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Cureus May 2024Dermatofibrosarcoma protuberans (DFSP) is a low- to intermediate-grade dermal soft tissue malignant tumor (sarcoma) with a high local recurrence rate but low metastatic...
Dermatofibrosarcoma protuberans (DFSP) is a low- to intermediate-grade dermal soft tissue malignant tumor (sarcoma) with a high local recurrence rate but low metastatic potential. DFSP is characterized by uniform spindle cell fascicles arranged classically in a storiform pattern and by CD34 immunoreactivity. On gross examination, DFSP usually manifests as a white or yellow soft tissue mass with a smooth outer surface and poor circumscription. In this study, we report a case of DFSP with fibrosarcomatous transformation, a rare but well-known phenomenon encountered in DFSP that is correlated with an increased risk of adverse outcomes in patients with DFSP. A 45-year-old male presented with a progressively enlarging lump on his left shoulder, initially suspected of being a lipoma but diagnosed as a fibrosarcomatous transformation of DFSP. Surgical resection was performed, with the subsequent identification of metastatic sarcoma in pulmonary nodules. Robotic-assisted thoracoscopy excised the nodules, confirming metastatic sarcoma with aggressive behavior. Despite negative adjuvant treatment plans, the patient remains under surveillance with imaging, showing no recurrence in recent scans. Continued follow-up with medical and surgical oncology is planned. DFSP is a rare soft tissue sarcoma characterized by indolent growth and low metastatic potential, except in fibrosarcomatous transformation cases. Molecularly, DFSP is defined by a COL1A1-PDGFB fusion transcript that is targetable with imatinib therapy. Treatment involves wide surgical resection, with adjuvant radiation therapy in select cases. Radiation therapy may be employed in cases with close or positive margins, while conventional chemotherapy has limited utility. Multidisciplinary collaboration is crucial for optimal management. Overall, this case underscores the challenges in diagnosing and managing aggressive sarcomas like fibrosarcomatous DFSP, emphasizing the importance of vigilant surveillance and multidisciplinary collaboration in optimizing patient outcomes. Further research is needed to understand the mechanisms underlying fibrosarcomatous transformation and to explore novel therapeutic avenues for this challenging malignancy.
PubMed: 38841035
DOI: 10.7759/cureus.59742 -
Cureus May 2024Peripheral ossifying fibroma (POF) is a reactive overgrowth that most commonly occurs on the gingiva. It is a benign oral soft tissue tumour. It is most commonly found...
Peripheral ossifying fibroma (POF) is a reactive overgrowth that most commonly occurs on the gingiva. It is a benign oral soft tissue tumour. It is most commonly found on the anterior maxilla and has a female predilection. Most commonly found to occur in the second decade of life. This type of lesion originates from the cells of the periodontal ligament. It is often associated with trauma or local irritants, such as subgingival plaque and calculus, dental appliances and poor-quality dental restorations. This entity requires a proper treatment protocol and a regular follow-up. It can cause significant discomfort and irritation in the oral health if left untreated. The recurrence rate of the lesion varies according to the authors. This case report describes a case of POF in an adult female patient which was treated using surgical excision resulting in an uneventful healing during the post-operative period.
PubMed: 38841021
DOI: 10.7759/cureus.59749 -
International Journal of Surgery Case... Jul 2024Ovarian fibromas are benign tumours arising from the connective tissue of the ovarian cortex, classified into three pathological subtypes: fibroma, thecoma, and...
INTRODUCTION AND IMPORTANCE
Ovarian fibromas are benign tumours arising from the connective tissue of the ovarian cortex, classified into three pathological subtypes: fibroma, thecoma, and fibrothecoma. Their diagnosis is complicated by their solid nature and potential association with ascites and pleural effusion, resembling Meigs syndrome. Elevated serum CA125 levels can further complicate differentiation from malignant ovarian epithelial tumours.
CASE PRESENTATION
A 37-year-old female from a rural area presented with a distended abdomen and weight loss lasting 2 months. Clinical examinations revealed a solid pelvic mass and diagnostic tests showed significantly elevated CA125 levels. Imaging suggested a large ovarian mass and surgical intervention confirmed a fibrothecoma of the left ovary. The postoperative course was uneventful, with subsequent resolution of ascites and pleurisy.
CLINICAL DISCUSSION
The diagnosis of ovarian fibromas/fibrothecomas poses challenges due to their asymptomatic nature, solid appearance, and occasional association with the Meigs syndrome. Elevated CA125 levels can mislead the diagnosis of epithelial ovarian carcinoma. The case underscores the importance of considering ovarian fibromas/fibrothecomas in the differential diagnosis of ovarian tumours with elevated CA125 levels, especially in women of reproductive age. The benign nature of these tumours necessitates a conservative surgical approach, emphasizing the importance of intraoperative frozen section analysis.
