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Wang X, Guan W, Bao L, Li Q, Wang X. Desmoplastic fibroma of the pediatric cranium with CTNNB1 mutation: case report and literature review. Childs Nerv Syst 2024; 40:2227-2233. [PMID: 38635072 DOI: 10.1007/s00381-024-06375-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Desmoplastic fibroma (DF) is an uncommon intermediate bone tumor rarely involving the skull with unidentified pathogenesis. We report the first case of pediatric temporoparietal cranial desmoplastic fibroma (DF) with a CTNNB1 gene mutation and review the previous literature. CASE PRESENTATION A 3-year-old boy had a firm, painless mass on the right temporoparietal region for 22 months. The cranial CT scan showed isolated osteolytic destruction in the outer plate and diploe of the right temporoparietal bone. Gross total resection of the lesion and cranioplasty were performed. After that, a growing epidural hematoma was observed so another operation was performed to remove the artificial titanium plate. Postoperative pathology indicated a DF diagnosis and molecular pathology suggested a missense mutation in exon 3 of the CTNNB1 gene (c.100G > A,p.Gly34Arg). CONCLUSION Pediatric cranial DF is rare and easy to be misdiagnosed before operation. For cranial DF, lesion resection can be performed and perioperative management should be strengthened. Mutations in the CTNNB1 gene might be one of the molecular pathologic features of DF.
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Affiliation(s)
- Xinyao Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbin Guan
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Bao
- Department of Imaging, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqiang Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Liu Y, Housley Smith M, Patel PB, Bilodeau EA. Pediatric Gnathic Bony and Mesenchymal Tumors. Pediatr Dev Pathol 2023; 26:621-641. [PMID: 37232383 DOI: 10.1177/10935266231170744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Evaluation of bone pathology within the head and neck region, particularly the gnathic bonesis is complex, demonstrating unique pathologic processes. In part, this variation is due to odontogenesis and the embryological cells that may be involved, which can contribute to disease development and histologic variability. As with any boney pathosis, the key is to have clinical correlation, particularly with radiographic imaging prior to establishing a definitive diagnosis. This review will cover those entities that have a predilection for the pediatric population, and while it is not all inclusive, it should serve as a foundation for the pathologist who is evaluating bony lesions involving the craniofacial skeleton.
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Affiliation(s)
- Yingci Liu
- Rutgers School of Dental Medicine, Newark, NJ, USA
| | | | - Paras B Patel
- Center for Oral Pathology, Dallas, TX, USA
- Oral and Maxillofacial Pathology ProPath, Dallas, TX, USA
| | - Elizabeth Ann Bilodeau
- Oral & Maxillofacial Pathology, Director, UDHS Oral Pathology Laboratory, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
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Hui M, Uppin SG, Narayanan R, Rao KN, Kumar BA. Fibrocartilaginous mesenchymoma of pelvis-a potential diagnostic pitfall. Skeletal Radiol 2023; 52:791-795. [PMID: 36042034 DOI: 10.1007/s00256-022-04167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/15/2022] [Accepted: 08/20/2022] [Indexed: 02/02/2023]
Abstract
Fibrocartilaginous mesenchymoma (FM) is a rare bone tumor mimicking other fibrocartilaginous lesions on imaging and histologically. Hence, it is difficult to diagnose this entity especially on small biopsies. In this article, we report a case of FM mimicking desmoplastic fibroma on biopsy. A 36-year-old male presented with pain in the left hip. Imaging showed a large expansile lytic lesion involving the acetabulum and pubis. The differential diagnosis was suggestive of giant cell tumor, aneurysmal bone cyst, intraosseous desmoplastic fibroma, and chondrosarcoma. Biopsy revealed a low-grade spindle cell lesion with no evidence of osteoid or chondroid matrix. The lack of cartilaginous nodules in the biopsy prompted a preoperative diagnosis of desmoplastic fibroma. The excised mass showed bland spindle cell proliferation, benign cartilage nodules, and epiphyseal plate-like enchondral ossification suggestive of fibrocartilaginous mesenchymoma. Negative immunostaining for SATB2, CDK4, and MDM2 ruled out low-grade central osteosarcoma. Though GNAS mutations were not performed in this case, rimming of the bony trabeculae at the periphery of the epiphyseal growth plate-like cartilaginous nodule ruled out fibrous dysplasia. The absence of cartilaginous component misleads the diagnosis preoperatively in small biopsies.
