RESUMEN
OBJECTIVE: Mitotically active cellular fibroma (MACF) of the ovary, characterized by relatively high mitotic activity without severe atypia, was first described in the WHO classification in 2014. However, due to its rarity, the clinicopathological characteristics of ovarian MACF have not been established. This study was performed to describe the clinical, radiological, and pathological features of MACF by analyzing 11 cases of ovarian MACF. MATERIALS AND METHODS: Between 2015 and 2022, 11 patients with ovarian MACFs underwent surgical treatment at our institution. Clinicopathologic data of the patients were retrospectively reviewed from their medical records. RESULTS: Median patient age was 53.7 years (range 21-77 years), and median tumor diameter was 7.8 cm (range 4.3-14.0 cm). Preoperative CA125 was elevated in 4 cases. Four of the eleven patients had abdominal pain, and two presented with vulvar pain or a palpable abdominal mass, respectively. Preoperative radiological impressions included fibroma, fibrothecoma, stromal tumor, and cystadenocarcinoma. A laparoscopic approach was adopted in 7 cases (64%). Intraoperative frozen section was performed in 5 patients, and all demonstrated the presence of a benign, fibromatous stromal tumor. Three patients underwent fertility-sparing surgery, including laparoscopic ovarian cystectomy and unilateral salpingo-oophorectomy. Median follow-up was 37.7 months (range 2-84 months), and no patient experienced disease relapse or died of their disease. CONCLUSION: This study shows that ovarian MACF has a benign clinical course. Fertility-sparing surgery provides a safe therapeutic option for MACF, which can be managed safely by laparoscopy. Imaging findings and final pathological diagnosis were not well matched. Intraoperative frozen section is important for determining surgical extent in mitotically active cellular fibroma of the ovary.
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Fibroma , Neoplasias Ováricas , Humanos , Femenino , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Neoplasias Ováricas/diagnóstico por imagen , Persona de Mediana Edad , Adulto , Fibroma/patología , Fibroma/cirugía , Fibroma/diagnóstico por imagen , Anciano , Estudios Retrospectivos , Adulto Joven , Antígeno Ca-125/sangre , Laparoscopía/métodos , Mitosis , Ovario/patología , Ovario/cirugía , Ovario/diagnóstico por imagenRESUMEN
BACKGROUND: Cardiac fibromas are extremely rare in adults. The preferred treatment is surgical resection, but antiarrhythmic medications or heart transplantation have also been used previously. The cardiac imaging, particularly MRI, can be useful to help delineate between primary cardiac tumors, and surgical factors such as the extent/size of the fibroma, involvement of the coronary arteries or mitral apparatus and amount of residual myocardium influence whether surgical resection is feasible. CASE PRESENTATION: A 42-year-old male presented with a wide-complex tachycardia, unresponsive to amiodarone. An echocardiogram was performed which showed a possible posterior wall mass. A cardiac MRI showed a well circumscribed lateral wall intracardiac fibroma, measuring 5.2 × 5.1 × 3.8 cm with preserved function. Surgical resection was successful, and he was discharged without a defibrillator. CONCLUSIONS: Cardiac fibromas are encapsulated tumors which do not infiltrate myocardium and should be surgically resected if possible.
