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Frontiers in Oncology 2023Extraskeletal osteosarcoma (EO) is a soft tissue sarcoma characterized by the production of bone matrix by neoplastic cells. Benign osteoid in EO, leading to a...
Extraskeletal osteosarcoma (EO) is a soft tissue sarcoma characterized by the production of bone matrix by neoplastic cells. Benign osteoid in EO, leading to a diagnostic dilemma, is rarely encountered. Herein, for the first time, we present a case with cytogenetically confirmed EO combined with or preceding myositis ossificans (MO). A 21-year-old man had a mildly painful swelling in his left knee. Imaging studies demonstrated a 39-mm mass with peripheral mineralization and cystic change on the posterolateral side of the left fibular head. He was clinically suspected of having either MO or a malignancy, such that wide resection was performed. Macroscopically, the mass was grayish to brown. In the cut section, multiple cystic lesions in addition to solid components were noted. Histopathologically, the solid components demonstrated diffuse proliferation of pleomorphic tumor cells with osteoclast-like giant cells. The malignant tumor cells formed osteoid. In the periphery, the mass was benign, showing mature bone tissue and focally non-malignant woven bone with fibroblasts, compatible with zonation. Fluorescence hybridization (FISH) demonstrated split signals of the gene. These findings suggested EO with preceding MO. Although the pathogenesis remains to be elucidated, the observed rearrangement might contribute to both the diagnosis of EO with preceding MO and an understanding of the underlying histopathology.
PubMed: 36910624
DOI: 10.3389/fonc.2023.1024768 -
Journal of Maxillofacial and Oral... Dec 2022Traumatic myositis ossificans is rare pathology affecting muscles/soft tissue. Its involvement in temporalis muscle is rarely reported in literature. The...
INTRODUCTION
Traumatic myositis ossificans is rare pathology affecting muscles/soft tissue. Its involvement in temporalis muscle is rarely reported in literature. The aetiopathogenesis is unknown, the diagnosis is based on clinco-radiological findings. Surgical management and follow-up are paramount.
MATERIALS AND METHODS
A database search was done using Science Direct and PubMed search engines along with other published and unpublished literature. The final publications were tabulated using a custom made Performa. The available publications were subjected to appropriate statistical analysis. The data were recorded on excel spreadsheet (Microsoft Inc), and review was made using Review Manager (Rev Man) software for meta-analysis.
RESULTS
A total of 21 articles were considered for systemic review and meta-analysis. Forest plotting for demographics included the gender predilection/age of involvement. The data segregation was done with "temporalis involved" group and "other than temporalis involved" group. The study was free of homogeneity ( 2 = 0.26 I 2 = 5%) for gender and age. The overall analysis revealed that Temporalis muscle although rare to be affected shows greater propensity for involvement. This is supported by a lesser degree of heterogeneity ( 2 = 0.000) with a I 2 value of (The test showed a higher degree of significance for overall effect of muscle involvement ( = 2.33, = 0.02) (< 25%). The test showed a higher degree of significance for overall effect of muscle involvement ( = 2.33, = 0.02) (< = 0.05).Case reports.Two male cases with similar age predilection, reported after sustaining trauma. Both the cases presented with limited mouth opening and ultrasound was done for the first time to arrive at clinic-radiological diagnosis. The management was conservative with temporalis myotomy and coronidectomy.
CONCLUSION
Traumatic myositis ossificans presents as a rare disorder that poses a dilemma to the treating surgeon. The present article makes an attempt to critically analyse the pathology that is scantly reported in the literature.
PubMed: 36896048
DOI: 10.1007/s12663-022-01690-w -
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 -
Journal of Orthopaedic Case Reports Oct 2022Myositis ossificans (MO) is a disease with self-limiting, benign ossifying lesions. MO traumatica is most common cause and occurs after blunt trauma to muscle tissue and...
INTRODUCTION
Myositis ossificans (MO) is a disease with self-limiting, benign ossifying lesions. MO traumatica is most common cause and occurs after blunt trauma to muscle tissue and the most common site of occurrence is the anterior thigh often developing after an intramuscular hematoma. The pathophysiology of MO is not well understood. The association of myositis and diabetes is quite rare.
CASE REPORT
A 57-year-old male presented with a discharging ulcer on the right lateral lower leg. A radiograph was carried out to ascertain the degree of bone involvement. However, the X-ray showed calcifications. Ultrasound, magnetic resonance imaging (MRI) and X-ray imaging were used to exclude malignant disorders such as osteomyelitis or osteosarcoma. The diagnosis of myositis ossificans was confirmed with MRI. As the patient had a background of diabetes, this could have led to MO as a result of the macrovascular complication of a discharging ulcer; hence, diabetes could be considered a risk factor for the disease.
CONCLUSION
The reader may appreciate that diabetic patients may present with MO and that repeated discharging ulcers may imitate the effects of physical trauma on calcifications. The specific take home message is that regardless of the apparent rarity of a disease and subversion to typical clinical presentation, it should still be considered. Furthermore, the exclusion of severe and malignant diseases which benign diseases may mimic is of utmost importance to correctly manage patients.
PubMed: 36874884
DOI: 10.13107/jocr.2022.v12.i10.3362 -
Boletin Medico Del Hospital Infantil de... 2023Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant disease affecting connective tissue, primarily caused by de novo mutations of the ACVR1 gene....
BACKGROUND
Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant disease affecting connective tissue, primarily caused by de novo mutations of the ACVR1 gene. FOP is a disease with congenital malformations of the toes and heterotopic ossification in characteristic patterns that progresses with flare-ups and remissions. Cumulative damage results in disability and, eventually, death. This report aimed to describe a case of FOP to highlight the importance of early diagnosis of this rare condition.
