hospital. The patient is a 2-year-old girl who has been disease-free for 32 months.
肺泡软组织肉瘤(ASPS)是一种罕见的、组织发生不明的恶性肿瘤,无良性对应物。在某些病例中,已报道17号染色体涉及q25带的结构重排。该肿瘤最常发生于女性青少年和年轻成人,主要发生在四肢。相比之下,婴儿和儿童最常见的发病部位是眼眶(41%)和舌头(25%)。主要的治疗选择是完整的手术切除。由于肿瘤生长缓慢且肿块无疼痛,20%的患者在初诊时已有转移。据报道,全身各部位的中位生存时间为79个月。然而,当ASPS出现在舌部区域时,受累患者通常是儿童,其预后比四肢受累的患者要好。辅助化疗或放疗在儿童中的效用尚存在疑问。由于转移可能在几十年后发生,ASPS患儿在整个青春期及成年期都应接受随访。1952年至2006年期间,MEDLINE仅收录了10例5岁以下儿童舌部发生ASPS的病例。在此,我们报道我院15年来首例符合典型舌部ASPS的病例。该患者是一名2岁女童已无病生存32个月。