Malignant Peripheral Nerve Sheath Tumor (MPNST) 101...Explained by a Sarcoma Pathologist

Рет қаралды 30,208

Күн бұрын

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
This video explores the clinical, histologic, and immunophenotypic features of MPNST. Malignant Triton tumor and epithelioid MPNST are also discussed. Over 15 different cases of MPNST are shown in the video. Cases/topics discussed (click time stamp to go to that part of the video):
Intro/clinical settings for MPNST: 0:00
MPNST histologic features: 7:00
Example of palisading in MPNST: 25:00 (see WSI digital slide for this case: )
IHC in MPNST: 36:50
Malignant Triton tumor (MPNST w rhabdomyoblastic differentiation): 42:48
Striated rhabdomyoblast in Triton tumor: 58:25
Epithelioid MPNST: 1:06:18
Additional relevant videos:
- Neurofibroma, NF-1, and low grade MPNST: • Neurofibroma, Neurofib...
- Schwannoma (neurilemmoma): • Schwannoma (Neurilemmo...
- Synovial sarcoma: • Synovial Sarcoma 101…E...
Additional suggested reading:
- Atypical neurofibromatous neoplasms / "low grade MPNST" in setting of NF-1: www.ncbi.nlm.nih.gov/pubmed/2...
- Our case report of malignant Triton tumor MPNST arising in free flap: www.ncbi.nlm.nih.gov/pubmed/2....
Whole slide digital pathology images from the case:
- bit.ly/TritonFreeFlap1
- bit.ly/TritonFreeFlap2
- bit.ly/TritonFreeFlap3
- S100: bit.ly/TritonFreeFlapS100
Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: bit.ly/2Te2haB ‬
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
Follow me on:
Snapchat: JMGardnerMD
Twitter: @JMGardnerMD
Instagram: @JMGardnerMD
Kiko: kikoxp.com/profile/jerad_gard...
Facebook: / jmgardnermd

Пікірлер: 73

@JMGardnerMD 3 жыл бұрын

@sarahloulou2613 Жыл бұрын

Thank you very much doctor

@Roadkiller85 6 жыл бұрын

The best pathology presentations with great cases and helpul info for fellow colleagues. A big thank you from Germany! Keep it up, you make the pathworld better.

@JMGardnerMD 6 жыл бұрын

Thank you! I’m glad you find it useful. It’s my honor to be able to help my colleagues around the world so they can better care for their patients.

@nazarhussain8510 4 жыл бұрын

Excellent lecture dr nazar hussIn Pakistan

@milicakukicc Жыл бұрын

I'm a 19 year old female from Serbia and i had Triton tumor when i was 11, back then it took doctors all around the world a whole month to figure out what it was. I had surgery, went trough chemo and radiotherapy and it was all very experimental. Over the years i've been trying to get a better understanding of the tumor itself but i rarely found anything since it was pretty rare. Now that i tried to research it again in 2022 i was pleasently surprised that there are actual articles about it and mentions of it in this video, thank you for educating us!

@JMGardnerMD Жыл бұрын

It’s my pleasure to help! And I’m so happy to hear you are doing well! Best wishes for continued health and happiness to you. PS - I visited Bosnia and Croatia a few years ago and loved them both. I very much want to visit Serbia one day too. I love that part of the world!

@milicakukicc Жыл бұрын

@@JMGardnerMD Thank you so much for the kind wishes, i'm very glad that you enjoyed your time in my neighbourhood countries! Wish you all the best in the future🌻

@omarsadouki9385 6 жыл бұрын

great video mister GARDNER,thanks a lot for what are you doing

@tinocasadeitherezo6063 3 жыл бұрын

So well explained and demonstrated! Thank you!!

@ramadanshatwan2205 4 жыл бұрын

Amazing videos as usual. Many thanks dr Gardner for all your wonderful teaching materials

@AzadMustafa 4 жыл бұрын

Perfect ... Clear explanation... Very helpfull .... can't stop the video until the end.

