Progressive osseous heteroplasia-like heterotopic ossification in a male infant with pseudohypoparathyroidism type Ia: A case report

Abstract Background Heterotopic ossification (HO) is the formation of osseous tissue outside the skeleton. HO in malignant tumors of the digestive tract is extremely rare, as is ossification in metastatic lesions from HO-negative digestive tract tumors. Regarding the pathogenesis of HO, two theories have been proposed. The first is that the osteoblastic metaplasia of tumor cells (driven by the epithelial-mesenchymal transition, EMT) results in HO, and the second is that factors secreted by cancer cells lead to the metaplasia of stromal pluripotent cells into osteoblasts. However, the osteogenic mechanisms remain unclear. Case presentation An 83-year-old Japanese woman underwent low anterior rectal resection for rectal cancer before presentation at our institution, in June 2018. The final diagnosis was stage IIB rectal adenocarcinoma (T4aN0M0). Histological examination did not reveal HO in the primary tumor. Thirteen months after the operation, a solitary metastatic lesion in the brain 20 mm in size and a solitary metastatic lesion in a right axillary lymph node 20 mm in size were diagnosed. The patient was treated with gamma-knife therapy for the brain metastasis. One month later, she was referred to our institution. She underwent lymph node resection. Histological examination revealed that most portions of the affected lymph node were occupied by metastatic tumor cells and that central necrosis and four small ossified lesions without an osteoblast-like cell rim were present in the peripheral region. Immunohistochemical analysis showed tumor cells positive for BMP-2, osteonectin, osteocalcin, AE1/AE3, TGF-β1, Gli2, Smad2/3, and CDX2 and negative for nestin, CD56, and CK7. Conclusion This is the first English case report of HO in a metachronous metastatic lymph node after the curative resection of HO-negative rectal cancer. Unlike HO lesions in past reports, the HO lesion did not show peripheral osteoblast-like cells, and the immunohistochemical findings indicated that the present case resulted from the EMT.

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Heterotopic ossification in the anterior maxilla: a case report and review of the literature

Journal of Oral Pathology and Medicine ◽

10.1111/j.1600-0714.2007.00467.x ◽

2007 ◽

Vol 36 (2) ◽

pp. 120-122

Author(s):

Eneida F. Vencio ◽

Rita C. Alencar ◽

Eduardo Zancope

Keyword(s):

Case Report ◽

Heterotopic Ossification ◽

Review Of The Literature ◽

Anterior Maxilla

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Poster 187 Heterotopic Ossification (HO) Encasing the Sciatic Nerve: A Case Report

PM&R ◽

10.1016/j.pmrj.2012.09.809 ◽

2012 ◽

Vol 4 ◽

pp. S254-S254

Author(s):

Jeremy Jacobs

Keyword(s):

Case Report ◽

Sciatic Nerve ◽

Heterotopic Ossification

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Heterotopic Ossification as an Unusual Complication After Guillain-Barré Syndrome: A Case Report

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2007.11.004 ◽

2008 ◽

Vol 89 (3) ◽

pp. 564-567 ◽

Cited By ~ 1

Author(s):

Su-Ra Ryu ◽

Jae-Hyung Kim ◽

In-Sung Choi ◽

Jae-Young Han ◽

Sam-Gyu Lee

Keyword(s):

Case Report ◽

Heterotopic Ossification ◽

Guillain Barre Syndrome ◽

Unusual Complication ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Lactic Acidosis in Children—Pathophysiology, Diagnosis, and Treatment: A Workbook Exercise

Pediatrics in Review ◽

10.1542/pir.4.7.225 ◽

1983 ◽

Vol 4 (7) ◽

pp. 225-230

Author(s):

Marc Yudkoff ◽

Fred Burg

Keyword(s):

