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Primäre Sarkome und Sarkommetastasen in der Leber

Morphologische und molekulare Befunde

Primary sarcomas and sarcoma metastases in the liver: morphological and molecular aspects

  • Schwerpunkt: Lebertumoren
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Zusammenfassung

Die Fortschritte in der Bildgebung, im operativen Management mit kurativer Zielsetzung und in der Identifizierung neuartiger, gegen molekulare Zielstrukturen gerichteter Therapiesubstanzen, wie beispielsweise der Tyrosinkinaseinhibitor Imatinib bei gastrointestinalen Stromatumoren (GIST), haben die Behandlung von hepatischen Sarkommanifestationen in den letzten Jahren entscheidend beeinflusst. Voraussetzung für ein adäquates therapeutisches Procedere ist nicht nur die klare pathomorphologische Abgrenzung von Sarkomen gegenüber anderen Tumorentitäten, wie spindelzellig dedifferenzierten/pleomorphen Karzinomen, aggressiven Non-Hodgkin-Lymphomen oder amelanotischen malignen Melanomen, sondern auch ihre genaue Subtypisierung. Neben der Makro- und Histomorphologie haben charakteristische immunphänotypische Konstellationen und bei einzelnen Sarkomentitäten auch molekulare Signaturen das diagnostische Werkzeug der Pathologie deutlich erweitert.

Abstract

The considerable progress made in radiology, in surgical management with curative intent, and in the identification of molecularly targeted small molecules, such as the tyrosine kinase inhibitor imatinib mesylate, in the treatment of gastrointestinal stromal tumors has greatly influenced the treatment of sarcoma manifestations within the liver. This requires not only the unequivocal pathomorphological differentiation of sarcomas from other tumor entities, e. g. spindle cell dedifferentiated/pleomorphic carcinomas, aggressive non-Hodgkin lymphomas or amelanotic malignant melanomas, but also an accurate subtyping of this complex group of tumors. Additionally to macroscopic and histological findings, the recognition of characteristic immunophenotypic constellations and, at least in some types of sarcoma, the identification of molecular signatures, have greatly expanded the diagnostic tools in pathology.

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Literatur

  1. Anagnostopoulos G, Sakorafas GH, Grigoriadis K, Kostopoulos P (2005) Malignant fibrous histiocytoma of the liver: A case report and review of the literature. Mount Sinai J Med 72: 50–52

    Google Scholar 

  2. Antonescu CR, Sommer G, Sarran L et al. (2003) Association of KIT exon 9 mutations with nongastric primary site and aggressive behaviour: KIT mutation analysis and clinical correlates of 120 gastrointestinal stromal tumors. Clin Cancer Res 9: 3329–3337

    Google Scholar 

  3. Bläker H, Hofmann WJ, Theuer D, Otto HF (2001) Pathohistologische Befunde bei Lebermetastasen. Radiologe 41: 1–7

    Article  PubMed  Google Scholar 

  4. Blay J-Y, Bonvalot S, Casali P et al. (2005) Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST consensus conference of 20–21 March 2004, under the auspices of ESMO. Annals Oncol 16: 566–578

    Article  Google Scholar 

  5. Boldt C, Pabst U, Nitsche R, Bürrig KF (1999) Primäres Osteosarkom der Leber. Fallbericht und Literaturübersicht. Pathologe 20: 359–364

    Article  PubMed  Google Scholar 

  6. Budd GT (2002) Management of angiosarcoma. Curr Oncol Rep 4: 515–519

    PubMed  Google Scholar 

  7. Bürrig K-F, Knauer S (1994) Rhabdomyosarkom der Leber im Erwachsenenalter. Fallbericht und Literaturübersicht. Pathologe 15: 54–57

    Article  PubMed  Google Scholar 

  8. Carriaga MT, Henson DE (1995) Liver, gallbladder, extrahepatic bile ducts, and pancreas. Cancer 75: 171–190

    PubMed  Google Scholar 

  9. Cathomas G (2003) Kaposi’s sarcoma-associated herpesvirus (KSHV)/human herpesvirus 8 (HHV-8) as a tumour virus. HERPES 10: 72–77

