1.Rare metastatic primary intra-abdominal follicular dendritic cell sarcoma poorly responsive to chemotherapy: A case report
Leah Anne E. Legaspi ; Mary Ondinee-Igot ; Gracieux Fernando
Philippine Journal of Internal Medicine 2024;62(1):308-313
Background:
Follicular dendritic cell sarcoma (FDCS) accounts for about 0.4% of soft tissue sarcomas. Approximately onethird of cases occur in extranodal sites and about 28% of extranodal FDCS may metastasize. Intra-abdominal occurrence is
rare and there is limited published data to guide oncologists on how to best treat this malignancy.
Case Presentation:
This is a case of a 33-year-old female who came in due to incidental finding of a left supraclavicular
mass with 2-year history of early satiety. Neck node biopsy revealed a poorly differentiated malignant tumor with positive
staining for CD21, CD23, vimentin and S100 consistent with FDCS. PET-CT revealed an intensely FDG-avid large mass in
the left upper abdomen with signs of necrosis and mass effect. The patient was given three different chemotherapy
regimens that included (1) gemcitabine/docetaxel, (2) single agent doxorubicin and (3) ifosfamide/etoposide, but she
progressed on all these. Off-label use of bendamustine was then offered and after just the first cycle, the patient reportedly
regained strength and was able to get up from wheelchair with noted interval decrease in size of the cervical mass.
Unfortunately, the patient deteriorated and succumbed to infection and multiple pulmonary embolisms.
Conclusion
Intra-abdominal FDCS is a rare malignancy with heterogenous outcomes with no uniform treatment strategy
at present. Molecular tumor board discussion and multi-disciplinary approach in extranodal FDCS is important in the
diagnosis and management. Patients with multiple poor prognostic factors are at risk for tumor recurrence, metastasis, and
death.
Dendritic Cell Sarcoma, Follicular
;
Abdominal Neoplasms
;
Drug Therapy
;
Bendamustine Hydrochloride
;
Prognosis
2.Efficacy and safety of Anlotinib in the treatment of advanced sarcoma.
Qiang YAN ; Wei Tao YAO ; Xin Hui DU ; Liang Yu GUO ; Yi Chao FAN
Chinese Journal of Oncology 2023;45(10):904-910
Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.
Humans
;
Hand-Foot Syndrome
;
Retrospective Studies
;
Sarcoma/drug therapy*
;
Sarcoma, Synovial/drug therapy*
;
Soft Tissue Neoplasms
;
Bone Neoplasms
3.Efficacy and safety of Anlotinib in the treatment of advanced sarcoma.
Qiang YAN ; Wei Tao YAO ; Xin Hui DU ; Liang Yu GUO ; Yi Chao FAN
Chinese Journal of Oncology 2023;45(10):904-910
Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.
Humans
;
Hand-Foot Syndrome
;
Retrospective Studies
;
Sarcoma/drug therapy*
;
Sarcoma, Synovial/drug therapy*
;
Soft Tissue Neoplasms
;
Bone Neoplasms
4.Antitumor Effects of Ethanol Extract from Ventilago leiocarpa Benth on Sarcoma 180 Tumor-Bearing Mice and Possible Immune Mechanism.
Dao-Hai CHENG ; Ying LIU ; Li WANG
Chinese journal of integrative medicine 2021;27(12):905-911
OBJECTIVE:
To explore the antitumor effects of ethanol extract from Ventilago leiocarpa Benth (EEVLB) on sarcoma 180 (S180) tumor-bearing mice and the potential mechanism.
METHODS:
Sixty mice were randomly assigned to 6 groups according to a random number table: normal group, model group, 5-fluorouracil (5-FU) group (0.02 g·kg
RESULTS:
EEVLB with different concentrations achieved inhibition of tumor growth in vivo, wherein the high-dose group showed the most significant reduction in tumor weight and increased apoptosis of tumor cells (P<0.05). In addition, both net weight gain and spleen index of mice showed uptrend in EEVLB treatment groups (P<0.05). Besides, serum levels of IL-2 and IL-6, percentages of CD3
CONCLUSIONS
EEVLB exhibits promising antitumor activity in vivo. This effect might be due to activation of apoptotic signaling pathway, increase of cytokine levels and enhancement of immune function in tumor-bearing mice.
