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At least 235 records · Page 13Linked to original sources

Uterine leiomyosarcoma with massive necrosis diagnosed during gonadotropin-releasing hormone analog therapy for presumed uterine fibroid.

Recurrence of heavy vaginal bleeding and massive necrosis of a uterine leiomyosarcoma are reported in a 41-year-old female who was being treated with GnRH-a for a presumed uterine fibroid. The pathogenic mechanisms of such an event are reviewed and discussed in light of the available literature on the subject of GnRH-a and the treatment of uterine smooth muscle neoplasms.

Adult↗

Localized muscle wasting as an initial symptom of skeletal muscle lymphoma.

A 25-year-old man who developed painless muscle wasting and weakness of only the right thigh, was eventually shown to have systemic lymphoma with muscle infiltration. The patient was initially misdiagnosed as focal inflammatory myopathy, and he had a partial response to steroid therapy. Immunohistochemical analysis of the biopsied muscle and the subcutaneous tumor revealed the infiltrating cells with a positive macrophage-associated marker (CD68) and negative T- or B-cell-associated antigens, leading to the final diagnosis of true histiocytic lymphoma. Although skeletal muscle lymphoma is extremely rare, it should be considered in the differential diagnosis of localized muscle wasting.

Adult↗

Focal myositis of the neck.

Focal myositis is a recently defined, rapidly growing, inflammatory pseudotumor of skeletal muscle. It is characterized by marked myopathic changes of muscle fibers, hypocellular fibrosis of perimysium and endomysium, and an intense inflammatory reaction in the fibrous septa. This report describes the first instance involving the neck muscle of a 40 year old man. A brief discussion of other histologically similar subcutaneous lesions is also presented.

Adolescent↗

Glomus tumor with diffuse infiltration of the quadriceps muscle: a case report.

A case of a diffuse growing glomus tumor with interstitial infiltration of the musculus vastus medialis and intermedius (quadriceps muscle) in a 21-year-old woman is reported. The tumor was diagnosed by needle biopsy and then removed with wide margins. The typical histological appearance and the immunohistochemical findings in the resected specimen confirmed the diagnosis. Histogenesis and the biological behavior of glomus tumors are discussed.

Adult↗

Expression of neural cell adhesion molecules and neurofilament protein isoforms in skeletal muscle tumors.

In a series of rhabdomyosarcomas, the expression of neural cell adhesion molecules (NCAM) and neurofilament isoforms was probed in frozen sections. It was found that NCAM was widely expressed in rhabdomyosarcomas without relation to subtype or differentiation level. Neurofilament isoforms were found throughout all subtypes but were largely restricted to those neurofilament isoforms that are expressed early in neurogenesis, that is, poorly phosphorylated low- and medium-weight isoforms. It was concluded that the expression of these "neural" markers is widespread and does not signify a neural tumor.

Adolescent↗

Primary CD30/Ki-1 positive anaplastic large cell lymphoma of skeletal muscle with der(17)t(1;17)(q11;p11).

CD30/Ki-1 positive anaplastic large cell lymphoma (Ki-1 ALCL) frequently exhibits extranodal disease and chromosomal t(2;5)(p23;q35). An 11-year-old girl presented with an intramuscular tumor of the right upper arm. Tumors of the chest wall, left arm and leg, hepatomegaly, pleural effusion, and enlarged lymph nodes then developed. The intramuscular tumor and pleural effusion showed a diffuse infiltration of large atypical cells with abundant amphophilic cytoplasms. The tumor cells were positive for CD30, CD2, CD45RO, and p80, but were negative for other T-cell, B-cell, and myeloid cell antigens. She was diagnosed as having Ki-1 ALCL with a T-cell origin. Cytogenetic studies showed an abnormal karyotype including a der(17)t(1;17)(q11;p11). She received seven cycles of intensive chemotherapy followed by an autologous peripheral blood stem cell transplantation, and has been in complete remission for more than two years. The primary involvement of skeletal muscle is quite uncommon in ALCL, and an abnormal karyotype including t(1;17)(q11;p11) has not been reported previously. Since a high frequency of aberrations of 1p36/1q12 or 17p13.3 was detected in sarcoma cells, the presence of suppressor genes is suggestive in these sites.

Child↗

[Sonography of muscles].

