Fibrosarcoma occurring at the site of a plastic vascular graft

Burns, William A.; Kanhouwa, Suryabala; Tillman, Leonard; Saini, Nirmal; Herrmann, John B.

doi:10.1002/1097-0142(197201)29:1<66::aid-cncr2820290112>3.0.co;2-q

Cited by 58 publications

(14 citation statements)

References 7 publications

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“…Several reports have been published of aortic intimal sarcomas arising in association with Dacron grafts, 7,8,14,16,30,[33][34][35][41][42][43] suggesting an inducing or promoting effect of the foreign material on the endothelium. Oppenheimer et al 31 demonstrated that the implantation of plastic discs in animals could induce fibrosarcoma in the fibrous capsule that forms around the disc.…”

Section: Discussionmentioning

confidence: 99%

Undifferentiated Intimal Sarcoma of Large Systemic Blood Vessels

Šebenik¹,

Ricci²,

Dipasquale³

et al. 2005

American Journal of Surgical Pathology

131

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Intimal sarcoma (IS) is defined as a malignant tumor arising in the tunica intima of large blood vessels. In systemic circulation, the majority of IS develop in the aorta, where close to three fourths of published cases lack specific differentiation and are called undifferentiated intimal sarcomas (UIS). The remaining cases are intima-associated sarcomas of recognized types, also called differentiated intimal sarcomas (DIS). In this report, we further characterize UIS, including its immunohistochemical profile and results of comparative genomic hybridization. A total of 14 cases of UIS were collected from 17 medical institutions, including slides, blocks, electron photomicrographs, clinical abstracts, and reports of surgical pathology specimens and autopsies. The patients, 7 women and 7 men, were 41 to 85 years of age (median, 65.6 years). Twelve tumors arose from the aorta, one from the left external iliac and femoral arteries, and one in a large systemic vein (the venous tumor was included due to histologic similarity with the arterial lesions). Tumors ranged from 1 cm to over 10 cm in diameter. Histopathology was that of a largely necrotic, poorly differentiated epithelioid and pleomorphic malignant neoplasm relating to the tunica intima. Usually there was only a thin layer of viable tumor cells overlying a large thrombus. All tumors stained at least focally with the endothelial markers CD31 and Fli-1; however, there was otherwise considerable variability in immunophenotype. The distinctive histopathologic appearance of the primary luminal lesion was lost whenever tumor invaded outside the vessel wall (into adventitia and beyond) or in metastatic sites. Such extravascular tumors assumed a variety of patterns reminiscent of undifferentiated pleomorphic sarcoma (UPS; in older literature also known as pleomorphic malignant fibrous histiocytoma, MFH) or other distinct types of sarcomas, including osteosarcoma, angiosarcoma, and rhabdomyosarcoma. The results of comparative genomic hybridization were nonspecific. Eleven patients died of the disease, in an average of 11 months after diagnosis. Three patients are still alive and free of disease at 4, 16, and 27 years. UIS of large systemic vessels represents a distinct clinical entity where intraluminal sarcoma presents with thrombosis and occlusion of large vessels. It is associated with a highly characteristic, although not entirely specific, histology and immunohistochemical phenotype. The histogenesis of UIS is not certain; however, it seems that the cell of origin must leave the confines of the vessel wall to show altered morphology. Although there are rare long-term survivors, UIS behaves as a fully malignant neoplasm that is almost uniformly associated with metastases and tumor-related death.

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Section: Discussionmentioning

confidence: 99%

Undifferentiated Intimal Sarcoma of Large Systemic Blood Vessels

Šebenik¹,

Ricci²,

Dipasquale³

et al. 2005

American Journal of Surgical Pathology

131

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“…22 Some rare cases of soft tissue sarcomas have been reported in surgical scars or in contact with metallic 23 or plastic implants. 5,24 Sarcomas have also been found in animal experimental models in contact with implanted biomaterials. 25 No chemical constituent involved in the composition of metallic alloys used in spinal surgery is clearly recognized as a carcinogen potentially responsible for sarcomatous tumors.…”

Section: Discussionmentioning

confidence: 99%

Late Paraplegia After Scoliosis Treatment

Vialle¹,

Wolff²,

David³

et al. 2005

Journal of Spinal Disorders &Amp; Techniques

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We report the case of a young girl treated at age 16 for a progressive scoliosis by posterior instrumented arthrodesis. Ten years later, she suddenly developed lumbar pain and paraplegia. The surgical procedure showed a mass infiltrating the vertebral canal and the dural sheath following a supralaminar hook. Histology revealed a diagnosis of leiomyosarcoma. The outcome was poor with a rapid and fatal extension of the tumor. There is nothing to justify a causal link between the scoliosis and the late onset of a malignant tumor. Nevertheless, we discuss the potential role of diagnostic irradiation consecutive to scoliosis monitoring during growth and the potential role of environmental carcinogens like metallic biomaterials. Finally, rapid intrusion of this extraspinal tumor into the dural sheath resulted in a confusing clinical picture and delayed the diagnosis and treatment of the tumor.

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“…Although the relationship between surgical im plants and sarcogenesis has not been clearly dem onstrated, several case reports have described a tem po ral relation ship between the placem en t o f surgical im plants and the successive development of sarcoma. 17,18 T he m ost frequent histotype described was ® brosarcom a 19,20 with rhabdom yosarcom a also described. 21 Recently a patient was reported to have a malignant ® brous histiocytom a in the bone± cement m em brane after revision for a loose total hip prosthesis.…”

Section: Discussionmentioning

confidence: 99%