Omental fibroma combined with right indirect inguinal hernia masquerades as a scrotal tumor: A case report

BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by external tumors of the scrotum is rare.The patient had both a greater omentum tumor and an inguinal hernia,and the tumor protruded into the scrotum through the hernia sac,which is even rarer.Moreover,omental tumors are mostly metastatic,and primary omental fibroma is rare.CASE SUMMARY Here,we report a rare case of a 25-year-old young man with scrotal enlargement and pain for 3 months.Preoperative examination and multidisciplinary discu-ssions considered intra-abdominal tumor displacement and inguinal hernia,and intraoperative exploration confirmed that the greater omentum tumor protruded into the scrotum.Therefore,tumor resection and tension-free inguinal hernia repair were performed.The final diagnosis was benign fibroma of the greater omentum accompanied by an indirect inguinal hernia.CONCLUSION This unusual presentation of a common inguinal hernia disease illustrates the necessity of performing detailed history taking,physical examination,and imaging before surgery.

Cemento-ossifying fibroma of the left mandible:A case report

BACKGROUND Ossifying fibroma is a type of benign fibro-osseous lesion.Most lesions affect the mandible region,particularly the molar and pre-molar areas.It predominantly affects females between the second to fourth decades of life.Larger ossifying fibroma tumors require more extensive resection.CASE SUMMARY A 39-year-old female complained of occasional pain and tumor enlargement on her left jaw for the 3 years prior to presentation.Intraoral examination revealed a firm swelling on her left lower gum.Extraoral examination revealed swelling on the left mandible body with no erythema and superficial ulcer.Computed tomography scan revealed a circular-shaped lesion on the patient’s left mandible body with a well-defined radiolucent border,sized 3.2 cm×2.8 cm×0.9 cm.The tumor was removed by marginal mandibulectomy.Biopsy from the resected tumor suggested cemento-ossifying fibroma(COF).CONCLUSION COF is often unnoticed,but this slow-growing tumor can cause significant symptoms regarding its distortion into adjacent structures.

Bilateral Ovarian Fibroma: About a Case Seen at Chu Anosiala, Antananarivo

Ovarian fibroma is a tumor of the stroma and sex cords of the ovary. It is rare and represents 1% to 4% of benign ovarian tumors. It is sometimes associated with Demons-Meigs syndrome, raising suspicion of malignancy at the clinical and paraclinical stages. We report a case of bilateral ovarian fibroma diagnosed in the Pathological Anatomy Department of CHU Anosiala. A 46-year-old woman presented with abdominal pain and pollakiuria. Clinical examination revealed a palpable abdominopelvic mass lateralized to the right. Ultrasound suspected leiomyoma. Foci of microcalcifications were observed. The patient underwent bilateral adnexectomy. The histological study confirmed the diagnosis of bilateral ovarian fibroma. This is the first case of ovarian fibroma reported at the CHU Anosiala.

Non-ossifying fibromas: Case series, including in uncommon upper extremity sites

AIM To investigate non-ossifying fibromas(NOFs) common fibrous bone lesions in children that occur in bones of the lower extremities.METHODS We analyzed 44 cases of NOF including 47 lesions, which were referred with a working diagnosis of neoplastic lesions. Lesions were located in the upper extremities(1 proximal humerus, 1 distal radius) and the lower extremities(25 distal femurs, 12 proximal and 4 distal tibias, and 4 proximal fibulas).RESULTS Three cases had NOFs in multiple anatomical locations(femur and fibula in 1 case, femur and tibia in 2 cases). Overall, larger lesions > 4 cm and lesion expansion at the cortex were seen in 21% and 32% of cases, respectively. Multiple lesions with bilateral symmetry in the lower extremities suggest that these NOFs were developmental bone defects. Two patients suffered from fracture and were treated without surgery, one in the radius and one in the femur. Lesions in the upper extremities(i.e., humerus of a 4-year-old female and radius of a 9-year-old male) expanded at the cortex and lesion size increased with slow ossification.CONCLUSION NOFs in the lower extremity had fewer clinical problems, regardless of their size and expansiveness. In these two upper extremity cases, the NOFs had aggressive biological features. It seems that there is a site specific difference, especially between the upper extremity and the lower extremity. Furthermore, NOFs in the radius are predisposed to fracture because of the slender structure of the radius and the susceptibility to stress.