CONCLUSION
Ovarian fibrothecomas associated with elevated serum CA125 levels are rare. Their presentation can mimic malignant ovarian neoplasms, leading to potential diagnostic confusion. Surgical removal remains the treatment of choice, with a favorable prognosis post-surgery.
PubMed: 38830334
DOI: 10.1016/j.ijscr.2024.109847 -
Cureus May 2024Most odontogenic tumors are intraosseous growths. A peripheral odontogenic fibroma presents as a slow-growing and firm swelling on the gingiva. It develops more...
Most odontogenic tumors are intraosseous growths. A peripheral odontogenic fibroma presents as a slow-growing and firm swelling on the gingiva. It develops more commonly on the mandibular than the maxillary region. It can be found on either the palatal or lingual and on the labial or buccal surface of the jaw. It usually does not ulcerate. The most common type is a peripheral odontogenic fibroma, which is a benign odontogenic neoplasm of the periodontal soft tissues. In this case report, a 53-year-old male patient with peripheral odontogenic fibroma was treated using a laser.
PubMed: 38826900
DOI: 10.7759/cureus.59453 -
BMC Musculoskeletal Disorders Jun 2024This article reports a case of a female patient admitted with swelling and subcutaneous mass in the right forearm, initially suspected to be multiple nerve fibroma.... (Review)
Review
This article reports a case of a female patient admitted with swelling and subcutaneous mass in the right forearm, initially suspected to be multiple nerve fibroma. However, through preoperative imaging and surgery, the final diagnosis confirmed superficial thrombophlebitis. This condition resulted in entrapment of the radial nerve branch, leading to noticeable nerve entrapment and radiating pain. The surgery involved the excision of inflammatory tissue and thrombus, ligation of the cephalic vein, and complete release of the radial nerve branch. Postoperative pathology confirmed the presence of Superficial Thrombophlebitis. Through this case, we emphasize the importance of comprehensive utilization of clinical, imaging, and surgical interventions for more accurate diagnosis and treatment. This is the first clinical report of radial nerve branch entrapment due to superficial thrombophlebitis.
Topics: Humans; Female; Thrombophlebitis; Nerve Compression Syndromes; Forearm; Radial Nerve; Radial Neuropathy; Middle Aged
PubMed: 38824539
DOI: 10.1186/s12891-024-07545-4 -
International Journal of Surgery Case... Jul 2024Fibroma, thecoma, and fibrothecoma collectively denote a range of non-cancerous sex cord-stromal tumors distinguished by the presence of fibroblastic stromal cells...
INTRODUCTION AND IMPORTANCE
Fibroma, thecoma, and fibrothecoma collectively denote a range of non-cancerous sex cord-stromal tumors distinguished by the presence of fibroblastic stromal cells and/or cells resembling luteinized theca cells.
CASE PRESENTATION
In this report, we present a case study of a 52-year-old patient in whom this uncommon tumor was identified via MRI, highlighting the distinctive diagnostic and treatment considerations associated with it.
CLINICAL DISCUSSION
Ovarian fibrothecoma tumors are infrequent, constituting less than 4 % of all ovarian tumors. Although they may manifest at any age, they are more commonly observed in elderly and post-menopausal individuals. Diagnosis hinges on clinical and paraclinical data, yet definitive confirmation is predominantly achieved through anatomopathological examination. For younger patients, conservative surgery is usually favored, whereas peri- or post-menopausal individuals may undergo radical treatment.
CONCLUSION
Ovarian Fibrothecoma, though rare, are typically benign tumors frequently found in older patients. Diagnosis primarily relies on histological examination. Fortunately, the prognosis for these tumors is generally favorable.
PubMed: 38810296
DOI: 10.1016/j.ijscr.2024.109771 -
Revista Paulista de Pediatria : Orgao... 2024Pediatric cardiac tumors are rare and, among them, 90% are benign. Cardiac fibroma is the second most frequent tumor, after rhabdomyoma. The objective of this study is...
OBJECTIVE
Pediatric cardiac tumors are rare and, among them, 90% are benign. Cardiac fibroma is the second most frequent tumor, after rhabdomyoma. The objective of this study is to report a case of cardiac fibroma diagnosed incidentally in a patient admitted with acute viral bronchiolitis.