    PubMed  Google Scholar 

  10. Clary BM, De Matteo RP, Lewis JJ et al. (2001) Gastrointestinal stromal tumors and leiomyosarcomas of the abdomen and retroperitoneum: a clinical comparison. Ann Surg Oncol 8: 290–299

    PubMed  Google Scholar 

  11. Conran RM, Stocker JT (1985) Malignant fibrous histiocytoma of the liver. A case report. Am J Gastroenterol 80: 813–815

    PubMed  Google Scholar 

  12. Corless CL, Fletcher JA, Heinrich MC (2004) Biology of gastrointestinal stromal tumors. J Clin Oncol 22: 3813–3825

    Article  PubMed  Google Scholar 

  13. Corless CL, Schroeder A, Griffith D et al. (2005) PDGFRA mutations in gastrointestinal stromal tumors: frequency, spectrum and in vitro sensitivity to imatinib. J Clin Oncol 23: 5357–5364

    Article  PubMed  Google Scholar 

  14. Cornali E, Zietz C, Benelli R et al. (1996) Vascular endothelial growth factor regulates angiogenesis and vascular permeability in Kaposi’s sarcoma. Am J Pathol 149: 1851–1869

    PubMed  Google Scholar 

  15. Debiec-Rychter M, Dumez H, Judson I et al. (2004) Use of c-KIT/PDGFRA mutational analysis to predict the clincical response to imatinib in patients with advanced gastrointestinal stromal tumours entered on phase I and II studies of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer 40: 689–695

    Article  PubMed  Google Scholar 

  16. Debiec-Rychter M, Cools J, Dumez H et al. (2005) Mechanisms of resistance to imatinib mesylate in gastrointestinal stromal tumors and activity of PKC412 inhibitor against imatinib-resistant mutants. Gastroenterology 128: 270–279

    Article  PubMed  Google Scholar 

  17. DeMatteo RP, Lewis JJ, Leung D et al. (2000) Two hundred gastrointestinal stromal tumors. Recurrence patterns and prognostic factors for survival. Ann Surg 231: 51–58

    Article  PubMed  Google Scholar 

  18. DeMatteo RP, Shah A, Fong Y et al. (2001) Results of hepatic resection for sarcoma metastatic to liver. Ann Surg 234: 540–548

    Article  PubMed  Google Scholar 

  19. Demetri GD, Mehren M v, Blanke CD et al. (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347: 472–480

    Article  PubMed  Google Scholar 

  20. Demetri GD, Desai J, Fletcher J et al. (2004) SU11248, a multi-targeted tyrosine kinase inhibitor, can overcome imatinib (IM) resistance caused by diverse genomic mechanisms in patients (pts) with metastatic gastrointestinal stromal tumors (GIST). J Clin Oncol 22: S14

    Google Scholar 

  21. DuBois SG, Kalkika Y, Lukens JN et al. (1999) Metastatic sites in stage IV and stage IVS neuroblastoma correlate with age, tumor biology, and survival. J Pediatr Hematol Oncol 21: 178–180

    Article  PubMed  Google Scholar 

  22. Duensing A, Joseph NE, Medeiros F et al. (2004) Proetin kinase C θ (PKCθ) expression in constitutive activation in gastrointestinal stromal tumors (GISTs). Cancer Res 64: 5127–5131

    Article  PubMed  Google Scholar 

  23. El-Rifai W, Sarlomo-Rikala M, Andersson LC et al. (2000) DNA sequence copy number changes in gastrointestinal stromal tumors: tumor progression and prognostic significance. Cancer Res 60: 3899–3903

    PubMed  Google Scholar 

  24. Falk H, Herbert J, Crowley S et al. (1981) Epidemiology of hepatic angiosarcoma in the United States: 1964–1974. Environ Health Perspect 41: 107–113

    PubMed  Google Scholar 

  25. Fiel MI, Schwartz M, Min AD et al. (1996) Malignant schwannoma of the liver in a patient without neurofibromatosis. A case report and review of the literature. Arch Pathol Lab Med 120: 1145–1147

    PubMed  Google Scholar 

  26. Fletcher CDM, Unni KK, Mertens F (2002) World Health Organization Classification of Tumours. Pathology & genetics. Tumours of soft tissue and bone. IARC, Lyon

