关键词: ASPSCR1:: TFE3 alveolar soft part sarcoma

Mesh : Adult Female Humans Child Adolescent Sarcoma, Alveolar Soft Part / diagnosis genetics surgery Oncogene Proteins, Fusion Gene Fusion Prognosis Basic Helix-Loop-Helix Leucine Zipper Transcription Factors / genetics

来  源:   DOI:10.48095/ccko2023396

Abstract:
BACKGROUND: Alveolar soft part sarcoma (ASPS) is a very rare mesenchymal malignancy of uncertain origin. It mostly affects young people, with about a quarter of cases being diagnosed in children.
METHODS: An 11-year-old girl had a painless subcutaneous \"lump\" in the left elbow area. Imaging exams revealed a solid soft-tissue intramuscular mass of suspicious appearance. A surgical excision of lesion was performed. The biopsy consisted of a lobular tumor measuring 35 × 20 × 12 mm. Histology revealed an epithelioid-cell population arranged in organoid pseudoalveolar pattern. It immunohistochemically expressed TFE3 and harbored the ASPSCR1:: TFE3 gene fusion. A diagnosis of ASPS was established. Subsequently, a wide re-excision of the scar was performed without microscopic residual tumor. The patient is currently without evidence of local recurrence or metastasis.
CONCLUSIONS: ASPS is considered an aggressive and prognostically unfavorable chemoresistant neoplasm. Children have a better prognosis compared to adults. Early detection of tumor in a localized stage with complete surgical removal remains a mainstay therapeutic option. Due to its tendency to late metastases, a long-term thorough follow-up of the patient is necessary.
摘要:
背景:肺泡软组织肉瘤(ASPS)是一种非常罕见的起源不确定的间充质恶性肿瘤。它主要影响年轻人,大约四分之一的病例被诊断为儿童。
方法:一名11岁女孩在左肘区域有一个无痛的皮下“肿块”。影像学检查显示,肌肉内的软组织肿块可疑。进行了病灶的手术切除。活检由35×20×12毫米的小叶肿瘤组成。组织学显示,上皮样细胞群以类器官假肺泡模式排列。它在免疫组织化学上表达TFE3,并带有ASPSCR1::TFE3基因融合。建立了ASPS的诊断。随后,对瘢痕进行了广泛的再切除,没有显微镜下残留的肿瘤。患者目前没有局部复发或转移的证据。
结论:ASPS被认为是侵袭性和预后不良的化学耐药肿瘤。与成人相比,儿童的预后更好。在完全手术切除的局部阶段早期检测肿瘤仍然是主要的治疗选择。由于其晚期转移的倾向,有必要对患者进行长期彻底的随访.
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