RESUMO
OBJECTIVE: Elastofibroma dorsi (ED) is a rare benign tumor located in the subscapular region. The aim of this study was to evaluate our clinical findings, surgical approach, and management of ED patients based on single-center data with the relevant literature. METHODOLOGY: A retrospective evaluation was conducted on 20 patients who were operated on for ED. RESULTS: Of the 16 (80%) female patients and 4 (20%) male patients, the main complaint was swelling (80%), and 10 cases (50%) had unilateral involvement. All patients were operated on using standard surgical procedures. Despite a long follow-up period (6-53 months, mean of 26.6 months), no recurrences were observed. Two patients (10%) required simple needle aspiration due to post-operative seroma, and one patient, due to infection, required evacuation (5%). CONCLUSION: Although rare, ED should not be overlooked in patients with swelling in the back region. Our data suggests that surgery can be safely performed in such patients after a clinical and radiological diagnosis of ED has been established.
OBJETIVO: Evaluar los hallazgos clínicos, el enfoque quirúrgico y el manejo de los pacientes con urgencias a partir de los datos de un solo centro y la literatura relevante. MÉTODO: Se realizó una evaluación retrospectiva de 20 pacientes que fueron operados de ED. RESULTADOS: En los 16 (80%), pacientes del sexo femenino y cuatro (20%) del sexo masculino, la queja principal fue la tumefacción (80%) y 10 casos (50%) tuvieron afectación unilateral. Todos los pacientes fueron operados utilizando procedimientos quirúrgicos estándar. Con un largo periodo de seguimiento (6-53 meses, media de 26.6 meses), no se observaron recurrencias. Dos pacientes (10%) requirieron aspiración con aguja simple por seroma posoperatorio y un paciente (5%) requirió evacuación por infección. CONCLUSIONES: Aunque es raro, el ED no debe pasarse por alto en pacientes con hinchazón en la región de la espalda. Nuestros datos sugieren que la cirugía se puede realizar de manera segura en estos pacientes después de haber establecido el diagnóstico clínico y radiológico de ED.
Assuntos
Fibroma , Neoplasias de Tecidos Moles , Humanos , Masculino , Feminino , Estudos Retrospectivos , Fibroma/cirurgia , Fibroma/diagnóstico por imagem , Fibroma/patologia , Pessoa de Meia-Idade , Adulto , Idoso , Neoplasias de Tecidos Moles/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Seroma/etiologiaAssuntos
Fibroelastoma Papilar Cardíaco , Humanos , Fibroelastoma Papilar Cardíaco/cirurgia , Fibroelastoma Papilar Cardíaco/patologia , Fibroelastoma Papilar Cardíaco/diagnóstico por imagem , Fibroelastoma Papilar Cardíaco/diagnóstico , Feminino , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/patologia , Masculino , Fibroma/cirurgia , Fibroma/patologia , AdultoRESUMO
Surgical treatment of chondromyxoid fibroma of ribs is described. The diagnosis was verified after histological analysis. The patient underwent resection of multinodular tumor of anterolateral thoracic wall invading abdominal cavity via thoracoabdominal access. Postoperative period was uneventful. This case demonstrates the need for total en-bloc resection of tumor with surrounding tissues. Surgery is the only effective method for these patients.
Assuntos
Neoplasias Ósseas , Fibroma , Costelas , Humanos , Costelas/cirurgia , Fibroma/cirurgia , Fibroma/diagnóstico , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/patologia , Resultado do Tratamento , Masculino , Parede Torácica/cirurgia , Feminino , Tomografia Computadorizada por Raios X/métodos , Adulto , Toracotomia/métodosAssuntos
Fibroma , Humanos , Fibroma/cirurgia , Lactente , Dedos/cirurgia , Feminino , Masculino , Dedos do PéRESUMO
The clinical differences between odontogenic myxoma (OM) and odontogenic myxofibroma (OMF), and the clinical significance of their classifications, remain unclear. This study reviewed the clinicopathological characteristics of patients with OM or OMF and evaluated the fibrous component of the specimens. Medical records of 21 patients with OM or OMF who underwent tumour resection were reviewed. The percentage of fibrous tissue on the representative sections was evaluated using haematoxylin and eosin- and Masson's trichrome-stained specimens. Histopathological diagnoses included 11 OMs and 10 OMFs with no tumour recurrence except for two cases in which the dredging method was applied. More cortical bone perforation was observed in OM than in OMF cases, without significant differences. Location-locularity and apparent diffusion coefficient value (ADC)-cortical bone perforation were significantly correlated in all OM and OMF cases. The percentage of fibrous tissue in specimens showed bimodal distribution bordered by 45%. There was a significant association between diagnosis based on 45% fibrous tissue criterion and the final pathological diagnosis. Our study showed a tendency for cortical bone perforation in OM compared to OMF and correlation between ADC and cortical bone perforation. According to the histopathological analyses, the fibrous component of each case was bimodal with 45%, which may be a criterion to distinguish between OM and OMF. Accumulating knowledge, such as significant differences in prognosis, may allow for minimal surgical treatment options based on the diagnosis according to this novel histopathological criterion.
