1
|
Werenski JO, Hung YP, Chang CY, Nielsen GP, Lozano-Calderón SA. Myositis ossificans mimicking bone surface osteosarcoma: case report with literature review. APMIS 2024; 132:535-543. [PMID: 38741286 DOI: 10.1111/apm.13422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 04/26/2024] [Indexed: 05/16/2024]
Abstract
Myositis ossificans, a benign tumor composed of spindle cells and osteoblasts, can clinically and radiologically mimic osteosarcoma. While recognition and accurate diagnosis of myositis ossificans can be a challenge, this is critical as it may allow a conservative surgical approach to maximize functional outcomes. Herein, we present a patient with surface myositis ossificans confirmed genetically by the presence of COL1A1::USP6 gene fusion, along with a literature review. Due to the enhanced visualization of the bone matrix, computed tomography (CT) imaging may be a superior imaging modality to magnetic resonance (MR) imaging. Staged biopsies with samples obtained from the periphery and center of the lesions may allow pathologists to discern the zonal distribution histologically. Furthermore, immunohistochemistry fluorescence in situ hybridization and molecular testing can aid in the distinction of myositis ossificans from mimics. Because of their resemblance to other bone tumors, these cases of myositis ossificans highlight the importance of a multidisciplinary approach integrating clinical, radiologic, and pathologic analysis and involving serial imaging, sampling, and judicious use of ancillary immunohistochemical and molecular testing.
Collapse
Affiliation(s)
- Joseph O Werenski
- Orthopaedic Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yin P Hung
- Division of Bone and Soft Tissue Pathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Connie Y Chang
- Division of Musculoskeletal Imaging & Intervention, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - G Petur Nielsen
- Division of Bone and Soft Tissue Pathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Santiago A Lozano-Calderón
- Orthopaedic Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Cherry I, Mutschler M, Samara E, Merckaert S, Zambelli PY, Tschopp B. Myositis ossificans in the pediatric population: a systematic scoping review. Front Pediatr 2023; 11:1295212. [PMID: 38161430 PMCID: PMC10757320 DOI: 10.3389/fped.2023.1295212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Circumscribed or pseudomalignant myositis ossificans (MO) is a rare and benign condition characterized by heterotopic bone formation in soft tissues. The clinical presentation of MO, imaging investigations, histological findings, and treatment strategies are unclear, especially in the pediatric population. Materials and methods A literature search was conducted in PubMed, Scopus, and Google Scholar electronic databases to identify original articles and reviews in English or French of traumatic and non-traumatic MO. Studies were selected by 2 independent reviewers following the PRISMA recommendation and descriptive data were extracted. We harvest in each case the sex, age at diagnosis, location, presence of initial trauma, pre-emptive diagnosis, modalities of imagery used, realized biopsy, treatment performed, and type of follow-up. Results Sixty pediatric cases of MO were identified between 2002 and 2023. Twenty-three patients (38.3%) were diagnosed with idiopathic/pseudomalignant and 37 patients (61.7%) with circumscribed. The mean age at diagnosis was 9.5 years (range 0.2-17 years), with a male-to-female ratio of 1:1. The initial pre-emptive diagnosis was neoplasia in 13 patients (21.7%). The biopsy was percutaneous in 9 patients (15%) and incisional in 7 patients (11.7%). Histological analysis was achieved in 35 cases (57%). Surgical excision was the first line treatment in 46.7% of patients, and non-surgical in the remaining patients. The follow-up strategy was clinical in 16 patients (26.7%) or based on imaging investigation in 23 patients (38.3%). Discussion Although MO in children is described as a rare pathology, identifying the benignity of the condition is essential to avoid unnecessary invasive treatment and to avoid delaying the treatment of a potentially life-threatening entity. It seems that there is no consensus established concerning the proper imaging for diagnosis. Clinicians should acknowledge that the absence of a triggering trauma tends to direct the investigation and the management toward a surgical attitude. Conservative management is key, however, surgical excision can be proposed on matured lesions on a case-by-case basis. The absence of recurrence is not excluded. Therefore, a close clinical follow-up is suggested for all cases. The true benefit of a radiological is questioned in a question known to be self-resolving.
