Uncommon thigh mass in neurofibromatosis type 1: unveiling aggressive epithelioid sarcoma
  • Mohamed A. Gharbi
    University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; Department of Orthopaedic and Trauma Surgery, Mongi Slim Marsa University Hospital Centre, Tunis, Tunisia
  • Faten Limaiem
    University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; Pathology Department, Mongi Slim Marsa University Hospital Centre, Tunis, Tunisia
  • Khaled B. Romdhane
    Private Pathology Laboratory, Tunis, Tunisia
  • Anis Tebourbi
    University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; Department of Orthopaedic and Trauma Surgery, Mongi Slim Marsa University Hospital Centre, Tunis, Tunisia
  • Ramzi Bouzidi
    University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; Department of Orthopaedic and Trauma Surgery, Mongi Slim Marsa University Hospital Centre, Tunis, Tunisia
  • Mouadh Nefiss
    University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; Department of Orthopaedic and Trauma Surgery, Mongi Slim Marsa University Hospital Centre, Tunis, Tunisia

Keywords

Neurofibromatosis type 1, epithelioid sarcoma, soft-tissue tumour

Abstract

Background: Patients with neurofibromatosis type I (NF1) have an increased risk of developing soft-tissue sarcomas, particularly those related to the nervous system. Epithelioid sarcoma (ES) is an exceptionally rare subtype of soft-tissue sarcoma, with limited knowledge about its clinical presentation and optimal management in NF1. This report aims to provide insights into the characteristics and outcomes of ES in NF1 patients.
Case description: A 37-year-old man with a history of NF1 presented with a progressively worsening mass on his right inner thigh. An MRI scan revealed a well-defined tissue mass originating from the adductor magnus muscle, later confirmed as ES through histopathology and immunohistochemistry. Considering poor local and general prognosis, the multidisciplinary team recommended salvage hip disarticulation, however the patient refused and opted for palliative marginal resection to reduce the tumour size. The patient’s condition declined rapidly, and he succumbed six days after the surgery.
Conclusion: This case highlights the rarity of ES in NF1 patients and underscores the potential for malignant tumour development in this population. Further research is needed to improve our understanding and management of sarcomas in the context of NF1.

VIEW THE ENTIRE ARTICLE

References

  • Siegel A, Toledo-Tamula MA, Martin S, Gillespie A, Goodwin A, Widemann B, et al. Written language achievement in children and adolescents with neurofibromatosis type 1 and plexiform neurofibromas. Child Neuropsychol 2024;6:1–21.
  • Hwang SO, Lee SH, Lee HB. Epithelioid sarcoma associated with neurofibromatosis type I. Arch Craniofac Surg 2020; 21:41–44.
  • Bittencourt MJS, Lima CDS, Dias AL, Neri CC. Epithelioid sarcoma of the upper limb with nine years of evolution. An Bras Dermatol 2021;96:116–117.
  • Thway K, Jones RL, Noujaim J, Fisher C. Epithelioid sarcoma: diagnostic features and genetics. Adv Anat Pathol 2016;23:41–49.
  • Nunes LF, Fiod NJJ, Vasconcelos RAT, Meohas W, Rezende JFN. Sarcoma epitelióide: aspectos clínicos, fatores prognósticos e sobrevida [Epithelioid sarcoma: clinical behavior, prognostic factors and survival]. Rev Col Bras Cir 2010;37:251–255. Portugese.
  • Lammert M, Friedman JM, Kluwe L, Mautner VF. Prevalence of neurofibromatosis 1 in German children at elementary school enrollment. Arch Dermatol 2005;141:71–74.
  • Evans DG, Howard E, Giblin C, Clancy T, Spencer H, Huson SM, et al. Birth incidence and prevalence of tumor-prone syndromes: estimates from a UK family genetic register service. Am J Med Genet A 2010;152A:327–332.
  • Neurofibromatosis. Conference statement. National Institutes of Health Consensus Development Conference. Arch Neurol 1988;45:575–578.
  • Gutmann DH, Aylsworth A, Carey JC, Korf B, Marks J, Pyeritz RE, et al. The diagnostic evaluation and multidisciplinary management of neurofibromatosis 1 and neurofibromatosis 2. JAMA 1997;278:51–57.
  • Ward BA, Gutmann DH. Neurofibromatosis 1: from lab bench to clinic. Pediatr Neurol 2005;32:221–228.
  • Sørensen SA, Mulvihill JJ, Nielsen A. Long-term follow-up of von Recklinghausen neurofibromatosis. Survival and malignant neoplasms. N Engl J Med 1986;314:1010–1015.
  • Carli M, Ferrari A, Mattke A, Zanetti I, Casanova M, Bisogno G, et al. Pediatric malignant peripheral nerve sheath tumor: the Italian and German soft tissue sarcoma cooperative group. J Clin Oncol 2005;23:8422–8430.
  • Sung L, Anderson JR, Arndt C, Raney RB, Meyer WH, Pappo AS. Neurofibromatosis in children with Rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma Study IV. J Pediatr2004;144:666–668.
  • Kashyap D, Rastogi S, Garg V, Shrivastava S, Barwad A, Shamim SA, et al. Epithelioid sarcoma and its outcome: a retrospective analysis from a tertiary care center in North India. Future Sci OA 2023;8:FSO822.
  • Thway K, Jones RL, Noujaim J, Fisher C. Epithelioid sarcoma: diagnostic features and genetics. Adv Anat Pathol 2016;23:41–49.
  • Jawad MU, Extein J, Min ES, Scully SP. Prognostic factors for survival in patients with epithelioid sarcoma: 441 cases from the SEER database. Clin Orthop Relat Res 2009;467:2939–2948.
  • Views: 103
    HTML downloads: 11
    PDF downloads: 58


    Published: 2024-03-28
    Issue: 2024: Vol 11 No 4 (view)


    How to cite:
    1.
    Gharbi MA, Limaiem F, Romdhane KB, Tebourbi A, Bouzidi R, Nefiss M. Uncommon thigh mass in neurofibromatosis type 1: unveiling aggressive epithelioid sarcoma. EJCRIM 2024;11 doi:10.12890/2024_004432.