SOFT TISSUE TUMORS ppt

SOFT TISSUE TUMORS Edited by Fethi Derbel Soft Tissue Tumors Edited by Fethi Derbel Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Marija Radja Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright Photosani, 2011. Used under license from Shutterstock.com First published October, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Soft Tissue Tumors, Edited by Fethi Derbel p. cm. ISBN 978-953-307-862-5 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Fundamental Aspects of Soft Tissue Tumors 1 Chapter 1 Considerations for Treatment Development in Rhabdomyosarcoma: In Vitro Assessment of Novel DNA Binding Drugs 3 Steven J. Wolf, Laurence P.G. Wakelin and Daniel R. Catchpoole Chapter 2 Telomere Maintenance Mechanisms in Soft Tissue Sarcomas 31 Matthew J. Plantinga and Dominique Broccoli Part 2 Diagnosis and Investigations in Soft Tissue Tumors 51 Chapter 3 Classification of Soft Tissue Tumors by Machine Learning Algorithms 53 Jaber Juntu, Arthur M. De Schepper, Pieter Van Dyck, Dirk Van Dyck, Jan Gielen, Paul M. Parizel and Jan Sijbers Chapter 4 Medical Theory on Orthopedics Combining Molecular Imaging with Clinical Practice 69 Jing jing Peng Chapter 5 Imaging Findings of Adipocytic Tumors 91 Jun Nishida, Shigeru Ehara and Tadashi Shimamura Part 3 Types of Soft Tissue Tumors 101 Chapter 6 Pediatric Soft Tissue Tumors 103 Ezequiel Trejo-Scorza, Belinda Beatriz Márquez Álvarez, Carlos José Trejo-Scorza and Simón Paz-Ivannov Chapter 7 Head and Neck Soft Tissue Sarcoma 117 Rogelio Gonzalez – Gonzalez, Ronell Bologna – Molina, Omar Tremillo – Maldonado, Ramon Gil Carreon – Burciaga and Marcelo Gomez Palacio - Gastelúm VI Contents Chapter 8 Dermatofibrosarcoma Protuberans – Special Challenges of Management in Resources Constrained Countries 143 Titus Osita Chukwuanukwu and Stanley Anyanwu Chapter 9 Clinical and Molecular Biology of Angiosarcoma 149 N.J. Andersen, R.E. Froman, B.E. Kitchell and N.S. Duesbery Chapter 10 Gastrointestinal Stromal Tumours: A Contemporary Review on Pathogenesis, Morphology and Prognosis 175 Muna Sabah Part 4 Treatment of Soft Tissue Tumors 207 Chapter 11 Treatment of Synovial Sarcoma in Children 209 Shvarova Anna Viktorovna, Rykov Maxim Yurjevich, Karseladze Appolon Irodionovich and Ivanova Nadezhda Mikhailovna Chapter 12 Novel Therapeutic Targets in Soft Tissue Sarcomas 217 Quincy S.C. Chu and Karen E. Mulder Part 5 Prognosis of Soft Tissue Tumors 253 Chapter 13 Prognostic Factors in Soft Tissue Sarcoma 255 Luiz Eduardo Moreira Teixeira, Jose Carlos Vilela and Ivana Duval De Araujo Chapter 14 Metastatis of Soft Tissue Sarcomas 263 Fethi Derbel, Sonia Ziadi, Medi Ben Hadj Hamida, Jaafar Mazhoud, Mohamed Ben Mabrouk, Abdallah Mtimet, Sabri Youssef, Ajmi Chaouch, Ali Ben Ali, Ibtissam Hasni, Mrad Dali Kaouthar, Jemni Hela, Moncef Mokni and Ridha Ben Hadj Hamida Preface Soft tissue tumors include a heterogeneous group of diagnostic entities, most of them benign in nature and behavior. Malignant entities, soft tissue sarcomas, are rare tumors that account for 1% of all malignancies. These are predominantly tumors of adults, but 15% arise in children and adolescents. The wide biological diversity of soft tissue tumors, combined with their high incidence and potential morbidity and mortality represent challenges to contemporary researches, both at the level of basic and clinical science. Determining whether a soft tissue mass is benign or malignant is vital for appropriate management. This book is the result of collaboration between several authors, experts in their fields; they have tried to convey to the reader the complexity of soft tissue tumors and the diversity in the diagnosis and management of these tumors. In this book, entitled Soft Tissue Tumors, we have highlighted many of the significant advances in the diagnosis and treatment of soft tissue tumors; we tried to offer a comprehensive overview of this wide field, from basic mechanisms underlying soft tissue tumors to current advances and future directions in the prevention, early detection and management of these neoplasms. The presented textbook is subdivided into five sections termed: Fundamental Aspects of Soft Tissue Tumors, Diagnosis and Investigations,Types and Classification of Soft Tissue Tumors, Treatment of Soft Tissue Tumors, Prognosis of Soft Tissue Tumors. Although this book does not cover all aspects related to soft tissue tumors, it is intended for at least two kinds of readers : residents of intermediate and advanced courses in medicine; oncologist, pathologist, surgeon, radiologists and all doctors whatever their specialty. As editor in chief of this textbook, I would like to acknowledge the efforts made by all of the contributing authors and the entire editorial team in the publishing of this book especially Mrs Marija Radja for her very precious collaboration. Their dedication to the publication of the most contemporary and comprehensive scientific data has this excellent work as a result. I would like to dedicate this textbook to all my colleagues surgeons, pathologist, oncologist and radiologist at Sahloul Hospital, the past and X Preface actual deans of our university Professor Mohsen Jeddi, Sahloul Essoussi, Abdelkrim Zbidi, Nejib Mrizak and Ali Mtiraoui for their encouragement, and Professor Moncef Mokni pathologist in the department of pathology at Farhat Hached Hospital in Sousse. I