Giant Nodular Fasciitis Originating From The Humeral Periosteum: A Diagnostic Challenge

Abstract Background: Nodular fasciitis (NF) is a self-limiting, benign, fibroblastic, and myofibroblastic tumor that mostly occurs in the subcutaneous superficial fascia, although there are reports of NF occurrences at atypical sites, such as intraneural and intra-articular locations. However, NF originating from the appendicular periosteum is extremely rare, and NF lesions usually are smaller than 4 cm. A large NF lesion of periosteal origin can be misdiagnosed as a malignant bone tumor and may cause overtreatment.Case presentation: This case report presents a large NF that originated from the humeral periosteum in an adult and was initially diagnosed intraoperatively as low-grade sarcoma, but later diagnosed as NF after post-resection histopathological evaluation. Furthermore, fluorescence in situ hybridization analysis revealed a USP6 gene rearrangement that confirmed the diagnosis. To the best of our knowledge, this is the first case of NF in the humeral periosteum.Discussion and Conclusions: NF poses a diagnostic challenge especially occurrences at rare sites as it is often mistaken for a sarcoma. Postoperative histopathological examination of whole sectionscan be combined with immunohistochemical staining and, if necessary, the diagnosis can be confirmed by molecular detection, and thus help avoid overtreatment.

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Large-size intramuscular nodular fasciitis, a challenging histopathologic diagnosis confirmed by molecular detection of USP6 gene rearrangement: A case report and literature review

10.21203/rs.3.rs-141423/v1 ◽

2021 ◽

Author(s):

Changrong Wang ◽

Wei Wang ◽

Rujun Xu ◽

Jingjing Xiang

Keyword(s):

Gene Rearrangement ◽

Molecular Detection ◽

Giant Cells ◽

Outer Edge ◽

Nodular Fasciitis ◽

Large Tumor ◽

Case Presentation ◽

Large Size ◽

Initial Surgery ◽

Histopathologic Diagnosis

Abstract Background: The intramuscular subtype of nodular fasciitis (NF) is rare with lesions normally not more than 2 cm in size and characterized by pseudosarcomatous morphology. Case presentation: Here, we report a case of a 27-year-old man presenting with a chief complaint of an increasingly enlarged mass of the left upper arm for 4 months. Magnetic resonance imaging confirmed the presence of a well-defined tumor measuring 5 cm within the outer edge of the middle humerus. Microscopically, the neoplasm was highly cellular with focally discohesive and myxoid features. In more cellular areas, cells grew in bundles with an interlaced pattern. The mitotic index was high and multinuclear giant cells were evident. The stroma contained collagen with erythrocyte extravasation. The tumor border was infiltrative. Immunohistochemically, the tumor cells were positive for SMA and negative for CK, desmin, CD34, S100, ALK, and β-catenin. Molecular detection demonstrated evidence of USP6 gene rearrangement in this tumor. Based on the findings, we diagnose this case as intramuscular NF. At 48 months after the initial surgery, the patient had recovered well with no evidence of recurrence or metastasis. Conclusions: In this study, the diagnosis of intramuscular NF with a relatively large tumor was confirmed by molecular detection of USP6 gene rearrangement.

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The diagnostic challenge of low-grade ductal carcinoma in situ

European Journal of Cancer ◽

10.1016/j.ejca.2017.04.013 ◽

2017 ◽

Vol 80 ◽

pp. 39-47 ◽

Cited By ~ 15

Author(s):

Tracy Onega ◽

Donald L. Weaver ◽

Paul D. Frederick ◽

Kimberly H. Allison ◽

Anna N.A. Tosteson ◽

...

