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Papers by António Nascimento

Cancer, 1995

Extraskeletal osteosarcomas are rare malignancies that account for about 1% of all soft tissue sa... more Extraskeletal osteosarcomas are rare malignancies that account for about 1% of all soft tissue sarcomas. Few large series have been reported. Clinical records and histologic slides of all patients with extraskeletal osteosarcomas treated at the Mayo Clinic between 1915 and 1988 were reviewed. The study group consisted of 40 patients, most of whom presented in the sixth and seventh decades of life (mean age, 50.7 years). There was a male predominance (male-to-female ratio, 1.9:1). The lower limbs most commonly were involved (68%), usually the thigh and buttock regions. Ninety-three percent of tumors presented as an enlarging soft tissue mass, with a history of trauma in nine patients. In nine patients, the lesions were initially interpreted histologically as benign, most commonly as myositis ossificans. Histologically, all were high grade osteosarcomas. Multiple local recurrences (45%) are a feature of this tumor. All recurrences occurred within 3 years. Distant metastasis (65%) is also common and is usually to the lungs (81%). Radical resections appear to be the best option for local control, with resection of the pulmonary metastasis occasionally producing a cure. By univariate analysis of Kaplan-Meier survival curves, the patients with predominantly chondroblastic tumors fared better than those with predominantly osteoblastic tumors (P = 0.03). Analysis of survival differences of the three main subtypes together (osteoblastic, chondroblastic, and fibroblastic) was not significant. A small-sized initial lesion did not equate with better survival. Seventy-three percent died of the disease, with a mean follow-up of 5.9 years. Extraskeletal osteosarcoma is a high grade malignant tumor associated with a 5-year survival rate of 37% (95% confidence interval, 28%-59%). Local recurrences and distant metastasis are common and usually occur by 3 years after excision. Patients with the chondroblastic subtype survive longer than those with the osteoblastic subtype.

Cancer, 1998

BACKGROUND. Patients with mesenchymal chondrosarcomas in general have a 5-year survival rate rang... more BACKGROUND. Patients with mesenchymal chondrosarcomas in general have a 5-year survival rate ranging from 42-54.6% and a 10 -year survival rate of 28%.

Clinical Orthopaedics and Related Research, 1995

This study reviews 16 cases of lymphangiosarcoma of the upper extremity after mastectomy for brea... more This study reviews 16 cases of lymphangiosarcoma of the upper extremity after mastectomy for breast cancer (Stewart-Treves syndrome) was done at the author's institution from 1970 to 1992. Lymphangiosarcoma was diagnosed an average of 10.6 years (range, 5.6-18 years) after the diagnosis of breast cancer. Presenting signs included a bruise (6 patients); increased swelling (4); a red, raised lesion (2); a palpable mass (2); a blister appearance (1); and a non-healing eschar with continual bleeding (1). After biopsy, surgical treatment included forequarter amputation (8 patients), wide excision with grafting (5), and above-elbow amputation (1). Local recurrence of the lymphangiosarcoma occurred on the chest wall in 11 of the 16 patients after an average of 10.9 months. Metastasis occurred in 11 patients. (Metastasis occurred in 1 patient without local recurrence, and 1 patient with locally recurrent lymphangiosarcoma died of breast cancer before evidence of metastatic lymphangiosarcoma.) There are 2 long-term survivors who have lived 9.3 and 6 years, respectively, since the operation. One had been treated with a forequarter amputation and the other with wide excision. Early recognition and surgical treatment seem to offer the only chance for long-term survival.

Head & Neck Surgery, 1986

Forty-six cases of mucoepidermoid carcinoma (MEC) of the salivary glands were reviewed with an em... more Forty-six cases of mucoepidermoid carcinoma (MEC) of the salivary glands were reviewed with an emphasis on the clinicopathologic aspects and prognosis of the tumors. MEC occurred in a wide age range, with few cases being diagnosed in childhood. Its peak of incidence was in the fifth decade and it involved major and minor salivary glands with equal frequency; the parotid gland was the gland most commonly affected. Presence of a mass was the most common complaint of all 46 patients. About 64% of the patients presented with stages 3 and 4 disease. Three distinct histologic grades were found after analyzing cellular pleomorphism, mitotic activity, and presence of necrosis. This study showed that clinical staging and histologic grading are the most important factors influencing survival and they seem to be independent of each other. Other variables found to be important in prognosis were age, sex, and the development of recurrent disease after surgery. Surgery with total resection of the tumor was the most effective treatment in our cases and adjuvant radiotherapy proved to be of little value in improving survival of MEC in our series of cases, considering that the patients in whom this type of treatment was used had unfavorable clinicopathologic factors.

American Journal of Surgical Pathology, 1980

A review of 347 Ewing's tumors that were seen at the Mayo Clinic during the perio... more A review of 347 Ewing's tumors that were seen at the Mayo Clinic during the period to the end of 1978 revealed 20 that differed histologically from the remainder. These 20--called "large-cell Ewing's tumor"--differed from the classic Ewing tumor in having larger, more pleomorphic cells, often with conspicuous nucleoli. More males than females had such tumors, and most patients were in the second decade of life. The diaphysis of long bone was commonly involved. The radiologic appearance was that of a permeative lesion. This large-cell Ewing tumor may be confused with malignant lymphoma and small-cell osteosarcoma. In the present study, there was no apparent difference in the clinical behavior of large-cell and typical Ewing's tumors.