  27. Grenacher L, Thorn M, Knaebel HP et al. (2005) Bedeutung der 3-D-Bildgebung und computerbasierten Nachverarbeitung für die Chirurgie der Leber und des Pankreas. Fortschr Röntgenstr 177: 1219–1226

    Google Scholar 

  28. Gunawan B, Schulten HJ, Heydebreck A v et al. (2004) Site-dependent prognostic value of chromosome 9q loss in primary gastrointestinal stromal tumours. J Pathol 202: 421–429

    Article  PubMed  Google Scholar 

  29. Hashimoto M, Ohsawa M, Ohnishi A et al. (1995) Expression of vascular endothelial growth factor and its receptor mRNA in angiosarcoma. Lab Invest 73: 859–863

    PubMed  Google Scholar 

  30. Heinrich MC, Corless CL, Demetri GD et al. (2003) Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol 21: 4342–4349

    Article  PubMed  Google Scholar 

  31. Hirota S, Isozaki K, Moriyama Y et al. (1998) Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 279: 577–580

    Article  PubMed  Google Scholar 

  32. Holloway H, Walsh CB, Thomas R, Fielding J (1996) Primary hepatic leiomyosarcoma. J Clin Gastroenterol 23: 131–133

    Article  PubMed  Google Scholar 

  33. Hollstein M, Marion MJ, Lehmann T et al. (1994) p53 mutations at A:T base pairs in angiosarcomas of vinyl chloride-exposed factory workers. Carcinogenesis 15: 1–3

    PubMed  Google Scholar 

  34. Ioachim HL, Adsay V, Giancotti RF et al. (1995) Kaposi’s sarcoma of internal organs. Cancer 75: 1376–1385

    PubMed  Google Scholar 

  35. Ishak KG (1997) Malignant mesenchymal tumors and some other non-hepatocellular tumors of the liver. In: Okuda K, Tabor E (eds) Liver cancer. Churchill Livingstone, New York, pp 291–314

  36. Ishak KG (2000) Liver. In: Henson DE, Albores-Saavedra J (eds) The pathology of incipient neoplasia. 3rd edn. Oxford University Press, New York

  37. Ishak KG, Sesterhenn IA, Goodman ZD et al. (1984) Epithelioid hemangioendothelioma of the liver: a clinicopathologic and follow-up study of 32 cases. Hum Pathol 15: 839–852

    PubMed  Google Scholar 

  38. Ishak KG, Bijwaard KE, Makhlouf HR et al. (1998) Absence of human herpesvirus 8 DNA sequences in vascular tumors of the liver. Liver 18: 124–127

    PubMed  Google Scholar 

  39. Ishak KG, Goodman ZD, Stocker JT (2001) Tumors of the liver and intrahepatic bile ducts. Atlas of tumor pathology, 3rd series, fascicle 31. Armed Forces Institute of Pathology, Washington/DC

  40. Jain RK, Duda DG, Clark JW, Loeffler JS (2006) Lessons from phase III clinical trials on anti-VEGF therapy for cancer. Nat Clin Pract Oncol 3: 24–40

    Article  PubMed  Google Scholar 

  41. Kelle S, Paetsch I, Neuss M et al. (2005) Primary fibrosarcoma of the liver infiltrating the right atrium of the heart. Int J Cardiovasc Imaging 21: 655–658

    Article  PubMed  Google Scholar 

  42. Koon HB, Bubley GJ, Pantanowitz L et al. (2005) Imatinib-induced regression of AIDS-related Kaposi’s sarcoma. J Clin Oncol 23: 982–989

    Article  PubMed  Google Scholar 

  43. Lack EE, Perez-Atayada AR, Schuster SR (1981) Botryoid rhabdomyosarcoma of the biliary tract: report of five cases with ultrastructural observations and literature review. Am J Surg Pathol 5: 643–652

    PubMed  Google Scholar 

  44. Lasota J, Miettinen M (1999) Absence of Kaposi’s sarcoma-associated virus (human herpesvirus-8) sequences in angiosarcoma. Virchows Arch 434: 51–56