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Low Grade ◽

Diagnostic Challenge

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Plasmablastic Lymphoma Mimicking Acute Pancreatitis

Case Reports in Oncological Medicine ◽

10.1155/2016/9751736 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4

Author(s):

Faisal Inayat ◽

Hafeez Ul Hassan Virk ◽

Ahmad R. Cheema ◽

Muhammad Wasif Saif

Keyword(s):

Acute Pancreatitis ◽

Histopathological Examination ◽

Plasmablastic Lymphoma ◽

Hiv Positive ◽

Case Presentation ◽

Barr Virus ◽

Immunodeficiency Virus ◽

Rna In Situ Hybridization ◽

Epstein Barr

Background.Plasmablastic lymphoma (PBL) is a rare B-cell neoplasm. It predominantly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients and exhibits a highly aggressive clinical behavior.Case Presentation.We describe an unusual case of a 37-year-old HIV-positive male who presented with acute pancreatitis secondary to multiple peripancreatic masses compressing the pancreas. Histopathological examination of the lesions showed diffuse and cohesive pattern of large B-cells resembling immunoblasts or plasmablasts. The neoplastic cells were positive for BOB1 and MUM1, partially positive for CD79a, and negative for CD20, CD56, CD138, CD3, CD5, AE1/AE3, and HHV8. Epstein-Barr virus-encoded RNA in situ hybridization was positive. These features were consistent with PBL. The patient was initiated on cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy, demonstrating a striking response.Conclusion.To our research, this is the first report of PBL with the initial presentation of acute pancreatitis. The findings in this case suggest that PBL should be included in the differential diagnosis of pancreatic and peripancreatic tumors.

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Malignant Gastrointestinal Neuroectodermal Tumor in the Right Atrium: The First Case Report Presenting with an Extra-Gastrointestinal Mass

10.21203/rs.3.rs-620292/v1 ◽

2021 ◽

Author(s):

Zhiwen Li ◽

Xiaohong Pu ◽

Yao Fu ◽

Lin Li ◽

Yuemei Xu ◽

...

Keyword(s):

Case Report ◽

Right Atrium ◽

Tumor Location ◽

Neuroectodermal Tumor ◽

Case Presentation ◽

First Case ◽

Mitotic Figures ◽

The Right ◽

Whole Transcriptome

Abstract Background: Malignant gastrointestinal neuroectodermal tumor is an extremely rare soft tissue sarcoma which was firstly described in 2003 but until recently it had been designated as a definite new entity. According to the previous literatures, Malignant gastrointestinal neuroectodermal tumor was almost exclusively occurred in gastrointestinal tract.Case presentation: A 62-year-old male showed a mass in right atrium and the occupying mass was founded on the right ventricular diaphragm and involved the right atrium along the coronary sinus during the operation. Microscopically, the tumor characterized by the solid sheet and pseudopapillary focally architectures, and was composed of small to medium cells with round or oval nuclei, variable amount of eosinophilic or clear, and frequent mitotic figures. Immunohistochemically, the neoplastic cells were positive for S100 and SOX-10 but negative for HMB-45, A103 and CD99. EWSR1-AFTF1 rearrangement was detected by fluorescence in situ hybridization and further confirmed involving fusion of EWSR1 exon 8 with ATF1 exon 4 by whole transcriptome sequence analysis.Conclusions: This is the first case report of extra-gastrointestinal Malignant gastrointestinal neuroectodermal tumor that occurring in the right atrium，which remind of the new prospect of the tumor location.

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Skull base low-grade non-intestinal adenocarcinoma in a paediatric patient

Rhinology online ◽

10.4193/rhinol/21.046 ◽

2021 ◽

Vol 4 (4) ◽

pp. 218-222

Author(s):

K. Miu ◽

C. Tornari ◽

P. Surda

Keyword(s):

Paediatric Population ◽

Endoscopic Biopsy ◽

Nasal Discharge ◽

Low Grade ◽

Case Presentation ◽

Olfactory Cleft ◽

First Case ◽

Recurrent Epistaxis ◽

Endoscopic Operation ◽

Ct And Mri

Background: Non-intestinal adenocarcinomas of the sinonasal tract are uncommon neoplasms in adults, and particularly rare in the paediatric population. Case presentation: A 10-year-old male presented to the Paediatric Otolaryngology clinic with symptoms of recurrent epistaxis, persistent clear nasal discharge, and a left-sided polypoidal swelling causing nasal obstruction. An endoscopic biopsy of the polyp under general anaesthesia found a mass arising from the anterior olfactory cleft, and the histology report described the mass as a low-grade non-intestinal adenocarcinoma. CT and MRI of the sinuses post-biopsy demonstrated no bony structure infiltration. The patient underwent a further endoscopic operation for definitive excision of the nasal mass, and the histology findings confirmed a complete resection of the tumour. Conclusion: This case demonstrates the first case of a primary low-grade non-intestinal adenocarcinoma originating from the olfactory cleft.

