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1.
Kyobu Geka ; 74(11): 967-971, 2021 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-34601484

RESUMO

A 75-year-old man was admitted for cerebral infarction. Magnetic resonance imaging revealed parietal lobe cerebral infarction. Transesophageal echo and contrast-enhanced computed tomography indicated mobile and speckled mass arising from left atrium. He was diagnosed with cardiogenic cerebral embolism. Under cardiopulmonary bypass, resection of the mass including endocardium tissue was per formed. The resected specimen showed multiple small fronds resembling a sea anemone. Microscopic examination showed multiple branching fronds of paucicellular and avascular fibroelastic tissue lined by a single layer of endocardium. Pathological diagnosis was papillary fibroelastoma. Three years passed without recurrence.


Assuntos
Fibroelastoma Papilar Cardíaco , Fibroma , Neoplasias Cardíacas , Idoso , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Masculino , Recidiva Local de Neoplasia
3.
Ann Ital Chir ; 922021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34569469

RESUMO

Mandible can be affected by a great variety of neoformations, like aneurysmal bone cyst, odontogenic myxoma, CGCG (Central Giant Cell Granuloma), GCT (giant cell tumor), sarcoma, ameloblastoma, lymphoma, ossifyng fibroma, odontogenic mixoma, granuloma, arteriovenous malformations and Schwannoma. Occasionally is not possible to find clinical or radiological distinctive findings so is usefull to perform additional exams, think about rare disease and perform an explorative surgical treatment which can be adapted to the intraoperatory findings. This attitude may help to reduce overtreatment but also to be radical especially in case of rare condition like the case presented: a Central Giant Cell Granuloma of the jaws. In this case report the authors present a 19-year-old female with a slowly enlarging, painfull swelling on the left side of the lower jaw. Ortopantomography exam revealed an osteolytic bone formation confirmed by Tomographic Dental Scan, MRI and Eco-Doppler exam. No one of these procedures, however, allowed to characterize the neoformation. For that reason was planned immediately an explorative surgical treatment, instead of an agosbiopsy. Macroscopic free margins resection provided radicality on one side and saved much bone tissue as possible on the other; morever it would have permitted to be more demolitive with a further procedure if the histopathological examination of specimen didn't show complete neoformation removal. KEY WORDS: Central Giant Cell Granuloma, Rare Mandibular Neoplasm, Explorative Surgical Treatment.


Assuntos
Fibroma , Granuloma de Células Gigantes , Neoplasias Mandibulares , Tumores Odontogênicos , Feminino , Granuloma de Células Gigantes/diagnóstico por imagem , Granuloma de Células Gigantes/cirurgia , Humanos , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/cirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
4.
Vestn Otorinolaringol ; 86(4): 106-110, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34499457

RESUMO

A very rare case of 46-yaer-old woman with chondromyxoid fibroma (CMF) of infralabyrinthine area of temporal bone was described in this article. The only manifestation of this disease was a severe temporary pain in the postauricular area with irradiation in the occipital bone and headache during the last 3 months. A detail description of the CT scan and MRI data was presented. Tumor removing was performed through the retrofacial approach with combination of the microscopic and endoscopic assistance technique, which allows to had a good visualization and controlling of tumor separation from the vital structures with hearing and facial nerve function preserve. Also, we presented a brief review of literature with differential diagnosis of the CMF of the temporal bone, which conducted to minimize the diagnosis mismatches in the otologic and head and neck practice and to optimize the treatment of patients with such tumor.