Sonography constitutes a method of choice in the evaluation of muscular structures. Traumatic lesions represent the majority of muscular injuries. A good anatomical knowledge of the weakness sites, as well as knowledge of traumatic signs and symptoms is essential in order to deliver a precise report to the referring physician. Sonography may suggest other causes of muscle lesions, tumoral or dystrophic, before confirmation by MRI.

Adult↗

Establishment of three rat soft tissue tumor cell lines with different degrees of myogenic differentiation.

Soft tissue malignancies often show divergent differentiation, including myogenic lineage. Five rat tumors induced with 20-hydroxymethylcholanthrene (20-OH-MCA), were cultured in vitro, and three cell lines (YMC-1, YMC-2, YMC-3) were established from them. YMC-2 and -3 cells were spindle-shaped, and YMS-1 cells round and epithelioid. In confluency, YMC-3 cells formed myotubes. The nude mouse xenotransplants showed morphological features consistent with their myogenic phenotypes. Muscle-specific enzyme activities were highest in YMC-3 cells. These lines may be useful in the investigation of the myogenic differentiation of undifferentiated mesenchymal cells.

Animals↗

Subdeltoid lipoma presenting as subluxation of the glenohumeral joint.

This case illustrates that space-occupying lesions beneath the heavily collagenated portion of the deltoid can produce a confusing clinical picture mimicking subluxation. This patient's clinical presentation was quite extraordinary in its resemblance to glenohumeral instability. The case also illustrates the importance of imaging studies in confirming questionable diagnoses. Such studies should be read by the surgeon, and any discrepancies from the radiologist's reading should be addressed.

Diagnosis, Differential↗

Intraosseous leiomyoma of the mandible.

An intraosseous leiomyoma arising within the mandible was diagnosed in a 24-year-old woman. Clinically, a nodular swelling of the lower border of the mandible was noted. Radiographically, a unilocular ellipsoid radiolucency, loss of the lower border of the mandible, and tooth resorption were observed. The mitotic count was 0.4 per 10 high-power fields, which supported the benign nature of the tumor. The clinical and histologic parameters for distinguishing between benign and malignant smooth muscle neoplasms are discussed.

Adult↗

Orofacial rhabdomyosarcoma in neonates and young children: a review of literature and management of four cases.

Rhabdomyosarcoma (RMS) is an aggressive malignant skeletal muscle neoplasm arising from embryonal mesenchyme. It accounts for over 50% of all pediatric soft tissue sarcomas. The head and neck region is the most common site for this tumor in children. Neonatal presentation of this tumor is rare. We present the management of one neonatal case and three additional cases of orofacial RMS in children under the age of 7 years. All four patients were seen in the department of oral and maxillofacial surgery at Children's Hospital and Regional Medical Center (CHRMC) in Seattle between 1992-2000. Three of the four cases were alveolar RMS and one was botryoid sub-type of embryonal RMS. Three patients were treated with a combination of surgery, chemotherapy and radiation, while the patient with botryoid RMS was treated with surgery and chemotherapy only. The patient with congenital RMS died at 2.5 years of age due to recurrent metastatic disease. The other three patients are alive without evidence of recurrent with a mean follow up was 5.5 years (range 2.5-8.5 years). We discuss the current management, diagnosis, biological behavior, histopathology, prognosis and survival of head and neck RMS in neonates and young children.

Child↗

[Blunt trauma in soccer. The initial manifestation of synovial sarcoma].

Report on a young man, who was operated upon after adequate trauma following the diagnosis "organizing haematoma of the adductorial compartment". Surprisingly we found intraoperatively tumor suggilations. According to the definition of Enneking the surgical procedure was finished as "marginal excision" and the patient was referred to an oncological center. After multimodal therapy the patient is meanwhile tumor and recurrence free for 5 years. In case of such an unexpected diagnosis the importance of paying attention to the criterias of an "incisional biopsy" is emphasized. The concept of a "conceived biopsy" is explained in preoperatively malignant looking tumors. The outstanding responsibility of the surgeon for prognosis (local recurrence) and patients quality of life (amputation versus limb salvaging) is elaborated.

Adult↗

[Pulmonary and pleural metastasis of a malignant granular cell tumor].

