Fibroma mole gigante vulvar: relato de caso / Giant soft vulvar fibroma: case report

Fibroma mole, ou pólipo fibroepitelial, é uma lesão de proporções geralmente reduzidas, de cor hiperpigmentada ou igual à da pele, localizando-se frequentemente na face, pescoço, tronco e regiões intertriginosas. É um tumor classificado como benigno e pode acometer tanto homens quanto mulheres em idade reprodutiva e depois da quarta década de vida. Ocorre principalmente em obesos, diabéticos e durante a gestação. Com menor frequência, podem alcançar dimensões que excedem 5 cm. Seu crescimento pode ser lento ou rápido e comumente são assintomáticos, mas podem promover sangramentos por conta de ulcerações decorrentes de traumas repetidos. Apresentamos neste relato um fibroma mole, gigante, de localização vulvar, com 11 cm de comprimento, 11 cm de largura e 5 cm de espessura, pesando 500 g.

Giant soft vulvar fibroma is a fibroepithelial polyp lesion with generally reduced proportions, with a hyperpigmented color or similar to that of the skin, frequently located on the face, neck, trunk and intertriginous regions. It is a tumor classified as benign, can affect both men and women, of reproductive age and after the fourth decade, mainly obese, diabetic and during pregnancy. However, less frequently, they can reach dimensions that exceed 5 cm, may have a slow or accelerated evolution. They are commonly asymptomatic, but bleeding may be present due to ulcerations resulting from repeated trauma. In the current study, we describe a giant soft fibroma with a vulvar location measuring 11 cm in length, 11 cm in width, 5 cm in thickness and weighing 500 grams.

Hiperplasia fibroepitelial mamária em um gato macho: relato de caso / Mammary fibroepithelial hyperplasia in a male cat: case report

As neoplasias mamárias representam a terceira neoplasia mais comum em gatas, enquanto nos machos a incidência é rara. Esse trabalho relata o caso de um gato macho, não castrado, atendido no Hospital Veterinário da Universidade Estadual do Ceará, com uma neoformação mamária. O diagnóstico inicial, obtido por meio de punção aspirativa por agulha fina, sugeriu a presença de carcinoma mamário. Exames de imagem como a radiografia torácica e a ultrassonografia abdominal não evidenciaram a presença de metástase no parênquima pulmonar e nos órgãos abdominais, respectivamente. O tratamento instituído foi a remoção cirúrgica da neoformação, pela técnica de mastectomia parcial bilateral. O exame histopatológico da massa evidenciou uma hiperplasia fibroepitelial. Diante disso, conclui-se que, apesar de raras, as neoformações mamárias em gatos do sexo masculino podem ocorrer, devendo, dessa forma, compor parte da lista de diagnósticos diferenciais para aumentos de volume na região ventral desses animais.(AU)

Mammary neoplasms represent the third most common neoplasm in queens, while in tomcats the incidence is rare. This study reports the case of a tomcat, not neutered, treated at the Veterinary Hospital of the State University of Ceará, with a mammary neoformation. The initial diagnosis, obtained through aspiration cytology, suggested the presence of mammary carcinoma. Imaging tests such as thoracic radiography and abdominal ultrasound, did not show the presence of metastasis in the lung parenchyma and abdominal organs, respectively. The chosen treatment was the surgical removal of the neoformation, using the bilateral partial mastectomy technique. Histopathological examination of the mass showed a mammary fibroepithelial hyperplasia. Therefore, it is concluded that, although rare, mammary neoformations in male cats can occur, thus, it should be part of the list of differential diagnoses for increases in volume in the ventral region of these animals.(AU)

Pólipo fibroepitelial atípico em córnea de um cão Lhasa Apso / Atypical fibroepithelial polyp in the cornea of a Lhasa Apso dog