Assuntos
Neoplasias Ósseas , Fibroma , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Osso Temporal/diagnóstico por imagem , Osso Temporal/cirurgia , Tomografia Computadorizada por Raios X
5.
Medicine (Baltimore) ; 100(36): e27164, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34516510

RESUMO

ABSTRACT: Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm which can be misdiagnosed as the gastrointestinal stromal tumor. This tumor almost formed a lobulated intramural/submucosal mass in the gastric antrum and prepyloric area. It was considered as a benign tumor that exhibited no recurrence, metastasis, or tumor-related mortality. In this study, we reported 2 cases of gastric PF. The first case was a PF patient coexisting with gastric adenocarcinoma. The second case occurred in the gastric upper body close to gastric fundus. They underwent distal gastrectomy and laparoscopic partial gastric resection, respectively. Both of them exhibited a plexiform growth pattern in the submucosa, muscularis propria, and subserosal adipose tissues. The nodules were composed of abundant myxoid or fibromyxoid matrix riching in small thin-walled blood vessels and bland-looking spindle cells. The first case partially showed staggered growth pattern of PF and adenocarcinoma. Immunohistochemically, the spindle cells were diffusely immunoreactive for SMA and vimentin, and focally immunoreactive for CD10. It was important to distinguish the PF from other spindle cell tumors involving the stomach.


Assuntos
Adenocarcinoma/diagnóstico , Fibroma/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Gástricas/diagnóstico , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Diagnóstico Diferencial , Feminino , Fibroma/complicações , Fibroma/patologia , Fibroma/cirurgia , Gastrectomia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/complicações , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Primárias Múltiplas/complicações , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
8.
J Int Med Res ; 49(8): 3000605211027878, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34369189

RESUMO

OBJECTIVE: This article aimed to study the clinicopathological features, immunophenotypes, and differential diagnoses of plexiform fibromyxoma (PF). METHODS: We searched clinical and pathology databases of our hospital for patients with histologically confirmed PF from 2007 to 2020 and reviewed the relevant English and Chinese language literature. RESULTS: Two cases of PF were identified, a 67-year-old woman and a 23-year-old man. Both patients presented with melena and anemia and underwent partial gastrectomy. Histologically, the tumors exhibited a plexiform growth pattern in the gastric submucosa and the presence of bland-looking spindle cells in the fibromyxoid stroma with the formation of small blood vessels. Immunohistochemically, the two cases were strongly positive for vimentin, smooth muscle actin, and muscle-specific actin and negative for CD117, discovered on gastrointestinal stromal tumors protein 1, CD34, CD10, S100, desmin, H-caldesmon, estrogen receptor, progesterone receptor, ß-catenin, and cytokeratin. CONCLUSIONS: PF is a rare mesenchymal tumor of the stomach that can be distinguished from other gastrointestinal mesenchymal tumors based on its distinctive morphology and immunophenotype.


Assuntos
Fibroma , Tumores do Estroma Gastrointestinal , Neoplasias Gástricas , Idoso , Diagnóstico Diferencial , Feminino , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Gastrectomia , Humanos , Masculino , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Adulto Jovem
9.
J Pak Med Assoc ; 71(7): 1897-1899, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34410270

RESUMO

Chondromyxoid fibroma is a rare tumour, representing <1% of all primary bone neoplasm. We report the case of a four-year-old female child with a one-year history of nasal obstruction and facial swelling. A large enhanced lesion with amorphous densities spreading into the right cribriform plate and floor of sphenoid sinus, laterally into the right lamina papyracea, inferolaterally into the medial wall of maxillary sinus, posteriorly into the nasopharynx and superior aspect of oropharynx was observed on CT scan. The mass was excised by Caldwell Luc's endoscopic medial maxillectomy via sublabial approach. CMF was confirmed histopathologically.


