scholarly journals Successful Multidisciplinary Treatment for Aggressive Primary Pulmonary Undifferentiated Pleomorphic Sarcoma

2020 ◽  
Vol 13 (1) ◽  
pp. 385-391 ◽  
Author(s):  
Mitsunori Higuchi ◽  
Hitoshi Yamada ◽  
Kakeru Machino ◽  
Ikuro Oshibe ◽  
Nobutoshi Soeta ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Multidisciplinary Treatment ◽  
Stage Iv ◽  
Resected Specimen ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Pleomorphic Sarcoma ◽  
18F Fluorodeoxyglucose ◽  
Positron Emission ◽  
Left Upper Lobectomy ◽  
Almost All

Undifferentiated pleomorphic sarcoma (UPS) was previously known as malignant fibrous histiocytoma (MFH). This sarcoma occurs preferentially in the extremities and retroperitoneal space; primary pulmonary UPS/MFH is rare. We report a 52-year-old woman referred to our hospital with dyspnea and severe cough. Chest computed tomography (CT) revealed a pulmonary mass in the left upper lobe and pleural effusion. Cytology of the effusion showed no malignancy; however, the tumor increased rapidly in size, and the patient’s respiratory symptoms worsened. The tumor occupied almost all of the left upper lobe and involved the adjacent pericardium. She underwent left upper lobectomy with pericardial resection and reconstruction. Postoperative pathology of the resected specimen showed undifferentiated pulmonary sarcoma, pT4N0M1a stage IV A, and genetic analyses revealed the v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation. The patient’s dyspnea recurred 1 month postoperatively, and CT showed marked pleural effusion. An 18F-fluorodeoxyglucose positron emission tomography demonstrated abnormal diffuse accumulation of 18F-fluorodeoxyglucose in the left pleural cavity. We initiated five cycles of chemotherapy with doxorubicin and ifosfamide, and the patient has been well without recurrence for 24 months after multidisciplinary treatment with surgery followed by systemic combination chemotherapy. We successfully treated our patient with primary pulmonary UPS/MFH using a multidisciplinary approach, even though this sarcoma carries a poor prognosis and is insensitive to both chemotherapy and radiotherapy.

A case of undifferentiated pleomorphic sarcoma with giant cells arising from the chest wall with pleural effusion

2014 ◽  
Vol 53 (1) ◽  
pp. 35-40
Author(s):  
Eiji SADASHIMA ◽  
Mayuko KAWAHARA ◽  
Junko KINOSHITA ◽  
Kanako YAMAZAKI ◽  
Natsu SADASHIMA ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Chest Wall ◽  
Giant Cells ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Pleomorphic Sarcoma

scholarly journals Primary diaphragmatic undifferentiated pleomorphic sarcoma in a cat

2021 ◽  
Vol 7 (1) ◽  
pp. 205511692110189
Author(s):  
Irene Bonazzi ◽  
Simona Morabito ◽  
Barbara Brunetti ◽  
Stefano Nicoli ◽  
Paola Valenti
Keyword(s):  
Pleural Effusion ◽  
Soft Tissue ◽  
Giant Cells ◽  
Needle Aspiration ◽  
Whole Body ◽  
Left Hemithorax ◽  
Tissue Mass ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Pleomorphic Sarcoma ◽  
Contrast Enhanced Ct

Case summary A 5-year-old neutered female domestic shorthair cat was referred for acute onset of dyspnoea. Thoracic radiographs performed by the referring veterinarian revealed the presence of pleural effusion. Upon presentation, the cat was dyspnoeic, and cardiopulmonary auscultation revealed muffled heart sounds and bilaterally increased bronchovesicular sounds. Radiographic study of the thorax revealed bilateral pleural effusion and a soft tissue opacity in the dorsocaudal region of the left hemithorax. A whole-body contrast-enhanced CT scan identified a soft tissue mass arising from the left diaphragmatic crus. Transthoracic ultrasound-guided fine-needle aspiration (FNA) of the mass was performed and the result was consistent with a malignant mesenchymal neoplasia, showing giant cells. Cytoreductive surgery was performed and the histopathology diagnosis of undifferentiated pleomorphic sarcoma was made. Adjuvant chemotherapy was then offered. Ten days after surgery pleural effusion recurred. Thoracic echography revealed the presence of a diaphragmatic thickening in the area of surgical resection. FNA of the thickening was consistent with mesenchymal neoplasia. Even when chemotherapy and supportive treatment with pain relief was instituted, the clinical condition of the cat worsened within a few days and it was euthanased 1 month after surgery. Relevance and novel information Primary diaphragmatic tumours (PDTs) have been rarely reported in human and in veterinary medicine, where only three cases have been described in the dog. To our knowledge, this is the first report to describe a PDT, specifically an undifferentiated pleomorphic sarcoma, in a cat.

