scholarly journals A rapidly progressing mass of nasal cavity in a child: Nodular fasciitis

2020 ◽  
pp. 014556132093233
Author(s):  
Yujie Chen ◽  
Wei Lv ◽  
Zhenzhen Zhu
Keyword(s):  
Nasal Cavity ◽  
Soft Tissue Tumor ◽  
Malignant Lesion ◽  
Final Diagnosis ◽  
Low Grade ◽  
Nodular Fasciitis ◽  
Left Nasal Cavity ◽  
Complete Excision ◽  
Initial Biopsy

Nodular fasciitis (NF) is a benign, self-limiting, reactive soft tissue tumor that is composed of fibroblasts and myofibroblasts and is often misdiagnosed as a malignant lesion. Nodular fasciitis is often reported in adults but rarely seen in children. We report the case of a 3-year-old girl with a rapidly growing NF in the left nasal cavity. The initial biopsy suggested the possibility of a spindle cell tumor or low-grade malignant tumor, respectively. The child underwent complete excision of the tumor. With the help of immunohistochemistry and pathological consultation, the final diagnosis was confirmed as NF. There was no recurrence during an 18-month follow-up period.

An unusual presentation of aggressive epithelial-myoepithelial carcinoma of the nasal cavity with high-grade histology

2011 ◽  
Vol 125 (12) ◽  
pp. 1286-1289 ◽  
Author(s):  
J-O Park ◽  
C-K Jung ◽  
D-I Sun ◽  
M-S Kim
Keyword(s):  
Nasal Cavity ◽  
Rare Case ◽  
Low Grade ◽  
High Grade ◽  
Myoepithelial Carcinoma ◽  
Left Nasal Cavity ◽  
Unique Case ◽  
Medial Maxillectomy ◽  
Epithelial Myoepithelial Carcinoma

AbstractBackground:Epithelial-myoepithelial carcinoma is an uncommon, low-grade carcinoma that generally occurs in the salivary glands. A few cases of epithelial-myoepithelial carcinoma arising in the nasal cavity have been reported. We describe a unique case of aggressive epithelial-myoepithelial carcinoma in the nasal cavity.Case report:A 36-year-old woman presented with a mass in her left nasal cavity. Histopathological evaluation revealed it to be an epithelial-myoepithelial carcinoma with overt nuclear atypia, frequent mitoses and necrosis. The tumour recurred in the contralateral nasal cavity 15 months following primary excision. Medial maxillectomy and radiation therapy were performed. Seven-month follow up revealed extensive bone metastases.Conclusion:We report a rare case of aggressive epithelial-myoepithelial carcinoma in the nasal cavity, with high-grade histology.

Intraarticular Nodular Fasciitis of the Knee With MHY9-USP6 Fusion: A Case Report

2020 ◽  
Vol 28 (6) ◽  
pp. 672-677 ◽  
Author(s):  
Jasminka Igrec ◽  
Iva Brčić ◽  
Renato Igrec ◽  
Marko Bergovec ◽  
Karl Kashofer ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Smooth Muscle Actin ◽  
Malignant Lesion ◽  
Cell Tumor ◽  
Malignant Neoplasms ◽  
Low Grade ◽  
Nodular Fasciitis ◽  
Tenosynovial Giant Cell Tumor ◽  
Mesenchymal Neoplasm

Background. Nodular fasciitis (NF) is a self-limiting, benign mesenchymal neoplasm of fibroblastic/myofibroblastic origin. Due to the fast growth, cellularity, and frequently observed high mitotic count, it is commonly misdiagnosed as a sarcoma, often resulting in overtreatment. Intraarticular examples of NF are extremely rare. Radiologically, NF can mimic fibroma of the tendon sheath, tenosynovial giant cell tumor, and synovial chondromatosis. Histology can vary from hypercellular, mitotically active lesions to fibrotic, less cellular ones, and can, therefore, mimic other benign and low-grade malignant neoplasms. Recently, the MYH9-USP6 fusion has been found in up to 92% of NF. Case Presentation. In this article, we report a case of a 38-year-old patient with an intraarticular lesion, radiologically suspicious of tenosynovial giant cell tumor. Histology demonstrated a spindle cell lesion composed of fibroblasts/myofibroblasts embedded in a highly collagenous/hyalinized stroma, partly arranged in short fascicles. Extravasated erythrocytes and rare mitotic figures were present. Immunohistochemically, tumor cells expressed smooth muscle actin and were negative for desmin, β-catenin, CD34, and SOX10. These findings rendered the diagnosis of NF. Molecular analysis using next-generation sequencing (Archer FusionPlex Sarcoma Panel) revealed gene rearrangement involving USP6 and MYH9 supporting the diagnosis of NF in the knee joint. Conclusions. Radiological and histological features of NF can overlap with other benign and low-grade malignant lesion. Identification of the USP6 gene rearrangements or finding of the MYH9-USP6 fusion, especially in core needle biopsies and in the lesions occurring at unusual sites, can result in adequate therapeutic approach avoiding overtreatment.

