Surgery Today

, Volume 27, Issue 9, pp 806–811 | Cite as

Surgery for multiple lung metastases from alveolar soft-part sarcoma

  • Ken Kodama
  • Osamu Doi
  • Masahiko Higashiyama
  • Hideoki Yokouchi
  • Keiko Kuriyama
  • Takafumi Ueda
  • Hideki Yoshikawa
Original Articles


Between 1985 and 1993, six patients were surgically treated for alveolar soft-part sarcoma (ASPS) arising from the thighs or buttocks, four of whom underwent aggressive excision of multiple metastases using a neodymium: yttriumaluminum garnet (Nd: YAG) laser. In total, 33 tumors were removed from these four patients during eight pulmonary operations. In patients, 1, 3, and 4, uncontrollable extrapulmonary involvement and/or local recurrence at the primary site were noted during their treatment course, and they died of tumor progression 40, 68, and 46 months after excision of the primary lesion, respectively. In patient 1, a 37-year-old woman, prolonged survival with adequate lung function was achieved after the excision of metastases, including one bulky metastatic tumor located adjacent to the mediastinum, which might have led to a lethal complication. Patient 3, a 25-year-old woman who underwent aggressive metastasectomies for both pulmonary and extrapulmonary metastases combined with intermittent chemotherapy, died of widespread metastases to multiple organs. On the other hand, patient 2, a 23-year-old woman who underwent excision of 130 pulmonary and three brain metastases during four thoracotomies and two craniotomies, is still alive without any symptoms 98 months after excision of the primary lesion. These data suggest that repeated excisions of lung metastases from ASPS may influence long-term survival or maintenance of good performance status in patients in whom extrapulmonary metastasis and recurrence are either absent or controlled.

Key Words

aggressive excision alveolar soft-part sarcoma (ASPS) Nd: YAG laser pulmonary metastases 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Enzinger FM, Weiss SW (1983) Soft tissue tumors. CV Mosby, St. Louis, pp 780–787Google Scholar
  2. 2.
    Christopherson WM, Foote FW, Stewart FW (1952) Alveolar soft-part sarcomas: Structurally characteristic tumors of uncertain histogenesis. Cancer 5:100–111PubMedGoogle Scholar
  3. 3.
    Ordonez NG, Ro JY, Mackay B (1989) Alveolar soft part sarcoma: An ultrastructural and immunocytochemical investigation of its histogenesis. Cancer 63:1721–1736PubMedGoogle Scholar
  4. 4.
    Mathew T (1982) Evidence supporting neural crest origin of an alveolar soft part sarcoma: An ultrastructural study. Cancer 50:507–514PubMedGoogle Scholar
  5. 5.
    Chaudhry AP, Lin C-C, Lai S, Yamane G (1984) Alveolar soft part sarcoma of the tongue in a female neonate. J Oral Med 39:2–6PubMedGoogle Scholar
  6. 6.
    Mukai M, Torikata C, Iri H, Kageyama K, Nakajima T, Ueno N, Hirose S, Murakami K (1984) Alveolar soft part sarcoma. Am J Pathol 116:398–406PubMedGoogle Scholar
  7. 7.
    Cordier JF, Bailly C, Tabone E, Cheix F, Brune J, Touraine R (1985) Alveolar soft part sarcoma presentingas asymptomatic pulmonary nodules: Report of a case with ultrastructural diagnosis. Thorax 40:203–204PubMedGoogle Scholar
  8. 8.
    Baum ES, Fickenscher L, Nachman JB, Idriss F (1981) Pulmonary resection and chemotherapy for metastatic alveolar soft-part sarcoma. Cancer 47:1946–1948PubMedGoogle Scholar
  9. 9.
    Berman TM, Fuhrman SA, Johnson FE (1984) Prolonged survival after bilateral thoractomy for metastatic alveolar soft-part sarcoma. Minn Med 67:261–262PubMedGoogle Scholar
  10. 10.
    Kodama K, Doi O, Higashiyama M, Tatsuta M, Iwanaga T (1991) Surgical management of lung metastases: Usefulness of resection with the neodymium: yttrium-aluminum-garnet laser with median sternotomy. J Thorac Cardiovasc Surg 101:901–908PubMedGoogle Scholar
  11. 11.
    Ueda T, Uchida A, Kodama K, Doi O, Nakahara K, Fujii Y, Komatsubara Y, Ono K (1993) Aggressive pulmonary metastasectomy for soft tissue sarcomas. Cancer 72:1919–1925PubMedGoogle Scholar
  12. 12.
    Lieberman PH, Foote FW Jr, Stewart FW, Berg JW (1966) Alveolar soft-part sarcoma. JAMA 198:1047–1051PubMedCrossRefGoogle Scholar
  13. 13.
    Lieberman PH, Brennan MF, Kimmel M, Erlandson RA, Garin-Chesa P, Flehinger BY (1989) Alveolar soft-part sarcoma. A clinico-pathologic study of half a century. Cancer 63:1–13PubMedGoogle Scholar
  14. 14.
    Evans HL (1985) Alveolar soft-part sarcoma: A study of 13 typical examples and one with a histologically atypical component. Cancer 55:912–917PubMedGoogle Scholar
  15. 15.
    Udekwu FA, Pulvertaft RJ (1965) Studies of an alveolar soft-part sarcoma. Br J Cancer 19:744–748PubMedGoogle Scholar
  16. 16.
    Hurt R, Bates M, Harrison W (1982) Alveolar soft-part sarcoma. Thorax 37:877–886PubMedGoogle Scholar
  17. 17.
    Remy-Jardin M, Remy J, Giraud F, Marquette C-H (1993) Pulmonary nodules: Detection with thick-section spiral CT versus conventional CT. Radiology 187:513–520PubMedGoogle Scholar
  18. 18.
    Lillehei KO, Kleinschmidt-DeMasters B, Mitchell DH, Spector E, Kruse CA (1993) Alveolar soft part sarcoma: An unusually long interval between presentation and brain metastasis. Hum Pathol 24:1030–1034PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Ken Kodama
    • 1
  • Osamu Doi
    • 1
  • Masahiko Higashiyama
    • 1
  • Hideoki Yokouchi
    • 1
  • Keiko Kuriyama
    • 2
  • Takafumi Ueda
    • 3
  • Hideki Yoshikawa
    • 3
  1. 1.Department of Thoracic SurgeryOsaka Medical Center for Cancer and Cardiovascular Diseases (formerly the Center for Adult Diseases, Osaka)OsakaJapan
  2. 2.Department of Diagnostic RadiologyOsaka Medical Center for Cancer and Cardiovascular Disease (formerly the Center for Adult Diseses, Osaka)OsakaJapan
  3. 3.Department of Orthopaedic SurgeryOsaka Medical Center for Cancer and Cardiovascular Diseases (formerly the Center for Adult Diseases, Osaka)OsakaJapan

Personalised recommendations