Immunologic and virus studies with human sarcomas.
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Immunofluorescent examination of extracellular matrix of 5 fibrosarcomas showed the matrix to contain fibronectin and collagen type I, III, V. Fibrosarcoma matrix is characterized by the absence of collagen type IV and collagen type III predominance over type I differentiating this tumor from synovial sarcoma, neurogenic sarcoma, dermatofibrosarcoma protuberans, malignant fibrous histiocytoma. Their matrices showed the presence of type IV collagen, equal proportion of interstitial collagens or collagen type I predominance over type III typical for synovial sarcoma. The findings can be employed in practical morphologic diagnosis of soft tissue tumors.
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The term spindle cell lesion, or tumor, is a purely descriptive one and if applied without further qualification is meaningless as a guide to therapy and prognosis. The three lesions presented in this report--sarcomatoid carcinomas, nodular fasciitis, and fibrosarcoma--serve to illustrate this point. One, the sarcomatoid carcinoma, is an epithelial malignancy in which the majority of the sarcoma-like spindle cells are believed to be variants of the epithelial cells. Nodular fasciitis, a self-limited and benign soft tissue lesion, is composed principally of myofibroblasts. Primarily an extramucosal lesion, it presents a pseudosarcomatous microscopic appearance. Fibrosarcomas represent the other end of the spindle cell lesion spectrum in that they are soft tissue malignancies of fibroblastic origin. Clinical, pathologic, and biologic implications of these lesions when they arise in the mucosae of the upper aerodigestive tracts of the head and neck are presented.
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The clinical and pathologic features of two primary pure testicular sarcomas are reported. One tumor was an osteosarcoma and was found in a 30-year-old man; the other was a fibrosarcoma from an 86-year-old man. The patients were treated with orchiectomy and high ligation of the spermatic cord and received no postoperative therapy. Both of them were alive and well with no evidence of disease 6 months and 5 1/2 years, respectively, after orchiectomy. Most testicular sarcomas arise from a teratoma or, less commonly, originate from a spermatocytic seminoma, but our two cases and rare previously reported cases illustrate that pure sarcomas occur occasionally and may be associated with a favorable prognosis.
CT findings of 4 patients with primary pulmonary sarcomas are presented. In all cases there was a more than 5 cm large solid, circular configured, intrapulmonary growth without enlarged hilar and mediastinal lymph nodes and also without atelectasis.
Two of five male Sprague-Dawley rats with hepatic tapeworm cysts developed large multinodular fibrosarcomas. Fibrosarcomas envelope tapeworm cysts, invaded the serosa of multiple organs, and extended through the diaphragm into the pleural cavity. Light microscopy, immunohistochemistry, and electron microscopy supported the diagnosis of fibrosarcoma. The parasites were identified as Cysticercus fasciolaris, the larval stage of Taenia taeniaeformis. The development of sarcomas in rats induced by Taenia sp. is thought to be attributable to the chronic inflammatory reaction of the capsule. There are parallels between these and other tumors occurring in mice and cats with suggested chronic inflammatory etiologies.
The fate of tumors and associated retroviremia was studied in 111 cats infected with the Snyder-Theilen strain of feline sarcoma virus (FeSV). Tumors appeared at the site of inoculation within 7 to 10 days. A retroviremia, due mainly to the associated feline leukemia virus helper virus (FeLV-helper), developed at the same time as tumors. Of the cats, 44 developed progressively growing tumors and therefore had to be killed, and 67 developed tumors that regressed. There was a strong correlation between the persistence of the accompanying retroviremia and the growth of the tumors. The 44 cats with progressively growing fibrosarcomas remained retroviremic until death. Conversely, 53 of the 67 cats with solitary, regressing tumors were only transiently retroviremic. Tumor regression in these cats paralleled the disappearance of retrovirus from the blood. The fate of tumors and retroviremia was not always the same, however. Twelve cats remained persistently retroviremic after all signs of gross tumors disappeared. Two other kittens became nonviremic within 20 days after inoculation, yet tumors continued to grow and even metastasize for another 3 to 5 weeks before regressing. Fibrosarcomas recurred 3 weeks to 8 months later in 8 of 12 persistently retroviremic cats with regressed tumors. Although the blood and bone marrow from these cats contained predominantly FeLV-helper, tumor cells yielded both FeSV and FeLV-helper. Of 53 animals, 3 developed recurrent fibrosarcomas 5 weeks to 8 months after all signs of tumors and retroviremia had disappeared. Cells cultured from these tumors appeared initially like normal fibroblasts and were virus nonproducers. After one to three passages in culture, however, cells became malignantly transformed and replicated both FeSV and FeLV-helper. Cultures of the bone marrow from these and other nonviremic cats with regressed tumors yielded only FeLV-helper.
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A case of soft-tissue fibrosarcoma with pulmonary metastases in a dog is reported. Although three attempts of fine-needle aspiration (FNA) biopsy failed to provide definitive tumor diagnosis, results of angiography strongly indicated a soft-tissue sarcoma. Transcatheter arterial embolization (TAE) using particles of gelatin sponge was performed following selective angiography. The mass was decreased in size on reevaluation 2 weeks after embolization. The dog was euthanized on the request of the owners due to overall failing health. Necropsy and pathological study confirmed the diagnosis of soft-tissue fibrosarcoma with pulmonary metastases. In a review of the literature, angiographic findings of soft-tissue sarcoma in the dog of this report were similar to those in human beings, suggesting a potential role for angiography in the differential diagnosis of suspect soft-tissue fibrosarcomas and for guiding FNA or surgical biopsy. Previous reports have also shown therapeutic embolization to be an effective treatment both in experimental animal study and in clinical practice in the human; therefore, TAE could be an effective adjunctive treatment of soft-tissue fibrosarcoma in the dog.