Background: Fibroepithelial polyps are benign tumors of mesenchymal and ectodermal origin. Regarding the localization related to the cutaneous region, they may affect the eyelid and periocular area. In veterinary medicine, polyps located in the urethra of dogs and monkeys, vagina of bitches and on the skin have been described. Fibroepithelial polyps may present as single to multiple nodules, exophytic to pedunculated, usually arising on a smooth surface of a common base. The aim of this paper is to describe the ocular and histopathological changes of a corneal fibroepithelial polyp of recurrent character in a dog. Case: A 20-year-old Lhasa Apso dog, with a history of progressive corneal neoformation in the right eye for 4 months. Patient was submitted to routine ophthalmic evaluation. At biomicroscopy, a discrete mucopurulent discharge was observed in the nasal corner, a nodule in the lower eyelid (± 3 mm), moderate conjunctival hyperemia, vascularization and corneal edema between 12 and 5 h, presence of a pinkish proliferative mass in 3 h, affecting the anterior stroma and opacity of the lens, Schirmer's Tear Test (STT) 20 mm/min and intraocular pressure (IOP) 10 mm/Hg. In the left eye, the STT and IOP were within normal range (17 mm/min and 11 mg/Hg, respectively) and at biomicroscopy only lens opacity was observed. Given the presence of the neoformation in the cornea, the patient underwent lamellar keratectomy to excise the mass and third eyelid flap. The tissue was then submitted to histopathology. The histopathological examination showed a proliferation of fibrous component with areas presenting reactive fibroblasts, with acidophilic cytoplasm and with little volume and slight neovascularization, presence of hyperplasia of the lining epithelium and cells with round to oval nuclei, with inconspicuous nucleoli, compatible with fibroepithelial polyp, without evidence of malignancy. After 18 months, the patient presented recurrence of the condition with a history of slow evolution (about ten months). The ophthalmic evaluation showed lesions very similar to the initial one, describing a recurrence of the lesion. Discussion: Corneal neoplasms are uncommon in dogs. The clinical findings in patients with ocular neoplasms include irregular to nodular masses, gray to reddish in color, and typically associated with a vascular supply. These features are related to the type of tumor and its degree of evolution. There are reports in the literature of ocular neoplasms such as squamous cell carcinoma, papilloma, melanocytoma, fibrosarcoma, hemangiosarcoma, melanoma, lymphoma. Related to fibroepithelial polyp with ocular involvement, there are rare reports in human literature and none in veterinary medicine. There is a human description of the presence of a polyp affecting the cornea associated with a corneal dermoid and e other cases of polyps of conjunctival origin. As far as treatment is concerned, the polyp should be surgically removed because of the possibility of recurrence, tissue metaplasia, or even transformation into a malignant tumor, as seen in the case reported here, in which even with surgical removal there was recurrence and metaplasia of the cells. Based on the histopathological findings, it can be concluded that this is a fibroepithelial polyp with a recidivating characteristic, not well described in the veterinary literature, with an atypical presentation affecting the cornea.

Core needle biopsy in fibroepithelial tumors: predicting factors for phyllodes tumors.

OBJECTIVES: This study aimed to evaluate the clinical and imaging predictive factors for the diagnosis of phyllodes tumors in patients with inconclusive results from core needle biopsy (fibroepithelial lesions). METHODS: We retrospectively analyzed data of patients who underwent surgical excision of breast lesions previously diagnosed as fibroepithelial lesions. Numeric variables were analyzed using the Shapiro-Wilk and t-tests, and categorical variables were analyzed using the chi-square and Fisher's exact tests. Multivariate logistic regression was performed to calculate odds ratios and detect predictive factors for the diagnosis of PT. RESULTS: A total of 89 biopsy samples were obtained from 77 patients, of which 43 were confirmed as fibroadenomas, 43 as phyllodes tumors, and 3 as other benign, non-fibroepithelial breast lesions. The mean tumor size was 3.61 cm (range, 0.8-10 cm) for phyllodes tumors and 2.4 cm (range, 0.8-7.9 cm) for fibroadenomas. The predictive factor for phyllodes tumor diagnosis was lesion size >3 cm (p<0.001). CONCLUSION: Our data indicate that fibroepithelial lesions of the breast larger than 3 cm are more likely to be phyllodes tumors.