Cancer, 1995

Extraskeletal osteosarcomas are rare malignancies that account for about 1% of all soft tissue sa... more Extraskeletal osteosarcomas are rare malignancies that account for about 1% of all soft tissue sarcomas. Few large series have been reported. Clinical records and histologic slides of all patients with extraskeletal osteosarcomas treated at the Mayo Clinic between 1915 and 1988 were reviewed. The study group consisted of 40 patients, most of whom presented in the sixth and seventh decades of life (mean age, 50.7 years). There was a male predominance (male-to-female ratio, 1.9:1). The lower limbs most commonly were involved (68%), usually the thigh and buttock regions. Ninety-three percent of tumors presented as an enlarging soft tissue mass, with a history of trauma in nine patients. In nine patients, the lesions were initially interpreted histologically as benign, most commonly as myositis ossificans. Histologically, all were high grade osteosarcomas. Multiple local recurrences (45%) are a feature of this tumor. All recurrences occurred within 3 years. Distant metastasis (65%) is also common and is usually to the lungs (81%). Radical resections appear to be the best option for local control, with resection of the pulmonary metastasis occasionally producing a cure. By univariate analysis of Kaplan-Meier survival curves, the patients with predominantly chondroblastic tumors fared better than those with predominantly osteoblastic tumors (P = 0.03). Analysis of survival differences of the three main subtypes together (osteoblastic, chondroblastic, and fibroblastic) was not significant. A small-sized initial lesion did not equate with better survival. Seventy-three percent died of the disease, with a mean follow-up of 5.9 years. Extraskeletal osteosarcoma is a high grade malignant tumor associated with a 5-year survival rate of 37% (95% confidence interval, 28%-59%). Local recurrences and distant metastasis are common and usually occur by 3 years after excision. Patients with the chondroblastic subtype survive longer than those with the osteoblastic subtype.

Cancer, 1998

BACKGROUND. Patients with mesenchymal chondrosarcomas in general have a 5-year survival rate rang... more BACKGROUND. Patients with mesenchymal chondrosarcomas in general have a 5-year survival rate ranging from 42-54.6% and a 10 -year survival rate of 28%.

Clinical Orthopaedics and Related Research, 1995

This study reviews 16 cases of lymphangiosarcoma of the upper extremity after mastectomy for brea... more This study reviews 16 cases of lymphangiosarcoma of the upper extremity after mastectomy for breast cancer (Stewart-Treves syndrome) was done at the author's institution from 1970 to 1992. Lymphangiosarcoma was diagnosed an average of 10.6 years (range, 5.6-18 years) after the diagnosis of breast cancer. Presenting signs included a bruise (6 patients); increased swelling (4); a red, raised lesion (2); a palpable mass (2); a blister appearance (1); and a non-healing eschar with continual bleeding (1). After biopsy, surgical treatment included forequarter amputation (8 patients), wide excision with grafting (5), and above-elbow amputation (1). Local recurrence of the lymphangiosarcoma occurred on the chest wall in 11 of the 16 patients after an average of 10.9 months. Metastasis occurred in 11 patients. (Metastasis occurred in 1 patient without local recurrence, and 1 patient with locally recurrent lymphangiosarcoma died of breast cancer before evidence of metastatic lymphangiosarcoma.) There are 2 long-term survivors who have lived 9.3 and 6 years, respectively, since the operation. One had been treated with a forequarter amputation and the other with wide excision. Early recognition and surgical treatment seem to offer the only chance for long-term survival.

Head & Neck Surgery, 1986

Forty-six cases of mucoepidermoid carcinoma (MEC) of the salivary glands were reviewed with an em... more Forty-six cases of mucoepidermoid carcinoma (MEC) of the salivary glands were reviewed with an emphasis on the clinicopathologic aspects and prognosis of the tumors. MEC occurred in a wide age range, with few cases being diagnosed in childhood. Its peak of incidence was in the fifth decade and it involved major and minor salivary glands with equal frequency; the parotid gland was the gland most commonly affected. Presence of a mass was the most common complaint of all 46 patients. About 64% of the patients presented with stages 3 and 4 disease. Three distinct histologic grades were found after analyzing cellular pleomorphism, mitotic activity, and presence of necrosis. This study showed that clinical staging and histologic grading are the most important factors influencing survival and they seem to be independent of each other. Other variables found to be important in prognosis were age, sex, and the development of recurrent disease after surgery. Surgery with total resection of the tumor was the most effective treatment in our cases and adjuvant radiotherapy proved to be of little value in improving survival of MEC in our series of cases, considering that the patients in whom this type of treatment was used had unfavorable clinicopathologic factors.

American Journal of Surgical Pathology, 1980

A review of 347 Ewing's tumors that were seen at the Mayo Clinic during the perio... more A review of 347 Ewing's tumors that were seen at the Mayo Clinic during the period to the end of 1978 revealed 20 that differed histologically from the remainder. These 20--called "large-cell Ewing's tumor"--differed from the classic Ewing tumor in having larger, more pleomorphic cells, often with conspicuous nucleoli. More males than females had such tumors, and most patients were in the second decade of life. The diaphysis of long bone was commonly involved. The radiologic appearance was that of a permeative lesion. This large-cell Ewing tumor may be confused with malignant lymphoma and small-cell osteosarcoma. In the present study, there was no apparent difference in the clinical behavior of large-cell and typical Ewing's tumors.