Animals
;
Cell Line, Tumor
;
Ethanol
;
Mice
;
Plant Extracts/therapeutic use*
;
Rhamnaceae
;
Sarcoma 180/drug therapy*
5.Langerhans Cell Sarcoma of the Scalp with Concomitant Multiple Cervical Lymph Node and Adjacent Soft Tissue Involvement: A Case Report
Man Hoon HAN ; Jun Young KIM ; Weon Ju LEE ; Seok Jong LEE
Korean Journal of Dermatology 2019;57(9):538-543
Currently, the World Health Organization classifies Langerhans cell tumors into Langerhans cell histiocytosis and Langerhans cell sarcoma (LCS). LCS is a neoplastic proliferation of Langerhans cells showing malignant cytological features and aggressive clinical behavior with grave prognosis. Only a few cases have been reported in the available literature; therefore, to date, no definitive treatment has been established. A 64-year-old woman presented with a 1-year history of an asymptomatic, slow-growing erythematous nodule measuring 0.7 cm on her scalp. The patient also reported a 3-month history of a painful swelling on the right side of her neck. Histopathological examination of a scalp biopsy specimen revealed sheets of atypical cells with hyperchromatic nucleoli and clear cytoplasm. Immunohistochemical studies revealed malignant cells positive for CD1a, CD31, CD68, and S-100 expression. Additionally, positron emission tomography–computed tomography and fine-needle aspiration revealed LCS of the cervical lymph nodes and surrounding soft tissue. We recommended surgical excision and adjunctive chemotherapy; however, the patient refused treatment and died of the disease 28 months later.
Biopsy
;
Biopsy, Fine-Needle
;
Cytoplasm
;
Drug Therapy
;
Electrons
;
Female
;
Histiocytosis, Langerhans-Cell
;
Humans
;
Langerhans Cell Sarcoma
;
Langerhans Cells
;
Lymph Nodes
;
Middle Aged
;
Neck
;
Parotid Gland
;
Prognosis
;
Scalp
;
World Health Organization
6.Characteristics and Treatment Patterns of Patients with Advanced Soft Tissue Sarcoma in Korea
Hyo Song KIM ; Chung Mo NAM ; Suk Yong JANG ; Sun Kyu CHOI ; Minkyung HAN ; Seonmin KIM ; Maria Victoria MONETA ; Sae Young LEE ; Jae Min CHO ; Diego NOVICK ; Sun Young RHA
Cancer Research and Treatment 2019;51(4):1380-1391
PURPOSE: A soft tissue sarcoma (STS) is a rare type of cancer, accounting for 1% of adult solid cancers. The aim of the present study is to determine the incidence of localized and advanced STS in Korean patients, their treatment patterns, and the survival of patients by disease status. MATERIALS AND METHODS: The STS patient cohort was defined using National Health Insurance Service medical data from 2002 to 2015. Incidence, distribution, anatomical location of tumors, survival rates (Kaplan-Meyer survival function) and treatment patterns were analyzed by applying different algorithms to the STS cohort containing localized and advanced STS cases. RESULTS: A total of 7,813 patients were diagnosed with STS from 2007 to 2014, 4,307 were localized STS and 3,506 advanced STS cases. The total incidence of STS was 2.49 per 100,000 person- years: 1.37 per 100,000 person-years for localized STS and 1.12 per 100,000 person-years for advanced STS. The 5-year survival rate after diagnosis was 56.4% for all STS, 82.4% for localized, and 27.2% for advanced STS. Half of the advanced STS patients (49.98%) received anthracycline-containing chemotherapy as initial treatment after diagnosis. CONCLUSION: This study provides insights into localized and advanced STS epidemiology, treatment patterns and outcomes in Korea, which could be used as fundamental data in improving clinical outcomes of STS patients in the future.
Adult
;
Cohort Studies
;
Diagnosis
;
Drug Therapy
;
Epidemiology
;
Humans
;
Incidence
;
Korea
;
National Health Programs
;
Sarcoma
;
Survival Rate
7.Ewing Sarcoma
Clinical Pediatric Hematology-Oncology 2019;26(1):27-34
Ewing sarcoma is the second most frequently occurring malignant tumor of the bone and soft tissue in adolescents and young adults. Genetically, Ewing sarcoma is characterized by balanced chromosomal translocation in which a member of FET gene family is fused with an ETS transcription factor, with the most common fusion being EWSR1-FLI1 (85% of cases). Treatment of Ewing sarcoma is based on multidisciplinary approach (local surgery, radiotherapy and multiagent chemotherapy), which are associated with chronic late effects that may compromise quality of life of survivors. First line treatment includes combination of drugs incorporating doxorubicin, vincristine, cyclophosphamide, ifosfamide, etoposide, and dactinomycin. The beneficial role of high dose chemotherapy has been suggested in high-risk localized Ewing sarcoma patients, and the studies are being performed to investigate the role in metastatic disease. The 5-year overall survival for localized Ewing sarcoma has improved to reach 65% to 75%. But patients with metastatic disease have a 5-year survival rate of <30%, except for those with isolated pulmonary metastasis (approximately 50%). Patients with recurrent tumor have a dismal prognosis. Novel therapeutic strategies based on understanding of molecular mechanisms are needed to improve the outcome of Ewing sarcoma and to lessen the treatment-related late effects.
