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Georgiev A, Genova S, Uchikov P, Kraev K, Kraeva M, Chakarov D, Uchikov A. Solitary primary intraosseous xanthoma of the mandible in a 15-year-old boy: a case report. J Med Case Rep 2024; 18:225. [PMID: 38711147 PMCID: PMC11075217 DOI: 10.1186/s13256-024-04534-y] [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: 01/19/2024] [Accepted: 04/01/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND A xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor. CASE REPORT A 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods. CONCLUSION The diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis.
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Affiliation(s)
- A Georgiev
- Department of Maxillo Facial Surgery, Multiprofile Hospital for Active Medical Treatment "Sv. Panteleimon" Plovdiv, Plovdiv, Bulgaria
| | - S Genova
- Department of General and Clinical Pathology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - P Uchikov
- Department of Special Surgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Krasimir Kraev
- Department of Propedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 15A Vasil Aprilov Boulevard, Plovdiv, 4000, Bulgaria.
| | - M Kraeva
- Department of Otorhinolaryngology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - D Chakarov
- Department of Propaedeutics of Surgical Diseases, Section of General Surgery, Faculty of Medicine, Medical University of Plovdiv, 4002, Plovdiv, Bulgaria
| | - A Uchikov
- Department of Special Surgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
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2
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Pandiar D, Anbumani P, Krishnan RP. Literature Review, Case Presentation and Management of Non-ossifying Fibroma of Right Angle of Mandible: More Than just a Cortical Defect! Indian J Otolaryngol Head Neck Surg 2024; 76:1054-1061. [PMID: 38440574 PMCID: PMC10908682 DOI: 10.1007/s12070-023-04110-8] [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: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 03/06/2024] Open
Abstract
Non-ossifying fibroma (NOF) of jaw bones are rare. While NOF is the most common benign bone tumor of long bones with pathognomonic radiological features and bear a tendency for self-regression, gnathic NOF appears to be comparatively larger in size and behave more aggressively. A 16 years old female patient reported with painless swelling of the right side of the face of 4 months duration. Radiographic analysis showed a unilocular radiolucent lesion of right angle of the mandible with ill-defined margins, cortical perforation and thinning of inferior border. The lesion was provisionally diagnosed as odontogenic keratocyst/unicystic ameloblastoma and incisional biopsy was performed. The histopathological features and immunohistochemical characteristics favored a diagnosis of NOF. The lesion was excised and reconstructed. The excised specimen confirmed the diagnosis. There are no signs of recurrence at 18 months follow-up. NOF should be considered in the differential diagnosis of uni-/multilocular radiolucencies of jaws particularly the posterior mandible.
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Affiliation(s)
- Deepak Pandiar
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu India
| | - P. Anbumani
- Oral and Maxillofacial Surgeon, 115, Vellam Thangiya Pillayar Kovil street, Tirunelveli town, Tirunelveli, Tamil Nadu India
| | - Reshma Poothakulath Krishnan
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu India
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3
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Mewar P, Foss RD. Benign fibrohistiocytic jaw lesions: a 48-year clinicopathologic analysis and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00428-5. [PMID: 37277279 DOI: 10.1016/j.oooo.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 04/02/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Intra-osseous fibrohistiocytic lesions have long been reported in the literature; evidence suggests they represent a heterogeneous group of reactive and neoplastic processes. This study evaluated a series of gnathic fibrohistiocytic lesions to identify and categorize their clinical, radiographic and morphologic spectrum. STUDY DESIGN A retrospective case search over 48 years was conducted for maxillary and mandibular intra-bony fibrohistiocytic lesions. Diagnoses were confirmed and demographic, radiographic, clinical and follow-up data was analyzed. RESULTS Fifty cases met the inclusion criteria. Most cases (80%) were found in the second through fourth decades (mean, 29 years). The most common location (86%) was the posterior mandible. Radiographic presentations varied, but a few patterns emerged, including a distinctive mottled, honeycomb type with punctate lucencies. All cases demonstrated fibrous components admixed with variable histiocytes. Eight cases (16%) were histiocyte-rich with dominant sheets of xanthoma cells. Immunohistochemical staining revealed strong CD68 and CD163 expression, along with variable smooth muscle actin staining. The vast majority (92%) of cases were treated conservatively. Available follow-up showed lesional stability in 17 cases (average, 85 months) with 2 recurrences (24 months each) and no evidence of malignant transformation. CONCLUSIONS This study is the largest to date of fibrohistiocytic gnathic lesions, revealing distinctive radiographic and histologic findings and characteristic clinical and immunophenotypic features. Available evidence suggests that most of these are indolent, slow-growing lesions amenable to conservative therapy.