Chondromyxoid fibroma of the temporal bone: A case report and review of the literature

BACKGROUND Chondromyxoid fibroma(CMF) is a rare benign bone tumour of cartilaginous origin, which usually affects the metaphysis of the long bone. Involvement of the temporal bone is extremely rare. Patients with CMF in the temporal bone can present some neurological deficits due to involvement of surrounding neural structures. CASE SUMMARY We present the first case of histopathologically proven CMF originating in the temporal bone and involving the hypoglossal canal in a 40-year-old woman. Hypoglossal nerve paralysis was identified on the cranial nerve examination. The patient underwent surgical excision and was neurologically normal except for mild left facial palsy on 5-mo follow-up examination after surgery. In the current report, the major characteristics and computed tomography/magnetic resonance imaging features of the lesion are discussed. Furthermore, previous literature regarding this pathology is reviewed.CONCLUSION The current study presents the first case of temporal bone CMF involving the hypoglossal canal.

Ovarian Thecoma Fibroma Causing Menstrual Disorder &Infertility: Dramatic Resolution with Surgery

Purpose: To report the case of successfully managed oligo-amenorrhoea with infertility as a result of thecoma fibroma in a young Nigerian Igbo woman. Case Presentation: She was a 24-year-old, married, nulliparous woman who presented with 5 years history of oligomenorrhoea and 18 months history of infertility. Following her menarche at 14 years of age, she had a regular 30-day menstrual cycle with 4 - 6 days moderate flow. Symptoms of oligomenorrhoea worsened to amenorrhoea over time with menstrual flow occurring only when a progesterone agent was used. Clinical evaluation revealed no abnormalities in the systems apart from the presence of left adnexal mass on pelvic examination. Radiological test suggested benign left adnexal mass. Results: She had surgical removal of the mass after work up. Her normal menstrual flow resumed 48 hours following surgery and became regular thereafter. The histopathology report confirmed thecoma-fibroma. She commenced sexual intercourse 12 weeks after surgery. At 18 weeks post operative period, she presented with amenorrhoea and pregnancy symptoms. Intra-uterine pregnancy was confirmed with a pelvic ultrasound scan. She was managed in antenatal clinic till 38 weeks gestational age when she had spontaneous vaginal delivery of a live female neonate that weighed 3 kg with good APGAR scores. She is currently being followed up. Conclusion: Ovarian thecoma-fibroma is a rare cause of menstrual irregularities and infertility in young women. Surgical removal could result in a dramatic and favourable clinical response, as in the case presented.

Peripheral cemento-ossifying fibroma: A case report with review of literature

Peripheral cemento-ossifying fibroma(PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. This is of a reactive rather than neoplastic nature and its pathogenesis is uncertain. PCOF predominantly affects adolescent and young adults with greatest prevalence around 28 years. We report here a rare clinical case of PCOF of the mandible, 1 cm mesiodistally and 1.5 cm occluso-gingivally in diameter, which caused difficulty in eating and speech, in a 42-year-old female patient. She was asymptomatic for 1 year and on follow-up for 6 mo post surgically showed gingival health and normal radioopacity of bone without any recurrence. Clinical, radiographic and histological characteristics are discussed and recommendations regarding differential diagnosis, treatment and follow up are provided. The controversial varied nomenclature and possible etiopathogenesis of PCOF are emphasized.

