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A calcifying aponeurotic fibroma involving the soft tissue and bone of the occipital area compressed and attenuated the cerebellum and brainstem of a 9-year-old female dog of mixed breeding. Clinical signs included a head tilt to the left; gait ataxia; anisocoria, with a midly dilated left pupil; horizontal nystagmus, with the fast phase to the right; and a mild depression of the level of consciousness. The signs were sequential and progressive.
We report an unusual tumor related to the meninges designated as a calcifying fibroma of the meninges. Our patient was a 44-year-old man.The tumor was located in the right frontotemporoparietal region and was excised totally via a right frontotemporoparietal craniotomy. The patient had recovered completely, and no recurrence was observed in a follow-up period of three years. Histopathologically, we noted scattered spindle cells among the hyalinized collagenous stroma, dystrophicpsammomatous calcifications, abundant perivascular hyalinization and cartilagenous metaplasia. Immunohistochemically, the tumor cells showed actin, smooth muscle and vimentin immunreactivities. Ultrastructurally, spindle cells showed fibroblastic features. The lesion is a true tumor and it should be kept in mind in the differential diagnoss of meningeal calcifying lesions.
We report a case of chondromyxoid fibroma arising from the middle phalanx of the index finger. The radiographic and pathologic findings are described.
Three cases of a distinctive soft tissue fibrous tumor with spotty calcification demonstrate the lesion originally described by Keasby as Juvenile Aponeurotic Fibroma. The tumor tends to occur on the volar surface of the hands and feet in children and adolescents but may be seen in other areas in all age groups. Size rarely exceeds 3.0 cm. The tumors are fixed to the fascial layers. In previously reported patients pain was not described as an important factor, but both pain and tenderness were striking in all 3 of our cases. Microscopically the dominant feature is a fribrous stromal pattern of fusiform cells with inclusions of mast cells. Spotty calcification is a constant finding and appears to increase with duration of tumor. Local recurrence after excision and an aggressive histologic appearance may raise the question of malignancy. However, neither destruction of normal tissue surrounding the tumor nor metastases have occurred. Local exicision is the treatment of choice.
Stress, fatigue or march fractures rarely occur in children. Usually the bones do not show any other pathological alterations. The authors observed a 10 year old girl with stress fracture of the tibia, and additional skeletal alterations like "fibroma non ossificans" which probably are not connected with the main disease.
An unusual case of fibroma on the end of the tail of a 7-year-old cross-breed cow. The most prominent clinical findings were the size and weight of the tumour, and the tail length. The extension of the tail was apparently caused by the weight of the tumour.
PURPOSE: Reported clinicopathologic studies on the peripheral ossifying fibroma (POF), a reactive gingival lesion, have not addressed the pediatric population in specific detail. This study, the first devoted to children, investigated the clinical features of a large number of POFs and compared the findings to cases reported in the English language literature. METHODS: Detailed clinical and historical information of 134 surgically removed POFs in patients aged 1-19 formed the basis of this study. Clinical manifestations, histogenesis, treatment rationale with pediatric considerations, and biologic behavior were emphasized. RESULTS: The POF was found more frequently in females (60%). It had a predilection for the maxillary gingiva (60%) and for the incisor/cuspid region. The average patient age was 14 years. Only 2 (1%) POFs were found to be unequivocally associated with primary teeth. The clinician seldom included the POF in the differential diagnosis. The recurrence rate after surgical excision was 8%. CONCLUSIONS: This study revealed that a POF arising from the periodontal ligament of a primary tooth is most likely a rare event. However, the pediatric patient with a POF has special management considerations compared to the adult. Because of the POF behavior pattern, a proper treatment protocol is warranted with close postoperative follow-up.
Calcifying aponeurotic fibroma is a rare benign soft tissue tumor that usually involves distal extremities in children and young adults. It is characterized by a high rate of recurrence. We report a case in a 15-year-old boy who complained of painless swelling of his right foot. Tomodensitometry showed a dense well-circumscribed tumor with peripheral calcification. The tumor was completely removed. The patient is well at 28 months follow-up. Diagnosis relied on microscopic analysis showing fibroblastic proliferation with focal calcification and chondroid differentiation.
Three cases of calcifying aponeurotic fibroma in an 8-year-old boy, a 43-year-old woman and a 48-year-old man are presented. The lesions involved the substance of the palmaris longus tendon, the lateral aspect of the foot at the base of the fifth metatarsal and the fifth digit of the foot, respectively. The clinical and radiologic findings, including ultrasound and computed tomography, are described. Histologic features included chondroid tissue and calcification within areas of proliferative plump fibroblasts in the younger patient, while in the two adults the lesions were more sharply defined showing increased calcification of dense connective tissue with less pronounced cellularity and no evidence of chondroid differentiation.