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Affiliation(s)
- Parth Mewar
- Head and Neck Pathology, The Joint Pathology Center, Silver Spring, MD; Oral and Maxillofacial Pathology, Madigan Army Medical Center, Joint Base Lewis-McChord, WA.
| | - Robert D Foss
- Head and Neck Pathology, The Joint Pathology Center, Silver Spring, MD
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4
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Wang Y, Huang Y, Cai WX, Tao Q. Multiple benign fibrous histiocytomas of the mandible: A case report and review of the literature. Exp Ther Med 2022; 24:593. [PMID: 35949345 PMCID: PMC9353540 DOI: 10.3892/etm.2022.11530] [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: 03/09/2022] [Accepted: 07/05/2022] [Indexed: 12/03/2022] Open
Abstract
Benign fibrous histiocytoma (BFH) mostly occurs on the skin of the extremities, while it is unusual to manifest on the bone and mandibular involvement of BFH is even rarer. The present study reports a case of BFH in a 42-year-old female who had a slowly progressive swelling of the bilateral mandible and slight facial asymmetry over a period of 4 months. However, the outcome of this patient was unsatisfactory, with the first and second recurrence observed 16 and 46 months after surgery, respectively. The present case suggests that BFH has a risk of recurrence after transoral curettage. Regular follow-up is advised to detect tumor recurrence after the surgery of transoral curettage.
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Affiliation(s)
- Yue Wang
- Guangdong Provincial Key Laboratory of Stomatology, Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Yun Huang
- Guangdong Provincial Key Laboratory of Stomatology, Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Wei-Xin Cai
- Guangdong Provincial Key Laboratory of Stomatology, Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Qian Tao
- Guangdong Provincial Key Laboratory of Stomatology, Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong 510055, P.R. China
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5
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Benign fibrous histiocytoma of the oral and maxillofacial region: A systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:e43-e56. [PMID: 34511357 DOI: 10.1016/j.oooo.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of the present study was to carry out a systematic review of available data regarding case reports and case series of oral and maxillofacial benign fibrous histiocytoma (BFH). STUDY DESIGN A search strategy was performed using the PubMed, Web of Science, Scopus, and EMBASE electronic databases. RESULTS Male individuals (56.89%) were more affected, with a mean age of 34.55 ± 20 years. The buccal mucosa (20.33%) represented the most common site, with the clinical presentation of a painless (86.95%) nodule (98.03%). The clinical hypothesis of a fibroma was reported in most cases (31.57%). Radiographic presentation of intraosseous lesions showed multilocular radiolucent images (55.55%). Regarding the histopathologic features, the biphasic population of fibroblastic and histiocytic cells was seen in 21 cases (39.62%), and a spindle-shaped fibroblastic cell population organized into a storiform pattern was observed in 25 cases (47.16%). CD68 (n = 26) and vimentin (n = 25) showed immunoreactivity in all BFH cases in which they were used. All cases were treated with a surgical resection, and 8.10% recurred. CONCLUSIONS The current systematic review demonstrated that BFH represents a rare lesion that mainly affects the buccal mucosa of male individuals, and the treatment is mainly surgical with a good prognosis.
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6
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Singh Chauhan JP, Kumar A, Porwal PK, Thakur RK, Mittal K, Singh H. Benign fibrous histiocytoma of the maxilla: A rare case report and literature review. Natl J Maxillofac Surg 2020; 11:298-301. [PMID: 33897199 PMCID: PMC8051644 DOI: 10.4103/njms.njms_85_18] [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] [Received: 11/14/2018] [Revised: 01/03/2019] [Accepted: 04/30/2019] [Indexed: 11/14/2022] Open
Abstract
Benign fibrous histiocytoma (FH) is a benign soft-tissue tumor that can present as a fibrous tissue mass anywhere in the body. The involvement of the paranasal sinuses is extremely rare, and very few cases have been reported in literature till date. We here report a case of benign FH localized in the maxillary sinus. The clinical and histological features of the lesion are discussed with a brief literature review of this pathology in the paranasal sinuses.
