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Yumuşak doku mikzofibrosarkomunun klinikopatolojik incelemesi

Yıl 2021, Cilt: 46 Sayı: 1, 116 - 124, 31.03.2021

Öz

Amaç: Bu çalışmada amaç, farklı mikzofibrosarkom vakalarının epidemiyolojik verileri yanı sıra patolojik özelliklerini vurgulayarak bu tümörlerin klinik gidişi ile ilişkisini değerlendirmektir.
Gereç ve Yöntem: Tek merkezli çalışmaya 22 mikzofibrosarkom olgusu dahil edilmiştir. Olguların yaş, cinsiyet, tümör yerleşimi, çapı, histopatolojik özellikleri yanı sıra tedavi yöntemleri, klinik takibi de araştırılmıştır. Patoloji değerlendirmesinde ayırıcı tanıya yönelik ek immünohistokimyasal çalışmalar yapılmıştır.
Bulgular: Bu seride ortalama yaş 54 olup kadın-erkek oranı eşittir. Ekstremiteler en sık yerleşim yeridir. Yüzeyel yerleşmiş tümörler, derin yerleşim gösterenlere kıyasla belirgin olarak iyi seyretmektedir. Patolojik değerlendirme sonucu verilen grade ile klinik gidiş yakın ilişkilidir. Ortalama rekürrens süresi 16 ay olduğu için olguların uzun dönem takibi gereklidir. Metastaz görülen tüm olgularda öncesinde rekürrens mevcuttur. Hastalıktan ölüm sadece yüksek dereceli olanlarda gerçekleşmiştir.
Sonuç: Sonuçta bu tümörler çok nadir görülmekle birlikte tanıda zorluk yaratması bakımından önem teşkil etmektedir. Histopatolojik olarak reaktif lezyonlarla bile karışabilmesi nedeniyle doğru tanı koymak hasta yönetiminde şarttır. Bu tümör grubunda bizim serimizde yüzeyel olanlar ve derecesi düşük olanlar çok iyi seyirli olup, doğru tanı ve tedavi ile bu hastaların iyi prognozlu da olabileceği literatüre katkı olarak sunulmuştur.

