scholarly journals Desmoplastic Fibroma Recurrence Associated with Tuberous Sclerosis in a Young Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
A. M. Espinoza-Coronado ◽  
J. P. Loyola-Rodríguez ◽  
J. H. Olvera-Delgado ◽  
J. O. García-Cortes ◽  
J. F. Reyes-Macías
Keyword(s):  
Tuberous Sclerosis ◽  
Surgical Excision ◽  
Clinical Findings ◽  
Desmoplastic Fibroma ◽  
Volume Increase ◽  
Benign Pathology ◽  
The Brain ◽  
Recurrence Frequency ◽  
Hard Consistency

Case Report. A nine-year-old patient with a diagnosis of tuberous sclerosis (with no pathological record) that showed calcifications at the brain level. Besides, the case showed the Vogt triad (epilepsy, mental retardation, and sebaceous adenoma). The patient clinically showed a volume increase of hard consistency, without suppuration and no sessile that included the following teeth 73, 74, and 75. Cone beam computed tomography (CBCT) was obtained, and it displayed a delimited unilocular lesion. After surgical excision, the histopathological report was desmoplastic fibroma (DF). It was observed that the patient had an aggressive recurrence of DF at four months after surgery treatment. Due to these clinical findings, resective osseous surgery and curettage were carried out. It is uncommon to find these two pathologies together (DF and tuberous sclerosis). Since DF is a benign pathology but very invasive and destructive, it is necessary a constant follow-up examination due to a high recurrence frequency.

scholarly journals Multiple Koenen Tumors, a Rare Entity: Combination Treatment with 1% Topical Sirolimus Electrofulguration and Excision

2020 ◽  
Vol 7 (1) ◽  
pp. 66-70
Author(s):  
Vishalakshi Viswanath ◽  
Jay D. Gupte ◽  
Niharika Prabhu ◽  
Nilima L. Gour
Keyword(s):  
Tuberous Sclerosis ◽  
Combination Treatment ◽  
Tumor Regression ◽  
Surgical Excision ◽  
Tumor Formation ◽  
Rare Entity ◽  
Rare Presentation ◽  
Cutaneous Manifestations ◽  
Elderly Female

<b><i>Introduction:</i></b> Koenen tumors are benign, cutaneous manifestations of tuberous sclerosis. These are disfiguring, painful, and challenging to treat as they frequently recur. We report a case of long-standing, multiple Koenen tumors affecting all twenty nails in an elderly female who was successfully treated with a combination of topical sirolimus 1%, surgical excision, and electrofulguration. <b><i>Case Report:</i></b> A 57-year-old lady presented with multiple, asymptomatic periungual, and subungual tumors affecting all twenty nails since 27 years. Cutaneous examination revealed confetti macules, ash-leaf macule, and shagreen patch over trunk. Nail biopsy was compatible with Koenen’s tumor. Computerized tomography of brain showed diffuse patchy sclerosis. The tumors were treated with topical sirolimus 1% ointment for 10 months with excellent regression. Electro­fulguration for both great toenails and surgical excision of right thumbnail periungual fibroma was done. 1% sirolimus was advised after the surgical treatment. There were no adverse effects or recurrence of tumors over a 2-year follow-up. <b><i>Discussion:</i></b> Topical sirolimus 1% was effective in tumor regression and preventing new tumor formation. Larger tumors that interfered in daily chores were treated with excision and electrofulguration. Thus, a combination treatment for this rare presentation of tuberous sclerosis provided optimum results.

scholarly journals MNG-08 VOLUMETRIC STUDIES IN ASYMPTOMATIC MENINGIOMAS: SLOWDOWN CASES AND GROWTH ARREST CASES

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii36-ii36
Author(s):  
Ryuichi Hirayama ◽  
Tomoyoshi Nakagawa ◽  
Toru Umehara ◽  
Chisato Yokota ◽  
Noriyuki Kijima ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Growth Arrest ◽  
Surgical Excision ◽  
Volume Measurement ◽  
Female Ratio ◽  
Volume Increase ◽  
Volume Curve ◽  
Increase Rate ◽  
Mri Scans

