LARYNX MYOFIBROBLASTIC TUMOR, A RARE CASE REPORT

Myofibroblastic tumour is extremely rare in the larynx, with just over 40 published cases. Despite being a benign tumour, they are tumours with a marked inflammatory character, local destruction and the possibility of degeneration to malignant histological types and with metastatic capacity. Anatomopathological differential diagnosis is fundamental in this cases.

First comprehensive report on distribution of histologically confirmed oral and maxillofacial pathologies; a nine year retrospective study

Objective: To report the distribution of oral and maxillofacial pathologies diagnosed histologically in laboratory. Methods: The retrospective descriptive cross-sectional study was conducted at Rehman Medical Institute, Peshawar, Pakistan, and comprised biopsied lesions submitted to the institutional laboratory from 2010 to 2019. Data on gender, age, site of the lesion and histopathological diagnosis was retrieved from the records. Data was analysed using Microsoft Excel. Results: Of the 986 histologically confirmed cases, 545(55.27%) related to males and 441(44.72%) to females. The overall mean age of the patients was 43.20+19.85. Tongue was the most affected site 159(16.1%). The most common diagnostic category was malignant tumours 338(34%), followed by salivary gland pathology 162(16%), and cysts and odontogenic tumours 138(14%). The most common histopathological finding was oral squamous cell carcinoma 249(25.2%), and pleomorphic adenoma was the most common benign tumour 103(10.4%). Conclusion: Oral squamous cell carcinoma was the most common malignancy, while pleomorphic adenoma was the most common benign tumour. Key Words: Oral and maxillofacial lesions, Prevalence, Histopathology, Benign lesions, Malignant lesions.

Physiotherapy Rehabilitation in Subject with Scapular Osteochondroma: A Case Report

Introduction: The most prevalent benign tumour affecting the metaphysis of long bone is osteochondroma, a form of cartilaginous tumour. Solitary or multiple osteochondromas can prevail.Hereditary multiple exostosis (HME) or familial osteochondromatosis is the multiple variant, which is an autosomal dominant syndrome. Case Presentation: A 35-year old female with right-hand dominance was referred todepartment of physiotherapy. On palpation small nodular swelling of marble size was present in left axilla. X-rays findings showed increased scapular mass and ribs were compressed laterally. Discussion: The most widespread benign tumour is osteochondroma. In 3.0-6.4 percent of all instances, the scapula is implicated. The osteochondroma normally develops on the scapula's anterior aspect. The scapula osteochondroma induces pain and a grating sound when the scapula is moved. Mechanic irritation of muscle, tendon, or soft tissue, emergence of a pseudoaneurysm or bursa, fracture, or malignant transformation are all causes of symptoms. Conclusion: Osteochondroma is a common benign tumor. Management of osteochondroma is important to improve the quality of life. Physiotherapy plays an important role in managing Scapular osteochondroma.

Solitary neurofibroma of the right lateral wall of the oropharynx

Solitary neurofibroma of the oropharynx is extremely rare. Imaging explorations may be necessary, but the diagnostic certainty is pathological. We report a case of benign tumour of the oropharynx in a 25-year-old woman who was seen for a consultation with dysphagia, a change in voice and dyspnea in the supine position. The excision was performed under general anaesthesia with orotracheal intubation via the oropharyngeal route. Pathological examination of the surgical specimen revealed neurofibroma. Although rare, solitary neurofibroma of the oropharynx should be considered in any benign tumour in the area.

