Leiomyosarcoma historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]

Overview

Soft tissue sarcoma derived their name from the Greek term for a fleshy excrescences. Early reports of myxoid liposarcoma by Severinius(1580-1637) and retroperitoneal sarcoma by Morgagni (1682-1771) have been recorded.An Edinburg surgeon, Wardrop( 1782-1869),who studied in Vienna,describes the term soft cancer.Charles Bell ( 1772-1842) ,in his book Surgical Observations, published in 1816, has been credited with the utilization of the term soft tissue sarcoma to differentiate it form carcinoma.In 1804, Abernethy describes the first classification of the sarcoma.In 1932 Stout (1885-1967) published a seminal monograph on the pathology and treatment of sarcoma.Ewing was one of the first to list benign and malignant counterparts of tumors arising in soft tissues.Celsus (25 BC to AD 50), a native of Greece practicing in Rome, separated benign tumors, eg, lipoma, from malignant growths, cancer. Galen (AD 131–200), another Greek physician who settled in Rome, described sarcoma as ‘‘fleshy excrescence’’ having the appearance of raw meat ‘‘sarkos.’’ Under the term of sarcoma, he combined swellings, benign tumors, as well as undefined tumors, such as ‘‘fungus.’’1 With regard to treatment, Celsus, Galen, and most physicians and surgeons for centuries advised refraining from the surgical excision of tumors, including sarcomas, that were irregular in shape, livid in color, insensible, ulcerated, or could not be moved with fingers. Theodoric of Salerno (1205–1296), a priest physician, noted that lipomatous tumors that were dark in color and firm to touch were cancerous, and treatment was not appropriate for such lesions. A French surgeon, Guy de Chauliac (1300–1368), who was the physician to 3 Popes in Avignon, held a different view. He recommended wide excision for cancer at an early stage when the cancer was small and superficial.2 Progress in medicine was hindered until the end of the 1600s by Galen’s humoral theory, insufficient knowledge of anatomy, and lack of microscopy. Microscopic study of connective tissue was inaugurated by the description and illustration of voluntary muscle, in 1721, by the Dutch Leeuwenhoek (1632–1723). Etmullerus (1644– 1683) in his book,3 which was published posthumously in 1712, urged the readers to study tumor through the microscope and gave the first description of a tumor originating from the membranes of the knee joint. He indicated that, for the most part, such lesions were very dangerous because of their tendency to become cancer (Fig. 1). By the end of the 1700s, it was accepted that cancers, including sarcomas, should be treated by surgery. John Hunter (1728–1793), the famous English surgeon, proposed that cancers, including sarcomas, should be excised with some of the surrounding substance (tissue). This was the first recommendation that malignant tumors should be removed with clear surgical margins. It seems that, although surgeons advanced the treatment of cancers, progress in understanding the composition of tumors was lacking.

Historical Perspective

    • Soft tissue sarcoma derived their name from the Greek term for a fleshy lump. [1]
    • Around 460 B.C, Hippocrates recognized soft tissue tumors in the arm and thigh in older people and recommended the removal by knife as therapy. [2]
    • Around 200 C.E., a greek physician named Galen suggested that these lumps were cancerous tumors.[3]
    • In 1809, an Edinburg surgeon, Wardrop describes the first illustration of amputation and used the term "soft cancer".[4]
    • In 1816, Charles Bell, used the term soft tissue sarcoma to differentiate it form carcinoma.[5]
    • In 1804, Abernethy describes the first classification of the sarcoma.[6]
    • In 1932, Stout published a litreature on the pathology and treatment of sarcoma.[7]
    • In 1982, Rosenberg evaluated limb-sparing surgery with adjuvant radiotherapy compared with major amputation.[8]


References

  1. Hajdu, Steven I. (2007). "Soft tissue sarcomas". Cancer. 109 (9): 1697–1704. doi:10.1002/cncr.22608. ISSN 0008-543X.
  2. Hajdu, Steven I. (2007). "Soft tissue sarcomas". Cancer. 109 (9): 1697–1704. doi:10.1002/cncr.22608. ISSN 0008-543X.
  3. Hajdu, Steven I. (2007). "Soft tissue sarcomas". Cancer. 109 (9): 1697–1704. doi:10.1002/cncr.22608. ISSN 0008-543X.
  4. Erstad, Derek J.; Raut, Chandrajit P. (2017). "Amputation for Sarcoma: Revisiting a 19th Century Treatment in the 21st Century". Annals of Surgical Oncology. 25 (2): 351–353. doi:10.1245/s10434-017-6243-2. ISSN 1068-9265.
  5. Hajdu, Steven I. (2007). "Soft tissue sarcomas". Cancer. 109 (9): 1697–1704. doi:10.1002/cncr.22608. ISSN 0008-543X.
  6. Hajdu, Steven I. (2007). "Soft tissue sarcomas". Cancer. 109 (9): 1697–1704. doi:10.1002/cncr.22608. ISSN 0008-543X.
  7. Hajdu, Steven I. (2007). "Soft tissue sarcomas". Cancer. 109 (9): 1697–1704. doi:10.1002/cncr.22608. ISSN 0008-543X.
  8. Rosenberg SA, Tepper J, Glatstein E, Costa J, Baker A, Brennan M, DeMoss EV, Seipp C, Sindelar WF, Sugarbaker P, Wesley R (September 1982). "The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy". Ann. Surg. 196 (3): 305–15. PMC 1352604. PMID 7114936.

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