Core needle biopsy in fibroepithelial tumors: predicting factors for phyllodes tumors

OBJECTIVES: This study aimed to evaluate the clinical and imaging predictive factors for the diagnosis of phyllodes tumors in patients with inconclusive results from core needle biopsy (fibroepithelial lesions). METHODS: We retrospectively analyzed data of patients who underwent surgical excision of breast lesions previously diagnosed as fibroepithelial lesions. Numeric variables were analyzed using the Shapiro-Wilk and t-tests, and categorical variables were analyzed using the chi-square and Fisher's exact tests. Multivariate logistic regression was performed to calculate odds ratios and detect predictive factors for the diagnosis of PT. RESULTS: A total of 89 biopsy samples were obtained from 77 patients, of which 43 were confirmed as fibroadenomas, 43 as phyllodes tumors, and 3 as other benign, non-fibroepithelial breast lesions. The mean tumor size was 3.61 cm (range, 0.8-10 cm) for phyllodes tumors and 2.4 cm (range, 0.8-7.9 cm) for fibroadenomas. The predictive factor for phyllodes tumor diagnosis was lesion size >3 cm (p<0.001). CONCLUSION: Our data indicate that fibroepithelial lesions of the breast larger than 3 cm are more likely to be phyllodes tumors.

Tumor Phyllodes: revision de la literatura / Phyllodes tumor: literature review

Resumen El tumor phyllodes de mama es un tumor fibroepitelial raro, pero clínicamente importante, que representa menos del 1% de las neoplasias de mama. Histológicamente, los tumores phyllodes se clasifican en tres; como: benignos, limítrofes o malignos, basándose en una combinación de criterios histológicos y patológicos. Esta clasificación del tumor phyllodes de mama es precisamente relevante en su clínica. Si bien la recurrencia local del tumor phyllodes puede ocurrir en todos los grados, la metástasis se limita principalmente a casos malignos y pocos casos limítrofes, por lo general siendo estos dos últimos los que presentan un peor pronóstico de la enfermedad. El tratamiento es principalmente quirúrgico ya que los tumor phyllodes no responden bien a la terapia sistémica. Esta revisión del tumor phyllodes de mama permite orientar a toda la comunidad médica, con base en la evidencia más reciente, a diagnosticar y así poder manejar esta patología, evitando sus complicaciones.

Abstract Phyllodes tumor of the breast is a rare, but clinically important fibroepithelial tumor, accounting for <1% of breast tumors. Histologically, phyllodes tumor is classified into three; as: benign, borderline or malignant, based on a combination of histological and pathological criteria. This classification of the phyllodes breast tumor is precisely relevant in the clinic. While local recurrence of phyllodes tumor may occur in all grades, metastasis is mostly limited to malignant and few borderline cases, usually the latter two types having a worse prognosis of the disease. Treatment is mainly surgical as phyllodes tumor doesn´t respond well to systemic therapy. This review of the phyllodes tumor allows to guide the entire medical community based on the most recent evidence to diagnose and thus be able to manage this pathology, avoiding its complications.

Atypical presentation of fibroepithelial polyp: a report of two cases / Apresentação atípica de pólipo fibroepitelial: um relato de dois casos

ABSTRACT Fibroepithelial polyps are benign non-epithelial tumors arising from mesodermal tissue and are commonly found on the skin. They can develop on the eyelid and surrounding area and rarely appear at other sites. While most cutaneous cases are diagnosed incidentally, the lesions may be symptomatic based on their location. The etiology of fibroepithelial polyps is not fully understood but may involve trauma, chronic irritation, allergic factors, and developmental or congenital causes. Although fibroepithelial polyps are benign lesions, they can be malignant in extremely rare cases. Herein we discuss 2 cases of fibroepithelial polyp with an atypical presentation and their treatment.

