Maxillary Malignant Mesenchymoma and Massive Fibrous Dysplasia

Beuerlein, Matthew E.; Schuller, David E.; DeYoung, Barry R.

doi:10.1001/archotol.1997.01900010116019

Cited by 16 publications

(8 citation statements)

References 13 publications

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“…After applying the inclusion and exclusion criteria, 14 studies were included for review. The manual search added five more studies, resulting in 19 articles included in this systematic review reporting the malignant transformation of 27 patients with FOLs . Only cases that fulfilled all the inclusion criteria within case series studies were included in this review.…”

Section: Resultsmentioning

confidence: 99%

“…In five cases of osteosarcoma, the tumor's subtype was specified, being two cases of osteoblastic osteosarcoma and three cases of chondroblastic osteosarcoma. The remaining cases were diagnosed as chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and malignant mesenchymoma . This latter diagnosis was established in 1997 by Beuerlein et al This nomenclature is no longer accepted by the World Health Organization (WHO) classification of tumors of soft tissue and bone .…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, immunohistochemical analysis of MDM2 and CDK4 can help to distinguish low‐grade osteosarcoma from benign histological mimics and could be performed in borderline cases. In this review, it was common to observe that the authors reported that the patient “had a history of” a FOLs . This was observed as the main failure in quality assessment.…”

Section: Discussionmentioning

confidence: 98%

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Malignant transformation of craniomaxillofacial fibro‐osseous lesions: A systematic review

Wagner

Carlos²,

Romañach

et al. 2019

J Oral Pathology Medicine

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The purpose of this study was to perform a systematic review of the literature concerning all documented cases of malignant transformation of craniomaxillofacial fibro‐osseous lesions (FOLs). Three electronic databases were searched. Data were evaluated descriptively. Kaplan‐Meier survival curves were constructed and compared using the log‐rank test. A critical appraisal of included articles was performed through the Joanna Briggs Institute tool. A total of 19 studies including 27 patients were selected for data extraction. Twenty‐six cases were initially diagnosed as fibrous dysplasia and one as ossifying fibroma. The mean age at the time of malignant transformation was 38.11 years, and the average time from initial diagnosis to malignant transformation was 18.2 years. The male:female ratio was 1:1.2, and the maxilla:mandible ratio was 1.5:1. The histological type of the malignant tumor was predominantly osteosarcoma. Follow‐up was available for 21 patients. The 3‐year overall survival rate was 51%. Mandible tumors and diagnoses other than osteosarcoma tended to have poor survival rates, but no significant difference was identified. We concluded that between all FOLs, only fibrous dysplasia seems to have a considerable increased risk of malignant transformation. Thus, a regular and long follow‐up period is advised.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

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Malignant transformation of craniomaxillofacial fibro‐osseous lesions: A systematic review

Wagner

Carlos²,

Romañach

et al. 2019

J Oral Pathology Medicine

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“…Most of these tumors occur in the retroperitoneum or thigh in older patients, but tumors have been reported in such diverse locations as the pleura, spermatic cord, face, bone, scars, and bladder. Most authors report a high rate of recurrence and a very poor overall rate of survival [3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Radical resection of a malignant mesenchymoma with hypogastric artery transposition

