Lipomatosis arborescente. Presentación de un caso pediátrico / Arborescens lipomatosis in a young girl. A case report

La lipomatosis sinovial es una entidad, rara y benigna, de la membrana sinovial, que fue descrita por Albert Hoffa en 1904, y afecta con mayor frecuencia a la articulación de la rodilla, pudiendo presentarse en otras articulaciones. Ocurre en varones de mediana edad y, raramente, en niños. Siendo normalmente monoarticular, en algunos casos aparece en más de una articulación. Su etiología es desconocida y se habla de un proceso reactivo más que neoplásico. Esta enfermedad tiene una morfología radiológica, macroscópica y microscópica característicamente arborescente, por infiltración adiposa del tejido subsinovial, que es clave para su diagnóstico. Presentamos el caso de una niña de 12 años de edad, realizándose revisión de los hallazgos radiológicos y patológicos, así como su diagnóstico diferencial con otras entidades y su tratamiento (AU)

Synovial lipomatosis, described by Albert Hoffa in 1904, is a rare and benign entity of the synovial membrane. The knee joint is the most frequent site, although it can occur in other joints. Middle-aged men are most often affected; it is rarely found in children. It is normally monoarticular, although in some cases it appears in more than one joint. Of unknown etiology, it is thought to be a reactive, rather than a neoplastic, process. The pathology shows characteristic arborescent radiological, macroscopic and microscopic morphology due to adipose infiltration of sub-synovial tissue, which is essential for diagnosis. We report a case of synovial lipomatosis in a 12 year old girl and discuss the radiological and pathological findings, differential diagnosis and treatment (AU)

Concrescencia clínica pero no histológica: presentación de un caso clínico / Fused roots does not imply concrescence: a case report with histological analysis

La concrescencia es una anomalía dentaria poco frecuente que se define como la unión de las raíces de dos dientes adyacentes a través del cemento. Aunque en la práctica clínica el término "concrescencia" es utilizado para referirse a todos los casos de unión entre las raíces de dos dientes adyacentes, para confirmar el diagnóstico de concrescencia es necesario un estudio histológico que demuestre la unión a nivel del cemento. Esta anomalía se ha identificado en el 0,8% de los casos de exodoncia de dientes permanentes, siendo su incidencia mayor en la región posterior del maxilar superior. La detección previa de la concrescencia mediante la exploración clínica y radiográfica es, la mayoría de las ocasiones, casi imposible, por lo que el diagnostico suele hacerse después de la extracción. No obstante, es conveniente que el clínico evalúe cada paciente y cada diente de forma exhaustiva para poder planificar, caso de que exista concrescencia, la técnica quirúrgica adecuada para la extracción. Por lo tanto, deben conocerse la incidencia e implicaciones de esta anomalía para llevar a cabo un diagnóstico y plan de tratamiento correcto. En este artículo se presenta un caso clínico de aparente concrescencia diagnosticado post-extracción y cuyo estudio histológico no mostró unión de cemento entre ambas raíces. Por lo tanto, en la práctica clínica es más conveniente utilizar el término "raíces fusionadas" que "concrescencia", el cual sólo debería ser utilizado después del examen histológico de la pieza extraída

Concrescence is a rare dental anomaly defined as the cemental union of two adjacent teeth. Concrescence diagnosis requires histological confirmation, but in the clinical practice the term "concrescence" is used to refer to all the cases of union of the roots of two adjacent teeth. The anomaly has been reported in extraction cases with an incidence of 0.8% in the permanent dentition. Also has been reported a higher incidence of concrescence in the posterior maxilla. It is prudent for the clinician to evaluate carefully each patient and each tooth to be removed for the possibility and desirability of a surgical extraction technique. Therefore, consideration should be given to the possible occurrence, recognition, and implications of this anomaly in diagnosis and treatment planning. Clinically and radiographically is nearly impossible to detect concrescent teeth, and most of these cases are diagnosed post extraction. The purpose of this article is to report a case of clinical concrescence between a retained third molar and an erupted second molar identified during the extraction, which histological study did not show cementum union between both roots. Thus, in the clinical practice is better to use the term "fused roots" than "concrescence", which would be used only after the histological examination of the specimen

Metástasis ováricas y mamarias bilaterales de melanoma con localización primaria desconocida / Bilateral breast and ovarian metastases from melanoma of unknown primary site

Las metástasis mamarias bilaterales de melanoma son infrecuentes y generalmente en el momento del diagnóstico este tumor posee otros sitios de diseminación. El pronóstico clínico es malo, con una supervivencia habitualmente menor a un año a pesar de efectuar un tratamiento agresivo. La afectación ovárica por un melanoma metastásico tampoco es habitual y puede confundirse con un tumor primario, representando un reto diagnóstico tanto clínico como anatomopatológico. Presentamos un caso atípico de melanoma de localización primaria desconocida que comenzó clínicamente con metástasis mamarias y ováricas bilaterales(AU)

