Neurofibrosarcoma

神经纤维肉瘤
  • 文章类型: Case Reports
    1型神经纤维瘤病可能是严重的,并伴有恶变。正确的随访和监测对预防神经纤维瘤病的恶变非常重要。我们遇到了一例丛状神经纤维瘤恶性转化为神经纤维肉瘤(也称为恶性周围神经鞘瘤)的病例。几年来,她一直背上有一个大肿块,这也与溃疡有关。她做了背部大切除活检,组织病理学检查(HPE)发现恶性周围神经鞘瘤。该病例得出结论,任何已知神经纤维瘤病病例的患者都应接受随访以检测该疾病的任何恶性转化。早期发现神经纤维瘤病的恶性转化有助于预防疾病的进展。主要的治疗方法是手术切除;然而,局部复发的风险更高,特别是在1型神经纤维瘤病患者中。
    Neurofibromatosis type 1 can be severe and associated with malignant transformation. Proper follow-up and monitoring are very important in preventing the malignant transformation of neurofibromatosis. We encountered a case of malignant transformation of plexiform neurofibroma into neurofibrosarcoma (also known as malignant peripheral nerve sheath tumor). She had been presenting with a large mass on her back for a few years, which was also associated with an ulcer. She underwent a wide-excision biopsy of her back, and the histopathology examination (HPE) came back with a malignant peripheral nerve sheath tumor. This case concludes that any patient with a known case of neurofibromatosis should undergo follow-up to detect any malignant transformation of the disease. Early detection of the malignant transformation of neurofibromatosis can help prevent the disease\'s progression. The main treatment is surgical resection; however, the risk of local recurrence is higher, especially in patients with neurofibromatosis type 1.
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  • 文章类型: Case Reports
    恶性triton肿瘤(MTT)是恶性周围神经鞘瘤(MPNST)的亚型,由周围神经或神经纤维瘤的Schwan细胞发展而来,并显示横纹肌母细胞分化。是一种罕见的软组织肿瘤,预后较差。
    我们报告了一名46岁男性患者的右肩恶性Triton肿瘤(MTT)病例,该患者于2018年6月在侯赛因国王医疗中心皇家康复中心的肌肉骨骼肿瘤诊所就诊。
    患者主诉8个月的进行性右肩疼痛和肩后外侧区肿胀。在这种情况下,准确的诊断至关重要,包括X线和磁共振成像(MRI)在内的研究表明,软组织肿瘤累及右肩区域,从而对侵袭性软组织肿瘤进行了鉴别诊断,并制定了开放切开活检的计划,以组织病理学报告为一例。恶性Triton肿瘤是一种非常罕见且侵袭性的肉瘤,起源于周围神经鞘,因为它是恶性周围神经鞘肿瘤的亚型,此后对整个肿瘤进行了辅助切除,并进行了安全化疗。
    选择的治疗方法是广泛的肿瘤切除,然后进行化疗和/或放疗,以提高5年生存率。
    UNASSIGNED: Malignant triton tumors (MTT) are subtype of malignant peripheral nerve sheath tumor (MPNST) which develop from Schwan cells of peripheral nerves or within neurofibromas, and shows rhabdomyoblastic differentiation. It is a rare soft tissue tumor with poor prognosis.
    UNASSIGNED: We report a case of Malignant Triton Tumor (MTT) arising in the right shoulder in a 46 year old male patient presented to our Musculoskeletal Oncology Clinic at Royal Rehabilitation center at King Hussein Medical Center during June 2018.
    UNASSIGNED: The patient was complaining of an 8 months long progressive right shoulder pain and swelling at the posterior lateral area of the shoulder. As accurate diagnosis is crucial in such case, investigations that included x-rays and magnetic resonance imaging (MRI) demonstrated an soft tissue tumor involving the right shoulder area leading to the differential diagnosis of aggressive soft tissue tumor which laid down the plan of an open incisional biopsy to be reported histopathological as a case of Malignant Triton Tumor which is a very rare and aggressive sarcoma originates from the peripheral nerve sheaths as it is subtype of malignant peripheral nerve sheath tumors after which excision of the entire tumor with safety margin was performed and referred for adjuvant chemotherapy.
    UNASSIGNED: The treatment of choice is radical tumor excision with wide margins followed by chemotherapy and /or radiotherapy to improve the 5 years survival rates.
