AIM To investigate non-ossifying fibromas(NOFs) common fibrous bone lesions in children that occur in bones of the lower extremities.METHODS We analyzed 44 cases of NOF including 47 lesions, which were referred with a...AIM To investigate non-ossifying fibromas(NOFs) common fibrous bone lesions in children that occur in bones of the lower extremities.METHODS We analyzed 44 cases of NOF including 47 lesions, which were referred with a working diagnosis of neoplastic lesions. Lesions were located in the upper extremities(1 proximal humerus, 1 distal radius) and the lower extremities(25 distal femurs, 12 proximal and 4 distal tibias, and 4 proximal fibulas).RESULTS Three cases had NOFs in multiple anatomical locations(femur and fibula in 1 case, femur and tibia in 2 cases). Overall, larger lesions > 4 cm and lesion expansion at the cortex were seen in 21% and 32% of cases, respectively. Multiple lesions with bilateral symmetry in the lower extremities suggest that these NOFs were developmental bone defects. Two patients suffered from fracture and were treated without surgery, one in the radius and one in the femur. Lesions in the upper extremities(i.e., humerus of a 4-year-old female and radius of a 9-year-old male) expanded at the cortex and lesion size increased with slow ossification.CONCLUSION NOFs in the lower extremity had fewer clinical problems, regardless of their size and expansiveness. In these two upper extremity cases, the NOFs had aggressive biological features. It seems that there is a site specific difference, especially between the upper extremity and the lower extremity. Furthermore, NOFs in the radius are predisposed to fracture because of the slender structure of the radius and the susceptibility to stress.展开更多
BACKGROUND Jaffe-Campanacci syndrome(JCS)is a very rare syndrome.The treatment of JCS is more conservative,and most authors recommend that no surgery should be done in asymptomatic patients.The conventional concept ho...BACKGROUND Jaffe-Campanacci syndrome(JCS)is a very rare syndrome.The treatment of JCS is more conservative,and most authors recommend that no surgery should be done in asymptomatic patients.The conventional concept holds that the natural course of non-ossifying fibromas(NOFs)grows with the development of bones,and the osteolytic region gradually stops expanding and self-healing through bone ossifying around the lesion and ossification within the lesion.But in this case,the bone lesions were potentially biologically aggressive,which led to severe limb deformities and pain.CASE SUMMARY We present the case of a 5-year-old girl with JCS presenting with not only NOF sand café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,axilla,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.We present the case of a 5-year-old girl with JCS presenting with not only NOFs and café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,armpit,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.CONCLUSION In our opinion,education on preventing pathological fractures and explaining the consequent serious consequences to the parents is a matter of prime significance.At the same time,prophylactic treatment(restricted exercise,support,or surgery)is also considerable for JSC.展开更多
BACKGROUND Chondromyxoid fibroma(CMF) is a rare benign bone tumour of cartilaginous origin, which usually affects the metaphysis of the long bone. Involvement of the temporal bone is extremely rare. Patients with CMF ...BACKGROUND Chondromyxoid fibroma(CMF) is a rare benign bone tumour of cartilaginous origin, which usually affects the metaphysis of the long bone. Involvement of the temporal bone is extremely rare. Patients with CMF in the temporal bone can present some neurological deficits due to involvement of surrounding neural structures. CASE SUMMARY We present the first case of histopathologically proven CMF originating in the temporal bone and involving the hypoglossal canal in a 40-year-old woman. Hypoglossal nerve paralysis was identified on the cranial nerve examination. The patient underwent surgical excision and was neurologically normal except for mild left facial palsy on 5-mo follow-up examination after surgery. In the current report, the major characteristics and computed tomography/magnetic resonance imaging features of the lesion are discussed. Furthermore, previous literature regarding this pathology is reviewed.CONCLUSION The current study presents the first case of temporal bone CMF involving the hypoglossal canal.展开更多
BACKGROUND Postmenopausal bleeding(PMB)is a common gynecologic complaint among elderly women,and endometrial hyperplasia is a common cause of this bleeding.Ovarian fibromas are the most common type of ovarian sex cord...BACKGROUND Postmenopausal bleeding(PMB)is a common gynecologic complaint among elderly women,and endometrial hyperplasia is a common cause of this bleeding.Ovarian fibromas are the most common type of ovarian sex cord-stromal tumor(SCST).They arise from non-functioning stroma,rarely show estrogenic activity,and stimulate endometrial hyperplasia,causing abnormal vaginal bleeding.CASE SUMMARY We report herein the case of a 64-year-old Chinese woman who presented with recurrent PMB.A sex hormone test revealed that her estrogen level was significantly higher than normal,and other causes of hyperestrogenism had been excluded.The patient had undergone four curettage and hysteroscopy procedures in the past 7 years due to recurrent PMB and endometrial hyperplasia.The culprit behind the increase in estrogen level—an ovarian cellular fibroma with estrogenic activity—was eventually found during the fifth operation.CONCLUSION Ovarian cellular fibromas occur insidiously,and some may have endocrine functions.Postmenopausal patients with recurrent PMB and endometrial thickening observed on ultrasonography are recommended to undergo sex hormone testing while waiting for results regarding the pathology of the endometrium.If the estrogen level remains elevated,the clinician should consider the possibility of an ovarian SCST and follow-up the patient closely,even if the imaging results do not indicate ovarian tumors.Once the tumor is found,it should be removed as soon as possible no matter the size to avoid endometrial lesions due to long-term estrogen stimulation.More studies are needed to confirm whether preventive total hysterectomy with bilateral salpingo-oophorectomy should be recommended for women with recurrent PMB exhibiting elevated estrogen levels,despite the auxiliary examination results not indicating ovarian mass.The physical and psychological burden caused by repeated curettage could be prevented using this technique.展开更多
