phenylephrine-hydrochloride and Osteosarcoma

Osteosarcoma is the second most common primary tumor of the skeletal system and the most common primary bone tumor. Usually occurring at the metaphysis of long bones, osteosarcomas are highly aggressive lesions that comprise osteoid-producing spindle cells. Craniofacial osteosarcomas comprise <8% and are believed to be less aggressive and lower grade. Primary osteosarcomas of the skull and skull base comprise <2% of all skull tumors. Osteosarcomas originating from the clivus are rare. We present a case of a primar, high-grade clival osteosarcoma.. A 29-year-old man presented to our institution with a progressively worsening right frontal headache for 3 weeks. There were no sensory or cranial nerve deficits. Computed tomography revealed a destructive mass involving the clivus with extension into the left sphenoid sinus. Magnetic resonance imaging revealed a homogenously enhancing lesion measuring 2.7 × 2.5 × 3.2 cm. The patient underwent endonasal transphenoidal surgery for gross total resection. The histopathologic analysis revealed proliferation of malignant-appearing spindled and epithelioid cells with associated osteoclast-like giant cells and a small area of osteoid production. The analysis was consistent with high-grade osteosarcoma. The patient did well and was discharged on postoperative day 2. He was referred for adjuvant radiation therapy and chemotherapy. Two-year follow-up showed postoperative changes and clival expansion caused by packing material.. Osteosarcoma is a highly malignant neoplasm. These lesions are usually found in the extremities; however, they may rarely present in the craniofacial region. Clival osteosarcomas are relatively infrequent. We present a case of a primary clival osteosarcoma with high-grade pathology.

Topics: Adult; Cranial Fossa, Posterior; Humans; Magnetic Resonance Imaging; Male; Neurosurgical Procedures; Nose; Osteosarcoma; Skull Base Neoplasms; Tomography Scanners, X-Ray Computed

When a sarcomatous neoplasm is identified in the breast, distinguishing metaplastic carcinoma, malignant phyllodes tumor (MPT), and primary sarcoma is a diagnostic challenge, especially on small biopsies, as all these tumors may have overlapping morphological features, thoroughly grossing with histological examination and immunohistochemical staining being the standard approach to aid in classifying these lesions. Recently, we identified a highly sensitive and specific breast carcinoma marker TRPS1 with high expression in metaplastic breast carcinoma. In the current study, we tested TRPS1 in MPTs and primary sarcoma of the breast. We found TRPS1 was highly expressed (95%) within spindle cell, chondro-osseous, and/or liposarcomatous components of MPTs, in all breast primary chondrosarcomas and extraskeletal osteosarcomas, but not in other sarcomas of the breast. In extramammary sarcomas, TRPS1 was expressed in 28% of conventional chondrosarcomas and 56% of osteosarcomas of bone, but rarely in undifferentiated pleomorphic sarcomas (UPSs), liposarcomas, and angiosarcomas. In summary, MPTs may share similar genetic background with metaplastic carcinoma exhibiting TRPS1 expression, and TRPS1 may play a role in chondro-osseous differentiation because of its expression in chondro-osseous sarcomas from both breast and extramammary sites. Our findings suggest TRPS1 may be clinically useful in distinguishing MPT and metaplastic carcinoma from primary breast sarcoma except for tumors with chondro-osseous differentiation.

Topics: Bone Neoplasms; Breast Neoplasms; Carcinoma; Chondrosarcoma; Female; Fingers; Hair Diseases; Humans; Langer-Giedion Syndrome; Nose; Osteosarcoma; Phyllodes Tumor; Repressor Proteins; Sarcoma; Soft Tissue Neoplasms

Topics: Aged; Bone Neoplasms; Cell Differentiation; Chondrosarcoma; Humans; Immunohistochemistry; Male; Nose; Osteosarcoma; Skin; Skin Neoplasms

Sarcomas of the head and neck are rare tumours accounting for less than 1% of all malignant neoplasms in this region. The prognosis of these tumours and the survival in adults (< 50% at 5 years) is directly related to histological tumour type, tumour size and the possibility of adequate tumour resection. In the present paper, the authors present the course of sarcomas with special reference to rhabdomyosarcoma and osteosarcoma in the nose and paranasal sinuses. Surgical resection with pathologically free margins represents the best modality of initial therapy. Additional adjuvant radiotherapy and/or chemotherapy have shown better survival rates in pediatric patients and, to some degree, also in adults. The purpose of future studies should be the development of new therapy protocols which could further elucidate the beneficial effects of adjuvant therapy in the treatment of sarcomas of the head and neck.

Topics: Adolescent; Adult; Biopsy; Chemotherapy, Adjuvant; Child, Preschool; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Neoplasm Staging; Nose; Nose Neoplasms; Osteosarcoma; Paranasal Sinus Neoplasms; Paranasal Sinuses; Radiotherapy, Adjuvant; Rhabdomyosarcoma

Topics: Adolescent; Adult; Child; Child, Preschool; Ethmoid Sinus; Female; Fibroma; Frontal Sinus; Giant Cell Tumors; Humans; Male; Maxillary Sinus; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasm Recurrence, Local; Neoplasms, Connective Tissue; Nose; Nose Neoplasms; Ossification, Heterotopic; Osteoma; Osteoma, Osteoid; Osteosarcoma; Paranasal Sinus Neoplasms; Paranasal Sinuses; Sphenoid Sinus

Topics: Bone Neoplasms; Humans; Nasal Bone; Neoplasms; Nose; Nose Neoplasms; Osteosarcoma; Sarcoma; X-Ray Therapy