RESUMO
This case study presents a 66-year-old man referred to the Otolaryngology and Head and Neck Surgery department due to a one-history of persistent pain in the left posterior cervical region. No abnormalities were detected in the oral and pharyngeal regions during clinical and endoscopic examinations. Subsequently, a magnetic resonance imaging revealed a lesion (14 × 12 × 14 mm) into the left parapharyngeal space, with high signal intensity on T2-weighted images, enhancement after contrast medium, restricted signal on diffusion weighted imaging and high vascularization on perfusion MRI. The histological examination of the lesion led to a diagnosis of myopericitoma. Post-surgery, no adjuvant therapy was administered. Myopericytomas are rare soft-tissue benign neoplasms, predominantly reported in extremities, with a limited number of cases in the head and neck region and almost never described in the literature with elective localization in the parapharyngeal space.
Assuntos
Imageamento por Ressonância Magnética , Miopericitoma , Espaço Parafaríngeo , Neoplasias Faríngeas , Humanos , Masculino , Idoso , Neoplasias Faríngeas/diagnóstico por imagem , Neoplasias Faríngeas/cirurgia , Neoplasias Faríngeas/patologia , Espaço Parafaríngeo/diagnóstico por imagem , Espaço Parafaríngeo/cirurgia , Espaço Parafaríngeo/patologia , Miopericitoma/diagnóstico por imagem , Miopericitoma/patologia , Miopericitoma/cirurgia , Meios de Contraste , Diagnóstico DiferencialRESUMO
RATIONALE: Myopericytoma of the parotid gland is a rare condition of which preoperative definitive diagnosis is relatively challenging. The purpose of this case report is to highlight the radiologic features of myopericytoma of parotid gland. PATIENT CONCERNS: A 62-year-old man presented with a history of a walnut-size mass in left parotid gland when yawned for half-month, and a 48-year-old woman complaint about a grape-size, painless mass behind the right ear for a month. DIAGNOSES: Radiological examinations suggested that both lesions were cyst-solid mixed lesions with relatively smoothed margins, with or without significant enhancement while the lesion without enhancement had a hemorrhage. Then a diagnosis of benign tumor arising from the parotid gland was made. Final diagnosis of myopericytoma was confirmed by histopathological and immunohistochemical examinations after surgical resection. INTERVENTIONS: Both patients underwent excision of the tumor and the superficial parotidectomy with facial nerve preservation. OUTCOMES: Both patients recovered without any intraoperative or postoperative complication and had no signs of recurrence during a 17-month and 5-year follow-up. LESSONS: Parotid gland myopericytoma is an exceedingly rare tumor which diagnosis can be challenging, and this is the first published report specifying the magnetic resonance features of the disease.
Assuntos
Imageamento por Ressonância Magnética , Miopericitoma/diagnóstico por imagem , Neoplasias Parotídeas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopericitoma/patologia , Miopericitoma/cirurgia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/cirurgiaRESUMO
Two cases of myopericytosis combined with pericytoma originating within the lung are reported. These are rare pulmonary tumors. The differential diagnosis for hemangiopericytoma and pericytic tumors with glomus elements is discussed. Both myopericytic lesions mimic other lesions, which are more commonly seen in the lung. Based on the expression of vascular growth factor receptors 2 and 3, an antiangiogenic therapy was suggested for the patient with the myopericytoma. A treatment with an angiogenesis inhibitor resulted in a regression of the tumor, but not the precursor lesion. Probably a more specific therapy using tyrosine kinase inhibitors for VEGFR2/3 might better control these myopericytic proliferations.
Assuntos
Neoplasias Pulmonares/patologia , Pulmão/patologia , Miopericitoma/patologia , Pericitos/patologia , Lesões Pré-Cancerosas/patologia , Adulto , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/uso terapêutico , Biomarcadores Tumorais/análise , Feminino , Humanos , Pulmão/química , Pulmão/diagnóstico por imagem , Pulmão/efeitos dos fármacos , Neoplasias Pulmonares/química , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Miopericitoma/química , Miopericitoma/diagnóstico por imagem , Miopericitoma/tratamento farmacológico , Pericitos/química , Pericitos/efeitos dos fármacos , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/tratamento farmacológico , Lesões Pré-Cancerosas/metabolismo , Resultado do Tratamento , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/análise , Receptor 3 de Fatores de Crescimento do Endotélio Vascular/análiseRESUMO
Myopericytoma is a rare soft tissue tumor found in the subcutaneous and superficial soft tissues in the extremities. The present study reports a unique case of myopericytomas found in the first and second toes of a patient. The masses were surgically excised, and on pathologic and immunohistochemical examination, the diagnosis of myopericytoma was made. At the follow-up visit, the patient had no recurrence of the soft tissue tumor.
Assuntos
Doenças do Pé , Miopericitoma , Feminino , Doenças do Pé/diagnóstico por imagem , Doenças do Pé/patologia , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Miopericitoma/diagnóstico por imagem , Miopericitoma/patologia , Dedos do Pé/diagnóstico por imagemRESUMO
A previously healthy 46-year-old woman presented with a mass lesion between the bases of the fourth and fifth fingers of the right hand. The mass had grown progressively over 2 years and started to cause practical difficulties in everyday life. Imaging depicted a hypervascular and well-circumscribed soft tissue tumor with imaging characteristics of a sarcoma. The lesion was treated surgically. The final diagnosis of the specimen upon pathology was a myopericytoma, a benign smooth-muscle cell neoplasm. Myopericytoma is a rare disease entity; however, it is important because it can mimic more ominous conditions.
Assuntos
Dedos/cirurgia , Miopericitoma/patologia , Neoplasias de Tecidos Moles/patologia , Feminino , Dedos/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Miopericitoma/diagnóstico por imagem , Miopericitoma/cirurgia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/cirurgiaRESUMO
Rheumatoid Arthritis can present with consistent pain over peripheral joints. The manner of presentation of a subcutaneous tumour such as Myopericytoma may be very similar to that of an inflamed joint leading to the high frequency of it being overlooked and inadequately treated. Knowing the radiological and pathological differences will direct us in the right road to timely and adequate treatment.