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Affiliation(s)
| | - Abhay Kumar
- Department of ENT, UPUMS, Etawah, Uttar Pradesh, India
| | | | | | - Kailash Mittal
- Department of Radiotherapy, UPUMS, Etawah, Uttar Pradesh, India
| | - Harshita Singh
- Department of ENT, Tata Main Hospital, Jamshedpur, Jharkhand, India
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7
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Das S, Faquin WC, Caruso PA, McCain JP, August M, Kaban LB. An incidental finding of a radiolucent lesion in the mandibular condyle. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 132:124-129. [PMID: 33139240 DOI: 10.1016/j.oooo.2020.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/06/2020] [Accepted: 09/21/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Somdipto Das
- Department of Oral & Maxillofacial Surgery, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - William C Faquin
- Director of Head and Neck Pathology, Massachusetts Eye and Ear Infirmary, Harvard Medical School
| | - Paul A Caruso
- Director of Pediatric Neuroradiology, Massachusetts Eye and Ear Infirmary, Harvard Medical School
| | - Joseph P McCain
- Department of Oral & Maxillofacial Surgery, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Meredith August
- Department of Oral & Maxillofacial Surgery, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Leonard B Kaban
- Department of Oral & Maxillofacial Surgery, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
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8
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Wilkinson PE, Merkourea S, Gopalakrishnan R, Argyris PP. Primary Intraosseous Xanthomas of the Jaws: A Series of Six Cases Including an Example with Formation of Apoptosis-Related Hyaline Globules, So-Called "Thanatosomes". Head Neck Pathol 2020; 14:859-868. [PMID: 31916206 PMCID: PMC7669974 DOI: 10.1007/s12105-020-01126-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/03/2020] [Indexed: 12/13/2022]
Abstract
Primary intraosseous xanthomas of the jaws (PIXJ) are rare and predominantly affect the posterior mandible (86%) of normolipemic patients, with a mean age of 30 years and no gender predilection. Clinically, PIXJ exhibit indolent biologic behavior; curettage is considered treatment of choice. Only 36 PIXJ have been reported. Apoptosis-related hyaline globules (HGs), also known as "thanatosomes", have not been previously reported in PIXJ. Cases diagnosed as xanthoma of bone were retrieved. Six cases fulfilling currently accepted criteria were identified and their clinicopathologic and immunohistochemical properties are presented herein. Mean age for PIXJ was 21.8 years (range = 12-33) and F:M ratio = 2:1. All cases presented as well-demarcated, unilocular or multilocular radiolucencies. Microscopically, PIXJ featured sheets of lipid-laden macrophages with eosinophilic or foamy cytoplasm. A secondary fibroblastic population lacking storiform pattern was evident in two cases. Adipocytes (3/6), peripheral neurovascular bundles (1/6), bone fragments (3/6) and dystrophic calcifications (3/6) were observed enclosed by the xanthoma cells. Notably, one case exhibited numerous, spherical, eosinophilic HGs containing apoptotic nuclei. PIXJ were consistently CD68(+) and negative for CD1α and S100. CD45 decorated lymphocytes and the membrane of foamy histiocytes. Xanthoma cells stained for lysozyme and plasma proteins including alpha-1 antitrypsin (AAT), IgG and IgA in one probed case. HGs were lysozyme(+), AAT(+), IgG(+), IgA(+), PAS(+) and diastase-resistant, and fuchsinophilic with Masson's trichrome. PIXJ represent infrequent, solitary, mandibular lesions with a predilection for the second and third decade of life. Thanatosomes associated with cell injury and death can be present in PIXJ.
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Affiliation(s)
- Peter E. Wilkinson
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA
| | - Stavroula Merkourea
- grid.5216.00000 0001 2155 0800School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Rajaram Gopalakrishnan
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA
| | - Prokopios P. Argyris
- grid.17635.360000000419368657Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Department of Biochemistry, Molecular Biology, and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Institute for Molecular Virology, University of Minnesota, Minneapolis, MN 55455 USA
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9
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Saha A, Tocaciu S, Subramanian B. Primary Xanthoma of the Mandible-A Case Report. J Oral Maxillofac Surg 2017; 76:374.e1-374.e4. [PMID: 29125930 DOI: 10.1016/j.joms.2017.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/01/2017] [Accepted: 10/05/2017] [Indexed: 11/17/2022]
Abstract
Xanthomas are common cutaneous and subcutaneous lesions that occur due to altered metabolic or endocrinal function. They are found on skin and around tendon sheaths in individuals with dyslipidemias. In extremely rare cases, they can present as isolated intrabony lesions in otherwise healthy individuals. The isolated intrabony lesions are referred to as primary xanthomas. This report describes a case of an incidentally found primary xanthoma, its management, and follow-up in an otherwise healthy patient.
