Case report of cutaneous histiocytic sarcoma: diagnostic and therapeutic dilemmas

Trevisan, Flávia; Xavier, Célia Antônia; Pinto, Clóvis Antônio Lopes; Cattete, Fernanda Gomes; Stock, Fabiola Schauffler; Martins, Marcella Ledo

doi:10.1590/abd1806-4841.20132070

Cited by 11 publications

(11 citation statements)

References 1 publication

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“…Trevisan et al. also reported on an early‐stage cutaneous HS case with a good and stable clinical status, even with a simple excision. Presumably primary cutaneous HS is more likely to be found at an earlier stage, be of a small size and not have regional or distant metastases.…”

Section: Discussionmentioning

confidence: 94%

Primary cutaneous localized/clearly‐outlined true histiocytic sarcoma: Two long‐term follow‐up cases

Sato

Arai

Nakamura

et al. 2020

The Journal of Dermatology

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Histiocytic sarcoma (HS) is a rare hematopoietic tumor that mainly involves extranodal sites, including the intestinal tract, skin, soft tissues and other organs. It is well known as an aggressive neoplasm that shows a poor response to therapy. However, a subset of patients with resectable disease has shown a favorable outcome with surgical treatment. Primary cutaneous HS is exceedingly rare and, to date, its long-term prognosis has thus not been well described. Here, we highlight two cases of primary cutaneous HS that showed long-term survival. Case 1 was a healthy 47-year-old woman who found a 12-mm tumor on her forehead. Case 2 was a 66-year-old woman, under follow up of a myxoid liposarcoma in her leg, who presented with a 25-mm tumor in her hypothenar eminence. Histologically, the tumors in both cases had a smooth outline with proliferating atypical tumor cells that showed histiocytic differentiation as revealed by immunohistochemistry with antibodies to CD68 (KP-1) and lysozyme in case 1; and CD68, lysozyme and CD163 in case 2. Tumor cells in case 1 had a monotonous appearance. After complete resection, cases 1 and 2 have survived for 10 and 4 years, respectively, without recurrence. To date, such patients are relatively long follow-up cases of survival from HS and highlight how a clear outline of the primary cutaneous HS tumor may be associated with its resectability and be an important factor in the assessment of its curability.

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Section: Discussionmentioning

confidence: 94%

Primary cutaneous localized/clearly‐outlined true histiocytic sarcoma: Two long‐term follow‐up cases

Sato

Arai

Nakamura

et al. 2020

The Journal of Dermatology

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“…General remarks and clinical presentation: Histiocytic sarcoma (HS) may affect all age groups, but has its highest incidence in the 5th decade of life. The majority of patients present with tumor bulks, mostly in lymph nodes, but also in extralymphatic organs, such as the skin [68,208] and the gastrointestinal tract [7,80,94,186,234]. Less often, primary lung disease resembling pulmonary LCH [196], and primary parotid gland involvement have been described [6].…”

Section: Histiocytic Sarcoma (Histiocytic Mh)mentioning

confidence: 99%

“…In individual cases with localized disease, surgical resection may be sufficient [208]. However, in most patients, systemic polychemotherapy is indicated.…”

Section: Therapymentioning

confidence: 99%

The Non-Langerhans Cell Histiocytoses (Rare Histiocytoses) – Clinical Aspects and Therapeutic Approaches

2016

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Rare histiocytoses, also called non-Langerhans cell histiocytoses, include all proliferative disorders of histiocytes, macrophages and dendritic cells that are not classified as Langerhans cell histiocytosis (LCH) and do not belong to the hemophagocytic lymphohistiocytosis (HLH) group of diseases. Thus, the term includes numerous benign or malignant, localized or systemic, adult or pediatric diseases. The classification of the histiocytic disorders has been revised several times. Here, we follow the classification recently published by Jean Francois Emile and an international expert panel, defining subgroups of histiocytoses described as L-Group, C-Group, M-Group, R-Group, and H-Group, which stands for LCH-like, cutaneous or mucocutaneous, malignant, Rosai-Dorfman-Disease like and HLH like. Some of the diseases have an excellent prognosis after resection or even disappear spontanously, others progress rapidly, requiring intensive systemic therapies. The malignant non-Langerhans cell histiocytoses in general have a poor prognosis, here, complex chemotherapy protocols are usually applied, with inconsistant results. An interesting perspective in non-malignant rare histiocytoses might be small molecular inhibitors, in particular BRAF inhibitors, since BRAF mutations have been found in some subtypes of non-Langerhans cell histiocytoses. By prospective and retrospective collection of experiences in a new registry (the "International Rare Histiocytic Disorders Registry", IRHDR), knowledge about these rare diseases might hopefully be improved.

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“…The lesional cells were also negative for CDX2, anti-HMW cytokeratin (34bE12), CAM5.2, desmin, SMA, caldesmon, CD21, SOX10, pancytokeratin, ERG, p63, and S100, effectively ruling out poorly differentiated carcinoma, sarcoma, and melanoma. A diagnosis of histiocytic sarcoma was rendered based upon positive staining for histiocytic markers such as CD163 and CD68, as well as the T-lymphocyte marker CD4, which can also be expressed in cells of the myelomonocytic and histiocytic lineage [ 11 ]. The patient was admitted to hospice and treated with palliative radiation.…”

Section: Case Reportmentioning

confidence: 99%

Postradiation Histiocytic Sarcoma in the Setting of Muir-Torre Syndrome

Baumgartner¹,

Ullman²,

Jones³

et al. 2018

Case Reports in Pathology

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Hereditary nonpolyposis colorectal carcinoma (HNPCC) is an autosomal dominant genetic disorder characterized by a predisposition towards colorectal carcinoma and other extracolonic neoplasms. Histiocytic sarcoma (HS) is a very rare hematologic neoplasm characterized by a malignant proliferation of cells with histiocytic differentiation. We present the case of a 62-year-old male with previous diagnosis of MTS who presented with metastatic colorectal adenocarcinoma, bilateral papillary renal cell carcinoma, and a new squamous cell carcinoma of the scalp, treated with resection and adjuvant radiation therapy. After reconstructive surgery for his scalp resection, the patient developed a persistent nonhealing skin defect. A punch biopsy of this nonhealing skin defect and subsequent immunohistochemistry revealed neoplastic histiocytic cells restricted to the epidermis and underlying dermis. The diagnosis of cutaneous histiocytic sarcoma was then rendered. Histiocytic sarcoma is an exceptionally rare malignancy. Consequently, there is no universally agreed upon management protocol for this malignancy. The patient was admitted to hospice and treated with palliative radiation. This case demonstrates the need for awareness of the risk of secondary malignancies in cancer patients in order to facilitate early surgical intervention and optimal treatment.

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Case report of cutaneous histiocytic sarcoma: diagnostic and therapeutic dilemmas

Cited by 11 publications

References 1 publication

Primary cutaneous localized/clearly‐outlined true histiocytic sarcoma: Two long‐term follow‐up cases

Primary cutaneous localized/clearly‐outlined true histiocytic sarcoma: Two long‐term follow‐up cases

The Non-Langerhans Cell Histiocytoses (Rare Histiocytoses) – Clinical Aspects and Therapeutic Approaches

Postradiation Histiocytic Sarcoma in the Setting of Muir-Torre Syndrome

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