Undifferentiated high grade pleomorphic sarcoma/ malignant fibrous histiocytoma associated a gouty tophus. a case report
DOI:
https://doi.org/10.31053/1853.0605.v69.n4.20886Keywords:
gouty tophus, malignant fibrous histiocytoma, undifferentiated high grade pleomorphic sarcomaAbstract
Background: Gout is a metabolic disease by deposition of uric acid crystals, which undertakes joint and soft tissue in both acute and chronic stages. Is a rare event the onset of a tumor in the site of the lesion.Objective: To present a rare case of association between sarcoma and tophi.
Methods: 83 year old man who consulted for tumor in his left elbow about 40 years of evolution, which spontaneously started to hurt. With the presumptive diagnosis of tophi treated surgically. The lesion recurred after 60 days, reintervention and radiotherapy was performed for diagnosis of malignant mesenchymal tumor associated with tophi. At 10 months developed ipsilateral nodal metastases, died within 2 years of the initial consultation.
Results: The diagnosis of the first material resected was tophi. In the reintervention material was diagnosed mesenchymal spindle cell high grade neoplasm associated with tophi; immunohistochemistry revealed: vimentin + / +, MYO D1 - / - ASMA - / -, FVIII - / -, A1ATT - / -, CD68-/ -, S100-/ - with final diagnosis the undifferentiated high grade pleomorphic sarcoma.
Conclusions: It is uncommon for gouty tophi are associated with other diseases and even fewer do so to tumors. In the literature have reported three previous cases concurrent with neoplasms, which were angiosarcoma, giant cell tumor and malignant fibrous histiocytoma. The latter have a high tendency to recur locally and have ability to distant metastases, especially lung and regional lymph nodes.
Downloads
References
Robbins y Cotrán. Patología estructural y funcional . Elsevier. Madrid, 2010; 8° Ed. 26: 1314-1317.
Schuind F.A., Remmelink M., Lambert Pasteels J. Co-existent gout and septic arthritis at the wrist: a case report. Hand Surgery, 2003; 8(1): 107–109.
Enzinger a Weiss’s. Soft tissue tumors. Mosby Elsevier. St. Louis , 2008; 5 Ed. 4-13. 406-427.
Richter H, Vinh T.N., Mizel M.S., Temple H.T. Malignant fibrous histiocytoma associated with remote internal fixation of an ankle fracture. Foot Ankle Int, 2006; 27: 375-379.
Rosai Juan. Ackerman’s Surgical Pathology . Mosby. St. Louis, 2010; 10Ed. 2237-73.
Barbarulo A.M., Spelta M.G., Gavazza S., Fontana M.I., Barrera M., Moya J, Lado Jurjo L., Zeitlin E., Azcune R. Gota tofácea crónica: presentación clínica atípica. Dermatol. Argent., 2008;14 (4):296-300.
Asz Sigall D., Arenas R., Domínguez Cherit J., Veja Memije M.E. Tofo Gotoso: El gran imitador. Med. Cutan. Iber. Am. 2005; 33 (2):76-79.
O’Connell P.G., Milburn B.M., Nashel D.J. Coexistent gout and septic arthritis: a report of two cases and literature review. Clin Exp Rheum, 1985; 3 : 265–267.
Folpe A.L., Johnston F., Weiss S.W. Cutaneous angiosarcoma arising in a gouty tophus: report of a unique case and review of foreign material associated angiosarcomas. Am J Dermatopathol, 2000; 22: 418-21.
Schuind F.A, Stallenberg B., Remmelink M., Lambert Pasteels J. Associated giant cell tumor and Tophaceous deposits in a finger pulp: a case report. J Hand Surg, 2003; 28: 871-4.
Pérez-Mies B., Ruiz de la Parte A., Echevarría Iturbe C., García Higuera I.,
Velasco Osés A., Terán Saavedra P. Fibrohistiocitoma maligno (sarcoma pleomórfico indiferenciado de alto grado) sobre tofo gotoso. Rev Esp Patol, 2006; 39: 113-116.
Al-Agha O.M., Igbokwe A.A. Malignant fibrous histiocytoma. Between the past and the present. Arch Pathol Lab Med, 2008 ;132: 1030–1035.
Cruz J., Navarro S., Guerra M., García R., Lima M., Molina P., Llombart-Bosch A. Valor de la inmunohistoquímica en la tipificación de los sarcomas de partes blandas y su disconcordia con el análisis histopatológico convencional: un estudio de casos procedentes del INO (Cuba). Rev Esp Patol, 2005; 38; 3: 149-156.
O’Brien JE, Stout AP. Malignant fibrous xanthomas. Cancer, 1964; 17: 1445–1455.
Fletcher C., Krishnan Unni K., Mertens F. World Health Organization Classification of Tumours. Pathology and Genetics of. Soft tissue and bone. IARC Press . Lyon, France. 2002: 9-16.
Fernández- Sanz J., Rivero-García S., Torres-Olivera F.J., Salguero-Villadiego M., González-Cámpora R., Galera-Davidson H. Tumores de partes blandas inducidos en ratas Wistar por Ni3S2 y/o 3-4 benzopireno. Patología, 1997; 30: 127-133.
Maekawa A., Ogiu T., Onodera H., Furuta K., Matsuoka C., Ohno Y.,Tanigawa H., Salmo G.S., Matsuyama M., Hayashi Y. Malignant fibrous histiocytomas induced in rats by polymers. J Cancer Res Clin Oncol, 1984; 108 : 364-365
Downloads
Published
How to Cite
Issue
Section
License
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).
