desmoplastic

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  • 文章类型: Case Reports
    原发性眼眶黑色素瘤和转移性皮肤黑色素瘤极为罕见。促纤维化黑色素瘤(DM)是黑色素瘤的罕见变体,可以通过神经营养机制从浅表位置延伸到深层组织。尽管接受了治疗,但一名78岁的男性在其左下眼睑患有眼周混合性恶性黑色素瘤(梭形细胞黑色素瘤伴增生反应),患有无法控制的疾病(眼眶和下眶缘侵袭)。手术技术包括延长的眼眶切除术,上颌骨切除术,和筛骨切除术,具有2厘米的宏观手术边缘。我们使用经眶入路用颞肌皮瓣进行了延迟的窝重建。自手术以来,患者保持1.5年无病,生活质量良好。此时,他提出了一个新的眼眶侵犯的黄斑瘢痕区域复发,最后,他死于纵隔,胸膜,和肺转移。在眼周区域出现的皮肤黑素瘤的治疗是具有挑战性的重建问题,并且它可能损害眼球和视觉功能。
    Primary orbital melanoma and metastatic cutaneous melanoma of the orbit are extremely rare. Desmoplastic melanoma (DM) is an infrequent variant of melanoma that can extend from a superficial location into deep tissues by neurotropic mechanisms. A 78-year-old male was referred to us with a periocular mixed malignant melanoma (spindle cell melanoma with desmoplastic reaction) in his left lower eyelid with uncontrollable disease (orbital and inferior orbital rim invasion) despite treatment. The surgical technique consisted of an extended orbital exenteration, maxillectomy, and ethmoidectomy, with a 2 cm macroscopic surgical margin. We performed a delayed socket reconstruction with a temporalis muscle flap using a transorbital approach. The patient remained disease-free for 1.5 years with a good quality of life since exenteration surgery. At this time, he presented a recurrence in the area of the malar scar with a new orbital invasion, and finally, he died due to mediastinal, pleural, and pulmonary metastasis. The treatment of a cutaneous melanoma arising in the periocular region is a challenging reconstructive problem and it may compromise the globe and visual function.
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  • 文章类型: Case Reports
    纤维增生性纤维瘤(DF)是一种罕见的骨肿瘤,起源于间充质组织,尽管是良性的,在当地表现出攻击性行为。以下报告描述了一个7岁男孩的情况,该男孩的下颌骨右侧肿胀迅速扩大。经过全面的临床检查,射线成像,和组织病理学分析,确诊为DF。考虑到肿瘤局部复发的倾向和患者的健康状况,制定治疗计划。由于病人年龄小,段切除被认为是不合适的,并进行了积极的刮除和病灶摘除,然后进行骨移植。患者在术后第一个月接受密切随访,随后在3、6、9和12个月后进行复查。分别。在X光片上观察到良好的骨愈合。根据临床或影像学评估,患者未显示任何复发迹象,也未表现出任何神经感觉缺陷。
    Desmoplastic fibroma (DF) is an uncommon bone tumor that originates from the mesenchymal tissue and despite being benign, exhibits aggressive behavior locally. The following report describes the case of a 7-year-old boy with a rapidly enlarging swelling on the right side of the mandible. After a thorough clinical examination, radiographic imaging, and histopathological analysis, the diagnosis of DF was confirmed. Treatment planning was formulated considering both the tumor\'s tendency for local recurrence and the patient\'s well-being. Due to the patient\'s young age, segmental resection was not deemed appropriate, and an aggressive curettage and enucleation of the lesion followed by the bone graft was performed instead. The patient was kept under close follow-up for the first month of post-surgery and later reviewed after 3, 6, 9, and 12 months, respectively. Good bone healing was observed on radiographs. The patient did not show any signs of recurrence based on clinical or radiographic assessments and did not exhibit any neurosensory deficits as well.
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  • 文章类型: Case Reports
    尚未报道患有硬皮样反应的手掌先天性痣。它具有跟随纤维束的深度延伸的潜力。建议使用慢速Mohs或冷冻切片进行免疫组织化学染色。
    Palmar congenital nevus with sclerodermoid reaction has not been reported. It has the potential of deep extension following the fibrous bundle. The utilization of slow Mohs or frozen sections with immunohistochemistry staining was recommended.
