Alveolar Soft Part Sarcoma

腺泡状软组织肉瘤 (ASPS)
  • 文章类型: Review
    背景:肺泡软组织肉瘤是一种罕见的软组织肿瘤,大多位于四肢的肌肉或深层软组织。在极少数情况下,这种肿瘤在腹部或骨盆的深层组织中发展。
    方法:在本案例报告中,我们描述了一例46岁的男性,他发展为原发性脾肺泡软组织肉瘤。肿瘤表现出典型的形态肺泡方面,以及免疫组织化学谱,特别是TFE3核染色。分子生物学中ASPSCR1外显子7::TFE3外显子6融合转录本的检测和FISH中TFE3重排的检测证实了诊断。
    结论:我们描述了第一例原发性脾肺泡软组织肉瘤,这再次质疑这种罕见肿瘤的起源细胞。
    BACKGROUND: Alveolar soft part sarcoma is a rare tumour of soft tissues, mostly localized in muscles or deep soft tissues of the extremities. In rare occasions, this tumour develops in deep tissues of the abdomen or pelvis.
    METHODS: In this case report, we described the case of a 46 year old man who developed a primary splenic alveolar soft part sarcoma. The tumour displayed typical morphological alveolar aspect, as well as immunohistochemical profile notably TFE3 nuclear staining. Detection of ASPSCR1 Exon 7::TFE3 Exon 6 fusion transcript in molecular biology and TFE3 rearrangement in FISH confirmed the diagnosis.
    CONCLUSIONS: We described the first case of primary splenic alveolar soft part sarcoma, which questions once again the cell of origin of this rare tumour.
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  • 文章类型: Journal Article
    肺泡软组织肉瘤(ASPS)是一种罕见且独特的软组织肉瘤亚型。这项研究旨在描述女性生殖道中ASPS的独特表现。
    使用多变量分析评估癌症特异性总生存期(CSS)的预后因素。
    在我们的案例系列中,我们在1例24岁未婚宫颈ASPS患者中发现了一种新型TFE3-PRCC基因融合体,该患者接受了保留生育功能的手术,并在41个月内保持无复发.另外两名患者接受了根治性子宫切除术和双侧附件卵巢切除术。在撰写本文时,这两名患者已经无病治疗了49个月和71个月,荧光原位杂交显示ASPL-TFE3基因的信号分离。在PubMed/Medline数据库提供的55例病例中,大多数表现为局部疾病,在最后一次随访中,所有患者均存活,45例患者无疾病迹象.SEER数据库中女性生殖道队列的5年CSS率为86.2%。多因素分析显示,年龄与癌症特异性死亡率增加1.042倍相关(HR=1.042,95%CI1.022-1.063,P<0.001)。包括心脏在内的软组织受累与4.786倍的风险相关(HR=4.7868,95%CI1.681-13.623,P=0.003),与局部疾病相比,区域浸润和远处转移与癌症特异性死亡率的风险高约8.6倍和18倍相关。(HR=8.652,95%CI2.529-29.63,P=0.001;HR=18.366,95%CI6.153-54.817,P<0.001)。与接受局部切除术的患者相比,接受根治性切除术的患者未显示出降低的癌症特异性死亡率(HR=0.492,95%CI0.224-1.081,P=0.078)。
    以前未被识别的遗传多样性存在于ASPS中。女性生殖道ASPS患者出现远处疾病的可能性最低,并且与更有利的生存结果相关。
    UNASSIGNED: Alveolar soft part sarcoma (ASPS) is a rare and distinct subtype of soft tissue sarcoma. This study aims to describe the unique presentation of ASPS in the female genital tract.
    UNASSIGNED: Prognostic factors for cancer-specific overall survival (CSS) were evaluated using multivariate analyses.
    UNASSIGNED: In our case series, we identified a novel TFE3-PRCC gene fusion in a 24-year-old unmarried patient with cervical ASPS who underwent fertility-sparing surgery and remained recurrence-free for 41 months. The other two patients underwent radical hysterectomy and bilateral salpingo-oophorectomy. At the time of writing, the two patients had been disease-free for 49 and 71 months, fluorescence in situ hybridization showed break-apart signals for the ASPL-TFE3 gene. Among the 55 cases with available information from the PubMed/Medline database, most presented with localized disease, and at the last follow-up, all patients were alive and 45 patients showed no evidence of disease. The 5-year CSS rate in the female genital tract cohort from SEER database was 86.2%. Multivariate analysis revealed that older age was associated with a 1.042-fold increased risk of cancer-specific mortality (HR=1.042, 95% CI 1.022-1.063, P < 0.001), involvement of soft tissue including the heart was associated with a 4.786-fold higher risk (HR=4.7868, 95% CI 1.681-13.623, P= 0.003), and regional infiltration and distant metastasis were associated with approximately 8.6-fold and 18-fold higher risk of cancer-specific mortality compared to local disease, respectively (HR=8.652, 95% CI 2.529-29.63, P = 0.001; HR=18.366, 95% CI 6.153-54.817, P< 0.001). Patients who underwent radical excision did not show reduced cancer-specific mortality compared to those who underwent local excision (HR=0.492, 95% CI 0.224-1.081, P = 0.078).
