Submit Your Article CMED MEACR meeting
Home Print this page Email this page Users Online: 163
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 10  |  Issue : 3  |  Page : 108-111

Histological spectrum of benign soft-tissue neoplasm in a tertiary care center


1 Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, pimpri Pune 18, Maharashtra, India
2 Department of Medicine, PCMC'sPGI YCMH, pimpri Pune 18, Maharashtra, India

Date of Submission17-Nov-2020
Date of Decision25-Jan-2021
Date of Acceptance01-Mar-2021
Date of Web Publication21-Jul-2021

Correspondence Address:
Rupali Ramakant Bavikar
C 1004, Triose, Near Govind Garden, Pimple Saudager, Pune - 411 027, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ccij.ccij_165_20

Rights and Permissions
  Abstract 


Background: Benign soft-tissue tumors are very frequently received specimen in surgical pathology as compare to malignant one. Aims: The purpose of the study is to calculate the incidence and prevalence of benign soft-tissue tumors, to calculate their frequency in different age, sex, and site distribution in tertiary care hospital, and to study their different histological types. Subjects and Methods: We studied all soft-tissue tumors received in histopathology department in 4 years. All clinical parameters such as age, sex, incidence, site and size of swelling, gross, and microscopy of the lesions were studied carefully. Statistical Analysis Used: Data were analyzed using a Chi-square test. Results: Total 360 (9.9%) soft-tissue tumors were received, 330 (91.7%) were benign, and 30 (8.3%) were malignant. The incidence of benign and malignant tumors was more common in males (55.8%) than in females (44.2%). The peak incidence of benign tumors was in 21–30 years. The most common site for benign tumors was the extremities, followed by head and neck. Lipomas formed major bulk of benign tumors (52.4%), followed by vascular tumors (21.2%), peripheral nerve sheath tumors (20.9%), fibrous tumors (3.3%), fibrohistiocytic tumors (1.8%), smooth muscle tumors and tumors of uncertain differentiation (0.3%) in descending order. Conclusions: Benign soft-tissue tumors were most commonly occurring lesions in clinical practice. From this study, we were re-evaluate the clinical data of benign soft-tissue tumors, there histological types along with age, sex, and site distribution.

Keywords: Benign, hemangioma, lipoma, malignant


How to cite this article:
Ingale YP, Bavikar RR, Kulkarni SP, Kale NC. Histological spectrum of benign soft-tissue neoplasm in a tertiary care center. Clin Cancer Investig J 2021;10:108-11

How to cite this URL:
Ingale YP, Bavikar RR, Kulkarni SP, Kale NC. Histological spectrum of benign soft-tissue neoplasm in a tertiary care center. Clin Cancer Investig J [serial online] 2021 [cited 2021 Aug 2];10:108-11. Available from: https://www.ccij-online.org/text.asp?2021/10/3/108/322057




  Introduction Top


Soft tissue is nothing but a nonepithelial extra skeletal tissue of the body without reticuloendothelial system, glia, and supporting tissue of various parenchymal organs. It includes smooth muscles, striated muscles, fat and fibrous tissue, with vessels. It also includes peripheral nervous system because tumors from nerves present as soft-tissue masses. Soft tissue is derived embryologically from mesoderm with some contribution from neuroectoderm.[1]

Benign soft-tissue tumors 100 times more common than malignant one. The annual clinical incidence of benign soft-tissue tumors has been estimated as up to 3000/million population.[2] They occur in any part of the body, most commonly in extremities, trunk, abdomen, and head and neck.[3]

It is sometimes possible to make an accurate diagnosis by detail clinical history, physical examination, and naked eye examination of the tumors. Clinical features such as age of the patient, location and size of the tumor help greatly in narrowing down the differential diagnosis. A definite relationship exists between soft-tissue tumor type and the age of presentation.[4]

Light microscopic evaluation of hematoxylin-eosin-stained section remains the standard technique for the diagnosis of these tumors and for predicting the clinical behavior of the tumor.[5]

Most patients with suspected soft-tissue neoplasm present with a painless mass, although pain is reported in one-third of cases.[6] Diagnosis is delayed in such cases; frequently misdiagnoses include posttraumatic or spontaneous hematoma and “lipoma.”

Benign soft-tissue tumors are very frequent as compare to benign bone tumors.

Benign tumors of soft tissue are more common than benign tumors of bone. They can occur anywhere in body like in between muscles, ligaments, blood vessels, and nerves. These tumors extensively differ in appearance and behavior.

