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The authors report a case of mesenteric fibroma in an 18 year old African woman revealed by an increase in the size of her abdomen without any accompanying symptoms. The complete removal of the tumor required resection of 50 cm of intestine. The postoperative course was uneventful. In view of this case, the authors recall the rarity of this kind of abdominal tumor, and the difficulty in diagnosis preoperatively.
Starting from a case of pure fibroma of the small intestine, which led to ileo-ileo-colic invagination, the Authors review the literature on the subject. The great rarity both of the type of neoplastic pathology found and the type of induced intestinal invagination is stressed. It is concluded by asserting that correct diagnosis, adequate selection of the type of surgery and its efficient performance allow a favourable prognosis in the overwhelming majority of cases.
A rare case of fibroma of the inner and lower orbital wall in a 75-year-old man is described. The tumor was adherent to the periosteum of the orbital bones and occurred 1 1/2 years after an uncomplicated dacryocystectomy.
A new cell line (B-25F) obtained from a benign polypoid fibrous lesion of the mucosa of oral cavity is described. The cells at first grew in suspension but after a month of cultivation they began to adhere and subsequently formed a monolayer typical for fibroblastoid cells. Population doubling time both in lower and higher passages was 60 h. Electron microscopy studies failed to detect any viral particles or mycoplasmas. A comparison of cell surface glycoproteins of fibroblasts (B-41FB), fibroma cells (B-25F), and fibrosarcoma cells (B-6FS) was made. These lines share common traits in their surface membranes although distinct differences among the individual lines could be detected. Karyological analysis showed that 64% of cells contained 46 chromosomes. This number veiled both diploid and pseudodiploid karyotypes. An aberrant chromosome, t(13;18?) was found. For isoenzyme comparison of B-41FB, B-25F, B-6FS, and HeLa cell lines the mobility of lactate dehydrogenase (LDH) and glucose-6-phosphate dehydrogenase (G-6-PD) was employed. All these lines had LDH patterns of human cells, and a G-6-PD pattern of phenotype B except that of HeLa cells that had phenotype A.
A case of ethmoidal fibroma in an 18-month-old infant is reported, and nosological, histological, and pathogenic features of this rare affection discussed. Though similar in some respects to Jaffe Lichtensteins fibrous dysplasia in its localized form, it differs, in that it sometimes runs a rapid course and has a tendency to relapse.
This is the first description in the national literature of morphology of the so-called medullar fibromas of the human kidney which are considered to be hormonally-active (producing prostaglandines) tumours or tumour-like focal hyperplasias of interstitial cells of the kidney medullary layer.
The authors report their experiments in the diagnosis and treatment of naso-pharyngeal fibromas. They point out:--the usefulness of tomo-densitometric and arteriographic examinations; but they are concerned by the neurological dangers of embolization;--the usefulness of surgical treatment in this condition, usually done by the infralabial route, in the Rouge-Denker technique.
Present special investigations offer the possibility of very good assessment of the extension and vascularisation of nasopharyngeal fibromas. It is no longer logical to seek to treat all tumours via wide surgical approaches since tumour size and spread vary from one case to another. Amongst the various surgical approaches available, the transpalatine technique is extremely valuable in the excision of small limited tumours limited to the cavum or to remove the sphenoidal prolongation of a large tumour. In such a case, a combined transpalatine and transantral approach facilitates the operation and ensures perfect control of the whole excision process, which considerably reduces the risk of recurrence.
A benign encapsulated fibroma within the right lacrimal sac was found to be the cause of nasolacrimal obstruction in a 75-year-old man. This rare tumour was completely excised through an incision for a routine dacryocystorhinostomy, which could then be done.
The authors report a case of pleural fibroma discovered during an examination for thoracic pains in a 65 year old woman. Histochemical studies were positive with vimentin and negative with KL1 antibodies and compatible with the most recent hypotheses concerning the purely fibroblastic origin of these tumours.
A case of Thecoma-fibroma secreting oestrogen to cause insulin intolerance in a post-menopausal woman is presented. Blood levels of sugar became normal 24 hours after removal of the tumor. The possible mechanism is presented.
Calcifying (juvenile) aponeurotic fibroma (CAF) is a rare disease entity characterized by a tendency to develop in the palms and soles of children and young adults. It has definite histologic features of an ill-circumscribed fibroblastic proliferation, with foci of calcification and chondroid differentiation, as well as a recurring or locally aggressive growth pattern. The commonly accepted mode of treatment is wide excision of the tumor; extensive surgery is usually not necessary even for recurrences. Three cases are reported, all of when were female with the age ranging from 8 to 27 years. All lesions were in the hand or foot, and one of them was recurrent. Immunohistochemical study was performed and the literature reviewed.