Kaynakça

  • 1 Lurkin A, Ducimetiere F, Vince DR, et al. Epidemiological evaluation of concordance between initial diagnosis and central pathology review in a comprehensive and prospective series of sarcoma patients in the Rhone- Alpes region. BMC Cancer. 2010;10:150.
  • 2 S.W. Weiss, F.M. Enzinger, Myxoid variant of malignant fibrous histiocytoma,Cancer 39 (1977) 1672–1685.
  • 3 Fletcher C.D.M., Bridge J.A., Hogendoorn P.C.W., Mertens F. WHO Classification of Tumours of Soft Tissue and Bone. Pathology and Genetics of Tumours of Soft Tissue and Bone (4th), IARC Press, Lyon (2013)
  • 4 Sambri, A., Bianchi, G., Righi, A., Ferrari, C., & Donati, D. (2016). Surgical margins do not affect prognosis in high grade myxofibrosarcoma. European Journal of Surgical Oncology (EJSO), 42(7), 1042–1048. doi:10.1016/j.ejso.2016.05.015 
  • 5 Baheti AD, Tirumani SH, Rosenthal MH, Howard SA, Shinagare AB, Ramaiya NH, et al. Myxoid soft-tissue neoplasms: comprehensive update of the taxonomy and MRI features. AJR Am J Roentgenol. 2015; 204(2) : 374 -85.
  • 6 Gronchi A, Lo Vullo S, Colombo C, et al. Extremity soft tissue sarcoma in a series of patients treated at a single institution: local control directly impacts survival. Ann Surg 2010;251:506–11.
  • 7 Fletcher CD, Gustafson P, Rydholm A, Willen H, Akerman M. Clinicopathologic re-evaluation of 100 malignant fibrous histiocytomas: prognostic relevance of subclassification. J Clin Oncol 2001;19: 3045–50.
  • 8 Mentzel T, van den Berg E, Molenaar W. Myxofibrosarcoma In: Fletcher C, Unni K, Mertens F, editors. WHO classification of tumors-pathology and genetics, tumors of soft tissue and bone. Lyon: IARC Press; 2002. p. 102-103.
  • 9 Fletcher CDM, Hogendoorm PCW, Mertens F, Bridge J, eds. WHO Classification of Tumors of Soft Tissue and Bone. Lyon, France: IARC Press: 2013.
  • 10 Odei B, Rwigema JC, Eilber FR, Eilber FC, Selch M, Singh A, Chmielowski B, Nelson SD, Wang PC, Steinberg M, Kamrava M.Predictors of Local Recurrence in Patients With Myxofibrosarcoma.Am J Clin Oncol. 2018 Sep;41(9):827-831. doi: 10.1097/COC.0000000000000382.
  • 11 Dei Tos, Angelo Paolo. Soft tissue sarcomas: a pattern based approach to diagnosis. 2019. Cambridge, United Kingdom. DOI: 10.1017/9781316535097.
  • 12 Val-Bernal JF, García-González MR, Mayorga M, Marrero RH, Jorge-Pérez N. Primary renal myxofibrosarcoma. Pathology Research and Practice 211 (2015) 619–624.
  • 13 Buccoliero AM, Castiglione F, Garbini F, Degl’Innocenti DR, Moncini D, Franchi A, Paglierani M, Simoni A, Baroni G, Daniele D, Sardi I, Giordano F, Mussa F, Arico M, Genitori L, Taddei GL. Primary cerebral myxofibrosarcoma: clinical, morphologic, immunohistochemical, molecular, and ultrastructural study of an infrequent tumor in an extraordinary localization. J Pediatr Hematol Oncol 2011;33:e279–e283.
  • 14 Udaka T, Yamamoto H, Shiomori T, Fujimura T, Suzuki H. Myxofibrosarcoma of the neck. J Laryngol Otol 2006, 120:872-874.
  • 15 Prasad I, Sharan R. Myxofibrosarcoma of larynx. Indian J Otolaryngol Head Neck Surg 1981, 33(2):71-71.
  • 16 Qiubei Z, Cheng L, Yaping X, Shunzhang L, Jingpin F. Myxofibrosarcoma of the sinus piriformis: case report and literature review. World Journal of Surgical Oncology 2012, 10:245.
  • 17 Nomura T, Sakakibara S, Moriwaki A,Kawamoto T,Suzuki S,Ishimura T, Hashikawa K, Terashi H. Low-grade myxofibrosarcoma of the rectus abdominus muscle infiltrating into abdominal cavity: a case report. Eplasty. 2017 Feb 21;17:e6. eCollection 2017.
  • 18 Tjarks BJ, Ko JS, Billings SD. Myxofibrosarcoma of unusual sites. doi: 10.1111/cup.13063. J Cutan Pathol. 2018 Feb;45(2):104-110.
  • 19 J.M. Coindre, Grading and staging of sarcomas, in: C.D.M. Fletcher, J.A. Bridge, P.C.W. Hogendoorn, F. Mertens (Eds.), World Health Organization Classification of Tumors of Soft Tissue and Bone, IARC Press, Lyon, 2013, pp. 17–18.
  • 20 Oda Y, Takahira T, Kawaguchi K, Yamamoto H, Tamiya S, Matsuda S, Tanaka K, Iwamoto Y, Tsuneyoshi M. Low-grade fibromyxoid sarcoma versus low-grade myxofibrosarcoma in the extremities and trunk. A comparison of clinicopathological and immunohistochemical features.Histopathology. 2004 Jul;45(1):29-38.
  • 21 Delaney D, Diss TC, Presneau N, et al. GNAS1 mutations occur more commonly than previously thought in intramuscular myxoma. Mod Pathol 2009;22:718–724.