RESUMO Pólipos fibroepiteliais são tumores benignos não-epiteliais que surgem do tecido mesodérmico e são comumente encontrados na pele. Eles podem se desenvolver na pálpebra e na área adjacente, e raramente aparecem em outros locais. Embora a maioria dos casos cutâneos seja diagnosticada incidentalmente, as lesões podem ser sintomáticas com base em sua localização. A etiologia dos pólipos fibroepiteliais não é completamente compreendida, mas pode envolver trauma, irritação crônica, fatores alérgicos e causas de desenvolvimento ou congênitas. Apesar dos pólipos fibroepiteliais serem lesões benignas, podem ser malignos em casos extremamente raros. Aqui discutimos 2 casos de pólipo fibroepitelial com uma apresentação atípica e seu tratamento.

Atypical presentation of fibroepithelial polyp: a report of two cases.

Fibroepithelial polyps are benign non-epithelial tumors arising from mesodermal tissue and are commonly found on the skin. They can develop on the eyelid and surrounding area and rarely appear at other sites. While most cutaneous cases are diagnosed incidentally, the lesions may be symptomatic based on their location. The etiology of fibroepithelial polyps is not fully understood but may involve trauma, chronic irritation, allergic factors, and developmental or congenital causes. Although fibroepithelial polyps are benign lesions, they can be malignant in extremely rare cases. Herein we discuss 2 cases of fibroepithelial polyp with an atypical presentation and their treatment.

Tumores infrecuentes en pediatría: tumor de ovario: caso clínico / Infrequent tumors in pediatrics: ovarian tumor presentation of a case and bibliographic review

Introducción: Los tumores malignos de ovario son raros en la edad pediátrica, con una incidencia de 1-2 por cada 1 000 000 habitantes, caracterizados por dolor abdominal y efecto de masa, cuya edad de diagnóstica varia teniendo dos picos de incidencia entre 8 a 9 años de vida y entre los 13 a 17 años. Objetivo: Identificar los puntos critico que influyeron en el diagnóstico y tratamiento de niña con tumor de ovario. Descripción del caso: Referimos el caso de una adolescente de 14 años que ingresa al servicio de pediatría, por presentar dolor abdominal, distención abdominal y vómito. Al ser evaluada se encuentra una gran distención abdominal con una masa dura que abarca especialmente hemi-abdomen derecho. La TAC y ECO revelan masa quística dependiente de ovario derecho que desplaza asas intestinales, además la presencia de derrame pleural bilateral que lleva al diagnóstico de metástasis pulmonar. No se realiza examen histopatológico debido a que la paciente acude a recibir atención médica especializada en estadios avanzados de la enfermedad al proceder de área rural. Conclusiones: Se describe un caso de niña a la que se le realiza diagnóstico de tumor de ovario avanzado y metástasis pulmonar, que no se realiza examen histopatológico por provenir de área rural, recibir tratamientos naturales por periodo prolongado lo que impidieron realizar diagnóstico y tratamiento oportuno

Introduction: Malignant ovarian tumors are rare in the pediatric age, with an incidence of 1-2 per 1 000 000 persons. Introduction: Malignant ovarian tumors are rare in the pediatric age, with an incidence of 1-2 per 1 000 000 inhabitants, characterized by abdominal pain and mass effect, whose diagnostic age varies with two peaks of incidence between 8 to 9 years of life and between 13 to 17 years. Objetive: To identify the critical points that influenced the diagnosis and treatment of a girl with an ovarian tumor. Case description: We report the case of a 14-year-old girl who enters the pediatric service, due to abdominal pain, abdominal distention and vomiting. When evaluated, a large abdominal distension is found with a hard mass that especially includes the right hemi-abdomen. CT and ECO reveal cystic mass dependent on the right ovary that displaces intestinal loops, in addition to the presence of bilateral pleural effusion that leads to the diagnosis of pulmonary metastasis. Histopathological examination is not performed because the patient goes to receive specialized medical attention in advanced stages of the disease when coming from rural area. Conclusions: We describe a case of a girl who is diagnosed with advanced ovarian tumor and pulmonary metastasis, who did not undergo histopathological examination due to being from rural areas, receiving natural treatments for a prolonged period, which prevented diagnosis and timely treatment

