Histopathological study of soft tissue tumors: A three year experience in tertiary care centre
Authors: Preeti Rihal Chakrabarti, Suvadip Chakravarti, Ajita Pandit, Purti Agrawal, Shilpi Dosi, Mukul Raj J
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Background: Soft tissue sarcomas compared with carcinomas and other neoplasms are relatively rare and constitute less than 1% of all the cancer. Soft tissue sarcomas may occur anywhere in the body but most arise from large muscle of extremeties, the chest wall, the mediastinum and the retroperitoneum.
Aims and objectives: To study the macroscopic and microscopic pathology of benign and malignant soft tissue tumour and there clinicopathological correlation.
Materials and methods: The study was conducted in Dr .D .Y Patil School of Medicine, Navi Mumbai, from 1st of January 2008 to December 2010. A Cross sectional study of 150 cases of soft tissue tumors were carried out in details. A pretested proforma was used to classify each tumor and details like age, sex, clinical features, gross and microscopic findings were noted.
Results: The most common soft tissue tumor in the study were benign tumors (140 cases), followed by malignant (9 cases) and one case was reported as borderline. Lipomas were the most common benign tumors accounting for 49 out of 140 cases. Benign smooth muscle tumors were the next most common tumor accounting for 44 cases.Benign vascular and benign peripheral nerve sheath tumor accounted for 19 cases in each category. Of 19 cases of benign vascular tumor, 16 cases were of haemangioma, 3 cases were of angiofibroma. Of 19 benign peripheral nerve sheethtumor, 12 cases were reported as neurofibroma and 7 schwannomas. Of 5 cases of fibrohistiocytictumor, 3 cases were benign, 1 case of borderline (Dermatofibrosarcoma protuberance) and 1 case of malignant fibrous histiocytoma (MFH). Of 7 cases of Fibrous tumor, 6 cases were of Benign and 1 cases of malignant variant (Fibrosarcoma). Out of 6 cases which were reported as benign, comprised of 2 cases each of fibroma, fibromxyoma, and palmar fibromatosis. 9 out of 150 cases were malignant tumors,3 cases were malignant peripheral nerve sheath tumor(MPNST) ,whearas Gastrointestinal stromal tumor(GIST),leiomyosarcoma, MFH, atypical lipomatoustumor, Fibrosarcoma, Embryonal rhabdomyosarcoma accounted for one case each.
Conclusion: Benign soft tissue tumors outnumbered malignant tumors by a ratio of 14:1. Lipomas and leiomyomas of gynaec origin were the most common benign tumors and MPNST were the most common malignant tumor in the present study. Most patients with soft tissue neoplasm presented with painless mass. Sarcomas, for the most part develop as deeply located mass. Hematoxylin and eosin stained sections represented the mainstay of diagnosis, however ancilliary techinque like immunohistochemistry (IHC) plays a important role in diagnosis.