Search

Background. Angiosarcoma is rare, and information about its clinical features are limited. Therefore, a large scale study of angiosarcoma was performed in Japan. Methods. Through a nationwide Japanese study, 99 cases of angiosarcoma were collected and their clinicopathologic findings were summarized relative to predisposing risk factors. Results. The patient age at diagnosis was 3-92 years, (mean, 62 years), with a two to one male to female ratio. The head and face were the most common primary site (29 cases); other sites were liver (17); trunk (13): pleural cavity (6), chest wall (2), abdominal wall (2), buttock (2), inguinal region (1); heart (12); and extremities (7). The proven predisposing risk factors included chronic pyothorax for angiosarcoma in the pleural cavity (six), thorotrast in the liver five), radiotherapy to the abdominal wall and buttock (four), and chronic limb edema of the forearm (one). Irrespective of primary sites, the majority of cases had metastases to lung in 72 cases, bone in 42, liver in 36, regional lymph nodes in 30, and adrenal gland in 24. The 2-year survival rate was 17%. Conclusions. This study describes a different etiology in the development of angiosarcoma in patients from Japan compared with that of patients from Western countries, though the frequency of angiosarcoma among all soft-tissue sarcomas was similar in both areas. In Japan, chronic pyothorax, radiotherapy, and thorotrast proved to be distinctive causative factors of angiosarcoma. Cancer 1995;75:989-96.

Background. To evaluate the efficacy of aggressive pulmonary metastasectomy for treating soft tissue sarcomas, the clinical data on the surgical management of 23 patients with extensive pulmonary metastases from soft tissue sarcomas were reviewed. Methods. Between January 1973 and April 1991, 9 male patients and 14 female patients were treated. Their ages ranged from 13-68 years (median, 42 years). Twenty-one patients (91%) had bilateral and multiple metastases, and two patients had solitary metastasis. The number of resected metastatic nodules ranged from 1-110 (mean, 30.5). As an initial surgical approach, median sternotomy was used on 18 patients and lateral thoracotomy on 5 patients. Eleven patients underwent two or more explorations for recurrent metastases using lateral thoracotomy. The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was adopted in 10 patients since 1986. Results. The actuarial 2-year and 5-year survival rates after the first pulmonary resection were 49.7% and 24.8%, respectively. Histologic type (alveolar soft part sarcoma versus synovial sarcoma, P < 0.025), histologic grade Gi and G2 versus G3, P < 0.01), and metastatic localization (subpleural versus extrapleural, P < 0.005) were the most significant prognostic factors for aggressive pulmonary metastasectomy of soft tissue sarcomas. Application of laser surgery, absence of local recurrences, and absence of extrapulmonary metastases before pulmonary resection also correlated with better prognosis with borderline significance. Conclusions. Aggressive pulmonary metastasectomy for soft tissue sarcomas is a recommended procedure, even in the case of extensive metastases. The combination of median sternotomy and Nd:YAG laser-assisted surgery is a useful technique, especially in bilateral multiple pulmonary metastases. Cancer 1993; 72:1919-25.

Osteosarcoma, a malignant tumor of the bone, may metastasize to the lungs and affect the prognosis of the patient. The overgrowth of the tumor in the pulmonary artery, the major blood vessel supplying the lungs, rarely occurs. Surgery and chemotherapy have influenced the patterns of pulmonary metastasis within the lung. Two cases are described of patients with osteosarcoma that progressed to tumor overgrowth within the pulmonary artery. The tumors caused massive pulmonary emboli, the formation of blood clots. The tumor emboli were myxoid, consisted of mucus-like tissue, and differed in structure from that of the original tumor and the metastases. The original tumor and the metastases were osteoblastic (similar to bone-forming cells) in one case; and chondroblastic (similar to cartilage-forming cells) in the other case. Both patients later died as a result of the pulmonary emboli. (Consumer Summary produced by Reliance Medical Information, Inc.)

Non-Hodgkin's lymphoma (NHL) of the bone is a cancer of the lymphocytes, a type of white blood cell, which develops in bone marrow. Some studies have shown a difference in the distribution of some lymphomas between Western countries and Japan. The microscopic cell examinations and immunological properties of 34 cases of primary NHL were studied in Japan. The results indicate that there was a higher incidence of T-cell lymphoma, a malignancy of the T lymphocytes, in Japan than in Western countries. Lower grade tumors were found to have a better prognosis, but it was not statistically significant. There were no differences between Western countries and Japan with respect to age, sex and distribution of bone tumors. (Consumer Summary produced by Reliance Medical Information, Inc.)