Assuntos
Neoplasias Ósseas , Fibroma , Criança , Pré-Escolar , Endoscopia , Feminino , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Humanos , Tomografia Computadorizada por Raios X
10.
BMJ Case Rep ; 14(8)2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353844
11.
BMC Musculoskelet Disord ; 22(1): 677, 2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34376178

RESUMO

BACKGROUND: A phosphaturic mesenchymal tumor (PMT) is classified into four histological subtypes: mixed connective tissue, osteoblast-like, non-ossifying fibroma-like, and ossifying fibroma-like. The ossifying fibroma-like subtype being extremely rare. Most PMTs are benign, with a minimal number becoming malignant after recurrence. In this study, we report a case of recurrence and malignant transformation of PMT-ossifying fibroma-like subtype in the left hip bone. CASE PRESENTATION: Here, we report the clinical manifestations, histology, pathological features, and treatment of a 57-year-old Chinese woman with a recurrent and malignant ossifying fibroma-like subtype PMT of the left iliac bone. The tumor was first discovered 3 years ago when the patient underwent surgery to remove the tumor. Precisely 2 years and 6 months after the operation, the pain in the left hip reappeared. After 6 months, the patient went to our hospital for treatment. After the tumor resection, the postoperative symptoms improved significantly, and the serum alkaline phosphatase level returned to normal. Based on clinical manifestations, evaluation of serum biochemical indicators, X-ray examination, computerized tomography scan of the pelvis, and histopathological examination of the two operations, the patient was finally diagnosed with a recurring and malignant transformation of the left iliac bone phosphaturic mesenchymal tumor-ossifying fibroma-like subtype. No tumor recurrence was found during the follow-up 15 months after the operation. CONCLUSIONS: This case increases the awareness of a rare malignant subtype of PMT and provides a valuable reference for the diagnosis of this disease.


Assuntos
Fibroma Ossificante , Fibroma , Mesenquimoma , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgia , Tomografia Computadorizada por Raios X
12.
BMJ Case Rep ; 14(8)2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34400421

RESUMO

The extraosseous/peripheral odontogenic fibroma (E/POF) is a benign mesenchymal odontogenic tumour found on the gingival surface with clinical characteristics identical to those of reactive lesions. A histopathological analysis is the only method for determining the difference between reactive lesions and these neoplastic lesions, whose recurrence potential varies between 38.9% and 50%, highlighting the importance of correct diagnosis. The following report describes an E/POF case with a clear cells component, as well as a long-term follow-up treatment, which we emphasise due to its potential for recurrence.


Assuntos
Fibroma , Neoplasias Gengivais , Tumores Odontogênicos , Diagnóstico Diferencial , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Seguimentos , Neoplasias Gengivais/diagnóstico por imagem , Neoplasias Gengivais/cirurgia , Humanos , Recidiva Local de Neoplasia , Tumores Odontogênicos/diagnóstico por imagem , Tumores Odontogênicos/cirurgia
13.
J Oral Biosci ; 63(3): 278-283, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34280532

RESUMO

OBJECTIVES: Irritation fibroma in the oral cavity causes atrophy or squamous epithelium thickening with respect to external injury-associated factors. However, ulcers do not occur in most cases. This study aimed to elucidate the mechanism by which ulcers do not form, focusing on the vascular network in the mucosal epithelium of irritation fibroma. METHODS: Immunostaining was performed using an enzyme antibody method with primary antibodies against CD31 and Ki-67 in 17 cases of irritation fibroma in the buccal mucosa. One section was taken at three points from the margin and three points from just above the lesion for measurement. The number of blood vessels in the superficial and deep lamina propria at the measurement site were determined, and the area per blood vessel was measured. RESULTS: The number and area of blood vessels in the superficial lamina propria just below the lesion epithelium were smaller than those in the margin. No difference was observed in the number and area of blood vessels in the deep lamina propria between the margins and lesions. CONCLUSIONS: Our results suggest that the vascular network in the deep lamina propria is maintained and compensates for the nutrient supply to the covering epithelium.