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Affiliation(s)
- Monalisa Hui
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, 500082, India
| | - Shantveer G Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, 500082, India.
| | - Ramakrishna Narayanan
- Department of Radiology and Imaging, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, 500082, India
| | - K Nageshwara Rao
- Department of Orthopaedics, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, 500082, India
| | - B Aravind Kumar
- Department of Orthopaedics, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, 500082, India
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Abstract
Fibrous and fibro-osseous tumors are some of the most common benign lesions involving bones. Although many of the histomorphologic features of these tumors overlap significantly, an interdisciplinary approach helps to consolidate the classification of these tumors. Herein, the clinical, radiologic, and pathologic features of lesions within these categories are described.
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Affiliation(s)
- Ivan Chebib
- James Homer Wright Pathology Laboratories, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
| | - Connie Y Chang
- Division of Musculoskeletal Imaging, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Santiago Lozano-Calderon
- Department of Orthopaedic Oncology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Abstract
Bone tumors are a rare and heterogeneous group of neoplasms that occur in the bone. The diversity and considerable morphologic overlap of bone tumors with other mesenchymal and nonmesenchymal bone lesions can complicate diagnosis. Accurate histologic diagnosis is crucial for appropriate management and prognostication. Since the publication of the fourth edition of the World Health Organization (WHO) classification of tumors of soft tissue and bone in 2013, significant advances have been made in our understanding of bone tumor molecular biology, classification, prognostication, and treatment. Detection of tumor-specific molecular alterations can facilitate the accurate diagnosis of histologically challenging cases. The fifth edition of the 2020 WHO classification of tumors of soft tissue and bone tumors provides an updated classification scheme and essential diagnostic criteria for bone tumors. Herein, we summarize these updates, focusing on major changes in each category of bone tumor, the newly described tumor entities and subtypes of existing tumor types, and newly described molecular and genetic data.
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Affiliation(s)
- Joon Hyuk Choi
- Department of Pathology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jae Y Ro
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, TX
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Cleven AHG, Schreuder WH, Groen E, Kroon HM, Baumhoer D. Molecular findings in maxillofacial bone tumours and its diagnostic value. Virchows Arch 2019; 476:159-174. [PMID: 31838586 PMCID: PMC6968989 DOI: 10.1007/s00428-019-02726-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 02/08/2023]
Abstract
According to the WHO, mesenchymal tumours of the maxillofacial bones are subdivided in benign and malignant maxillofacial bone and cartilage tumours, fibro-osseous and osteochondromatous lesions as well as giant cell lesions and bone cysts. The histology always needs to be evaluated considering also the clinical and radiological context which remains an important cornerstone in the classification of these lesions. Nevertheless, the diagnosis of maxillofacial bone tumours is often challenging for radiologists as well as pathologists, while an accurate diagnosis is essential for adequate clinical decision-making. The integration of new molecular markers in a multidisciplinary diagnostic approach may not only increase the diagnostic accuracy but potentially also identify new druggable targets for precision medicine. The current review provides an overview of the clinicopathological and molecular findings in maxillofacial bone tumours and discusses the diagnostic value of these genetic aberrations.
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Affiliation(s)
- Arjen H G Cleven
- Department of Pathology, Leiden University Medical Center, PO, Box 9600, L1-Q, 2300 RC, Leiden, the Netherlands.
| | - Willem H Schreuder
- Department of Oral and Maxillofacial Surgery/Head and Neck Surgery, Amsterdam University Medical Center/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Eline Groen
- Department of Pathology, Leiden University Medical Center, PO, Box 9600, L1-Q, 2300 RC, Leiden, the Netherlands
| | - Herman M Kroon
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Daniel Baumhoer
- Bone Tumour Reference Centre, Institute of Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
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