  • 22 de Saint Aubain Somerhausen N, Rubin BP, Fletcher CD. Myxoid solitary fibrous tumor: a study of seven cases with emphasis on differential diagnosis. Mod Pathol. 1999 May;12(5):463-71.
  • 23 Billings SD, Giblen G, Fanburg-Smith JC. Superficial low-grade fibromyxoid sarcoma (Evans tumor): a clinicopathologic analysis of 19 cases with a unique observation in the pediatric population. Am J Surg Pathol 2005;29:204–210.
  • 24 Beane JD, Yang JC, White D, et al. Efficacy of adjuvant radiation therapy in thetreatment of soft tissue sarcoma of the extremity: 20-year follow-up of a randomizedprospective trial. Ann Surg Oncol 2014;21(8):2484–9.
  • 25 Roland CL,Wang WL,Lazar AJ, Torres KE. Myxofibrosarcoma. Surg Oncol Clin N Am2016; 1-14. DOI: http://dx.doi.org/10.1016/j.soc.2016.05.008.
  • 26 Haglund KE, Raut CP, Nascimento AF, et al. Recurrence patterns and survival forpatients with intermediate- and high-grade myxofibrosarcoma. Int J Radiat OncolBiol Phys 2012;82(1):361–7.
  • 27 Mutter RW, Singer S, Zhang Z, et al. The enigma of myxofibrosarcoma of theextremity. Cancer 2012;118(2):518–27.
  • 28 Gronchi A, et al. Extremity soft tissue sarcoma in a series ofpatients treated at a single institution: local control directlyimpacts survival. Ann Surg 251:506—11.
  • 29 Lin CN, et al. Prognostic factors of myxofibrosarcomas: implicationsof margin status, tumor necrosis, and mitotic rate onsurvival. J Surg Oncol 2006;93:294—303.
  • 30 Sanfilippo R, Miceli R, Grosso F, et al. Myxofibrosarcoma: prognostic factors andsurvival in a series of patients treated at a single institution. Ann Surg Oncol 2011;18(3):720–5.
  • 31 Huang HY, Lal P, Qin J, Brennan MF, Antonescu CR.Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of3-tier and 4-tier grading systems. Hum Pathol 2004; 35(5): 612-621.
  • 32 Mentzel T, Calonje E, Wadden C, et al. Myxofibrosarcoma. Clinicopathologic analysis of 75 cases with emphasis on the low-grade variant. Am J Surg Pathol 1996;20:391–405.
  • 33 Willems SM, et al. Local recurrence of myxofibrosarcoma isassociated with increase in tumour grade and cytogenetic aberrations,suggesting a multistep tumour progression model. ModPathol 2006;19:407—16.
  • 34 Fukunaga M, Fukunaga N. Low-grade myxofibrosarcoma: progressionin recurrence. Pathol Int 1997;47:161—5.
  • 35 Riouallon G, Larousserie F, Pluot E, Anract P. Superficial myxofibrosarcoma: Assessment ofrecurrence risk according to the surgical marginfollowing resection. A series of 21 patients. Orthopaedics & Traumatology: Surgery & Research (2013) 99, 473—477.
  • 36 Nascimento AF, Bertoni F, Fletcher CD. Epithelioid variant of myxofibrosarcoma:expanding the clinicomorphologic spectrum of myxofibrosarcoma in a series of17 cases. Am J Surg Pathol 2007;31(1):99–105.
  • 37 Scoccianti, G., Ranucci, V., Frenos, F., Greto, D., Beltrami, G., Capanna, R., & Franchi, A.Soft tissue myxofibrosarcoma: A clinico-pathological analysis of a series of 75 patients with emphasis on the epithelioid variant.J Surg Oncol. 2016 Jul;114(1):50-5. doi: 10.1002/jso.24250.
  • 38 T. Mentzel, E. Calonge, C. Wadden, R.S. Camplejohn, A. Beham, M.A. Smith, C.D.M. Fletcher, Myxofibrosarcoma. Clinicopathologic analysis of 75 cases with emphasis on the low grade variant, Am. J. Surg. Pathol. 20 (1996) 391–405.
  • 39 Dewan V, Darbyshire A, Sumathi V, Jeys L, Grimer R. Prognosticand survival factors in myxofibrosarcomas. Sarcoma. 2012;2012:830879.
  • 40 Mühlhofer HML, Lenze U, Gersing A, Lallinger V, Burgkart R, Obermeier A, VON Eisenhart-Rothe R, Knebel C.Prognostic factors and outcomes for patients with myxofibrosarcoma: a 13-year retrospective evaluation.Anticancer Res. 2019 Jun;39(6):2985-2992. doi: 10.21873/anticanres.13430.
  • 41 Tsuchie H, Kaya M, Nagasawa H, Emori M,Murahashi Y, Mizushima E, Miyakoshi N, Yamashita T, Shimada Y. Distant metastasis in patients withmyxofibrosarcoma.UPSALA JOURNAL OF MEDICAL SCIENCES, 2017. https://doi.org/10.1080/03009734.2017.1356404
  • 42 Lohberger B, Stuendl N, Leithner A, Rinner B, Sauer S, Kashofer K, Liegl-Atzwanger B. Establishment of a novel cellular model for myxofibrosarcoma heterogeneity. Sci Rep, 2017, 7:44700.
  • 43 Mizuno T, Susa M,, Horiuchi K, Shimazaki H, Nakanishi K, Chibaa K. Spontaneous Regression of Myxofibrosarcoma of the Thigh after Open Biopsy. Case Rep Oncol. 2019 May-Aug; 12(2): 364–369.