Assuntos
Fibroma , Mucosa Bucal , Epitélio , Humanos
15.
J Pediatr Orthop ; 41(8): e671-e679, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34138818

RESUMO

BACKGROUND: Nonossifying fibroma (NOF) is a common benign lesion in children and adolescents. This study investigated the risk of pathologic fracture in NOF lesions of the distal tibial based on anatomic location, clinical symptomatology, and imaging features, in order to propose an algorithm for the management of such lesions. METHODS: In an IRB-approved retrospective case-control study, all patients diagnosed with NOF between 2010 and 2017 were extracted from our database. Patients below 18 years of age at the time of diagnosis and with lesions involving the distal tibia were included. Demographic data, the reason for visit, and the mechanism of injury were recorded. Radiographs were reviewed to record the size (absolute and relative to bone width) and location of each lesion. Computed tomography and magnetic resonance imaging examinations were also reviewed when available. Two authors graded all lesions using the Ritschl classification and determined the presence of 2 novel signs: the syndesmosis sign and the Pac-Man sign. RESULTS: A total of 84 patients were included in the final analysis, of which 25 were in the fracture group and 59 in the nonfracture group. None of the patients in the fracture group was previously diagnosed with NOF, but nine (36%) patients had symptoms for >6 months preceding the fracture. Ankle sprain was the most common reason for visit in the nonfracture group. The lateral location of the lesion in the distal tibia (P=0.001), size (P<0.001 for both absolute and relative values), Ritschl stage (P=0.003), syndesmosis sign (P=0.005), and the Pac-Man sign (P=0.002) were significant predictors of fracture. All measurements had almost-perfect to perfect inter-rater agreements. CONCLUSIONS: The most significant imaging risk factors for fracture are a larger size, Ritschl stage B, and the presence of cortical thinning on anteroposterior or lateral radiographs. We introduced 2 signs for these distal tibial NOFs, a scoring system, and a management algorithm that is based on radiographs alone but incorporates advanced imaging findings in equivocal cases. LEVEL OF EVIDENCE: Therapeutic Level III-case-control study.


Assuntos
Neoplasias Ósseas , Fibroma , Fraturas da Tíbia , Adolescente , Algoritmos , Neoplasias Ósseas/diagnóstico por imagem , Estudos de Casos e Controles , Humanos , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Fraturas da Tíbia/diagnóstico por imagem
16.
Magn Reson Imaging ; 81: 53-59, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34116132

RESUMO

BACKGROUND: Superficial fibromatosis exhibits variable MR signal intensity due to collagenous and fibroproliferative components. Quantifying this signal heterogeneity using image texture analysis and T2-mapping could have prognostic and therapeutic implications. METHODS: This IRB-approved retrospective study included 13 patients with superficial fibromatosis, managed by observation, electron beam radiotherapy (EBT), or pentoxifylline/vitamin E. Two-dimensional regions of interest (ROIs) were drawn on proton-density or T2-weighted MRI for radiomics feature analysis, and corresponding T2-maps. Comparisons were made between baseline and follow-up T2 relaxation times and radiomics features: Shannon's entropy, kurtosis, skewness, mean of positive pixels (MPP), and uniformity of distribution of positive gray-level pixel values (UPP). RESULTS: There were 19 nodules in 13 subjects. Mean patient age was 60 years; 62% (8/13) were female; mean follow-up was 9.7 months. Nodule diameter at baseline averaged 18.2 mm (std dev 16.2 mm) and decreased almost 10% to 16.6 mm (p = 0.1, paired t-test). Normalized T2 signal intensity decreased 23% from 0.71 to 0.55 (p = 0.03, paired t-test). T2 relaxation time decreased 16% from 46.5 to 39.1 ms (p < 0.001, paired t-test). Among radiomics features, skewness increased to 0.71 from 0.41 (p = 0.03, paired t-test), and entropy decreased from 8.37 to 8.03 (p = 0.05, paired t-test); differences in other radiomics features were not significant. CONCLUSIONS: Radiomics analysis and T2-mapping of superficial fibromatosis is feasible; robust decreases in absolute T2 relaxation time, and changes in image textural features (increased skewness and decreased entropy) offer novel imaging biomarkers of nodule collagenization and maturation.


