Electron microscopic observations on structures resembling myxovirus in human sarcomas.
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Fourteen cases of synoviosarcoma were investigated by electron microscopy and immunohistochemical technique (PAP) using keratin and EMA as epithelial markers, vimentin as a mesenchymal marker. Of the 14 cases 9 were biphasic (BS) and 5 were monophasic synoviosarcoma (MS). In BS, epithelial-like cells, glandular, tubular of slit-like structures, junctional complex, microvilli at the luminar surface and basal lamellae at bottom could be easily seen. Spindle cells both in BS and MS were similar. These cells had somewhat similarity with epithelia-like cells, such as slender cell processes or microvilli, the external lamellae and cell junctions. The spindle cells also formed some slit-like structures. Collagenization was mild in matrix. Whether in BS or MS, epithelial or spindle cells, there were positive reactions for keratin, EMA and vimentin. The present study suggests that synoviosarcoma is neither a tumor of synovium origin nor a sarcoma of synovial differentiation, but a carcinosarcoma or adenosarcoma of soft tissues; the monophasic type is not a variant of fibrosarcoma either. It really is a distinct variant of synoviosarcoma. The expressions of both epithelial and mesenchymal features are useful criteria for diagnosis of synoviosarcoma.
Identification of genetic alterations has contributed greatly to the understanding of sarcoma biology. Additionally, detection of these abnormalities is providing new tools for the diagnosis of sarcomas. In this paper, three important new genetic findings from the past year are reviewed, including the t(12;15) translocation of congenital fibrosarcoma, mutation of the putative tumor suppressor gene hSNF5/INI1 in malignant rhabdoid tumor, and the association of c-kit mutations with gastrointestinal stromal tumor. Highlighted are important studies concerning mechanisms of chromosomal translocation, functions of sarcoma-specific fusion proteins, genetic abnormalities other than translocations, molecular diagnosis, and molecular profiling of gene expression. Particular emphasis is placed on information obtained with comparative genomic hybridization and microarray techniques, because these powerful technologies will facilitate the rapid acquisition of data that provide insight into the molecular genetic and biologic basis of sarcomas.
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The clinicopathologic features of 53 cases of postradiation soft tissue sarcoma (PRS) were correlated with the physical characteristics of the administered radiation. All but three patients received radiation for malignant processes. Of the secondary sarcomas, malignant fibrous histiocytoma (MFH) accounted for 36 cases (68%), followed by seven extraskeletal osteosarcomas (13%), six fibrosarcomas (11%), two malignant Schwannomas (4%), one extraskeletal chondrosarcoma, and one angiosarcoma. The sex incidence, age of the patient at time of diagnosis, and location of the PRS correlated only with the clinical characteristics of the initial treated condition. The latency period (mean 10 years) showed an indefinite relationship to patient survival but no definite relationship to the patient's age at the time of the initial radiation. There was no difference between patients treated with megavoltage radiation (39 patients) and with orthovoltage radiation (seven patients) in the type of sarcoma, location, or survival, although the orthovoltage group received a lower mean radiation dose (3880 rads) than the megavoltage group (4446 rads). Megavoltage radiation, however, produced deeper tissue radiation changes and was associated with a shorter latency period. Most PRS were poorly differentiated, produced abundant collagen, and had a dismal prognosis.
The literature of the last 25 years pertaining to the treatment of sarcomas of the soft somatic tissues by surgery and radiotherapy, both separately and in combination, has been reviewed. Surgery alone, if it is to be successful in an appreciable proportion of cases, must be radical. There is a growing body of evidence which suggests that less-than-radical surgery in combination with postoperative radiotherapy may give results equal or superior to those of radical surgery alone. There is need for a multicentre controlled clinical trial to compare the results of the two modes of treatment.
The antitumor activity of a new antibiotic, kazusamycin, against various murine tumors was studied by various treatment schedules. Single, intermittent, and successive injections of the antibiotic were almost equally effective against Ehrlich carcinoma, IMC carcinoma and sarcoma 180 tumor, but successive injections showed more efficacy than the other schedules against Meth A fibrosarcoma and Lewis lung carcinoma. Interestingly, there was no clear dose response for the efficacy of kazusamycin on murine tumors. When HeLa cells were exposed to kazusamycin for 72 hours in vitro, the IC50 value was about 1 ng/ml, however the cytotoxicity of the antibiotic depended on the incubation time.
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An accurate pathological diagnosis must be made prior to treatment of a primary malignant bone tumour. Consideration must be given to the clinical and radiologic aspects as well as the histology. Both benign and malignant tumours occur more frequently in certain decades. A search should be made for precursor lesions such as Paget's disease. The presenting manifestations of pain, a mass and dysfunction are not specific for tumours. Laboratory tests may be helpful, especially in distinguishing tumours from infections and metabolic diseases. Metastasis is usually via the blood stream to the lungs and bones. The low survival rate following amputation for osteosarcoma and radiation therapy for Ewing's sarcoma has been improved by chemotherapy. The lower-grade tumours such as aggressive giant cell tumour and low-grade chondrosarcoma can often by treated successfully by resection and insertion of an autograft, an allograft or a metallic implant.
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