Bourne

Kraiss

Holden

et al. 2002

Journal of Surgical Oncology

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Malignant mesenchymoma is a rare soft tissue neoplasm containing two or more subtypes of sarcoma within the same tumor, not including fibrosarcoma or undifferentiated sarcoma. In case reports and a few small series these tumors have generally been associated with a poor prognosis. We report herein a case involving a 38-year-old man with a 25-cm, 3.75-kg, rapidly growing malignant mesenchymoma with distinct areas of chondrosarcoma, osteosarcoma, and myxoid liposarcoma in addition to fibrosarcoma. We performed a radical resection, including right hemicolectomy with primary ileocolic anastomosis and external iliac artery segmental resection with hypogastric artery transposition. Approximately 24 months after surgery the patient has no evidence of tumor recurrence or vascular insufficiency. TECHNIQUEThe patient, a 38-year-old man, sought treatment for a painless, asymptomatic abdominal mass that seemed to have gotten larger since he first noticed it 2 months earlier.He had no other significant medical conditions. Physical examination revealed a football-sized, nontender, right-sided abdominal mass. There was no adenopathy or other associated findings. Abdominal computerized axial tomography (CT) showed a right-sided midabdominal mass measuring 23 by 19.5 by 15 cm (Fig. 1). The mass was heterogeneous, with areas of probable central necrosis and foci of calcification, and did not appear to involve the aorta, vena cava, right kidney, or ureter. No tissue plane was identified between the mass and the right iliacus muscle. The abdominal CT also suggested a 1.5-cm splenic nodule. A chest CT was also performed to rule out pulmonary metastases. Because the radiographic findings were highly suggestive of retroperitoneal sarcoma, we elected not to perform a percutaneous biopsy and chose to proceed directly to surgery.At laparotomy, a large, right retroperitoneal mass was present, displacing the right colon anteriorly. There was no evidence of metastatic disease and the splenic nodule suggested on the abdominal CT was not palpable. No tissue plane could be created between the mass and the right colon. Inferiorly, the tumor was adherent to the iliacus muscle and the external iliac artery. It did not involve the kidney or ureter. We performed an en bloc resection including the right colon, and 2.5 cm of the external iliac artery and iliacus muscle.Although the patient had received mechanical and antibiotic preoperative bowel preparation, we were reluctant to perform vascular reconstruction with prosthetic material in a potentially contaminated wound. Although an autogenous vein graft was considered, we elected to reconstruct the external iliac artery with a hypogastric artery transposition. After mobilizing the hypogastric artery and ligating multiple branches, we transected it distally and rotated it anteriorly to the distal external iliac artery (Fig. 2). A spatulated end-to-end anastomosis was performed with running 5-0 polypropylene. After restoring perfusion to the right leg, femoral and distal pulses were present. A primary...

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“…Malignant mesenchymoma arising in bone is exceedingly rare. The first example was described by Lichtenstein in 1952 (8), and thereafter only around 20 cases have been reported in the English literature, all as single or two case reports (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). For better characterization of this tumor and in accordance with recent terminology employed for the designation of neural tumor showing divergent differentiation of neurofibroma, schwannoma and/ or perineurioma as 'hybrid nerve sheath tumor' (27)(28)(29), it is proposed for reasons detailed in our discussion that malignant mesenchymoma should be renamed as 'composite sarcoma'.…”

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confidence: 99%

Critical reappraisal of primary osseous composite sarcoma (malignant mesenchymoma) – analysis of four cases and literature review

Chow

2016

APMIS

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In accordance with recent terminology, it is proposed that malignant mesenchymoma should be renamed 'composite sarcoma' and defined as 'a sarcoma composed of two or more cellular types each of which is sufficiently differentiated to permit clear recognition of its histogenetic type microscopically, immunohistochemically or ultrastructurally; excluding fibrosarcomatous and high-grade pleomorphic undifferentiated sarcomatous component, dedifferentiated sarcoma and the combination of osteosarcoma and chondrosarcoma which is regarded as a single histogenetic type'. Four cases of primary osseous composite sarcoma (POCS) were identified among 928 primary bone sarcomas. Their age ranged from 10 to 87 years, peak incidence in the second decade with equal sex distribution. Most presented with pain, commonest in the knee, affecting the metaphysis, appearing radiologically as expansile infiltrative osteolytic lesions with cortical erosion, periosteal reaction, variable extent of osteoblastic areas and soft tissue extension. All contained variable amounts of conventional high-grade osteosarcoma with or without chondrosarcoma component; the other constituents were liposarcoma, rhabdomyosarcoma and leiomyosarcoma. In all cases, Ki67 proliferative index was over 35%, there was no CDK4 and MDM2 amplification. The absence of low-grade component supported the de novo origin of POCS rather than derivation from divergent dedifferentiation. The two older patients with hitherto undescribed osteoleiomyosarcoma died 2 and 10 months after operation, whereas the two younger with osteorhabdomyosarcoma and osteoliposarcoma enjoyed disease-free survival at 16 and 6 years after chemotherapy despite the latter showing lung metastasis at presentation. Identification of the different lines of differentiation together with their approximate amounts and histological grades is therefore mandatory for POCS as multi-agent chemotherapy catered for each sarcoma component might offer hope for long-term disease-free survival.

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Maxillary Malignant Mesenchymoma and Massive Fibrous Dysplasia

Cited by 16 publications

References 13 publications

Malignant transformation of craniomaxillofacial fibro‐osseous lesions: A systematic review

Malignant transformation of craniomaxillofacial fibro‐osseous lesions: A systematic review

Radical resection of a malignant mesenchymoma with hypogastric artery transposition

Critical reappraisal of primary osseous composite sarcoma (malignant mesenchymoma) – analysis of four cases and literature review

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