scholarly journals Intracranial temporal bone angiomatoid fibrous histiocytoma: illustrative case

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Shivani Gillon ◽  
Jacqueline C. Junn ◽  
Emily A. Sloan ◽  
Nalin Gupta ◽  
Alyssa Reddy ◽  
...  

BACKGROUNDAngiomatoid fibrous histiocytoma (AFH) is a rare, slowly progressive neoplasm that most commonly occurs in soft tissues. AFH rarely occurs in bone such as the calvaria. The authors present a case of AFH in the petrous temporal bone, which, to their knowledge, is the first case of AFH in this location.OBSERVATIONSA 17-year-old girl presented with worsening positional headaches with associated tinnitus and hearing loss. Imaging demonstrated an extraaxial mass extending into the right cerebellopontine angle, with erosion of the petrous temporal bone, with features atypical for a benign process. The patient underwent retrosigmoid craniotomy for tumor resection. Pathology was consistent with a spindle cell tumor, and genetic testing further revealed an EWSR1 gene rearrangement, confirming the diagnosis of AFH. The patient was discharged with no complications. Her symptoms have resolved, and surveillance imaging has shown no evidence of recurrence.LESSONSThe authors report the first case of AFH in the petrous temporal bone and only the second known case in the calvaria. This case illustrates the importance of the resection of masses with clinical and imaging features atypical of more benign entities such as meningiomas. It is important to keep AFH in the differential diagnosis for atypical masses in the calvaria and skull base.

2020 ◽  
Author(s):  
Adelaide Valluzzi ◽  
Salvatore Donatiello ◽  
Graziana Gallo ◽  
Monica Cellini ◽  
Antonino Maiorana ◽  
...  

AbstractOsteoid osteoma is a benign osteoblastic tumor, quite uncommon in the spine. We report a case of an osteoid osteoma involving the atlas in a 6-year-old boy, who presented with suboccipital pain and torticollis. Initial radiological findings were ambiguous as magnetic resonance imaging showed mainly edema of upper cervical soft tissues. The subsequent computed tomography depicted a lesion of left lamina of C1. As conservative treatment failed, the lesion was surgically resected and the patient became pain free. To our knowledge, this is the first case of osteoid osteoma involving the atlas associated with abnormal soft tissue reaction reported in literature.


2018 ◽  
Vol 128 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Adam McCann ◽  
Sameer A. Alvi ◽  
Jessica Newman ◽  
Kiran Kakarala ◽  
Hinrich Staecker ◽  
...  

Background: Cervicofacial actinomycosis is an uncommon indolent infection caused by Actinomyces spp that typically affects individuals with innate or adaptive immunodeficiencies. Soft tissues of the face and neck are most commonly involved. Actinomyces osteomyelitis is uncommon; involvement of the skull base and temporal bone is exceedingly rare. The authors present a unique case of refractory cervicofacial actinomycosis with development of skull base and temporal bone osteomyelitis in an otherwise healthy individual. Methods: Case report with literature review. Results: A 69-year-old man presented with a soft tissue infection, culture positive for Actinomyces, over the right maxilla. Previous unsuccessful treatment included local debridement and 6 weeks of intravenous ceftriaxone. He was subsequently treated with conservative debridement and a prolonged course of intravenous followed by oral antibiotic. However, he eventually required multiple procedures, including maxillectomy, pterygopalatine fossa debridement, and a radical mastoidectomy to clear his disease. Postoperatively he was gradually transitioned off intravenous antibiotics. Conclusions: Cervicofacial actinomycosis involves soft tissue surrounding the facial skeleton and oral cavity and is typically associated with a history of mucosal trauma, surgery, or immunodeficiency. The patient was appropriately treated but experienced disease progression and escalation of therapy. Although actinomycosis is typically not an aggressive bacterial infection, this case illustrates the need for prompt recognition of persistent disease and earlier surgical intervention in cases of recalcitrant cervicofacial actinomycosis. Chronic actinomycosis has the potential for significant morbidity.


2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Nikita Sushentsev ◽  
Yvonne Rimmer ◽  
Tristan Barrett

ABSTRACT Giant multilocular prostatic cystadenoma (GMPC) is a rare benign pelvic mass for which complete surgical resection is an accepted treatment of choice. This report presents the first case of complete resolution of GMPC following a 3-year course of luteinising hormone-releasing hormone agonist alongside external beam radiotherapy for the concurrent treatment of unfavorable intermediate-risk prostate cancer. In addition to illustrating the imaging features of the effect of androgen deprivation therapy (ADT) and radiotherapy on GMPC regression, this case provides evidence for considering ADT as an alternative, noninvasive GMPC treatment option in patients in whom surgical treatment is either contraindicated or can be made less invasive by reducing the size of GMPC prior to its removal.


