Diagnosis and Management: Soft Tissue Sarcoma by Murray F Brennan; Jonathan J Lewis; James M Woodruff

By Murray F Brennan; Jonathan J Lewis; James M Woodruff

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These cells may blend with cells having epithelioid features. 72,73 Thus, tumors with <1 mitotic figure per 50 high-power field have a metastatic rate of 2%, compared to those with >10 mitoses per 50 high-power field, which commonly metastasize. Within the abdomen, about 20% will ultimately metastasize. Tumors that are histologically malignant should be treated with the same principles as leiomyosarcoma. Those that are benign should still be completely excised, and all patients should have ongoing follow-up.

3 Common sites of first metastasis by primary site. MSKCC, 7/82–12/00. 28 Evidence suggests that both of these tumors are tumors of the pacemaker cell (interstitial cell of Cajal). 27 In older patients, leiomyosarcoma is the most common type of genitourinary sarcoma,29 and arises in the bladder, kidney or prostate. In young men, rhabdomyosarcoma arises in paratesticular tissues. Four major types of uterine sarcoma are recognized: (1) leiomyosarcoma; (2) mesodermal mixed tumor (malignant mixed Mullerian tumors), a tumor composed of elements of carcinoma and sarcoma; (3) Mullerian adenosarcoma, a tumor composed of low-grade sarcoma and hyperplastic epithelium; and (4) endometrial stromal sarcoma, which is usually low grade and mainly locally aggressive.

Hibernoma 9. Lipoblastoma or lipoblastomatosis 10. Lipomatosis (a) Diffuse lipomatosis (b) Cervical symmetrical lipomatosis (Madelung’s disease) 11. Atypical lipomatous tumor B. Malignant tumors 1. Liposarcoma (a) Well-differentiated liposarcoma (i) Lipoma-like liposarcoma (ii) Sclerosing liposarcoma (iii) Inflammatory liposarcoma (b) Myxoid liposarcoma (c) Round cell (poorly differentiated myxoid) liposarcoma (d) Pleomorphic liposarcoma (e) Dedifferentiated liposarcoma (f) Liposarcoma with divergent myosarcomatous differentiation IV.

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