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Oral Surgery, Oral Medicine, Oral... Jan 2017Intramuscular nodules can be the clinical presentation of several groups of lesions, such as reactive disorders and benign and malignant tumors. Here, we present three...
Intramuscular nodules can be the clinical presentation of several groups of lesions, such as reactive disorders and benign and malignant tumors. Here, we present three cases with similar clinical features and image aspects on Doppler ultrasonography. Two of the lesions were diagnosed as intramasseteric hemangioma and the third as intramasseteric metastasis from high-grade pleomorphic sarcoma of the thigh. The diagnosis of intramasseteric nodules is challenging, and various differential diagnoses must be considered. Clinical features, evolution time, and information from complementary examinations, such as Doppler ultrasonography and fine-needle aspiration cytology, are useful in making a precise diagnosis and providing appropriate treatment.
Topics: Adult; Biopsy, Fine-Needle; Diagnosis, Differential; Female; Hemangioma; Humans; Male; Masseter Muscle; Middle Aged; Muscle Neoplasms
PubMed: 27938944
DOI: 10.1016/j.oooo.2016.10.008 -
Journal of Aquatic Animal Health Jun 2016Rhabdomyosarcoma is a primitive neoplasm that originates from skeletal muscle progenitor cells. In a routine inspection of a cyprinid farm in southwestern Iran, an...
Rhabdomyosarcoma is a primitive neoplasm that originates from skeletal muscle progenitor cells. In a routine inspection of a cyprinid farm in southwestern Iran, an approximately 2-year-old female Silver Carp was observed to have a raised mass located on the dorsolateral surface just caudal to the head. Macroscopic examination revealed a firm irregular fleshy pink mass (5 × 4 cm, depth = 3 cm) that appeared to arise from the subcutaneous musculature. Histologic sections were prepared using routine methods and separate sections were stained with hematoxylin-eosin and Massons' trichrome. Microscopically, the tumor mass was composed of spindle cells that were densely packed and arranged in long interwoven bundles. The nuclei were vesicular and oval to elongated or cigar-shaped. Nuclear pleomorphism and multinucleate tumor giant cells were clearly evident. The neoplastic cell cytoplasm was eosinophilic with indistinct cell margins, and clear cross striations were observed in fibrils. The striated fibrils stained diffusely red with Masson's trichrome. This account represents the first reported occurrence of rhabdomyosarcoma in Silver Carp Hypophthalmichthys molitrix. Received July 10, 2015; accepted February 4, 2016.
Topics: Animals; Carps; Female; Fish Diseases; Muscle Neoplasms; Rhabdomyosarcoma
PubMed: 27229885
DOI: 10.1080/08997659.2016.1152325 -
AJR. American Journal of Roentgenology Sep 2014The purposes of this article are to discuss the technical considerations for performing quantitative diffusion-weighted MRI (DWI) with apparent diffusion coefficient... (Review)
Review
OBJECTIVE
The purposes of this article are to discuss the technical considerations for performing quantitative diffusion-weighted MRI (DWI) with apparent diffusion coefficient (ADC) mapping, examine the role of DWI in whole-body MRI, and review how DWI with ADC mapping can serve as an adjunct to information gleaned from conventional MRI in the radiologic evaluation of musculoskeletal lesions.
CONCLUSION
The primary role of whole-body DWI is in tumor detection; localized DWI is helpful in differentiating malignant bone and soft-tissue lesions. After treatment, an increase in tumor ADC values correlates with response to cytotoxic therapy. The use of DWI in the evaluation of musculoskeletal lesions requires knowledge of potential diagnostic pitfalls that stem from technical challenges and confounding biochemical factors that influence ADC maps but are unrelated to lesion cellularity.
Topics: Adult; Aged; Bone Neoplasms; Diffusion Magnetic Resonance Imaging; Female; Humans; Image Enhancement; Imaging, Three-Dimensional; Joint Diseases; Male; Middle Aged; Muscle Neoplasms; Whole Body Imaging
PubMed: 25148158
DOI: 10.2214/AJR.13.12165 -
Cancer Immunology, Immunotherapy : CII Feb 2022Latency-associated peptide (LAP) was identified as crucial immune regulator in tumor microenvironment (TME) in recent researches. In this study, we aimed to estimate the...
BACKGROUND
Latency-associated peptide (LAP) was identified as crucial immune regulator in tumor microenvironment (TME) in recent researches. In this study, we aimed to estimate the predictive value of LAP expression for clinical survival and therapeutic response in muscle-invasive bladder cancer (MIBC).
METHODS
Our study encompassed 140 MIBC patients from Zhongshan Hospital (ZSHS cohort), 401 patients from The Cancer Genome Atlas (TCGA cohort) and 195 patients received PDL1 blockade from IMvigor210 trial. Survival analyses were conducted through Kaplan-Meier curve and Cox regression model. LAP expression and its association with immune contexture were evaluated in ZSHS and TCGA cohort.