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  • 文章类型: Case Reports
    纤维增生性纤维瘤是一种罕见的原发性良性骨肿瘤,通常会影响长骨,下颌骨,还有骨盆.它具有与软组织纤维瘤病相似的局部侵袭性。它很少涉及手的小骨头。我们描述了一种极为罕见的病例,该患者的手部近端指骨的纤维增生性纤维瘤,该患者的左无名指上有明显扩大但无痛的肿块。放射学特征提示恶性肿瘤;然而,最初的活检显示纤维化组织。使用小指的局部尺骨皮瓣进行无名指和小指的掌骨截肢和软组织重建。最终的组织病理学评估显示纤维增生性纤维瘤。手部剧烈增长的肿块应根据肉瘤管理方案进行治疗,鉴别诊断应包括纤维增生性纤维瘤。
    Desmoplastic fibroma is a rare primary benign bone tumour that typically affects the long bones, mandible, and pelvis. It has a similar local aggressiveness to soft tissue fibromatosis. It rarely involves the small bones of the hand. We describe an extremely rare case of desmoplastic fibroma of the proximal phalanx of the hand in a patient who presented with an aggressively enlarging but painless mass on the left ring finger. Radiological features suggested malignancy; however, an initial biopsy revealed fibrotic tissue. Trans-metacarpal amputation of the ring and little fingers and soft tissue reconstruction were performed using a local ulnar-based flap of the little finger. The final histopathological evaluation revealed desmoplastic fibroma. Aggressively growing masses in the hand should be treated according to a sarcoma management protocol, and desmoplastic fibroma should be included in the differential diagnosis.
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  • 文章类型: Case Reports
    本病例报告描述了异常大的促纤维增生性成纤维细胞瘤。病变的诊断在临床上似乎具有欺骗性。此病例图像的目的是突出其大小并呈现症状,很容易被误认为是牙源性的,唾液腺,或是软组织肿瘤.
    The present case report depicts an unusually large desmoplastic fibroblastoma. The diagnosis of the lesion appears to be deceptive clinically. The purpose of this case image is to highlight its size and presenting symptoms, which could easily be mistaken for an odontogenic, salivary gland, or a soft tissue neoplasm.
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  • 文章类型: Case Reports
    Desmoplastic fibroma (DF) is a benign, locally aggressive neoplasm that rarely occurs in the facial skeleton. It usually presents during the first three decades of life. Due to its aggressiveness and high recurrence rate, early diagnosis is imperative, and complete surgical removal of the lesion is the treatment of choice. Herein, we present three cases of DF namely a 2 year-old girl with a mandibular DF, a 9 year-old boy with a maxillary lesion and a 1.5-year old boy with a mandibular DF. Complete clinicopathological information, treatment plan and long-term follow-up of patients are discussed. Histopathologic features of 3 cases revealed non-capsulated spindle cell tumor with fascicular or swirling patterns in incisional biopsy. Immunohistochemical staining was performed to make a definitive diagnosis. Strongly positive nuclear immunoreactivity for β-catenin confirmed the diagnosis of desmoplastic fibroma in 3 cases. Segmental mandibulectomy, partial maxillectomy and hemimandibulectomy were done for the cases. There was no recurrence in our reported cases after 8 and 11 months and 3 years follow up, respectively. It is noteworthy that despite the aggressive nature of DF, young patients often respond well to wide resection treatment.
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  • 文章类型: Case Reports
    增生性恶性胸膜间皮瘤(DMM)是弥漫性恶性胸膜间皮瘤(MPM)的少见组织学亚型,占病例的5-10%。预后不良,直接侵入胸壁或肺和远处转移。它的病理特征包括致密的胶原纤维,呈层状。其预处置病理诊断困难,纤维状胸膜炎和反应性间皮增生作为潜在的鉴别诊断。
    我们回顾性回顾了1996年至2012年MPM患者的病历。在60例MPM患者中,确定了四名具有促纤维化亚型的患者及其临床特征,包括接触石棉,治疗,和预后,被审查了。所有患有DMM的患者都是男性,年龄中位数为69岁(范围:63-74岁)。所有四名患者都接触过石棉。在所有4例患者中,对组织学进行了明确诊断,并进行了国际间皮瘤兴趣小组分类(III/IV:2/3)。3例患者接受了化疗(2例接受顺铂/培美曲塞治疗,1例接受顺铂/吉西他滨治疗),1例患者接受了手术。DMM患者的中位生存时间为3.8个月(范围:0.9-11.5个月)。与我们机构的其他亚型MPM患者的10.5个月相比。
    DMM继续具有不良预后。识别这种变异并将其与胸膜斑块区分开来是很重要的,非特异性反应性胸膜纤维化,胸膜炎,和其他肺部疾病。
    Desmoplastic malignant pleural mesothelioma (DMM) is rare histological subtype of diffuse malignant pleural mesothelioma (MPM), accounting for 5-10 % of cases. It has a poor prognosis, with direct invasion of the chest wall or lungs and distant metastases. Its pathological characteristics include dense collagen fibers in a storiform pattern. Its pretreatment pathological diagnosis is difficult, with fibrous pleuritis and reactive mesothelial hyperplasia as potential differential diagnoses.