BACKGROUND Chondromyxoid fibroma(CMF)is an unusual benign tumour of cartilaginous tissues that may be confused with other malignant tumours.It is rarely seen in the cervical spine.CASE SUMMARY A 24-year-old young woma...BACKGROUND Chondromyxoid fibroma(CMF)is an unusual benign tumour of cartilaginous tissues that may be confused with other malignant tumours.It is rarely seen in the cervical spine.CASE SUMMARY A 24-year-old young woman was admitted to the hospital because of neck and shoulder pain.Computed tomography,magnetic resonance imaging,X-ray and other imaging examinations of the cervical spine and laboratory-related indicators combined with intraoperative pathology revealed that the patient had cervical CMF.We performed total resection of the vertebral body and intervertebral disc,and internal fixation was performed to simultaneously maintain the stability of the entire spine.The clinical results from extensive resection were satisfactory.At the 2-year follow-up,the patient's symptoms had not recurred.CONCLUSION CMF is a benign primary bone tumour that is rarely located in the vertebral bone.Accurate initial diagnosis of these tumours is important for appropriate treatment.En bloc surgical resection of the tumour is the cornerstone of treatment.展开更多
Central granular cell odontogenic tumors(CGCOTs)are rare,benign,slowly growing odontogenic neoplasms.Due to their uncertain histogenesis,CGCOTs are still not included as a distinct entity in the WHO classification(201...Central granular cell odontogenic tumors(CGCOTs)are rare,benign,slowly growing odontogenic neoplasms.Due to their uncertain histogenesis,CGCOTs are still not included as a distinct entity in the WHO classification(2017)of odontogenic tumors.We report a case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white female.Immunohistochemical staining showed that granular cells positively expressed CD68 and vimentin,and negatively expressed S-100 protein.Meanwhile,we searched Pub Med,Google Scholar,and Scopus databases to summary the clinico-pathological features of 51 reported cases of CGCOT.The results showed that the granular cells of 28.6%cases were immunopositive for vimentin and CD68,and odontogenic epithelial cells were positive immunoreactivity for cytokeratin.These findings reinforced the mesenchymal origin of granular cells and the odontogenic nature of epithelium islands.展开更多
Peripheral cemento-ossifying fibroma(PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. PCOF p...Peripheral cemento-ossifying fibroma(PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. PCOF predominantly affects adolescent and young adults with greatest prevalence around 28 years. We report here a rare clinical case of PCOF of the mandible, 1 cm mesiodistally and 1.5 cm occluso-gingivally in diameter, which caused difficulty in eating and speech, in a 42-year-old female patient. She was asymptomatic for 1 year and on follow-up for 6 mo post surgically showed gingival health and normal radioopacity of bone without any recurrence. Clinical, radiographic and histological characteristics are discussed and recommendations regarding differential diagnosis, treatment and follow up are provided. The controversial varied nomenclature and possible etiopathogenesis of PCOF are emphasized.展开更多
: Objective: To analyze the relation between the pathological changes and the clinical manifestations and the prognosis of cardiac tumors through the pathological study on 42 cases with cardiac tumor, in order to impr...: Objective: To analyze the relation between the pathological changes and the clinical manifestations and the prognosis of cardiac tumors through the pathological study on 42 cases with cardiac tumor, in order to improve the knowledge of the tumors, to make early diagnosis and to raise the curative ratio.Materials and Methods: 42 confirmed cardiac tumors of our department were selected, among whick 41was surgical specimen and 1 was autopsy. The study was Pcrformed by using the common and special histochemical staining.Results: 41 is Primary and 1 is secondary which is a metastazed hepatocelular carcinoma. In the Primary ones,39 (95.1%) is benign, including myxoma, fibroma,rhabdomyoma and Pericardial cyst, while 2 (4. 9%) is malignant, including neuroleminafibrosarcoma and malignant mesothelioma. In the myxomas, female patients occupy 75%, 91.7% exists in the left atrium and every one has got a peduncle adbesive to the fossa ovalis or adjacency of the atrial septum.Conclusions: The results of the pathological and prognostic study sbowes cardiac tuinors are quite different from the tumors in other sites, i.e., cven benign ones could cause fatal hemodynamic disturbance. Hence early diagnosis and early operation are necessary and if in such instance, the Prognosis of inost of the benign oncs would be good. But the prognosis of the malignant tumors is worst. The myxomas are different from the organized thrombi in heart cavity. And also the criteria of diagnosis and differential diagnosis are discussed.展开更多
BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by exter...BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by external tumors of the scrotum is rare.The patient had both a greater omentum tumor and an inguinal hernia,and the tumor protruded into the scrotum through the hernia sac,which is even rarer.Moreover,omental tumors are mostly metastatic,and primary omental fibroma is rare.CASE SUMMARY Here,we report a rare case of a 25-year-old young man with scrotal enlargement and pain for 3 months.Preoperative examination and multidisciplinary discu-ssions considered intra-abdominal tumor displacement and inguinal hernia,and intraoperative exploration confirmed that the greater omentum tumor protruded into the scrotum.Therefore,tumor resection and tension-free inguinal hernia repair were performed.The final diagnosis was benign fibroma of the greater omentum accompanied by an indirect inguinal hernia.CONCLUSION This unusual presentation of a common inguinal hernia disease illustrates the necessity of performing detailed history taking,physical examination,and imaging before surgery.展开更多
