scholarly journals Angiographic Embolization followed by Excision of Large Cellular Angiofibroma of the Vulva

2019 ◽  
pp. 221-225
Author(s):  
Torres SB ◽  
Diez Brito M ◽  
Peremateu MS ◽  
Wernicke A ◽  
Saez Perrotta C ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Multidisciplinary Approach ◽  
Soft Tissues ◽  
Buenos Aires ◽  
Histopathological Diagnosis ◽  
Angiographic Embolization ◽  
Internal Pudendal Artery ◽  
Cellular Angiofibroma ◽  
Pathology Section ◽  
Vulvar Mass

Introduction: Cellular angiofibroma is a rare benign mesenchymal tumor, occurring almost exclusively in the superficial soft tissues of the genital region. Some of these lesions presents as large, hypervascularized masses. There are no reports in the literature to date on the challenges of resection of hypervascularized vulvar masses, or of hypervascularized cellular angiofibroma.Materials and methods: We describe a case of a cellular angiofibroma of the vulva and the surgical approach with tumoral vessel embolization and posterior resection.Case: A 47-year-old women was referred to vulvar pathology section of Italian Hospital of Buenos Aires for evaluation of left vulvar mass. A pelvic angiography was performed 5 days prior to surgery. It showed a hypervascularized formation at the level of the left vulva at the expense mainly of branches of the left internal pudendal artery. A complete resection was performed afterwards at our institution. The histopathological diagnosis was compatible with cellular angiofibroma.Conclusion: We consider that surgical planning is essential and has to be performed with a multidisciplinary approach. Angiographic embolization should be taken into account as a valid resource when planning a surgery with a high risk of blood loss in order to decrease morbidity.

scholarly journals Cellular Angiofibroma of the Buccal Mucosa: A Rare Case Report and Review of Literature

2012 ◽  
Vol 1 (1) ◽  
pp. 23-25
Author(s):  
Kamran Bokhari ◽  
Luqman Manikandan ◽  
Ajmal Mohammad ◽  
Mohammad Shahul ◽  
Mustafa Abdul Bagi ◽  
...  
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Buccal Mucosa ◽  
Rare Case ◽  
Soft Tissues ◽  
Surgical Excision ◽  
Histopathological Diagnosis ◽  
Review Of Literature ◽  
Cellular Angiofibroma ◽  
Rare Case Report

ABSTRACT Background Cellular angiofibromas are rare benign mesenchymal neoplasms characterized by spindle cell component and numerous small vessels. They are commonly well-circumscribed, localized in the superficial soft tissues. The lesion is more frequently seen in the inguinoscrotal or vulvovaginal regions and occurs equally in men and women, and rarely involves oral cavity. Due to its clinical and histological similarity with other mesenchymal tumors, such as angiomyoma, hemangioma, lymphangioma and hemangiopericytoma, angiofibroma presents a diagnostic dilemma. Case report Very few cases of angiofibroma involving maxillofacial region have been reported in the literature. This case report involves cellular angiofibroma involving left buccal mucosa in a 23-year-old female patient. Following detailed clinical examination, radiological interpretation and histopathological diagnosis, surgical excision was performed. The patient was followed-up on a regular basis and was disease free. Summary and conclusion Benign angiofibroma involving oral cavity is a rare tumor. There is a close resemblance of this tumor with other mesenchymal lesions and, thus, faces a diagnostic challenge. Surgical excision with a long-term followup gives good prognosis to this lesion—benign cellular angiofibroma. How to cite this article Bokhari K, Manikandan L, Mohammad A, Shahul M, Bagi MA, Kota Z. Cellular Angiofibroma of the Buccal Mucosa: A Rare Case Report and Review of Literature. Int J Exper Dent Sci 2012;1(1):23-25.

scholarly journals Epiphysiodesis for the treatment of tall stature and leg length discrepancy

2021 ◽  
Author(s):  
Madeleine Willegger ◽  
Markus Schreiner ◽  
Alexander Kolb ◽  
Reinhard Windhager ◽  
Catharina Chiari
Keyword(s):  
Surgical Planning ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Bone Age ◽  
Leg Length Discrepancy ◽  
Tall Stature ◽  
Complication Rates ◽  
Leg Length ◽  
Growth Prediction ◽  
Length Discrepancy

