Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_ Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_
Poster Topic: Tumours Abstract number: 23788 A CASE OF EXTRA-ABDOMINAL DESMOID TUMOR AFTER CERVICAL LAMINOPLASTY Minoru KASHIHARA Naze Tokushukai Hospital, Amami City (JAPAN) Introduction:Desmoid tumors (DT) are rare, nonmalignant, slow-growing neoplasms with the potential for locally aggressive growth invading surrounding structures. We report a case of extra-abdominal DT arising in the operation scar of cervical laminoplasty.Case:A 63-year-old male presented three months history of a slowly growing painless mass situated over the left nuchal region 13 months after cervical spinous process-splitting laminoplasty for cervical myelopathy. A firm and immobile, 4×3 cm mass was located at the left side of the operation scar. MR image revealed low signal intensity on T1WI, low and high intensity on T2WI, and the mass was diffusely enhanced by Gadolinium. Marginal excision was performed to preserve paravertebral muscles and to prevent postoperative axial pain. Microscopic findings showed that the tumor was composed of proliferation of fibroblastic or elongated spinlde cells with abundant fibrocollagenous stroma, invading to surrounding skeletal muscle fibers with atrophic change. The tumor was diagnosed as extra-abdominal DT. Three years following surgical excision there was no evidence of recurrence. Conclusion:The factors contributing to the etiology of DT are pregnancy in fertile female, hormonal constitution in fertile female, minor bone malformation and surgical trauma including previous operation. Several authors reported abdominal or extraabdominal DT after operations such as cervical laminectomy, suboccipital craniotomy, thyroidectomy, mammaplasty for breast carcinoma, laparoscopy, cesarean secsion, thoracotomy for a vagotomy, and lumbar spinal operation. Cervical laminoplasty might be one of the etiology in our case. 622
Poster Topic: Tumours Abstract number: 23846 METASTATIC CARCINOMA TO SUBCUTANEOUS TISSUE AND SKELETAL MUSCLE Yasuo YOSHIMURA 1 , Ken-ichi ISOBE 1 , Takeshi KOIKE 2 , Hideki ARAI 1 , Hiroyuki KATO 1 1 Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto,Nagano Prefecture (JAPAN), 2 Department of Orthopaedic Surgery, Ina Central Hospital, Ina,Nagano Prefecture (JAPAN) Metastatic carcinoma to subcutaneous tissue or skeletal muscle is relatively rare, and few studies on case-series are reported. Differentiation between primary soft tissue sarcoma and metastatic carcinoma to soft tissue is important at presentation because the treatments and prognoses markedly differ. We retrospectively reviewed records of 11 patients with soft tissue metastasis in our institution from 1996 to 2009 to consider usefulness of methods for confirming diagnosis as soft tissue metastasis and determining the primary site. In 9 cases of 10 patients who underwent MRI, findings consisted of (1) poorly circumscribed high intensity lesions around tumor on T2-weighted images, and (2) irregular peritumoral enhancement and (3) poorly enhanced lesions on the center of tumor on T1-weighted images. Serum C-reactive protein level was slightly high in 7 of 9 patients. Immunohistochemical findings of biopsy specimens were more valuable for diagnosing as soft tissue metastasis and determining the primary site. The expression patterns of cytokeratin 7 (CK7) and cytokeratin 20 (CK20) and tissue-specific antibodies such as thyroid transcription factor-1 (TTF-1), PE-10, MUC5AC, and CDX2 were particularly valuable diagnostic markers. Although 9 of 11 patients had poorly differentiated carcinoma, the primary site could be determined in 4 patients with CK 7 /CK 20 immunophenotype and positivity for tissue-specific antibodies. Even in the other 5 patients, CK 7 /CK 20 immunophenotype provided useful information for determination of the primary site. Immunohistochemical examination was thus helpful in the discrimination of primary origin in soft tissue metastasis of carcinoma. 623
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Poster<br />
Topic: Tumours<br />
Abstract number: 23788<br />
A CASE OF EXTRA-ABDOMINAL DESMOID TUMOR AFTER CERVICAL<br />
LAMINOPLASTY<br />
Minoru KASHIHARA<br />
Naze Tokushukai Hospital, Amami City (JAPAN)<br />
Introduction:Desmoid tumors (DT) are rare, nonmalignant, slow-growing neoplasms<br />
with the potential for locally aggressive growth invading surrounding structures. We<br />
report a case of extra-abdominal DT arising in the operation scar of cervical<br />
laminoplasty.Case:A 63-year-old male presented three months history of a slowly<br />
growing painless mass situated over the left nuchal region 13 months after cervical<br />
spinous process-splitting laminoplasty for cervical myelopathy. A firm and immobile,<br />
4×3 cm mass was located at the left side of the operation scar. MR image revealed<br />
low signal intensity on T1WI, low and high intensity on T2WI, and the mass was<br />
diffusely enhanced by Gadolinium. Marginal excision was performed to preserve<br />
paravertebral muscles and to prevent postoperative axial pain. Microscopic findings<br />
showed that the tumor was composed of proliferation of fibroblastic or elongated<br />
spinlde cells with abundant fibrocollagenous stroma, invading to surrounding skeletal<br />
muscle fibers with atrophic change. The tumor was diagnosed as extra-abdominal<br />
DT. Three years following surgical excision there was no evidence of recurrence.<br />
Conclusion:The factors contributing to the etiology of DT are pregnancy in fertile<br />
female, hormonal constitution in fertile female, minor bone malformation and surgical<br />
trauma including previous operation. Several authors reported abdominal or extraabdominal<br />
DT after operations such as cervical laminectomy, suboccipital<br />
craniotomy, thyroidectomy, mammaplasty for breast carcinoma, laparoscopy,<br />
cesarean secsion, thoracotomy for a vagotomy, and lumbar spinal operation.<br />
Cervical laminoplasty might be one of the etiology in our case.<br />
622
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