BACKGROUND Ameloblastic fibromas and ameloblastic fibrosarcomas are rare odontogenic tumors,and controversy exists in the classification of cases presenting hard-tissue production:Ameloblastic fibrodentinoma(AFD)and a...BACKGROUND Ameloblastic fibromas and ameloblastic fibrosarcomas are rare odontogenic tumors,and controversy exists in the classification of cases presenting hard-tissue production:Ameloblastic fibrodentinoma(AFD)and ameloblastic fibro-odontoma(AFO).These cases are currently considered“developing odontomas”(hamartomatous lesions).AIM To analyze the clinicopathologic features of these lesions and discuss the changes in the 2017 World Health Organization classification.METHODS An electronic literature search was performed in the PubMed/MEDLINE database.An electronic search of the English language literature was performed and last updated in September 2020 in the PubMed/MEDLINE database using the following terms:“ameloblastic fibroma”,“ameloblastic fibrodentinoma”,“ameloblastic fibro-odontoma”,“ameloblastic sarcoma”,“ameloblastic fibrosarcoma”,“ameloblastic fibrodentinosarcoma”,“ameloblastic fibroodontosarcoma”and“odontogenic carcinosarcoma”.The inclusion criteria were odontogenic tumor series,case reports and systematic reviews that provided sufficient clinical,radiological and microscopic documentation to confirm the diagnosis.RESULTS The database search strategy resulted in 947 papers.Articles focusing on other topics,articles that were not in English,duplicate articles,and articles without fulfilling the inclusion criteria were excluded.Finally,96 publications were included in this review to describe and discuss the main features of the searched entities.Several aspects of AFO and AFD,such as biological behavior,age of occurrence,amount of hard tissue,and potential for malignant transformation into odontogenic sarcomas,support the neoplastic nature in most of the reported cases.Considering the clinical,radiographic,histopathological and molecular characteristics of odontogenic lesions with hard tissue production,we suggest that these types of lesions should continue to be recognized as odontogenic tumors by maintaining the classically used terms.CONCLUSION This recommendation will be relevant for future clinical,microscopic,and molecular studies to better understand the biology of these interesting odontogenic tumors.展开更多
Cemento-ossifying fibroma (COF) of maxilla is comparatively rare lesion of the maxillofacial region. There is often a misdiagnosis in the category of fibroosseous lesions, owing to an overlap of clinical, histological...Cemento-ossifying fibroma (COF) of maxilla is comparatively rare lesion of the maxillofacial region. There is often a misdiagnosis in the category of fibroosseous lesions, owing to an overlap of clinical, histological and radiographic features amongst the separate entities. We present a case of giant maxillary COF causing extensive disfiguration of the face, along with extensive review of the clinico-pathologic and treatment aspects of the fibro-osseous lesions.展开更多
Fibroma-like lesions occur with relatively high frequency in oral soft tissues, but represent reactive proliferation against chronic irritation. True fibromas are rare. Tumor size is often seen to range from the mass ...Fibroma-like lesions occur with relatively high frequency in oral soft tissues, but represent reactive proliferation against chronic irritation. True fibromas are rare. Tumor size is often seen to range from the mass of a red bean to a soybean. We encountered a case of huge fibroma in the palate with a long history of more than 30 years. The patient was a 60-year-old man who became aware of a tumor in the right palate about 30 years earlier. The mass had tended to increase in size in recent years, and was introduced to our department for the first visit. As an intraoral finding, a pedicled mass measuring 29 × 27 mm was found in the right palate. We also considered the possibility of verrucous carcinoma, and performed biopsy, obtaining a diagnosis of fibroma. Right palatectomy was performed under general anesthesia in October 2016. We performed immunohistochemical examination of the surgical specimen, obtaining a definitive diagnosis of fibroma. As of 1 year postoperatively, no recurrence has been identified and the course has been good.展开更多
Juvenile Aggressive Ossifying Fibroma (JAOF) is a benign but locally aggressive fibro-osseous lesion. It is a rapidly growing non-odontogenic neoplasm of the jaws, generally occurring in children and young adults. It ...Juvenile Aggressive Ossifying Fibroma (JAOF) is a benign but locally aggressive fibro-osseous lesion. It is a rapidly growing non-odontogenic neoplasm of the jaws, generally occurring in children and young adults. It is often confused with malignant condition because of its clinical behaviour. Long term follow-up is necessary, considering the high recurrence nature of this tumour. The reconstruction of affected patients, particularly the younger, is often challenging since it has to be done in stages, to keep up with the developing face. We report a case of maxillary JAOF in a 6-month-old female who was referred to our department. Histopathological examination of a resected specimen revealed a trabecular type of JAOF. The patient was followed up for a period of 2 years.展开更多
