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Cunha BSA, Cassini Marques LO, Chahud F, Cruz AAV. Large congenital myopericytoma of the lower eyelid. Orbit 2024:1-4. [PMID: 39352797 DOI: 10.1080/01676830.2024.2403457] [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: 08/02/2024] [Accepted: 09/06/2024] [Indexed: 10/04/2024]
Abstract
Congenital fibrous soft tissue tumors in the eyelids are exceptionally rare, with only seven cases of neonatal myofibromas reported. Myopericytoma, a variant with pericytic differentiation, has not previously been described in neonatal eyelid tumors. This report details a case of a massive congenital myopericytoma in a newborn's lower eyelid. The lesion had a broad area of adhesion to the anterior lamella of the lid. After resection, when the child was 11 days old, the resulting defect was successfully reconstructed with a V-Y type perforator-based flap.
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Affiliation(s)
- Barbara Salomão A Cunha
- Department of Ophthalmology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
- Department of Ophthalmology, Santa Casa of Belo Horizonte, Belo Horizonte, Brazil
| | | | - Fernando Chahud
- Department of Pathology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - Antonio Augusto V Cruz
- Department of Ophthalmology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
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2
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Periorbital Myofibroma in a Child: A Case Report and Review of the Literature. Ophthalmic Plast Reconstr Surg 2021; 36:e127-e128. [PMID: 32251175 DOI: 10.1097/iop.0000000000001632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Infantile myofibroma is a rare benign tumor usually diagnosed before the age of 2 and found in the head and neck but much more rarely in the orbital region. There have only been 7 cases of periorbital myofibromas reported in children in the literature to date. The current case is of an 8-year-old boy with a left upper eyelid myofibroma confirmed on histopathological and immunochemical analysis. A literature review of periorbital myofibromas has been performed to bring the reader up-to-date with the current understanding and management of the disease.
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3
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Lavie JL, Rogers CL, Stalder MW, St Hilaire H. Primary Resection and Immediate Autologous Reconstruction of Fronto-orbital Infantile Myofibromatoses. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3261. [PMID: 33552804 PMCID: PMC7858576 DOI: 10.1097/gox.0000000000003261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
Infantile myofibromatosis is an unusual and rare lesion of the bone and soft tissue, which can be seen in the craniofacial skeleton. These complex tumors present a challenge to craniofacial surgeons regarding diagnosis, management, and safe and effective surgical treatment, frequently requiring complex reconstruction. We present the case of a 7-month-old girl with multicentric infantile myofibromatosis of the right parietal and fronto-orbital region, the associated clinical presentation, histopathologic findings, and surgical management, along with a review of the relevant literature.
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Affiliation(s)
- Jennifer L Lavie
- Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, La
| | - Camille L Rogers
- Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, La
| | - Mark W Stalder
- Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, La.,Division of Plastic and Reconstructive Surgery, Children's Hospital, New Orleans, La
| | - Hugo St Hilaire
- Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, La.,Division of Plastic and Reconstructive Surgery, Children's Hospital, New Orleans, La
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Abstract
BACKGROUND Infantile myofibromatiosis (IM) is a rare benign tumor in the infants, but it has a bad prognosis if IM erncroaches on the viscera. Multiple tissues can be invaded by IM, including the subcutaneous tissue, the muscle of the neck, back, and head, but seldom in the bones and the viscera. The histopathologic and immunohistochemical examinations are necessary in daigonosis of IM as it might be misdiagnosed as the malignant tumor. MATERIALS AND METHOD Thirty-two consecutive patients with IM in our hospital (2003-2013) were enrolled and the clinical date were analyzed to understand IM better, such as the feature of clinical manifestations, pathology, imaging tests, and treatment. RESULTS All of them underwent excision operations, 4 of them with invasion in the bones, 2 with invasion in the craniums, and the rest in the ulna and the humerus. The immunohistiochemical analysis shown that the tumor cells were positive to vimentin and smooth muscle actin while negative to the S100 protein and desmin. Twenty-five patients were in follow-up, 2 cases recurred. CONCLUSIONS IM is a benign tumor, but IM with the viscera involvement has a bad prognosis. The strategy of waiting and observation for IM without visceral involvement could be selected.
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Effects of Sunitinib and Other Kinase Inhibitors on Cells Harboring a PDGFRB Mutation Associated with Infantile Myofibromatosis. Int J Mol Sci 2018; 19:ijms19092599. [PMID: 30200486 PMCID: PMC6163232 DOI: 10.3390/ijms19092599] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 12/23/2022] Open
Abstract
Infantile myofibromatosis represents one of the most common proliferative fibrous tumors of infancy and childhood. More effective treatment is needed for drug-resistant patients, and targeted therapy using specific protein kinase inhibitors could be a promising strategy. To date, several studies have confirmed a connection between the p.R561C mutation in gene encoding platelet-derived growth factor receptor beta (PDGFR-beta) and the development of infantile myofibromatosis. This study aimed to analyze the phosphorylation of important kinases in the NSTS-47 cell line derived from a tumor of a boy with infantile myofibromatosis who harbored the p.R561C mutation in PDGFR-beta. The second aim of this study was to investigate the effects of selected protein kinase inhibitors on cell signaling and the proliferative activity of NSTS-47 cells. We confirmed that this tumor cell line showed very high phosphorylation levels of PDGFR-beta, extracellular signal-regulated kinases (ERK) 1/2 and several other protein kinases. We also observed that PDGFR-beta phosphorylation in tumor cells is reduced by the receptor tyrosine kinase inhibitor sunitinib. In contrast, MAPK/ERK kinases (MEK) 1/2 and ERK1/2 kinases remained constitutively phosphorylated after treatment with sunitinib and other relevant protein kinase inhibitors. Our study showed that sunitinib is a very promising agent that affects the proliferation of tumor cells with a p.R561C mutation in PDGFR-beta.
