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Diagnosis and Treatment of Nodular Fasciitis of Ear Region in Children: A Case Report and Review of Literature. Healthcare (Basel) 2022; 10:healthcare10101962. [PMID: 36292409 PMCID: PMC9601438 DOI: 10.3390/healthcare10101962] [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: 07/23/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 11/04/2022] Open
Abstract
Nodular fasciitis (NF) is a benign fibroblastic and myofibroblastic proliferation of subcutaneous tissues. Rarely, it has been identified in the ear and more rarely in children. We describe a case in a four-year-old girl and the surgical management of it. The patient was referred to the otolaryngology unit of a tertiary referral center because she was affected by a painless and growing lesion in the left external auditory canal (EAC). The girl was treated by large-spectrum antibiotic therapy for one week without success. For this reason, we requested ultrasonography (US) of the left hemiface, maxillofacial and temporal bone computed tomography (CT) and magnetic resonance imaging (MRI) of the head with and without contrast. The imaging identified an irregular ovoid hypoechoic nodule with distinct margins indissociable from the cartilaginous planes and extending into the parotid loggia with local infiltration of the fascia. The lesion was surgically removed through preauricular access due its extension into the parotid area. The mass was excised in toto and sent to the pathologist for immunohistochemistry. The histopathologist based on the finding diagnosed a nodular fasciitis. In case of suspicion of malignancy, early investigations should be done to evaluate the lesion, then a traditional parotidectomy can be safely and successfully performed even in a very young child. The open technique allows the removal of NF with full control of the surgical area and facial nerve. In this article, we presented the management of a case in a 4-year-old female affected by NF of the external auditory canal (EAC), and we described clinical and surgical management of the case. We also reviewed literature of nodular fasciitis cases of ears in children.
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Erber R, Preidl R, Stoehr R, Haller F, Hartmann A, Kesting M, Agaimy A. DICER1-Mutated Botryoid Fibroepithelial Polyp of the Parotid Duct: Report of the First Case. Head Neck Pathol 2022; 16:573-580. [PMID: 34282560 PMCID: PMC9187814 DOI: 10.1007/s12105-021-01364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/07/2021] [Indexed: 11/27/2022]
Abstract
DICER1, a member of the ribonuclease III family, is involved in the biogenesis of microRNAs and, hence, it influences gene expression regulation. DICER1 germline (associated with the inherited DICER1 syndrome) or somatic mutations have been linked to tumorigenesis in histogenetically diverse benign and malignant neoplasms in different organs including pleuropulmonary blastoma, cystic nephroma, embryonal rhabdomyosarcoma, nasal chondromesenchymal hamartoma, poorly differentiated thyroid carcinoma, thyroblastoma, intracranial sarcoma and gonadal Sertoli-Leydig cell tumors in addition to others. Moreover, rare botryoid (giant) fibroepithelial polyps may harbor this mutation. Herein, we describe the first reported case of a DICER1-mutated botryoid fibroepithelial polyp occurring within the parotid duct of a 65-year-old female who has no other features or family history of the DICER1 syndrome. Based on its distinctive morphology, we tested this lesion specifically for DICER1 mutations and confirmed the presence of a pathogenic DICER1 variant with a low allele frequency, consistent with a somatic mutation.
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Affiliation(s)
- Ramona Erber
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Raimund Preidl
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Erlangen, Germany
| | - Robert Stoehr
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Florian Haller
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
| | - Marco Kesting
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Erlangen, Germany
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen (UKER), Krankenhausstrasse 8-10, 91054, Erlangen, Germany.
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.
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Marini K, Garefis K, Skliris JP, Peltekis G, Astreinidou A, Florou V. Fibroepithelial polyp of palatine tonsil: a case report. Pan Afr Med J 2021; 39:276. [PMID: 34754353 PMCID: PMC8556748 DOI: 10.11604/pamj.2021.39.276.31057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/10/2021] [Indexed: 12/02/2022] Open
Abstract
Fibroepithelial polyps represent a frequent cutaneous lesion of mesodermal origin, with a prevalence of 1.2% and are rarely located at palatine tonsils. We present a rare clinical report of a 70-year-old female patient with fibroepithelial polyp of palatine tonsil. This entity represents the eighth case of palatine tonsil fibroepithelial polyp in the English literature. She presented with a polypoid mass at the right tonsil and unspecified throat symptoms. Physicians should pay attention to such lesions because of the residual risk of malignant transformation, along with non-specific symptoms. Differential diagnosis was among neurofibroma, lipoma, squamous papilloma and fibroepithelial polyp. Histopathological examination following tonsillectomy showed a structure rich in vesicles inside lamina propria and surrounding inflammation, establishing the diagnosis of a fibroepithelial polyp. It requires vigilance during complete clinical examination, in order to detect masses at patients with throat symptoms that could have remained undiagnosed until they become even life threatening.