The motive of this study was to assess the benign soft tissue tumors according to their different histology patterns, age groups, sex, and site distribution. To correlate our data with different studies done by different authors.

This variability, diversity, and uniqueness of these tumors produce interest of undertaking a study on soft-tissue tumors.


  Subjects and Methods Top


This study was done in 4-years period from June 2008 to June 2012 in a tertiary care hospital. We obtained total 330 benign soft-tissue cases. Detailed clinical data such as age, sex, and site of tumor were collected. We categorized them under extremities, trunk-abdomen, and head-and-neck region.

Gross examination was done in detailed with tumor size, consistency, presence of necrosis, hemorrhage, calcification, status of capsule, surgical margin of resection, and invasion or adhesion of tumor to the adjacent structures.

The tissues were fixed in 10% formalin and processed through standard paraffin embedding technique.[7] Sections of approximately 5 μ was taken and stained by routine hematoxylin and eosin.[8]

A Chi-square test was used, which showed that these results were statistically significant.


  Results Top


Benign soft-tissue tumors represented 9.04% (330 cases) of all tumors and 71% (2590 cases) received during these 4-year study.

Nearly 91.7% (330 cases) formed bulk of benign soft-tissue tumors in all soft-tissue tumors received.

Benign soft-tissue tumors had slightly male preponderance having male-to-female ratio was 1.2:1.

Adipocytic tumors are more common in male, followed by blood vessels tumor, and while in females, adipocytic tumors are common, followed by peripheral nerve sheath tumors [Table 1].
Table 1: Sex incidence of benign soft tissue tumors

Click here to view


The highest prevalence of benign soft-tissue tumors was in the third decade, adipocytic tumors are more frequent in that, while blood vessel tumors are more common in the first and second decades [Table 2].
Table 2: Incidence of age in benign soft-tissue tumors

Click here to view


Extremities were the most common location for benign tumors, there after head-and-neck region was common. Adipocytic tumors are more commonly found on back and shoulder, while blood vessel tumor are seen in head-and-neck region. Peripheral nerve sheath tumor was commonly seen in extremities and head and neck [Table 3].
Table 3: Site distribution of benign soft-tissue tumors

Click here to view


The most common benign tumor in this study was lipoma (52.4%) form all benign tumors, followed by vascular tumors (21.2%), peripheral nerve sheath tumors (20.9%), fibrous tumors (3.3%), fibrohistiocytic tumors (1.8%), and smooth muscle tumors and tumors of uncertain differentiation (0.3%) in descending order.


  Discussion Top


Soft-tissue tumors are very rarely obtained samples in histopathology department. In our study, we received 330 benign soft-tissue tumors; we recorded clinical data which includes age, sex, and location of tumor. Along with also record the incidence and different microscopic pattern of soft-tissue tumors. We have compared our results with similar studies in India and abroad. Thus, data available for comparison are from different geographic areas and of different time periods. Collective studies of all types of soft-tissue tumors are very few as compared to individual soft-tissue tumor.

In the present study, the frequency of benign tumors was 91.7% which is nearer to Myhre-Jensen study[9] [Table 4].
Table 4: Comparative analysis of incidence of benign soft tissue tumors

Click here to view
Figure 1: Spindle cell lipoma shows bland spindled cell are blended within the scattered Mature adipocytes. (Paraffin & E, X400)

Click here to view
Figure 2: Capillary haemangioma- Multiple dilated by thinned walled vascular channels surrounded by spindle cells. (Paraffin, H & E, X400)

Click here to view
Figure 3: Schwannoma- Neoplastic cells form short palisades with interposed fibrillary collections of cell processes, designated as Verocay bodies. (Paraffin, H & E,X 100)

Click here to view
Figure 4: Neurofibroma - proliferation of fibroblasts and Schwann cells with wavy nuclei are noted Within fibrillary stroma scattered mast cells are seen. (Paraffin, H & E, X400)

Click here to view


Benign soft-tissue tumors found more often in male than female, ratio is 1.2:1 in the present study, which is similar to Myhre-Jensen[9] 1981, Kransdorf,[10] 1995, Beg et al.[12]

In the present study, age ranged from 2 months to 72 years and 35.5 years is the average age of benign tumors which is comparable with studies done by Myhre-Jensen.[9] 1981, Hassawi et al.[3] in 2010, and Agravat et al.[13] 2010 reported average age 44.5, 27.6, and 26.6, respectively [Table 5].
Table 5: Comparative analysis of age incidence of benign soft-tissue tumors