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Neuroendocrine tumor arising from the greater omentum treated with laparoscopic tumor resection: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01217-4 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Taichi Terai ◽

Kenji Nakagawa ◽

Kota Nakamura ◽

Shunsuke Doi ◽

Kohei Morita ◽

...

Keyword(s):

Neuroendocrine Tumor ◽

Histopathological Examination ◽

Tumor Resection ◽

Ventral Side ◽

Greater Omentum ◽

Preoperative Imaging ◽

Ki 67 ◽

Case Presentation ◽

First Case ◽

Omental Tumor

Abstract Background Primary omental tumors are extremely rare. Herein, we report the first case of a primary omental neuroendocrine tumor (NET). Case presentation A 59-year-old woman was referred to our hospital for the treatment of an 18-mm tumor located at the ventral side of the duodenum. No other tumor was detected. The preoperative imaging diagnosis was omental tumor. A laparoscopic tumor resection was performed. Histopathological examination revealed that the tumor consisted of cuboidal cells with eosinophilic, granular cytoplasm showing trabecular or ribbon architecture. No other component was seen. The mitotic count was of 5 per 10 high-power fields. Immunohistochemical staining was positive for chromogranin A, synaptophysin, and CD56. Her Ki-67 index was 5%. These results led to the diagnosis of grade 2 omental NET. The patient was discharged on the 3rd postoperative day without any complications and did not develop any recurrence for 3 years. Conclusions We encountered a very rare case of omental NET. Complete resection is recommended with minimally invasive surgery for the diagnosis of NET.

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Atypical Meningioma in the Medulla Oblongata Parenchyma

10.21203/rs.3.rs-112925/v1 ◽

2020 ◽

Author(s):

Qiushi Xu ◽

Ziang Pan ◽

Meidan Hou ◽

Fang Peng

Keyword(s):

Magnetic Resonance Imaging ◽

Medulla Oblongata ◽

Preoperative Diagnosis ◽

Histopathological Examination ◽

Atypical Meningioma ◽

Resonance Imaging ◽

Case Presentation ◽

First Case ◽

History Of ◽

Atypical Meningiomas

Abstract Background: Glioma is the most common tumor occurring in the brainstem. A primary intraparenchymal meningioma located in the brainstem without dura attachment is rare. Meanwhile, atypical meningiomas that occur in the medulla oblongata parenchyma, and without dura coverage, are extremely rare. In this study, we report the first case of atypical meningioma in the medulla oblongata parenchyma and review the existing literature.Case presentation: A 38-year-old female was admitted at our hospital with a 2-week history of progressive neck and occipital pain. Magnetic resonance imaging revealed a presence of a 1.5x0.9cm mass lesion, located in the left side of the medulla oblongata, which was hypointense on T1-weighted and hyperintense on T2-weighted images, and with inhomogeneous enhancement following gadolinium-diethylenet-riamine pentaacetic acid (Gd-DTPA) administration. The initial preoperative diagnosis was glioma or angioblastoma. The patient underwent a total surgical resection of the left medulla oblongata tumor and the histopathological examination indicated that the lesion was an atypical meningioma. The patient returned to normal life after surgery.Conclusions: Although glioma is the most common tumor occurring in the brainstem parenchyma, the possibility of meningioma cannot be ruled out in this area.

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FUS (16p11) Gene Rearrangement as Detected by Fluorescence In-Situ Hybridization in Cutaneous Low-Grade Fibromyxoid Sarcoma: A Potential Diagnostic Tool

American Journal of Dermatopathology ◽

10.1097/iae.0b013e318176de80 ◽

2011 ◽

Vol 33 (2) ◽

pp. 140-143 ◽

Cited By ~ 30

Author(s):

Rajiv M Patel ◽

Erinn Downs-Kelly ◽

Monisha N Dandekar ◽

Julie C Fanburg-Smith ◽

Steven D Billings ◽

...

