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TUMORI MEKIH TKIVA (Općenito (Th (kemoth (visok rizik), OP, RT adjuvatno),…
TUMORI MEKIH TKIVA
Općenito
Incidencija
Etiologija
KLinička slika
bezbolna masa
dugo traje
dijagnoza
biospija
Th
OP
RT adjuvatno
kemoth
visok rizik
Main symptoms
Presence of mass
Impairment of function
Pain
NCCN
https://www.nccn.org/professionals/physician_gls/pdf/sarcoma.pdf
studije sarkom 66 str
kemo MS 10
GIST, imatinib 87, AE 90str, regora 93str
molekularno
SDH
PDGF
mutacija na eksonu
D842V
BENIGN
Cartilaginous tissue origin
Most common types
Chondromas
Definition
Where?
✦ In bones of endochondral origin
✦ They can arise within the medullary cavity or on the surface of bone
✦ Hands and feet
Treatment
Observation or Surgery
Benign tumors of hyaline cartilage
Giant cell tumor
Definition
✦ Aggressive tumor
✦ Often behaves like a malignant tumor, metastasizing
through the bloodstream
Characteristics
✦ Pathologic fractures are common
✦ Common around the knee, wrist, shoulder
✦ Mix of mononuclear and multinucleated osteoclast-type giant cells
Osteochondromas
Most common
Where?
✦ Only in bones of endochondral origin
✦ Arising from the metaphysis
near the growth plate of tubular bones
Definition
✦ Benign cartilage-capped tumor attached to the
underlying bone by a bony stalk
Fibrous tissue origin
Common in growing bone
Asymptomatic
GIST
Gastrointestinal Stromal Tumors (GIST)
2
Clinical picture:
Asymptomatic
the mass of tumor may affect the region where it
exists
depends on the size of the tumo
might affect the mucosa and lead to mucosal ulceration
Prognosis:
Metastases can appear after 20 years of removal of the original tumor, mainly
to
liver
.
divided into risk categories (low – high) depending on
Location (gastric, esophageal or intestinal)
Tumor size.
Mitotic count per 50 HPF (high power field)
GIST may show wide range of morphology
epithelioid cells (rounded cells)
mixture
Spindle stretched
Smooth muscle differentiation can be seen in these
tumors
very important because we need to
differentiate between GIST and the tumors that are
originally derived from smooth muscle which are
leiomyoma
The Hematoxylin stain works in an opposite way, it colors the negative cells
(cells which lack the antigen)
95% of GISTs are positive for CD117 (c-KIT)
immunostain
to detect the gene
color the antibody with a brown color, this is why the
cells, which express this antigen, will be colored with
brown color, so the cells in brown color have the
CD117 (c-KIT) mutation
Treatment:
Surgery
Targeted therapy like imatinib mesylate which is only targeted against
tyrosine kinase. That means they target only the cells that exhibit the mutation
Liposarkom
vrste
atipični
miskoidni