1068 Cranial Fasciitis of the Temporal Bone

We present the case of a child with a rare benign tumour of the temporal bone. A nine-month-old girl was referred to her local paediatric hospital with a painless right-sided, post-auricular swelling increasing in size in the preceding two months. On examination there was a 2x2cm mass overlying the temporal bone posterior to the right ear. The mass was firm, immobile, non-tender and well circumscribed. Ultrasound demonstrated a 1.9cm subcuticular mass with evidence of intracranial extension through the suture. Vascular flow and hyperechoic foci were demonstrated within the lesion. The local paediatric team requested magnetic resonance imaging (MRI) and computed tomography (CT) of temporal bone prior to referral to tertiary care centre. Imaging displayed a 2cm expansile lesion of the temporal bone with cortical loss and effacement of underlying dural venous sinus. The patient proceeded to incisional biopsy for tissue diagnosis which was suggestive of cranial fasciitis. Following discussion at the regional multidisciplinary meeting, she underwent surgical excision of the tumour in a joint Neurosurgery/Otology case. The tumour was fully resected macroscopically, with the normal surrounding bone and mastoid air cells preserved. Final histopathology showed a highly cellular lesion composed of spindle cells arranged in fascicles, with areas of myxoid background and confirmed the tumour to be cranial fasciitis. The child has made a good recovery and will be kept under close clinical follow-up. This case demonstrates a rare benign tumour of the temporal bone that may present to an otolaryngologist and the importance of tissue diagnosis, imaging and multidisciplinary management.

Adult nasal chondromesenchymal hamartoma: a rare and benign tumour with aggressive malignant transformation

Nasal chondromesenchymal hamartoma (NCMH) is an extremely rare benign tumour of the nasal cavity predominantly described in infants. We report a case involving a 48-year-old woman who had been diagnosed with NCMH a year earlier and now re-presented with a short history of progressive nasal blockage, recurrent epistaxis and orbital apex syndrome. Histopathology was suggestive of malignant transformation into sinonasal sarcoma. However, following multidisciplinary team (MDT) discussions, including second and third opinions from external departments, the histological diagnosis was revised to ‘NCMH with bizarre stromal cells’. Despite this, the lesion demonstrated malignant features of rapid, invasive growth and was treated with palliative radiotherapy. The patient later developed radiological evidence of lung and liver metastases with subsequent pulmonary emboli. Shortly after this, she passed away. This case is unique in its diagnostic challenge, with ambiguous histopathological findings, and highlights the importance of an MDT approach when managing complex sinonasal tumours.

Chorioangioma with pre-eclampsia and IUGR: a case report

Chorioangioma is a non-trophoblastic benign tumour of the placenta, arising from the primitive chorionic mesenchyme with an estimated incidence of 0.6% diagnosed antenatal on ultrasound imaging. Small chorioangiomas are often asymptomatic with a frequency of about 1%, giant chorioangiomas more than >5 cm in diameter, are rare seen in 1:3500 to 1:16000 births and are associated with maternal and fetal complications. We report a case of 23-year-old, primigravida 36.4 weeks of gestation with pre-eclampsia with asymmetrical intrauterine growth restriction (IUGR), ultrasound suggestive of large placental chorioangioma 8×6.8 cm. This patient despite having large tumour and being diagnosed late at 35 weeks had a favourable maternal and fetal outcome. Histopathology confirmed the diagnosis.

Chondromyxoid Fibroma of Calcaneum – A Rare Case Report with Review of Literature

Chondromyxoid fibroma (CMF) is a slow-growing benign tumour seen in the metaphysis of a long bone. World health organization (WHO) Classification of Bone and Soft Tissue Tumours (2002) defines CMF as ''benign tumour characterized by lobules of spindle or stellate-shaped cells with abundant myxoid or chondroid intercellular material.1 Jaffe and Lichtenstein were the first to describe this tumour in 1943.2 They differentiated CMF as a benign lesion from chondrosarcoma which is a much more common malignant tumour. Chondromyxoid fibroma is a potentially aggressive tumour with a cartilage-like matrix. It accounts for approximately 1 % of all bone tumors.3 CMF is found in older children and young adults. This type of tumour normally affects people between the age of 10 to 30 years.3,4,5 It is associated with high local recurrence and with less than 2 % of malignant transformation5. While the cells of the CMF tumour do not undergo metastasis, but they can invade nearby tissues. It is painful and causes other symptoms like swelling, stiffness, tenderness, and abnormal growth under the skin. The most common site of this lesion is the tibia and other affected sites are the flat and facial bones, and sparsely in bones of the feet and hand.6,7,8,9 Its occurrence in calcaneum is rarely seen.9 So here we report a case of a female patient, presented with cystic swelling and pain in the left foot, which was diagnosed as CMF in excision biopsy.