Clinicalopathological evaluation of soft tissue myxofibrosarcoma

Yıl 2021, Cilt: 46 Sayı: 1, 116 - 124, 31.03.2021

Öz

Purpose: The aim of this study is to evaluate the relationship between the clinical course of these tumors by emphasizing the epidemiological data as well as the pathological features of different myxofibrosarcoma cases.
Materials and Methods: 22 cases of myxofibrosarcoma were included in the single center study. Age, gender, tumor location, size, histopathological features as well as treatment modalities and clinical follow-up of the cases were also evaluated. Additional immunohistochemical studies were applied for the differential diagnosis in pathological evaluation.
Results: The mean age of the patients was 54 years old and there is no sex predilection. The extremities are the most common location. Deep located myxofibrosarcoma were highly aggressive unlike superficial counterparts. The grade given as a result of pathological examination is closely related to the clinical course. Since the mean recurrence period is 16 months, long term follow up is required. Recurrence is present in all metastatic cases. Death from the disease occurred only in those with a higher grade.
Conclusion: Myxofibrosarcomas are rarely seen but diagnostically challenging. Accurate diagnosis is essential to differentiate myxofibrosarcoma from other pleomorphic sarcomas, and to manage the treatment of patients since it may mimic even reactive lesions by histopathologically. Superficial and low grade myxofibrosarcoma of present study showed excellent prognosis and it has been presented as a contribution to the literature that these patients may have a good prognosis with correct diagnosis and treatment.