Rat skin was exposed to the plateau region of the 1.0 GeV/nucleon 56Fe beam at the Brookhaven AGS. Rats were irradiated or not with single of split doses of 56Fe or argon; some 56Fe-exposed rats were fed 250 ppm retinyl acetate continuously in the lab chow beginning 1 week before irradiation. All lesions were noted, photographed and identified for eventual histological diagnosis. The preponderance of the tumors so far are fibromas. The data show that single doses of 56Fe ions are 2 or 3 fold more effective than argon in producing tumors at 4.5 Gy but are about equally effective at 3.0 Gy and 9.0 Gy. The presence of 250 ppm retinyl acetate in the lab chow reduced the incidence of tumors by about 50-60% in comparison to groups exposed only to the radiation. These are preliminary findings based on only about one-fourth the eventual number of tumors expected.
Twelve cases of ossifying fibroma of long bones, the lesions in 11 cases were resected with their sclerotic margin. Inactivation of the tumor cells within bone cavity was applied 50% Zinc Chloride, and autogenous bone grafts were applied with or without a few man-made bones. One case was treated by en bloc resection of the lesion. Follow-up for 3-14 years revealed that 2 cases recurred, and secondary operation was performed. After that follow-up for 5-14 years revealed no-recurrence. Recurrence rate of these cases was low and the effect of treatment was satisfactory. This kind of lesion showed the features of its aggressive growth and proneness to recur after operation. The authors consider that resection of the lesion including its sclerotic margin was effective to prevent recurrence.
A 24-year-old patient had a long history of low backache. After examination he was found to have a presacral mass grossly displacing the rectum anteriorly. Surgical exploration revealed a large rounded mass (20x17x10cm) occupying the presacral space and adherent to the sacral promontory. The mass was totally excised. The histology was a benign fibroma. The patient persued an excellent post-operative course and has remained symptom free for one year now.
A 12-year-old patient case is reported, presented with a desmoid fibroma of the left pterygoid region, extended to the cortical and endosteal regions of the mandible, reconstructed immediately with a free peroneal flap, recovering with this both form and function. To date, 3 years from surgery, he has no complications. Evolution of this case and a brief review of the literature is reported. It is concluded that free peroneal graft for mandible reconstruction is safe and has excellent results, both aestethic and functional.
Chondroblastoma and chondromyxoid fibroma (CMF) has been investigated in numerous histological studies, but its biological nature and histogenetic origin are still a matter of debate. We evaluated the expression of type II collagen, S100A2, S100B, and osteocalcin to study the matrix biochemistry and phenotype of the neoplastic cells in these tumors. Immunohistochemically, the expression of type II collagen was diffuse in 15 cases (75%) among total 20 chondroblastomas and 12 (85.7%) among total 14 CMFs. The expression of S100B was also diffuse in all cases (100%) of chondroblastomas and 12 cases (85.7%) of CMFs. We were able to obtain the expression of S100A2, focally. The expression of osteocalcin was focally noted in 18 cases (90%) of chondroblastomas and 8 cases (57.1%) of CMFs. In conclusion, our data support that chondroblastoma and CMF are a distinct tumor entity with the basic expression of chondroid markers. But these tumors also show histologic diversity with focal co-expression of osteoid markers.
A case of multilocular desmoplastic fibroma in both bones of the fore-arm, a very rare localization, is described. Diagnosis and treatment are discussed with cases so far puclished. The important distinction from a highly differentiated fibrosarcoma is mentioned.
The authors describe a case of naso-pharyngeal fibroma which they treated, in order to prevent per-operative haemorrhage, by means of embolisation of the arterial pedicles. The result was very satisfactory, the operation being practically bloodless. They stress the advantages of angiography for obtaining information about these tumours. And, thinking ahead on the subject of embolisation, they weigh up the risk of haemorrhage due to surgery (which remains considerable whatever methods have been used hitherto) against the possible risk of embolism which appears to be negligible if it is carried out by a radiologist who is expert in this method.
The authors present the results of treatment of 2 cases of fibroma chondromyxoides in children. In Polish orthopaedic literature only 2 other cases have been presented. The first case--a 13-year-old boy--was referred to our centre because of a recurrent tumour in the 1st metatarsal bone and surrounding soft tissues. The boy had received treatment 3 years earlier outside our centre, where curettage of the tumour was performed. The bone cavity was then filled with bone grafts. The tumour was removed again and autogenous bone grafts were applied. On follow-up 7 years after surgery no recurrence was noted, along with full remodelling of the bone grafts. The second case was a 9-year-old child. The tumour was localised in the proximal phalanx of the thumb. During curettage and application of autogenous bone grafts for the tibia, transplantation of the tumour site occurred to the donor site. Two years after surgery tumour recurrence was observed. A re-operation was performed, with complete resection of the basal phalanx, with a fibular graft implantation. The tumour in the tibia was also removed. Two and a half years after surgery both tumour sites remain free of signs of recurrence.
An adolescent with bilateral ovarian fibromas associated with Gorlin's or the multiple nevoid basal cell carcinoma syndrome is described. The syndrome should be considered and looked for when bilateral solid ovarian masses are found in young women.