scholarly journals Nasal Cavity Ossifying Fibrosarcoma: An Unusual Fibro-Osseous Neoplasm

2010 ◽  
Vol 89 (11) ◽  
pp. E1-E3 ◽  
Author(s):  
Yadiel A. Alameda ◽  
Carlos Perez-Mitchell ◽  
José M. Busquets
Keyword(s):  
Soft Tissue ◽  
Nasal Cavity ◽  
English Language ◽  
Clinical Presentation ◽  
Soft Tissue Mass ◽  
Histopathologic Examination ◽  
Left Nasal Cavity ◽  
Tissue Mass ◽  
Language Literature

We describe the case of a 65-year-old woman who presented with left nasal obstruction. Clinical and radiographic examinations revealed the presence of a soft-tissue mass that had obliterated the left nasal cavity. The mass was completely excised via an endoscopic approach. Histopathologic examination identified the tumor as an ossifying fibrosarcoma. The patient recovered uneventfully and remained free of disease at the 2-year postoperative follow-up. To the best of our knowledge, no case of an ossifying fibrosarcoma of the nasal cavity has been previously reported in the English-language literature. We discuss the features of this case and the clinical presentation, diagnosis, and management of fibrosarcomas of the nasal cavity and paranasal sinuses.

scholarly journals Calcifying odontogenic cyst: a report of two clinical cases

2019 ◽  
Vol 25 (4) ◽  
pp. 36
Author(s):  
Xavier Lagarde ◽  
Julie Sturque ◽  
Mathilde Fenelon ◽  
Jean Marie Marteau ◽  
Jean Christophe Fricain ◽  
...  
Keyword(s):  
Local Anesthesia ◽  
Final Diagnosis ◽  
Odontogenic Cyst ◽  
University Hospital ◽  
Complete Excision ◽  
Cystic Form ◽  
Anterior Aspect ◽  
Calcifying Odontogenic Cyst ◽  
First Case

Introduction: Cystic maxillary lesions are common. In 1962, Gorlin described a rare cystic form termed the calcifying odontogenic cyst (COC) or Gorlin's cyst. Two cases of this form were treated at Bordeaux University Hospital. Observation: The first case was a 17-year-old patient with mandibular odontoma, which had developed over the previous 6 months. Excision was performed under local anesthesia, and the diagnosis of COC was made following pathological analysis. A 6-month follow-up was planned. The second case was a 62-year-old patient with a post-extraction mandibular lesion, which had been evolving for 1 year. Enucleation under local anesthesia led to the diagnosis of COC. No recurrence was observed after 5 years of follow-up. Discussion: COCs are rare lesions affecting mainly the anterior aspect of the mandible. COCs are usually discovered in unforeseen circumstances, and they can be observed as a clinically painless and well-defined oral deformation. Radiological examination often reveals radiolucent and uniloculated lesions, sometimes associated with radiopaque lesions. Pathological analyses are required for final diagnosis. Management is based on complete excision, more or less associated with marsupialization, and requires an annual clinical radiographic monitoring over the next 5 years. Conclusion: COC are rare lesions, usually asymptomatic, whose treatment is based on complete excision. Clinical and radiological follow-up is necessary until complete reossification is achieved.

scholarly journals Clinical Characteristics of Nodular Fasciitis of Ear in Children

2021 ◽  
Author(s):  
Xiaoxu Wang ◽  
Wei Liu ◽  
Lejian He ◽  
Min Chen ◽  
Jianbo Shao ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Neck Surgery ◽  
Final Diagnosis ◽  
Diagnosis And Treatment ◽  
Nodular Fasciitis ◽  
Gene Test ◽  
The Right

Abstract Purpose Summarized the clinical characteristics and diagnosis and treatment process of three cases of nodular fasciitis of ear, to provide a basis for clinical diagnosis and treatment. Methods Reviewed the clinical manifestations, images, pathology, treatment and postoperative follow up results of three cases of pediatric nodular fasciitis in the Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University from 2018 to 2020. Results The average age at diagnosis were 24 months, with two girls and a boy. Two lesions were found in the left ear and one in the right ear. All cases had a history of biopsy before surgery. Two of three cases showed a sign of rapid growth after biopsy and three of which were ineffective in anti-inflammatory treatment. FISH test for USP6 were performed in two of the three cases with positive results. Three lesions show a hypointensity or isointensity on T1-weighted MRI and a heterogeneous hyperintensity on T2-weighted MRI. ‘‘Fascial tail’’ sign was found on image of all three cases. All lesions underwent surgical resection. Follow-up showed no recurrence and had an intact ear appearance. Conclusion The early misdiagnosis rate of nodular fasciitis of the ear is high. Combine clinical features with imaging findings may improve the accuracy of preoperative diagnosis. Besides the appearance of pathology, USP6 gene test is also an important tool in the diagnosis. The final diagnosis should be based on comprehensive assessment. Complete surgical resection can prevent recurrence.