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6
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Intraosseous myofibroma of the femoral neck: a case report and review of the literature. CURRENT ORTHOPAEDIC PRACTICE 2017. [DOI: 10.1097/bco.0000000000000543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Dégardin N, Jaloux C, Mallet S, Hesse S, Bardot J. [Skin tumors in children]. ANN CHIR PLAST ESTH 2016; 61:498-512. [PMID: 27374221 DOI: 10.1016/j.anplas.2016.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 05/30/2016] [Indexed: 11/28/2022]
Abstract
The presence of a congenital or acquired cutaneous lesion is a frequent reason for consultation in pediatric plastic surgery unit. The management of these lesions requires a good knowledge of specific diagnoses in children. This step is sometimes difficult because of the multiplicity of possible diagnosis. Some skin tumors may be the external sign of a general disease or an underlying malformation; those can change the overall prognosis and management and require to be properly identified. The decision of surgical excision depends on various criteria, including diagnosis but also the reconstruction possibilities. The timing of surgical treatment depends on the medical emergency of the tumor resection (benign tumor, spontaneously regressive tumor, risk of degeneration into malignancy), on the cosmetic and psychological impact but also on the growth or learning steps in child life. This article first provides an aid in the diagnosis of the most common or more characteristic skin tumors. The algorithm is principally based on the pigmentation aspect of the tumor. The age and conditions of the surgical management are specified for each type of tumor. Cutaneous hemangiomas and vascular malformations, and congenital cysts and fistulas are not reported in this article.
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Affiliation(s)
- N Dégardin
- Service de chirurgie plastique pédiatrique, hôpital Timone-Enfants, CHU de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
| | - C Jaloux
- Service de chirurgie plastique pédiatrique, hôpital Timone-Enfants, CHU de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - S Mallet
- Unité de dermatologie pédiatrique, hôpital Timone CHU de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - S Hesse
- Unité de dermatologie pédiatrique, hôpital Timone CHU de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - J Bardot
- Service de chirurgie plastique pédiatrique, hôpital Timone-Enfants, CHU de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
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8
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MacIntosh PW, Grob SR, Stagner AM, Kazlas MA, Jakobiec FA, Yoon MK, Lee NG. Multicentric myofibromatosis presenting as a large congenital eyelid myofibroma. J AAPOS 2016; 20:70-3. [PMID: 26917077 DOI: 10.1016/j.jaapos.2015.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 12/01/2022]
Abstract
Infantile myofibromatosis is a rare mesenchymal neoplasm that commonly involves the head and neck but rarely the eyelid. We report the case of a newborn boy referred for evaluation of a left eyelid lesion that occluded the visual axis. Urgent biopsy was performed to evaluate for malignancy. Histopathologic analysis demonstrated myofibroma. Although these lesions have been reported to regress spontaneously, debulking surgery was performed to prevent sensory or anisometropic amblyopia. Follow-up systemic evaluation revealed numerous subcutaneous and deep soft tissue lesions. There was no visceral involvement.
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Affiliation(s)
- Peter W MacIntosh
- Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Seanna R Grob
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Anna M Stagner
- Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary
| | - Melanie A Kazlas
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Pediatric Ophthalmology and Strabismus, Massachusetts Eye and Ear Infirmary
| | - Frederick A Jakobiec
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary
| | - Michael K Yoon
- Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
| | - Nahyoung Grace Lee
- Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
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9
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Argenta AE, Chen W, Davis A, Losee JE, Davit A, Grunwaldt L. A review of eight unusual pediatric skin and soft-tissue lesions: Diagnosis, workup, and treatment. J Plast Reconstr Aesthet Surg 2015; 68:1637-46. [DOI: 10.1016/j.bjps.2015.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 05/22/2015] [Accepted: 06/20/2015] [Indexed: 11/26/2022]
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10
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Ruptured Infantile Myofibroma of the Head Presenting in a Neonate: Case Report and Review of the Literature. World Neurosurg 2015; 98:884.e13-884.e18. [PMID: 26459706 DOI: 10.1016/j.wneu.2015.09.106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 09/21/2015] [Accepted: 09/23/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Infantile myofibroma/myofibromatosis (IM/M) is a myofibroblastic proliferative disorder often seen in infants and children. IM/M can result in congenital tumors of the head and neck and may occasionally present to the neurosurgeon. CASE DESCRIPTION We report a case of a solitary ruptured myofibroma of the head in a newborn patient. The lesion was initially suggestive of encephalocele. We describe the presentation and management of this patient, including relevant imaging, histopathologic evaluation, and surgical technique. We subsequently review the literature of IM/M of the head and neck, highlighting the 3 forms of the condition, each requiring a distinct management strategy. CONCLUSIONS Although this tumor rarely presents to the neurosurgeon, it may do so in the process of ruling out other more dangerous conditions. It is therefore important to consider this diagnosis in masses that occur in the head and neck of newborns.