SummaryPainful orthopedic conditions associated with extreme tall stature and leg length discrepancy (LLD) include back pain and adopting bad posture. After failure of conservative treatment options, blocking of the growth plates (epiphysiodesis) around the knee emerged as gold standard in patients with tall stature and LLD in the growing skeleton. Surgical planning includes growth prediction and evaluation of bone age. Since growth prediction is associated with a certain potential error, adequate planning and timing of epiphysiodesis are the key for success of the treatment. LLD corrections up to 5 cm can be achieved, and predicted extreme tall stature can be limited. Percutaneous epiphysiodesis techniques are minimally invasive, safe and efficient methods with low complication rates. In general, a multidisciplinary approach should be pursued when treating children and adolescents with tall stature.

scholarly journals Squamous cell carcinoma mimicking a wart

2021 ◽  
Vol 12 (4) ◽  
pp. 471-472
Author(s):  
Aida Oulehri ◽  
Sara Elloudi ◽  
Hanane Baybay
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Soft Tissues ◽  
Verrucous Carcinoma ◽  
Previous History ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Complete Surgical Excision ◽  
Safety Margins

Sir, Cutaneous squamous cell carcinoma, a malignant proliferation of the cutaneous epithelium, represents the second most common non-melanoma skin cancer after basal cell carcinoma [1]. Verrucous carcinoma (VC) is a rare, low-grade, well-differentiated squamous cell carcinoma most commonly seen in the mucosa, infrequently reported to occur in the skin, where it is a slow-growing and locally aggressive tumor. It is not uncommon for cutaneous verrucous carcinomas to be mistaken for the more frequent wart (verruca vulgaris) and treated accordingly [2]. The etiopathogenesis of VC is not completely known. One theory mentions the human papillomavirus (HPV) infection; with plantar lesions, the types involved are reported to be 16 and 11 [3]. Histopathological diagnosis is difficult and needs one or more broad and in-depth biopsies. Morbidity results from the local destruction of the skin and soft tissues and, occasionally, from a perineural, muscular, and even bony invasion. Metastasis to regional lymphatic ganglia is rare, found in 5% of cases [4]. VC bears a high risk of local relapse. No matter the treatment employed, the rate of recurrence varies from 30% to 50% and usually is not the result of incomplete surgical interventions. The treatment of choice is complete surgical excision with safety margins [5]. A forty-year-old female patient with no previous history presented herself with a hyperkeratotic lesion on the right foot persistent for two years, which she had been manipulating routinely, which had progressively been increasing in size for the previous year, and which, for the previous three months, had become painful and bleeding. An examination revealed a hyperkeratotic plaque with a hyperpigmented border, hard on palpation, adherent to the deep plane, and with an eroded surface (Fig. 1). Dermoscopy was able to find a papillomatous appearance surrounded by dotted vessels (Fig. 2). This dermoscopic aspect typical of vulgar warts was confusing. Indeed, dermoscopy of the foot wart shows red or black dots in the center of papillomatous structures, which are thrombosed vessels supplying the wart; hence the importance, in our opinion, of the clinical and pathological correlation. For this reason, we performed a skin biopsy; an anatomopathological study found a squamous cell carcinoma of the verrucous type.

scholarly journals A Reliable Surgical Procedure for Sinus Floor Augmentation with Antral Pseudocysts

2021 ◽  
Vol 9 (10) ◽  
pp. 122
Author(s):  
Yasuhiro Nosaka ◽  
Hitomi Nosaka ◽  
Yasushi Nakajima ◽  
Tadasuke Tanioka ◽  
Daniele Botticelli ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Correct Diagnosis ◽  
Inflammatory Cells ◽  
Histological Evaluation ◽  
Histopathological Diagnosis ◽  
Cystic Lesions ◽  
Two Stage ◽  
Asymptomatic Patients ◽  
Sinus Floor Augmentation ◽  
Sinus Floor

