Pure Pleomorphic Rhabdomyosarcomas of the Uterus

Ordi, Jaume; Stamatakos, Michael D.; Tavassoli, Fattaneh A.

doi:10.1097/00004347-199710000-00013

Cited by 52 publications

(31 citation statements)

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“…Although not enough material was available to test all of the antibodies on every case, myoglobin (95%) and fast skeletal muscle myosin (80%) appeared to be the most sensitive markers for PRMS in our series. These findings compare similarly with those of myoglobin and fast skeletal muscle myosin on PRMS in the literature (15,23,28,29). Although myoglobin is often a difficult stain to interpret due to its high background, in this study, we found myoglobin to be highly sensitive for these poorly differentiated rhabdomyosarcomas, if interpreted carefully.…”

Section: Figuresupporting

confidence: 89%

“…With the exception of myoglobin, a protein found late in embryonic muscle development and requiring experienced interpretation, all other antibodies were found to be nonspecific for skeletal muscle phenotype. In the most recent decade, several series have used an immunohistochemical approach to identify PRMS (15,17,(27)(28)(29)(30)(31). In 1993, fast myosin, a skeletal muscle-specific marker, was added to the repertoire for PRMS (15).…”

Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 98%

“…15,21,29,31). However, with the exception of one group (29), who described a background of larger round cells, presumably rhabdomyoblasts, mainly only spindled and polygonal background cells have been previously recognized in the literature (15)(16)(17)(18)29). The above morphologic characteristics of the cases in the current study, with atypical large polygonal pleomorphic rhabdomyoblasts and two additional types of background rhabdomyoblasts, distinguish our proposed recognized morphologic variants of pleomorphic rhabdomyosarcoma as classic, round cell, and spindle cell variants, respectively.…”

Section: Figurementioning

confidence: 99%

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Pleomorphic Rhabdomyosarcoma in Adults: A Clinicopathologic Study of 38 Cases with Emphasis on Morphologic Variants and Recent Skeletal Muscle-Specific Markers

2001

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Pleomorphic rhabdomyosarcoma (PRMS) is a rare and controversial tumor of skeletal muscle phenotype. Diagnostic criteria for PRMS by combined histology and currently available immunohistochemistry have not been clearly defined. We report 38 pleomorphic rhabdomyosarcomas in adults, explore morphologic variants, and discuss our experience with both specific and nonspecific skeletal muscle markers in these tumors. Clinical data, morphology, and immunohistochemistry were reviewed. Electron microscopy was performed. Of 38 cases, there were 28 males and 10 females. Patient ages ranged from 21 to 81 years (median ‫؍‬ 54 y; mean ‫؍‬ 51 y). Tumors were located in the lower extremity (n ‫؍‬ 18), abdomen/retroperitoneum (n ‫؍‬ 6), chest/abdominal wall (n ‫؍‬ 5), spermatic cord/ testes (n ‫؍‬ 4), upper extremity (n ‫؍‬ 3), and one each in the mouth and orbit. Tumor sizes ranged from 1.5 to 15.0 cm (mean ‫؍‬ 7.3 cm; median ‫؍‬ 6.8 cm). The cases were divided into three variants, each with large, atypical, pleomorphic polygonal rhabdomyoblasts (PRMB) with abundant eosinophilic cytoplasm in varying numbers and different morphologic backgrounds of round or spindled rhabdomyoblasts (RMB). , fast skeletal muscle myosin, or myf4). In addition, all cases had some positivity for nonspecific muscle markers (desmin, MSA, SMA, myf3). Electron microscopy (EM), performed on eight selected cases from all three morphologic groups, demonstrated definitive skeletal muscle differentiation in all cases. Follow-up, available on 30 (79%) cases, revealed that 70% of patients died of disease (mean 20 months, range 1 month-108 months), 3% were alive with disease at 12 months (n ‫؍‬ 1); and 27% had no evidence of disease (mean, 83 mo; range, 18 to 108 mo). PRMS, a tumor of predominantly middle-aged adult males in the lower extremity, can be diagnosed by the morphologic presence of scattered PRMB with immunohistochemical evidence of at least one skeletal muscle-specific marker. There are three morphologic variants of PRMS. The appropriate diagnosis of PRMS is significant as it is a high-grade sarcoma, with an aggressive clinical course.

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Section: Figuresupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 98%

Section: Figurementioning

confidence: 99%

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Pleomorphic Rhabdomyosarcoma in Adults: A Clinicopathologic Study of 38 Cases with Emphasis on Morphologic Variants and Recent Skeletal Muscle-Specific Markers

2001

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“…However, in contrast to ESSs, these tumors are uniformly composed of cells with abundant eosinophilic cytoplasm showing marked nuclear pleomorphism, and they are associated with a very poor prognosis. 22 It has also been noted by several authors that ESTs may show fibroblastic and or myxoid change, the former being prominent in one of our cases. 6,18,30 These morphologic features can bring into the differential diagnosis the possibility of a myxoid smooth muscle tumor either benign or malignant or in rare instances a malignant nerve sheath tumor.…”

Section: Discussionsupporting

confidence: 78%

Unusual Morphologic Features of Endometrial Stromal Tumors

Baker

Moch

Oliva

2005

American Journal of Surgical Pathology

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Endometrial stromal tumors with typical morphology usually do not pose diagnostic problems. However, the finding of unusual morphologic features may be misleading in the final interpretation of these tumors. Herein, we described two endometrial stromal sarcomas discovered in hysterectomy specimens of women 31 and 75 years of age. Features typical of endometrial stromal neoplasia were present in both cases. Additionally, in 1 case, extensive fatty metaplasia as well as smooth and skeletal muscle metaplasia were found; and in the second case, focal bizarre nuclei, smooth muscle differentiation, and fibrous change were present. The differential diagnosis in the first case included cellular intravenous leiomyomatosis/lipoleiomyomatosis with skeletal muscle differentiation; and in the second case, a cellular smooth muscle tumor with bizarre nuclei was considered.

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