Assuntos
Fibroma , Mixoma , Tumores Odontogênicos , Humanos , Tumores Odontogênicos/patologia , Tumores Odontogênicos/cirurgia , Feminino , Masculino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Mixoma/patologia , Mixoma/cirurgia , Fibroma/patologia , Fibroma/cirurgia , Idoso , Adolescente , Adulto Jovem , Diagnóstico DiferencialRESUMO
OBJECTIVES: This study aimed to review a 35-year experience with chondromyxoid fibroma at our institution. PATIENTS AND METHODS: The study retrospectively analyzed the records of 31 consecutive patients (17 males, 14 females; mean age: 30.5±15.7 years; range, 6 to 63 years) with chondromyxoid fibroma who were treated between January 1988 and December 2021. The clinical and radiological characteristics of lesions, tumor volume, and recurrence rates were assessed using the tumor archive of the hospital. RESULTS: The mean follow-up duration was 65.9±42.0 months. Pelvis, proximal tibia, and distal femur were the most common sites of localization. The initial surgical treatment was performed on 27 patients at our clinic, while four patients were referred to the clinic after recurrence. The overall recurrence rate was 16.1%. Intralesional curettage was applied to 21 (77.8%) out of 27 patients. The cavity created after curettage was filled with bone graft (autograft or allograft) in 15 (55.5%) cases. Bone cement was applied in four (14.8%) cases. Resection was applied to five (18.5%) patients. In two (7.4%) cases, intralesional curettage alone was performed. One of these two patients experienced recurrence, resulting in a recurrence rate of 50% in this patient group. No recurrence was observed in other treatment groups. CONCLUSION: Intralesional curettage and filling the defect with bone graft or cement were effective for local control in most cases. Curettage alone was associated with high recurrence rates.
Assuntos
Neoplasias Ósseas , Curetagem , Fibroma , Recidiva Local de Neoplasia , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Adolescente , Pessoa de Meia-Idade , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/patologia , Neoplasias Ósseas/diagnóstico por imagem , Adulto Jovem , Criança , Fibroma/cirurgia , Fibroma/patologia , Curetagem/métodos , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/patologia , Transplante Ósseo/métodos , Cimentos Ósseos/uso terapêuticoRESUMO
A 35-year-old patient presented with a painless, broad-based exophytic lesion in the buccal interdental region between teeth 13 and 14. Despite oral hygiene efforts the lesion persisted for around one year. Radiology excluded bone involvement, and histopathology after excision confirmed a fibromatous epulis, which is characterized by collagen-rich connective tissue. There was no recurrence within one-year follow-up. Surgical removal proved to be efficient.
Assuntos
Neoplasias Gengivais , Adulto , Humanos , Diagnóstico Diferencial , Fibroma/cirurgia , Fibroma/patologia , Fibroma/diagnóstico , Neoplasias Gengivais/cirurgia , Neoplasias Gengivais/patologia , Neoplasias Gengivais/diagnósticoAssuntos
Carcinoma de Células Renais , Neoplasias Renais , Humanos , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/cirurgia , Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Neoplasias Renais/diagnóstico por imagem , Masculino , Fibroma/patologia , Fibroma/cirurgia , Fibroma/diagnóstico por imagem , Nefrectomia/métodos , Pessoa de Meia-Idade , FemininoAssuntos
Fibroma , Períneo , Teratoma , Humanos , Teratoma/cirurgia , Teratoma/diagnóstico por imagem , Teratoma/patologia , Teratoma/diagnóstico , Fibroma/patologia , Fibroma/cirurgia , Fibroma/diagnóstico por imagem , Períneo/patologia , Recém-Nascido , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgia , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico por imagem , Feminino , MasculinoAssuntos
Fibroelastoma Papilar Cardíaco , Feminino , Humanos , Fibroelastoma Papilar Cardíaco/diagnóstico por imagem , Fibroelastoma Papilar Cardíaco/cirurgia , Fibroelastoma Papilar Cardíaco/diagnóstico , Fibroelastoma Papilar Cardíaco/patologia , Fibroma/cirurgia , Fibroma/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/patologia , IdosoRESUMO
INTRODUCTION: Ischaemic stroke results from a sudden interruption of cerebral blood flow, often caused by thrombosis, embolism or hypoperfusion. Rarely, cardiac tumours are the cause of an embolic event. We report on an 80-year-old woman with a cerebral stroke. Successful thrombectomy revealed a histopathologically confirmed papillary fibroelastoma as the embolic source. Although it was not detectable on initial echocardiography, the tumour was discovered by transesophageal echocardiography. This case emphasises the importance of considering primary cardiac tumours as potential sources of emboli in ischaemic stroke. Keywords.