2008 ◽  
Vol 132 (4) ◽  
pp. 698-702
Author(s):  
Beverly E. White ◽  
Alan Kaplan ◽  
Dolores H. Lopez-Terrada ◽  
Jae Y. Ro ◽  
Robert S. Benjamin ◽  
...  

Abstract Synovial sarcomas most commonly arise in the soft tissue of the extremities. Less commonly, these tumors present in the head and neck, abdominal wall, and other sites. However, synovial sarcoma occurring in the vulvar area is extremely rare. Only 2 previous cases of biphasic synovial sarcoma of the vulva have been reported, but no case of vulvar monophasic synovial sarcoma has been described in the English literature. We report the third case of synovial sarcoma and apparently the first case of monophasic synovial sarcoma arising in soft tissues of the vulva. The patient was a 33-year-old woman who presented for evaluation of a painless vulvar mass. The tumor was located in the deep fibroadipose tissue of the right vulva (6.5 × 4.2 × 3.5 cm). The histology of the lesion was that of a monophasic synovial sarcoma with a hemangiopericytic vascular pattern. A subsequent molecular analysis revealed SYT-SSX2 gene fusion, which confirmed the diagnosis of synovial sarcoma. After an initial wide local excision, the patient developed a recurrence in the right groin and received chemotherapy and additional surgery. The patient is currently disease free, on adjuvant chemotherapy, and being followed up closely.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Diniz Ferrer ◽  
CARLOS Silveira ◽  
ADRIAN Reis ◽  
PAULA Abreu E Lima ◽  
ROBERT Diniz ◽  
...  

Abstract Funding Acknowledgements governmental grants Uterine leiomyoma is a commom disease in women, however, intravenous leiomyomatosis of uterine origin extending via inferior vena cava into the right side of the heart,known as intracardiac leiomyomatosis is a rare condition (3%). In 1907, Durk reported the first case of intracardiac extension. The patient was a Woman, 35 years old, admitted to our emergency department for an intracardiac mass. She had shortness of breath,fatigue and chest pain. The transthoracic two dimensional echocardiography showed an echogenic oval mass mobile in right atrium and projected through right ventricle in diastole. This mass was observed to extend from inferior vena cava to the right atrium. The echotransesophageal three dimensional showed a large mobile mass that extended from inferior vena cava to the right atrium. A Computer tomographic (CT) scan showed a hypodense multilobulated mass in the pelvis, which had invaded the inferior vena cava and right atrium. The patient underwent a two stages surgery. In first stage (transatrial tumor resection). The operation was performed normal temperature with establisment of cardiopulmonary bypass (CPB). Subsequently, the pathological report was confirmed uterin smooth muscle origin. The second stage surgery ( total histerectomy) was done four weeks later for removing lobulated mass uterin with dimensions 20x15x7.5cm with confirmed histopathological of leiomyoma. Because of it is nonspecific clinical presentation and rarity, an intracardiac Leiomyomatosis continues to be a misdiagnosed as either thrombus or myxoma. The cardiac imaging techniques like a transthoracic echocardiography 2d and transesophageal echocardiography 3d have been used to define the presence, extension of tumor as appearance of the mass and involvement of adjacent structures. Abstract P169 Figure. Echotransesophageal 3D (bicaval view)


2019 ◽  
Vol 08 (02) ◽  
pp. 053-056 ◽  
Author(s):  
Ajay Kumar ◽  
Alok Tripathi ◽  
Shilpi Jain ◽  
Satyam Khare ◽  
Ram Kumar Kaushik ◽  
...  

Abstract Introduction Optic canal connects orbit to middle cranial fossa. Optic nerve and ophthalmic artery pass through this canal. The aim of the present study is to make morphometric and anatomical observations of endocranial opening of optic canal. Materials and Methods The observations were conducted on 30 dry adult human skulls. The observations were made on shape, margins, confluence, septations, dimensions, and distance of optic foramen from apex of petrous temporal bone. Result and Statistical Analysis On morphometric observation, transverse diameter (TD) was 6.00 mm and 6.15 mm on the left and the right side, respectively. The vertical diameter (VD) was 5.14 mm on the left side and 4.82 mm on the right side. The distance of optic foramen to apex of petrous temporal bone was 21.84 mm on the left side and 21.90 mm on the right side. The mean, standard deviation, range, and p value were measured by using SPSS software version 19.00. Conclusion In the present study we attempt to provide a comprehensive anatomical and morphometric data of optic foramen that may help ophthalmologists and neurosurgeons during surgery.


2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Renato J. Galzio ◽  
Mattia Del Maestro ◽  
Diamantoula Pagkou ◽  
Massimo Caulo ◽  
Sofia Asioli ◽  
...  