Click here to view


In our study, the most common site of benign tumors is an extremity (33%) mainly lower extremity, followed by head-and-neck region (32.1%), which is comparable with Beg et al. in 2012 study showing common location of benign tumors in extremities (40.9%) then head and neck (35.5%).[12] Kransdorf, 1995, also reported the same site incidence as 60.6% in extremities and 13.8% in head and neck[10] [Table 6].
Table 6: Comparative analysis of anatomical site distribution of benign soft-tissue tumors

Click here to view


Lipoma (52.4%) is the most common benign tumor found, followed by hemangioma (21.2%) and schwannoma (20.9%) which is comparable to Myhre-Jensen[9] 1981 and Kransdorf study[10] 1995.


  Conclusion Top


Diagnosis and management of soft-tissue tumor is team work. Benign soft-tissue tumors are more frequently received specimen in surgical practice which required simple excision. Histopathology examination of all tumors should be necessary. In our study, we studied the various types of benign soft-tissue tumors and their relative incidence, prevalence, distribution in age, sex, and site of tumors.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Weiss SW. Goldblum JR. Enzinger and Weiss's Soft Tissue Tumours. 5th ed. publisher is Elsevier: Mosby; 2008. p. 1-1220.  Back to cited text no. 1
    
2.
Rydholm A. Management of patients with soft-tissue tumours. Strategy developed at a regional oncology centre. Acta Orthop Scand Suppl 1983;203:13-77.  Back to cited text no. 2
    
3.
Hassawi BA, Suliman AY, Hasan IS. Soft tissue tumours-Histopathological study of 93 cases. Ann Coll Med Mosul 2010;36:92-8.  Back to cited text no. 3
    
4.
Soule EH, Mahour GH, Mills SD, Lynn HB. Soft-tissue sarcomas of infants and children: A clinicopathologic study of 135 cases. Mayo Clin Proc 1968;43:313-26.  Back to cited text no. 4
    
5.
Enjoji M, Hashimoto H. Diagnosis of soft tissue sarcomas. Pathol Res Pract 1984;178:215-26.  Back to cited text no. 5
    
6.
Poissonnet CM, LaVelle M, Burdi AR. Growth and development of adipose tissue. J Pediatr 1988;113:1-9.  Back to cited text no. 6
    
7.
Anderson G, Bancroft J. Tissue processing and microtomy. In: Bancroft J, Gamble M, editors. Theory and Practice of Histological Techniques. 5th ed.. Philaldelphia, USA: Churchill Livingstone; 2002. p. 85-99.  Back to cited text no. 7
    
8.
Wilson I, Gamble M. The haematoxylins and eosin. In: Bancroft J, Gamble M, editors. Theory and Practice of Histological Techniques. 5th ed.. Philaldelphia, USA: Churchill Livingstone; 2002. p. 126-130.  Back to cited text no. 8
    
9.
Myhre-Jensen O. A consecutive 7-year series of 1331 benign soft tissue tumours. Clinico-pathologic data. Comparison with sarcomas. Acta Orthop Scand 1981;52:287-93.  Back to cited text no. 9
    
10.
Kransdorf MJ. Benign soft tissue tumors in a large referral population: Distribution of specific diagnosis by age, sex and location. AJR Am J Roentgenol 1995;164:395-402.  Back to cited text no. 10
    
11.
Lazim AF, Al-Irhayim BA. Soft tissue sarcomas in Mosul: A pathologic evaluation. Ann Coll Med Mosul 2008;34:152-60.  Back to cited text no. 11
    
12.
Beg S, Vasenwala SM, Haider N, Ahmad SS, Maheshwari V, Khan M. A comparison of cytological and histopathological findings and role of immunostains in the diagnosis of soft tissue tumors. J Cytol 2012;29:125-30.  Back to cited text no. 12
  [Full text]  
13.
Agravat AH, Dhruva GA, Parmar SA. Histopathology study of human soft tissue tumors and tumor like lesions. J Cell Tissue Res 2010;10:2287-92.  Back to cited text no. 13
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Subjects and Methods
Results
Discussion
Conclusion
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed82    
    Printed0    
    Emailed0    
    PDF Downloaded13    
    Comments [Add]    

Recommend this journal