Abstract BACKGROUND The opportunity to follow up for asymptomatic meningiomas has increased. We have reported the risk of volume increase by individual continuous volume measurement of asymptomatic meningiomas. However, We have not reached fully understanding about natural history of meningiomas. Among cases are followed up over time, there are some cases that the volume increase rates slows down or almost stops are observed. METHODS We enrolled consecutive adult patients of asymptomatic meningiomas who follow-up for 2 years or more and 3 or more MRI scans. We performed sequential volumetric measurements on 95 patients (105 lesions) who met the criteria. We classified these transient volume curve of each lesion into three groups “Growing”, “Slowdown”, and “Growth arrest” for analysis. RESULTS The average age at the first visit was 62.8 years, the average follow-up period was 61.8 months, and the male-female ratio was 20:75 (male: female). There were 67 cases (73 lesions: 70.9%) that were in increasing trend, and 19 cases of those were received resection. Eleven cases (12 lesions: 11.7%) showed a tendency of “slow down” the increase rate, and one patient who became symptomatic led to surgical excision. In 18 cases (18 lesions: 17.4%) in which almost no volume change was observed during the observation period, no cases resulted in surgical treatment. CONCLUSIONS Among the meningiomas cases that have been followed for a long time, there are not a few those increase rate of tumor volume slows or does not change. Furthermore, most of these cases did not result in surgical treatment. The presence of these “Slowdown” and “Growth arrest” cases at a certain rate may have suggested the possibility of a Gompertz curve model as the natural course of meningiomas.

scholarly journals Mucocele and Fibroma: Treatment and Clinical Features for Differential Diagnosis

2013 ◽  
Vol 24 (5) ◽  
pp. 537-541 ◽  
Author(s):  
Rodrigo Alexandre Valério ◽  
Alexandra Mussolino de Queiroz ◽  
Priscila Coutinho Romualdo ◽  
Luiz Guilherme Brentegani ◽  
Francisco Wanderley Garcia de Paula-Silva
Keyword(s):  
Connective Tissue ◽  
Buccal Mucosa ◽  
Benign Lesion ◽  
Surgical Excision ◽  
Local Trauma ◽  
Frequent Site ◽  
Gland Duct ◽  
Children And Young Adults ◽  
Hard Consistency

Mucocele is a benign lesion occurring in the buccal mucosa as a result of the rupture of a salivary gland duct and consequent outpouring of mucin into soft tissue. It is usually caused by a local trauma, although in many cases the etiology is uncertain. Mucocele is more commonly found in children and young adults, and the most frequent site is the lower inner portion of the lips. Fibroma, on the other hand, is a benign tumor of fibrous connective tissue that can be considered a reactionary connective tissue hyperplasia in response to trauma and irritation. They usually present hard consistency, are nodular and asymptomatic, with a similar color to the mucosa, sessile base, smooth surface, located in the buccal mucosa along the line of occlusion, tongue and lip mucosa. Conventional treatment for both lesions is conservative surgical excision. Recurrence rate is low for fibroma and high for oral mucoceles. This report presents a series of cases of mucocele and fibroma treated by surgical excision or enucleation and the respective follow-up routine in the dental clinic and discusses the features to be considered in order to distinguish these lesions from each other.

scholarly journals Neurodegeneration with cerebral iron accumulation: a case report

2021 ◽  
Author(s):  
Monalisa Moura Saito ◽  
Dhyego Ferreira Moreira de Lacerda ◽  
Ana Claudia Marque Gouveia de Melo ◽  
Lucas Monteiro Barros Nunes ◽  
Luana Cristina Rodrigues de Oliveira Costa ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Disease ◽  
Movement Disorders ◽  
Retinal Dystrophy ◽  
Rapid Onset ◽  
Clinical Findings ◽  
Iron Accumulation ◽  
Significant Clinical Improvement ◽  
The Brain

Introduction: NBIA is a rare disease, with a prevalence of 1/1,000,000.It is characterized by abnormal iron accumulation. Clinical findings may include progressive extrapyramidal disorders, involvement of the pyramidal, peripheral, autonomic nervous systems, superior cortical, visual and cerebellar functions. The diagnosis is made through the association of clinical findings and complementary exams. Currently, the treatment is only symptomatic, with no specific therapy. Case report: 5-year-old female, reporting involuntary movements and difficulty walking a day ago. Presented agitation and delayed neuropsychomotor development, seen since 1 year of age. On examination, dysarthria, dystonia and parkinsonian stiffness were observed. MRI of the brain showed the radiological signal “tiger’s eye” and the ophthalmological evaluation showed retinal dystrophy. Positive acanthocyte screening. NBIA’s NGS panel confirmed the diagnosis. Triexfenid was started and there was an improvement in movement disorders. In outpatient follow-up, the symptoms worsened. Levodopa was associated with the return of walking without support and ability to pick up objects. Discussion: In this case, Triexafenid 2mg/day was initially prescribed, with a slight improvement in movement disorders. Levodopa was started with the aim of improving symptoms of parkinsonian stiffness. The excellent response to the association of the drug in low doses stands out, enabling ambulation and functionality for daily activities. Conclusion: NBIA is a rare disease, with rapid onset and progression. Studies show limited benefits of levodopa in the case of PKAN. We emphasize significant clinical improvement, with a return to walking after administration of the drug.