Collapse
|
3
|
Kha ST, Sharma J, Kenney D, Daldrup-Link H, Steffner R. Assessment of the Interval to Diagnosis in Pediatric Bone Sarcoma. Pediatr Emerg Care 2023; 39:963-967. [PMID: 37567167 DOI: 10.1097/pec.0000000000003031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
OBJECTIVES The timely diagnosis of primary bone malignancies in pediatric patients is critical to clinical outcomes. The purpose of this study is to investigate the initial presentation of pediatric bone sarcoma patients to an academic health care system and assess the current interval to diagnosis. METHODS We conducted a retrospective review of pediatric patients (aged 1-18) with biopsy-proven diagnosis of osteosarcoma or Ewing sarcoma presenting between 2004 and 2020. All living patients had 1 year or more of follow-up. Primary outcomes were interval to diagnosis, clinical features on initial presentation, percent of patients with negative radiographic workup at initial presentation, and number of health care encounters before diagnosis. RESULTS Seventy-one patients (osteosarcoma, 51; Ewing sarcoma, 20) were included. Average age at presentation was 13.1 ± 3.3 years (range, 4.4-18.3). Average symptom duration was 5.4 ± 13.9 months (range, 0.1-84). Clinical features at initial presentation included limb/back pain (91.5% of patients), activity modification/pain medication use (78.9%), palpable mass (40.8%), night pain (35.2%), limp (25.4%), limb disuse (18.3%), and recent fever history (2.8%). Fourteen of 71 patients (19.7%) had negative radiographs at initial presentation. Average number of health care encounters before diagnosis was 1.9 ± 0.6 (range, 1.0-4.0), with most in the outpatient pediatrician clinics (81.2%) and emergency department (18.3%). Average time to diagnosis from initial presentation was 19.5 ± 65 days (range, 0-493); the 14 patients with initial negative radiographs had a statistically significant prolonged interval to diagnosis of 54 ± 134 days (range, 0-493; P = 0.018). CONCLUSIONS We found pediatric patients with primary bone sarcoma present with an average interval to diagnosis of 20 days. Twenty percent of patients had a significantly prolonged interval to diagnosis of 54 days. Clinical features suggest night pain is not a sensitive indicator. In patients of appropriate age with persistent unilateral pain in suspicious locations, early advanced imaging with magnetic resonance imaging should be considered.
Collapse
|
4
|
Al Khader A, Habaibeh E, Tawalbeh HY, Mansour BM, Mansour SM, Haj Ahmad AN, Owais TT, Odeh H. Myositis ossificans of the chest wall in an 8-year-old boy: a case report of a diagnostic pitfall. Indian J Thorac Cardiovasc Surg 2023; 39:186-189. [PMID: 36785605 PMCID: PMC9918642 DOI: 10.1007/s12055-022-01463-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 01/01/2023] Open
Abstract
Myositis ossificans of the chest wall is extremely unusual with fewer than a dozen reported cases. In addition, the occurrence in children younger than 10 years is extremely rare. We report a case of an 8-year-old male who presented with painful and progressively enlarging left-sided chest wall mass. The tumor showed close histo-morphological mimicry with osteosarcoma. Moreover, the characteristic radiographic findings of myositis ossificans were absent. The age of the patient and the absence of attachment to the rib helped exclude extra-skeletal and parosteal osteosarcomas, respectively. The patient was doing well 4 months after surgery.