Fibroadenoma vulvar: a propósito de un caso clínico / Vulvar fibroadenoma: about a clinical case

RESUMEN El fibroadenoma vulvar es un tumor benigno poco frecuente con muy pocos casos descritos en la literatura. Por lo general, se diagnostica entre los 20 y 70 años. Tiene un buen pronóstico y rara vez recurre después de la escisión. Presentamos un caso de fibroadenoma vulvar, en una mujer de 33 años, manifestado como un tumor localizado, bien definido de partes blandas en el labio mayor izquierdo. La lesión fue extirpada completamente y la histología confirmó un fibroadenoma con marcador de estrógeno positivo.

ABSTRACT Vulvar fibroadenoma is a rare benign tumor with few cases reported in the literature. It usually occurs between 20 and 70 years of age. It has a good prognosis and rarely recurs following excision. We present a case of vulvar fibroadenoma as a localized, well-defined soft tissue mass in the left labium majus of a 33-year-old woman. The mass was excised completely, and histology demonstrated a fibroadenoma positive for estrogen receptor.

Unusual size, topography, and surgical resolution of an acquired fibrokeratoma.

Acquired fibrokeratoma is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digits. We report a case of plantar acquired fibrokeratoma evidencing its atypical size and topography, in addition to the treatment with simple surgical excision followed by healing by second intention. Nondigital fibrokeratomas may occur in 18% of cases and rarely affect the palmoplantar region. These lesions are usually asymptomatic and show ≥ 3cm in size at the time of diagnosis due to delayed diagnosis. Complete surgical excision is the treatment of choice, which is usually curative. In general, primary closure is chosen; however healing by second intention becomes an option in regions of difficult approach.

Unusual size, topography, and surgical resolution of an acquired fibrokeratoma

Abstract: Acquired fibrokeratoma is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digits. We report a case of plantar acquired fibrokeratoma evidencing its atypical size and topography, in addition to the treatment with simple surgical excision followed by healing by second intention. Nondigital fibrokeratomas may occur in 18% of cases and rarely affect the palmoplantar region. These lesions are usually asymptomatic and show ≥ 3cm in size at the time of diagnosis due to delayed diagnosis. Complete surgical excision is the treatment of choice, which is usually curative. In general, primary closure is chosen; however healing by second intention becomes an option in regions of difficult approach.

Alternative approach of a Fibroepithelial polyp.

A 41-year-old male presented at Emergency Department (ED) with right flank pain associated with hematuria for 3 days. Patient had a previous history of nephrolithiasis. The physical examination and blood tests were normal. Urine analyses showed haematuria > 1.000.000/µL. After clinical evaluation, a computer tomography (CT) showed right ureteral dilata¬tion caused by a 5 mm proximal stone and a distal intraluminal mass of 8 cm in length. In this setting, an ureteroscopic biopsy was performed and revealed a large polypoid lesion histologically suggestive of fibroepithelial polyp. Due to technical difficulties (intraluminal mass length and technical issue for the passage of guidewire) and after discussing all available minimally invasive options, we opted for a laparoscopic approach. Instead of ureterectomy of the affected segment of the ureter, as classically performed, we proceeded with an ureterotomy, blunt dissection of the tumor and ureterolithotomy, with complete removal of the mass. This approach did not require ureteral anastomosis and the ureteral dilatation facilitated its primary closure. No complications occurred, even after 3 years of follow-up.