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Fibroma , Neoplasias Cardíacas , Taquicardia Ventricular , Humanos , Masculino , Adulto , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/diagnóstico por imagen , Fibroma/cirugía , Fibroma/complicaciones , Taquicardia Ventricular/cirugía , Taquicardia Ventricular/etiología , Imagen por Resonancia Magnética , EcocardiografíaAsunto(s)
Hallazgos Incidentales , Imagen Multimodal , Humanos , Femenino , Fibroelastoma Papilar Cardíaco/diagnóstico por imagen , Fibroelastoma Papilar Cardíaco/patología , Fibroelastoma Papilar Cardíaco/cirugía , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/patología , Persona de Mediana Edad , Fibroma/diagnóstico por imagen , Fibroma/patología , Fibroma/cirugíaAsunto(s)
Fibroelastoma Papilar Cardíaco , Humanos , Fibroelastoma Papilar Cardíaco/cirugía , Fibroelastoma Papilar Cardíaco/patología , Fibroelastoma Papilar Cardíaco/diagnóstico por imagen , Fibroelastoma Papilar Cardíaco/diagnóstico , Femenino , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/patología , Masculino , Fibroma/cirugía , Fibroma/patología , AdultoRESUMEN
OBJECTIVE: Elastofibroma dorsi (ED) is a rare benign tumor located in the subscapular region. The aim of this study was to evaluate our clinical findings, surgical approach, and management of ED patients based on single-center data with the relevant literature. METHODOLOGY: A retrospective evaluation was conducted on 20 patients who were operated on for ED. RESULTS: Of the 16 (80%) female patients and 4 (20%) male patients, the main complaint was swelling (80%), and 10 cases (50%) had unilateral involvement. All patients were operated on using standard surgical procedures. Despite a long follow-up period (6-53 months, mean of 26.6 months), no recurrences were observed. Two patients (10%) required simple needle aspiration due to post-operative seroma, and one patient, due to infection, required evacuation (5%). CONCLUSION: Although rare, ED should not be overlooked in patients with swelling in the back region. Our data suggests that surgery can be safely performed in such patients after a clinical and radiological diagnosis of ED has been established.
OBJETIVO: Evaluar los hallazgos clínicos, el enfoque quirúrgico y el manejo de los pacientes con urgencias a partir de los datos de un solo centro y la literatura relevante. MÉTODO: Se realizó una evaluación retrospectiva de 20 pacientes que fueron operados de ED. RESULTADOS: En los 16 (80%), pacientes del sexo femenino y cuatro (20%) del sexo masculino, la queja principal fue la tumefacción (80%) y 10 casos (50%) tuvieron afectación unilateral. Todos los pacientes fueron operados utilizando procedimientos quirúrgicos estándar. Con un largo periodo de seguimiento (6-53 meses, media de 26.6 meses), no se observaron recurrencias. Dos pacientes (10%) requirieron aspiración con aguja simple por seroma posoperatorio y un paciente (5%) requirió evacuación por infección. CONCLUSIONES: Aunque es raro, el ED no debe pasarse por alto en pacientes con hinchazón en la región de la espalda. Nuestros datos sugieren que la cirugía se puede realizar de manera segura en estos pacientes después de haber establecido el diagnóstico clínico y radiológico de ED.
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Fibroma , Neoplasias de los Tejidos Blandos , Humanos , Masculino , Femenino , Estudios Retrospectivos , Fibroma/cirugía , Fibroma/diagnóstico por imagen , Fibroma/patología , Persona de Mediana Edad , Adulto , Anciano , Neoplasias de los Tejidos Blandos/cirugía , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Seroma/etiologíaRESUMEN
Surgical treatment of chondromyxoid fibroma of ribs is described. The diagnosis was verified after histological analysis. The patient underwent resection of multinodular tumor of anterolateral thoracic wall invading abdominal cavity via thoracoabdominal access. Postoperative period was uneventful. This case demonstrates the need for total en-bloc resection of tumor with surrounding tissues. Surgery is the only effective method for these patients.
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Neoplasias Óseas , Fibroma , Costillas , Humanos , Costillas/cirugía , Fibroma/cirugía , Fibroma/diagnóstico , Neoplasias Óseas/cirugía , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Resultado del Tratamiento , Masculino , Pared Torácica/cirugía , Femenino , Tomografía Computarizada por Rayos X/métodos , Adulto , Toracotomía/métodosAsunto(s)
Fibroma , Humanos , Fibroma/cirugía , Lactante , Dedos/cirugía , Femenino , Masculino , Dedos del PieRESUMEN
OBJECTIVES: This study aimed to review a 35-year experience with chondromyxoid fibroma at our institution. PATIENTS AND METHODS: The study retrospectively analyzed the records of 31 consecutive patients (17 males, 14 females; mean age: 30.5±15.7 years; range, 6 to 63 years) with chondromyxoid fibroma who were treated between January 1988 and December 2021. The clinical and radiological characteristics of lesions, tumor volume, and recurrence rates were assessed using the tumor archive of the hospital. RESULTS: The mean follow-up duration was 65.9±42.0 months. Pelvis, proximal tibia, and distal femur were the most common sites of localization. The initial surgical treatment was performed on 27 patients at our clinic, while four patients were referred to the clinic after recurrence. The overall recurrence rate was 16.1%. Intralesional curettage was applied to 21 (77.8%) out of 27 patients. The cavity created after curettage was filled with bone graft (autograft or allograft) in 15 (55.5%) cases. Bone cement was applied in four (14.8%) cases. Resection was applied to five (18.5%) patients. In two (7.4%) cases, intralesional curettage alone was performed. One of these two patients experienced recurrence, resulting in a recurrence rate of 50% in this patient group. No recurrence was observed in other treatment groups. CONCLUSION: Intralesional curettage and filling the defect with bone graft or cement were effective for local control in most cases. Curettage alone was associated with high recurrence rates.