BACKGROUND: Vascular endothelial growth factor (VEGF) acts specifically on endothelial cells mediating tumour neovascularisation and initiating tumour growth and metastasis. In humans, high VEGF levels are correlated with poorer prognosis but in dogs minimal information on plasma VEGF is available. Therefore, we analysed plasma VEGF in a variety of spontaneous canine tumours. MATERIALS AND METHODS: Plasma from seventy dogs with various spontaneous tumours was taken prior to radiation therapy. A human VEGF ELISA was used for analysis. RESULTS: Mean plasma VEGF was 7.2+/-7.8 pg/ml. Mean plasma VEGF level varied among different tumour types with the highest level in oral melanomas (12.4 pg/ml). In patients with sarcomas of soft tissue or bone origin, plasma VEGF levels increased significantly with decreasing haemoglobin concentration (p =0.013). CONCLUSION: Canine plasma VEGF levels depend on tumour histology, with higher levels found in more aggressive tumours. The negative correlation between plasma VEGF and haemoglobin (hb) is most probably due to tissue hypoxia seen in anaemic animals.
The antitumour activity of cortiphen synthesized at the All-Union Cancer Research Centre of the USSR Academy of Medical Sciences was studied on human tumour strains transplanted into nude mice and rats. Cortiphen was found to possess an expressed activity to kidney cancer, cancer of corpus uteri, chorionepithelioma, fibrosarcoma. Two strains of colon adenocarcinoma out of three have displayed an expressed sensitivity to cortiphen, while melanoma and Jewing sarcoma strains proved to be weakly sensitive to the preparation.
A group of 21 adults patients with soft tissues sarcomas of the extremities were studied by CT. CT was a diagnostic procedure in only one case. However it has always permitted a precise local work-up particularly in demonstrating the vasculo-nervous connections of the lesions. The place of CT with regard to the other radiological procedures is discussed. by its contribution to the locoregional and general pretherapeutic work-up and to a better determination of radiotherapeutical dosimetry, CT appears to have an up standing place in the staging and the follow-up of soft tissues sarcomas.
BACKGROUND: Since January, 1984, 59 children with histologically confirmed Ewing sarcoma of the pelvic bone have been treated with three successive chemotherapy protocols recommended by the French Society of Pediatric Oncology. The purpose of the current study was to evaluate the role of surgery and/or radiotherapy in local progression-free, disease-free, and overall survivals (LPFS, DFS, and OS, respectively). PROCEDURE: We retrospectively examined 59 children treated for nonmetastatic, pelvic Ewing sarcoma over the last 12 years. All were first treated with chemotherapy according to the current French protocol. Six patients developed progressive disease before local treatment and were excluded for local control and survival analysis. Local treatment was surgery alone in 17 cases, radiation therapy in 27 cases, and surgery plus radiation therapy in 9 cases. RESULTS: With a median of follow-up of 6.5 years, no significant differences in local control or survival were observed with the three chemotherapeutic protocols. Of the 53 patients evaluable for local control, 6 relapsed locally only, 8 had local and distant relapses, and 9 had distant metastases only. The 5-year OS rate was worst for patients with radiotherapy alone compared to those with surgery or combined modality treatment (44 % vs. 72 %, P = 0.043). The 5-year LPFS and DFS rates were worst in the radiotherapy-alone group but not significantly (63% vs. 79%, P = 0. 22 and 42% vs 71%, P =0.07, respectively). The importance of surgery to OS and DFS was confirmed by multivariate analysis (P = 0.026 and P = 0.048, respectively). One surviving patient was diagnosed with in-field fibrosarcoma, which was presumably radiation induced. CONCLUSIONS: Despite intensive, multiagent chemotherapy, survival from pelvic Ewing sarcoma has not improved over the past decade; however, the survival rate does not seem to be worse than that from Ewing sarcoma at other locations, insofar as at least 50% of the patients were cured. Surgery or a combination of surgery and radiation therapy are the best local treatment; exclusive radiation therapy should be reserved for patients with inoperable lesions or partially or nonchemosensitive tumors or when surgery would be an amputation.
Twenty-six patients who had a malignant giant-cell tumor of bone--a sarcoma either juxtaposed to a zone of typical benign giant-cell tumor or occurring at the site of a previously documented benign giant-cell tumor--have been seen at the Mayo Clinic. Of the twenty-six tumors, nineteen were secondary to a previous attempt at local control of a benign giant-cell tumor. All but one of these nineteen patients with a secondary tumor had received therapeutic irradiation four to thirty-nine years earlier. The nature and duration of the symptoms and the sites of predilection of the malignant giant-cell tumors were the same as for benign giant-cell tumor. Fibrosarcoma occurred three times as frequently as osteosarcoma. The best results of treatment of the secondary sarcoma were obtained with early ablation.
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