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11
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Mbekeani JN, Kemeny JL, Nezzar H. Infantile orbital myofibroma. Int J Pediatr Adolesc Med 2015; 2:44-46. [PMID: 30805436 PMCID: PMC6372367 DOI: 10.1016/j.ijpam.2015.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 03/09/2015] [Accepted: 03/22/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Joyce N Mbekeani
- Dept. of Surgery, North Bronx Health Network, Bronx, NY, USA.,Dept. of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA
| | | | - Hachemi Nezzar
- Image-Guided Clinical Neurosciences and Connectomics, IGCNC, Université d'Auvergne, Clermont Ferrand, France.,Dept. of Ophthalmology, CHU Clermont Ferrand, Clermont-Ferrand, France.,Dept. of Ophthalmology, KFSH&RC, Riyadh, Saudi Arabia
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12
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Linhares ND, Freire MCM, Cardenas RGCCL, Pena HB, Bahia M, Pena SDJ. Exome sequencing identifies a novel homozygous variant in NDRG4 in a family with infantile myofibromatosis. Eur J Med Genet 2014; 57:643-8. [PMID: 25241110 DOI: 10.1016/j.ejmg.2014.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 08/31/2014] [Indexed: 10/24/2022]
Abstract
Infantile myofibromatosis (IM) is a rare disorder characterized by the development of benign tumors in the skin, muscle, bone, and viscera. The incidence is 1/150,000 live births and the disease is the most common cause of fibrous tumors in infancy. Cases which lack visceral involvement generally have a more benign course, usually with spontaneous regression of the tumors. On the other hand, the prognosis tends to be unfavorable when there is involvement of vital organs, which can lead to significant mortality. The identification of rare variants in genes that may cause IM is the first step towards the possibility of targeted treatments; however, the molecular pathogenesis of IM is poorly understood. In the present study, we report the results of exome sequence analysis of two brothers diagnosed with visceral multicentric infantile myofibromatosis, and their healthy consanguineous parents. In the two brothers we identified novel homozygous variants in NDRG4 gene (N-myc downregulated gene family member 4) and in RLTPR gene (RGD motif, leucine rich repeats, tropomodulin domain and proline-rich containing). The healthy parents were heterozygous for both variants. Consistent with the phenotype of IM, NDRG4 is a tumor-related gene; its expression has been shown to be decreased in numerous tumor types, suggesting that it might be a tumor suppressor gene. Additionally, studies have demonstrated that NDRG4 may have a role in cell survival and tumor invasion. We thus propose that this homozygous variant in NDRG4 may be the causative variant of the autosomal recessive form of IM in the studied family and that it should be investigated in other cases of autosomal recessive infantile myofibromatosis.
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Affiliation(s)
- Natália D Linhares
- Laboratório de Genômica Clínica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maíra C M Freire
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raony G C C L Cardenas
- Laboratório de Genômica Clínica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Heloísa B Pena
- Laboratório Gene - Núcleo de Genética Médica, Belo Horizonte, Brazil
| | - Magda Bahia
- Divisão de Gastroenterologia Pediátrica, Hospital das Clínicas da UFMG, Belo Horizonte, Brazil
| | - Sergio D J Pena
- Laboratório de Genômica Clínica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Laboratório Gene - Núcleo de Genética Médica, Belo Horizonte, Brazil.
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13
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Wu W, Chen J, Cao X, Yang M, Zhu J, Zhao G. Solitary infantile myofibromatosis in the bones of the upper extremities: Two rare cases and a review of the literature. Oncol Lett 2013; 6:1406-1408. [PMID: 24179532 PMCID: PMC3813798 DOI: 10.3892/ol.2013.1584] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 09/04/2013] [Indexed: 11/11/2022] Open
Abstract
Infantile myofibromatosis (IM) is the most common fibrous tumor of infancy. IM may arise in a solitary or multicentric form, with similar histopathological findings, however, the clinical features and prognoses may vary. The solitary form tends to occur predominantly in males and is typically observed in the dermis, subcutis or deep soft tissues. The reported incidence of solitary osseous myofibromatosis is rare. Furthermore, the majority of solitary IM cases of the bone occur in the craniofacial bones, while the occurrence of solitary osseous myofibromatosis on the extremities has been sporadically reported. The present study describes two cases of solitary IM involving the bones of the upper extremities in females who were over two years old. The cases show unusual symptom presentation and the tumor origin is in a rarely observed location. The study discusses the clinical, radiological and pathological features, in addition to the previously described etiology, prognosis and treatment options for this condition.
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Affiliation(s)
- Weiliang Wu
- Department of Orthopedics, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
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