A Case of Huge Fibroma in the Palate

Fibroma-like lesions occur with relatively high frequency in oral soft tissues, but represent reactive proliferation against chronic irritation. True fibromas are rare. Tumor size is often seen to range from the mass of a red bean to a soybean. We encountered a case of huge fibroma in the palate with a long history of more than 30 years. The patient was a 60-year-old man who became aware of a tumor in the right palate about 30 years earlier. The mass had tended to increase in size in recent years, and was introduced to our department for the first visit. As an intraoral finding, a pedicled mass measuring 29 × 27 mm was found in the right palate. We also considered the possibility of verrucous carcinoma, and performed biopsy, obtaining a diagnosis of fibroma. Right palatectomy was performed under general anesthesia in October 2016. We performed immunohistochemical examination of the surgical specimen, obtaining a definitive diagnosis of fibroma. As of 1 year postoperatively, no recurrence has been identified and the course has been good.

Giant cemento-ossifying fibroma—A case report and review of literature

Cemento-ossifying fibroma (COF) of maxilla is comparatively rare lesion of the maxillofacial region. There is often a misdiagnosis in the category of fibroosseous lesions, owing to an overlap of clinical, histological and radiographic features amongst the separate entities. We present a case of giant maxillary COF causing extensive disfiguration of the face, along with extensive review of the clinico-pathologic and treatment aspects of the fibro-osseous lesions.

Juvenile Aggressive Ossifying Fibroma in a 6-Months Old: A Case Report

Juvenile Aggressive Ossifying Fibroma (JAOF) is a benign but locally aggressive fibro-osseous lesion. It is a rapidly growing non-odontogenic neoplasm of the jaws, generally occurring in children and young adults. It is often confused with malignant condition because of its clinical behaviour. Long term follow-up is necessary, considering the high recurrence nature of this tumour. The reconstruction of affected patients, particularly the younger, is often challenging since it has to be done in stages, to keep up with the developing face. We report a case of maxillary JAOF in a 6-month-old female who was referred to our department. Histopathological examination of a resected specimen revealed a trabecular type of JAOF. The patient was followed up for a period of 2 years.

Chondromyxoid fibroma of the cervical spine:A case report

BACKGROUND Chondromyxoid fibroma(CMF)is an unusual benign tumour of cartilaginous tissues that may be confused with other malignant tumours.It is rarely seen in the cervical spine.CASE SUMMARY A 24-year-old young woman was admitted to the hospital because of neck and shoulder pain.Computed tomography,magnetic resonance imaging,X-ray and other imaging examinations of the cervical spine and laboratory-related indicators combined with intraoperative pathology revealed that the patient had cervical CMF.We performed total resection of the vertebral body and intervertebral disc,and internal fixation was performed to simultaneously maintain the stability of the entire spine.The clinical results from extensive resection were satisfactory.At the 2-year follow-up,the patient's symptoms had not recurred.CONCLUSION CMF is a benign primary bone tumour that is rarely located in the vertebral bone.Accurate initial diagnosis of these tumours is important for appropriate treatment.En bloc surgical resection of the tumour is the cornerstone of treatment.

Oocyte Cryopreservation before Tumorectomy in Gorlin-Goltz Syndrome with Recurrent Ovarian Fibroma: A Case Report

Background: Gorlin-Goltz syndrome is a very rare syndrome that reportedly occurs in 1 of 235,800 people in Japan. The proportion of women with Gorlin-Goltz syndrome complicated with an ovarian fibroma ranges from 12.5% to 17.0%. Some surgical cases of Gorlin-Goltz syndrome with an ovarian tumor have been reported. However, no studies have mentioned subsequent fertility preservation by using oocyte cryopreservation process. Case: In this case report, the patient with Gorlin-Goltz syndrome underwent laparotomy for bilateral ovarian fibrothecoma at 15 years of age. At 20 years of age, a recurrent ovarian tumor was detected in the remaining ovary. During the follow-up, we detected an increase in its size. As tumor torsion requiring left salpingo-oophorectomy was possible, tumorectomy was considered. However, her anti-Müllerian hormone level was low. As she was at risk for premature ovarian failure after tumorectomy, we planned to cryopreserve her oocytes to preserve her fertility before tumorectomy. Outcome: When the patient underwent surgery, the diameter of her left ovarian tumor was found to have increased to 56 mm. Egg collection was performed twice, and two oocytes were cryopreserved. Subsequently, she underwent tumorectomy of the left ovarian tumor. No recurrence has been observed. Conclusion: If a recurrent ovarian tumor is detected in patients with Gorlin-Goltz syndrome and a low anti-Müllerian hormone level, cryopreservation of oocytes before tumorectomy may be effective for preserving their fertility.