    UNASSIGNED: Previously unrecognized genetic diversity exists in ASPS. Patients with ASPS in the female genital tract have the lowest likelihood of presenting with a distant disease and are associated with a more favorable survival outcome.
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  • 文章类型: Review
    目的:女性生殖器肺泡软组织肉瘤(ASPS)罕见,与其他部位的ASPS相比,预后良好。我们报告了我们处理子宫体ASPS(UCASPS)病例的经验,并对女性生殖道不同部位ASPS的预后进行了文献综述。
    方法:本报告为一名33岁女性,患有UCASPS。她接受了保留子宫的肿瘤切除术,随访时间最长(155个月),没有复发。
    结论:UCASPS的预后优于宫颈ASPS,子宫下段,外阴阴道区和会阴.我们建议对患有UCASPS的年轻女性进行保守治疗。
    OBJECTIVE: Female genital alveolar soft part sarcoma (ASPS) is rare and has a favourable prognosis compared to ASPS from other sites. We reported our experience to manage a case with uterine corpus ASPS (UC ASPS) and conducted a literature review on prognosis of ASPS from different sites of female genital tract.
    METHODS: This report represented a 33-year-old woman who had UC ASPS. She received tumor excision with uterine preservation and had the longest follow-up time (155 months) without recurrence in the literature.
    CONCLUSIONS: UC ASPS has better prognosis than ASPS from the uterine cervix, the low uterine segment, vulvovaginal area and perineum. We recommended conservative treatment for young women with UC ASPS.
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  • 文章类型: Review
    肺泡软组织肉瘤是一种组织起源不确定的罕见肿瘤,属于新定义的超罕见肉瘤类别。肿瘤的特征是特定的染色体易位,der(17)t(X;17)(p11.2;q25),这导致ASPSCR1-TFE3基因融合。肺泡软组织肉瘤的自然史描述了四肢深层软组织中缓慢进展的惰性行为。青少年和年轻人的躯干和头/颈部。据报道,远处转移的检出率很高,最常见的转移部位以频率递减的顺序是肺,骨头和大脑完整的手术切除仍然是标准的治疗策略,而放疗适用于手术切缘不足或无法切除肿瘤的患者。尽管肺泡软组织肉瘤对传统的多柔比星化疗是难治性的,使用酪氨酸激酶抑制剂和免疫检查点抑制剂的单一疗法或联合疗法提供了抗肿瘤活性,并成为新的治疗策略.本文根据肺泡软组织肉瘤的临床阶段,概述了对这种超罕见肉瘤的当前理解以及治疗方法的最新进展。
    Alveolar soft part sarcoma is a rare neoplasm of uncertain histogenesis that belongs to a newly defined category of ultra-rare sarcomas. The neoplasm is characterized by a specific chromosomal translocation, der (17) t(X; 17)(p11.2;q25), that results in ASPSCR1-TFE3 gene fusion. The natural history of alveolar soft part sarcoma describes indolent behaviour with slow progression in deep soft tissues of the extremities, trunk and head/neck in adolescents and young adults. A high rate of detection of distant metastasis at presentation has been reported, and the most common metastatic sites in decreasing order of frequency are the lung, bone and brain. Complete surgical resection remains the standard treatment strategy, whereas radiotherapy is indicated for patients with inadequate surgical margins or unresectable tumours. Although alveolar soft part sarcoma is refractory to conventional doxorubicin-based chemotherapy, monotherapy or combination therapy using tyrosine kinase inhibitors and immune checkpoint inhibitors have provided antitumor activity and emerged as new treatment strategies. This article provides an overview of the current understanding of this ultra-rare sarcoma and recent advancements in treatments according to the clinical stage of alveolar soft part sarcoma.