Kaynakça

  • 1 Lurkin A, Ducimetiere F, Vince DR, et al. Epidemiological evaluation of concordance between initial diagnosis and central pathology review in a comprehensive and prospective series of sarcoma patients in the Rhone- Alpes region. BMC Cancer. 2010;10:150.
  • 2 S.W. Weiss, F.M. Enzinger, Myxoid variant of malignant fibrous histiocytoma,Cancer 39 (1977) 1672–1685.
  • 3 Fletcher C.D.M., Bridge J.A., Hogendoorn P.C.W., Mertens F. WHO Classification of Tumours of Soft Tissue and Bone. Pathology and Genetics of Tumours of Soft Tissue and Bone (4th), IARC Press, Lyon (2013)
  • 4 Sambri, A., Bianchi, G., Righi, A., Ferrari, C., & Donati, D. (2016). Surgical margins do not affect prognosis in high grade myxofibrosarcoma. European Journal of Surgical Oncology (EJSO), 42(7), 1042–1048. doi:10.1016/j.ejso.2016.05.015 
  • 5 Baheti AD, Tirumani SH, Rosenthal MH, Howard SA, Shinagare AB, Ramaiya NH, et al. Myxoid soft-tissue neoplasms: comprehensive update of the taxonomy and MRI features. AJR Am J Roentgenol. 2015; 204(2) : 374 -85.
  • 6 Gronchi A, Lo Vullo S, Colombo C, et al. Extremity soft tissue sarcoma in a series of patients treated at a single institution: local control directly impacts survival. Ann Surg 2010;251:506–11.
  • 7 Fletcher CD, Gustafson P, Rydholm A, Willen H, Akerman M. Clinicopathologic re-evaluation of 100 malignant fibrous histiocytomas: prognostic relevance of subclassification. J Clin Oncol 2001;19: 3045–50.
  • 8 Mentzel T, van den Berg E, Molenaar W. Myxofibrosarcoma In: Fletcher C, Unni K, Mertens F, editors. WHO classification of tumors-pathology and genetics, tumors of soft tissue and bone. Lyon: IARC Press; 2002. p. 102-103.
  • 9 Fletcher CDM, Hogendoorm PCW, Mertens F, Bridge J, eds. WHO Classification of Tumors of Soft Tissue and Bone. Lyon, France: IARC Press: 2013.
  • 10 Odei B, Rwigema JC, Eilber FR, Eilber FC, Selch M, Singh A, Chmielowski B, Nelson SD, Wang PC, Steinberg M, Kamrava M.Predictors of Local Recurrence in Patients With Myxofibrosarcoma.Am J Clin Oncol. 2018 Sep;41(9):827-831. doi: 10.1097/COC.0000000000000382.
  • 11 Dei Tos, Angelo Paolo. Soft tissue sarcomas: a pattern based approach to diagnosis. 2019. Cambridge, United Kingdom. DOI: 10.1017/9781316535097.
  • 12 Val-Bernal JF, García-González MR, Mayorga M, Marrero RH, Jorge-Pérez N. Primary renal myxofibrosarcoma. Pathology Research and Practice 211 (2015) 619–624.
  • 13 Buccoliero AM, Castiglione F, Garbini F, Degl’Innocenti DR, Moncini D, Franchi A, Paglierani M, Simoni A, Baroni G, Daniele D, Sardi I, Giordano F, Mussa F, Arico M, Genitori L, Taddei GL. Primary cerebral myxofibrosarcoma: clinical, morphologic, immunohistochemical, molecular, and ultrastructural study of an infrequent tumor in an extraordinary localization. J Pediatr Hematol Oncol 2011;33:e279–e283.
  • 14 Udaka T, Yamamoto H, Shiomori T, Fujimura T, Suzuki H. Myxofibrosarcoma of the neck. J Laryngol Otol 2006, 120:872-874.
  • 15 Prasad I, Sharan R. Myxofibrosarcoma of larynx. Indian J Otolaryngol Head Neck Surg 1981, 33(2):71-71.