@yesarieroksuz6964 2 жыл бұрын

Love your voice, your descriptions and reading the slides. Super thanks from Turkey.

@shadana.s.3575 4 жыл бұрын

what an astonishing video prof. You are out of this world. please keep going and continue sharing your fabulous informations.

@madhudewan8207 Жыл бұрын

Simplified and beautiful illustration, terrific video

@ogoijere2659 4 жыл бұрын

Thanks so much. Very helpful. The slides are wonderful

@johnfazio2892 6 жыл бұрын

Good discussion, excellent cases.

@borahmunmi 4 жыл бұрын

The video was really helpful sir... Thankyou for making such great videos and sharing your knowledge with us.

@juanchoca1961 4 жыл бұрын

Great educational video Jerad. Thank you very much

@JMGardnerMD 4 жыл бұрын

De nada, amigo!

@dr.tintinthein8566 4 жыл бұрын

thank you very much Prof, very clear explanation.

@gordonchristophertubo3164 5 жыл бұрын

I am laughing right now because I am looking at an MPNST slide and I am recognizing now for the first timd the perivascular change you are talking about. It is really there. I don't know why I am so happy seeing this. Saw this vid a few months back and returned just to rewatch what you said at around 14 mins. Thank you sir. It feels like I get to watch a superb lecture with continuing education credits for free.

@JMGardnerMD 5 жыл бұрын

Yes! It’s such an amazing clue right? My mentor Sharon Weiss taught me that and after she pointed it out I started noticing it all the time. I find it to be one of the more helpful histological clues for MPNST.

@mcgama88 3 жыл бұрын

A great clarity was made certain to my view by your comment upon the beauty, ordering of structure at the known malagancy of multi form tissue. Two decades on with molecular toolbar approach to disease, I am compelled to think of that counterpart beauty quite simply in the ordered complement of amino at gene...both healty and malfeasance to organ procession in process. Thus...so valuable...concrete and useful to thought...deeper study at these pathology. I simply ...quite thank you for your superb and excellence to express these domains at your expertise. I am at once your student. *McGary

@mcgama88 3 жыл бұрын

I have recently managed artificial tumor at Univie toolbar. While preliminary, and at the limits of that site's computational engine..and my model build as at "the "limits of my ability"..... .the model is defined at growth...hence available to dismantle to start position chemistry and individual mRNA components. drive.google.com/file/d/1KUahPmi2GxZdd7yAOfcuPRjFXWkL8KBr/view?usp=sharing Naturally, the data is huge. But if you manage to have a look, I hope the interested observer will in fact discover the beauty and compelling precision as seen in DermPath study. And scroll thru to read my comments...I hope of interest. This material is as ripped from my notebook page, and I am studying best format, revisit to more accepted abstract/body of article form.

@genicadelara5243 2 жыл бұрын

Thank you so much for this.

@kazumithumargondalia9171 3 жыл бұрын

Loved the rhabdomyoblast with straitions... Had only imagined.. today saw it . Sir we or me would love to hear and learn rhabdomyosarcoma series ... Thanks in advance.

@sarahharris-bow4554 5 жыл бұрын

Alas, if seeing eye pictures from the '90's makes you old, then I am too! Another great video, thanks.

@sarahharris-bow4554 5 жыл бұрын

Also, is it only me that sees fascicles/herringbone pattern and thinks of Guinea-Pig fur?

@kumarravish561 4 жыл бұрын

Great video

@joanchen8972 Жыл бұрын

Thanks a lot!❤

@rymahamoudi2692 5 жыл бұрын

Thank you soo much

@kingcraft5731 4 жыл бұрын

Thanks very helpful

@virabaranovska6773 2 жыл бұрын

Thank you for this amazing video! Do you have any videos about MPNST with perineurial differentiation?

@JMGardnerMD 2 жыл бұрын

No videos on that yet sorry!

