Tuesday, Nov 18 -- First appointment at SCCA. Mostly just established myself as a new patient and agreed to have my OHSU tumor slides & imaging sent to SCCA for a new path report that more clearly defines whether or not my knee mass was benign or malignant.
Tuesday, Nov 25 -- Phone call from new sarcoma specialist with malignant diagnosis. See below.
Soft tissue mass, left medial knee, excisional biopsy:
1) LOW-GRADE SPINDLE CELL SARCOMA WITH MYOFIBROBLASTIC DIFFERENTIATION
(FNCLCC grade 1 of 3); see Comment.
2) Tumor size: 1.3 cm in greatest dimension.
3) Sarcoma involves resection margin.
COMMENT:
Histologic sections from the left medial knee soft tissue mass show a neoplasm composed of spindle cells with eosinophilic cytoplasm, indistinct cell borders, and focal mild to moderate nuclear atypia. Cells are arranged into short intersecting fascicles. Mitotic activity is present (1 mitosis per 10 high power fields). No necrosis is seen. The provided outside immunostains show positive staining for CD34 and variable SMA in the neoplastic cells. Desmin, cytokeratin MNF116, EMA, S100, Melan-A, and SOX-10 are negative. The morphologic features and immunohistochemical profile are that of a myofibroblastic neoplasm. Due to the nuclear atypia, mitotic activity, and overall appearance of the tumor, we feel this tumor should be classified as a low-grade sarcoma.
Treatment recommended -- MRI of the site, CT of my lungs, radiation, and re-excision.
Now I am waiting for the scheduler at SCCA to call me to set up my next appointment. I will be in touch with my OHSU oncologist to find out why I was given contradictory treatment plans from OHSU and SCCA. Everyone is in the middle of Thanksgiving holiday, so I'm in limbo right now.
Glad I got a second opinion.
No comments:
Post a Comment