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Journal of Oral and Maxillofacial... 2022Desmoplastic ameloblastoma (DA) is an epithelial odontogenic tumor and a rare variant of ameloblastoma. It was first described by Eversole in 1984. In the World Health...
Desmoplastic ameloblastoma (DA) is an epithelial odontogenic tumor and a rare variant of ameloblastoma. It was first described by Eversole in 1984. In the World Health Organization (WHO) classification of odontogenic tumors (2005), DA has been considered as a distinct entity from conventional/multicystic ameloblastoma. DA differs strikingly in its clinical, radiological, and histopathological presentation when compared to other variants of ameloblastoma. We report here an extremely rare "Hybrid DA" in a 50-year-old female patient with painless hard swelling involving right posterior mandible with detailed clinical history, an unusual radiographic and histopathological presentation. Histopathology revealed odontogenic epithelium in the form of follicles, ameloblastoma with cystic degeneration, and squamous metaplasia at places and elsewhere there were odosntogenic islands compressed by dense fibrocellular stroma suggestive of desmoplasia along with osseous tissue formation. Also review of the literature and possible explanation of etiopathogenesis of cystic change and osseous tissue formation in DA are discussed.
PubMed: 37082038
DOI: 10.4103/jomfp.jomfp_20_22 -
Journal of Orthopaedic Case Reports Oct 2022Subcutaneous hemangioma is a rare variant of slow-flowing venous malformation. It occurs in both adults and children and is more common in women. It exhibits an...
INTRODUCTION
Subcutaneous hemangioma is a rare variant of slow-flowing venous malformation. It occurs in both adults and children and is more common in women. It exhibits an aggressive growth pattern, can occur anywhere in the body, and may recur after resection. This report shows a rare localization of hemangioma in the retrocalcaneal bursa.
CASE REPORT
A female patient, age 31, presented with swelling and pain over the retro calcaneum region for 1 year. The pain in the retrocalcaneal region has increased with gradual intensity over the past 6 months. The swelling she described to be insidious in onset and gradually progressive. Examination findings at presentation were a middle-aged female with diffuse swelling in the retrocalcaneal region with a size of 2 cm by 1.5 cm. Based on the X-ray, we defined it to be myositis ossificans. With this view in mind, we admitted the patient and surgically excised the area. We operated by posteromedial approach and sent the specimen for histopathology. Pathology revealed calcified bursa. Microscopically, it was hemangioma with phleboliths and osseous metaplasia. The post-operative period was uneventful. The patient's pain was reduced, and overall performance was good at follow-up.
CONCLUSION
This case report highlights the importance for surgeons, pathologist to consider cavernous hemangioma as a differential diagnosis for retrocalcaneal swellings.
PubMed: 36874889
DOI: 10.13107/jocr.2022.v12.i10.3378 -
Rechtsmedizin (Berlin, Germany) 2023This article reports the autopsy findings of a 1.5-year-old girl with no history of previous hospital admission who suddenly collapsed at home. After 45 minutes of...
This article reports the autopsy findings of a 1.5-year-old girl with no history of previous hospital admission who suddenly collapsed at home. After 45 minutes of resuscitation efforts, the cardiac activity was restored. During hospitalization, she had ventricular arrhythmia and extremely elevated cardiac troponin levels. Internal examination and immunohistochemistry revealed cardiac fibromas of the right and left ventricles and extensive hypoxic myocardial damage. The right ventricular fibroma demonstrated interdigitating and entrapped myocardium visible at the edges and within the central portion of the tumor. The left ventricular fibroma originated in the subepicardial region and propagated towards the endocardium.
PubMed: 36778761
DOI: 10.1007/s00194-023-00615-2 -
Indian Journal of Otolaryngology and... Dec 2022There exists paucity in recorded literature on the detailed microscopic appearance of elongated styloid processes (ESPs) in patients with Eagle's syndrome (ES). Although...