Collapse
Affiliation(s)
- Ali Al Khader
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
- Al-Hussein Salt Hospital, Al-Salt, Jordan
| | | | | | | | | | | | - Tala Tariq Owais
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Hadeel Odeh
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| |
Collapse
|
5
|
Broski SM, Wenger DE. Multimodality imaging features of USP6-associated neoplasms. Skeletal Radiol 2023; 52:297-313. [PMID: 35962835 DOI: 10.1007/s00256-022-04146-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 02/02/2023]
Abstract
Since the discovery of USP6 gene rearrangements in aneurysmal bone cysts nearly 20 years ago, we have come to recognize that there is a family of USP6-driven mesenchymal neoplasms with overlapping clinical, morphologic, and imaging features. This family of neoplasms now includes myositis ossificans, aneurysmal bone cyst, nodular fasciitis, fibroma of tendon sheath, fibro-osseous pseudotumor of digits, and their associated variants. While generally benign and in many cases self-limiting, these lesions may undergo rapid growth, and be confused with malignant bone and soft tissue lesions, both clinically and on imaging. The purpose of this article is to review the imaging characteristics of the spectrum of USP6-driven neoplasms, highlight key features that allow distinction from malignant bone or soft tissue lesions, and discuss the role of imaging and molecular analysis in diagnosis.
Collapse
Affiliation(s)
- Stephen M Broski
- Department of Radiology, Mayo Clinic, Charlton Building North, 1st Floor, 200 First Street SW , Rochester, MN, 55905, USA.
| | - Doris E Wenger
- Department of Radiology, Mayo Clinic, Charlton Building North, 1st Floor, 200 First Street SW , Rochester, MN, 55905, USA
| |
Collapse
|
6
|
Dietz M, Tordo J. Metabolic Activity of Neurogenic Heterotopic Ossification on 18F-FDG PET/CT Matching with Ongoing Osteoblastic Activity on Bone Scan. Mol Imaging Radionucl Ther 2022; 31:166-168. [PMID: 35771089 PMCID: PMC9246304 DOI: 10.4274/mirt.galenos.2021.48243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 54-year-old man, with previous history of neurogenic heterotopic ossification (HO) in muscles around the left hip following a spinal cord injury ten months earlier, was referred to our nuclear medicine center for an 18fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to rule out a spondylodiscitis. No sign of spondylodiscitis was found on 18F-FDG PET/CT, but images revealed an increased 18F-FDG uptake in HO areas, matching with ongoing osteoblastic activity on a following bone scan.
Collapse
Affiliation(s)
- Matthieu Dietz
- Hospices Civils de Lyon, Department of Nuclear Medicine, Lyon, France
| | - Jeremie Tordo
- Hospices Civils de Lyon, Department of Nuclear Medicine, Lyon, France
| |
Collapse
|
7
|
Lanuza Lagunilla L, Ramírez Barragán A, Miranda Gorozarri C. Ossifying myositis in the infant. About a case. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021. [DOI: 10.1016/j.recote.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
8
|
Sasaki M, Hotokezaka Y, Ideguchi R, Uetani M, Fujita S. Traumatic myositis ossificans: multifocal lesions suggesting malignancy on FDG-PET/CT-a case report. Skeletal Radiol 2021; 50:249-254. [PMID: 32588098 PMCID: PMC7677150 DOI: 10.1007/s00256-020-03521-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 02/06/2023]
Abstract
Myositis ossificans (MO) is a benign soft-tissue lesion characterized by the heterotopic formation of the bone in skeletal muscles, usually due to trauma. MO is occasionally difficult to diagnose because of its clinical and radiological similarities with malignancy. We report a case of traumatic MO (TMO) in the masseter and brachial muscles of a 37-year-old man who presented with painless swelling in the left cheek and severe trismus. Due to the absence of a traumatic history at the first consultation and identification of a tumorous lesion in the left masseter muscle by magnetic resonance imaging (MRI), the lesion was suspected to be a malignant tumor. Subsequently, 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) showed multiple regions of high FDG uptake across the whole body, suggestive of multiple metastases or other systemic diseases. However, intramuscular calcifications were also observed in the left masseter and brachial muscles, overlapping the areas with high FDG uptake. Moreover, multiple fractures were seen in the rib and lumbar spine, also overlapping the areas with high FDG uptake. Based on these imaging findings, along with a history of jet-ski trauma, TMO was suspected. The left cheek mass was surgically excised and histologically diagnosed as TMO. In this case report, FDG-PET/CT could detect multiple TMOs across the whole body. To the best of our knowledge, cases of multiple TMOs located far apart in different muscles are rare, and this may be the first report.
