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Peng S, Behbahani M, Sharma S, Speck S, Wadhwani NR, Rastatter JC, Alden TD. Pediatric benign triton tumor of trigeminal nerve: a case report and literature review. Childs Nerv Syst 2022; 38:2055-2061. [PMID: 35972536 DOI: 10.1007/s00381-022-05641-1] [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: 06/15/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Benign triton tumors (BTTs) in the pediatric population are extremely rare occurrences. Paucity of data on BTTs poses both diagnostic and therapeutic challenges, particularly when found intracranially. METHODS A case report of a 10-year-old male diagnosed with incidental maxillary trigeminal (V2) BTT is presented. We discuss radiographic and histopathological interpretations. Furthermore, we provide a brief review of current literature and historical background on pediatric trigeminal BTT diagnosis, histopathology, and management. RESULTS Successful gross total resection of the tumor was achieved via Dolenc approach to the cavernous sinus. Management options with consideration of outcomes from the few prior cases reported in the literature are presented. CONCLUSION Treatment of trigeminal nerve tumors requires a broad differential diagnosis and understanding rare tumors is essential in the diagnosis and treatment algorithm.
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Affiliation(s)
- Sophia Peng
- Department of Neurological Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Mandana Behbahani
- Division of Neurosurgery, Ann & Robert H Lurie Children's Hospital, 225 E Chicago Ave, Box 28, Chicago, IL, 60611, USA
| | - Shelly Sharma
- Division of Neurosurgery, Ann & Robert H Lurie Children's Hospital, 225 E Chicago Ave, Box 28, Chicago, IL, 60611, USA
| | - Stacy Speck
- Division of Neurosurgery, Ann & Robert H Lurie Children's Hospital, 225 E Chicago Ave, Box 28, Chicago, IL, 60611, USA
| | - Nitin R Wadhwani
- Department of Pathology, Ann & Robert H Lurie Children's Hospital, Chicago, IL, USA
| | - Jeff C Rastatter
- Division of Otolaryngology, Ann & Robert H Lurie Children's Hospital, Chicago, IL, USA
| | - Tord D Alden
- Division of Neurosurgery, Ann & Robert H Lurie Children's Hospital, 225 E Chicago Ave, Box 28, Chicago, IL, 60611, USA. .,Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. .,Division of Pediatric Neurosurgery, Ann & Robert H Lurie Children's Hospital, 225 E. Chicago Avenue, Chicago, IL, USA.
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Guo W, Wang H, Chen T, Yang W, Wang SF, Chen SL. Clinical features and ultrasound findings of a rare musculoskeletal system disease-neuromuscular choristoma. BMC Musculoskelet Disord 2022; 23:464. [PMID: 35581638 PMCID: PMC9112477 DOI: 10.1186/s12891-022-05238-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background Neuromuscular choristomas (NMCs), are extremely rare developmental lesions that, have been previously established associated with recurrent fibromatosis after surgery, leading to several operations or even amputation. However, reports on the ultrasound imaging features and clinical conditions of NMCs are rare. The purpose of this study is to describe the ultrasound features and clinical analysis of NMCs to provide suggestions to identify the optimal management strategy. Methods From September 2020 to September 2021, 7 patients with a confirmed diagnosis of NMC who underwent ultrasound examination in our department were enrolled in our study. Physical examinations were performed to detect motor deficits, sensory deficits, neuropathic pain, limb undergrowth, muscular atrophy, cavus foot and bone dysplasia. Ultrasound imaging was performed and investigated both in affected nerves and neuromuscular choristomas associated desmoid-type fibromatosis (NMC-DTF). All patients had a definite history and regular follow-up. The clinical course, physical examinations, ultrasound features and pathologic results of NMC patients were analyzed. Results Seven patients with an average age of 7.0 ± 7.2 years (range: 2–22 years) were enrolled in our study. The affected nerves included the sciatic nerve (6 cases) and the brachial plexus (1 case). Six patients (85.7%) presented with limb undergrowth, 6 (85.7%) with muscular atrophy, and 5 (71.4%) with cavus foot deformity. Based on ultrasound findings, all the visibly affected nerve segments presented with hypoechoic and fusiform enlargement with intraneural skeletal muscle elements. Five patients (71.4%) had NMC-DTFs at the site of the affected nerve. All NMC-DTFs were shown as hypoechoic solid lesions adjacent to the nerve and were well circumscribed. In the subset of the surgery group, all 5 patients presented with progression to NMC-DTFs at the site of the NMCs. No fibromatosis was detected in the other two nonsurgical patients. Conclusions Understanding the typical ultrasound features and clinically associated conditions would support the early diagnosis of this rare disease. When a potential diagnosis is determined, an invasive procedure such as biopsy or resection might not be a good choice given the frequent occurrence of complications such as aggressive recurrence.
