The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Christopher D M Fletcher - One of the best experts on this subject based on the ideXlab platform.
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cellular Angiofibroma with atypia or sarcomatous transformation clinicopathologic analysis of 13 cases
The American Journal of Surgical Pathology, 2010Co-Authors: Eleanor Chen, Christopher D M FletcherAbstract:Cellular Angiofibroma is a mesenchymal neoplasm that is characterized by a bland spindle cell component, morphologically reminiscent of spindle cell lipoma, and thick-walled vessels. The tumor occurs equally in men and women and usually arises in the inguino-scrotal or vulvovaginal regions. An earlier study of 51 cases from our group showed that the tumor follows a benign course without any tendency for recurrence. In 1 case, an intralesional microscopic nodule of pleomorphic liposarcoma was observed. The biologic significance of atypia or sarcomatous transformation in cellular Angiofibroma remains uncertain. In this study, we characterized clinicopathologic features in 13 cases of cellular Angiofibroma with morphologic atypia or sarcomatous transformation. Thirteen cases with atypia or sarcomatous transformation among 154 usual cellular Angiofibromas identified between 1993 and 2009 were retrieved from consultation files. There were 12 females and 1 male ranging in age from 39 to 71 years (median age, 46 y). Tumor size ranged from 1.2 to 7.5 cm. In 11 cases, the tumors occurred in the vulva. One case each occurred in the paratesticular and hip regions. Most tumors were located in subcutaneous tissue. There were 4 cases of cellular Angiofibroma with atypia. Three showed severely atypical cells as scattered foci within the cellular Angiofibroma. One case showed a discrete nodule of atypical cells. There were 9 cases of cellular Angiofibroma with morphologic features of sarcomatous transformation. In each case, abrupt transition to a discrete sarcomatous component was seen. Of these 9 cases, the sarcomatous component in 2 cases showed features of pleomorphic liposarcoma with multivacuolated lipoblasts readily identified. Three of these 9 cases showed discrete nodule(s) closely resembling atypical lipomatous tumor within usual cellular Angiofibroma. In the remaining 4 cases, the sarcomatous component was composed of pleomorphic spindle cells arranged in various patterns. By immunohistochemistry, atypical cells and sarcomatous areas showed either multifocal or more diffuse p16 expression compared with either scattered or negative expression in the conventional cellular Angiofibroma. The 3 cases with atypical lipomatous tumor-like areas were negative for MDM-2 and CDK4. Follow-up information was available for 7 patients (range from 2 to 75mo; median: 14mo). Six patients did not develop recurrence or metastasis. One patient died of metastatic carcinoma of unknown primary site 27 months after the diagnosis of cellular Angiofibroma with sarcomatous transformation. Cellular Angiofibroma with atypia or morphologic sarcomatous transformation occurs predominantly in the subcutaneous tissue of the vulva and, as yet, shows no evident tendency to recur based on limited clinical follow-up available for 7 cases. The sarcomatous component can show variable features including atypical lipomatous tumor, pleomorphic liposarcoma, and pleomorphic sarcoma NOS. Overexpression of p16 in the atypical cells and sarcomatous component suggests a possible underlying molecular mechanism.
Eleanor Chen - One of the best experts on this subject based on the ideXlab platform.
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cellular Angiofibroma with atypia or sarcomatous transformation clinicopathologic analysis of 13 cases
The American Journal of Surgical Pathology, 2010Co-Authors: Eleanor Chen, Christopher D M FletcherAbstract:Cellular Angiofibroma is a mesenchymal neoplasm that is characterized by a bland spindle cell component, morphologically reminiscent of spindle cell lipoma, and thick-walled vessels. The tumor occurs equally in men and women and usually arises in the inguino-scrotal or vulvovaginal regions. An earlier study of 51 cases from our group showed that the tumor follows a benign course without any tendency for recurrence. In 1 case, an intralesional microscopic nodule of pleomorphic liposarcoma was observed. The biologic significance of atypia or sarcomatous transformation in cellular Angiofibroma remains uncertain. In this study, we characterized clinicopathologic features in 13 cases of cellular Angiofibroma with morphologic atypia or sarcomatous transformation. Thirteen cases with atypia or sarcomatous transformation among 154 usual cellular Angiofibromas identified between 1993 and 2009 were retrieved from consultation files. There were 12 females and 1 male ranging in age from 39 to 71 years (median age, 46 y). Tumor size ranged from 1.2 to 7.5 cm. In 11 cases, the tumors occurred in the vulva. One case each occurred in the paratesticular and hip regions. Most tumors were located in subcutaneous tissue. There were 4 cases of cellular Angiofibroma with atypia. Three showed severely atypical cells as scattered foci within the cellular Angiofibroma. One case showed a discrete nodule of atypical cells. There were 9 cases of cellular Angiofibroma with morphologic features of sarcomatous transformation. In each case, abrupt transition to a discrete sarcomatous component was seen. Of these 9 cases, the sarcomatous component in 2 cases showed features of pleomorphic liposarcoma with multivacuolated lipoblasts readily identified. Three of these 9 cases showed discrete nodule(s) closely resembling atypical lipomatous tumor within usual cellular Angiofibroma. In the remaining 4 cases, the sarcomatous component was composed of pleomorphic spindle cells arranged in various patterns. By immunohistochemistry, atypical cells and sarcomatous areas showed either multifocal or more diffuse p16 expression compared with either scattered or negative expression in the conventional cellular Angiofibroma. The 3 cases with atypical lipomatous tumor-like areas were negative for MDM-2 and CDK4. Follow-up information was available for 7 patients (range from 2 to 75mo; median: 14mo). Six patients did not develop recurrence or metastasis. One patient died of metastatic carcinoma of unknown primary site 27 months after the diagnosis of cellular Angiofibroma with sarcomatous transformation. Cellular Angiofibroma with atypia or morphologic sarcomatous transformation occurs predominantly in the subcutaneous tissue of the vulva and, as yet, shows no evident tendency to recur based on limited clinical follow-up available for 7 cases. The sarcomatous component can show variable features including atypical lipomatous tumor, pleomorphic liposarcoma, and pleomorphic sarcoma NOS. Overexpression of p16 in the atypical cells and sarcomatous component suggests a possible underlying molecular mechanism.
