Soft Tissue Tumors

Question 1

What is the basic definition of a soft tissue tumor

Answer 1

Mesenchymal proliferations that occur in the extraskeletal, nonepithelialized tissues of the body, excluding the viscera, coverings of the brain, and the lymphoreticular system.

Question 2

What do we call a connective tissue neoplasm

Answer 2

A sarcoma.

Question 3

Lipoma

Answer 3

Basically a benign adipose tumor

Question 4

Are Lipomas usually slow growing or fast growing?

Answer 4

Usually slow growing

Question 5

What is the ifference between a Lipoma and Liposarcoma?

Answer 5

THE HISTOLOGY. Histology is important in soft tissue tumors.
In a liposarcoma you will generally see atypical cells. For example, a lipoblast may be present. Basically a lipoblast is a weird cell with an atypical nucleus and lipid vesicles in the cytoplasm.

Question 6

What is a nodular fascitis?

Answer 6

Rapidly growing, small benign , fibrous proliferationon the subcutis.

Question 7

Nodular fascitis is most common in what age group?

Answer 7

Young adults

Question 8

Nodular fascitis characteristically presents with what type of growth pattern?

Answer 8

Rapid

Question 9

Nodular fascitis generally follows what?

Answer 9

Injury. It is thought to be a mesenchymal reaction to injury

Question 10

Nodular fascitis most commonly seen in what areas of the body?

Answer 10

Arms. Particularly the flexxor surfaces of the arms

Question 11

What does the histology look like in nodular fascitis?

Answer 11

Said to have a “loose tissue culture appearance”

Question 12

What is Myositis Ossificans?

Answer 12

Reactive bone formation in the muscle as a result of injury. Entirely benign.

Question 13

Mysositis Ossificans generally occurs in what area of the body>?

Answer 13

Lower limb

Question 14

What is the key feature in differentiating myositis ossificans from a malignancy

Answer 14

Myositis ossificans shows a maturation pattern. The maturation pattern is woven bone at the periphery, but immature bone at the center. Malignancy does not show this pattern.

Question 15

What are the two classifications of fibromatoses?

Answer 15

Superficial and deep.

Question 16

Superficial fibromatoses appear where?

Answer 16

Hands, feet, penis

Question 17

Which of the superficial fibromatoses is most common

Answer 17

The palmar one

Question 18

Does fibromatoses tend to affect one sex more than the other?

Answer 18

Yes. Male predominance

Question 19

Palmar fibromatoses generally appear on one side only?

Answer 19

FALSE. Generally bilateral

Question 20

Plantar fibromatoses

Answer 20

Generally appear in a younger age group but are also bilateral in most cases

Question 21

Penile fibromatoses

Answer 21

Rare. Generally accompany other superficial fibromatoses

Question 22

What is infantile digital fibromatoses

Answer 22

superficial fibromatoses that appear in the digits of young children and are characterized by inclusion like condensations of cytoplasmic actin.

Question 23

What is Dupuytrens’s contracture

Answer 23

It is a condition of fixed flexion of the hand where the fingers bend towards the palm and cannot extend.

Question 24

What fingers are most commonly affected?

Answer 24

Ring and pinky

Question 25

Deep Fibromatoses

Answer 25

Aggressive, Rare, More common in females until after their 20's.

Question 26

Deep fibromatoses generally occur where in peds and in whom?

Answer 26

Extra-abdominal, females

Question 27

Deep fibromatoses generally appear where pts in their late 20's and who is generally affected?

Answer 27

Abdominal wall, females typically affected still. Past this, however, no sex predisposition and tumors do not occur in the abdomen as often.

Question 28

Does radiation work on these tumors?

Answer 28

Nope. They are not malignant....do not divide quickly.

Question 29

Definition of a fibrosarcoma

Answer 29

Tumor of mesenchymal origin that is composed of MALIGNANT FIBROBLASTS in a collagen background.q

Question 30

Where may fibrosarcomas develop?

Answer 30

THey may be soft tissue masses or bone tumors. Generally develop in the lower extremities (femur and Tibia if in bone, thigh and posterior knee if in soft tissue)

Question 31

When a fibrosarcoma arises in bone, what part of the bone is it in?

Answer 31

METAPHYSIS OF LONG BONES OR THE PELVIS

Question 32

Most frequently diagnosed in pts in what decade of life?

Answer 32

4th

Question 33

What is the prognosis of fibrosarcoma

Answer 33

Poor in adults. There is an infantile form that has a great prognosis however.

Question 34

Histology of a fibrosarcoma?

Answer 34

Herringbone pattern. Nuclei are spindle shaped with pointed ends

Question 35

What the hell is a dermatofibroma

Answer 35

Can also be called a fibrous histiocytoma. It basically is a benign growth of dermal dendritic histiocytic cells.

Question 36

Dermatofibroma may arise after....

Answer 36

relatively minor trauma like an insect bite or thorn prick

Question 37

DF Generally look like what

Answer 37

firm nodules, small

Question 38

DFSP

Answer 38

Dermatofibrosarcoma protuberans

Question 39

DFSP common or uncommon

Answer 39

Uncommon, Locally aggressive though with a high recurrence rate, It is a cutaneous malignancy that arises from the dermis and invades deeper subcutaneous tissue.

Question 40

DFSP exhibits partial features of three cell types, they are?

Answer 40

fibroblastic, histiocytic, neuroectodermal.

Question 41

malignant fibrohistiocytoma

Answer 41

MOst common soft-tissue sarcoma

Question 42

Most important prognostic factor for malignant fibrohistiocytoma?

Answer 42

Clinical stage ( tumor grade, size, presence of metastases)

Question 43

Distant metastasis of malignant fibrohistiocytoma seems to go where?

Answer 43

lung, bone, liver

Question 44

Histiologic appearance of malignant fibrohistiocytoma?

Answer 44

Storiform, woven mat appearance

Question 45

Rhabdomyosarcoma definition

Answer 45

tumor made up of cancerous muscle cells,

Question 46

Two thirds of rhabdomyosarcomas are found in what age group

Answer 46

children under ten

Question 47

Most common sites of Rhabdomyosarcoma development>

Answer 47

Adjacent to the skull, Around the eye, Nose and throat, arms and legs, urinary system and reproductive organs

Question 48

Prototypical cell type in rhabdomyosarcoma

Answer 48

Strap cell. ELongated bizzarre looking cells

Question 49

Leiomyoma definition

Answer 49

Tumor of the smooth muscle. Usually the wall of the uterus

Question 50

Leiomyomas affect what percentage of reproductive age women?

Answer 50

25-40%

Question 51

Most Leiomyomas

Answer 51

regress after menopause, are asymptomatic, may be found anywhere in the body on smooth muscle

Question 52

Typical cell appearance in a Leiomyoma

Answer 52

Cigar shaped

Question 53

Leiomyosarcoma are most common where

Answer 53

uterus, abdomen, or pelvis

Question 54

If you see cigar shaped cells indicative of a Leiomyosarcoma but also see mitotic figures

Answer 54

This is bad.

Question 55

Sarcomas tend to metastasize where and why?

Answer 55

Lungs, because they typically spread hematogenously.