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  • 文章类型: Review
    肺泡软组织肉瘤(ASPS)是一种极为罕见的软组织肉瘤。ASPS的主要部位主要位于四肢和躯干。原发性肺ASPS极为罕见。对PubMed®数据库的搜索仅发现5例原发性肺ASPS。当前的病例报告描述了一名15岁男性中的第六例ASPS,该病例表现为复发性头痛。头部计算机断层扫描显示左顶叶占位病变。正电子发射断层扫描-计算机断层扫描证实左顶叶占位性病变,并显示两肺和胸膜多发结节和肿块,被认为是低度恶性间充质肿瘤。病例报告介绍了临床特点,诊断和治疗过程。程序性细胞死亡蛋白1单克隆抗体(sintilimab)联合酪氨酸激酶抑制剂(盐酸安洛替尼)取得了良好的治疗效果,表明这种联合治疗值得进一步探索。需要大规模的前瞻性研究来探索和开发ASPS的标准化治疗方法。
    Alveolar soft part sarcoma (ASPS) is an extremely rare type of soft tissue sarcoma. The primary sites of ASPS are mostly located in the extremities and trunk. Primary pulmonary ASPS is extremely rare. A search of the PubMed® database identified only five cases of primary pulmonary ASPS. This current case report describes the sixth case of ASPS in a 15-year-old male that presented with recurrent headaches. Head computed tomography showed space-occupying lesions in the left parietal lobe. Positron emission tomography-computed tomography confirmed the space-occupying lesions in the left parietal lobe and showed multiple nodules and masses in the two lungs and pleura, which were considered to be low-grade malignant mesenchymal tumours. The case report presents the clinical characteristics, diagnosis and treatment process. Programmed cell death protein 1 monoclonal antibody (sintilimab) combined with a tyrosine kinase inhibitor (anlotinib hydrochloride) achieved a good therapeutic effect, indicating that this combination therapy is worth exploring further. Large-scale prospective studies are needed to explore and develop standardized treatments for ASPS.
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  • 文章类型: Case Reports
    肺泡软组织肉瘤(ASPS)是一种罕见的恶性肿瘤,在形态上具有独特的结节状,类器官,或嵌套生长模式,其中细胞被血管化的隔片分开。诊断是基于病理和免疫组织化学结果的组合以及下一代测序揭示的ASPSCR1-TFE3基因融合的存在。ASPS最常见于下肢的无痛肿块,如果存在转移,可能累及肺部。在这里,我们报告了一例ASPS,该病例表现出特征性的ASPSCR1-TFE3基因融合以及TFE3-ASPSCR1的相互融合,该融合出现在一名31岁女性的鼻唇沟中。采用口内方法对恶性肿瘤进行完整的手术切除,导致11个月后持续缓解。
    Alveolar soft part sarcoma (ASPS) is a rare malignancy that is morphologically characterized by a distinctive nodular, organoid, or nested growth pattern in which the cells are separated by vascularized septa. The diagnosis is based on a combination of pathologic and immunohistochemical findings and the presence of an ASPSCR1-TFE3 gene fusion revealed by next-generation sequencing. ASPS most commonly occurs as a painless mass in the lower extremity, with likely involvement in the lungs if metastasis is present. Here we report a case of ASPS that exhibited the characteristic ASPSCR1-TFE3 gene fusion along with a reciprocal fusion of TFE3-ASPSCR1, which presented in the nasolabial fold of a 31-year-old female. An intraoral approach was utilized for complete surgical resection of the malignancy, resulting in continued remission after 11 months.
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  • 文章类型: Review
    背景:肺泡软组织肉瘤(ASPS)是一种罕见的恶性软组织肿瘤,分化不明确,其中在各种软组织肿瘤中发病率仅占0.5-1.0%。更罕见的ASPS发生在肾脏中。
    方法:这里我们报道一例7岁女孩被诊断为肾源性ASPS,关于发病率的分析,临床表现,病理学和遗传学诊断,以加深对疾病的认识。
    结论:ASPS非常罕见,并且往往发生在年轻患者身上。早期准确诊断ASPS具有重要意义,这将是以下治疗选择和预后的关键点。
    BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare kind of malignant soft tissue tumor with undefined differentiation, of which the incidence rate accounts for only 0.5-1.0% among all kinds of soft tissue tumors. An even rarer ASPS occurs in kidney.
    METHODS: Here we reported a case of a 7-year-old girl diagnosed with nephrogenic ASPS, regarding the analyses of the incidence, clinical manifestation, pathology and genetic diagnosis, in order to deepen the recognition of the disease.
    CONCLUSIONS: ASPS is very rare, and tends to occur to young patients. It is very significant to precisely diagnose ASPS at an early stage, which will be the key point for the following treatment choices and prognosis.
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  • 文章类型: Journal Article
    肺泡软组织肉瘤(ASPS)是一种罕见的软组织肉瘤,具有独特的肿瘤特征,这在儿童中很少见。在这里,我们提出了免疫表型,治疗,中南大学湘雅二医院3例ASPS患儿的预后分析,在以前的文献中已经报道了51名患有ASPS的儿童,以及对临床特征的重点审查,病理特征,鉴别诊断,治疗,儿童ASPS的预后。
    Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma with unique tumor characteristics, which is rare in children. Herein, we present the immunophenotype, treatment, and prognosis of three children with ASPS from The Second Xiangya Hospital of Central South University, and 51 children with ASPS have been reported in the previous literature, along with a focused review of the clinical features, pathological features, differential diagnosis, treatment, and prognosis of ASPS in pediatric patients.