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Neoplasias Óseas , Legrado , Fibroma , Recurrencia Local de Neoplasia , Humanos , Masculino , Femenino , Estudios Retrospectivos , Adulto , Adolescente , Persona de Mediana Edad , Neoplasias Óseas/cirugía , Neoplasias Óseas/patología , Neoplasias Óseas/diagnóstico por imagen , Adulto Joven , Niño , Fibroma/cirugía , Fibroma/patología , Legrado/métodos , Recurrencia Local de Neoplasia/cirugía , Recurrencia Local de Neoplasia/patología , Trasplante Óseo/métodos , Cementos para Huesos/uso terapéuticoRESUMEN
A 35-year-old patient presented with a painless, broad-based exophytic lesion in the buccal interdental region between teeth 13 and 14. Despite oral hygiene efforts the lesion persisted for around one year. Radiology excluded bone involvement, and histopathology after excision confirmed a fibromatous epulis, which is characterized by collagen-rich connective tissue. There was no recurrence within one-year follow-up. Surgical removal proved to be efficient.
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Neoplasias Gingivales , Adulto , Humanos , Diagnóstico Diferencial , Fibroma/cirugía , Fibroma/patología , Fibroma/diagnóstico , Neoplasias Gingivales/cirugía , Neoplasias Gingivales/patología , Neoplasias Gingivales/diagnósticoRESUMEN
The clinical differences between odontogenic myxoma (OM) and odontogenic myxofibroma (OMF), and the clinical significance of their classifications, remain unclear. This study reviewed the clinicopathological characteristics of patients with OM or OMF and evaluated the fibrous component of the specimens. Medical records of 21 patients with OM or OMF who underwent tumour resection were reviewed. The percentage of fibrous tissue on the representative sections was evaluated using haematoxylin and eosin- and Masson's trichrome-stained specimens. Histopathological diagnoses included 11 OMs and 10 OMFs with no tumour recurrence except for two cases in which the dredging method was applied. More cortical bone perforation was observed in OM than in OMF cases, without significant differences. Location-locularity and apparent diffusion coefficient value (ADC)-cortical bone perforation were significantly correlated in all OM and OMF cases. The percentage of fibrous tissue in specimens showed bimodal distribution bordered by 45%. There was a significant association between diagnosis based on 45% fibrous tissue criterion and the final pathological diagnosis. Our study showed a tendency for cortical bone perforation in OM compared to OMF and correlation between ADC and cortical bone perforation. According to the histopathological analyses, the fibrous component of each case was bimodal with 45%, which may be a criterion to distinguish between OM and OMF. Accumulating knowledge, such as significant differences in prognosis, may allow for minimal surgical treatment options based on the diagnosis according to this novel histopathological criterion.
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Fibroma , Mixoma , Tumores Odontogénicos , Humanos , Tumores Odontogénicos/patología , Tumores Odontogénicos/cirugía , Femenino , Masculino , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Mixoma/patología , Mixoma/cirugía , Fibroma/patología , Fibroma/cirugía , Anciano , Adolescente , Adulto Joven , Diagnóstico DiferencialAsunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Humanos , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/cirugía , Carcinoma de Células Renales/diagnóstico por imagen , Neoplasias Renales/patología , Neoplasias Renales/cirugía , Neoplasias Renales/diagnóstico por imagen , Masculino , Fibroma/patología , Fibroma/cirugía , Fibroma/diagnóstico por imagen , Nefrectomía/métodos , Persona de Mediana Edad , FemeninoRESUMEN
INTRODUCTION: Ischaemic stroke results from a sudden interruption of cerebral blood flow, often caused by thrombosis, embolism or hypoperfusion. Rarely, cardiac tumours are the cause of an embolic event. We report on an 80-year-old woman with a cerebral stroke. Successful thrombectomy revealed a histopathologically confirmed papillary fibroelastoma as the embolic source. Although it was not detectable on initial echocardiography, the tumour was discovered by transesophageal echocardiography. This case emphasises the importance of considering primary cardiac tumours as potential sources of emboli in ischaemic stroke. Keywords.