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Affiliation(s)
- Katerina Marini
- Department of Otorhinolaryngology Head and Neck Surgery, Gennimatas General Hospital, Thessaloniki, Greece
| | - Konstantinos Garefis
- 2 Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | | | - George Peltekis
- 2 Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Anna Astreinidou
- Department of Otorhinolaryngology Head and Neck Surgery, Gennimatas General Hospital, Thessaloniki, Greece
| | - Vasiliki Florou
- Department of Otorhinolaryngology Head and Neck Surgery, Gennimatas General Hospital, Thessaloniki, Greece
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Jabbour J, Chappell JR, Busby M, McCubbery NW, Brown DF, Park SJK, O'Neill JG. Glottic Obstruction from Fibroepithelial Polyp. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:219-223. [PMID: 30778021 PMCID: PMC6388646 DOI: 10.12659/ajcr.914907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fibroepithelial polyps are benign lesions of mesodermal origin, which have been reported in the head and neck area. The aim of this study is to describe the management of an oropharyngeal fibroepithelial polyp causing stridor. CASE REPORT A 39-year-old male presented with 24 hours of stridor and dysphagia. Flexible laryngoscopy revealed a pedunculated sessile polyp on the posterior oropharynx. The mass was excised using bipolar diathermy and histopathology revealed a fibroepithelial polyp. The differential diagnoses for stridor are extensive. Although uncommon, a fibroepithelial polyp should be considered. CONCLUSIONS We present a rare case of a fibroepithelial polyp causing stridor and imminent airway obstruction. We recommend the use of SponTaneous Respiration using IntraVEnous anaesthesia and High-flow nasal oxygen (STRIVE Hi) for general anaesthesia and resection of pharyngeal polyps.
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Affiliation(s)
- Joe Jabbour
- Department of Otolaryngology, The Tweed Hospital, Tweed Heads, NSW, Australia
| | - James R Chappell
- Department of Anaesthetics, The Tweed Hospital, Tweed Heads, NSW, Australia
| | - Michael Busby
- Department of Otolaryngology, The Tweed Hospital, Tweed Heads, NSW, Australia
| | - Nathan W McCubbery
- Department of Anaesthetics, The Tweed Hospital, Tweed Heads, NSW, Australia
| | - Daniel F Brown
- Department of Anaesthetics, The Tweed Hospital, Tweed Heads, NSW, Australia
| | - Serena J K Park
- Department of Pathology, The Tweed Hospital, Tweed Heads, NSW, Australia
| | - John G O'Neill
- Department of Otolaryngology, The Tweed Hospital, Tweed Heads, NSW, Australia
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Fibroepithelial polyp of external auditory canal. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:141-142. [DOI: 10.1016/j.anorl.2016.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 01/04/2016] [Indexed: 11/24/2022]
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Telugu RB, Ashish G. Fibroepithelial Polyp of the Tonsil: Report of a Rare Case. J Clin Diagn Res 2015; 9:ED17-8. [PMID: 26816905 DOI: 10.7860/jcdr/2015/15080.6950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 11/02/2015] [Indexed: 11/24/2022]
Abstract
Pedunculated polyps of the palatine tonsil are rare benign tumours of tonsil. Most of the cases have been reported in adults with varying presenting symptoms. We report a 12-year-old male child who presented with 6 months history of difficulty in swallowing. There was no history of breathing difficulty, change in voice or history of trauma. Clinical examination revealed a 2x1 cm small pedunculated polyp arising from the superior pole of right tonsil which was excised under general anaesthesia. Left tonsil was normal. A diagnosis of fibroepithelial polyp of right palatine tonsil was made based on histopathological findings. An unusual presentation of a rare condition in a paediatric patient has been discussed along with the clinical and histopathological features of this lesion.
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Affiliation(s)
- Ramesh Babu Telugu
- Assistant Professor, Department of Pathology, Christian Medical College and Hospital , Vellore, Tamilnadu, India
| | - Gaurav Ashish
- Senior Resident, Department of Ear, Nose and Throat, Christian Medical College and Hospital , Vellore, Tamilnadu, India
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A case of sensorineural hearing loss involving a fibroepithelial polyp of the middle ear. Am J Otolaryngol 2015; 36:475-8. [PMID: 25701460 DOI: 10.1016/j.amjoto.2015.01.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/27/2015] [Indexed: 11/20/2022]
Abstract
Primary middle ear neoplasms are rare, and commonly cause conductive hearing loss. When aural masses result in sensorineural hearing loss, malignant etiologies are often suspected. Fibroepithelial polyps are benign lesions commonly found in the skin and genitourinary tract and are not commonly identified as primary lesions of the middle ear. Here, we present a case of a benign fibroepithelial polyp of the middle ear causing sensorineural hearing loss and describe its surgical management. Imaging and histologic characteristics are reviewed.
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Abstract
Patient: Male, 11 Final Diagnosis: Fibroepithelial polyp of epiglottis Symptoms: Dysphagia • sore throat Medication: — Clinical Procedure: — Specialty: —
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Affiliation(s)
- Zainab Farzal
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, USA
| | - Seckin O Ulualp
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, USA
| | - Dinesh Rakheja
- Departments of Pathology and Pediatrics, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, USA
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