There exists paucity in recorded literature on the detailed microscopic appearance of elongated styloid processes (ESPs) in patients with Eagle's syndrome (ES). Although literature is replete with numerous conflicting and inconclusive theories, the exact cause, mechanism of origin, development and progression of styloid apparatus enlargement remains unclear and ambiguous. To carry out detailed histopathogical examination of excised specimen of ESPs in a patient with ES, with the objective to determine its precise etiomorphogenesis, and to analyse the role of possible triggering factors. Light microscopic examination was carried out of the base, mid- and apical thirds of transorally excised ESPs in a 45-year-old patient with ES. Woven bone trabeculae were found emanating from tendinous insertions of the styloid group of muscles at the mid third of the ESPs. Apical region of the ESPs showed fibro-collagenous mesenchymal tissue with numerous, haphazardly scattered trabeculae of woven bone traversing it. Presence of deeply staining reversal lines all along the length of the ESPs was suggestive of multiple micro-fractures from recurrent traumatic/traction forces, and repeated attempts at repair and ossification. It is proposed that mesenchymal structures composing the stylohyoid ligament at its attachment, and tendinous insertions of styloid muscles into the ESPs are stimulated to undergo metaplastic alterations, by repetitive stress, traction or traumatic stimuli brought to bear upon them, from muscular contractions. This osseous metaplasia of connective cells within them, followed by dystrophic bone deposition, brings about SP thickening and lengthening with their attendant and associated clinico-pathological sequelae.
PubMed: 36742717
DOI: 10.1007/s12070-021-02438-7 -
Frontiers in Oncology 2022Among those tumors with consistent USP6 rearrangement, some arise from soft tissue and show bone metaplasia, including myositis ossificans (MO), fibro-osseous...
INTRODUCTION
Among those tumors with consistent USP6 rearrangement, some arise from soft tissue and show bone metaplasia, including myositis ossificans (MO), fibro-osseous pseudotumor of digits (FOPD), soft tissue aneurysmal bone cyst (ST-ABC) and fasciitis ossificans (FO). These lesions are easily confused with malignancies because they show a rapid growth rate and brisk mitoses. Here, we aim to clarify the clinicopathologic and genetic characteristics of this entity and analyze the correlations among the different subtypes in one of the largest cohorts.
MATERIALS AND METHODS
The clinicopathologic features of 73 cases of MO, FOPD, ST-ABC and FO diagnosed at West China Hospital, Sichuan University from January 2010 to December 2021 were retrospectively analyzed. Forty-three undecalcified samples were analyzed by systematic genetic studies, including fluorescence in situ hybridization (FISH), reverse transcription polymerase chain reaction (RT-PCR), Sanger sequencing and next-generation-based sequencing were performed.
RESULTS
This series included 40 males and 33 females aged 2 to 80 years old (median: 31 years). FOPD occurred in extremal soft tissue, while lower extremities (38/58, 65.5%) were the most commonly involved lesions in the other three subgroups. Histologically, proliferative myofibroblasts/fibroblasts with varying degrees of osteoid tissue were present. Fluorescence in situ hybridization (FISH) results indicated that 22 cases (22/27, 81.5%) were positive for USP6 rearrangement, and 5 cases were negative. Among those cases with positive FISH results, 18 underwent reverse transcription-polymerase chain reaction (RT-PCR) detection that successfully detected common USP6 fusion types. Thirteen cases showed COL1A1::USP6 fusion, one showed MYH9::USP6 fusion, and 4 were negative for common fusion types. Next-generation-based sequencing technology was performed on two lesions with negative RT-PCR results and novel fusion partners SNHG3 and UBE2G1 were discovered.
CONCLUSIONS
Our findings revealed that COL1A1 is the most common fusion partner in this entity, unlike primary aneurysmal bone cysts and nodular fasciitis. Notably, we believed that FO may demonstrate more similar clinicopathologic and genetic manifestations with MO/FOPD and ST-ABC instead of nodular fasciitis for involving lower limbs most frequently and showing recurrent COL1A1::USP6 fusion. Additionally, this study also found two novel USP6 fusion partners, which further expanded our knowledge of this neoplastic spectrum.