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Ecocardiografía Transesofágica , Neoplasias Cardíacas , Humanos , Femenino , Anciano de 80 o más Años , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/patología , Diagnóstico Diferencial , Trombectomía , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/etiología , Accidente Cerebrovascular Isquémico/cirugía , Fibroma/cirugía , Fibroma/diagnóstico por imagen , Fibroma/patologíaAsunto(s)
Fibroma , Perineo , Teratoma , Humanos , Teratoma/cirugía , Teratoma/diagnóstico por imagen , Teratoma/patología , Teratoma/diagnóstico , Fibroma/patología , Fibroma/cirugía , Fibroma/diagnóstico por imagen , Perineo/patología , Recién Nacido , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/cirugía , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Femenino , MasculinoAsunto(s)
Fibroelastoma Papilar Cardíaco , Femenino , Humanos , Fibroelastoma Papilar Cardíaco/diagnóstico por imagen , Fibroelastoma Papilar Cardíaco/cirugía , Fibroelastoma Papilar Cardíaco/diagnóstico , Fibroelastoma Papilar Cardíaco/patología , Fibroma/cirugía , Fibroma/patología , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/patología , AncianoRESUMEN
A patient without a diagnosis of diabetes mellitus presented to the hospital due to a fall and hypoglycaemia on admission. The patient was found to have recurrent nocturnal fasting hypoglycaemia. CT revealed a large lung mass consistent with a solitary pleural fibroma, a rare tumour associated with insulin-like growth factor 2 (IGF-2) production. This case is an important reminder that potential causes of hypoglycaemia should be considered in non-diabetic patients.
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Fibroma , Hipoglucemia , Neoplasias Pleurales , Tumor Fibroso Solitario Pleural , Humanos , Factor II del Crecimiento Similar a la Insulina/metabolismo , Neoplasias Pleurales/diagnóstico , Tumor Fibroso Solitario Pleural/complicaciones , Tumor Fibroso Solitario Pleural/diagnóstico por imagen , Tumor Fibroso Solitario Pleural/cirugía , Hipoglucemia/diagnóstico , Fibroma/complicaciones , Fibroma/diagnóstico por imagen , Fibroma/cirugíaRESUMEN
Cardiac papillary fibroelastomas (CPFs) are rare benign cardiac tumors more often involving the left-sided valves and related with threatening embolic complications. We report the case of a 35-year-old woman presenting with relapsing-remitting chest pain and elevated cardiac troponins. After a negative coronary angiography, an integrated imaging assessment based on echocardiography and cardiac magnetic resonance showed a pedunculated mass on the aortic valve causing an intermittent obstructive engagement of the right coronary ostium. A tailored surgical treatment was performed and the histopathological examination of the specimen revealed mesenchymal tissue with the characteristics of CPF.