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  • 文章类型: Review
    很少描述积液标本中MPNST的细胞形态学。在本文中,已在胸腔积液中描述了转移性MPNST的详细细胞病理学和免疫组织化学特征。患者的病史和辅助研究的明智利用有助于确保精确的细胞学诊断。积液标本中恶性周围神经鞘瘤(MPNST)的细胞形态学可能在诊断上具有挑战性。作者介绍了胸腔积液中转移性MPNST病例的详细细胞病理学和免疫组织化学特征。
    The cytomorphology of MPNST in effusion specimens is rarely described. In this paper, the detailed cytopathological and immunohistochemical characteristics of metastatic MPNST has been described in pleural effusion. Patients\' medical history and the judicious utilization of ancillary studies contribute to ensure precise cytological diagnoses. The cytomorphology of malignant peripheral nerve sheath tumour (MPNST) in effusion specimens can be diagnostically challenging. The author presents detailed cytopathological and immunohistochemical characteristics of a case of metastatic MPNST in pleural effusion.
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  • 文章类型: Case Reports
    头皮的恶性周围神经鞘瘤是周围神经系统的罕见肿瘤。这里,我们描述了一名84岁的亚洲男性的头皮异常恶性周围神经鞘瘤。肿瘤与骨质破坏有关,颅内,和颅外延伸。术前两次进行动脉栓塞。进行块切除术,并通过股前外侧游离筋膜皮瓣重建硬脑膜和软组织缺损。随访期间无复发,伤口愈合良好。
    UNASSIGNED: Malignant peripheral nerve sheath tumors of the scalp are rare neoplasms of the peripheral nervous system. Here, we describe an unusual malignant peripheral nerve sheath tumor of the scalp in an 84-year-old Asian man. The tumor was associated with bony destruction, intracranial, and extracranial extension. Trans-arterial embolization was done twice preoperatively. En block excision was performed and the dura and soft tissue defect were reconstructed by anterolateral thigh free fasciocutaneous flap. There is no recurrence and the wound healed well during follow-up.
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  • 文章类型: Review
    恶性Triton肿瘤(MTT)是一种高度侵袭性的恶性肿瘤,分类为具有横纹肌母细胞分化的恶性外周神经鞘瘤的变体。泌尿生殖系统发生MTT的报道很少。在本研究中,我们报告了第一次MTT发生在子宫内。一名57岁的妇女因持续2个月的阴道出血而来到急诊科。妇科触诊发现,阴道存在一个约7cm×3cm×3cm的棍棒状突起。位于子宫下段及子宫颈的肿块经妇科阴道超声及磁共振成像证实,初步诊断为宫颈癌。肿瘤穿刺活检后,病理诊断为恶性triton肿瘤。患者最终失去了随访。这是关于子宫MTT的首次报道,提示病理活检结合影像学检查对于很少的MTT诊断是必要的。
    Malignant triton tumor (MTT) is a highly aggressive malignant neoplasm, classified as a variant of malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation. There are few reports that MTT occurred in urogenital system. In the present study, we report the first MTT occurring in the uterus. A 57-year-old woman came to the emergency department due to persistent vaginal bleeding for 2 months. The gynecological palpation found that a club-shaped excrescence existed in the vagina about 7 cm × 3 cm × 3 cm. The mass located in the lower segment of the uterus and the cervix was confirmed by gynecological vaginal ultrasound and magnetic resonance imaging, which was preliminarily diagnosed as cervical carcinoma. After neoplasm punch biopsy, the pathological diagnosis was malignant triton tumor. The patient finally lost follow-up. This is the first report about MTT in the uterus and suggests that pathological biopsy combined with imaging examination is necessary for the diagnosis of rarely MTT.