Background: Gorlin-Goltz syndrome is a very rare syndrome that reportedly occurs in 1 of 235,800 people in Japan. The proportion of women with Gorlin-Goltz syndrome complicated with an ovarian fibroma ranges from 12.5...Background: Gorlin-Goltz syndrome is a very rare syndrome that reportedly occurs in 1 of 235,800 people in Japan. The proportion of women with Gorlin-Goltz syndrome complicated with an ovarian fibroma ranges from 12.5% to 17.0%. Some surgical cases of Gorlin-Goltz syndrome with an ovarian tumor have been reported. However, no studies have mentioned subsequent fertility preservation by using oocyte cryopreservation process. Case: In this case report, the patient with Gorlin-Goltz syndrome underwent laparotomy for bilateral ovarian fibrothecoma at 15 years of age. At 20 years of age, a recurrent ovarian tumor was detected in the remaining ovary. During the follow-up, we detected an increase in its size. As tumor torsion requiring left salpingo-oophorectomy was possible, tumorectomy was considered. However, her anti-Müllerian hormone level was low. As she was at risk for premature ovarian failure after tumorectomy, we planned to cryopreserve her oocytes to preserve her fertility before tumorectomy. Outcome: When the patient underwent surgery, the diameter of her left ovarian tumor was found to have increased to 56 mm. Egg collection was performed twice, and two oocytes were cryopreserved. Subsequently, she underwent tumorectomy of the left ovarian tumor. No recurrence has been observed. Conclusion: If a recurrent ovarian tumor is detected in patients with Gorlin-Goltz syndrome and a low anti-Müllerian hormone level, cryopreservation of oocytes before tumorectomy may be effective for preserving their fertility.展开更多
Ameloblastic fibroma (AF) is a rare tumour of mixed odontogenic origin that can occur either in mandible or maxilla but is most frequently found in the posterior region of mandible. Age of occurrence is generally betw...Ameloblastic fibroma (AF) is a rare tumour of mixed odontogenic origin that can occur either in mandible or maxilla but is most frequently found in the posterior region of mandible. Age of occurrence is generally between first and second decades of life. It is often mistaken for a den tigerous cyst due to presence of an impacted tooth. The diagnosis of AF usually occurs accidentally by routine radiographic examination for an impacted tooth. Histologically it consists of odontogenic ectomesenchyme resembling the dental papilla, epithelium resembling dental lamina and enamel organ without dental hard tissues. There is controversy in the literature as to whether the treatment should be conservative or a radical resection should be done. A conservative treatment strategy, such as enucleation and curettage, is usually sufficient. We describe a case of massive ameloblastic fibroma in a 5-year-old child with an unusual position in maxillary posterior region and without any impacted tooth. Surgical resection of the tumor through Weber Ferguson approach was done under GA with 2 years of follow-up without any recurrence.展开更多
It is a rare clinical condition that may occur to two possible types: puerperal uterine inversion (IUP) and no puerperal uterine inversion (IUNP). Obstetrician will observe often only once in his professional practice...It is a rare clinical condition that may occur to two possible types: puerperal uterine inversion (IUP) and no puerperal uterine inversion (IUNP). Obstetrician will observe often only once in his professional practice. The risk of maternal mortality by hemorrhage is high. We report two cases of uterine inversion requiring a hysterectomy, including a postpartum mode and the other gynecological mode with young women. Hysterectomy remained a last resort treatment in the two types, to reduce morbidity. In the case of uterine inversion, the treatments without hysterectomy could be facilitated if the management is early and adequate. Furthermore, the support should be multidisciplinary and fast in the two types.展开更多
In light of the lack of reliable molecular markers for odontogenic myxoma(OM),the detection of copy number variation(CNV)may present a more objective method for assessing ambiguous cases.In this study,we employed mult...In light of the lack of reliable molecular markers for odontogenic myxoma(OM),the detection of copy number variation(CNV)may present a more objective method for assessing ambiguous cases.In this study,we employed multiregional microdissection sequencing to integrate morphological features with genomic profiling.This allowed us to reveal the CNV profiles of OM and compare them with dental papilla(DP),dental follicle(DF),and odontogenic fibroma(OF)tissues.We identified a distinct and robustly consistent CNV pattern in 93.75%(30/32)of OM cases,characterized by CNV gain events in chromosomes 4,5,8,10,12,16,17,20,and 21.This pattern significantly differed from the CNV patterns observed in DP,DF,and OF.The Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis indicated potential links between this CNV patterns and the calcium signaling pathway and salivary secretion,while Gene Ontology(GO)term analysis implicated CNV patterns in tumor adhesion,tooth development,and cell proliferation.Comprehensive CNV analysis accurately identified a case that was initially disputable between OF and OM as OM.Our findings provide a reliable diagnostic clue and fresh insights into the molecular biological mechanism underlying OM.展开更多
<p> The fibroids affect 20<span style="font-family:Verdana;">%</span><span style="font-family:Verdana;"> to 25% of women of reproductive age and are 3 to 9 times more common...<p> The fibroids affect 20<span style="font-family:Verdana;">%</span><span style="font-family:Verdana;"> to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin</span> </p> <p> <span style="font-family:Verdana;">e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">cm in 48.66% of our patients.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and depends on the indications.</span> </p>展开更多
A 79-year-old woman with gradually worsening left nasal obstruction, purulent rhinorrhea and severe headaches for 6 months admitted to the hospital. A gray-white and huge mass occupying the left nasal cavity was found...A 79-year-old woman with gradually worsening left nasal obstruction, purulent rhinorrhea and severe headaches for 6 months admitted to the hospital. A gray-white and huge mass occupying the left nasal cavity was found in physical examination. CT revealed a soft-tissue-density mass in the left nasal cavity with erosion of adjacent bone structures. On T2-weighted MR images, the lesion showed homogenous extreme low signal intensity. The patient underwent successful surgical removal of huge sinonasal soft tissue mass measuring 50 × 45 × 40 mm. The final diagnosis of fibroma was made histologically. MR imaging studies showed characteristic signal intensities corresponding to histopathological components. To the best of our knowledge, this is the first report regarding the MR imaging findings of huge nasal fibroma in the English literature.展开更多