An antral pseudocyst (AP) is a common well-defined ‘dome-shaped’ faintly radiopaque lesion of the maxillary sinus, and usually does not require treatment in asymptomatic patients. However, when sinus floor augmentation is required to increase bone volume for implant installation, the elevation of the sinus mucosa might drive the AP against the ostium. This might cause its obstruction and, as possible consequence, sinusitis. The purpose of this study was to investigate the clinical and tomographic conditions of APs to identify a predictable cyst removal that might allow a safety sinus floor augmentation. A total of 52 maxillary sinuses in 46 patients (mean age 55.1 years) presenting AP were examined by cone beam computed tomographies (CBCTs). A two-stage approach was applied. At the first surgery, the cystic lesions were further inspected by an endoscope through the antrostomy, and histopathological diagnosis of the removed tissues was carried out. After the confirmation of decrease of the swelling of sinus membrane by CBCT, the sinus floor augmentation was performed, at least four months after cyst removal. The color and transparency of the 86 cystic lesions were classified into 4 types. The whitish transparent cysts were 34 (39.5%), the yellowish transparent cysts were 18 (20.9%), the dark purple transparent cysts were 8 (9.3%) and the milky-white opaque cysts were 26 (30.2%). The contents of the 60 (69.8%) transparent cysts were serous fluid, but those of milky-white cysts were composed of viscous or elastic soft tissues, and the aspiration of the contents was unsuccessful. The analysis of the preoperative CBCT did not provide certainty on the contents of the cystic lesions. All cystic lesions were diagnosed as AP, and an infection was identified in one AP, presenting marked infiltration of the inflammatory cells. Considering the difficulties of performing a correct diagnosis of the AP content by a CBCT analysis, the risk of failure of the surgery that creates severe afflictions to the patients, and the necessity of a histological evaluation of the cyst, a two-stage surgery appeared to be the most reliable procedure.

Monophasic Synovial Sarcoma Arising in the Vulva: A Case Report and Review of the Literature

2008 ◽  
Vol 132 (4) ◽  
pp. 698-702
Author(s):  
Beverly E. White ◽  
Alan Kaplan ◽  
Dolores H. Lopez-Terrada ◽  
Jae Y. Ro ◽  
Robert S. Benjamin ◽  
...  
Keyword(s):  
Synovial Sarcoma ◽  
Soft Tissues ◽  
English Literature ◽  
Review Of The Literature ◽  
First Case ◽  
Additional Surgery ◽  
Synovial Sarcomas ◽  
The Right ◽  
Disease Free ◽  
Vulvar Mass

Abstract Synovial sarcomas most commonly arise in the soft tissue of the extremities. Less commonly, these tumors present in the head and neck, abdominal wall, and other sites. However, synovial sarcoma occurring in the vulvar area is extremely rare. Only 2 previous cases of biphasic synovial sarcoma of the vulva have been reported, but no case of vulvar monophasic synovial sarcoma has been described in the English literature. We report the third case of synovial sarcoma and apparently the first case of monophasic synovial sarcoma arising in soft tissues of the vulva. The patient was a 33-year-old woman who presented for evaluation of a painless vulvar mass. The tumor was located in the deep fibroadipose tissue of the right vulva (6.5 × 4.2 × 3.5 cm). The histology of the lesion was that of a monophasic synovial sarcoma with a hemangiopericytic vascular pattern. A subsequent molecular analysis revealed SYT-SSX2 gene fusion, which confirmed the diagnosis of synovial sarcoma. After an initial wide local excision, the patient developed a recurrence in the right groin and received chemotherapy and additional surgery. The patient is currently disease free, on adjuvant chemotherapy, and being followed up closely.

scholarly journals A Multidisciplinary Approach to the Management of Atypical Osseous Epithelioid Hemangioendothelioma

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
J. K. Ma ◽  
J. Barr ◽  
S. Vijayakumar
Keyword(s):  
Multidisciplinary Approach ◽  
Pathological Fracture ◽  
Soft Tissues ◽  
Intensity Modulated Radiation Therapy ◽  
Vascular Tumor ◽  
Epithelioid Hemangioendothelioma ◽  
Histopathological Study ◽  
Incisional Biopsy ◽  
Multidisciplinary Intervention ◽  
Imaging Characteristics

Hemangioendothelioma is a rare vascular tumor of intermediate malignant potential. Though epithelioid hemangioendothelioma (EH) is commonly found in soft tissues, it has been known to be present in skeletal tissues. The authors present a case of a 50-year-old woman diagnosed with EH of the iliac bone and acetabulum, who experienced pathological fracture at presentation. This report describes a multidisciplinary approach to the management that includes initial incisional biopsy, curettage, and bone grafting, followed by Intensity Modulated Radiation Therapy. The patient finally underwent hemipelvic resection with allograft reconstruction after recurrence. Histopathological study revealed osseous EH of low mitotic activity that stained positively for CD31, CD34, vimentin, and Factor VIII. Herein, the authors discuss the imaging characteristics, histopathological aspects, cytogenetic findings, and the radiobiological behavior of osseous EH. After an aggressive multidisciplinary intervention, the patient is able to achieve local control with no evidence of distal metastatic disease.