Case Report ◽

Lactic Acidosis ◽

Emergency Room ◽

Respiratory Rate ◽

Rectal Temperature ◽

Opportunity To Learn ◽

Male Infant ◽

Diagnosis And Treatment

This article is designed to give you an opportunity to learn how lactic acidosis affects children, and how to diagnose and treat a child with this disorder. The process we have utilized is an interactive one in which you will be presented with questions commingled with problems and discussion. CASE REPORT A 3-month-old male infant had been well until two days prior to admission, when he had developed fever, vomiting, and diarrhea. Initially the vomiting and diarrhea were mild, and a pediatrician recommended administration of clear liquids. On the day of admission the infant ate nothing at all, vomited every one to two hours, and had more than ten stools, all of which consisted primarily of water. The parents reported that by 5 PM the child became suddenly pale and his skin seemed cool, although when they took the rectal temperature it was 37.7 C(100 F). The baby became increasingly lethargic and limp. By 6 PM, when the parents rushed the child to the emergency room, he could not be awakened at all. The receiving physician in the emergency room found an unresponsive flaccid baby with a respiratory rate of 62 breaths per minute. A feeble pulse was 154 beats per minute and the rectal temperature was 38.1 C. The odor of acetone was apprent in the baby's breath.

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Zenith AAA endovascular graft suprarenal bare metal stent separation with graft migration and type IA endoleak

Vascular ◽

10.1177/17085381211062737 ◽

2021 ◽

pp. 170853812110627

Author(s):

Julian Smith ◽

Simon Joseph ◽

Catherine Thoo

Keyword(s):

Case Report ◽

Endovascular Repair ◽

Bare Metal Stent ◽

Main Body ◽

Bare Metal ◽

Metal Stent ◽

Endovascular Graft ◽

Abdominal Aortic ◽

Type Ia ◽

Graft Migration

Background The Zenith endovascular graft (Cook Medical, Bloomington, IN, USA) is a well-recognised device used in endovascular repair of abdominal aortic aneurysms (EVAR). After a small number of reported cases of suprarenal stent separation from the main body of the graft, modifications were made to the strength and durability of the suture line attachment of the proximal bare metal component prior to release in 2003. This report describes a further case of suprarenal stent separation and type IA endoleak in a patient who underwent an EVAR using the Zenith device in 2012. Methods We present a case report of a 77-year-old male with incidental finding of type IA endoleak on a background of elective endovascular repair for 50.4-mm infrarenal abdominal aortic aneurysm (AAA), with a Cook Zenith endograft. Computed tomography (CT) demonstrated separation of the suprarenal bare metal stent from the main body of the endograft, with resultant graft migration and increase in native aneurysm sac size. Results The patient underwent semi-urgent surgery with successful placement of a bridging thoracic stent graft between the lowest renal artery and main body of the pre-existing graft. Conclusions This case report describes a rare complication of Zenith devices, additionally emphasising the importance of regular surveillance imaging following EVAR.

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Heterotopic Ossification of the Peroneus Longus Tendon in the Retromalleolar Portion with the Peroneus Quartus Muscle: A Case Report

Case Reports in Orthopedics ◽

10.1155/2018/7978369 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Song Ho Chang ◽

Takumi Matsumoto ◽

Koichi Okajima ◽

Masashi Naito ◽

Jun Hirose ◽

...

Keyword(s):

Case Report ◽

Heterotopic Ossification ◽

Soft Tissues ◽

Calcific Tendinitis ◽

Lamellar Bone ◽

Peroneus Longus Tendon ◽

Histological Features ◽

Longus Tendon ◽

Peroneus Longus ◽

Cuboid Bone

Heterotopic ossification (HO) is an ectopic formation of the lamellar bone in the soft tissues. Some authors have previously reported HO or calcific tendinitis of the peroneus longus tendon at the level of the cuboid bone, while the HO of the peroneus longus tendon in the retromalleolar portion has not been reported. The purpose of this report is to describe clinical, radiological, and histological features of this rare ossification and its treatment. To the best of our knowledge, this is the first report presenting a case of HO of the peroneus longus tendon, which developed in the retromalleolar portion.

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