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  • 文章类型: Case Reports
    背景:1型神经纤维瘤病(NF1)是一种常染色体显性遗传的神经皮肤综合征,可引起多发性中枢和外周神经鞘瘤。NF1患者有10%的机会发生恶性周围神经鞘瘤(MPNSTs)。在这里,我们报告了恶性神经鞘瘤的独特实例,自十年前首次切除以来一直没有转移。恶性神经鞘瘤在文献中很少有记载,值得注意的是,从未描述过如此广泛的术后时间没有转移的情况。
    方法:一名46岁的男性NF患者在身体不同部位有多个神经纤维瘤,大约10年前(2013年)接受了手术,并在组织病理学上被诊断为MPNST。
    方法:他因大腿近端后三分之一的肿块和严重的疼痛放射到左下肢而入院。表现为坐骨神经疼痛(2021年)。磁共振成像和氟脱氧葡萄糖-正电子发射断层扫描检查显示肿瘤可能是恶性的。
    方法:进行手术切除。
    结果:10年的随访显示无转移或神经损害。
    结论:当关于良性神经鞘瘤的文章放在一个单独的类别中时,关于NF-1相关的坐骨神经恶性神经鞘瘤的报道很少。MPNST是高级的,侵袭性肉瘤具有高的局部复发风险(40%-65%)和转移到其他身体部位。因此,在NF-1患者的各种良性周围神经鞘瘤中,MPNST的诊断至关重要。骨科医生应该意识到NF-1中的神经纤维瘤具有发生MPNSTs的巨大风险。本研究报告成功治疗巨大的恶性坐骨神经神经鞘瘤,随访期长,无转移。
    BACKGROUND: Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous syndrome that causes multiple central and peripheral nerve sheath tumors. People with NF1 have a 10% chance of developing malignant peripheral nerve sheath tumors (MPNSTs). Here we report a unique instance of a malignant schwannoma that has remained free of metastasis since its initial removal a decade ago. The malign schwannoma has been infrequently documented in the literature, and remarkably, no instances of such an extensive postoperative time without metastases have ever been described.
    METHODS: A 46-year-old male patient with NF had multiple neurofibromas in different parts of his body, underwent surgery about 10 years ago (2013), and was diagnosed histopathologically as MPNST.
    METHODS: He was admitted to our institution with a recurrent mass in the posterior third of the proximal thigh and severe pain radiating to the left lower extremity, which presented as sciatic pain (2021). A magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography examination revealed that the tumor was likely malignant.
    METHODS: Surgical excision was performed.
    RESULTS: A 10-year follow-up revealed no metastases or neurologic impairment.
    CONCLUSIONS: When articles about benign schwannomas are placed in a separate category, little is written about NF-1-related malignant schwannomas of the sciatic nerve. MPNSTs are high-grade, aggressive sarcomas with a high risk of local recurrence (40%-65%) and metastasis to other body parts. Therefore, among the various benign peripheral nerve sheath tumors in NF-1 patients, the diagnosis of MPNST is crucial.Orthopedic surgeons should be aware that neurofibromas in NF-1 have a significant risk of developing MPNSTs. This study reports the successful treatment of a giant malignant sciatic nerve schwannoma with a long follow-up period without metastasis.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    背景:恶性外周神经鞘瘤(MPNST)是一种极其罕见的鼻腔和鼻旁窦肉瘤。非特异性的临床和放射学表现以及具有挑战性的组织学诊断使其鲜为人知。我们描述了一例上颌窦MPNST,遵循护理指南。
    方法:一名62岁女性因右侧脸颊和硬腭肿胀而就诊,进展数月。CT和MRI显示右上颌窦有组织肿块,眶和上颌底骨质溶解,硬腭和上颌窦的外侧和内侧壁。活检证实诊断为低度MPNST。全切除和60Gy辅助放疗后,2年随访未见复发迹象。
    结论:MPNST在鼻腔和鼻旁窦非常罕见。因为复发的风险很高,应实施广泛切除,如果由于靠近危险结构而无法完成切除,则可能通过放射治疗完成。
    BACKGROUND: Malignant peripheral nerve-sheath tumor (MPNST) is an extremely rare sarcoma of the nasal cavity and paranasal sinuses. Non-specific clinical and radiological presentation and challenging histological diagnosis make it little known by physicians. We describe a case of maxillary sinus MPNST, following CARE guidelines.
    METHODS: A 62-year-old woman consulted for swelling of the right cheek and hard palate with several months\' progression. CT and MRI revealed a tissue mass in the right maxillary sinus with osteolysis of the orbital and maxillary floors, hard palate and lateral and medial walls of the maxillary sinus. Biopsy confirmed diagnosis of low-grade MPNST. After total resection and 60Gy adjuvant radiotherapy, 2-year follow-up showed no signs of recurrence.
    CONCLUSIONS: MPNST in the nasal cavity and paranasal sinuses is very rare. Because of a high risk of recurrence, wide resection should be implemented, possibly completed by radiotherapy if resection cannot be complete because of proximity to at-risk structures.
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