    Article  PubMed  Google Scholar 

  45. Lehnert T, Golling M (2001) Indikationen und Ergebnisse der Lebermetastasenresektion. Radiologe 41: 40–48

    Article  PubMed  Google Scholar 

  46. Lepreux S, Reboissou S, Le Bail B et al. (2005) Mutation of TP53 gene is involved in carcinogenesis of hepatic undifferentiated (embryonal) sarcoma of the adult, in contrast with Wnt or telomerase pathways: an immunohistochemical study of three cases with genomic realtiuon in two cases. J Hepatol 42: 424–429

    Article  PubMed  Google Scholar 

  47. Leuschner I, Schmidt D, Harms D (1990) Undifferentiated sarcoma of the liver in childhood: morphology, flow cytometry, and literature review. Hum Pathol 21: 68–76

    Article  PubMed  Google Scholar 

  48. Locker GY, Doroshow JH, Zwelling LA (1979) The clinical features of hepatic angiosarcoma: a report of four cases and a review of the English literature. Medicine (Baltimore) 58: 48–63

    Google Scholar 

  49. Maklouf HR, Ishak KG, Goodman ZD (1999) Epithelioid hemangioendothelioma of liver: a clinicopathologic study of 137 cases. Cancer 85: 999–1008

    Google Scholar 

  50. Marino IR, Todo S, Tzakis AG et al. (1988) Treatment of hepatic hemangioendothelioma with liver transplantation. Cancer 62: 2079–2084

    PubMed  Google Scholar 

  51. Marion MJ, Froment O, Trepo C (1991) Activation of ki-ras gene by point mutation in human liver angiosarcoma-associated with vinyl chloride exposure. Mol Carcinog 4: 450–454

    PubMed  Google Scholar 

  52. Martin J, Poveda A, Llombart-Bosch A et al. (2005) Deletions affecting codons 557–558 in patients with completely resected gastrointestinal stromal tumors: A study by the Spanish Group for Sarcoma Research (GEI). J Clin Oncol 23: 6190–6198

    Article  PubMed  Google Scholar 

  53. McClain KL, Leach CT, Jenson HB et al. (1995) Association of Epstein-Barr virus with leiomyosarcomas in young people with AIDS. N Engl J Med 332: 12–18

    Article  PubMed  Google Scholar 

  54. McDonagh DP, Liu J, Gaffey MJ et al. (1996) Detection of Kaposi’s sarcoma-associated hervesvirus-like DNA sequences in angiosarcoma. Am J Pathol 149: 1363–1368

    PubMed  Google Scholar 

  55. Mechtersheimer G, Lehnert T, Penzel R et al. (2003) Gastrointestinale Stromatumoren. Eine morphologisch und molekular eigenständige Tumorentität mit neuer therapeutischer Perspektive. Pathologe 24: 182–191

    PubMed  Google Scholar 

  56. Mechtersheimer G, Egerer G, Hensel M et al. (2004) Gastrointestinal stromal tumours and their response to treatment with the tyrosine kinase inhibitor imatinib. Virchows Arch 444: 108–118

    Article  PubMed  Google Scholar 

  57. Medeiros F, Corless CL, Duensing A et al. (2004) KIT-negative gastrointestinal stromal tumors. Proof of concept and therapeutic implications. Am J Surg Pathol 28: 889–894

    PubMed  Google Scholar 

  58. Miettinen M, Lindenmayer AE, Chaubal A (1994) Endothelial cell markers CD31, CD34, and BNH9 antibody to H- and Y-antigens – evaluation of their specificity and sensitivity in the diagnosis of vascular tumors and comparison with von Willebrand factor. Mod Pathol 7: 82–90

    PubMed  Google Scholar 

  59. Miettinen M, Sarkomo-Rikala M, Lasota J (2000) KIT expression in angiosarcomas and fetal endothelial cells: lack of mutation of exon 11 and exon 17 of C-kit. Mod Pathol 13: 536–541

    Article  PubMed  Google Scholar 

  60. Miettinen M, Fetsch JF, Sobin LH, Lasota J (2006) Gastrointestinal stromal tumors in patients with neurofibromatosis 1: a clinicopathologic and molecular genetic study of 45 cases. Am J Surg Pathol 30: 90–96

