Juvenile Hyaline Fibromatosis

The diagnostic challenge of juvenile hyaline fibromatosis, a case report with literature reviews

Introduction

Juvenile hyaline fibromatosis (JHF) is a rare genetic condition characterized by impaired collagen production or metabolism. This study aims to present a rare case of JHF.

Case report

An 11-year-old boy presented with bilateral keloid-like lesions on his ears and admitted intermittent reappearance of such lesions since he was seven. He was born to second-degree relative consanguineous parents. Physical examination revealed bilateral soft pink masses on the ears, multiple scars on the scalp, severe gingival hypertrophy, multiple small soft white papules on the anterior neck, broadly shaped enlargements on the ends of the fingers and toes, and multiple reticulated hard livedoid and hyperpigmented macules on the back and anterior lower extremities. A 5 mm biopsy was taken from the lesion on the ear and histopathological examination of the specimen revealed a normal epidermis but dermal and subcutaneous deposits of nodules composed of abundant amorphous eosinophilic hyaline material with sparse embedded fibroblast associated with areas of congestion and focal hemorrhage. The ear lesions were managed by surgical excision with intraregional steroid injections to prevent relapse. To improve eating ability and oral hygiene, a gingivectomy was planned.

Discussion

JHF presents with bone lesions, gingival hypertrophy, joint contractures, and skin lesions. The clinical features usually appear late in infancy and up to 5 years. The condition occurs mostly sporadically. A portion of the cases can be in siblings born to consanguineous parents.

Conclusion

JHF is a rare genetic disorder that can present even beyond five years. There is no standard treatment for these cases.

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Juvenile hyaline fibromatosis is an exceedingly rare genetic condition.

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Impaired collagen production or metabolism characterizes the disease.

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The clinical features usually appear late in infancy and up to 5 years.

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This report delivers a rare circumstance of juvenile hyaline fibromatosis.

Atypical Presentation of Juvenile Hyaline Fibromatosis of Hands

Juvenile hyaline fibromatosis is a rare disorder characterized by an extracellular accumulation of hyaline deposit. In the extremities, lesions may remain quiescent or gradually increase in size, eventually resulting in skin ulceration. There is no curative treatment. Surgery may allow some recovery of function, but recurrence is possible. We report a case of juvenile hyaline fibromatosis in both hands of a 25-year-old man who required multiple surgical procedures to address problems with function, pain, and appearance.

Imaging manifestations of juvenile hyaline fibromatosis: a case report and literature review

Objective:

Juvenile hyaline fibromatosis (JHF) is an autosomal recessive condition caused by a mutation in capillary morphogenesis gene 2 (CMG2) on chromosome 4q21. JHF is an extremely rare genetic disorder, and fewer than a hundred cases have been reported worldwide. In this case report, the clinical features, histopathological features and imaging manifestations of a case of JHF are presented. We present imaging manifestations of one case of JHF to deepen the radiologist’s understanding of this condition. The histopathological feature of JHF is hyaline degeneration involving skeletal muscle. Therefore, the lesion has a slightly high density on CT imaging, iso- or hypointense signal on T₁WI and hypointense signal on T₂WI. The boundary between the lesion and skeletal muscle is unclear.

Methods:

An 8-year-old male (Case 1) was examined in our department with a complaint of multiple masses on the head, neck and back in 2021. The boy was the only child of his parents and was delivered at 40 weeks gestation by caesarean section. His parents were non-consanguineous.

Results :

JHF displays multiple slowly or rapidly growing subcutaneous nodules. The imaging manifestations can reflect histopathological components, including nodular connective tissue and amorphous, partially calcified hyaline material.

[Hyaline juvenile fibromatosis: clinic, diagnostics, treatment]

Hyaline juvenile fibromatosis is a rare genetic disease, which is associated with ANTXR2 gene defect. Almost all organs and systems of the body are affected in this pathology. There are clinical symptoms: joint contracture, hyperpigmentation, skin damage like nodules, which can have different sizes, locations and forms, throughout the body, fibromatosis of the gums, internal organs damages (splenomegaly, hepatomegaly, anomalies of the kidneys and other organs), osteoporosis, increased susceptibility to infectious diseases, mental underdevelopment. In this article we describe clinical case of 6-old patient witht hyaline juvenile fibromatosis. The diagnosis was made on the basis of the clinical picture, additional research methods and the results of molecular genetic testing. The patient underwent a number of surgical interventions, histological examination of the surgical material and symptomatic therapy.

Juvenile hyaline fibromatosis: a rare oral disease case report and literature review

Juvenile hyaline fibromatosis (JHF) is a rare recessive autosomal hereditary disorder characterized by papulonodular skin, gingival hyperplasia, flexural joint contractures, and osteolytic bone lesions. Worldwide, less than 70 cases have been reported. JHF is thought to be a disorder of collagen metabolism which is caused by genomic sequence variations in the ANTXR2/CMG2 gene and is characterized by homogenous amorphous hyaline material and fibrous tissue. JHF is most commonly diagnosed in infants and in children less than 5 years. We report a 28-month-old child of a consanguineous marriage who presented with severe gingival hyperplasia, multiple facial nodules, posterior occipital tumors, joint contractures, and osteolytic bone lesions. His limbs and fingers cannot be straightened, with a posture of frog pose. The occlusal and incisal surfaces of the teeth were completely covered with the gingival overgrowth. The gingival hypertrophy and facial swellings were surgically removed, with pathological features of monomorphic spindled cell proliferation surrounded by an abundant amorphous hyaline matrix. The genome sequencing was performed that a homozygous nucleotide mutation of ANTXR2/CMG2 gene was found. We outline this particular patient's presentation, followed by a discussion highlighting the characteristics that change with the condition and the treatments of this disease. The treatment of JHF is generally symptomatic treatment and requires multidisciplinary care. Physical rehabilitation has been advocated for a lifetime.