RESULTS
We found that high intratumoral LAP cells infiltration anticipated inferior survival and adjuvant chemotherapy (ACT) response, and was closely related to an immunoevasive contexture with increased M2 macrophages, neutrophils and conspicuously a cluster of highly exhausted CD8 T cells. The combinational analysis of LAP cells and CD8 T cells infiltration stratified patients into distinct risk groups with implications for therapeutic sensitivity to PDL1 blockade and refinement of molecular classification in MIBC.
CONCLUSIONS
LAP expression was correlated with patients' inferior prognosis, ACT-tolerance and an immunoevasive TME with exhausted CD8 T cell infiltration, suggesting that LAP could serve as a promising therapeutic target in MIBC. Simultaneously, our novel TME classification based on LAP cells and CD8 T cells infiltration and its potential in appraising PDL1 blockade application for MIBC patients deserved further validation.
Topics: CD8-Positive T-Lymphocytes; Chemotherapy, Adjuvant; Drug Resistance, Neoplasm; Follow-Up Studies; Humans; Immune Checkpoint Inhibitors; Muscle Neoplasms; Peptides; Prognosis; Protein Precursors; Retrospective Studies; Survival Rate; Transforming Growth Factor beta; Tumor Escape; Tumor Microenvironment; Urinary Bladder Neoplasms
PubMed: 34152439
DOI: 10.1007/s00262-021-02987-4 -
Future Oncology (London, England) Mar 2022
Topics: Humans; Muscle Neoplasms; Muscle, Skeletal; Neoplasm Metastasis
PubMed: 35094526
DOI: 10.2217/fon-2021-1489 -
Lasers in Surgery and Medicine Mar 2017Sarcomas are rare but highly aggressive tumors, and local recurrence after surgical excision can occur in up to 50% cases. Therefore, there is a strong clinical need for...
BACKGROUND AND OBJECTIVE
Sarcomas are rare but highly aggressive tumors, and local recurrence after surgical excision can occur in up to 50% cases. Therefore, there is a strong clinical need for accurate tissue differentiation and margin assessment to reduce incomplete resection and local recurrence. The purpose of this study was to investigate the use of optical coherence tomography (OCT) and a novel image texture-based processing algorithm to differentiate sarcoma from muscle and adipose tissue.
STUDY DESIGN AND METHODS
In this study, tumor margin delineation in 19 feline and canine veterinary patients was achieved with intraoperative OCT to help validate tumor resection. While differentiation of lower-scattering adipose tissue from higher-scattering muscle and tumor tissue was relatively straightforward, it was more challenging to distinguish between dense highly scattering muscle and tumor tissue types based on scattering intensity and microstructural features alone. To improve tissue-type differentiation in a more objective and automated manner, three descriptive statistical metrics, namely the coefficient of variation (CV), standard deviation (STD), and Range, were implemented in a custom algorithm applied to the OCT images.
RESULTS
Over 22,800 OCT images were collected intraoperatively from over 38 sites on 19 ex vivo tissue specimens removed during sarcoma surgeries. Following the generation of an initial set of OCT images correlated with standard hematoxylin and eosin-stained histopathology, over 760 images were subsequently used for automated analysis. Using texture-based image processing metrics, OCT images of sarcoma, muscle, and adipose tissue were all found to be statistically different from one another (P ≤ 0.001).
CONCLUSION
These results demonstrate the potential of using intraoperative OCT, along with an automated tissue differentiation algorithm, as a guidance tool for soft tissue sarcoma margin delineation in the operating room. Lasers Surg. Med. 49:240-248, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Animals; Biopsy, Needle; Cats; Diagnosis, Differential; Dogs; Image Processing, Computer-Assisted; Immunohistochemistry; Margins of Excision; Monitoring, Intraoperative; Muscle Neoplasms; Neoplasms, Adipose Tissue; Sarcoma; Tomography, Optical Coherence
PubMed: 28319274
DOI: 10.1002/lsm.22633 -
Clinical Genitourinary Cancer Jun 2020We use observational methods to compare impact of perioperative chemotherapy timing (ie, neoadjuvant and adjuvant) on overall survival (OS) in muscle-invasive bladder... (Comparative Study)
Comparative Study Observational Study
BACKGROUND
We use observational methods to compare impact of perioperative chemotherapy timing (ie, neoadjuvant and adjuvant) on overall survival (OS) in muscle-invasive bladder cancer because there is no head-to-head randomized trial, and patient factors may influence decision-making.
