Malignant Soft Tissue Tumors Flashcards
What is a fibrosarcoma?
Malignant tumor of fibroblasts
Histopathologic appearance of fibrosarcoma?
Cellular mass of spindle shaped cells demonstrating mild pleomorphism
Tx for fibrosarcoma
Surgical excision including a wide margin of adjacent normal tissue
What is a liposarcoma?
Malignant neoplasm of fatty origin
Most common soft tissue sarcoma
What are the most common sites of lipsarcomas?
Thigh, retroperitoneum and iguinal regions
How common are the liposarcomas of the head and neck?
rare
What are the 3 major categories of liposarcoma?
3 major categories:
- well-differentiated/atypical lipomatous tumor (most common)
- myxoid/round cell liposarcoma
- pleomorphic liposarcoma
Tx for liposarcoma
Radical excision - tx of choice
Survival rates for liposarcoma?
5 year survival rate = 59-70%
10 year survival = 50%
Recurrence of liposarcoma?
~50%
Oral liposarcoma prognosis
More favorable because of the predominance of well differentiated subtypes and because tumors are small and diagnosed
What other disease is often seen with malignant peripheral nerve sheath tumor?
Half seen in NF-1 (neurofibromatosis)
Tx for malignant peripheral nerve sheath tumor
Radical surgical excision
Prognosis of malignant peripheral nerve sheath tumor
Poor especially in patients with neurofibromatosis
What is Kaposi’s sarcoma?
Vascular neoplasm caused by HHV8 and KSHV
Kaposi’s sarcoma has the propensity to develop in what patients?
HIV
What cell lineage does Kaposi’s sarcoma lesions mosty likely arise from?
Lesions most likely arise in endothelial cells although there is some evidence of lymphatic origin
What is leiomyosarcoma?
malignant neoplasm of smooth muscle differentiation
What is the most common site of leiomyosarcoma?
uterine wall and GI tract
How often do leiomyosarcomas occur in the oral cavity?
rare
What is a rhabdomyosarcoma?
Malignant neoplasm characterized by skeletal muscle differentiation
What is the most frequnt site of rhabdomyosarcoma?
head and neck
Is rhabdomyosarcoma more frequent in young chilren or adults?
young children
Primarily occurs in the first decade of life but may occur in teens
Clinical presentation of the rhabdomyosarcoma tumor
Tumor is most often a painless infiltrative mass that may grow rapidly
Tx for rhabdomyosarcoma
local surgical excision followed by multiagent chemotherapy
Prognosis of rhabdomyosarcoma
with the advent of multimodal therapy, prognosis has improved
How common are metastatic tumors to the oral cavity?
Uncommon
What tissues can metastasis to the oral cavity affect?
bone or soft tissues
What is the mechanism of metastatic spread to the head and neck?
primary malignancies from immediately adjacent tissues might be able to spread by a lymphatic route
Batson’s plexus
- explanation for blood-borne metastasis to the head and neck
- valve-less verterbral venous plexus that might allow retrograde spread of tumor cells, bypassing filtration through the lungs
What is the most common site for soft tissue metastases in the oral cavity?
gingiva, followed by the tongue
What is the clinical appearance of metastatic lesions in the oral cavity?
Lesions usually appear as a nodular mass that oftne resembles a hyperplastic or reactive growth
How can a metastatic lesion to the oral cavity affect adjacent teeth?
Adjacent teeth may be loosened by an underlying destruction of alveolar bone
How does the presence of teeth direct location of the metastatic lesion in the oral cavity?
Presence of teeth may plan an important role in the preference of metastases for the gingiva
How does the oral cavity affect malignant cell growth when there is metastases to the oral cavity?
Once malignant cells reach the oral cavity, the rich
vascular network of inflamed gingival tissues may
serve as a fertile site for further growth
What are the most common sources for metastasis to the oral cavity?
Lung
Kidney
Melanoma
Prostate
Breast
Prognosis of metastatic lesions to the oral cavity?
GEnerally poor because other metastatic sites are also present
Management of metastatic oral lesion?
palliative