Peter E Andersen - One of the best experts on this subject based on the ideXlab platform.
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high grade malignant transformation of a radiation naive nasopharyngeal Angiofibroma
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2016Co-Authors: Jordan J Allensworth, Scott H Troob, Christian Lanciault, Peter E AndersenAbstract:Background Nasopharyngeal Angiofibromas are typically considered benign vascular neoplasms, with descriptions of high-grade sarcomatous change found only in lesions with prior radiotherapy. Methods and Results We describe the first reported case of high-grade malignant change in a nasopharyngeal Angiofibroma naive to radiation. A 45-year-old man presented with left-sided nasal congestion and fullness and was found to have a left-sided nasopharyngeal mass with intracranial extension on CT scan. A biopsy of the mass revealed nasopharyngeal Angiofibroma. The patient opted for MRI surveillance, which revealed interval growth 3 years later. Decompression surgery revealed only Angiofibroma, but resection 9 months later demonstrated high-grade sarcoma and concomitant Angiofibroma. The patient had residual disease which progressed through chemoradiation, and is now pursuing clinical trial enrollment. Conclusion Malignant transformation of nasopharyngeal Angiofibroma is extremely rare. As highlighted by this report, high-grade undifferentiated lesions may arise in tumors without previous radiation. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
Ercihan Guney - One of the best experts on this subject based on the ideXlab platform.
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extranasopharyngeal Angiofibroma originating from the nasal septum
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: Mehmet Akif Somdas, Ibrahim Ketenci, Yasar Unlu, Ozlem Canoz, Ercihan GuneyAbstract:Angiofibroma arising outside the nasopharynx is unusual. The nasal septum is an extremely rare site for an Angiofibroma to originate, and, to date, only 3 cases have been reported in the literature. We reported here the fourth case of nasal septal Angiofibroma. A 27-year-old male patient with nasal deformity applied to the Erciyes University ENT Department. He also complained of nasal obstruction on the right for 6 years. Two years ago, he had experienced an epistaxis, which oozed for 2 weeks after being packed. Neither the patient nor his family had a history of any hematologic disorder. On examination, an external nasal deviation to left was remarkable. A dark grayish mass was seen through the right nostril, between the nasal septum and the inferior turbinate on anterior rhinoscopy. There was no mass in the nasopharynx on posterior rhinoscopy via endoscope. http://www.entnet.org/journal/casereports/OTO-24.pdf/
A R Antonelli - One of the best experts on this subject based on the ideXlab platform.
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endoscopic surgery for juvenile Angiofibroma when and how
Laryngoscope, 2003Co-Authors: Piero Nicolai, Marco Berlucchi, Davide Tomenzoli, J Cappiello, Matteo Trimarchi, Roberto Maroldi, G Battaglia, A R AntonelliAbstract:Objectives/Hypothesis: In recent years, the indications for endoscopic surgery of the sinonasal tract, originally introduced for the treatment of inflammatory diseases, have been expanded to include selected cases of benign and malignant neoplastic lesions. The aim of the present study was to establish the efficacy of endoscopic surgery in the management of small and intermediate-sized juvenile Angiofibromas. Study Design: Retrospective study. Methods: We reviewed the clinical records and the preoperative and postoperative imaging studies of 15 patients with juvenile Angiofibroma who were treated with an endoscopic approach after embolization in the period from January 1994 to April 2000. All patients were prospectively followed by endoscopic and magnetic resonance imaging evaluations performed at regular intervals (every 4 months during the first year and, subsequently, every 6 months). Results: According to a staging system reported in 1989, there were two patients with a type I, nine with a type II, three with a type IIIA, and one with a type IIIB juvenile Angiofibroma. Angiography demonstrated that the vascular supply was strictly unilateral in 11 patients and bilateral in 4. Intraoperative blood loss ranged from 80 to 600 mL (mean blood loss, 372 mL). During follow-up (range, 24-93 mo; mean follow-up, 50 mo [SD ± 19.9 mo]), only one patient presented a residual lesion on magnetic resonance imaging, which was 16 mm in diameter and was detected 24 months after surgery. Conclusions: The endoscopic approach is a safe and effective technique that allows removal of small and intermediate-sized juvenile Angiofibromas (without extensive involvement of the infratemporal fossa and cavernous sinus) with a low morbidity. Advanced lesions are more appropriately treated by external approaches.