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Affiliation(s)
- Anik Saha
- Oral Surgery Resident, Department of Oral and Maxillofacial Surgery, Royal Dental Hospital Melbourne, Carlton, VIC, Australia.
| | - Shreya Tocaciu
- Oral and Maxillofacial Registrar, Department of Oral and Maxillofacial Surgery, Royal Dental Hospital Melbourne, Carlton, VIC, Australia
| | - Balanand Subramanian
- Oral Surgery Consultant, Department of Oral and Maxillofacial Surgery, Royal Dental Hospital Melbourne, Carlton, VIC, Australia
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10
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Abstract
Extragnathic xanthomas are seen in the bones or as soft tissue masses. They are often associated with hyperlipidemia and are considered as reactive or metabolic lesions. Only 19 cases of xanthomas of the jaws have been reported so far in the English literature. A total of ten cases of central xanthoma of the jaw bones were identified from the Oral and Maxillofacial Pathology biopsy services of the University of Washington and the Tufts University School of Dental Medicine, between the years 2000-2016. The demographic and clinical information on these cases was tabulated logically on the basis of age, gender, location and presence or absence of symptoms, extragnathic lesions and serum hyperlipidemia. Radiographic and histopathological features were also examined. The findings in these cases were correlated with those available from the previously reported cases. Majority of cases are seen in the second and third decades of life. There is no gender predilection. Jaw lesions presented as solitary radiolucencies with a predilection for the posterior mandible. Unlike maxillary lesions, pain and expansion are inconsistent findings in mandibular lesions. Jaw lesions are not associated with extragnathic bone or soft tissue involvement or a hyperlipidemia. The central xanthoma of the jaws is a unique benign tumor. Histopathologically, many other jaw lesions contain variable numbers of foamy histiocytes. Therefore, a diagnosis of a central xanthoma of the jaws must be made after excluding all other such histiocyte containing lesions. This requires correlation of histopathological findings with clinical and radiographic features.
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11
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Castillo M, Sanjuán A, Pérez N, Zanón G, Bons N, Vilanova M, Vanrell JA, Merino MJ, Fernández PL. Fibrous Histiocytoma-like Spindle-Cell Proliferation in the Nipple After Body-Piercing. Int J Surg Pathol 2016; 14:89-93. [PMID: 16501844 DOI: 10.1177/106689690601400118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report the case of a 19-year-old pregnant woman who presented with a nipple tumor. The lesion consisted in a spindle-cell proliferation with histologic features similar to those of fibrous histiocytoma, with a highly vascularized stroma. Although it showed low mitotic activity, scattered marked atypical cells with prominent nucleoli were identified, thus raising concern about the benign nature of the tumor. Immunohistochemical evaluation revealed that the spindle cells were diffusely positive for vimentin, focally positive for CD68, and negative for all the other tested antibodies. The patient had a total excision of the lesion and she is free of disease after 30 months. To our knowledge this is the first reported case of a lesion of this type in the nipple after body-piercing.
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MESH Headings
- Adult
- Antigens, CD/analysis
- Antigens, Differentiation, Myelomonocytic/analysis
- Body Piercing/adverse effects
- Breast Neoplasms/chemistry
- Breast Neoplasms/diagnosis
- Breast Neoplasms/etiology
- Breast Neoplasms/pathology
- Cell Proliferation
- Female
- Histiocytoma, Benign Fibrous/chemistry
- Histiocytoma, Benign Fibrous/diagnosis
- Histiocytoma, Benign Fibrous/etiology
- Histiocytoma, Benign Fibrous/pathology
- Humans
- Immunohistochemistry
- Nipples/chemistry
- Nipples/pathology
- Nipples/surgery
- Pregnancy
- Pregnancy Complications, Neoplastic/diagnosis
- Pregnancy Complications, Neoplastic/etiology
- Pregnancy Complications, Neoplastic/pathology
- Vimentin/analysis
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Affiliation(s)
- M Castillo
- Department of Gynecology & Obstetrics, Hospital Clínic, University of Barcelona, Andorra, Spain
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12
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Vyloppilli S, Joseph B, Manoj Kumar KP, Kurian SD, Anirudhan A, Kumar N. Benign Spindle Cell Tumour of Mandible and Points of Modification in Reconstruction with Nonvascularised Iliac Crest Graft. J Maxillofac Oral Surg 2016; 15:262-5. [PMID: 27408449 DOI: 10.1007/s12663-015-0775-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 02/28/2015] [Indexed: 11/26/2022] Open
Abstract
Benign fibrous histiocytoma (BFH) is a rare spindle cell tumor occurring in the jaw. It is a benign lesion composed of spindle shaped fibroblasts arranged in a storiform pattern. Literature shows that there are less than hundred reported cases of BFH worldwide and only six reported cases in the mandible. In this article, we are reporting a rare case of BFH in mandible and novel points of modification in reconstruction with nonvascularised iliac crest graft .