Distant metastases in phyllodes tumours of the breast: an overview

Phyllodes tumours (PTs) of the breast are uncommon fibroepithelial neoplasms, comprising 0.3 ­ 1.0% of all primary breast malignancies in Western countries, but accounting for a higher proportion of primary breast tumours in Asian countries. They are graded as benign, borderline or malignant based on the World Health Organisation (WHO) classification, according to a constellation of 5 histologic parameters. While most PTs carry a good prognosis, malignant and occasionally borderline PTs have the potential to metastasize to distant sites. Although events of distant metastasis are few, the prognosis for such patients is dismal, as they are often unresponsive to chemotherapy with high mortality. This review seeks to provide an overview of this rare but important phenomenon of distant metastases in PTs of the breast (AU)

Efeito do tratamento com dose reduzida do aglepristone em uma hiperplasia mamaria felina: Relato de caso / Effect of the treatment with low dose of aglepristone in a feline mammary hyperplasia: case report

Feline mammary hyperplasia (FMH) is a benign condition representing a disorder of body related tonatural or synthetic progestogen characterized by rapid cell growth of one or more mammary glands. Havingrapidly evolving and can cause serious systemic changes, it is necessary to use instant protocols, such as the useof aglepristone an antiprogestogen. This study aims to report a case of FMH with aglepristone-based therapy. Acat mongrel, with 9 months old, nulliparous, who received a contraceptive dose, showed an increase in thethoracic right mammary gland M1. The history and physical examination indicated the diagnosis of FMH. Thetherapy established was aglepristone in 3 doses (10mg / kg) every 24 hours. The result was total remission ofsymptoms. The use of aglepristone proved to be effective in the treatment of FMH even without castration.(AU)

Efeito do tratamento com dose reduzida do aglepristone em uma hiperplasia mamaria felina: Relato de caso / Effect of the treatment with low dose of aglepristone in a feline mammary hyperplasia: case report

Feline mammary hyperplasia (FMH) is a benign condition representing a disorder of body related tonatural or synthetic progestogen characterized by rapid cell growth of one or more mammary glands. Havingrapidly evolving and can cause serious systemic changes, it is necessary to use instant protocols, such as the useof aglepristone an antiprogestogen. This study aims to report a case of FMH with aglepristone-based therapy. Acat mongrel, with 9 months old, nulliparous, who received a contraceptive dose, showed an increase in thethoracic right mammary gland M1. The history and physical examination indicated the diagnosis of FMH. Thetherapy established was aglepristone in 3 doses (10mg / kg) every 24 hours. The result was total remission ofsymptoms. The use of aglepristone proved to be effective in the treatment of FMH even without castration.

Tumor filoide. Estado del arte / Phyllodes tumour. State of the art

El tumor filoide (TF) es una neoplasia fibroepitelial con una baja incidencia a nivel mundial, lo que limita el poder contar con estudios prospectivos acerca de su abordaje diagnóstico y terapéutico. Se hace una revisión actualizada de su presentación, diagnóstico y tratamiento. Con las características histopatológicas disponibles actualmente se puede subdividir el TF en: de histología benigna, limítrofe y maligna. Esta subclasificación permite establecer el abordaje quirúrgico, que es la base del manejo terapéutico, la indicación de terapias adyuvantes, y finalmente establecer el pronóstico de la paciente.

Phyllodes tumour is a fibroepithelial neoplasm of the breast, with a low world incidence, and with few prospective trials on its diagnosis and treatment. A review is presented of the available world medical literature on this topic. Phyllodes tumours can currently be classified as benign, borderline and malign. This classification helps to determine the surgical treatment, which is the cornerstone of the treatment of Phyllodes tumour, as well as the adjuvant treatment, and finally it helps to determine the patient's prognosis.