Bilateral breast metastases from melanoma are rare and, at the time of diagnosis, usually show other sites of dissemination. The clinical prognosis is poor, with an average survival of less than 1 year despite aggressive treatment. Malignant melanoma involving the ovary is also uncommon and may be confused with a primary tumor, presenting a clinical and pathological diagnostic challenge. We report an unusual case of melanoma of unknown primary site that presented clinically as bilateral breast and ovarian metastases(AU)

Oral lichenoid lesions related to contact with dental materials: A literature review

Oral lichenoid lesions related to contact are defined as oral-cavity eruptions with an identifiable etiology, and areclinically and histologically similar to oral lichen planus. Within this group are found oral lichenoid lesions relatedto contact with dental materials (OLLC), the most common being those related to silver amalgam. Currently, it remainsdifficult to diagnose these lesions due to the clinical and histopathological similarity with oral lichen planusand other oral mucosa lesions of lichenoid characteristics. In the present paper, we carry out an updated reviewof the tests for, and the different characteristics of OLLC, which may aid the diagnosis. For this review, we madesearches in the Pubmed® and Cochrane® databases. Among the literature we found several published papers, fromwhich we have used review papers, case papers, cohort studies, case and control studies, and a meta-analysis study.After carrying out this review, we can conclude that the diagnosis of these lesions is still difficult and controversial.However, there are different aspects in the clinical presentation, pathological study and results obtained whenreplacing suspect materials, which, when taken together, may be useful when establishing the final diagnosis ofOLLC (AU)

Oral lichenoid lesions related to contact with dental materials: a literature review.

Oral lichenoid lesions related to contact are defined as oral-cavity eruptions with an identifiable etiology, and are clinically and histologically similar to oral lichen planus. Within this group are found oral lichenoid lesions related to contact with dental materials (OLLC), the most common being those related to silver amalgam. Currently, it remains difficult to diagnose these lesions due to the clinical and histopathological similarity with oral lichen planus and other oral mucosa lesions of lichenoid characteristics. In the present paper, we carry out an updated review of the tests for, and the different characteristics of OLLC, which may aid the diagnosis. For this review, we made searches in the Pubmed(R) and Cochrane(R) databases. Among the literature we found several published papers, from which we have used review papers, case papers, cohort studies, case and control studies, and a meta-analysis study. After carrying out this review, we can conclude that the diagnosis of these lesions is still difficult and controversial. However, there are different aspects in the clinical presentation, pathological study and results obtained when replacing suspect materials, which, when taken together, may be useful when establishing the final diagnosis of OLLC.

Myofibrosarcoma (low-grade myofibroblastic sarcoma) with intracytoplasmic hyaline (fibroma-like) inclusion bodies.

Myofibrosarcoma is a controversial neoplasm composed of cells with differentiation toward myofibroblasts. The authors report an unusual case of myofibrosarcoma in which, in addition to the characteristic features reported, tumor cells contained intracytoplasmic hyaline (fibroma-like) inclusion bodies. A 66-year-old man complained of a painless enlarged mass in his right shoulder over the previous 6 months. The tumor recurred 2 years after operation. On histologic examination, the tumor displayed diffusely infiltrative growth with isolation of individual skeletal muscle fibers. The tumor cells were most often arranged in an intersecting (herringbone) fascicular pattern but a vaguely storiform pattern was also observed. Cellularity varied from one area to another. The cells were spindle-shaped, with ill-define pale eosinophilic cytoplasm, and a wavy or tapering nucleus with fine chromatin and small nucleoli. Intracytoplasmic hyaline inclusion bodies of variable size, often located adjacent to the nucleus, were visible in numerous spindle and stellate cells. The mitotic index was 3/10 HPF. The tumor was scored as grade 1. Immunohistochemistry revealed positive staining to muscle-specific actin, desmin and vimentin in most tumor cells. Intracytoplasmic hyaline inclusion bodies did not react specifically to any one antibody, but showed a marked ring-like immune reaction, particularly to muscle-specific actin. Electron microscopy showed tumor cells with indented nuclei and small nucleoli, abundant rough endoplasmic reticulum, micropinocytotic vesicles, and longitudinally arranged fine filaments with focal electron-dense patches and subplasmalemmal plaques. The most striking feature was the presence of large, globular or ball-like, non-membrane-bound, randomly scattered clusters of fine filament, usually adjacent to the nucleus.