Assuntos
Ecocardiografia Transesofagiana , Neoplasias Cardíacas , Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/patologia , Diagnóstico Diferencial , Trombectomia , AVC Isquêmico/diagnóstico por imagem , AVC Isquêmico/etiologia , AVC Isquêmico/cirurgia , Fibroma/cirurgia , Fibroma/diagnóstico por imagem , Fibroma/patologiaRESUMO
Cardiac papillary fibroelastomas (CPFs) are rare benign cardiac tumors more often involving the left-sided valves and related with threatening embolic complications. We report the case of a 35-year-old woman presenting with relapsing-remitting chest pain and elevated cardiac troponins. After a negative coronary angiography, an integrated imaging assessment based on echocardiography and cardiac magnetic resonance showed a pedunculated mass on the aortic valve causing an intermittent obstructive engagement of the right coronary ostium. A tailored surgical treatment was performed and the histopathological examination of the specimen revealed mesenchymal tissue with the characteristics of CPF.
Assuntos
Valva Aórtica , Fibroelastoma Papilar Cardíaco , Neoplasias Cardíacas , Infarto do Miocárdio , Humanos , Feminino , Adulto , Valva Aórtica/cirurgia , Valva Aórtica/patologia , Valva Aórtica/diagnóstico por imagem , Neoplasias Cardíacas/patologia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Fibroelastoma Papilar Cardíaco/cirurgia , Fibroelastoma Papilar Cardíaco/patologia , Fibroelastoma Papilar Cardíaco/complicações , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/patologia , Resultado do Tratamento , Angiografia Coronária , Vasos Coronários/patologia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Biópsia , Fibroma/patologia , Fibroma/cirurgia , Fibroma/complicaçõesRESUMO
A patient without a diagnosis of diabetes mellitus presented to the hospital due to a fall and hypoglycaemia on admission. The patient was found to have recurrent nocturnal fasting hypoglycaemia. CT revealed a large lung mass consistent with a solitary pleural fibroma, a rare tumour associated with insulin-like growth factor 2 (IGF-2) production. This case is an important reminder that potential causes of hypoglycaemia should be considered in non-diabetic patients.
Assuntos
Fibroma , Hipoglicemia , Neoplasias Pleurais , Tumor Fibroso Solitário Pleural , Humanos , Fator de Crescimento Insulin-Like II/metabolismo , Neoplasias Pleurais/diagnóstico , Tumor Fibroso Solitário Pleural/complicações , Tumor Fibroso Solitário Pleural/diagnóstico por imagem , Tumor Fibroso Solitário Pleural/cirurgia , Hipoglicemia/diagnóstico , Fibroma/complicações , Fibroma/diagnóstico por imagem , Fibroma/cirurgiaRESUMO
OBJECTIVE: Central odontogenic fibromas (COF) are rare, benign tumors derived from dental mesenchymal tissue that may occur in the maxilla or mandible. This report describes primary and recurrent COF in the mandible of a patient with nevoid basal cell carcinoma syndrome (NBCCS). STUDY DESIGN: A 36-year-old African American male presented with a COF and its recurrence 17 months later. Tissue pieces were obtained from both occurrences with IRB-approved signed consent. Collected tissue pieces were dissected; one portion was formalin-fixed and paraffin-embedded, and the other was cultured for the isolation of cell populations from the primary (COdF-1) and recurrent (COdF-1a) tumors. Quantification real-time polymerase chain reaction (qRT-PCR), immunohistochemistry, and DNA sequencing were used for gene and protein analysis of the primary tumor and cell populations. RESULTS: Histopathologic analysis of the tumor showed sparse odontogenic epithelial cords in fibrous connective tissue, and qRT-PCR analysis of tumor and cell populations (COdF-1 and COdF-1a) detected VIM, CK14, CD34, CD99 and ALPL mRNA expression. Protein expression was confirmed by immunohistochemistry. CD34 expression in primary tissues was higher than in tumor cells due to tumor vascularization. DNA sequencing indicated the patient had PTCH1 mutations. CONCLUSIONS: Histopathology, mRNA, and protein expression indicate the rare occurrence of COF in a patient with mutated PTCH1 gene and NBCCS.
