bromochloroacetic-acid and Chondroma

Chordoid meningioma, World Health Organization grade II, is an uncommon variant of meningioma with a propensity for aggressive behavior and increased likelihood of recurrence. As such, recognition of this entity is important in cases that show similar morphologic overlap with other chondroid/myxoid neoplasms that can arise within or near the central nervous system. A formal comparison of the immunohistochemical features of chordoid meningioma versus tumors with significant histologic overlap has not been previously reported. In this study, immunohistochemical staining was performed with antibodies against D2-40, S100, pankeratin, epithelial membrane antigen (EMA), brachyury, and glial fibrillary acidic protein (GFAP) in 4 cases of chordoid glioma, 6 skeletal myxoid chondrosarcomas, 10 chordoid meningiomas, 16 extraskeletal myxoid chondrosarcoma, 18 chordomas, 22 low-grade chondrosarcomas, and 27 enchondromas. Staining extent and intensity were evaluated semiquantitatively and mean values for each parameter were calculated. Immunostaining with D2-40 showed positivity in 100% of skeletal myxoid chondrosarcomas, 96% of enchondromas, 95% of low-grade chondrosarcomas, 80% of chordoid meningiomas, and 75% of chordoid gliomas. Staining with S100 demonstrated diffuse, strong positivity in all (100%) chordoid gliomas, skeletal myxoid chondrosarcomas, low-grade chondrosarcomas, and enchondromas, 94% of chordomas, and 81% of extraskeletal myxoid chondrosarcomas, with focal, moderate staining in 40% of chordoid meningiomas. Pankeratin highlighted 100% of chordoid gliomas and chordomas, 38% of extraskeletal myxoid chondrosarcomas, and 20% of chordoid meningiomas. EMA staining was positive in 100% of chordoid gliomas, 94% of chordomas, 90% of chordoid meningiomas, and 25% of extraskeletal myxoid chondrosarcomas. Brachyury was positive only in the chordomas (100%), whereas GFAP was positive only in the chordoid gliomas (100%). EMA was the most effective antibody for differentiating chordoid meningioma from skeletal myxoid chondrosarcoma, low-grade chondrosarcoma, and enchondroma, whereas D2-40 was the most effective antibody for differentiating chordoid meningioma from extraskeletal myxoid chondrosarcoma and chordoma. Our findings demonstrate that in conjunction with clinical and radiographic findings, immunohistochemical evaluation with a panel of D2-40, EMA, brachyury, and GFAP is most useful in distinguishing chordoid meningioma from chordoid glioma, skeletal myxoid

Topics: Adolescent; Adult; Aged; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Biomarkers, Tumor; Child; Chondroma; Chondrosarcoma; Chordoma; Diagnosis, Differential; Female; Fetal Proteins; Glial Fibrillary Acidic Protein; Glioma; Humans; Immunohistochemistry; Keratins; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Mucin-1; Predictive Value of Tests; S100 Proteins; T-Box Domain Proteins; Young Adult

Parachordoma is a very rare peripheral soft tissue tumor of unknown lineage, which has been described under other names, all of which imply a similarity to chordoma. It forms a circumscribed firm tumor, usually in deep soft tissue, with a variety of histologic patterns and cytologic features, including cords and nests of cells, some of which are vacuolated. The ultrastructure and immunophenotype indicate epithelial differentiation and parachordomas are additionally S-100 protein positive. This tumor is distinct from extraskeletal myxoid chondrosarcoma and probably from soft tissue myoepithelioma. While histologically it somewhat resembles chordoma, parachordoma has a wider range of appearances, and the two neoplasms differ in their detailed cytokeratin immunophenotype and their clinical behavior. Parachordoma is a slowly growing tumor with occasional late recurrence; cases with reported metastasis have not been histologically convincing. This commentary discusses the terminology, origin, and possible nature of this enigmatic neoplasm.

Topics: Adolescent; Adult; Arm; Buttocks; Child; Chondroma; Collagen; Fascia; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Monosomy; S100 Proteins; Soft Tissue Neoplasms; Thigh; Thorax; Trisomy

Topics: Brain Neoplasms; Chondroma; Chondrosarcoma; Chordoma; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratins; Male; Membrane Glycoproteins; Mucin-1; S100 Proteins

A unique extraskeletal chondroma is reported which occupied the entire right parotid gland of a 32-year old man. The midsized tumour was hard and well circumscribed. Its histological pattern was typical of a chondroma with lobules of hyaline cartilage and several areas of calcification. The chondrocytes were positive for S-100 protein and negative for smooth muscle and myoepithelial markers. Epithelial neoplastic elements, as found in pleomorphic adenomas, were not detected in the present case, neither morphologically nor immunohistochemically.

Topics: Adult; Biomarkers, Tumor; Chondroma; Humans; Immunoenzyme Techniques; Keratins; Male; Membrane Glycoproteins; Mucin-1; Parotid Neoplasms; S100 Proteins

We describe 59 cases of a microscopically unique neoplasm that has not been previously reported. The tumor almost exclusively affected adults (range 14-79 years) and had a male predominance (38 men and 21 women). It presented in most cases as a small, painless, well-circumscribed mass (median, 4 cm) in subcutis or muscle. It occurred chiefly in the upper and lower extremities (40 cases) and less frequently in the trunk (11 cases) and the head and neck region (eight cases). Microscopically, the tumor was partly lobulated and composed of small, round cells that had vesicular nuclei and indistinct cytoplasm. Typically, the cells were arranged in a cord- or nestlike pattern within a myxoid matrix that frequently showed transitions toward hyaline fibrosis and focal osteoid formation. In about two-thirds of the cases, the cells contained immunoreactive S-100 protein. An additional typical feature, seen in 48 (81%) of the 59 cases, was the presence of an incomplete shell of mature bone in the capsular region of the tumor. Follow-up information, available in 41 cases, revealed that 11 patients (27%) experienced one or more recurrences. One patient with three recurrences developed a second tumor in the opposite thigh, presumably a metastasis. None of the patients died of the tumor, but three died of causes unrelated to the disease. Although the histogenesis is uncertain, cartilaginous or neural origin seem to be most likely. Until this issue is resolved, we prefer the descriptive and less committal designation of "ossifying fibromyxoid tumor of soft parts."

Topics: Adolescent; Adult; Aged; Chondroma; Chondrosarcoma; Female; Fibroma; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Male; Microscopy, Electron; Middle Aged; Neoplasm Recurrence, Local; Ossification, Heterotopic; S100 Proteins; Soft Tissue Neoplasms

The unusual feature of an intramandibular chondroma in association with an odontogenic keratocyst in a 59-year-old man is described. The keratocyst recurred and required two reoperations. The coexistence of an odontogenic keratocyst and a chondroma of the jaw was probably a coincidence of two simultaneous but otherwise unrelated lesions. The possibility that the keratocyst and the chondroma were due to a single developmental disturbance of the region cannot be excluded. No signs of a recurrence were seen at the last follow-up examination four years after the operation.

Topics: Chondroma; Humans; Keratins; Male; Mandibular Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Odontogenic Cysts

Topics: Adolescent; Adult; Age Factors; Aged; Bone Cysts; Child; Chondroma; Curettage; Diagnosis, Differential; Female; Fingers; Humans; Keratins; Male; Middle Aged; Postoperative Complications; Radiography; Sex Factors