Cm. Coffin et Lp. Dehner, PATHOLOGICAL EVALUATION OF PEDIATRIC SOFT-TISSUE TUMORS, AJCP. American journal of clinical pathology, 109(4), 1998, pp. 38-52
The subject of soft tissue tumors in children has some parallels with
the same topic in adults, but many of the details clearly establish th
e existence of distinct differences. Most soft tissue tumors in adults
arise in the extremities or in the superficial and deep soft tissues
elsewhere in the body, and most tumors are neoplastic, whether they ar
e benign or malignant. In children, some of the most common soft tissu
e tumors may not be neoplastic at all, but rather are malformations of
the supporting mesenchymal tissues. There is a common classification
of soft tissue tumors that is applicable to both pediatric-and adult-t
ype neoplasms. Although some of the ''adult''-type soft tissue tumors
may occur in children, the reverse situation is very uncommon. Because
pediatric soft tissue tumors are not seen with any regularity by many
pathologists in a practice dominated by adult cases, there is less fa
miliarity and more uncertainty about these tumors in children. The dif
ferential diagnosis of a malignant soft tissue tumor in a child encomp
asses the broad morphologic spectrum of spindle cells, round cells, or
combined-pattern neoplasms. The diagnostic process is complex and may
necessitate an array of ancillary studies, including immunohistochemi
stry, electron microscopy, and molecular diagnostics. After a decision
is reached to excise a soft tissue sarcoma in a child, many of the st
eps in the examination of the specimen and the reporting of results fo
r diagnostic and staging purposes are similar to those in the evaluati
on of a soft tissue sarcoma in an adult. However, it is important for
the pathologist and other members of the multidisciplinary health care
team to remember that a soft tissue tumor in a child may have genetic
implications that directly influence the care of the patient and the
family and for which the excised tissue offers a potentially invaluabl
e resource for future studies.