Successful treatment of disseminated granulomatous aspergillosis in an apparently immunocompetent host

2020 ◽  
Vol 50 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Umang Agrawal ◽  
Pratik Savaj ◽  
Kanishka Davda ◽  
Rajeev Soman ◽  
Anjali Shetty ◽  
...  
Keyword(s):  
Granulomatous Inflammation ◽  
Surgical Excision ◽  
Immunocompetent Host ◽  
Short History ◽  
Normal Individuals ◽  
History Of ◽  
One Year ◽  
Work Up ◽  
The Brain

A young Indian man presented elsewhere with a short history of haematuria and cough. Investigations revealed renal and pulmonary lesions. Histopathology of these lesions was reported as mucormycosis. He consulted us two months after onset of symptoms, asymptomatic and clinically well, having received no treatment. In view of clinico-histopathological discordance, a review of the biopsy slides was advised but the patient refused further work-up at that time. One week later, however, he was admitted with left hemiparesis. Brain imaging showed an abscess. He underwent surgical excision of the brain abscess and nephrectomy. Review of previous slides showed septate fungal filaments with granulomatous inflammation. Intraoperative cultures grew Aspergillus flavus. He received voriconazole for one year and is well at his two-year follow-up. His immunological work-up was negative for immunodeficiency. This case illustrates that granulomatous aspergillosis may be an indolent infection in apparently normal individuals and reiterates the importance of interpreting diagnostic reports in conjunction with clinical features.

scholarly journals Solitary Encapsulated Neurofibroma Not Associated with Neurofibromatosis-1 Affecting Tongue in a 73-Year-Old Female

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sk. Abdul Mahmud ◽  
Neha Shah ◽  
Moumita Chattaraj ◽  
Swagata Gayen
Keyword(s):  
Family History ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Neurofibromatosis Type ◽  
Clinical Findings ◽  
Benign Tumors ◽  
History Of

Neurofibromas are benign tumors of nerve cell origin arising due to proliferation of Schwann cells and fibroblasts. They are usually asymptomatic and hence remain undiagnosed. They are commonly found on the skin and intraorally tongue is the most common site for their occurrence. Here, we present a unique case of solitary encapsulated neurofibroma in the oral cavity without any clinical manifestations or family history of Neurofibromatosis type 1 in a 73-year-old female patient who presented with a painless swelling on the tongue. The histopathologic findings closely mimicked benign fibrous histiocytoma. In our case, definitive diagnosis of neurofibroma was made based on clinical findings, family history, and histopathological and immunohistochemical evaluation. Through this case report we want to emphasize the role of biopsy and immunohistochemistry in arriving at a confirmatory diagnosis. The patient was treated by surgical excision and showed no signs of recurrence over a follow-up period of 12 months.

Actinomycosis of the brain

1985 ◽  
Vol 63 (1) ◽  
pp. 131-133 ◽  
Author(s):  
He Chen-wei
Keyword(s):  
Central Nervous System ◽  
Rare Case ◽  
Surgical Excision ◽  
Content Type ◽  
Different Types ◽  
Excellent Health ◽  
The Central Nervous System ◽  
The Brain ◽  
Fine Print

✓ A rare case of actinomycosis of the brain is reported. The patient recovered after surgical excision of the lesion and a prolonged course of antibiotic therapy. At follow-up examination 25 months later, the patient was in excellent health. Different types of actinomycotic infections of the central nervous system are reviewed and the diagnosis and treatment of this disease are discussed.

scholarly journals Isolated Muscular Cysticercosis: A Rare Pseudotumor and Diagnostic Challenge, can It be treated Nonoperatively? A Report of Two Cases and Review of Literature

2012 ◽  
Vol 46 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Sharad Prabhakar ◽  
Sushil S Rangdal ◽  
Sarvdeep S Dhatt
Keyword(s):  
Case Reports ◽  
Taenia Solium ◽  
Surgical Excision ◽  
Drug Regimen ◽  
Clinical Findings ◽  
Oral Drug ◽  
Review Of Literature ◽  
Diagnostic Challenge ◽  
Oral Steroids