    We retrospectively reviewed the medical charts of patients with MPM from 1996 to 2012. Among 60 patients with MPM, four patients with the desmoplastic subtype were identified and their clinical characteristics, including asbestos exposure, treatment, and prognosis, were reviewed. All of the patients with DMM were men, with a median age of 69 years (range: 63-74 years). All four patients had been exposed to asbestos. The definitive diagnosis was made histologically and the International Mesothelioma Interest Group classification was advanced (III/IV: 2/3) in all four patients. Three patients were treated with chemotherapy (two with cisplatin/pemetrexed and one with cisplatin/gemcitabine) and one patient underwent surgery. The median survival time in the patients with DMM was 3.8 months (range: 0.9-11.5 months), compared with 10.5 months in patients with other subtypes of MPM in our institution.
    DMM continues to have a poor prognosis. It is important to recognize this variant and distinguish it from pleural plaques, non-specific reactive pleural fibrosis, pleurisy, and other lung diseases.
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  • 文章类型: Case Reports
    Desmoplastic infantile ganglioglioma (DIG) is a rare tumor that typically occurs in infants under the age of 24 months. These tumors commonly have a good prognosis after surgical resection despite their aggressive radiological appearances. Clinical signs are due to the large size of the tumor and include increased head circumference, bulging fontanel, sunset sign and seizures. We report an unusual DIG case who presented with parietal bulging associated with a bony defect. The patient was thought to have a leptomeningeal cystic formation, but on his cranial magnetic resonance imaging (MRI), we observed a centrally and homogeneously gadolinium-enhanced lesion fixed to the dura by its solid component. A surgical gross total resection was performed, and no residual tumor was observed on follow-up.
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  • 文章类型: Case Reports
    Desmoplastic fibroma of bone is a rare locally aggressive, but non-metastatic tumor. In this case report, we present a desmoplastic fibroma in an unusual location, the clavicle. Desmoplastic fibroma involving the clavicle is extremely rare, with only 2 reported cases before 1985. We report the imaging findings of a desmoplastic fibroma of the clavicle with a review of the relevant literature.
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  • 文章类型: Journal Article
    Fibromatoses are a heterogeneous group of distinct entities which differ in biological behaviour, but arehistologically very similar. This group of fibrous tumor or tumor like lesions, present considerable difficulties in pathologic diagnosis. Aggressive fibromatosis (AF) of the oral or para-oral structures is a very uncommon finding and its intra-osseous component is even relatively unusual. Such lesions with their origin from within the bone are termed desmoplastic fibromatosis (DF). These lesions must be distinguished from other fibroblastic tumors of the head and neck such as benign fibrous histiocytoma (BFH), fibrosarcoma, nerve sheath tumors and tumors of muscular origin. The major challenge in dealing with lesions of fibromatosis is to avoid an overdiagnosis of fibrosarcoma or an underdiagnosis of reactive fibrosis.Problems of differential diagnosis concern a wide range of diseases and immunohistochemical analysis may be helpful in diagnosis. With respect to the patient\'s post-operative well-being and if periodic follow-ups are guaranteed, the tumor should be carefully resected with only narrow safety margins. A rare case of aggressive desmoplastic fibromatosis in a 12-year-old girl is presented in this article with emphasis on the need and challenges for diagnosing such lesions as they have to be differentiated from other soft tissue tumors which display borderline pathological features regarding benign or malignant behaviour. Synonyms listed for the same include extra-abdominal desmoids, extra-abdominal fibromatosis, desmoids tumor, aggressive fibromatosis, juvenile desmoids-type fibromatosis, infantile fibromatosis.
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