Adolescent
;
Cyclophosphamide
;
Dactinomycin
;
Doxorubicin
;
Drug Therapy
;
Etoposide
;
Humans
;
Ifosfamide
;
Neoplasm Metastasis
;
Neuroectodermal Tumors, Primitive, Peripheral
;
Prognosis
;
Quality of Life
;
Radiotherapy
;
Sarcoma, Ewing
;
Survival Rate
;
Survivors
;
Transcription Factors
;
Translocation, Genetic
;
Vincristine
;
Young Adult
8.Menopausal hormone therapy in the cancer survivors
Journal of the Korean Medical Association 2019;62(3):160-166
Due to advances in the treatment and diagnosis of cancer, many women survive long after treatment, and therefore express concerns about the impact of estrogen deficiency on their quality of life. Cancer treatment can induce menopause through surgical removal of the ovaries, chemotherapy, or radiation. Women who undergo induced menopause usually experience more sudden and severe menopausal symptoms, including vasomotor symptoms, psychological symptoms, genitourinary symptoms, cardiovascular disease, and osteoporosis. Menopausal hormone therapy (MHT) is especially important in women younger than 40. In this review, we consider the role of MHT after the diagnosis of breast, gynecologic, colorectal, stomach, liver, lung, and hematologic cancers. MHT is advantageous in endometrial cancer type I, cervical squamous cell carcinoma, colorectal cancer, hepatocellular carcinoma, and hematologic malignancies. However, MHT is not recommended for use in breast cancer, endometrial stromal sarcoma, hormone receptor–positive gastric cancer, and lung cancer survivors because it is linked to an increased risk of cancer recurrence. Depending on the type of cancer, clinicians should recommend that cancer survivors receive appropriate MHT in order to reduce vasomotor symptoms and to benefit from its positive effects on the cardiovascular and skeletal systems.
Breast
;
Breast Neoplasms
;
Carcinoma, Hepatocellular
;
Carcinoma, Squamous Cell
;
Cardiovascular Diseases
;
Colorectal Neoplasms
;
Diagnosis
;
Drug Therapy
;
Endometrial Neoplasms
;
Estrogens
;
Female
;
Hematologic Neoplasms
;
Humans
;
Liver
;
Lung
;
Lung Neoplasms
;
Menopause
;
Osteoporosis
;
Ovary
;
Quality of Life
;
Recurrence
;
Sarcoma, Endometrial Stromal
;
Stomach
;
Stomach Neoplasms
;
Survivors
9.Pembrolizumab for Refractory Metastatic Myxofibrosarcoma: A Case Report.
Haa Na SONG ; Min Gyu KANG ; Jeong Rang PARK ; Jin Yong HWANG ; Jung Hun KANG ; Won Seop LEE ; Gyeong Won LEE
Cancer Research and Treatment 2018;50(4):1458-1461
Myxofibrosarcoma is a rare tumor, refractory to cytotoxic chemotherapy and radiotherapy. Pembrolizumab is an innovative immunotherapy drug consisting of programmed death receptor ligand 1 antibody proven to be useful for numerous types of cancer cells. A patient had been diagnosed with metastatic myxofibrosarcoma, refractory to radiotherapy and conventional cytotoxic chemotherapy. The patient achieved a partial response during palliative chemotherapy with pembrolizumab for 14 cycles. To the best of our knowledge, this is the first case report demonstrating the efficacy of pembrolizumab for refractory myxofibrosarcoma.
Drug Therapy
;
Humans
;
Immunotherapy
;
Radiotherapy
;
Sarcoma
10.Analysis of Postural Stability and Daily Energy Expenditure to Manage Tumor Patients' Functional Expectation.
Emrah CALISKAN ; Evrim KARADAG SAYGI ; Zeynep Kardelen GENCER ; Hizir KURTEL ; Bulent EROL
Clinics in Orthopedic Surgery 2018;10(4):491-499
BACKGROUND: Advances in surgical techniques, implant technology, radiotherapy, and chemotherapy have increased the recovery chances of patients with bone sarcomas. Accordingly, patients' expectations on life quality have also increased, highlighting the importance of objective evaluation of the functional results of reconstruction. METHODS: Thirteen patients with distal femoral endoprosthesis, who had been followed for an average of 2.9 years were evaluated. Postural stability, daily energy expenditure, muscle power, and range of motion were the four parameters analyzed in this study. The Musculoskeletal Tumor Society (MSTS) score and Toronto Extremity Salvage Score (TESS) were used to assess postoperative function and examine correlations with other parameters. RESULTS: Patients had sedentary activities in 84% of their daily lives. They exhibited a slower speed in the walk across test and a higher sway velocity in the sit-to-stand test (p = 0.005). MSTS scores were significantly correlated with the daily energy expenditure and walking speed. CONCLUSIONS: Objective functional results acquired from various clinics will provide significant data to compare reconstruction techniques, rehabilitation protocols, and surgical techniques. In this way, it will be possible to satisfy the expectations of patients that increase in relation to enhanced recovery.
Drug Therapy
;
Energy Metabolism*
;
Extremities
;
Femur
;
Humans
;
Quality of Life
;
Radiotherapy
;
Range of Motion, Articular
;
Rehabilitation
;
Sarcoma
;
Walking


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