would like to express a special dedication to our first dean and professor of pathology who had dedicated a lot of his scientific efforts to the soft tissue tumors. His name is Professor Chedly Bouzakkoura. He passed away last year. I also dedicate this book especially to Professor Ridha Ben Hadj Hamida, and Professor Rached Letaief, surgeons at the department of surgery in Sousse. A special dedication to Professor Gharbi Slaheddine and Hamadi Farhat, the first surgeons at Sousse University who died a few years ago. You have taught me, since my first steps as resident, not only to manage different types of digestive malignancies using the highest quality surgical and medical care but as well instilled in me a sense of responsibility to improve as a person and as a clinician. Fethi Derbel Professor of General and Digestive Surgery University Hospital Sahloul Sousse Tunisia [...]... Part 1 Fundamental Aspects of Soft Tissue Tumors 1 Considerations for Treatment Development in Rhabdomyosarcoma: In Vitro Assessment of Novel DNA Binding Drugs 1The Steven J Wolf1,3, Laurence P.G Wakelin2 and Daniel R Catchpoole1,3 Biospecimens... the cancer, continue to face a poor prognosis as a result of diminished tumour response to the current chemotherapy options Currently, less than 30% of patients with metastatic disease survive 4 Soft Tissue Tumors without relapse and despite this drastic difference in tumour response, chemotherapy protocols continue to utilize the same compounds regardless of tumour subtype, progression or stage (Wexler... ERMS ARMS References Maurer et al, 1988 Maurer et al, 1993 Crist et al, 2001 Baker et al, 2000 Sandler et al, 2001 Stevens et al, 2005 Marina et al, 1993 Kung et al, 1995 Van Winkle et al, 2005 6 Soft Tissue Tumors Study RMS Classification 97 STS patients Protocol Tested Results 82% 1 yr OS 40% 1 yr OS 46% 2 yr OS 20% 2 yr OS SIOP Untreated Single Course C, Epi + V 53% Total OR MMT89 Stage IV RMS ERMS... in that SN26700 has the amines substituted with a methyl group (Figure 1B) SN26871 has an N-methylated monocationic (CH2)3N(Me)(CH2)3- linker and an 8,9-benzphenazine chromophore (Figure 1C) ¶ 8 Soft Tissue Tumors Fig 1 Molecular structure of (A) novel transcription inhibitors Bis(9aminoacridinecarboxamides), C8 DMAE, C3NC3 DMAE and C2pipC2 DMAE, (B-C) novel transcription inhibitors Bis(phenazine-1-carboxamides),... groove (Li and Krueger, 1991) All are known to bind selectively to GC-rich sequences and block RNA polymerase progression by placing a bulky group in the DNA minor groove Furthermore, all cause 10 Soft Tissue Tumors similar profound perturbation to transcription profiles (Zilhif et al, 2006) We have found that all three agents have indistinguishable activity in the 5 RMS cell lines and that they are the... cytotoxicity in RMS cells Drug “resistance” is a phenomenon that impedes the efficacy of every compound used in the treatment of cancer at some stage Mechanisms governing cellular resistance to 12 Soft Tissue Tumors chemotherapy may be intrinsic, however in most cases they are acquired following repeated or extended exposure to chemotherapy Although “acquired” drug resistance is a term that is used to... RMS and STS patients, and found that of the 9 patients with detectable P-gp levels, all relapsed Of the 21 patients without detectable P-gp levels, only 1 patient relapsed (Chan et al, 1990) 14 Soft Tissue Tumors 5.1.3 MRP1 transport of AS-DACA in RMS cells The monointercalating acridine-4-carboxamide compounds used in this study are vulnerable to transport via these efflux pumps AS-DACA is a substrate... in Res-30 cells when compared to the parental RH30 cell line even after 48 hours exposure to the drug Whilst DNA damage was evident after just 1 hour in the sensitive RH30 cells, it does not 16 Soft Tissue Tumors appear until 24 hours later in the resistant Res-30 cells Interestingly, DNA damage is detected in RD cells after just 4 hours despite the drug exposure being approximately 450 times lower... topoisomerase IIβ in RH30 cells may promote an enhanced drug efficacy A higher expression of the target enzyme could translate to an increased frequency in the formation of cleavable complexes 18 Soft Tissue Tumors which are subsequently trapped by AS-DACA, resulting in the induction of permanent DNA damage Furthermore, the expression levels of each isoform may also contribute to the rate at which DNA... al, 2006) Without an ability to view the intracellular distribution of weakly basic compounds, this sequestration may go completely unnoticed As a research tool, the anthracycline antibiotics 20 Soft Tissue Tumors are commonly used because their fluorescence properties allow the intracellular distribution of the drugs to be explored using fluorescence techniques In 1986 it was first reported that doxorubicin . Fundamental Aspects of Soft Tissue Tumors, Diagnosis and Investigations,Types and Classification of Soft Tissue Tumors, Treatment of Soft Tissue Tumors, Prognosis of Soft Tissue Tumors. Although. Mechanisms in Soft Tissue Sarcomas 31 Matthew J. Plantinga and Dominique Broccoli Part 2 Diagnosis and Investigations in Soft Tissue Tumors 51 Chapter 3 Classification of Soft Tissue Tumors by. Therapeutic Targets in Soft Tissue Sarcomas 217 Quincy S.C. Chu and Karen E. Mulder Part 5 Prognosis of Soft Tissue Tumors 253 Chapter 13 Prognostic Factors in Soft Tissue Sarcoma 255 Luiz