@thericeclann7825 5 жыл бұрын

EXCELLENT VIDEO!! our child has NOONAN Syndrome LEOPARD syndrome genetically tested for NF1...Negative. I am having a very hard time getting someone to explain why our 11 year old has 46 granular cell tumors. Neurologist says they GCT do not grow on inside of body etc. MRI shows "prominence of neural foramina and nerve sheaths can be seen in setting of neurofibromatosis...which we know is negative NO NF1.

@ncorry8491 4 жыл бұрын

Another excellent video, I was wondering if you would consider doing a board type review of soft tissue lesions in a similar manner to your dermpath board review.

@JMGardnerMD 4 жыл бұрын

Yes I’m planning to do this.

@ncorry8491 4 жыл бұрын

Also looking forward to forward to soft tissue lipomatous tumour and DFSP videos. I got your soft tissue textbook , maybe if you could do an approach video to lipomatous tumours? I feel like I don't fully understand the lesions and nuances until ive watched your videos! Thanks again.

@ncorry8491 4 жыл бұрын

Great I dont know where you find the time.

@roseajith4215 5 жыл бұрын

Hi doctor...thanks a lot for tgs explanation....is tgat low grade mpnst is treatable.....can u pls brief about tge recurrent chancea

@ellenbruckermarshall4179 2 жыл бұрын

Dilated blood vessels, enlarged and vasculated vessles, does this condition possibly co-occur in patients with the blood parasite Babeosis? Asking on behalf of Lyme patients with Co-infections of Babesia and Bartonella, late stage. Who15 years out develop deep lipomas attached to a blood supply.

@raminsaadaat7630 5 жыл бұрын

This is vice and useful video, could you please share any thing about Sclerosing Epitheloid Fibrosarcoma with us,

@JMGardnerMD 5 жыл бұрын

I’ll try to get to that entity at some point. For now the closest I have is a low grade fibromyxoid sarcoma video: kzfaq.info/get/bejne/h6qSaZuQrJesgmg.html. LGFMS is probably somewhat related to sclerosing epithelioid fibrosarcoma.

@ShivaniSharma-cg4kw 3 жыл бұрын

I loved this one, the video looks like I was on a trip to MPNST island. Can we have other heterologous differentiation in MPNST ? and do we still call them Triton MPNST?

@JMGardnerMD 3 жыл бұрын

I only use the term malignant Triton tumor for MPNST with rhabdomyoblastic heterologous differentiation. But yes I've seen other types (like chondrosarcomatous differentiation) in MPNST also. But rhabdo seems to be most common heterologous component by far in MPNST

@WOLFNBEAST 2 жыл бұрын

I am a NF1 patient who had a late stage III, high grade & inoperable MPNST the size of a grapefruit in my mediastinum. I was given a 35% prognosis and went through 6 AIM cycles + 4 months of radiation. It has been three years and my oncologist thinks the tumor is now mostly scar tissue as it no longer shows up on a PET scan and hasn't shown signs of activity for about 2 years on CT scans.

@JMGardnerMD 2 жыл бұрын

I am so very happy to hear of the great response to treatment you have had! Thank you so much for sharing your story. Best wishes for health and continued healing.

@cheesesteakphilly Жыл бұрын

I have NF1 and had a MPNST removed from my arm (about 12cm) early this year. I just completed radiation a few weeks ago. They have now found 2 more MPNSTs on other limbs (maybe about 5-7cm size for both).

@JMGardnerMD Жыл бұрын

I am so very sorry to hear that. Best wishes for health and healing.

@JMGardnerMD Жыл бұрын

Are you a member of the MPNST patient support group on Facebook? facebook.com/groups/917385704945987/?ref=share. These groups can be a very helpful place for patients to find emotional and social support as they deal with their cancer.

@annoythedonkey 6 ай бұрын

@@JMGardnerMDI just sent a join request, I’m feeling so alone in this fight. I’m having a tumor debulked from the brachial plexus next Wednesday

@swatisharma-tr5of 6 жыл бұрын

Very nice and informative video.. What are the chances of PNST in spleen????