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Affiliation(s)
- Suresh Vyloppilli
- Oral and Maxillofacial Surgery, KMCT Dental College and Hospitals, Manassery P O, Mukkam, Calicut, 673602 India
| | - Benny Joseph
- Oral and Maxillofacial Surgery, KMCT Dental College and Hospitals, Manassery P O, Mukkam, Calicut, 673602 India
| | - K P Manoj Kumar
- Oral and Maxillofacial Surgery, KMCT Dental College and Hospitals, Manassery P O, Mukkam, Calicut, 673602 India
| | - Shijo Dany Kurian
- Oral and Maxillofacial Surgery, KMCT Dental College and Hospitals, Manassery P O, Mukkam, Calicut, 673602 India
| | - Anroop Anirudhan
- Oral and Maxillofacial Surgery, KMCT Dental College and Hospitals, Manassery P O, Mukkam, Calicut, 673602 India
| | - Nitin Kumar
- Oral and Maxillofacial Surgery, KMCT Dental College and Hospitals, Manassery P O, Mukkam, Calicut, 673602 India
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13
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Pattamparambath M, Sathyabhama S, Khatri R, Varma S, Narayanan NM. Benign Fibrous Histiocytoma of Mandible: A Case Report and Updated Review. J Clin Diagn Res 2016; 10:ZD24-6. [PMID: 27504429 DOI: 10.7860/jcdr/2016/19067.8056] [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: 01/24/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022]
Abstract
Benign Fibrous Histiocytoma (BFH) is a well recognised tumour of the soft tissue, developing entirely within the subcutaneous tissue, the deep soft tissues or in the parenchymal organs. However, BFH of bones is poorly defined. It has been rarely reported in the bones with femur, tibia and pelvic bone being the most commonly affected bones. Involvement of the jawbones is rare. Their clinical and radiographic features often simulate the common odontogenic and non-odontogenic lesions of the jaws. Hence, it is imperative for a dentist to have proper knowledge of various conditions affecting the jaws. Here we report a case of BFH which presented as an indolent swelling of the right mandibular posterior region for 15 years. The case emphasizes the need for considering BFH in the differential diagnosis of swellings of the jaws.
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Affiliation(s)
- Manjusha Pattamparambath
- Senior Resident, Department of Oral Pathology and Microbiology, Government Dental College , Calicut, Kerela, India
| | - Sudha Sathyabhama
- Professor and Head, Department of Oral Pathology and Microbiology, Government Dental College , Calicut, Kerela, India
| | - Rohitashwa Khatri
- Senior Resident, Department of Oral Medicine, Government Dental College , Alappuzha, Kerela, India
| | - Sujatha Varma
- Assistant Professor, Department of Oral Pathology and Microbiology, Government Dental College , Calicut, Kerela, India
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15
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Shoor H, Pai KM, Shergill AK, Kamath AT. Benign fibrous histiocytoma: A rare case involving jaw bone. Contemp Clin Dent 2015; 6:S266-8. [PMID: 26604585 PMCID: PMC4632234 DOI: 10.4103/0976-237x.166828] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Benign fibrous histiocytoma (BFH) is a soft tissue neoplasm which occurs mostly on the skin of extremities. BFH rarely occurs in bone and may affect femur, tibia, and pelvic bone. Jaw bone involvement is very unusual with only 11 cases reported till date. This report describes a case of BFH occurring in a 30-year-old female patient affecting left mandibular posterior region. Computed tomography revealed a well-defined expansile lytic lesion in the posterior mandible. Gross examination of the tumor revealed an admixture of fibroblasts and histiocytes in a fascicular and storiform pattern. Immunohistochemical staining was positive for CD68.