    Article  PubMed  Google Scholar 

  61. Moses AV, Jarvis MA, Raggo C et al. (2002) Kaposi’s sarcoma-associated herpesvirus-induced upregulation of the c-kit proto-oncogene, as identified by gene expression profiling, is essential for the transformation of endothelial cells. J Virol 76: 8383–8399

    Article  PubMed  Google Scholar 

  62. Nelson V, Fernandes NF, Woolf GM et al. (2001) Primary liposarcoma of the liver. A case report and review of the literature. Arch Pathol Lab Med 125: 410–412

    PubMed  Google Scholar 

  63. Niedt GW, Schinella RA (1985) Acquired immunodeficiency syndrome. Clinicopathologic study of 56 autopsies. Arch Pathol Lab Med 109: 727–734

    PubMed  Google Scholar 

  64. Nilsson B, Bümming P, Meis-Kindblom JM et al. (2005) Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era. Cancer 103: 821–829

    Article  PubMed  Google Scholar 

  65. Ohsawa M, Naka N, Tomita Y et al. (1995) Use of immunohistochemical procedures in diagnosing angiosarcoma. Cancer 75: 2867–2874

    PubMed  Google Scholar 

  66. O’Sullivan MJ, Swanson PE, Knoll J et al. (2001) Undifferentiated embryonal sarcoma with unusual features arising within mesenchymal hamartoma of the liver: report of a case and review of the literature. Pediatr Develop Pathol 4: 482–489

    Article  Google Scholar 

  67. Pantanowitz L, Schwartz EJ, Dezube BJ et al. (2005) C-Kit (CD117) expression in AIDS-related, classic, and African endemic Kaposi sarcoma. Appl Immunohistochem Mol Morphol 13: 162–166

    Article  PubMed  Google Scholar 

  68. Pauls K, Merkelbach-Bruse S, Thal D et al. (2005) PDGFRα- and c-kit-mutated gastrointestinal stromal tumours (GISTs) are characterized by distinctive histological and immunohistochemical features. Histopathology 46: 166–175

    Article  PubMed  Google Scholar 

  69. Penzel R, Aulmann S, Moock M et al. (2005) The location of KIT and PDGFRA gene mutations in gastrointestinal stromal tumours is site and phenotype associated. J Clin Pathol 58: 634–639

    Article  PubMed  Google Scholar 

  70. Prakash S, Sarran L, Socci N et al. (2005) Gastrointestinal stromal tumors in children and young adults: a clinicopathologic, molecular, and genomic study of 15 cases and review of the literature. J Pediatr Hematol Oncol 27: 179–187

    Article  PubMed  Google Scholar 

  71. Przygodzki RM, Finkelstein SD, Keohavong P et al. (1997) Sporadic and thorotrast-induced angiosarcomas of the liver manifest frequent and multiple point mutations in K-ras-2. Lab Invest 76: 153–159

    PubMed  Google Scholar 

  72. Robin Y-M, Guillou L, Michels J-J, Coindre J-M (2004) Human herpesvirus 8 immunostaining. A sensitive and specific method for diagnosing Kaposi sarcoma in paraffin-embedded sections. Am J Clin Pathol 121: 330–334

    Article  PubMed  Google Scholar 

  73. Rogatsch H, Bonnati H, Menet A et al. (2000) Epstein-Barr virus-associated multicentric leiomyosarcoma in an adult patient after heart transplantation. Am J Surg Pathol 24: 614–621

    Article  PubMed  Google Scholar 

  74. Rossi G, Sartori G, Valli R et al. (2006) The value of c-kit mutational analysis in a cytokeratin positive gastrointestinal stromal tumour. J Clin Pathol 58: 991–993

    Article  Google Scholar 

  75. Roth WK, Werner S, Schirren CG, Hofschneider PH (1989) Depletion of PDGF from serum inhibits growth of AIDS-related and sporadic Kaposi’s sarcoma cells in culture. Oncogene 4: 483–487

    PubMed  Google Scholar 

  76. Selby DM, Stocker JT, Ishak KG (1992) Angiosarcoma of the liver in childhood: a clinicopathologic and follow-up study in 10 cases. Pediatr Pathol 12: 485–498