@JMGardnerMD 5 жыл бұрын

I've never seen a case in the spleen personally.

@BrankaDejanovic-pi1qe Жыл бұрын

Hi, I'm diagnosed with MPNST, after over a month of analysing. I was told it was benign schwanomma before the resection, but it turned out it was this. Because it is on sciatic nerv, it is inoperable, i had chemo and radiation. Some of the doctors told me that there is more chance to be mistake in diagnose, than that is MPNST. And, most of the doctors never had anything like this in their experience. How can I be sure that I've got the right diagnose, if that is so rare? Thanks!

@JMGardnerMD Жыл бұрын

I am sorry to hear that you are going through this. You can request to have your Pathology specimens sent to a sarcoma pathology expert for a second opinion about the diagnosis. Dr. Christopher Fletcher at Brigham and women’s hospital in Boston Massachusetts. USA is a world renowned expert in that area. When I have difficult cases in my own practice, I send them to him for a second opinion.

@tribani 2 жыл бұрын

My husband is an NF1 patient. Thai had a tumor like 11 cm. It shows MPNST in the biopsy report after the operation. Will it be cured by radiation? Please reply.He is 40 years old.

@JMGardnerMD 2 жыл бұрын

I’m so sorry to hear this. I diagnose MPNST but I don’t treat it so I am not an expert on treatment. But my general understanding is that MPNST usually requires complete surgical removal often with the addition of radiation either before or after the surgery. Chemotherapy may also be given depending on the situation. These are rare and complicated tumors, please seek care at a major cancer center with sarcoma treatment experience if you are able to do so. I’m so sorry for what you and your husband are going through. Best wishes for health and healing and peace for you both.

@BasicInfo143 3 жыл бұрын

I was diagnosed with low grade type malignant peripheral nerve tumor. Can you please enlighten me about it? Is it dangerous? Is it curable? Can you please help me? I really need your advices. If anyone knows about it please give me your thoughts.

@JMGardnerMD 3 жыл бұрын

I’m sorry to hear this. Low grade MPNST is a very challenging diagnosis to make for most pathologists. It may be worthwhile to have a sarcoma pathology expert review your case to be sure the diagnosis is correct. For more info on mpnst and empathy/support, there is an mpnst Facebook patient support group you can join: facebook.com/groups/917385704945987/?ref=share. Please be sure to discuss everything you read online with your own doctor to be sure it is accurate and that it applies to you personally. Best wishes for health and healing.

@goharrehman7710 4 жыл бұрын

sir people were waiting for stains(IHC)

@JMGardnerMD 4 жыл бұрын

Did you watch the whole video? I show and discuss IHC stains at 37:00.

@amaliyadipita6906 Жыл бұрын

👍🏾👍🏾👍🏾👍🏾👍🏾👍🏾👍🏾❤️

@katechan8262 Жыл бұрын

Is it possible to live a normal life with this????

@elinoreberkley1643 Жыл бұрын

So I take it that each cancer is like an anti Cell to the Cell it derived and mutated from and so we can develope many many different types of cancers but who may vary only slightly from type to type. It is as if they have their own flavor or Style and mode of creation. Gene science must be hot ground given what we already know.

@niftynuggets1805 5 жыл бұрын

Million bucks for this video 😂😂

@lamwlw 4 жыл бұрын

like this video in general, but just too lengthy.

@amarahsboringchannel1715 6 жыл бұрын

I have one of those :(

@swatisharma-tr5of 6 жыл бұрын

Bjj

@natashadogra7097 Жыл бұрын

Thank U. I am a big fan of Ur videos. Has helped me in practice time and again. Sir U have been saying in most of Ur videos if superficial and small, Ur DDS are different. So how is superficial and size defined as per Ur experience... Say on the back. 5cm mass in subcutis and abutting muscle. Is it big enough and deep enough?