文摘AIM To investigate non-ossifying fibromas(NOFs) common fibrous bone lesions in children that occur in bones of the lower extremities.METHODS We analyzed 44 cases of NOF including 47 lesions, which were referred with a working diagnosis of neoplastic lesions. Lesions were located in the upper extremities(1 proximal humerus, 1 distal radius) and the lower extremities(25 distal femurs, 12 proximal and 4 distal tibias, and 4 proximal fibulas).RESULTS Three cases had NOFs in multiple anatomical locations(femur and fibula in 1 case, femur and tibia in 2 cases). Overall, larger lesions > 4 cm and lesion expansion at the cortex were seen in 21% and 32% of cases, respectively. Multiple lesions with bilateral symmetry in the lower extremities suggest that these NOFs were developmental bone defects. Two patients suffered from fracture and were treated without surgery, one in the radius and one in the femur. Lesions in the upper extremities(i.e., humerus of a 4-year-old female and radius of a 9-year-old male) expanded at the cortex and lesion size increased with slow ossification.CONCLUSION NOFs in the lower extremity had fewer clinical problems, regardless of their size and expansiveness. In these two upper extremity cases, the NOFs had aggressive biological features. It seems that there is a site specific difference, especially between the upper extremity and the lower extremity. Furthermore, NOFs in the radius are predisposed to fracture because of the slender structure of the radius and the susceptibility to stress.
文摘BACKGROUND Jaffe-Campanacci syndrome(JCS)is a very rare syndrome.The treatment of JCS is more conservative,and most authors recommend that no surgery should be done in asymptomatic patients.The conventional concept holds that the natural course of non-ossifying fibromas(NOFs)grows with the development of bones,and the osteolytic region gradually stops expanding and self-healing through bone ossifying around the lesion and ossification within the lesion.But in this case,the bone lesions were potentially biologically aggressive,which led to severe limb deformities and pain.CASE SUMMARY We present the case of a 5-year-old girl with JCS presenting with not only NOF sand café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,axilla,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.We present the case of a 5-year-old girl with JCS presenting with not only NOFs and café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,armpit,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.CONCLUSION In our opinion,education on preventing pathological fractures and explaining the consequent serious consequences to the parents is a matter of prime significance.At the same time,prophylactic treatment(restricted exercise,support,or surgery)is also considerable for JSC.
文摘BACKGROUND Chondromyxoid fibroma(CMF) is a rare benign bone tumour of cartilaginous origin, which usually affects the metaphysis of the long bone. Involvement of the temporal bone is extremely rare. Patients with CMF in the temporal bone can present some neurological deficits due to involvement of surrounding neural structures. CASE SUMMARY We present the first case of histopathologically proven CMF originating in the temporal bone and involving the hypoglossal canal in a 40-year-old woman. Hypoglossal nerve paralysis was identified on the cranial nerve examination. The patient underwent surgical excision and was neurologically normal except for mild left facial palsy on 5-mo follow-up examination after surgery. In the current report, the major characteristics and computed tomography/magnetic resonance imaging features of the lesion are discussed. Furthermore, previous literature regarding this pathology is reviewed.CONCLUSION The current study presents the first case of temporal bone CMF involving the hypoglossal canal.
基金National Natural Science Foundation of China,No.81872125Local Technology and Development Key Program of Liaoning Province,No.2019416020.
文摘BACKGROUND Postmenopausal bleeding(PMB)is a common gynecologic complaint among elderly women,and endometrial hyperplasia is a common cause of this bleeding.Ovarian fibromas are the most common type of ovarian sex cord-stromal tumor(SCST).They arise from non-functioning stroma,rarely show estrogenic activity,and stimulate endometrial hyperplasia,causing abnormal vaginal bleeding.CASE SUMMARY We report herein the case of a 64-year-old Chinese woman who presented with recurrent PMB.A sex hormone test revealed that her estrogen level was significantly higher than normal,and other causes of hyperestrogenism had been excluded.The patient had undergone four curettage and hysteroscopy procedures in the past 7 years due to recurrent PMB and endometrial hyperplasia.The culprit behind the increase in estrogen level—an ovarian cellular fibroma with estrogenic activity—was eventually found during the fifth operation.CONCLUSION Ovarian cellular fibromas occur insidiously,and some may have endocrine functions.Postmenopausal patients with recurrent PMB and endometrial thickening observed on ultrasonography are recommended to undergo sex hormone testing while waiting for results regarding the pathology of the endometrium.If the estrogen level remains elevated,the clinician should consider the possibility of an ovarian SCST and follow-up the patient closely,even if the imaging results do not indicate ovarian tumors.Once the tumor is found,it should be removed as soon as possible no matter the size to avoid endometrial lesions due to long-term estrogen stimulation.More studies are needed to confirm whether preventive total hysterectomy with bilateral salpingo-oophorectomy should be recommended for women with recurrent PMB exhibiting elevated estrogen levels,despite the auxiliary examination results not indicating ovarian mass.The physical and psychological burden caused by repeated curettage could be prevented using this technique.