scholarly journals The role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region

2019 ◽  
Vol 10 (1) ◽  
pp. 48-53
Author(s):  
Mohammad Sowkat Hossain ◽  
S M Mahbubul Alam ◽  
Sk Md Jaynul Islam ◽  
Wasim Selimul Haque ◽  
Shamoli Yasmin
Keyword(s):  
Head And Neck ◽  
Soft Tissues ◽  
Histopathological Examination ◽  
Malignant Neoplasm ◽  
Cervical Lymphadenopathy ◽  
Neck Region ◽  
Histopathological Diagnosis ◽  
Female Ratio ◽  
Head And Neck Region

Background: Undifferentiated tumours in the head and neck region are not uncommon. They can arise from different sites like in mucosa as well as in salivary glands, soft tissues or lymph nodes. Histopathological examination plays a central role in the diagnosis but difficulties arise with some tumours which are poorlydifferentiated due to their high inter- and intra-observer variability. In those cases, immunohistochemistry has greatly assisted to diagnose the tumours that cannot be accurately identified using routine histopathological procedures. The correct histopathological diagnosis is essential especially in case of malignant tumourwhere subsequent specific therapy is required. The aim of this study was to determine the role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region. Methods: This cross-sectional study was conducted during July 2014 to June 2015. A total of 35 Bangladeshi patient’s specimens of head and neck swelling were collected from two renowned laboratories in Dhaka city.These cases were diagnosed as undifferentiated tumour in histopathological examination.Standard protocol was followed for immunohistochemistry.Then primary immunohistochemical panel which included the markers for Epithelial CK (AE1/AE3),mesenchymal marker (Vimentin) and lymphoid marker (LCA) were used.The cases which were not resolved by primary immunohistochemistry panel, the second panel was applied for further sub classification (Desmin, Chromogranin, CK20, CEA, CD20, CD30, HMB45, NSE). Based on interpretation of immunohistochemical findings final diagnoses were made.Data analysis was performed using the Statistical Package for the Social Sciences for Windows version 22.0 (SPSS, Chicago, Illinois, USA). Results: A total of 35 undifferentiated tumorsof head-neck region were studied.The mean age was 46.3±17.6 years and male to female ratio was 4.8:1. The majority 13 (37.1%) patient had cervical lymphadenopathy, 11 (31.4%) had neck mass and 4(11.4%) had in nasal/sinonasal mass.Regarding histopathologicalcell types, round cell was 21 (60.0%), spindle cell 6 (17.1%), pleomorphic cells 6(17.1%) and epithelioid cells 2(5.7%). In initial histopathological examination, majority 25(71.4%) were undifferentiated malignant neoplasm, 8(22.8%) were metastatic undifferentiated carcinoma, 1(2.9%) was pleomorphic sarcoma and the remaining 1(2.9%) had malignant adnexal tumour. By application of immunohistochemistry, most (33, 94.3%) of the cases were resolved and the two cases remained unresolved. Among the resolved cases majority (15, 45.5%) were lymphoma, 4(12.1%) were metastatic carcinoma, 3(9.1%) were Ewing’s sarcoma and malignant melanoma were found in 3(9.1%) cases. Conclusion: This study supports that the immunohistochemical technique has a fundamental role in the investigation of undifferentiated tumour origin, to determine the correct guidance for treatment and improving the prognosis for head and neck tumour patients. Birdem Med J 2020; 10(1): 48-53

scholarly journals Major Trauma and Severe Burn: A Synergistic Mortality. Case Report and Literature Review

2020 ◽  
Vol 61 (01) ◽  
pp. 023-027
Author(s):  
Oriol Pujol ◽  
Jordi Selga ◽  
Jordi Serracanta ◽  
Juan Antonio Porcel ◽  
José Vicente Andrés-Peiró
Keyword(s):  
Synergistic Effect ◽  
Multidisciplinary Approach ◽  
Open Fracture ◽  
Major Trauma ◽  
Soft Tissues ◽  
Total Body Surface Area ◽  
High Energy ◽  
Complex Case ◽  
Severe Burns ◽  
The Right