CASE REPORT
We describe the case of a 3-year-old female diagnosed with congenital hallux valgus, who initially presented with soft tissue tumors, predominantly in the neck and chest, with partial remission. Multiple diagnostic tests were performed, including biopsies and magnetic resonance imaging, with nonspecific results. We observed ossification of the biceps brachii muscle during evolution. The molecular genetic study found a heterozygous ACVR1 gene mutation that confirmed FOP.
CONCLUSIONS
Knowledge of this rare disease by pediatricians is critical for an early diagnosis and for avoiding unnecessary invasive procedures that may promote disease progression. In case of clinical suspicion, performing an early molecular study is suggested to detect ACVR1 gene mutations. The treatment of FOP is symptomatic and focused on maintaining physical function and family support.
Topics: Female; Humans; Child, Preschool; Myositis Ossificans; Arthrogryposis; Biopsy; Disease Progression; Family Support
PubMed: 36867574
DOI: 10.24875/BMHIM.22000039 -
Neurology India 2023
Topics: Humans; Myositis Ossificans; Neuromyelitis Optica
PubMed: 36861589
DOI: 10.4103/0028-3886.370467 -
Radiologia 2023Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology...
Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology books do not cover some of them. This series of two articles aims to review the clinical and radiological characteristics of a selection of palpable tumors in children that radiologists need to be familiar with.
Topics: Humans; Child; Fibroma; Soft Tissue Neoplasms; Diagnostic Imaging
PubMed: 36842785
DOI: 10.1016/j.rxeng.2023.01.001 -
South African Journal of Sports Medicine 2022A 13-year-old female athlete presented with a painful lesion in her right buttock for which she had been receiving physiotherapy. It was keeping her from participating...
BACKGROUND
A 13-year-old female athlete presented with a painful lesion in her right buttock for which she had been receiving physiotherapy. It was keeping her from participating in sports.
AIM
To report on a case of traumatic myositis ossificans in a child athlete - including the presentation, investigations, management, and outcome.
FINDINGS
Palpation of the right buttock indicated a tender mass. Investigation by musculoskeletal ultrasound detected a large hypoechoic lesion. An MRI revealed patterns of calcification that were inconclusive in differentiating between a malignant or benign lesion. Macroscopic and microscopic histological examination, as well as immunohistochemistry, were consistent with myositis ossificans (MO), a non-malignant condition. The patient improved remarkably within three months of treatment with rest, non-steroidal anti-inflammatory drugs (NSAIDs) and extracorporeal shock wave therapy (ESWT).
IMPLICATIONS
Accurate differentiation of myositis ossificans from other benign and malignant soft tissue lesions may require histological evaluation in addition to a comprehensive radiological workup. Successful treatment with the patient being able to return to a pain-free and active state is achievable. Extracorporeal shock-wave therapy can play an important role in the management of this condition and should be considered when presented with a case of MO.
PubMed: 36815913
DOI: 10.17159/2078-516X/2022/v34i1a14931 -
Journal of Advanced Pharmaceutical... Dec 2022Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder which is autosomal dominant distinguished by congenital malformations of large toes and flare ups,...
Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder which is autosomal dominant distinguished by congenital malformations of large toes and flare ups, etc. It is a disorder of connective tissue, with heterotopic ossifications seen with skeletal muscles, tendons, and cartilages and also called as Stone man disease, myositis ossificans, and Munchmeyer disease. The main objective of the study is to assess and create the awareness about FOP among dental students. An online-based survey was conducted among 103 dental students, undergraduates and postgraduates. About 20 questionnaires were prepared and circulated among the students through the "Google forms" across Chennai. A survey questionnaire asked about the knowledge of fibrodysplasia, its causes, treatment, and diagnosis was enquired. Thus, the data obtained were analyzed statistically using the SPSS software. In our study, about 64% were undergraduates and 35% of them were postgraduates. About 66% of the participants were aware of fibrodysplasia and 32% of them were not aware. Most of the undergraduate students were more aware of fibrodysplasia (40%) when compared to postgraduates (29%). However, this is statistically not significant. Fibrodysplasia ossificans reported to have a high incidence in 1 in 2 million people worldwide. Hence, an early diagnosis of this disorder can prevent further complications. Although the survey has provided significant knowledge about fibrodysplasia, awareness still has to be created among dental students.
PubMed: 36798559
DOI: 10.4103/japtr.japtr_165_22 -
Radiology Case Reports Apr 2023Myositis ossificans is non-neoplastic heterotopic bone forms in skeletal muscle. We recognize 3 subtypes: fibrodysplasia ossificans progressiva, myositis ossificans with...
Myositis ossificans is non-neoplastic heterotopic bone forms in skeletal muscle. We recognize 3 subtypes: fibrodysplasia ossificans progressiva, myositis ossificans with no history of trauma (nontraumatic or pseudomalignant), and circumscribed or traumatic myositis ossificans. Traumatic myositis ossificans circumscripta has not, as far as we are aware, been previously documented as a complication of traumatic hip dislocation. We present the radiological findings of a 10-year-old girl with Thevenards syndrome, whose traumatic hip dislocation was complicated by circumstantial myositis ossificans. X-rays and computed tomography scan enabled us to diagnose by the presence of mature bone in the periphery of the lesion with a smooth contour and well separated from the bone. The treatment of dislocation and complication was nonoperatively.
PubMed: 36798065
DOI: 10.1016/j.radcr.2022.12.060