Presentation
In this report, we present a 53-year-old woman with primary mast cell sarcoma of the thoracic spine vertebrae. Mast cell sarcoma is an aggressive and rare cancer. [ncbi.nlm.nih.gov]
A prominent, patchy infiltrate of eosinophils was also present. Scattered very large epithelioid cells were also present; these often showed bizarre features, including multilobated nuclei and multinucleation. [nature.com]
Multifocal, dense infiltrates of mast cells are present. [msdmanuals.com]
Entire Body System
- Anemia
Rare coagulation disorder Rare hematologic disease Rare immune disease Rare neoplastic disease Rare tumor Refractory anemia Refractory anemia with excess blasts Refractory anemia with excess blasts in transformation Refractory anemia with excess blasts [se-atlas.de]
Symptoms include: Flushing Hives and/or Itching (Pre)Syncope (Fainting/Blackouts) Chronic Pain (Bone Pain, Muscle Pain, Nerve Pain) Nausea, Vomiting, Reflux, GERD Alternating Diarrhea and/or Constipation Anemia Abnormal Electrolytes Organ Inflammation [hospitalprincess.com]
In this case symptoms are: Anemia Thrombocytopenia Leucopenia Leukocytosis Diffuse fibrosis of bone marrow and hypocellularity Gastrointestinal Abdominal pain Diarrhea Nausea Vomiting Peptic ulcer Malabsorbtion Liver dysfunction, hepatomegaly and portal [cancerwall.com]
She had a history of nephrolithiasis and cystectomy for chronic cystitis, as well as chronic anemia. Her family history was significant for ovarian cancer, an unspecified brain tumor, and melanoma. [nature.com]
She was found to have splenomegaly, a high infiltration grade (MC) in bone marrow biopsies (>30%), mild anemia, and a high serum tryptase level (>500 ng/ml). [thedoctorsdoctor.com]
- Disability
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J Cutan Laser Ther 2000 Mar;2(1):45-7 Abstract quote Urticaria pigmentosa is a chronic benign proliferation of mast cells in the skin that presents considerable cosmetic disability, for which there is no current successful treatment. [thedoctorsdoctor.com]
Gastrointestinal
- Abdominal Pain
The patient initially presented with a 1-month history of pelvic and abdominal pain. Inconclusive gynecological evaluation resulted in a CT of the abdomen and pelvis, demonstrating a destructive lesion centered at the 11th thoracic vertebral body. [ncbi.nlm.nih.gov]
The excess release of mediators can cause clinical features such as pruritus, flushing, nausea, vomiting, diarrhoea, abdominal pain, vascular instability and anaphylaxis. [patient.info]
pain Arthralgias Bone pain Dermatographism Diaphoresis Fatigue Fever Flushing Fractures Headache Hepatosplenomegaly Hypotension Myalgias Neutropenia Pruritis Respiratory problems Syncope Tachycardia Thrombocytopenia Urticaria Weight loss Progression [seer.cancer.gov]
In this case symptoms are: Anemia Thrombocytopenia Leucopenia Leukocytosis Diffuse fibrosis of bone marrow and hypocellularity Gastrointestinal Abdominal pain Diarrhea Nausea Vomiting Peptic ulcer Malabsorbtion Liver dysfunction, hepatomegaly and portal [cancerwall.com]
- Dyspepsia
Symptoms result mainly from mediator release and include pruritus, flushing, and dyspepsia due to gastric hypersecretion. Diagnosis is by skin or bone marrow biopsy or both. Treatment is with antihistamines and control of any underlying disorder. [msdmanuals.com]
Hyperacidity, dyspepsia and peptic ulcers. Hepatomegaly and splenomegaly. Cardiovascular: Syncope, hypotension or anaphylactic shock. Haematological and bones: Anaemia or other cytopenias (if bone marrow involvement). Hypersplenism. Lymphadenopathy. [patient.info]
Cardiovascular
- Hypertension