PATIENTS AND METHODS
Using Surveillance, Epidemiology, and End Results-Medicare data, we identified patients receiving cystectomy for muscle-invasive bladder cancer diagnosed between 2004 and 2013. Patients were classified as receiving neoadjuvant or adjuvant chemotherapy. Propensity of receiving neoadjuvant chemotherapy was determined using gradient boosted models. Inverse probability of treatment weighted survival curves were adjusted for 13 demographic, socioeconomic, temporal, and oncologic covariates.
RESULTS
We identified 1342 patients who received neoadjuvant (n = 676) or adjuvant chemotherapy (n = 666) with a median follow-up of 23 months (interquartile range, 9-55 months). Inverse probability of treatment weighted adjustment allows comparison of the groups head-to-head as well as counterfactual scenarios (eg, effect if those getting one treatment were to receive the other). The average treatment effect (ie, "head-to-head" comparison) of adjuvant compared with neoadjuvant on OS was not significant (hazard ratio, 1.14; 95% confidence interval, 0.99-1.31). However, the average treatment effect of the treated (ie, the effect if the neoadjuvant patients were to receive adjuvant instead) was associated with a 33% increase in risk of mortality if they were given adjuvant therapy instead (hazard ratio, 1.33; 95% confidence interval, 1.12-1.57).
CONCLUSION
Significant treatment selection bias was noted in peri-cystectomy timing, which limits the ability to discriminate differential efficacy of these 2 approaches with observational data. However, patients with higher propensity to receive neoadjuvant therapy were predicted to have increased OS with approach, in keeping with existing paradigms from trial data.
Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Female; Follow-Up Studies; Humans; Insurance Claim Review; Male; Medicare; Muscle Neoplasms; Neoadjuvant Therapy; Neoplasm Invasiveness; Prognosis; Retrospective Studies; SEER Program; Survival Rate; United States; Urinary Bladder Neoplasms
PubMed: 31917172
DOI: 10.1016/j.clgc.2019.12.011 -
Endocrine, Metabolic & Immune Disorders... 2019Mazabraud's syndrome is a rare form of bone fibrous dysplasia associated with intramuscular myxomas. Fibrous dysplasia, is generally localized to pelvis and femur and it... (Review)
Review
OBJECTIVE
Mazabraud's syndrome is a rare form of bone fibrous dysplasia associated with intramuscular myxomas. Fibrous dysplasia, is generally localized to pelvis and femur and it results in a fragile bone with deformities, pain, pathological fractures and functional impairment. Intramuscular myxomas, are rare benign mesenchymal neoplasms that exceptionally may evolve to malignant forms.
METHODS
This case report describes a 66-year-old woman with Mazabraud's Syndrome (MS), characterized both by monostotic right femur fibrous dysplasia and by a solitary intramuscular myxoma at the right quadriceps muscle, that underwent a long-term treatment (4 years) with intravenous zoledronic acid.
RESULTS
Zoledronic acid therapy rapidly lowered bone pain together with a reduction of intramuscular myxoma volume, but did not affect the extension of fibrous dysplasia. No adverse effects have been observed during treatment.
CONCLUSION
Highly active bisphosphonates are commonly used for the treatment of bone metabolic disorders and they are generally well tolerated. Zoledronic acid may represent a promising alternative to surgical intervention in MS, although its use in rare form of bone fibrous dysplasias is still controversial.
Topics: Aged; Diagnosis, Differential; Female; Fibrous Dysplasia of Bone; Humans; Italy; Muscle Neoplasms; Myxoma; Syndrome; Tomography, X-Ray Computed
PubMed: 30585553
DOI: 10.2174/1871530319666181226103700 -
JAMA Surgery Oct 2018Radical cystectomy is the guidelines-recommended treatment of muscle-invasive bladder cancer, but a resurgence of trimodal therapy has occurred. Limited comparative data... (Comparative Study)
Comparative Study
IMPORTANCE
Radical cystectomy is the guidelines-recommended treatment of muscle-invasive bladder cancer, but a resurgence of trimodal therapy has occurred. Limited comparative data are available on outcomes and costs attributable to these 2 treatments.
OBJECTIVE
To compare the survival outcomes and costs between trimodal therapy and radical cystectomy in older adults with muscle-invasive bladder cancer.
DESIGN, SETTING, AND PARTICIPANTS
This population-based cohort study used data from the Surveillance, Epidemiology, and End Results-Medicare linked database. A total of 3200 older adults (aged ≥66 years) with clinical stage T2 to T4a bladder cancer diagnosed from January 1, 2002, to December 31, 2011, and with claims data available through December 31, 2013, were included in the analysis. Patients who received radical cystectomy underwent either only surgery or surgery in combination with radiotherapy or chemotherapy. Patients who received trimodal therapy underwent transurethral resection of the bladder followed by radiotherapy and chemotherapy. Propensity score matching by sociodemographic and clinical characteristics was used. Data analysis was performed from August 1, 2017, to March 11, 2018.
