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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Clinical and computed tomography features of adult abdominopelvic desmoplastic small round cell tumor

To investigate the clinical and computed tomography(CT)features of desmoplastic small round cell tumor(DSRCT),we retrospectively analyzed the clinical presentations,treatment and outcome,as well as CT manifestations of four cases of DSRCT confirmed by surgery and pathology.The CT manifestations of DSRCT were as follows:(1)multiple soft-tissue masses or diffuse peritoneal thickening in the abdomen and pelvis,with the dominant mass usually located in the pelvic cavity;(2)masses without an apparent organbased primary site;(3)mild to moderate homogeneous or heterogeneous enhancement in solid area on enhanced CT;and(4)secondary manifestations,such as ascites,hepatic metastases,lymphadenopathy,hydronephrosis and hydroureter.The prognosis and overall survival rates were generally poor.Commonly used treatment strategies including aggressive tumor resection,polychemotherapy,and radiotherapy,showed various therapeutic effects.CT of DSRCT shows characteristic features that are helpful in diagnosis.Early discovery and complete resection,coupled with postoperative adjuvant chemotherapy,are important for prognosis of DSRCT.Whole abdominopelvic rather than locoregional radiotherapy is more effective for unresectable DSRCT.

Combined resection and multi-agent adjuvant chemotherapy for desmoplastic small round cell tumor arising in the abdominal cavity:Report of a case

促结缔织增生的小圆房间肿瘤(DSRCT ) 是有特殊组织学的特征的稀罕、高度好攻击的恶意：在稠密的促结缔织增生基质以内的细胞的生长的一个嵌套的模式，与男优势发生在年轻人口。吝啬的幸存时期仅仅关于 1.5-2.5 年。肿瘤共同表示上皮，在免疫的肌肉，和神经标记组织化学的研究。这个工作报导与吐血和长期的便秘介绍的一个 27 岁的人。包括内视镜检查法，上面的胃肠的系列，腹的计算断层摄影术和钡灌肠的连续研究学习内脏的机关的显示出的传播参与。病人经历了好攻击的外科并且收到了由 5 氟尿嘧啶，出租机动三轮车磷酰胺， etoposide， doxorubicin，和 cisplatin 组成的手术后的辅助化疗。没有任何疾病，他在外科以后为 20 瞬间幸存。没有标准疗法协议被建立了。与手术后的多代理人助手化疗相结合的好攻击的外科被认为正当不仅减轻症状而且试着在这个先进 DSRCT 年轻病人改进结果。

Retroperitoneal desmoplastic small round cell tumor:Pediatric patient treated with multimodal therapy

A desmoplastic small round cell tumor (DSRCT) is a rare, aggressive mesenchymal neoplasm. Although a DSRCT can develop at various sites, the intraabdominal site is the most common location. These tumors are found most commonly among young adolescents and the prognosis is extremely poor. Multimodal treatment with surgery, chemotherapy and radiotherapy is very important for these rare cases, and this treatment can improve patient survival. In this report, we describe the case of an 8-year-old boy diagnosed with DSRCT located in the retroperitoneal space. The patient has undergone surgical resection and adjuvant chemoradiation therapy, and is currently alive without disease recurrence.

Ovarian desmoplastic small round cell tumors: Prognosis is poor! Case report

The tumor desmoplastic small round cell in women is rare. Ovarian its location is exceptional. We report a patient of 20 years, the originalNorth Africawho consulted for an increase in abdominal volume with impaired general condition. Pelvic ultrasonography and computed tomography were in favor of multiple peritoneal masses with ascites. After surgical exploration, the histological and immunohistochemical data for diagnosis small round cell desmoplastic tumor of ovarian the patient was a candidate for poly chemotherapy but she was died a month later. Diagnosis relies on histological and immunohistochemical data. The demonstration of a nonrandom translocation t (11;22) (p13;q12) is specific for the disease. The management is multidisciplinary and combining surgery, a poly aggressive chemotherapy and radiotherapy. The prognosis remains poor.

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.