scholarly journals Inflammatory Undifferentiated Pleomorphic Sarcoma Mimicking Bacteremia in an Elderly Patient: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 175
Author(s):  
Kazuhiko Hashimoto ◽  
Shunji Nishimura ◽  
Tomohiko Ito ◽  
Naohiro Oka ◽  
Masao Akagi
Keyword(s):  
Soft Tissue Sarcomas ◽  
Standardized Uptake Value ◽  
Unknown Origin ◽  
Major Type ◽  
Wide Margin ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Reactive Protein ◽  
Pleomorphic Sarcoma ◽  
Positron Emission ◽  
Sources Of Infection

Undifferentiated pleomorphic sarcoma (UPS) is major type of soft tissue sarcomas. UPS presenting with inflammation is rare, and its pathophysiology remains unclear. Herein, we report a rare case of UPS with prolonged fever. A 91-year-old female complaining of high fever was referred to our hospital because of a high C-reactive protein (CRP) level of 12.51 mg/dL. She had been experiencing intermittent fevers for approximately 10 years. The fever of unknown origin worsened with time and went into remission with repeated antimicrobial therapy. She also had a mass on her central lower back over the sacral region for 6 years, which showed a gradual increase in size. The blood tests showed that the leukocyte count and neutrophils were 6.51 × 103 /µL and 70.3%, respectively. She had a 10 × 10 cm mass on her buttock that showed 2-[fluorine-18] fluoro-2-deoxy-d-glucose (FDG) accumulation on FDG-positron emission tomography-computed tomography examination (standardized uptake value-max value: 5.4). A blood culture examination was performed to rule out bacteremia, however, no bacteria were identified. We then performed a needle biopsy and confirmed the diagnosis of UPS; subsequently, the patient underwent a wide-margin resection. A few days after the surgery, her CRP, leukocyte, and neutrophil levels decreased to 0.305 mg/dL, 2.83 × 103/uL, and 50.1%, respectively. This case demonstrated that UPS with inflammation should be treated surgically as soon as possible after ruling out other sources of infection to achieve a favorable prognosis.

scholarly journals Undifferentiated Pleomorphic Sarcoma of Liver: Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Jirong (Betty) Mass ◽  
Geoffrey Talmon
Keyword(s):  
Spindle Cell ◽  
Primary Malignancy ◽  
Ct Guided ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Spindle Cell Neoplasm ◽  
Pleomorphic Sarcoma ◽  
Positron Emission ◽  
Medication Side ◽  
Liver Biopsies ◽  
Immunohistochemical Studies

Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma (MFH), is rarely reported in the liver as a primary site. We report a case of a previously healthy 56-year-old male, who presented with abdominal pain and jaundice. The patient was originally diagnosed with cholecystitis, treated with cholecystectomy, which was complicated by abdominal abscess. One week following discharge, the patient was readmitted with fever, chills, and leukocytosis. Computed tomography (CT) guided liver biopsies demonstrated an epithelioid to spindle cell neoplasm with markedly atypical nuclei and prominent necrosis infiltrating between hepatocytes. Immunohistochemical studies were negative for epithelial, melanocytic, and hematolymphoid differentiation. Positron emission tomography (PET) was performed, which showed a single markedly hypermetabolic central hepatic mass (14 x 8.5 x 8.5 cm) with likely central necrosis, consistent with primary malignancy. The patient was treated with one cycle of chemotherapy (doxorubicin and ifosfamide), refusing additional cycle due to medication side effects. The patient subsequently succumbed to complications associated with the malignancy and died within 19 days of diagnosis.

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