Collapse
Affiliation(s)
- Miho Sasaki
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Yuka Hotokezaka
- Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.
| | - Reiko Ideguchi
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Masataka Uetani
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Shuichi Fujita
- Department of Oral Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| |
Collapse
|
9
|
Lanuza Lagunilla L, Ramírez Barragán A, Miranda Gorozarri C. Ossifying myositis in the infant. About a case. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 65:152-157. [PMID: 32709564 DOI: 10.1016/j.recot.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/15/2020] [Accepted: 05/15/2020] [Indexed: 11/27/2022] Open
Abstract
Myositis ossificans is a benign disorder characterized by the formation of heterotopic bone in skeletal muscle or soft tissues. It is extremely rare in children, <1% of cases occur in children under 10 years. We present a 17-day-old boy that, after 10 days of Intermediate Care Unit stay, was referred to our hospital for a developmental dysplasia of the hip. On clinical examination, he had swelling on the left thigh and increase in size compared to the contralateral one, therefore was admitted for studying. Imaging findings including plain radiographs, CT, MRI and bone scintigraphy, as well as treatment performed, are described. To the best of our knowledge, is the youngest case reported in the literature.
Collapse
Affiliation(s)
- L Lanuza Lagunilla
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Infantil Universitario Niño Jesús, Madrid, España.
| | - A Ramírez Barragán
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - C Miranda Gorozarri
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| |
Collapse
|
10
|
Zubler V, Mühlemann M, Sutter R, Götschi T, Müller DA, Dietrich TJ, Pfirrmann CW. Diagnostic utility of perilesional muscle edema in myositis ossificans. Skeletal Radiol 2020; 49:929-936. [PMID: 31907558 DOI: 10.1007/s00256-019-03351-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the value of extensive perilesional muscle edema for the differentiation between myositis ossificans (MO) and malignant intramuscular soft tissue tumors on MRI. MATERIALS AND METHODS Two blinded readers analyzed MR examinations of 90 consecutive patients with intramuscular soft tissue masses (group 1: MO, n = 20; group 2: malignant tumors, n = 70). Extent of edema around lesions was graded (0, none; 1, minimal edema; 2, moderate edema; 3, extensive edema). Edema-lesion ratio (ELR = ratio of the maximal diameter of the edema and the maximal diameter of the central lesion) was calculated. ROC analysis, Mann-Whitney U test, and Kappa test were used. RESULTS A total of 70% and 60% of patients with MO had edema grade 3 (reader 1/reader 2), 30%/40% edema grade 2. For the patients with malignant tumors, it was 2.9%/1.4% (edema grade 3) and 16%/23% (edema grade 2). Interrater reliability was substantial (kappa = 0.66). Extent of edema was significantly higher for patients of group 1 (p < 0.0001, both readers). Mean ELR was 3.60 (group 1) and 1.35 (group 2), with statistically significant differences (p < 0.0001). Grade 3 edema showed a sensitivity/specificity of 70%/97.1% (reader 1) and 60%/99% (reader 2) for diagnosing MO. For ELR > 2.0, sensitivity was 90% and specificity 91% for diagnosing MO. CONCLUSIONS Extensive perilesional muscle edema on MRI of more than double the size of the central lesion is highly specific, but not pathognomonic for myositis ossificans in the early/intermediate stage in the differentiation to malignant intramuscular soft tissue lesions.