文摘BACKGROUND Chondromyxoid fibroma(CMF)is an unusual benign tumour of cartilaginous tissues that may be confused with other malignant tumours.It is rarely seen in the cervical spine.CASE SUMMARY A 24-year-old young woman was admitted to the hospital because of neck and shoulder pain.Computed tomography,magnetic resonance imaging,X-ray and other imaging examinations of the cervical spine and laboratory-related indicators combined with intraoperative pathology revealed that the patient had cervical CMF.We performed total resection of the vertebral body and intervertebral disc,and internal fixation was performed to simultaneously maintain the stability of the entire spine.The clinical results from extensive resection were satisfactory.At the 2-year follow-up,the patient's symptoms had not recurred.CONCLUSION CMF is a benign primary bone tumour that is rarely located in the vertebral bone.Accurate initial diagnosis of these tumours is important for appropriate treatment.En bloc surgical resection of the tumour is the cornerstone of treatment.
文摘Central granular cell odontogenic tumors(CGCOTs)are rare,benign,slowly growing odontogenic neoplasms.Due to their uncertain histogenesis,CGCOTs are still not included as a distinct entity in the WHO classification(2017)of odontogenic tumors.We report a case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white female.Immunohistochemical staining showed that granular cells positively expressed CD68 and vimentin,and negatively expressed S-100 protein.Meanwhile,we searched Pub Med,Google Scholar,and Scopus databases to summary the clinico-pathological features of 51 reported cases of CGCOT.The results showed that the granular cells of 28.6%cases were immunopositive for vimentin and CD68,and odontogenic epithelial cells were positive immunoreactivity for cytokeratin.These findings reinforced the mesenchymal origin of granular cells and the odontogenic nature of epithelium islands.
文摘Peripheral cemento-ossifying fibroma(PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. PCOF predominantly affects adolescent and young adults with greatest prevalence around 28 years. We report here a rare clinical case of PCOF of the mandible, 1 cm mesiodistally and 1.5 cm occluso-gingivally in diameter, which caused difficulty in eating and speech, in a 42-year-old female patient. She was asymptomatic for 1 year and on follow-up for 6 mo post surgically showed gingival health and normal radioopacity of bone without any recurrence. Clinical, radiographic and histological characteristics are discussed and recommendations regarding differential diagnosis, treatment and follow up are provided. The controversial varied nomenclature and possible etiopathogenesis of PCOF are emphasized.
文摘: Objective: To analyze the relation between the pathological changes and the clinical manifestations and the prognosis of cardiac tumors through the pathological study on 42 cases with cardiac tumor, in order to improve the knowledge of the tumors, to make early diagnosis and to raise the curative ratio.Materials and Methods: 42 confirmed cardiac tumors of our department were selected, among whick 41was surgical specimen and 1 was autopsy. The study was Pcrformed by using the common and special histochemical staining.Results: 41 is Primary and 1 is secondary which is a metastazed hepatocelular carcinoma. In the Primary ones,39 (95.1%) is benign, including myxoma, fibroma,rhabdomyoma and Pericardial cyst, while 2 (4. 9%) is malignant, including neuroleminafibrosarcoma and malignant mesothelioma. In the myxomas, female patients occupy 75%, 91.7% exists in the left atrium and every one has got a peduncle adbesive to the fossa ovalis or adjacency of the atrial septum.Conclusions: The results of the pathological and prognostic study sbowes cardiac tuinors are quite different from the tumors in other sites, i.e., cven benign ones could cause fatal hemodynamic disturbance. Hence early diagnosis and early operation are necessary and if in such instance, the Prognosis of inost of the benign oncs would be good. But the prognosis of the malignant tumors is worst. The myxomas are different from the organized thrombi in heart cavity. And also the criteria of diagnosis and differential diagnosis are discussed.
文摘BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by external tumors of the scrotum is rare.The patient had both a greater omentum tumor and an inguinal hernia,and the tumor protruded into the scrotum through the hernia sac,which is even rarer.Moreover,omental tumors are mostly metastatic,and primary omental fibroma is rare.CASE SUMMARY Here,we report a rare case of a 25-year-old young man with scrotal enlargement and pain for 3 months.Preoperative examination and multidisciplinary discu-ssions considered intra-abdominal tumor displacement and inguinal hernia,and intraoperative exploration confirmed that the greater omentum tumor protruded into the scrotum.Therefore,tumor resection and tension-free inguinal hernia repair were performed.The final diagnosis was benign fibroma of the greater omentum accompanied by an indirect inguinal hernia.CONCLUSION This unusual presentation of a common inguinal hernia disease illustrates the necessity of performing detailed history taking,physical examination,and imaging before surgery.