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Válvula Aórtica , Fibroelastoma Papilar Cardíaco , Neoplasias Cardíacas , Infarto del Miocardio , Humanos , Femenino , Adulto , Válvula Aórtica/cirugía , Válvula Aórtica/patología , Válvula Aórtica/diagnóstico por imagen , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/cirugía , Neoplasias Cardíacas/diagnóstico por imagen , Fibroelastoma Papilar Cardíaco/cirugía , Fibroelastoma Papilar Cardíaco/patología , Fibroelastoma Papilar Cardíaco/complicaciones , Infarto del Miocardio/etiología , Infarto del Miocardio/patología , Resultado del Tratamiento , Angiografía Coronaria , Vasos Coronarios/patología , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/cirugía , Biopsia , Fibroma/patología , Fibroma/cirugía , Fibroma/complicacionesRESUMEN
Pediatric fibromyxoid soft tissue tumors may be associated with gene fusions such as YHWAZ::PLAG1, with only three reported cases in the literature. We present the fourth case, a 13-year-old male with a pediatric fibromyxoid brachial plexus tumor with YWHAZ::PLAG1 gene fusion. This is also the first case to be reported in an adolescent, in the brachial plexus, and in the Philippines. The patient presented with a 10-year history of a slowly growing left supraclavicular mass and a 1-year history of intermittent dysesthesia in the left upper extremity. Neurologic examination was unremarkable. Imaging revealed a large left supraclavicular lesion with intrathoracic extension. Surgical excision was performed, and histopathology revealed a fibromyxoid tumor with YWHAZ::PLAG1 gene fusion. Although previous examples of this gene fusion pointed toward lipoblastoma as their primary pathology, our tumor does not completely fulfill the current diagnostic criteria for a lipoblastoma and may represent an intermediate form of the disease. Our case is unique not only because it is the first reported adolescent patient harboring such a lesion but also because of the relatively lengthy natural history exhibited by the tumor prior to its resection. This provided us with valuable information about its behavior, which suggests a more indolent growth pattern. This case also highlights the clinical importance of molecular testing of tumors, where recognition of disease entities can assist clinicians in deciding and advocating for the proper management.
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Plexo Braquial , Humanos , Masculino , Adolescente , Plexo Braquial/cirugía , Fusión Génica/genética , Proteínas 14-3-3/genética , Fibroma/genética , Fibroma/cirugía , Neoplasias del Sistema Nervioso Periférico/genética , Neoplasias del Sistema Nervioso Periférico/cirugía , Neoplasias del Sistema Nervioso Periférico/patología , Proteínas de Unión al ADN/genética , Neoplasias de los Tejidos Blandos/genética , Neoplasias de los Tejidos Blandos/cirugía , Neoplasias de los Tejidos Blandos/patologíaRESUMEN
OBJECTIVE: Central odontogenic fibromas (COF) are rare, benign tumors derived from dental mesenchymal tissue that may occur in the maxilla or mandible. This report describes primary and recurrent COF in the mandible of a patient with nevoid basal cell carcinoma syndrome (NBCCS). STUDY DESIGN: A 36-year-old African American male presented with a COF and its recurrence 17 months later. Tissue pieces were obtained from both occurrences with IRB-approved signed consent. Collected tissue pieces were dissected; one portion was formalin-fixed and paraffin-embedded, and the other was cultured for the isolation of cell populations from the primary (COdF-1) and recurrent (COdF-1a) tumors. Quantification real-time polymerase chain reaction (qRT-PCR), immunohistochemistry, and DNA sequencing were used for gene and protein analysis of the primary tumor and cell populations. RESULTS: Histopathologic analysis of the tumor showed sparse odontogenic epithelial cords in fibrous connective tissue, and qRT-PCR analysis of tumor and cell populations (COdF-1 and COdF-1a) detected VIM, CK14, CD34, CD99 and ALPL mRNA expression. Protein expression was confirmed by immunohistochemistry. CD34 expression in primary tissues was higher than in tumor cells due to tumor vascularization. DNA sequencing indicated the patient had PTCH1 mutations. CONCLUSIONS: Histopathology, mRNA, and protein expression indicate the rare occurrence of COF in a patient with mutated PTCH1 gene and NBCCS.
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Síndrome del Nevo Basocelular , Fibroma , Recurrencia Local de Neoplasia , Tumores Odontogénicos , Humanos , Masculino , Síndrome del Nevo Basocelular/genética , Síndrome del Nevo Basocelular/patología , Tumores Odontogénicos/patología , Tumores Odontogénicos/genética , Tumores Odontogénicos/cirugía , Adulto , Recurrencia Local de Neoplasia/patología , Fibroma/patología , Fibroma/genética , Fibroma/cirugía , Inmunohistoquímica , Neoplasias Mandibulares/patología , Neoplasias Mandibulares/genética , Neoplasias Mandibulares/cirugía , Reacción en Cadena en Tiempo Real de la Polimerasa , Técnicas In VitroRESUMEN
We experienced a case of papillary fibroelastoma of aortic valve, which had been located for preoperative 12 years without any symptom. We could assess tumor growth rate of 0.17 mm/year. Because of recent reports of recurrence, close follow-up should be continued.