In an 8-month-old infant presenting with a systolic heart murmur, a cardiac tumor was diagnosed by means of 2-dimensional echocardiography, cardiac catheterization, and magnetic resonance imaging. In the following years, the child developed ventricular arrhythmias, which were controlled with antiarrhythmic drugs. The operation was undertaken when the boy was 4 years and 3 months of age. A tumor of the interventricular septum measuring 45 x 13 x 25 mm was resected in toto. The defect in the ventricular septum was closed with a Dacron patch. The postoperative course was uneventful. Histologic examination classified the tumor as a fibroma.
In this article, the authors present 5 patients with desmoplastic fibroma and review the literature. Four patients had aggressive curettage with bone graft, and 1 had aggressive curettage alone. Although the literature reports that many patients have recurrence after curettage, there have been no recurrences in these 5 patients during followup periods ranging from 5 years 6 months to 9 years. Although wide excision has been recommended in the literature, treatment with aggressive curettage achieved clinical and radiographic control of the lesions for at least an intermediate duration of followup.
The authors report the case of a pulmonary fibroma in a 66 year-old smoker. Intrapulmonary localization of solitary fibrous tumors is rare; these tumors are more frequently described in pleura. Histologically, the presence of spindle cells without nuclear atypy on a collagen background must evoke the diagnosis made difficult by the unusual localization.
83 cases with ossifying fibroma were diagnosed by clinical, histopathological and radiological criteria, and were analyzed radiologically. Four distinct radiographic patterns were identified according to the radiodensity and shape: (1) cystic radiolucent (42.2%), (2) ground-grass (7.2%), (3) sclerotic change (9.6%), (4) mixed change of radiolucent and radiopaque (41.0%). The lesions showed a growth pattern of round expanding in all directions with well-defined margin and frequent involvement of teeth. A preliminary analysis of the relationship among the clinical, radiological and histopathological manifestations was presented. The diagnostic criteria was proposed and differentiate diagnosis was discussed.
Giant cell tumor of tendon sheath (GCTTS; "nodular tenosynovitis") and fibroma of tendon sheath (FTS) have traditionally been considered to be two points in a single neoplastic continuum. However, no systematic studies have addressed this concept directly to date. To more clearly define their relationship to one another, we studied five FTSs and seven typical GCTTSs by light microscopy and paraffin section immunohistochemistry. Tissue samples were stained for vimentin, desmin, smooth muscle actin (SMA), S100 protein, leukocyte common antigen (CD45), CD68 antigen (KP1), HAM56 antigen, alpha-1-antichymotrypsin (AACT), and MAC387 antigen. These reagents were chosen to address proposed "fibrohistiocytic" and myofibroblastic lineages for the two lesions. All tumors had a lobular appearance. GCTTS was more cellular than FTS; it contained conspicuous numbers of osteoclast-like cells, and the stroma was not extensively hyalinized. In contrast, FTS was matrix-rich, often with extensive stromal sclerosis, and contained only rare giant cells. Immunophenotyping of GCTTS showed that both the spindle cell and giant cell components were positive for vimentin, LCA, CD68, HAM56, AACT, and MAC387, suggesting monocyte-macrophage-like features. Limited reactivity for desmin and SMA also implied conjoint myofibroblastic differentiation. On the other hand, FTS showed focal staining with HAM56 (all cases) and for CD68 (one case); staining for vimentin and SMA was uniformly intense and diffuse. Based on these results, we conclude that GCTTS and FTS both exhibit varying degrees of monocyte-macrophage-like and myofibroblastic differentiation. The predominance of macrophage-related determinants in GCTTS and myofibroblastic markers in FTS supports the premise that these lesions represent phenotypic extremes of a single clinicopathologic entity.
Fibrous dysplasia (FD) and cemento-ossifying fibroma (COF) are benign fibro-osseous lesions that are generally considered to be separate entities, distinguished by histologic and radiographic features. In our experience, some lesions lack the classic clinical, radiographic, or pathologic features of FD or COF and rather have overlapping features of both entities. Consequently, these cases are frequently diagnosed nonspecifically as fibro-osseous lesions. We examined 56 gnathic and extragnathic fibro-osseous lesions of bone morphologically, clinically, and radiographically to determine whether they can be reliably distinguished and whether their distinction has any clinical or prognostic significance. The lesions exhibited a broad morphologic spectrum of patterns ranging from pure FD (24 cases) to pure COF (10 cases). Twenty-two lesions contained a mixture of both patterns; 11 lesions with a predominant FD pattern contained calcified spherules histologically indistinguishable from those characteristically seen in COF. The remaining 11 lesions contained areas of typical FD adjacent to areas of COF. The lesions examined also demonstrated considerable radiographic overlap, and FD could not be reliably distinguished from COF. The recurrence rate was low for all lesions regardless of the histologic pattern. Because of histologic and radiographic overlap and similar low recurrence rate of FD and COF, we consider them to be related lesions, and COF is probably an opposing end of a morphologic spectrum of FD.