Keyword(s):

In Situ Hybridization ◽

Fluorescence In Situ Hybridization ◽

Diagnostic Tool ◽

Gene Rearrangement ◽

Low Grade ◽

Fibromyxoid Sarcoma

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Canine ovarian gonadoblastoma with dysgerminoma overgrowth: a case study and literature review

Journal of Ovarian Research ◽

10.1186/s13048-019-0561-x ◽

2019 ◽

Vol 12 (1) ◽

Author(s):

Ana R. Flores ◽

João Lobo ◽

Francisco Nunes ◽

Alexandra Rêma ◽

Paula Lopes ◽

...

Keyword(s):

Germ Cell ◽

Y Chromosome ◽

Epithelial Membrane Antigen ◽

Histopathological Examination ◽

Stromal Tumour ◽

Pcr Analysis ◽

Case Presentation ◽

First Case

Abstract Background Gonadoblastoma (GB) is a rare mixed germ cell-sex cord-stromal tumour, first described in humans, commonly found in dysgenetic gonads of intersex patients that have a Y chromosome. However, this entity in not recognized in the WHO classification of tumours of genital system of domestic animals. Herein, we describe a case of ovarian gonadoblastoma with proliferation of dysgerminoma and sex cord-stromal tumour components, in a phenotypically and cytogenetically normal bitch. Case presentation A 17-year-old cross-breed bitch had a firm, grey-white multinodular mass in the left ovary. The tumour was submitted to histopathological examination and Y chromosome detected through karyotype analysis and PCR studies. Microscopically, the ovary was almost replaced by an irregular neoplasm composed of three distinct, intermixed elements: dysgerminoma, mixed germ cell-sex cord-stromal tumour resembling human GB and a proliferative sex cord-stromal tumour component. The germ cells of gonadoblastoma and dysgerminoma components were immunoreactive for c-KIT. Sex cord-stromal cells of gonadoblastoma were immunoreactive for α-inhibin. The sex cord-stromal tumour was immunoreactive for AE1/AE3, occasionally for α-inhibin and negative for epithelial membrane antigen (EMA). The karyotype was 78, XX and PCR analysis confirmed the absence of the Y chromosome. Conclusion Based on these findings, a diagnosis of gonadoblastoma with proliferation of dysgerminoma and sex cord-stromal tumour was made. This is the first case of ovarian gonadoblastoma in a female dog.

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Case Report: Response to Intra-arterial Cisplatin and Concurrent Radiotherapy Followed by Salvage Surgery in a Patient With Advanced Primary Sinonasal Low-Grade Non-intestinal Adenocarcinoma

Frontiers in Surgery ◽

10.3389/fsurg.2020.599392 ◽

2020 ◽

Vol 7 ◽

Author(s):

Hirohiko Tachino ◽

Hiromasa Takakura ◽

Hideo Shojaku ◽

Michiro Fujisaka ◽

Katsuichi Akaogi ◽

...

Keyword(s):

Case Report ◽

Salvage Surgery ◽

Histopathological Examination ◽

Locally Advanced ◽

Middle Turbinate ◽

Lymphocytic Infiltration ◽

Low Grade ◽

Fractionated Radiotherapy ◽

First Case ◽

Positron Emission

Background: The clinical usefulness of concurrent chemoradiotherapy before surgery in the treatment of primary, locally advanced sinonasal low-grade, non-intestinal type adenocarcinoma (LG non-ITAC) is unclear.Methods: We present the first case report of the efficacy of super-selective intra-arterial cisplatin (CDDP) infusion concurrent with conventional fractionated radiotherapy (RT) for LG non-ITAC in a Japanese patient.Results: A white, rugged-marginal mass that was histopathologically diagnosed as LG non-ITAC occupied the right nasal cavity. Based on the imaging findings, including computed tomography, magnetic resonance imaging, and positron emission tomography, the tumor was diagnosed as T4aN0M0, stage IVa. After treatment, the nasal tumor disappeared leaving only a small bulge in the medial wall of the middle turbinate. The patient also underwent right transnasal ethmoidectomy performed as salvage surgery. A histopathological examination revealed that the lesion was replaced by granulation tissue with lymphocytic infiltration and hemosiderin-laden macrophages, and no viable tumor cells remained. In the seven years after treatment, the patient has not experienced any local recurrence or regional or distant metastasis.Conclusions: Super-selective intra-arterial CDDP infusion concurrent with conventional fractionated RT followed by salvage surgery might be useful for the management of sinonasal LG non-ITAC.

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