An Aggressive Ameloblastic Fibroma in Maxilla of a 5-Year-Old Child—Reconstruction of the Defect with Buccal Flap Advancement—A Conservative Approach

Ameloblastic fibroma (AF) is a rare tumour of mixed odontogenic origin that can occur either in mandible or maxilla but is most frequently found in the posterior region of mandible. Age of occurrence is generally between first and second decades of life. It is often mistaken for a den tigerous cyst due to presence of an impacted tooth. The diagnosis of AF usually occurs accidentally by routine radiographic examination for an impacted tooth. Histologically it consists of odontogenic ectomesenchyme resembling the dental papilla, epithelium resembling dental lamina and enamel organ without dental hard tissues. There is controversy in the literature as to whether the treatment should be conservative or a radical resection should be done. A conservative treatment strategy, such as enucleation and curettage, is usually sufficient. We describe a case of massive ameloblastic fibroma in a 5-year-old child with an unusual position in maxillary posterior region and without any impacted tooth. Surgical resection of the tumor through Weber Ferguson approach was done under GA with 2 years of follow-up without any recurrence.

Gigantic Nasal Fibroma: CT and MR Imaging Findings with Histopathological Correlation

A 79-year-old woman with gradually worsening left nasal obstruction, purulent rhinorrhea and severe headaches for 6 months admitted to the hospital. A gray-white and huge mass occupying the left nasal cavity was found in physical examination. CT revealed a soft-tissue-density mass in the left nasal cavity with erosion of adjacent bone structures. On T2-weighted MR images, the lesion showed homogenous extreme low signal intensity. The patient underwent successful surgical removal of huge sinonasal soft tissue mass measuring 50 × 45 × 40 mm. The final diagnosis of fibroma was made histologically. MR imaging studies showed characteristic signal intensities corresponding to histopathological components. To the best of our knowledge, this is the first report regarding the MR imaging findings of huge nasal fibroma in the English literature.

Characteristic Radiological and Histological Patterns of Fibrous Dysplasia and Ossifying Fibroma of the Jaws at University of Nairobi Dental Teaching Hospital

Objective: To characterize the diagnostic features of ossifying fibroma (OF) and fibrous dysplasia (FD) of the jaw bones. Study Design: A histopathological and radiological analysis with full clinical documentation. Setting: University of Nairobi Dental Teaching Hospital (UNDH). Study Population: All archival cases diagnosed as FD and OF from 1992-2006 were retrieved from the UNDH Oral Pathology Laboratory records. New cases were included as they pre-sented over a 6-month period from January to June 2007. Methodology: Information regarding the histological type of a fibro-osseous lesion (FOL) including the clinical features, demographic and radiographic data was documented for analysis;and comparison between pathological parameters and the final diagnosis was evaluated with the chi-square test. Results: FD lesions constituted 40 (27.2%) cases while 107 (72.8%) were OF. The age ranged from 1 - 72 years (mean = 24.19 ± SD 13 years). The differences in the gender distribution were not statistically significant. Radiographic analyses showed statistically significant differences between the appearances of the body (p = 0.012) and the margins (p = 0.003) of FD and OF. The microscopic differences between the two lesions were not statistically significant. Conclusion: Differentiation between FD and OF is only possible after critically analyzing the clinical, radiological and histological criteria.