scholarly journals Intraosseous Hemangioma of the Inferior Turbinate

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Kazuya Takeda ◽  
Yukinori Takenaka ◽  
Michiko Hashimoto
Keyword(s):  
Nasal Cavity ◽  
Histological Examination ◽  
Cavernous Hemangioma ◽  
English Literature ◽  
Inferior Turbinate ◽  
Left Nasal Cavity ◽  
Mesenchymal Tumors ◽  
Complete Excision ◽  
Intraosseous Hemangioma ◽  
Intraosseous Cavernous Hemangioma

The nasal cavity harbors an enormous variety of neoplasms, including epithelial and mesenchymal tumors. Hemangioma is an infrequent mesenchymal tumor of the nasal cavity, mostly arising in the mucosa and rarely in the bones. We describe the case of a 73-year-old woman who was referred to our hospital with a tumor in her left nasal cavity. The tumor originated from the left inferior turbinate. Histological examination subsequent to complete excision revealed that the tumor was an intraosseous cavernous hemangioma. To our knowledge, this is the second case of intraosseous hemangioma of the inferior turbinate reported in the English literature.

Characteristics of thoracolumbar intramedullary subependymomas

2009 ◽  
Vol 10 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Berk Orakcioglu ◽  
Peter Schramm ◽  
Patricia Kohlhof ◽  
Alfred Aschoff ◽  
Andreas Unterberg ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Mr Imaging ◽  
Neurological Outcome ◽  
Tumor Recurrence ◽  
Medial Septum ◽  
Low Grade ◽  
Complete Excision ◽  
Spinal Cord Dysfunction ◽  
Favorable Neurological Outcome

Object Thoracolumbar intraspinal subependymomas are very rare intramedullary low-grade tumors. The authors report on the clinical and morphological features of 2 cases of thoracolumbar intraspinal subependymomas and provide midterm follow-up data. Methods The clinical and radiological profiles of 2 patients with progressive spinal cord dysfunction due to thoracolumbar intraspinal subependymomas were retrospectively studied and compared with previously reported cases. Results Patients with intraspinal subependymomas initially presented with back pain and long-tract signs. The tumors were hyperintense on T2-weighted MR imaging, isointense on T1-weighted imaging, and noncontrast enhancing. Within 1 of the tumors, a medial septum was present on axial T2-weighted imaging. The tumors were intramedullary but grew exophytically and were amenable to gentle surgical separation from normal neural structures. Therefore, gross-total resection was feasible, and neurological outcome was good. No further adjuvant therapy was conducted. On follow-up (at 58 and 18 months, respectively), no tumor recurrence was observed. Conclusions Symptomatic thoracolumbar intraspinal subependymomas with a distinct appearance on MR imaging are amenable to complete excision with favorable neurological outcome. In this study no tumor recurrence was observed at midterm follow-up in either patient, neither of whom underwent adjuvant therapy.

Concordance of Intradepartmental Consultations of Barrett’s Dysplasia

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S54-S55
Author(s):  
Fengming Chen ◽  
Yongjun Liu ◽  
Francesca Ruggiero
Keyword(s):  
Patient Management ◽  
Clinical Information ◽  
Final Diagnosis ◽  
Progression Rate ◽  
Low Grade ◽  
Rate Of Progression ◽  
Major Discrepancy ◽  
A Minor ◽  
Optimal Patient Management

Abstract Introduction Barrett’s esophagus (BE) is a well-known precursor to esophageal adenocarcinoma (EAC). Simple BE has an annual rate of progression to EAC of only up to 0.5%, while BE with low-grade dysplasia (LGD) or with high-grade dysplasia (HGD) has a higher progression rate of ~10% and ~40%, respectively. Therefore, accurate diagnosis and grading of dysplasia in BE are critical for optimal patient management. However, grading dysplasia is not well defined in practice, which often results in poor interobserver and/or intraobserver reproducibility. In this study, we aim to (1) investigate the concordance of intradepartmental consultations of BE dysplasia and (2) compare consultant diagnosis with final diagnosis and follow-up diagnosis. Methods We retrospectively reviewed 856 intradepartmental consultation records obtained from May 2017 to March 2018. For cases of Barrett’s dysplasia in biopsy specimens, H&E-stained slides were re-reviewed and the corresponding clinical information was retrieved from the electronic medical record. Results Twenty intradepartmental consultation cases of Barrett’s dysplasia were identified (involving 2 females and 18 males, mean age 67.8 ± 8.6 years, ranging 50-81 years). The most frequent reasons for consultation were indefinite dysplasia (IND) vs LGD and LGD vs HGD. Half of the cases showed concordance between referring pathologist and consultant pathologist(s), while 10% of the case showed a major discrepancy (resulting in significant changes in patient management and/or prognosis) and 40% showed a minor discrepancy (resulting in no significant impact on patient management and/or prognosis). The final diagnoses were changed after consultation for cases with major discrepancy, while 60% of cases with minor discrepancy remained the original diagnoses. Conclusions Intradepartmental consultations are strongly recommended for the challenging cases of BE dysplasia, which can effectively prevent over- or underdiagnosis. For challenging cases such as IND vs LGD, two or more consultants are usually needed to reach an agreement.

