Extraosseous spinal epidural plasmocytoma associated with multiple myeloma: Two case reports

BACKGROUND Multiple myeloma is a malignant hematological disease characterized by proliferation of monoclonal plasma cells mainly in the bone marrow.Extraosseous epidural plasmacytoma associated with myeloma arises from lymphoid tissue in the epidural space without focal vertebral involvement,and is rare.CASE SUMMARY A 52-year-old woman was diagnosed with kappa subtype nonsecretory multiple myeloma and presented with bilateral arm weakness 11 mo after completing multiple courses of chemotherapy.Spinal magnetic resonance imaging(MRI)showed a posterior C7–T3 epidural mass with spinal cord compression.After five courses of chemotherapy,follow-up MRI showed resolution of cord compression.A 54-year-old man presented with paraplegia 15 mo after a diagnosis of IgD kappa subtype multiple myeloma and completing multiple courses of chemotherapy.He underwent Th11 and L1 laminectomies for tumor resection because MRI showed an epidural mass causing cord compression.Histopathologic examination was consistent with IgD multiple myeloma.The patients have currently survived for 33 mo and 19 mo,respectively.CONCLUSION Isolated extraosseous epidural plasmacytoma associated with multiple myeloma without bony involvement is difficult to diagnose by imaging.Definitive diagnosis requires pathological and immunohistochemical examination.

Primary extraosseous Ewing's sarcoma of the lung in a 36-year-old female patient:clinical,imaging,and pathologic findings

Primary extraosseous Ewing's sarcoma is a very rare clinical entity. In the report, we present the case of a 36year-old female patient who underwent resection of lung mass and was diagnosed as having Ewing's sarcoma by pathological examination. The clinical, imaging, and pathologic features of the case are described and discussed.

Extraosseous Ewing's sarcoma arising from the pterygomandibular space

Extraosseous Ewing’s sarcoma (EES) arising in head and neck is extremely rare. We report on a rare case of EES originating from the pterygomandibular space. A 15-year-old boy was seen with a rapidly growing mass in the right upper neck, difficulty in opening mouth, dysphagia, numbness in the right lower lip and buccal skin. Clinical and radiological examinations indicated that a soft tissue mass origi-nated from the pterygomandibular space with the submandibular space and mouth floor extension. Histological and immunohistochemical evaluations of the biopsy specimen revealed poorly differentiated small blue round cells with positive stains for CD99 and neuron-specific enolase. According to the clinical manifestation, CT and MRI findings, histological pattern and the results of the immunohistochemical studies, the final diagnosis was EES. Our patient was treated with chemotherapy and radiotherapy. The lesion recurred locally after 10 months and he died of multiple distant metastases 22 months later. Early and confident diagnosis coupled with combined surgical excision and modern chemotherapy/radiotherapy appears to be the most effective treatment plan.

Isolated cervical extraosseous intradural chordoma attached to the C5 nerve root: a case report

Background:As chordomas are slow growing and locally invasive with high recurrence rates,initial recommendations include complete surgical resection with or without radiation therapy.A large proportion of recurrences occur years after initial resection necessitating lengthy follow-up.The novel biomarker brachyury and the repurposing of pharmaceutical products have the potential to substantially impact long-term recurrence rates.Case presentation:A 43-year-old woman presented with an isolated,cervical extraosseous intradural extramedullary chordoma attached to a nerve root underwent a C3-5 laminectomy,C3-5 lateral mass screw instrumentation,and mass resection.All symptoms resolved by the 12-month postoperative follow-up visit.Conclusions:This is the first report of an isolated,cervical extraosseous intradural extramedullary chordoma attached to a nerve root,and this case adds to the previous six TypeⅣchordomas in the literature.Unfortunately,the very rare form of extraosseous intradural chordoma is poorly understood:the lack of detailed knowledge in how they are differentiated from other forms of chordoma confounds the development of optimal treatment strategies and follow-up guidelines.

Two rare cases of craniofacial chondrosarcoma

The craniofacial region is a rare site for chondrosarcomas.These tumors may have osseous or extraosseous origin.Extraosseous chondrosarcomas have the same histological features as osseous chondrosarcomas.Chondrosarcomas usually present in the fifth to seventh decades of life,although several cases with younger age at presentation have been reported.They usually present as a painless mass that gradually progresses to various complaints,such visual impairment,nasal obstruction,and dental abnormalities.In this article,we present two cases of chondrosarcoma occurring at rather unusual locations.It is important to keep this rare malignancy in the list of differential diagnoses for a mass in the head and neck region,as these tumors may not always show the features typical of this malignancy.

Peripheral Primary Neuroectodermal Tumour of the Ileum: A Case Report and Review of the Literature

Background: Ewing’s Sarcoma (ES)/peripheral Primitive Neuroectodermal Tumor (pPNET) is a rare aggressive malignant small round cell tumour. Most of them arise in bony sites, and they represent the second commonest primary osseous malignancy in adolescence and young adults. The localization of the small bowel is very rare, to our knowledge only 35 cases of ES/pPNET of the small bowel have been reported in the literature. Case Presentation: We report a case of pPNET of the ileum in a 26-year-old female, presented abdominal pain with a transit disorder. The clinical examination was unremarkable. The histological and immunohistochemical study confirmed the diagnosis of peripheral primary neuroectodermal tumours. The patient was treated by tumor resection followed by adjuvant chemotherapy. The evolution was good, without recurrence with a follow-up of 12 months. Conclusion: PNET of the ileum is very rare. We report this case to enrich the database of this rare clinical entity and to improve the management of patients with PNET of the ileum.

Peripheral Complex Odontoma in the Gingiva:A Case Report of an 11 Year Old Boy and Review of Literature

According to the WHO histological classification of odontogenic tumours, odontomas originate from odontogenic epithelium and odontogenic ectomesenchyme, with or without hard tissue formation. They are generally classified into two types: complex and compound. Odontomas are usually intraosseous and often associated with delayed eruption of teeth. However, they can be extraosseous and are then referred to as either peripheral complex or compound odontoma. Peripheral odontomas are rare entities. We report a case of an 11 year old boy referred to the Department of Oral and Maxillofacial Surgery, Aarhus University Hospital by the boy’s dentist due to fibrous mass in the marginal gingiva in the anterior lower mandible. Removal of the mass revealed a peripheral complex odontoma and at the final 5-month postoperative inspection there was satisfying healing observed, a small, elevated, hyperplastic fibrous marginal gingiva.