RESUMEN
BACKGROUND: Juvenile ossifying fibroma (JOF) is a benign fibro-osseous lesion that can be locally aggressive. It is typically treated with surgical excision. A few cases using adjuvant radiotherapy have been reported in the literature. METHODS: We report a case of JOF treated with surgical excision and adjuvant radiotherapy to minimize the risk of local recurrence. We also review the literature. RESULTS: Our patient tolerated radiotherapy without complication and had not experienced a local recurrence at the time of writing this manuscript. CONCLUSIONS: This is one of the first reports of adjuvant radiotherapy after surgical excision to improve local control in patients with JOF. Radiotherapy should be considered in patients for whom reexcision after a recurrence would result in unacceptable morbidity.
Asunto(s)
Fibroma Osificante/radioterapia , Neoplasias Maxilares/radioterapia , Adulto , Fibroma Osificante/diagnóstico por imagen , Fibroma Osificante/cirugía , Humanos , Masculino , Neoplasias Maxilares/diagnóstico por imagen , Neoplasias Maxilares/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Recurrencia Local de Neoplasia/radioterapia , Radioterapia Adyuvante , Tomografía Computarizada por Rayos XRESUMEN
Ossifying fibromyxoid tumors were first described in 1989. They are composed of small round cells dispersed in a myxoid matrix and contain bone, osteoid, and collagen. Bone invasion is very rare. Our case was unusual because of the spinal location of the tumor and its invasive features including destruction of the cortex of the vertebral body, and invasion of the spinal canal causing a radioculopathy. The clinical presentation, radiologic features, and histopathologic findings are described, and the relevant literature is reviewed.
Asunto(s)
Fibroma Osificante/diagnóstico , Osificación Heterotópica/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de la Columna Vertebral/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Fibroma Osificante/radioterapia , Fibroma Osificante/cirugía , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Imagen por Resonancia Magnética/métodos , Invasividad Neoplásica , Osificación Heterotópica/radioterapia , Osificación Heterotópica/cirugía , Enfermedades Raras , Neoplasias de los Tejidos Blandos/radioterapia , Neoplasias de los Tejidos Blandos/cirugía , Canal Medular/diagnóstico por imagen , Neoplasias de la Columna Vertebral/cirugía , Tomografía Computarizada por Rayos X/métodosRESUMEN
Ossifying fibromyxoid tumor is usually a benign tumor. However some of these tumors with histologic and clinical evidence of malignancy have also been reported and little information is available regarding surgery for metastatic ossifying fibromyxoid tumor. We present a case involving extensive excision of a huge metastatic ossifying fibromyxoid tumor occupying the upper mediastinum and upper half of the right hemithorax.
Asunto(s)
Fibroma Osificante/patología , Neoplasias Pulmonares/secundario , Neoplasias del Mediastino/secundario , Adulto , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/secundario , Errores Diagnósticos , Resultado Fatal , Femenino , Fibroma Osificante/complicaciones , Fibroma Osificante/diagnóstico , Fibroma Osificante/radioterapia , Fibroma Osificante/cirugía , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Lipoma/diagnóstico , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/cirugía , Neoplasias del Mediastino/complicaciones , Neoplasias del Mediastino/radioterapia , Neoplasias del Mediastino/cirugía , Invasividad Neoplásica , Pericardio/patología , Pericardio/cirugía , Nervio Frénico/patología , Nervio Frénico/cirugía , Neumonectomía , Radioterapia Adyuvante , Reoperación , Convulsiones/etiología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Síndrome de la Vena Cava Superior/etiologíaRESUMEN
A 7-year-old female Thoroughbred was admitted with a history of labored breathing, stridor, and exercise intolerance. Examination revealed a mass in the left paranasal sinuses that was determined to be an ossifying fibroma. Initial treatment consisted of surgical removal of the mass alone; however, the mass recurred 9 months after surgery. The mass was again removed, and adjunctive radiotherapy consisting of 3,000 cGy of cobalt radiation was administered. This time, the tumor did not recur for > 6 years. A third surgery was performed to remove the mass, and adjunctive radiotherapy consisting of 4,000 cGy of photon beam radiation from a linear accelerator was administered. The mass did not recur during the subsequent 3 years. Ossifying fibromas are uncommon tumors that frequently recur if incompletely excised. Results in this horse suggest that adjunctive radiotherapy may delay or prevent tumor recurrence in affected horses.