PubMed: 36727055
DOI: 10.3389/fonc.2022.1065071 -
Surgical Case Reports Feb 2023Tumor embolization due to venous infiltration of breast cancer pulmonary metastases is very rare.
BACKGROUND
Tumor embolization due to venous infiltration of breast cancer pulmonary metastases is very rare.
CASE PRESENTATION
A 72-year-old female was diagnosed with triple-negative breast cancer. Neoadjuvant chemotherapy was discontinued because of progressive disease, and a right mastectomy with sentinel lymph node biopsy was performed. The pathological analysis of surgical specimens revealed carcinoma with cartilaginous and/or osseous metaplasia. At 22 months after surgery, lung metastasis was observed, and 6 months after initiating treatment for lung metastases, she complained of sudden numbness in the left-lower limb with trouble walking. Ultrasonography showed an embolism in the left popliteal artery, and contrast computed tomography showed enlarged lung metastases and infiltration of the left-upper lobe disease into the left superior pulmonary vein and left atrium. Acute arterial occlusive disease in the left-lower limb caused by the tumor embolism was suspected, so an endovascular thrombectomy was performed. Tumor emboli were removed by embolectomy catheter.
CONCLUSION
This report of lung metastasis from breast cancer with cartilaginous and/or osseous metaplasia and acute lower-limb artery occlusion due to a tumor thrombus adds useful information to the literature on these extremely rare cases.
PubMed: 36723693
DOI: 10.1186/s40792-023-01598-8 -
Cureus Dec 2022Osseous metaplasia is rarely detected in benign and malignant lesions in the gastrointestinal tract, especially in the pediatric population under the age of six. Here,...
Osseous metaplasia is rarely detected in benign and malignant lesions in the gastrointestinal tract, especially in the pediatric population under the age of six. Here, we report the case of a four-year-old boy with a history of constipation associated with painless bleeding per rectum for six months which was excised successfully. Microscopically, there was osseous metaplasia with no malignant changes. Further reporting is needed due to the limited cases of osseous metaplasia in colorectal polyps, with unknown mechanisms of pathogenesis and prognostic factors, specifically in the pediatric population.
PubMed: 36721624
DOI: 10.7759/cureus.33052 -
Revista Espanola de Enfermedades... Apr 2023A 17-year-old male with no previous medical history presented with a 1-year history of rectal bleeding, mucus discharge and occasional rectal prolapse. Colonoscopy...
A 17-year-old male with no previous medical history presented with a 1-year history of rectal bleeding, mucus discharge and occasional rectal prolapse. Colonoscopy revealed several polypoidal growth masses in the distal rectum, formed by multiple sessile polyps with a glistening mucus-covered surface and fleshy, friable appearance, that coalesced forming large conglomerates. Given their complexity and large size, piecemeal endoscopic mucosal resection of the rectal lesions was performed and histopathological examination revealed ulcerated polypoid mucosa with mixed inflammatory cell infiltrate in the lamina propria and dilated cystic mucus-filled glands. Remarkably, bony trabeculae surrounded by osteoblastic cells were also seen. These findings were consistent with juvenile polyps with foci of osseous metaplasia. Osseous metaplasia has been described in a wide variety of tissue types, such as prostate, uterus, breasts, lungs and urinary tract, with respect to both neoplastic and non-neoplastic conditions. However, it is exceedingly rare in colonic polyps and, to the best of our knowledge, only 9 cases have been described in juvenile polyps.
Topics: Male; Female; Humans; Adolescent; Endoscopic Mucosal Resection; Intestinal Polyps; Colonic Polyps; Rectum; Colonoscopy; Calcinosis; Choristoma; Hamartoma; Metaplasia; Polyps
PubMed: 36719331
DOI: 10.17235/reed.2023.9489/2023 -
BMC Veterinary Research Jan 2023Interpretation of patellar ligament (PL) ultrasonography may be difficult, as hypoechoic or heterogenous echogenicity are common findings. Verifying suspected disease of...