Collapse
Affiliation(s)
- Veronika Zubler
- Faculty of Medicine, University of Zurich, Zurich, Switzerland. .,Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Malin Mühlemann
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Reto Sutter
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Tobias Götschi
- Unit for Clinical and Applied Research, Balgrist University Hospital, Zurich, Switzerland.,Laboratory for Orthopaedic Biomechanics, ETH Zurich, Switzerland
| | - Daniel A Müller
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Orthopedic Surgery, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Tobias J Dietrich
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Christian W Pfirrmann
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Radiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
| |
Collapse
|
11
|
Myositis ossificans traumatica of the piriformis muscle: a rare mature case in an adult African male. Surg Radiol Anat 2019; 41:1513-1517. [PMID: 31586233 DOI: 10.1007/s00276-019-02349-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
Myositis ossificans traumatica (MOT) is a common form of heterotopic ossification associated to trauma. Rare mature manifestations and topographically atypical presentations of MOT are often misdiagnosed as osteosarcoma. This case study discusses a rare, mature case of MOT of the piriformis muscle, potentially clinically associated with piriformis syndrome. The ossification was observed on a dry sacral bone of an adult skeleton belonging to a South African male during routine inventory of the Raymond A. Dart Collection of Human Skeletons, the University of the Witwatersrand, Johannesburg. The MOT was located on the anterior aspect of the sacrum at a site corresponding to the upper portion of the origin of the muscle and extended laterally towards the greater trochanter, beyond the greater sciatic notch. It was cylindrical in shape and measured approximately 52.70 mm in length and 12.10 mm in diameter. Micro-focus CT revealed an extensive and mature bony development of the piriformis muscle with distinct outer cortical and inner trabecular bone. In addition, the skeleton showed widespread healed skeletal trauma, suggesting a history of trauma. The MOT was completely fused to the sacral bone excluding the possibility of congenital anomalies. Information on the MOT of the piriformis muscle is vital to clinicians and radiographers to aid in successful diagnosis and management of the piriformis syndrome and sciatica in the gluteal region. This case also provides a rare example to biological anthropologists, paleoanthropologists and bioarchaeologists of the representation of pathologies like these on a dry bone sample.
Collapse
|
12
|
Sferopoulos NK, Kotakidou R, Petropoulos AS. Myositis ossificans in children: a review. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017; 27:491-502. [DOI: 10.1007/s00590-017-1932-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/16/2017] [Indexed: 12/29/2022]
|
13
|
Ozbayrak M, Guner AL, Unal VS, Tokat F, Er O, Karaarslan E. 18F-fluorodeoxyglucose-positron emission tomography avid paraspinal soft-tissue mass mimicking a malign neoplasm: non-traumatic myositis ossificans. Spine J 2016; 16:e705-e706. [PMID: 27001110 DOI: 10.1016/j.spinee.2016.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 03/09/2016] [Accepted: 03/15/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Mustafa Ozbayrak
- Medical Imaging Department,Istanbul University,Kocamustafapasa, Istanbul 34090, Turkey
| | - Ahmet Levent Guner
- Department of Nuclear Medicine, Acibadem University,Maslak Hospital, Istanbul 34457, Turkey
| | - Vuslat Sema Unal
- Department of Orthopedic Surgery, Acibadem University,Maslak Hospital, Istanbul 34457, Turkey
| | - Fatma Tokat
- Department of Pathology, Acibadem University,Maslak Hospital, Istanbul 34457, Turkey
| | - Ozlem Er
- Department of Medical Oncology, Acibadem University,Maslak Hospital, Istanbul 34457, Turkey
| | - Ercan Karaarslan
- Department of Radiology, Acibadem University,Maslak Hospital, Istanbul 34457, Turkey
| |
Collapse
|
14
|
Yamaga K, Kobayashi E, Kubota D, Setsu N, Tanaka Y, Minami Y, Tanzawa Y, Nakatani F, Kawai A, Chuman H. Pediatric myositis ossificans mimicking osteosarcoma. Pediatr Int 2015; 57:996-9. [PMID: 26508182 DOI: 10.1111/ped.12672] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 02/10/2015] [Accepted: 02/19/2015] [Indexed: 10/23/2022]
Abstract
Myositis ossificans (MO) is a rare benign cause of heterotopic bone formation in soft tissue that most commonly affects young adults, typically following trauma. We report the case of an 11-year-old girl who developed MO mimicking osteosarcoma in her right shoulder. Plain radiography and computed tomography showed poorly defined flocculated densities in the soft tissue and a periosteal reaction along the proximal humerus. On magnetic resonance imaging, the mass displayed an ill-defined margin and inhomogeneous signal change. Histologically, the mass had a pseudosarcomatous appearance. Based on these findings, the patient was initially misdiagnosed with osteosarcoma at another hospital. The diagnosis was difficult because the patient was 11 years old and had no trauma history, with atypical radiographic changes and a predilection for the site of origin for osteosarcomas. We finally made the correct diagnosis of MO by carefully reviewing and reflecting on the pathological differences between stages.