Juvenile cemento-ossifying fibroma of the maxilla:Report of one case and review of the literature

Juvenile cemento-ossifying fibroma (JCOF) is a rare lesion that exhibits a slow growing but may reach massive proportion and cause considerable cosmetic and functional problems. This lesion has the tendency for recurrence following incomplete excision. A case report of giant JCOF in a 46-year-old female with 23-year history is presented. Local excision and thorough curettage was performed and the normal skeletal structure was maximally preserved. 15-month follow up demonstrated no sign of recurrence.

促结缔组织增生性纤维母细胞瘤1例并文献复习

报告1例促结缔组织增生性纤维母细胞瘤。患者男,18岁。右侧足部小趾末节肿块5年。皮肤科检查:右足小趾末节一约0.8cm×1.0cm肤色肿块,表面光滑,形状规则,界限清,质地韧,无压痛和触痛。皮损组织病理检查:肿瘤主要由大量致密的胶原纤维和星状成纤维细胞组成,胶原纤维排列紊乱,不呈束状,成纤维细胞核染色质均匀、细致,可见细小核仁,很少见核分裂象,局部区域间质内有薄壁的小血管。诊断:促结缔组织增生性纤维母细胞瘤。

真空辅助乳腺微创旋切术治疗乳腺纤维腺瘤的临床效果研究

目的:探讨真空辅助乳腺微创旋切术治疗乳腺纤维腺瘤的临床效果。方法:选取笔者医院2019年9月-2020年9月收治的92例乳腺纤维腺瘤患者,随机分为观察组(n=46,应用真空辅助乳腺微创旋切术)和对照组(n=46,应用环乳晕切口术),采用统计学方法分析两组患者治疗后的围术期指标(手术时间、术中出血量、切口长度、切口愈合时间)、美学效果(乳房对称性、凹陷程度、质地与弹性、皮肤颜色)、乳晕区感觉神经功能损伤情况、并发症(乳房变形、皮下血肿、皮肤破损、皮下瘀斑)、肿瘤复发率及肿瘤残余率。结果:术后,观察组手术时间、切口愈合时间短于对照组,术中出血量少于对照组,切口长度短于对照组,差异均有统计学意义(P<0.05);术后1个月,观察组美学效果优良率高于对照组患者(P<0.05);观察组患者术后1 d与术后6个月乳晕区感觉神经功能正常的比例为43.48%、91.30%,均高于对照组的23.91%、73.91%(P<0.05);术后,观察组肿瘤残余率和复发率均低于对照组(P<0.05),两组并发症发生情况比较差异无统计学意义(P>0.05)。结论:真空辅助乳腺微创旋切术能够降低围术期指标和术后并发症,美学效果好,肿瘤残余率和复发率低,值得临床推广应用。

Jaffe-Campanacci syndrome resulted in amputation: A case report

BACKGROUND Jaffe-Campanacci syndrome(JCS)is a very rare syndrome.The treatment of JCS is more conservative,and most authors recommend that no surgery should be done in asymptomatic patients.The conventional concept holds that the natural course of non-ossifying fibromas(NOFs)grows with the development of bones,and the osteolytic region gradually stops expanding and self-healing through bone ossifying around the lesion and ossification within the lesion.But in this case,the bone lesions were potentially biologically aggressive,which led to severe limb deformities and pain.CASE SUMMARY We present the case of a 5-year-old girl with JCS presenting with not only NOF sand café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,axilla,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.We present the case of a 5-year-old girl with JCS presenting with not only NOFs and café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,armpit,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.Amputation from the middle level of the right femur was performed.CONCLUSION In our opinion,education on preventing pathological fractures and explaining the consequent serious consequences to the parents is a matter of prime significance.At the same time,prophylactic treatment(restricted exercise,support,or surgery)is also considerable for JSC.