HISTORY AND CLINICAL FINDINGS: A 72-year-old woman, who suffered from increasing dyspnea and productive cough was admitted to hospital. Clinical examination revealed a reduced respiratory sounds over the left lung and a painless and unmovable tumor in the area of the left hip. CLINICAL AND LABORATORY TESTS: Apart from hypoxemia (pO2 7.81 kPa) the laboratory values did not indicate any pathological findings. The X-ray and CT-scan of the chest showed a few spotty shadows and pleura effusion on the left. No tumor cells were detected in the pleural effusion. In biopsies of the visceral and parietal pleura as well as biopsy within the tumor in the area of the left hip there were clusters of tumor cells of a granular cell tumor. DIAGNOSIS, TREATMENT AND CLINICAL COURSE: Because the same tumor cell type was detected in the visceral and parietal pleura and wihtin the tumor at the left gluteus area, we diagnosed a malignant granular cell tumor. The CT-scan was suspicious of lung metastasis. The primary tumor was located in the area of left hip. The patient was in a poor general condition and she suffered from an extensive metastastic disease; curative treatment was not possible. A pleurodesis was performed. The patient died nine months after initial diagnosis. CONCLUSION: A rare malignant granular cell tumor was discovered by detecting tumor tissue of granular cell tumor in the pleura and within a tumor in the left gluteus area. Another indication of a metastatic disease were multifocal lesions in the lung detected by CT-scan. Curative treatment was not possible.

Aged↗

[Reconstruction of defects at the neuromuscular junction].

Loss of muscle tissue at the area of the neuromuscular junction after tumor resection or after trauma precludes the reconstruction with conventional nerve grafts, because the distal nerve stump is absent. For these cases, we recommend direct insertion of the nerve grafts into the muscle. We describe a standardized technique, which has been performed in 19 patients and led to a mean motor recovery of grade M4 after Highet. The key procedure of this technique is the interfascicular dissection of the nerve grafts, which allows a wide distribution of the grafts into the muscle tissue.

Adult↗

Primary mouse myoblast purification, characterization, and transplantation for cell-mediated gene therapy.

The transplantation of cultured myoblasts into mature skeletal muscle is the basis for a new therapeutic approach to muscle and non-muscle diseases: myoblast-mediated gene therapy. The success of myoblast transplantation for correction of intrinsic muscle defects depends on the fusion of implanted cells with host myofibers. Previous studies in mice have been problematic because they have involved transplantation of established myogenic cell lines or primary muscle cultures. Both of these cell populations have disadvantages: myogenic cell lines are tumorigenic, and primary cultures contain a substantial percentage of non-myogenic cells which will not fuse to host fibers. Furthermore, for both cell populations, immune suppression of the host has been necessary for long-term retention of transplanted cells. To overcome these difficulties, we developed novel culture conditions that permit the purification of mouse myoblasts from primary cultures. Both enriched and clonal populations of primary myoblasts were characterized in assays of cell proliferation and differentiation. Primary myoblasts were dependent on added bFGF for growth and retained the ability to differentiate even after 30 population doublings. The fate of the pure myoblast populations after transplantation was monitored by labeling the cells with the marker enzyme beta-galactosidase (beta-gal) using retroviral mediated gene transfer. Within five days of transplantation into muscle of mature mice, primary myoblasts had fused with host muscle cells to form hybrid myofibers. To examine the immunobiology of primary myoblasts, we compared transplanted cells in syngeneic and allogeneic hosts. Even without immune suppression, the hybrid fibers persisted with continued beta-gal expression up to six months after myoblast transplantation in syngeneic hosts. In allogeneic hosts, the implanted cells were completely eliminated within three weeks. To assess tumorigenicity, primary myoblasts and myoblasts from the C2 myogenic cell line were transplanted into immunodeficient mice. Only C2 myoblasts formed tumors. The ease of isolation, growth, and transfection of primary mouse myoblasts under the conditions described here expand the opportunities to study muscle cell growth and differentiation using myoblasts from normal as well as mutant strains of mice. The properties of these cells after transplantation--the stability of resulting hybrid myofibers without immune suppression, the persistence of transgene expression, and the lack of tumorigenicity--suggest that studies of cell-mediated gene therapy using primary myoblasts can now be broadly applied to mouse models of human muscle and non-muscle diseases.

Animals↗