Assuntos
Síndrome do Nevo Basocelular , Fibroma , Recidiva Local de Neoplasia , Tumores Odontogênicos , Humanos , Masculino , Síndrome do Nevo Basocelular/genética , Síndrome do Nevo Basocelular/patologia , Tumores Odontogênicos/patologia , Tumores Odontogênicos/genética , Tumores Odontogênicos/cirurgia , Adulto , Recidiva Local de Neoplasia/patologia , Fibroma/patologia , Fibroma/genética , Fibroma/cirurgia , Imuno-Histoquímica , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/genética , Neoplasias Mandibulares/cirurgia , Reação em Cadeia da Polimerase em Tempo Real , Técnicas In VitroRESUMO
Pediatric fibromyxoid soft tissue tumors may be associated with gene fusions such as YHWAZ::PLAG1, with only three reported cases in the literature. We present the fourth case, a 13-year-old male with a pediatric fibromyxoid brachial plexus tumor with YWHAZ::PLAG1 gene fusion. This is also the first case to be reported in an adolescent, in the brachial plexus, and in the Philippines. The patient presented with a 10-year history of a slowly growing left supraclavicular mass and a 1-year history of intermittent dysesthesia in the left upper extremity. Neurologic examination was unremarkable. Imaging revealed a large left supraclavicular lesion with intrathoracic extension. Surgical excision was performed, and histopathology revealed a fibromyxoid tumor with YWHAZ::PLAG1 gene fusion. Although previous examples of this gene fusion pointed toward lipoblastoma as their primary pathology, our tumor does not completely fulfill the current diagnostic criteria for a lipoblastoma and may represent an intermediate form of the disease. Our case is unique not only because it is the first reported adolescent patient harboring such a lesion but also because of the relatively lengthy natural history exhibited by the tumor prior to its resection. This provided us with valuable information about its behavior, which suggests a more indolent growth pattern. This case also highlights the clinical importance of molecular testing of tumors, where recognition of disease entities can assist clinicians in deciding and advocating for the proper management.
Assuntos
Plexo Braquial , Humanos , Masculino , Adolescente , Plexo Braquial/cirurgia , Fusão Gênica/genética , Proteínas 14-3-3/genética , Fibroma/genética , Fibroma/cirurgia , Neoplasias do Sistema Nervoso Periférico/genética , Neoplasias do Sistema Nervoso Periférico/cirurgia , Neoplasias do Sistema Nervoso Periférico/patologia , Proteínas de Ligação a DNA/genética , Neoplasias de Tecidos Moles/genética , Neoplasias de Tecidos Moles/cirurgia , Neoplasias de Tecidos Moles/patologiaRESUMO
We experienced a case of papillary fibroelastoma of aortic valve, which had been located for preoperative 12 years without any symptom. We could assess tumor growth rate of 0.17 mm/year. Because of recent reports of recurrence, close follow-up should be continued.
Assuntos
Fibroelastoma Papilar Cardíaco , Fibroma , Neoplasias Cardíacas , Humanos , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Fibroelastoma Papilar Cardíaco/patologia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Fibroma/diagnóstico por imagem , Fibroma/cirurgiaRESUMO
The plexiform fibromyxoma is a rare mesenchymal tumor in adults that generally originates in the antrum of stomach, being its occurrence in pediatric patients exceptional. It was classified as a distinct entity by World Health Organization in 2010. No recurrences and metastases have been documented in many of the reported patients to date, being the surgical treatment curative. We report the case of a 3-month-old infant who presented to the emergency department with an episode of intestinal subocclusion requiring an emergent surgery. During the surgical intervention, a mass was identified in the jejunum, causing partial occlusion of its lumen. The surgical pathology report revealed an infiltrative tumor composed of spindle-shaped cells disposed in a stroma with a plexiform pattern alternating myxoid areas. These findings and the immunohistochemical characteristics of the neoplastic cells led to classify the tumor as a plexiform fibromyxoma. A description of the immunophenotype of this tumor is made and differential diagnosis with other gastrointestinal tumors is also discussed.