    PubMed  Google Scholar 

  77. Soini Y, Welsh JA, Ishak KG, Bennett WP (1995) p53 mutations in primary hepatic angiosarcomas not associated with vinyl chloride exposure. Carcinogenesis 16: 2879–2881

    PubMed  Google Scholar 

  78. Srivastava A, Nielsen PG, Dal Cin P, Rosenberg AE (2005) Monophasic synovial sarcoma of the liver. Arch Pathol Lab Med 129: 1047–1049

    PubMed  Google Scholar 

  79. Stocker JT, Ishak KG (1978) Undifferentiated (embryonal) sarcoma of the liver: report of 31 cases. Cancer 42: 336–348

    PubMed  Google Scholar 

  80. Teas S, Ronan SG, Ghos L (1978) Solitary metastatic liposarcoma of the liver. Arch Pathol Lab Med 102: 605

    PubMed  Google Scholar 

  81. Trivers GE, Cawley HL, DeBenedetti VMG et al. (1995) Detection of p53 antibodies in patients highly exposed to vinyl chloride (VC), before and after diagnosis of angiosarcoma of the liver. J Natl Cancer Inst 87: 1400–1407

    PubMed  Google Scholar 

  82. Van Glabbeke M, van Oosterom AT, Oosterhuis JW et al. (1999) Prognostic factors for the outcome of chemotherapy in advanced soft tissue sarcoma: an analysis of 2,185 patients treated with anthracycline-containing first-line regimens –; a European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Study. J Clin Oncol 17: 150–157

    PubMed  Google Scholar 

  83. Van Kaick G, Bahner ML, Liebermann D et al. (1999) Thorotrast-induzierte Tumoren der Leber. Ergebnisse der Deutschen Thorotraststudie. Radiologe 39: 643–651

    Article  PubMed  Google Scholar 

  84. Verwej J, Casali PG, Zalcberg J et al. (2004) Progression-free survival in gastrointestinal stromal tumours with high-dose imatinib: randomized trial. Lancet 364: 1127–1134

    Article  PubMed  Google Scholar 

  85. Wardelmann E, Losen I, Hans V et al. (2003) Deletion of Trp-557 and Lys-558 in the juxtamembrane domain of the c-kit protooncogene indicates malignant histology and metastatic phenotype of gastrointestinal stromal tumors. Int J Cancer 106: 887–895

    Article  PubMed  Google Scholar 

  86. Wardelmann E, Hrychyk A, Merkelbach-Bruse S et al. (2004) Association of platelet-derived growth factor receptor alpha mutations with gastric primary site and epithelioid or mixed cell morphology in gastrointestinal stromal tumors. J Mol Diagn 6: 197–204

    PubMed  Google Scholar 

  87. Wardelmann E, Thomas N, Merkelbach-Bruse S et al. (2005) Acquired resistance to imatinib in gastrointestinal stromal tumours caused by multiple KIT mutations. Lancet Oncol 6: 249–251

    Article  PubMed  Google Scholar 

  88. Weihrauch M, Markwarth A, Lehnert G et al. (2002) Abnormalities of the ARF-p53 pathway in primary angiosarcomas of the liver. Hum Pathol 33: 884–892

    Article  PubMed  Google Scholar 

  89. Weinberg AG, Finegold MJ (1993) Pimary hepatic tumors of childhood. Hum Pathol 14: 512–537

    Google Scholar 

  90. Weiss SW, Goldblum JR (2001) Enzinger and Weiss’s soft tissue tumors, 4th edn. Mosby, St. Louis

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Danksagung

Wir danken Herrn John Moyers für die fotographische Dokumentation und Frau Ursula Sturm für die technische Unterstützung.

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  1. Pathologisches Institut, Universitätsklinikum, Im Neuenheimer Feld 220/221, 69120, Heidelberg

    G. Mechtersheimer, R. Penzel & P. Schirmacher

  2. Pathologisches Institut, Klinikum Memmingen

    W. J. Hofmann

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  1. G. Mechtersheimer
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Mechtersheimer, G., Penzel, R., Hofmann, W.J. et al. Primäre Sarkome und Sarkommetastasen in der Leber. Pathologe 27, 251–262 (2006). https://doi.org/10.1007/s00292-006-0841-2

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