Pathology of malignant skin tumours

The skin gives rise to a diverse spectrum of malignant tumours derived from the varied constituents of the epidermis and dermis. It is possible to discuss only a few of these in this article; the more common lesions derived from the epidermal keratinoctyes (basal and squamous cell carcinomas) together with melanomas (derived mainly from epidermal melanocytes) are presented. Some rarer but biologically aggressive tumours such as Merkel cell carcinoma and angiosarcoma are also discussed. Our understanding of the molecular biology of cutaneous tumours continues to evolve rapidly particularly for melanomas and in the coming years genetic profiling of individual tumours with targeted therapy is likely to play an important role in management.     

Primary retroperitoneal angiosarcoma: MR imaging features

We report a rare case of retroperitoneal angiosarcoma in a 72-year-old man who presented with abdominal pain. Diagnosis was obtained histologically after radical excision of the tumour. Fat-suppression MRI after intravenous administration of the contrast agent gadolinium-DTPA was able to define tissue planes between the lesion and the adjacent structures, suggesting the vascular nature of the lesion, and provided useful information for an accurate surgical approach. To the best of our knowledge, this is the first report that illustrates the MRI characteristics of a retroperitoneal angiosarcoma. Received: 13 March 2000 Revised: 14 July 2000 Accepted: 17 July 2000     

Surgical outcome in 85 patients with primary cardiac tumors

BACKGROUND: We present a large, single institution experience with adult cardiac tumors and address factors affecting outcome. METHODS: A retrospective review was made of all patients who underwent surgery for primary cardiac tumors from April 1975 through August 2002. RESULTS: Eighty-five patients (33 male and 52 female) with a mean age of 54 years were identified with follow-up available for 80 (94%) patients. There were 68 (80%) benign tumors and 17 (20%) malignant tumors. Three tumors recurred and were resected giving a total of 88 surgeries. All benign tumors were grossly resected and the extent of resection for malignant disease ranged from 14 (78%) gross resections and 3 (17%) debulkings to 1 (5%) biopsy. There were 4 (5%) early hospital deaths. Median survival was 9.6 months and 322 months for patients with malignant and benign diseases, respectively. Significant predictors of long-term mortality were malignant disease (P <0.0001) and New York Heart Association class (P <0.03). CONCLUSIONS: Surgical resection provides excellent outcome in patients with benign cardiac tumors. Malignant tumors continue to pose a challenge with good local tumor control but limited survival owing to metastatic disease.     

Infantile hemangioendothelioma: A case report and discussion

Infantile hepatic hamangioendothelioma type II is similar to angiosarcoma in terms of histomorphology and behavior. Various presentations of this lesion have been reported in the literature, e.g. cases with a hepatic mass, cutaneous hemangiomas, heart failure, etc. We report on a patient, male/2 years, who had two jejunal masses and a hepatic mass accompanied by lower GI bleeding and intestinal obstruction. The two jejunal masses and the hepatic lesion were diagnosed as angiosarcoma histomorphologically (IHHE type II), and were positive for vascular markers (CD31 and CD34) on immunohistochemistry. The patient had no skin lesions. We report this case and provide a literature review because of the unusual presentation and the overall rarity of this entity.     

乳腺血管肉瘤4例临床病理分析

 目的 分析乳腺血管肉瘤的临床特征及病理学诊断及鉴别诊断。方法 对4例乳腺血管肉瘤进行临床分析和病理免疫组织化学研究。结果 4例中,2例单纯肿块切除术后局部复发。4例中3例分别在治疗后7月、11月和2年死亡,1例存活达16年。结论 乳腺血管肉瘤是一种高度恶性肿瘤,预后与分化程度有关。     

胸壁巨大上皮样血管肉瘤的临床病理分析

目的探讨发生于胸壁上皮样血管肉瘤的临床病理特征、病理诊断及鉴别诊断。方法对1例原发于胸壁的上皮样血管肉瘤进行组织形态学、免疫组织化学分析,并复习相关文献。结果肿瘤大体形态有主瘤结及卫星瘤节的特点,镜下观察其瘤细胞呈上皮样排列,异型性明显,免疫组化结果显示Vim强阳性,CD31阳性,CD34阳性。结论发生于胸壁的上皮样血管肉瘤较少见,术前确诊较困难,须与原发于胸膜的恶性间皮瘤、转移癌、恶性黑色素瘤等鉴别。     

右大腿上皮样血管肉瘤1例

患者男,36岁,1年前自觉右大腿内侧包块,未予以治疗,近1月包块增大并出现间断性刺痛而来我院就诊。查体:右大腿内侧可触及大小约7cm×8cm软组织肿块,质地较硬,边界不清,活动差,压痛明显。包块区皮肤正常,无红肿及溃疡,未见静脉曲张。四肢关节活动良好,肌张力及各种生理反放射正常。实验室检查:血常规及肿瘤标志物无阳性发现,肝、肾功能正常。CT检查:右大腿下部内侧有一不规则软组织肿块,境界不清,密度不均,内有多发小斑块状钙化影(图1～4);增强扫描肿块呈不均匀网状强化,其内有分隔,并含有粗细不均的增生血管(图5、6)。CT诊断为良性病变可…     

乳腺原发性血管肉瘤误诊1例报道并文献复习

目的探讨乳腺血管肉瘤的临床病理特点、治疗和预后。方法对1例原发于乳腺的高分化血管肉瘤并再次复发进行组织形态学和免疫组化分析,并复习文献。结果乳腺血管肉瘤几乎均发生于女性,主要为20～30岁。临床表现不典型,组织学变化大,肿瘤通常CD31、CD34、UEA-1和F8（＋）,B72.3对上皮样血管肉瘤具有特异性。目前主要采取手术行单纯乳腺切除治疗,一般不主张腋窝清扫,术后放、化疗效果不肯定。结论乳腺原发性血管肉瘤较少见,肿瘤分化程度与预后密切相关。