  • 16 Qiubei Z, Cheng L, Yaping X, Shunzhang L, Jingpin F. Myxofibrosarcoma of the sinus piriformis: case report and literature review. World Journal of Surgical Oncology 2012, 10:245.
  • 17 Nomura T, Sakakibara S, Moriwaki A,Kawamoto T,Suzuki S,Ishimura T, Hashikawa K, Terashi H. Low-grade myxofibrosarcoma of the rectus abdominus muscle infiltrating into abdominal cavity: a case report. Eplasty. 2017 Feb 21;17:e6. eCollection 2017.
  • 18 Tjarks BJ, Ko JS, Billings SD. Myxofibrosarcoma of unusual sites. doi: 10.1111/cup.13063. J Cutan Pathol. 2018 Feb;45(2):104-110.
  • 19 J.M. Coindre, Grading and staging of sarcomas, in: C.D.M. Fletcher, J.A. Bridge, P.C.W. Hogendoorn, F. Mertens (Eds.), World Health Organization Classification of Tumors of Soft Tissue and Bone, IARC Press, Lyon, 2013, pp. 17–18.
  • 20 Oda Y, Takahira T, Kawaguchi K, Yamamoto H, Tamiya S, Matsuda S, Tanaka K, Iwamoto Y, Tsuneyoshi M. Low-grade fibromyxoid sarcoma versus low-grade myxofibrosarcoma in the extremities and trunk. A comparison of clinicopathological and immunohistochemical features.Histopathology. 2004 Jul;45(1):29-38.
  • 21 Delaney D, Diss TC, Presneau N, et al. GNAS1 mutations occur more commonly than previously thought in intramuscular myxoma. Mod Pathol 2009;22:718–724.
  • 22 de Saint Aubain Somerhausen N, Rubin BP, Fletcher CD. Myxoid solitary fibrous tumor: a study of seven cases with emphasis on differential diagnosis. Mod Pathol. 1999 May;12(5):463-71.
  • 23 Billings SD, Giblen G, Fanburg-Smith JC. Superficial low-grade fibromyxoid sarcoma (Evans tumor): a clinicopathologic analysis of 19 cases with a unique observation in the pediatric population. Am J Surg Pathol 2005;29:204–210.
  • 24 Beane JD, Yang JC, White D, et al. Efficacy of adjuvant radiation therapy in thetreatment of soft tissue sarcoma of the extremity: 20-year follow-up of a randomizedprospective trial. Ann Surg Oncol 2014;21(8):2484–9.
  • 25 Roland CL,Wang WL,Lazar AJ, Torres KE. Myxofibrosarcoma. Surg Oncol Clin N Am2016; 1-14. DOI: http://dx.doi.org/10.1016/j.soc.2016.05.008.
  • 26 Haglund KE, Raut CP, Nascimento AF, et al. Recurrence patterns and survival forpatients with intermediate- and high-grade myxofibrosarcoma. Int J Radiat OncolBiol Phys 2012;82(1):361–7.
  • 27 Mutter RW, Singer S, Zhang Z, et al. The enigma of myxofibrosarcoma of theextremity. Cancer 2012;118(2):518–27.
  • 28 Gronchi A, et al. Extremity soft tissue sarcoma in a series ofpatients treated at a single institution: local control directlyimpacts survival. Ann Surg 251:506—11.
  • 29 Lin CN, et al. Prognostic factors of myxofibrosarcomas: implicationsof margin status, tumor necrosis, and mitotic rate onsurvival. J Surg Oncol 2006;93:294—303.
  • 30 Sanfilippo R, Miceli R, Grosso F, et al. Myxofibrosarcoma: prognostic factors andsurvival in a series of patients treated at a single institution. Ann Surg Oncol 2011;18(3):720–5.
  • 31 Huang HY, Lal P, Qin J, Brennan MF, Antonescu CR.Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of3-tier and 4-tier grading systems. Hum Pathol 2004; 35(5): 612-621.