ABSTRACT Cysticercosis, an infection with the larval form of pork tape worm, Taenia solium, commonly presents with multiple muscular cysts or CNS involvement. Due to vague clinical presentation and unfamiliarity of clinicians with this entity, it is difficult to diagnosis when seen as an isolated cyst. Traditional treatment is surgical excision and a course of deworming agents. We present two cases of isolated muscular cysticercosis diagnosed by USG, MRI and blood tests, who responded successfully to oral medication without need of operative intervention. Case reports A 45-year-old male patient had a tender 2 week swelling of 4 × 5 cm on medial right proximal calf. A 26-year male presented with discomfort and diffuse 6 cm swelling at inner left forearm. In both ultrasound showed characteristic hypoechoic cyst with hyperechoic scolex, and MRI revealed isolated cyst surrounded by inflamed muscles. FNAC confirmed cysticercosis, and the patient responded to oral albendazole (3 weeks) with oral steroids (2 weeks). Conclusion Although rare, possibility of isolated muscular cysticercosis should always be considered in any small musculoskeletal soft tissue swelling presenting with nonspecific clinical findings. Both our patients responded to medical therapy and were disease free, as confirmed at 3 months by follow-up MRI. These cysts can be confidently diagnosed on the basis of ultrasound and MRI, and can be very well-treated nonsurgically with an oral drug regimen consisting of albendazole and steroid. How to cite this article Rangdal SS, Prabhakar S, Dhatt S S, Prakash M, Dhillon MS. Isolated Muscular Cysticercosis: A Rare Pseudotumor and Diagnostic Challenge, can It be treated Nonoperatively? A Report of Two Cases and Review of Literature. J Postgrad Med Edu Res 2012;46(1):43-48.

Can excisional biopsy be avoided for papillary breast lesions with typical benign sonographic features and concordant core needle biopsy (CNB)?

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 26-26
Author(s):  
Winnie Fu ◽  
David Motiuk ◽  
Tracy Elliot ◽  
Bobbie Docktor
Keyword(s):  
Surgical Excision ◽  
Excisional Biopsy ◽  
Chi Square ◽  
Institutional Review Board Approval ◽  
Institutional Review ◽  
Benign Pathology ◽  
Papillary Lesions ◽  
Smooth Margin

26 Background: The role of surgical excision in the management of papillary lesions remains controversial. Some studies have documented upgrade rates to malignancy or atypia as high as 17%. However, due to the inclusion of atypia or malignancy at percutaneous and other differences in methodology, these rates may have been over-estimated. This study was designed to determine sonographic features that can help to decide if a lesion warrants excision or standard follow-up. Methods: With institutional review board approval, we retrospectively reviewed 113 benign papillomas without atypia that were diagnosed at US-guided CNB at Foothills Medical Centre from 2005 to 2010. Surgical pathology for 62 of these lesions were assessed. Two radiologists who were blinded to the diagnosis reviewed the sonographic images to determine the likelihood of benignity. Statistical analysis was performed using chi-square and z-score tests. Results: In our study, 5.3% of benign papillomas were upgraded. The sonographic features associated with a higher likelihood of upgrade were intracystic type [LR+ 5.67, 95% CI (1.47,12)], non-periareolar location [LR+ 2.30, 95% CI (1.04,5.06)], complex echogenic pattern [LR+ 3.10, 95% CI (1.00,9.63)], and radiologist’s impression of unlikely benign (final BiRADS) [LR+ 1.48, 95% CI (1.01,1.90)]. Although no feature was statistically significant for greater likelihood of benignity, the sonographic features that may better predict benign pathology at excision include lesions <1cm in size [LR- 0.52], homogeneously solid [LR- 0.63], smooth margin [LR- 0.69] and periareolar location [LR- 0.47]. Conclusions: The management of benign papillomas diagnosed with CNB remains controversial with a lack of agreement among published articles. Our study identifies characteristic sonographic features that are associated with higher likelihood of malignancy, warranting surgical excision. Conversely, it may not be unreasonable to place patients with lesions that are stratified as low risk into standard radiographic follow-up. As the confidence intervals span 1.00 for latter, further study is necessary to confidently recommend follow-up in place of excision.

Sign in / Sign up

Export Citation Format

Share Document