BACKGROUND
Interpretation of patellar ligament (PL) ultrasonography may be difficult, as hypoechoic or heterogenous echogenicity are common findings. Verifying suspected disease of equine PLs by histopathology is also problematic as descriptions of normal PL vascularity and histology are scarce. The current study describes the PL and infrapatellar fat pad (IFP) vascular pattern from computed tomography scans of barium perfused normal equine specimens (n = 8; age 10 days to 18 years), as well as routine histology to serve as a reference for future investigations into PL pathology and IFP disease.
RESULTS
The PLs received a bipolar blood supply. Vascular architecture consisted of numerous distinct longitudinal vessels with several horizontal connections, which branched into extensive latticeworks of smaller vessels throughout the ligaments. Several vascular connections between the PLs and the IFP were identified. One distinct longitudinal vessel was seen entering each of the IFP lobes at the distocranial aspect, branching extensively into lobar vascular networks which anastomosed by several horizontal branches at the mid portion of the IFP where the two lobes merge. Histologically, there were large variations in PL interfascicular endotenon thickness, vascularity and fatty infiltration; these parameters increased with age for the intermediate and medial PL. Areas of metaplastic tenocytes / chondroid metaplasia were identified in all investigated adult medial PLs; in 2/7 in the intermediate PL and in 4/7 in the lateral PL. The adult IFP consisted of white unilocular adipose tissue, organized in lobules separated by thin connective tissue septa increasing in thickness towards the periphery and the distocentral aspect.
CONCLUSIONS
The equine PLs and IFP are highly vascularized structures with ample vascular connections suggestive of crosstalk. This, together with the large variation in PL endotenon thickness, vascularity and fatty infiltration, should be taken into consideration when assessing potential PL histopathology as these changes increase with age and are found in horses without clinical signs of stifle disease. Metaplastic tenocytes / chondroid metaplasia should be considered a normal finding throughout the medial PL and is not age dependent. The role of the equine IFP in stifle disease has yet to be elucidated.
Topics: Animals; Adipose Tissue; Horses; Knee Joint; Patella; Patellar Ligament; Stifle; Tomography, X-Ray Computed
PubMed: 36691004
DOI: 10.1186/s12917-023-03579-3 -
American Journal of Ophthalmology Case... Mar 2023To describe the clinical, optical coherence tomography (OCT), and histopathological findings of a patient who was found to have ossification of a pre-retinal membrane...
PURPOSE
To describe the clinical, optical coherence tomography (OCT), and histopathological findings of a patient who was found to have ossification of a pre-retinal membrane after multiple surgical repairs for retinal detachment.
METHODS
The patient had comprehensive ophthalmic examinations during seven years of follow-up and underwent surgical removal of her pre-retinal membrane.
RESULTS
A 24-year-old woman with a history of retinal detachment and multiple retina surgeries presented with baseline vision of 20/200 and refractory glaucoma in the left eye (right eye with no light perception due to prior failed retinal detachment repair). OCT showed a thick epiretinal membrane with hypo-reflective intraretinal spaces in the macula, and exam revealed a chronic retinal detachment superotemporally surrounded by laser barricade. She was stable for six years and then experienced vision loss and decreasing eye pressure, concurrent with rapid evolution of pre-retinal fibrosis, leading to a vascularized consolidation in the mid-periphery, for which she underwent vitrectomy and membrane peel. The vascularized lesion over the area of detachment in the superotemporal retina was removed en bloc through the anterior chamber. Pathological findings revealed woven bone formation anterior to the internal limiting membrane, and the tissue was GFAP negative.
CONCLUSIONS
Our case adds to the limited knowledge of the chronology, presentation, and surgical management of intraocular ossification, especially of the rarer pre-retinal type. Our patient highlights that development of ossification can happen more quickly than previously thought (year or years rather than decades), can be hidden under vascularized lesions, and is dynamic, with simultaneous release of traction in one area and increased traction in another. Diligent follow-up is indicated even in cases of vitreous membranes from retinal detachment that otherwise appear to have been stable for years.
PubMed: 36686266
DOI: 10.1016/j.ajoc.2022.101791