Abstract Case Presentation A 42-year-old man was transferred to our institution after a high-energy accident (an explosion). He presented second-degree burns on 20% of the total body surface area (TBSA), affecting the lower hemiabdomen and the lower right limb. He also presented a supraintercondylar open fracture of the right femur (Gustilo I). The burns were treated with debridement and coverage with mesh graft, while the fracture required an early transitory transarticular external fixation with delayed definitive osteosynthesis. Our patient presented good local and systemic evolution. We can offer a eleven-month follow-up. Discussion The literature supports that the combination of trauma and burn injuries is a relatively rare pattern, which may explain the lack of knowledge and studies on this subject. This double injury has demonstrated a synergistic effect on mortality. The management of soft tissues in the coexistence of an open fracture and a burn in the same limb is a challenge. The method and timing of the treatment of the fracture directly impacts the treatment of the burn (and vice versa), and most authors tend to treat the fracture first. All of the studies reviewed emphasized the importance of the multidisciplinary approach. Conclusions We have presented a complex case combining major trauma and severe burns. Although there is a lack of studies in the literature on this subject, the papers state that this is an unusual pattern with a synergistic effect on mortality. In our experience, the management of soft tissues and the multidisciplinary approach play a central role, as it is also stated in the literature. The management of these patients is still controversial, and more studies are needed.

scholarly journals Pediatric patient with diagnosis of extra osseous Ewing’s sarcoma of the tongue: case report

2018 ◽  
Vol 66 (4) ◽  
pp. 399-403
Author(s):  
Neira CHAPARRO ◽  
Amaurys DIAZ ◽  
Luis HERRERA ◽  
Rafael PINEDA ◽  
Betty PEROZO ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Soft Tissues ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Malignant Neoplasm ◽  
Histopathological Study ◽  
Histopathological Diagnosis ◽  
Unusual Behavior ◽  
Volume Increase ◽  
Tumoral Lesion

ABSTRACT Ewing’s sarcoma is a malignant tumor that arises mainly from bone tissue, so that its extra-osseous presentation is not very common and even more unusual, in the soft tissues of the oral cavity. The objective of this case was to describe the clinical characteristics of an extra-osseous Ewing’s Sarcoma of the tongue in a pediatric patient. An 11-year-old male school patient, who attended an oral medicine consultation referring a volume increase in the tongue. Intraorally, a tumoral lesion was observed on the left lateral edge of the tongue, indurated, with the same color of the mucosa with ulcerated areas, well defined edges and symptomatic on palpation, with an approximate size of 2.5 cm. A cervical and maxillofacial MRI was indicated, observing a partially delimited hyperintense and non-infiltrating lesion in the described area. An incisional biopsy was performed with histopathological diagnosis of malignant neoplasm of blue round cells, theCD99 marker was found to be positive in the immunohistochemical study and was key to the definitive diagnosis of this tumor. A thoraco-abdomino-pelvic tomography was requested by the Pediatric Oncology service, as well as biopsy and aspiration of bone marrow, in which no neoplastic infiltrations were evidenced. After four cycles of chemotherapy, total removal of the lesion was performed with a consecutive histopathological study of the surgical piece, indicating free edges of the lesion. Ewing’s sarcoma is a tumor with aggressive behavior, so this case represents a finding of clinical and epidemiological relevance, both due to its extra-osseous appearance and its unusual behavior.

scholarly journals Oropharyngeal Hairy Polyp: A Case of Respiratory Failure in a Newborn

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 465
Author(s):  
Paola Feraco ◽  
Emma Bragantini ◽  
Francesca Incandela ◽  
Cesare Gagliardo ◽  
Marina Silvestrini
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress ◽  
Surgical Planning ◽  
Soft Tissues ◽  
Neonatal Period ◽  
Upper Airway ◽  
Intracranial Extension ◽  
Essential Information ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri

Hairy polyps, also known as dermoid polyps (DPs), are rare benign cystic lesions of bigerminal origin that may occur in several head and neck regions, including the oropharynx. Despite their benign histopathological nature, DPs may be life threatening, due to their upper airway location, and DPs represent one of the most unusual causes of respiratory distress during the neonatal period. In this paper, we describe a case of respiratory failure in a newborn with an oropharyngeal mass that was accidentally found during difficult intubation. Magnetic resonance imaging (MRI) detected a well-defined soft tissue pedunculated mass, arising from the left oropharynx wall, consistent with an oropharyngeal DP. The newborn had a prompt recovery after trans-oral mass removal. Our case underlines the importance of imaging in differential diagnosis of children’s respiratory distress, secondary to a variety of lesions within the region of the skull base or oropharynx. It allowed us to assess the origin of the lesion, as well as its relationship with the adjacent soft tissues, and to exclude intracranial extension, thus providing essential information for the surgical planning.

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