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Affiliation(s)
- Hitesh Shoor
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Keerthilatha M Pai
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Ankur Kaur Shergill
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Abhay Taranath Kamath
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
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Daley T, Dunn G, Darling MR. Central xanthoma of the jaws: a clinicopathologic entity? Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:92-100. [DOI: 10.1016/j.oooo.2014.09.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 09/10/2014] [Accepted: 09/15/2014] [Indexed: 12/01/2022]
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17
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Benign Fibrous Histiocytoma: A Rare Case Report and Literature Review. J Maxillofac Oral Surg 2014; 15:116-20. [PMID: 26929563 DOI: 10.1007/s12663-014-0721-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 10/19/2014] [Indexed: 10/24/2022] Open
Abstract
Fibrous histiocytoma is a benign soft tissue tumour that may present as a fibrous mass anywhere in the human body. The involvement of the oral cavity is extremely rare and very few cases have been reported in literature till date. We here report a case of benign fibrous histiocytoma localized in the oral cavity. The clinical and histological features of the lesion are discussed precisely in the light of a literature review of this pathology in oral cavity.
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18
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Bowers LM, Cohen DM, Bhattacharyya I, Pettigrew JC, Stavropoulos MF. The non-ossifying fibroma: a case report and review of the literature. Head Neck Pathol 2013; 7:203-10. [PMID: 23008139 PMCID: PMC3642261 DOI: 10.1007/s12105-012-0399-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Accepted: 09/13/2012] [Indexed: 11/28/2022]
Abstract
The non-ossifying fibroma (NOF) is a benign, non-neoplastic lesion most commonly seen in the metaphyses of the long bones in children. While rare, the NOF has been reported in the mandible. The NOF in the extra-gnathic skeleton has a characteristic radiographic appearance, is typically asymptomatic and has a variable histologic make-up. Correlation of the radiographic appearance, clinical presentation and histopathology allows for differentiation of the NOF from odontogenic and non-odontogenic cysts and tumors. We report a new case of this interesting entity and review the radiographic, clinical and histologic features of the gnathic NOF reported in the literature. A thorough search of the English language literature returned a total of 19 cases of NOF involving the gnathic bones.
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Affiliation(s)
- Leah M Bowers
- Oral and Maxillofacial Diagnostic Sciences, University of Florida, Gainesville, FL, USA.
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19
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Ding YF, Hao SP. Benign fibrous histiocytoma of the cheek. Am J Otolaryngol 2013; 34:154-7. [PMID: 23218719 DOI: 10.1016/j.amjoto.2012.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 09/17/2012] [Indexed: 11/25/2022]
Abstract
Benign fibrous histiocytoma (FH) is a benign neoplasm of a mixture of fibroblastic and histiocytic cells. The tumor occurs most frequently on the skin of the extremities but rarely in deep soft tissues of the head and neck. The diagnosis of benign FH may be clinically difficult, and is frequently confirmed after excision. The most important diagnostic distinction is the separation of this tumor from malignant FH. A 22-year-old male presented with a painless swelling mass on the left cheek. Detailed clinical and laboratory examinations were performed. The patient received angiography with embolization and underwent an intraoral excision of the mass under general anesthesia with primary closure. The histopathology revealed a benign FH. The complete image survey and appropriate treatment of benign FH of the cheek are emphasized.
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20
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Havitçioğlu H, Biçen Ç, Hapa O, Balcı A. Treatment of intracapsular femoral neck lesions: aggressive or conservative surgery? Musculoskelet Surg 2012; 98:251-4. [PMID: 23263835 DOI: 10.1007/s12306-012-0236-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 12/08/2012] [Indexed: 11/28/2022]
Abstract
Benign fibrous histiocytomas (BFHs) and non-ossifying fibromas (NOFs) are benign bone tumors that are clinically different, but histologically similar. Most benign lesions are treated with curettage and grafting; however, some misdiagnosed cases are treated with more aggressive procedures, including arthroplasty. Herein, we present a 21-year-old patient that presented with a 1-year history of right hip pain. Anteroposterior X-ray showed a centrally located lesion in the femoral neck that was intracapsular and localized subcortically. To the best of our knowledge, the literature does not include any reposts of BFH or NOF localized at the intracapsular hip. In addition, localization of and treatment options for intracapsular hip lesions are clarified.