Assuntos
Fibroma , Imageamento por Ressonância Magnética , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
18.
BMJ Case Rep ; 14(6)2021 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-34162607

RESUMO

Paediatric cardiac tumours are rare, often benign and carry associations with genetic conditions. Cardiac fibromas are mainly composed of fibroblast and connective tissue . They can lead to symptoms due to obstruction of blood flow or arrythmias. In this case, we report an 8-month-old girl child who presented to paediatric cardiology office for cardiac evaluation given a family history of Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, found to have a large 4×4×6 cm fibroma in the apical lateral free wall of the left ventricle and later presented to the emergency department with cardiac arrest.


Assuntos
Síndrome do Nevo Basocelular , Fibroma , Parada Cardíaca , Neoplasias Cardíacas , Síndrome do Nevo Basocelular/diagnóstico , Síndrome do Nevo Basocelular/diagnóstico por imagem , Criança , Feminino , Fibroma/complicações , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Ventrículos do Coração , Humanos , Lactente
19.
Kyobu Geka ; 74(6): 449-452, 2021 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-34059590

RESUMO

Papillary fibroelastoma (PFE) is a rare benign cardiac tumor generally arising from the valvular endocardium. We report an extremely rare case of PFE arising from the left atrial wall. A 70-year-old male patient was admitted to our hospital with a diagnosis of left atrial tumor. Echocardiography and enhanced computed tomography showed an approximately 14 mm mass on the left atrial wall. Moreover, the magnetic resonance imaging showed hyperintenseness on a T2-weighted image. We diagnosed the tumor as a myxoma. Intraoperatively, we found a mobile tumor on the left atrial wall. It had a sea anemone-like appearance and was suspected to be PFE. We performed the tumor resection including the left atrial wall. Histological examination confirmed PFE. His postoperative course was uneventful.


Assuntos
Fibroelastoma Papilar Cardíaco , Fibroma , Neoplasias Cardíacas , Mixoma , Idoso , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Humanos , Masculino
20.
Endocrine ; 73(3): 693-701, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33999366

RESUMO

PURPOSE: We described the phenotype of a large 4-generation family with Hyperparathyrodism-Jaw Tumor syndrome (HPT-JT) associated with a rare deletion of exon 3 of the CDC73 gene. METHODS: We collected medical, genetic data on 24 family members descended from a common ancestor carrying a heterozygous deletion of exon 3. RESULTS: Thirteen carried the deletion, the penetrance was estimated at 50% at 40 years. Seven patients (39 ± 14.5 years) presented with HPT which could start at 13. Median plasmatic calcium and PTH levels were 3.13 ± 0.7 mmol/L and 115 ± 406 pg/ml, respectively. Kidney disease related to hypercalcemia were present in 57.1% of patients. All seven patients underwent surgery to remove a single parathyroid adenoma. One recurrence occurred 7 years post-surgery. No parathyroid carcinoma has been found to date. We found two atypical parathyroid adenomas. We described an additional somatic variant in exon 1 of gene CDC73 in two tumors. Jaw tumors were not necessarily associated with hyperparathyroidism, as shown in one case. Two kidney cysts were also reported. Variable phenotype expressivity was emphasized by clinical presentations in 2 monozygotic twins: acute hypercalcemia, kidney failure and ossifying fibroma in one twin, versus normocalcemic parathyroid adenoma in the other one. CONCLUSION: We report a family carrier of a deletion of exon 3 of the CDC73 gene. This is characterized by a high level of hypercalcemia, deleterious kidney effects and atypical parathyroid adenomas without carcinomas. Onset and intensity of HPT remain unpredictable. The additional somatic mutation found in the parathyroid tumor could lead to these phenotypical variations.


Assuntos
Hiperparatireoidismo , Neoplasias Maxilomandibulares , Adenoma , Éxons/genética , Família , Fibroma , Humanos , Hiperparatireoidismo/genética , Neoplasias Maxilomandibulares/genética , Recidiva Local de Neoplasia , Deleção de Sequência , Proteínas Supressoras de Tumor/genética
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