Hepatic and splenic infiltration may cause portal hypertension with resultant ascites. Clinical evaluation Skin lesion biopsy and sometimes bone marrow biopsy Diagnosis of mastocytosis is suggested by clinical presentation. [msdmanuals.com]
[…] this case symptoms are: Anemia Thrombocytopenia Leucopenia Leukocytosis Diffuse fibrosis of bone marrow and hypocellularity Gastrointestinal Abdominal pain Diarrhea Nausea Vomiting Peptic ulcer Malabsorbtion Liver dysfunction, hepatomegaly and portal hypertension [cancerwall.com]
Osteolysis or osteoporosis (thin bones, sometimes causing fractures) Malabsorption Weight loss Enlarged overactive spleen (which can destroy circulating blood cells) Enlarged liver with impaired liver function Ascites (fluid in the abdominal cavity) Portal hypertension [dermnetnz.org]
Aggressive disease [ 2 ] Splenectomy may be helpful for patients with significant hypersplenism or portal hypertension (it may reduce the mast cell burden and improve cytopenias). [patient.info]
Musculoskeletal
- Myalgia
Corresponding ICD-10-CM Codes (U.S. only) C96.22 Mast cell sarcoma (effective October 01, 2015) Signs and Symptoms Abdominal pain Arthralgias Bone pain Dermatographism Diaphoresis Fatigue Fever Flushing Fractures Headache Hepatosplenomegaly Hypotension Myalgias [seer.cancer.gov]
Skin
- Skin Disease
disease in mastocytosis; Treatment of advanced mastocytosis; Treatment strategies of mediator related symptoms in mastocytosis; and Neuro and psychological involvement in Mastocytosis. [books.google.de]
Mastocytoma of skin. Systemic mastocytosis: Indolent systemic mastocytosis. Systemic mastocytosis with associated haematological non-mast cell lineage disease (SM-AHNMD). Aggressive systemic mastocytosis. Mast cell leukaemia (very rare). [patient.info]
Neurologic
- Irritability
Try the following methods: Help your child from scratching or rubbing their irritated skin to prevent the lesions from spreading. Avoid hot baths to keep from drying out their skin and making the itching worse. [healthline.com]
Irritable Bowel Syndrome. Medscape, Last Update October 10, 2016. Available at: http://emedicine.medscape.com/article/180389-overview. Accessed December 20, 2016. Rowe W, Lichtenstein GR. Irritable Bowel Disease. [rarediseases.org]
People with mastocytosis may become irritable, depressed, or moody. Widespread reactions may occur. With systemic mastocytosis, the widespread reactions tend to be severe. [msdmanuals.com]
Workup
Mast cell activation disease: a concise practical guide for diagnostic workup and therapeutic options. J Hematology & Oncology March 2011. [ http://www.jhoonline.org/content/4/1/10 ] 5. [mastocytosis.ca]
Importance of Adequate Diagnostic Workup for Correct Diagnosis of Advanced Systemic Mastocytosis. J Allergy Clin Immunol Pract. 2020;8(9):3121-3127.e1. Valora este contenido: todavía no hay valoraciones × Ask Speakers [profesionalessanitarios.novartis.es]
A bone scan, GI workup, and identification of the D816V c-kit mutation can also be helpful in cases where the diagnosis requires confirmation. [msdmanuals.com]
[…] as CD2 and CD25 are not unique to atypical mast cells.4,5 This becomes particularly problematic in early stages of the disease with a low disease burden or in cases of MMCAS.3 For this reason, the development of new diagnostic approaches for the SM workup [cytometry.org]
Treatment
Our results indicate that imatinib is of potential use in the treatment of mast cell sarcoma. [ncbi.nlm.nih.gov]
Treatment There are no standards for treatment, which is unlikely to prolong life. Common treatment options include: Surgical Excision Radiation [knowcancer.com]
Cytotoxic drugs (eg, daunomycin, etoposide, 6-mercaptopurine) may be indicated for treatment of mast cell leukemia, but efficacy is unproved. [msdmanuals.com]