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Affiliation(s)
- Hasan Havitçioğlu
- Department of Orthopedic Surgery, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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21
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Ou DM, Zheng GS, Liao GQ, Su YX, Liu HC, Liang YJ. Clinical and Pathologic Characteristics and Surgical Management of Benign Fibrous Histiocytoma of the Mandible: A Case Report. J Oral Maxillofac Surg 2012; 70:2719-23. [DOI: 10.1016/j.joms.2012.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Revised: 02/02/2012] [Accepted: 02/02/2012] [Indexed: 11/25/2022]
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22
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Wagner MEH, Rana M, Traenkenschuh W, Kokemueller H, Eckardt AM, Gellrich NC. Piezoelectric-assisted removal of a benign fibrous histiocytoma of the mandible: an innovative technique for prevention of dentoalveolar nerve injury. Head Face Med 2011; 7:20. [PMID: 22040611 PMCID: PMC3213176 DOI: 10.1186/1746-160x-7-20] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Accepted: 10/31/2011] [Indexed: 11/10/2022] Open
Abstract
In this article, we present our experience with a piezoelectric-assisted surgical device by resection of a benign fibrous histiocytoma of the mandible. A 41 year-old male was admitted to our hospital because of slowly progressive right buccal swelling. After further radiographic diagnosis surgical removal of the yellowish-white mass was performed. Histologic analysis showed proliferating histiocytic cells with foamy, granular cytoplasm and no signs of malignancy. The tumor was positive for CD68 and vimentin in immunohistochemical staining. Therefore the tumor was diagnosed as primary benign fibrous histiocytoma. This work provides a new treatment device for benign mandibular tumour disease. By using a novel piezoelectric-assisted cutting device, protection of the dentoalveolar nerve could be achieved.
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23
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Zouloumis L, Iliopoulos C, Lazaridou M, Zarampoukas T. Benign fibroxanthoma of the mandible. J Oral Maxillofac Pathol 2011; 15:52-5. [PMID: 21731278 PMCID: PMC3125656 DOI: 10.4103/0973-029x.80026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Histiocytomas constitute a large group of tumors, the classification of which created a lot of confusion in the past. For this reason, various attempts were carried out during the last years so that a widely accepted classification system could be defined. Fibroxanthomas, according to contemporary data, are classified into benign histiocytomas and they are mostly located at the skin of extremities. They are rarely localized in the area of the head and neck, where they are found commonly in soft tissue. Fibroxanthomas located at the bones of oral and maxillofacial region are extremely rare. The purpose of this paper is to present a case of a fibroxanthoma located at the mandible as well as to analyze the histological findings of the lesion on which the diagnosis and differential diagnosis were based.
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Affiliation(s)
- L Zouloumis
- Associate Professor, Department of Oral and Maxillofacial Surgery, Dental School of Aristotle University of Thessaloniki, Greece
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24
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Tanaka T, Kobayashi T, Iino M. Transformation of Benign Fibrous Histiocytoma Into Malignant Fibrous Histiocytoma in the Mandible: Case Report. J Oral Maxillofac Surg 2011; 69:e285-90. [DOI: 10.1016/j.joms.2011.02.067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 02/05/2011] [Accepted: 02/08/2011] [Indexed: 11/30/2022]
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25
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Pandey NK, Sharma SK, Banerjee S. A rare case of fibrous histiocytic tumor of the tongue. Indian J Surg 2011; 75:1-5. [PMID: 24426494 DOI: 10.1007/s12262-011-0284-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 01/15/2011] [Indexed: 01/02/2023] Open
Abstract
Fibrous histiocytoma is a benign soft tissue tumor composed of a mixture of fibroblastic and histiocytic cells arising as a fibrous mass everywhere in the human body. Based on location it is divided into cutaneous type and those involving the deeper tissues. Involvement of the oral cavity is rare. It is important to distinguish this tumor from the more aggressive forms of fibrohistiocytic neoplasm including dermatofibrosarcoma protuberans and malignant fibrous histiocytoma (FH) (7).The clinical and histiological diagnosis, treatment, and prognosis of FH have been discussed.
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26
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Abstract
Benign fibrous histiocytoma (BFH) is one of the most common tumors of the superficial and deep soft tissues; it is commonly localized on the skin of the extremities and presents as a slow growing solitary nodule, made up of a mixture of fibroblastic and histiocytic cells. To our knowledge, involvement of the soft tissue of the oral cavity is rare. We present a case of BFH of the lower lip in a 61-year-old white woman who presented with a painless, slow-growing lump inside the lower lip. The lesion was surgically removed. Histologically, it was characterized by uniform spindle-shaped cells arranged in a prominent whorled or storiform pattern. Scattered xanthomatous cells, multinucleated giants cells, lymphocytes, and deposits of hemosiderin were noted throughout the lesion. This rare tumor should be considered in the differential diagnosis of the oral soft-tissue neoplasms.