MAIN OUTCOMES AND MEASURES
Overall survival and cancer-specific survival were evaluated using the Cox proportional hazards regression model and the Fine and Gray competing risk model. All Medicare health care costs for inpatient, outpatient, and physician services within 30, 90, and 180 days of treatment were compared. The total amount spent nationwide was estimated, using 180-day medical costs between treatments, by the total number of new cases of muscle-invasive bladder cancer in the United States in 2011.
RESULTS
Of the 3200 patients who met the inclusion criteria, 2048 (64.0%) were men and 1152 (36.0%) were women, with a mean (SD) age of 75.8 (6.0) years. After propensity score matching, 687 patients (21.5%) underwent trimodal therapy and 687 patients (21.5%) underwent radical cystectomy. Patients who underwent trimodal therapy had significantly decreased overall survival (hazard ratio [HR], 1.49; 95% CI, 1.31-1.69) and cancer-specific survival (HR, 1.55; 95% CI, 1.32-1.83). No differences in costs at 30 days were observed between trimodal therapy ($15 233 in 2002 vs $18 743 in 2011) and radical cystectomy ($17 990 in 2002 vs $21 738 in 2011). However, median total costs were significantly higher with trimodal therapy than with radical cystectomy at 90 days ($80 174 vs $69 181; median difference, $8964; Hodges-Lehmann 95% CI, $3848-$14 079) and at 180 days ($179 891 vs $107 017; median difference, $63 771; Hodges-Lehmann 95% CI, $55 512-$72 029). Extrapolating these figures to the total US population revealed $335 million in excess spending for trimodal therapy compared with the less costly radical cystectomy ($492 million) for patients who received a muscle-invasive bladder cancer diagnosis in 2011.
CONCLUSIONS AND RELEVANCE
Trimodal therapy was associated with significantly decreased overall survival and cancer-specific survival as well as $335 million in excess spending in 2011. These findings have important health policy implications regarding the appropriate use of high value-based care among older adults with invasive bladder cancer who are candidates for either radical cystectomy or trimodal therapy.
Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Combined Modality Therapy; Cystectomy; Female; Humans; Kaplan-Meier Estimate; Male; Muscle Neoplasms; Neoplasm Invasiveness; Retrospective Studies; SEER Program; Treatment Outcome; United States; Urinary Bladder Neoplasms
PubMed: 29955780
DOI: 10.1001/jamasurg.2018.1680 -
BJU International Jun 2019To investigate the association between smoking status and pathological response to cisplatin-based neoadjuvant chemotherapy (NAC) and survival outcomes in patients with...
Cigarette smoking is associated with adverse pathological response and increased disease recurrence amongst patients with muscle-invasive bladder cancer treated with cisplatin-based neoadjuvant chemotherapy and radical cystectomy: a single-centre experience.
OBJECTIVE
To investigate the association between smoking status and pathological response to cisplatin-based neoadjuvant chemotherapy (NAC) and survival outcomes in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy (RC).
PATIENTS AND METHODS
We reviewed 201 patients treated with NAC and RC for cT2-cT4N0M0 BC between 01/1999 and 01/2015. Smoking status was categorised as: 'never', 'former', and 'current' smoker. Pathological response to NAC was defined as: complete (ypT0N0), partial (ypTis/Ta/T1, N0), and no response (ypT2-4 or ypN+). Clinicopathological characteristics were analysed according to smoking status. Logistic regression analyses tested the association between smoking status and pathological response to NAC. Cox regression analyses tested risk factors associated with recurrence, overall (OM) and cancer-specific mortality (CSM).
RESULTS
Overall, there were 58 (28.9%) never smokers, 87 (43.3%) former smokers, and 56 (27.9%) current smokers. No response to NAC was more frequently noted in current smokers (73.2%; P = 0.007). Former smoker (odds ratio [OR] 2.28; P = 0.024) and current smoker statuses (OR 4.52; P < 0.001) were significantly associated with no response to NAC, after adjusting for age, gender, Charlson Comorbidity Index, and clinical stage. Similarly, current smoking status (hazard ratio [HR] 2.14; P = 0.03) and extravesical pathological tumour stage (HR 3.31; P < 0.001) were independently associated with an increased risk of recurrence after RC.
CONCLUSION
Cigarette smoking was significantly associated with adverse pathological response to cisplatin-based NAC in patients with MIBC treated with RC. Current smokers were at significantly higher risk of disease recurrence as compared to former and never smokers.
Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma in Situ; Chemotherapy, Adjuvant; Cigarette Smoking; Cisplatin; Cystectomy; Female; Humans; Male; Middle Aged; Muscle Neoplasms; Neoadjuvant Therapy; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Prospective Studies; Risk Factors; Urinary Bladder Neoplasms
PubMed: 30623554
DOI: 10.1111/bju.14612