文摘BACKGROUND Ameloblastic fibromas and ameloblastic fibrosarcomas are rare odontogenic tumors,and controversy exists in the classification of cases presenting hard-tissue production:Ameloblastic fibrodentinoma(AFD)and ameloblastic fibro-odontoma(AFO).These cases are currently considered“developing odontomas”(hamartomatous lesions).AIM To analyze the clinicopathologic features of these lesions and discuss the changes in the 2017 World Health Organization classification.METHODS An electronic literature search was performed in the PubMed/MEDLINE database.An electronic search of the English language literature was performed and last updated in September 2020 in the PubMed/MEDLINE database using the following terms:“ameloblastic fibroma”,“ameloblastic fibrodentinoma”,“ameloblastic fibro-odontoma”,“ameloblastic sarcoma”,“ameloblastic fibrosarcoma”,“ameloblastic fibrodentinosarcoma”,“ameloblastic fibroodontosarcoma”and“odontogenic carcinosarcoma”.The inclusion criteria were odontogenic tumor series,case reports and systematic reviews that provided sufficient clinical,radiological and microscopic documentation to confirm the diagnosis.RESULTS The database search strategy resulted in 947 papers.Articles focusing on other topics,articles that were not in English,duplicate articles,and articles without fulfilling the inclusion criteria were excluded.Finally,96 publications were included in this review to describe and discuss the main features of the searched entities.Several aspects of AFO and AFD,such as biological behavior,age of occurrence,amount of hard tissue,and potential for malignant transformation into odontogenic sarcomas,support the neoplastic nature in most of the reported cases.Considering the clinical,radiographic,histopathological and molecular characteristics of odontogenic lesions with hard tissue production,we suggest that these types of lesions should continue to be recognized as odontogenic tumors by maintaining the classically used terms.CONCLUSION This recommendation will be relevant for future clinical,microscopic,and molecular studies to better understand the biology of these interesting odontogenic tumors.
文摘Cemento-ossifying fibroma (COF) of maxilla is comparatively rare lesion of the maxillofacial region. There is often a misdiagnosis in the category of fibroosseous lesions, owing to an overlap of clinical, histological and radiographic features amongst the separate entities. We present a case of giant maxillary COF causing extensive disfiguration of the face, along with extensive review of the clinico-pathologic and treatment aspects of the fibro-osseous lesions.
文摘Fibroma-like lesions occur with relatively high frequency in oral soft tissues, but represent reactive proliferation against chronic irritation. True fibromas are rare. Tumor size is often seen to range from the mass of a red bean to a soybean. We encountered a case of huge fibroma in the palate with a long history of more than 30 years. The patient was a 60-year-old man who became aware of a tumor in the right palate about 30 years earlier. The mass had tended to increase in size in recent years, and was introduced to our department for the first visit. As an intraoral finding, a pedicled mass measuring 29 × 27 mm was found in the right palate. We also considered the possibility of verrucous carcinoma, and performed biopsy, obtaining a diagnosis of fibroma. Right palatectomy was performed under general anesthesia in October 2016. We performed immunohistochemical examination of the surgical specimen, obtaining a definitive diagnosis of fibroma. As of 1 year postoperatively, no recurrence has been identified and the course has been good.
文摘Juvenile Aggressive Ossifying Fibroma (JAOF) is a benign but locally aggressive fibro-osseous lesion. It is a rapidly growing non-odontogenic neoplasm of the jaws, generally occurring in children and young adults. It is often confused with malignant condition because of its clinical behaviour. Long term follow-up is necessary, considering the high recurrence nature of this tumour. The reconstruction of affected patients, particularly the younger, is often challenging since it has to be done in stages, to keep up with the developing face. We report a case of maxillary JAOF in a 6-month-old female who was referred to our department. Histopathological examination of a resected specimen revealed a trabecular type of JAOF. The patient was followed up for a period of 2 years.
文摘Background: Gorlin-Goltz syndrome is a very rare syndrome that reportedly occurs in 1 of 235,800 people in Japan. The proportion of women with Gorlin-Goltz syndrome complicated with an ovarian fibroma ranges from 12.5% to 17.0%. Some surgical cases of Gorlin-Goltz syndrome with an ovarian tumor have been reported. However, no studies have mentioned subsequent fertility preservation by using oocyte cryopreservation process. Case: In this case report, the patient with Gorlin-Goltz syndrome underwent laparotomy for bilateral ovarian fibrothecoma at 15 years of age. At 20 years of age, a recurrent ovarian tumor was detected in the remaining ovary. During the follow-up, we detected an increase in its size. As tumor torsion requiring left salpingo-oophorectomy was possible, tumorectomy was considered. However, her anti-Müllerian hormone level was low. As she was at risk for premature ovarian failure after tumorectomy, we planned to cryopreserve her oocytes to preserve her fertility before tumorectomy. Outcome: When the patient underwent surgery, the diameter of her left ovarian tumor was found to have increased to 56 mm. Egg collection was performed twice, and two oocytes were cryopreserved. Subsequently, she underwent tumorectomy of the left ovarian tumor. No recurrence has been observed. Conclusion: If a recurrent ovarian tumor is detected in patients with Gorlin-Goltz syndrome and a low anti-Müllerian hormone level, cryopreservation of oocytes before tumorectomy may be effective for preserving their fertility.