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  • 文章类型: Review
    背景:肺泡软组织肉瘤(ASPS)是一种罕见的易位相关软组织肉瘤,主要发生在青少年和青少年的四肢和躯干。ASPS很少见于头部和颈部,所描述的病例中有四分之一是舌头原发性的。鉴于其非特异性症状,临床发现,这个地方很罕见,舌侧ASPS(L-ASPS)常被误诊为多种良性肿瘤,导致不良后果。
    方法:我们报告了1例发生在迄今为止发表的年龄最大(78岁)的女性患者中的L-ASPS,并全面回顾了1952年至2022年的文献。
    结果:她表现出生长缓慢(持续2年)的舌头质量,测量3.5厘米的触诊。术中冰冻切片不能明确诊断。肿瘤的病理发现是ASPS的特征,具有类器官/嵌套模式的嗜酸性多边形细胞,丰富的正弦毛细血管,和TFE3免疫反应性,除了强烈的弥漫性异常细胞质CD68免疫表达和PAS上不存在胞质内晶体包涵体与淀粉酶。用荧光原位杂交鉴定TFE3基因重排后,反射测试证实TFE3基因与已知的融合伴侣ASPSCR1重排。
    结论:对于任何生长缓慢的舌部肿块(尤其是血管性肿块)具有非特异性临床表现的病例,应将ASPS纳入鉴别诊断中。不管病人的年龄。
    BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare translocation-related soft tissue sarcoma, occurring mainly in the limbs and trunk in young adults and adolescents. ASPS is rarely seen in the head and neck and one fourth of those cases described are tongue primary. Given its nonspecific symptoms, clinical findings, and rarity in this location, lingual ASPS (L-ASPS) has been reported to be commonly misdiagnosed as various benign tumors, leading to adverse outcomes.
    METHODS: We report a case of L-ASPS occurring in the oldest (78 years) female patient published to date and comprehensively review the literature from 1952 to 2022.
    RESULTS: She presented with a slow-growing (2-year duration) tongue mass, measuring 3.5 cm on palpation. Intraoperative frozen section could not render the definitive diagnosis. The pathological findings of the tumor were characteristic of ASPS with eosinophilic polygonal cells in an organoid/nested pattern, rich sinusoidal capillaries, and TFE3 immunoreactivity, except for the strong diffuse aberrant cytoplasmic CD68 immunoexpression and absence of intracytoplasmic crystalline inclusions on PAS with diastase. After TFE3 gene rearrangement had been identified with fluorescent in-situ hybridization, reflex testing confirmed a rearrangement of TFE3 gene with the known fusion partner ASPSCR1.
    CONCLUSIONS: ASPS should be included in the differential diagnoses in cases of any slow-growing lingual masses (especially vascular ones) with non-specific clinical pictures, regardless of the patient\'s age.
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  • 文章类型: Case Reports
    肺泡软组织肉瘤(ASPS)是一种非常罕见的软组织肉瘤,通常发生在四肢和躯干。
    一名25岁的女性出现8个月的眼球突出和右眼发红。她患有严重的右上眼睑水肿,结膜化学,地球的向下位移,和突起。放射学成像是非决定性的。组织病理学评估证实了ASPS。患者接受了作为挽救生命的手术。在16个月的随访中,患者病情稳定,无复发或转移迹象。
    我们报告了一例发生在上直肌的非常罕见的ASPS病例。文献中很少报道眼眶ASPS病例。对眼眶ASPS进行了文献综述,以阐明这种罕见肿瘤的诊断和治疗。
    UNASSIGNED: Alveolar soft part sarcoma (ASPS) is a very rare type of soft tissue sarcomas which usually occurs in the limbs and trunk.
    UNASSIGNED: A 25-year-old woman presented with proptosis and redness of the right eye for 8-month. She suffered from severe right upper lid edema, conjunctival chemosis, downward displacement of the globe, and proptosis. Radiological imaging was nonconclusive. Histopathological evaluations confirmed ASPS. The patient underwent exenteration as a lifesaving procedure. At 16-month follow-up, the patient is stable without any signs of recurrence or metastasis.
    UNASSIGNED: We report an extremely rare case of ASPS occurring in the superior rectus muscle. Few orbital ASPS cases have been reported in the literature. A literature review of orbital ASPS was done to shed lights on the diagnosis and management of this rare tumor.
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