BACKGROUND The authors reported the first documented case of intracranial extraaxial nonneurofibromatosis type 1–related nontriton malignant peripheral nerve sheath tumor (MPNST) originating from the falx cerebri. OBSERVATIONS A 34-year-old man with headache, short-term memory deficit, postural instability, and blurred vision presented with a large heterogenous contrast-enhanced intraventricular cystic lesion originating from the free margin of the falx cerebri. The patient received surgery using the right posterior interhemispheric approach. Gross total resection was performed, and the inferior border of the falx cerebri was resected. The postoperative course was uneventful. Histological examination revealed hypercellular foci of neoplastic spindle cells with hyperchromatic and wavy nuclei. Hence, a diagnosis of MPNST was made based on concomitant immunochemistry findings, including mouse double minute 2 homolog focal positivity and geographic loss of H3K27me3. The patient received adjuvant radiotherapy, and recurrence was not observed. LESSONS Intracranial MPNSTs are extremely rare tumors, typically originating from the cranial nerves in the posterior cranial fossa. An even rarer variant of these tumors, referred to as malignant intracerebral nerve sheath tumors, may directly arise from the brain parenchyma. The authors reported the first case of an intracranial MPNST originating from the dura mater of the falx cerebri, acting as an extraaxial lesion with prevalent expansion in the right ventricle.


2021 ◽  
Author(s):  
Yue Liu ◽  
Yan Liu ◽  
Xue Zhao ◽  
Hai Xian Guo ◽  
Dan Yu

Abstract Objective: This case improves the early etiologic diagnosis of recurrent and refractory secretory otitis media, avoiding missed diagnosis and misdiagnosis.Methods: Collecting the clinical manifestations of this case, fiberoptic otoscopy + fiber nasopharyngoscopy and imaging features.Results: This patient was admitted to the hospital with hearing loss and ear suffocation. He did not find the cause at the beginning of the disease. Before the hospital, he underwent the treatment of tympanic incision and eustachian tube balloon expansion with simple secretory otitis media, but still recurrent, he came into our hospital through imaging and other further examination this time, having the clear cause that the secretory otitis media recurrent episodes due to tumor lesions in the pterygopalatine. Under the general anesthesia, the navigation system assisted the endoscopic sinus combined with the cryo-plasma wing axillary tumor resection, and the right ear tympanic membrane incision was performed under the microscope.Conclusions: Clinicians need to be cautious and consider the causes in order to reduce missed diagnosis and misdiagnosis, and provide early diagnosis and early treatment to improve the quality of life of patients.


2010 ◽  
Vol 89 (7) ◽  
pp. E1-E13 ◽  
Author(s):  
Dare V. Ajibade ◽  
Iwao K. Tanaka ◽  
Kapila V. Paghda ◽  
Neena Mirani ◽  
Huey-Jen Lee ◽  
...  

We report the case of a 41-year-old man who presented with progressive right-sided ear pressure, otalgia, hearing loss, tinnitus, and intermittent otorrhea. Computed tomography and magnetic resonance imaging detected a soft-tissue mass in the right mastoid with intracranial invasion and erosion through the tegmen tympani and mastoid cortex. Histopathologic examination was consistent with an inflammatory pseudotumor (plasma cell granuloma). These lesions rarely occur in the temporal bone. When they do, they are locally destructive and can erode bone and soft tissues. Aggressive surgery is recommended as a first-line treatment, with adjunctive steroid or radiotherapy reserved for residual or refractory disease. Our patient subsequently experienced multiple recurrences, and his treatment required all of these modalities. At the most recent follow-up, he was disease-free and doing well.


2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S63-S64
Author(s):  
Margaux Canevari ◽  
Bryan Keenan ◽  
Iren Horkayne-Szakaly ◽  
Markku Miettinen

Abstract We report a case of a 15-year-old boy who presented with an intraventricular angiomatoid fibrous histiocytoma. The patient suffered a concussion during a wrestling match and underwent a head and spine CT, which prompted an MRI. MRI revealed an enhancing 2.3-cm mass in the posterior horn of the right lateral ventricle with no hydrocephalus. The patient subsequently admitted to having had headaches with associated appetite suppression but no visual problems or weakness. The tumor was resected. It was composed of sheets and cords of histiocytoid cells with focal pleomorphism. Interspersed throughout was a robust lymphoplasmacytic infiltration with Russell bodies and lymphoid follicles. The histiocytoid neoplastic cells were desmin, EMA, and sparsely S100 protein positive. They were negative for CD31, CD34, Cam 5.2, CD163, CD1a, HMB45, Melan-A, progesterone, and ERG. The abundant plasma cell population was confirmed by CD138 reactivity and was polyclonal by kappa and lambda immunohistochemistry. Fluorescence in situ hybridization revealed an EWSR gene rearrangement. The patient was radiographically free of disease 3 years after surgery with headaches as residual sequela. The differential diagnosis for this case included a lymphoplasmacyte-rich meningioma or a plasmacytoma. The EWSR rearrangement made both of these unlikely. The polyclonal nature of the plasma cell component and the age of the patient also argued against plasmacytoma. A literature search revealed one other ventricular-based angiomatoid fibrous histiocytoma in a pediatric patient.


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