Superficial Acral Fibromyxoma: An Overview

2011 ◽  
Vol 135 (8) ◽  
pp. 1064-1066 ◽  
Author(s):  
Harty Ashby-Richardson ◽  
Gary S Rogers ◽  
Miguel J Stadecker
Keyword(s):  
Soft Tissue ◽  
Stromal Cells ◽  
Soft Tissue Tumor ◽  
Cellular Proliferation ◽  
Epithelial Membrane Antigen ◽  
Complete Excision ◽  
Mitotic Figures ◽  
Slow Growing ◽  
Superficial Acral Fibromyxoma

Superficial acral fibromyxoma is a rare, slow-growing soft tissue tumor, which is commonly located in the periungual and subungual regions of the fingers and toes in adults. To date, fewer than 50 cases have been reported worldwide. Microscopic examination reveals a moderately circumscribed, nonencapsulated tumor situated in the dermis, which may also extend into the subcutis. The neoplasm consists of a moderately cellular proliferation of stellate and spindle-shaped fibroblast-like cells embedded in a myxocollagenous stroma. Mast cells are easily identified throughout this lesion. Multinucleated stromal cells may also be present, but nuclear atypia and mitotic figures are rare. The tumor shows immunoreactivity for CD34, epithelial membrane antigen, CD99, and less frequently, CD10. Superficial acral fibromyxoma has a benign behavior but may persist or recur if inadequately excised. Therefore, complete excision and close follow-up are advised.

scholarly journals Novel Pathologic Factors for Risk Stratification of Gastric “Indefinite for Dysplasia” Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Kwangil Yim ◽  
Jung Ha Shin ◽  
Jinyoung Yoo ◽  
Stephen Fink
Keyword(s):  
Image Analysis ◽  
Risk Stratification ◽  
Endoscopic Resection ◽  
Final Diagnosis ◽  
Low Grade ◽  
Test Set ◽  
Indefinite For Dysplasia ◽  
Validation Set ◽  
Nuclear Polarity

Background/Aims. “Indefinite for dysplasia” (IND) conditions of the stomach have high malignancy rates (22.6%–75.0%). Endoscopic resection is sometimes used for follow-up, but criteria for selecting this follow-up method are not established. We investigated pathologic factors to subclassify the IND of the stomach and select appropriate follow-up methods. Methods. In total, 123 IND cases with final diagnoses of cancer (29.3%), high-grade dysplasia (6.5%), low-grade dysplasia (11.4%), and nonneoplasm (52.8%) were randomly divided into test set ( n = 27 ) and validation set ( n = 96 ). By the image analysis, size, pleomorphism, hyperchromasia, irregularity of nuclei, and ratios of structural atypia area (SAA) to total IND area were measured in the test set. Using the validation set, consensus meetings were held for the evaluation of pathologic factors that predict the final diagnosis. Results. By image analysis, the only ratio of SAA to total IND area was associated with the final diagnosis ( p < 0.001 ). In the consensus meeting for validation, the nuclear factors, except loss of nuclear polarity ( p = 0.004 – 0.026 ), could not predict the final diagnosis. Conversely, most structural factors could predict the final diagnosis. In particular, SAA > 25 % was the most powerful predictive factor. We proposed criteria of risk stratification by using SAA > 25 % , loss of surface maturation (LOSM), and loss of nuclear polarity (LONP) (Malignancy rate; Category 0: SAA ≤ 25 % without LOSM and LONP; 0%, Category 1: SAA ≤ 25 % with any of LOSM or LONP; 15.2%–16.7%, Category 2: SAA > 25 % without LOSM and LONP; 44.4%–50.0%, Category 3: SAA > 25 % with any of LOSM or LONP 54.5%–55.6%). Conclusions. Structural atypia was more helpful than nuclear atypia and SAA > 25 % was the most powerful predictor for the diagnosis of INDs of the stomach. We propose shortening the follow-up period to six months for Category 1, endoscopic resection for Category 2 and 3, postresection follow-up periods of one year for Category 2, and six months for Category 3.

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