Collapse
Affiliation(s)
- Kensaku Yamaga
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Eisuke Kobayashi
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Daisuke Kubota
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Nokitaka Setsu
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuya Tanaka
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Minami
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshikazu Tanzawa
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Fumihiko Nakatani
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akira Kawai
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hirokazu Chuman
- Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
15
|
Luczyńska E, Kasperkiewicz H, Domalik A, Cwierz A, Bobek-Billewicz B. Myositis ossificans mimicking sarcoma, the importance of diagnostic imaging - case report. Pol J Radiol 2014; 79:228-32. [PMID: 25077008 PMCID: PMC4114761 DOI: 10.12659/pjr.890209] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/27/2014] [Indexed: 11/19/2022] Open
Abstract
Background Myositis ossificans is localized inflammatory process affecting skeletal muscles. Very rarely it can affect one of the neck muscles and present as a neck tumor, it can be misdiagnosed as the clinical, radiological and histological examinations can mimic a sarcoma. Case Report We report a 29 year old female patient with neck tumor suspected to be a sarcoma who underwent full diagnostics imaging and open bipsy with histopatological examination, afterwards surgical excision was performed. Conclusions The aim of this study was to present the differential diagnosis based on diagnostics imaging between MO and malignant tumors, such as parosteal sarcoma, synovial sarcoma and malignant fibrous histiocytoma.
Collapse
Affiliation(s)
- Elżbieta Luczyńska
- Department of Radiology and Diagnostic Imaging, Oncology Center and Institute. M. Skłodowska-Curie in Cracow, Cracow, Poland
| | - Hanna Kasperkiewicz
- Department of Radiology and Diagnostic Imaging, Oncology Center and Institute. M. Skłodowska-Curie in Cracow, Cracow, Poland
| | - Agnieszka Domalik
- Department of Radiology and Diagnostic Imaging, Oncology Center and Institute. M. Skłodowska-Curie in Cracow, Cracow, Poland
| | - Anna Cwierz
- Department of Radiology and Diagnostic Imaging, Oncology Center and Institute. M. Skłodowska-Curie in Cracow, Cracow, Poland
| | - Barbara Bobek-Billewicz
- Department of Radiology, Oncology Center and Institute. M. Sklodowska-Curie in Gliwice, Gliwice, Poland
| |
Collapse
|
16
|
Agrawal K, Bhattacharya A, Harisankar CNB, Abrar ML, Mittal BR, Tripathy SK, Sen RK. [18F]Fluoride and [18F]fluorodeoxyglucose PET/CT in myositis ossificans of the forearm. Eur J Nucl Med Mol Imaging 2011; 38:1956. [PMID: 21448700 DOI: 10.1007/s00259-011-1794-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 03/07/2011] [Indexed: 02/05/2023]
Affiliation(s)
- Kanhaiyalal Agrawal
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | | | | | | | | | | | | |
Collapse
|