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27
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Abdelsayed RA, Sharma S, Ferguson H. Fibrous cortical defect (nonossifying fibroma) of the mandibular ramus: report of 2 cases. ACTA ACUST UNITED AC 2010; 110:504-8. [DOI: 10.1016/j.tripleo.2010.04.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 04/26/2010] [Indexed: 10/19/2022]
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28
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Benign fibrous histiocytoma of the buccal mucosa: case report and literature review. Case Rep Med 2010; 2010:306148. [PMID: 20589214 PMCID: PMC2892663 DOI: 10.1155/2010/306148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 05/24/2010] [Indexed: 11/17/2022] Open
Abstract
Benign fibrous histiocytoma is an interesting and challenging entity even in its most usual, cutaneous presentation. Noncutaneous presentation is extremely limited, even more so for the mucosa of the head and neck area. We herein report such a case, describing the clinical characteristics of the lesion, complete diagnostic evaluation, management, and follow-up. Diagnostic histopathological challenges are specifically illustrated. A complete review of the relevant literature is also included.
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29
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Menditti D, Laino L, Mezzogiorno A, Sava S, Bianchi A, Caruso G, Di Maio L, Baldi A. Oral benign fibrous histiocytoma: two case reports. CASES JOURNAL 2009; 2:9343. [PMID: 20066060 PMCID: PMC2804724 DOI: 10.1186/1757-1626-2-9343] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 12/17/2009] [Indexed: 11/30/2022]
Abstract
Fibrous histiocytoma is a benign soft tissue tumour arising as a fibrous mass everywhere in the human body. The involvement of the oral cavity is rare. We report two cases of benign fibrous histiocytoma that localized in the oral cavity. The clinical and histological features of the lesion are reported. Finally, a literature revision of this pathology at the level of the oral cavity is reported.
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Affiliation(s)
- Dardo Menditti
- Dipartimento di Scienze Odontostomatologiche, Seconda Università di Napoli, 80138 Napoli, Italia
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30
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Ideguchi M, Kajiwara K, Yoshikawa K, Kato S, Fujii M, Fujisawa H, Suzuki M. Benign fibrous histiocytoma of the skull with increased intracranial pressure caused by cerebral venous sinus occlusion. J Neurosurg 2009; 111:504-8. [PMID: 19249956 DOI: 10.3171/2008.11.jns081206] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors present a very rare case of benign fibrous histiocytoma of the skull with increased intracranial pressure caused by sinus occlusion. A 33-year-old woman was referred for investigation of a right occipital protrusion with tenderness and double vision. She had only mild divergence insufficiency and bilateral papilledema neurologically. Imaging findings showed that the skull tumor was located at the right occipital bone with bone disruption and a compressed right sigmoid sinus. When planning the resection, caution was required to spare the collateral flow so as to manage the intracranial pressure. Immunohistochemical analysis showed that the tumor was positive for CD68, α1-antichymotrypsin, and α1-antitrypsin. From these findings, the tumor was diagnosed as a primary benign fibrous histiocytoma of the skull.
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31
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Katagiri W, Nakazawa M, Kishino M. Benign fibrous histiocytoma in the condylar process of the mandible: Case report. Br J Oral Maxillofac Surg 2008; 46:e1-2. [PMID: 17561319 DOI: 10.1016/j.bjoms.2007.03.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2007] [Indexed: 10/23/2022]
Abstract
A 48-year-old man was referred for investigation of an asymptomatic radiolucent lesion in the mandible. The margin was partly irregular, and there was no peripheral sclerosis. The tumour was composed of histiocytic cells, spindle cells, and fibrous tissue. Immunohistochemical analysis showed that the tumour cells stained for CD68 and vimentin, and not for cytokeratin, smooth muscle actin, S-100 protein, or CD34. The tumour was therefore diagnosed as a benign fibrous histiocytoma.
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Affiliation(s)
- Wataru Katagiri
- Department of Oral and Maxillofacial Surgery II, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
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32
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Tubbs RS, Kelly DR, Pugh JL, Loukas M, Oakes WJ. Benign fibrous histiocytoma of the skull base. Case report. J Neurosurg 2007; 106:65-7. [PMID: 17233317 DOI: 10.3171/ped.2007.106.1.65] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The authors report the case of benign fibrous histiocytoma (BFH) of the skull base in an 11-month-old girl. During draining for a middle ear infection, the child was noted to have an anomalous mass in the skull base. On magnetic resonance imaging studies a soft-tissue mass of the skull base primarily involving the regions of the temporal and occipital bones was discovered. Results of a surgical biopsy were consistent with BFH. At the most recent follow-up examination--18 months postoperatively--the child was noted to be asymptomatic with no gross increase in tumor size.
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Affiliation(s)
- R Shane Tubbs
- Department of Cell Biology, University of Alabama at Birmingham, Alabama 35233, USA.
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