[…] of advanced mastocytosis; Treatment strategies of mediator related symptoms in mastocytosis; and Neuro and psychological involvement in Mastocytosis. [books.google.de]
Prognosis
Prognosis The prognosis is very poor. Mast cell sarcoma quickly becomes mast cell leukemia. PREVENTION No preventative measures exist. [knowcancer.com]
In SM-AHNMD, the prognosis depends on the course of the associated haematological disorder. Agressive systemic mastocytosis and mast cell leukaemia have a poorer prognosis. [patient.info]
Mast cell sarcoma is a rare disease characterized by localized, but destructive and rapid, growth of the tumor, high risk of distant metastasis, possibility of a leukemic phase, and poor prognosis. [ncbi.nlm.nih.gov]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Etiology in many patients involves an activating mutation (D816V) in the gene coding for the stem cell factor receptor c-kit, which is present on mast cells. [msdmanuals.com]
[…] diagnostic criteria for mastocytosis but lack the full diagnostic criteria for systemic mastocytosis -MCAS = Pt with episodic allergy-like signs and symptoms (e.g., flushing, urticaria, diarrhea, wheezing) involving >/=2 organ systems without identifiable etiology [slideshare.net]
Plasmablastic lymphoma: CNS involvement, coexistence of other malignancies, possible viral etiology, and dismal outcome Annals of Hematology 88:351-358, 2009 Ustun C, Jillella AP, Salama ME. [siicsalud.com]
Epidemiology
Articles in this issue include Human Mast Cell Signal Transduction; Mast cell tryptase role in homeostasis and coagulation; Mastocytosis: Current Classification and Diagnostic criteria; Epidemiology, risk factors and prognosis of mastocytosis; Mast cell [books.google.de]
Epidemiology and Mortality Sources Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds): WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition) IARC: Lyon 2017 Section: Mastocytosis Pages: 69 [seer.cancer.gov]
Epidemiology of systemic mastocytosis in Denmark. Br J Haematol. 2014;166(4):521-8. 12. Schwaab J, Cabral do O Hartmann N, Naumann N, et al. Importance of Adequate Diagnostic Workup for Correct Diagnosis of Advanced Systemic Mastocytosis. [profesionalessanitarios.novartis.es]
A mutation of the oncogene C-KIT D816V is found in many (but not all) cases. [ 9 ] Epidemiology [ 10 ] This is a rare and heterogeneous group of disorders, of which urticaria pigmentosa is the most common manifestation. [patient.info]
Pathophysiology
However, the pathophysiological basis of such a coevolution has not been clarified. [thedoctorsdoctor.com]
Prevention
PREVENTION No preventative measures exist. Signs & Symptoms Patients do not have skin lesion as is common in similar diseases, nor do they fit the criteria of systemic mastocytosis. [knowcancer.com]
There is no sure way to prevent UP. The inherited form is very rare, and even when the child has the abnormal gene, they may not ever develop UP. However, you can prevent the disorder from getting worse. [healthline.com]
NIH: National Cancer Institute Cancer (Medical Encyclopedia) Cancer and lymph nodes (Medical Encyclopedia) Cancer treatment -- early menopause (Medical Encyclopedia) Cancer treatment: preventing infection (Medical Encyclopedia) Cancer treatments (Medical [icdlist.com]
[…] under supervision. [ 23 ] Bone pain Oral sodium cromoglicate may help. [ 21 ] Osteoporosis prevention/treatment - calcium, vitamin D, and bisphosphonates. [ 11 ] Drugs to avoid [ 24 ] Beta-blockers are contra-indicated in patients with systemic mastocytosis [patient.info]
Cromolyn 200 mg orally 4 times a day (100 mg 4 times a day for children 2 to 12 years; not to exceed 40 mg/kg/day) may help by preventing mast cell degranulation. Ketotifen 2 to 4 mg orally twice a day is inconsistently effective. [msdmanuals.com]