  • 32 Mentzel T, Calonje E, Wadden C, et al. Myxofibrosarcoma. Clinicopathologic analysis of 75 cases with emphasis on the low-grade variant. Am J Surg Pathol 1996;20:391–405.
  • 33 Willems SM, et al. Local recurrence of myxofibrosarcoma isassociated with increase in tumour grade and cytogenetic aberrations,suggesting a multistep tumour progression model. ModPathol 2006;19:407—16.
  • 34 Fukunaga M, Fukunaga N. Low-grade myxofibrosarcoma: progressionin recurrence. Pathol Int 1997;47:161—5.
  • 35 Riouallon G, Larousserie F, Pluot E, Anract P. Superficial myxofibrosarcoma: Assessment ofrecurrence risk according to the surgical marginfollowing resection. A series of 21 patients. Orthopaedics & Traumatology: Surgery & Research (2013) 99, 473—477.
  • 36 Nascimento AF, Bertoni F, Fletcher CD. Epithelioid variant of myxofibrosarcoma:expanding the clinicomorphologic spectrum of myxofibrosarcoma in a series of17 cases. Am J Surg Pathol 2007;31(1):99–105.
  • 37 Scoccianti, G., Ranucci, V., Frenos, F., Greto, D., Beltrami, G., Capanna, R., & Franchi, A.Soft tissue myxofibrosarcoma: A clinico-pathological analysis of a series of 75 patients with emphasis on the epithelioid variant.J Surg Oncol. 2016 Jul;114(1):50-5. doi: 10.1002/jso.24250.
  • 38 T. Mentzel, E. Calonge, C. Wadden, R.S. Camplejohn, A. Beham, M.A. Smith, C.D.M. Fletcher, Myxofibrosarcoma. Clinicopathologic analysis of 75 cases with emphasis on the low grade variant, Am. J. Surg. Pathol. 20 (1996) 391–405.
  • 39 Dewan V, Darbyshire A, Sumathi V, Jeys L, Grimer R. Prognosticand survival factors in myxofibrosarcomas. Sarcoma. 2012;2012:830879.
  • 40 Mühlhofer HML, Lenze U, Gersing A, Lallinger V, Burgkart R, Obermeier A, VON Eisenhart-Rothe R, Knebel C.Prognostic factors and outcomes for patients with myxofibrosarcoma: a 13-year retrospective evaluation.Anticancer Res. 2019 Jun;39(6):2985-2992. doi: 10.21873/anticanres.13430.
  • 41 Tsuchie H, Kaya M, Nagasawa H, Emori M,Murahashi Y, Mizushima E, Miyakoshi N, Yamashita T, Shimada Y. Distant metastasis in patients withmyxofibrosarcoma.UPSALA JOURNAL OF MEDICAL SCIENCES, 2017. https://doi.org/10.1080/03009734.2017.1356404
  • 42 Lohberger B, Stuendl N, Leithner A, Rinner B, Sauer S, Kashofer K, Liegl-Atzwanger B. Establishment of a novel cellular model for myxofibrosarcoma heterogeneity. Sci Rep, 2017, 7:44700.
  • 43 Mizuno T, Susa M,, Horiuchi K, Shimazaki H, Nakanishi K, Chibaa K. Spontaneous Regression of Myxofibrosarcoma of the Thigh after Open Biopsy. Case Rep Oncol. 2019 May-Aug; 12(2): 364–369.
Toplam 43 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Patoloji
Bölüm Araştırma
Yazarlar

Kivilcim Erdogan 0000-0002-4951-8703

Sevil Karabağ 0000-0002-8855-3798

Mehmet Ali Deveci 0000-0002-3670-3985

Alper Gamlı Bu kişi benim

Gülfiliz Gönlüşen 0000-0003-3065-1683

Hilmi Serdar Özbarlas 0000-0002-3670-3985

Yayımlanma Tarihi 31 Mart 2021
Kabul Tarihi 20 Ekim 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 46 Sayı: 1

Kaynak Göster

MLA Erdogan, Kivilcim vd. “Clinicalopathological Evaluation of Soft Tissue Myxofibrosarcoma”. Cukurova Medical Journal, c. 46, sy. 1, 2021, ss. 116-24.