文摘Ameloblastic fibroma (AF) is a rare tumour of mixed odontogenic origin that can occur either in mandible or maxilla but is most frequently found in the posterior region of mandible. Age of occurrence is generally between first and second decades of life. It is often mistaken for a den tigerous cyst due to presence of an impacted tooth. The diagnosis of AF usually occurs accidentally by routine radiographic examination for an impacted tooth. Histologically it consists of odontogenic ectomesenchyme resembling the dental papilla, epithelium resembling dental lamina and enamel organ without dental hard tissues. There is controversy in the literature as to whether the treatment should be conservative or a radical resection should be done. A conservative treatment strategy, such as enucleation and curettage, is usually sufficient. We describe a case of massive ameloblastic fibroma in a 5-year-old child with an unusual position in maxillary posterior region and without any impacted tooth. Surgical resection of the tumor through Weber Ferguson approach was done under GA with 2 years of follow-up without any recurrence.
文摘It is a rare clinical condition that may occur to two possible types: puerperal uterine inversion (IUP) and no puerperal uterine inversion (IUNP). Obstetrician will observe often only once in his professional practice. The risk of maternal mortality by hemorrhage is high. We report two cases of uterine inversion requiring a hysterectomy, including a postpartum mode and the other gynecological mode with young women. Hysterectomy remained a last resort treatment in the two types, to reduce morbidity. In the case of uterine inversion, the treatments without hysterectomy could be facilitated if the management is early and adequate. Furthermore, the support should be multidisciplinary and fast in the two types.
基金supported by the National Natural Science Foundation of China(Nos.81671006 and 81300894)the CAMS Innovation Fund for Medical Sciences(No.2019-I2M-5-038)the Program for New Clinical Techniques and Therapies of Peking University Hospital of Stomatology(No.PKUSSNCT 22A14),China。
文摘In light of the lack of reliable molecular markers for odontogenic myxoma(OM),the detection of copy number variation(CNV)may present a more objective method for assessing ambiguous cases.In this study,we employed multiregional microdissection sequencing to integrate morphological features with genomic profiling.This allowed us to reveal the CNV profiles of OM and compare them with dental papilla(DP),dental follicle(DF),and odontogenic fibroma(OF)tissues.We identified a distinct and robustly consistent CNV pattern in 93.75%(30/32)of OM cases,characterized by CNV gain events in chromosomes 4,5,8,10,12,16,17,20,and 21.This pattern significantly differed from the CNV patterns observed in DP,DF,and OF.The Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis indicated potential links between this CNV patterns and the calcium signaling pathway and salivary secretion,while Gene Ontology(GO)term analysis implicated CNV patterns in tumor adhesion,tooth development,and cell proliferation.Comprehensive CNV analysis accurately identified a case that was initially disputable between OF and OM as OM.Our findings provide a reliable diagnostic clue and fresh insights into the molecular biological mechanism underlying OM.
文摘<p> The fibroids affect 20<span style="font-family:Verdana;">%</span><span style="font-family:Verdana;"> to 25% of women of reproductive age and are 3 to 9 times more common in black women. We’ll talk about giant fibroids (GFs) when uterine height reaches or exceeds the navel. We have initiated this study in order to report the epidemioclinical and therapeutic aspects of giant fibroids at the Hopital du Mali.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">A descriptive retro-prospective study, conducted in the service of gynecology of the Hopital du Mali from November 2017 to December 2018 were included in this study, any patients, regardless of their age, having developed a fibroid, the uterin</span> </p> <p> <span style="font-family:Verdana;">e height of the patient reaching or exceeding the umbilicus on physical examination and who were on surgical treatment. We had collected 30 cases of GFs out of the 92 patients who had undergone myomectomies, with a frequency of 32.60%. The age group 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">29 years accounted for 46.6% with an average age of 35 years. Housewives represented 50% and nulligravida made up 33% of our patients. Desire to become pregnant was the main reason for consultation in 34.4% of cases. The uterine height was between 25 and 29 cm on physical examination in 46.66% of cases. Myomectomy was performed in 76.64% and hysterectomy in 23.3% of cases. The size of the nuclei after surgery was over 25</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">cm in 48.66% of our patients.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: The giant fibroid (GF) is a common cause of myomectomy. The treatment is either hysterectomy or myomectomy and depends on the indications.</span> </p>
文摘A 79-year-old woman with gradually worsening left nasal obstruction, purulent rhinorrhea and severe headaches for 6 months admitted to the hospital. A gray-white and huge mass occupying the left nasal cavity was found in physical examination. CT revealed a soft-tissue-density mass in the left nasal cavity with erosion of adjacent bone structures. On T2-weighted MR images, the lesion showed homogenous extreme low signal intensity. The patient underwent successful surgical removal of huge sinonasal soft tissue mass measuring 50 × 45 × 40 mm. The final diagnosis of fibroma was made histologically. MR imaging studies showed characteristic signal intensities corresponding to histopathological components. To the best of our knowledge, this is the first report regarding the MR imaging findings of huge nasal fibroma in the English literature.