CASE DESCRIPTION
A 5-month-old male infant was admitted to the pediatric emergency department with acute viral bronchiolitis requiring hospitalization. He presented a detectable respiratory syncytial virus in oropharyngeal swab, blood test with lymphocytosis and a chest radiography revealed cardiomegaly. Further cardiologic testing was performed detecting elevation of cardiac biomarkers, an electrocardiogram with alteration of left ventricular repolarization and echocardiogram with a heterogeneous mass in the left ventricular, with areas of calcification. A chest angiotomography suggested rhabdomyosarcoma or cardiac fibroma and a magnetic resonance showed a mass, with characteristics suggesting fibroma. The final diagnosis was made after two cardiac catheterizations for biopsy of the lesion, confirming cardiac fibroma by anatomopathological examination. Because the patient had moderate to severe systolic dysfunction, he was submitted to heart transplant.
COMMENTS
One third of cardiac fibromas are asymptomatic, generally diagnosed late through tests ordered for other reasons. The gold-standard test for definitive diagnosis is biopsy. Cardiac fibroma usually does not present spontaneous regression and, in most cases, partial or total surgical resection is necessary. When tumors are unresectable, heart transplantation should be indicated. It is essential to have detailed characterization of the cardiac mass to establish the most appropriate therapeutic approach for each patient.
Topics: Humans; Male; Heart Neoplasms; Fibroma; Infant; Incidental Findings; Bronchiolitis, Viral; Acute Disease
PubMed: 38808864
DOI: 10.1590/1984-0462/2024/42/2022157 -
Heliyon May 2024Accurate segmentation is crucial in diagnosing and analyzing skin lesions. However, automatic segmentation of skin lesions is extremely challenging because of their...
Accurate segmentation is crucial in diagnosing and analyzing skin lesions. However, automatic segmentation of skin lesions is extremely challenging because of their variable sizes, uneven color distributions, irregular shapes, hair occlusions, and blurred boundaries. Owing to the limited range of convolutional networks receptive fields, shallow convolution cannot extract the global features of images and thus has limited segmentation performance. Because medical image datasets are small in scale, the use of excessively deep networks could cause overfitting and increase computational complexity. Although transformer networks can focus on extracting global information, they cannot extract sufficient local information and accurately segment detailed lesion features. In this study, we designed a dual-branch encoder that combines a convolution neural network (CNN) and a transformer. The CNN branch of the encoder comprises four layers, which learn the local features of images through layer-wise downsampling. The transformer branch also comprises four layers, enabling the learning of global image information through attention mechanisms. The feature fusion module in the network integrates local features and global information, emphasizes important channel features through the channel attention mechanism, and filters irrelevant feature expressions. The information exchange between the decoder and encoder is finally achieved through skip connections to supplement the information lost during the sampling process, thereby enhancing segmentation accuracy. The data used in this paper are from four public datasets, including images of melanoma, basal cell tumor, fibroma, and benign nevus. Because of the limited size of the image data, we enhanced them using methods such as random horizontal flipping, random vertical flipping, random brightness enhancement, random contrast enhancement, and rotation. The segmentation accuracy is evaluated through intersection over union and duration, integrity, commitment, and effort indicators, reaching 87.7 % and 93.21 %, 82.05 % and 89.19 %, 86.81 % and 92.72 %, and 92.79 % and 96.21 %, respectively, on the ISIC 2016, ISIC 2017, ISIC 2018, and PH2 datasets, respectively (code: https://github.com/hyjane/CCT-Net).
PubMed: 38807881
DOI: 10.1016/j.heliyon.2024.e31395 -
Journal of Oral and Maxillofacial... 2024Sclerosing odontogenic carcinoma (SOC) was first described by Koutlas . in 2008. Despite its inclusion in the World Health Organization (WHO) as a distinct entity, it is...
Sclerosing odontogenic carcinoma (SOC) was first described by Koutlas . in 2008. Despite its inclusion in the World Health Organization (WHO) as a distinct entity, it is a tumour that remains poorly defined in the literature, with only 10 reported cases to date. The mandibular premolar and molar region is more commonly affected compared to the maxilla. In the maxilla, the anterior and the molar regions are most commonly affected. This article describes a case report of a Sclerosing Odontogenic Carcinoma in a 50 year old male patient in the mandibular region. The radiograph showed a well-defined radiolucency extending from the left ramus of the mandible to the right lower molar region. SOC is low grade with mild atypia and frequent mitosis and diffused infiltrative and perineural spread.
PubMed: 38800446
DOI: 10.4103/jomfp.jomfp_128_21