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Affiliation(s)
- Wen Guo
- Department of Ultrasound, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No.31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China
| | - Hong Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Haidian District, 52 Fucheng Road, Beijing, 100142, China
| | - Tao Chen
- Department of Ultrasound, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No.31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
| | - Wei Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Haidian District, 52 Fucheng Road, Beijing, 100142, China
| | - Shu-Feng Wang
- Department of Hand Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No.31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China
| | - Shan-Lin Chen
- Department of Hand Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, No.31 Xinjiekou East Street, Xicheng District, Beijing, 100035, China
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Maldonado AA, Planchard RF, Jack MM, Smith BW, Carter JM, Spinner RJ. Lipomatosis of the Nerve and Neuromuscular Choristoma: Two Rare Entities and Their Call for an Animal Model to Understand and Mitigate Nerve-Territory Sequelae. World Neurosurg 2021; 159:56-62. [DOI: 10.1016/j.wneu.2021.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
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Berklite L, Ozolek J, Wang L, Santoro L, Donofrio V, Stracuzzi A, John I, Alaggio R. Pediatric Benign Tumors With a Skeletal Muscle Component: Myogenin Expression, Diagnostic Pitfalls, and New Molecular Insights. Pediatr Dev Pathol 2021; 24:213-226. [PMID: 33683985 DOI: 10.1177/1093526621998932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Benign tumors with skeletal muscle differentiation are rare and their characterization in the literature is limited. We present a series of twelve pediatric benign tumors with rhabdomyomatous differentiation including seven rhabdomyomatous mesenchymal hamartomas, four fetal rhabdomyomas, and one benign triton tumor, analyzing myogenic markers as well as clinicopathologic and molecular features. A review of the literature was also performed with an emphasis on myogenic marker expression and correlation with molecular features. METHODS AND RESULTS Cases obtained from three tertiary pediatric hospitals were retrospectively reviewed. Eleven of twelve cases expressed myogenin in rare to greater than 15% of cells. Five of nine cases had rare to 70-80% of cells positive for MyoD1. One fetal rhabdomyoma demonstrated homozygous deletions in ZEB2. The benign triton tumor harbored a CTNNB1 mutation. Review of the literature identified 160 pediatric benign tumors with skeletal muscle differentiation of which 9 reported myogenin positivity. CONCLUSIONS Myogenin and MyoD1 may be variably expressed in benign lesions with skeletal muscle differentiation. Recognition of key morphologic features remains critical to diagnose these lesions and, in rhabdomyoma, to exclude malignancy. Our series expands the knowledge of the relationship between rhabdomyoma and rhabdomyosarcoma (RMS) by identifying a shared molecular alteration in ZEB2.
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Affiliation(s)
- Lara Berklite
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - John Ozolek
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, 64 Medical Center Drive, Morgantown, West Virginia
| | - Larry Wang
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California
| | - Luisa Santoro
- Department of Pathology, Azienda Ospedaliera di Padova, Padova, Italy
| | - Vittoria Donofrio
- Department of Pathology, Ospedale Pediatrico Pausilipon, Napoli, Italy
| | | | - Ivy John
- Department of Pathology, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, Pennsylvania
| | - Rita Alaggio
- Department of Pathology, Ospedale Pediatrico Bambino Gesú, Rome, Italy
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Sharareh B, Hicks J, Castro E, Bell B. Neuromuscular Choristoma Variant in the Forearm Presenting as a Posterior Interosseous Nerve Palsy: A Case Report. JBJS Case Connect 2021; 10:e0525. [PMID: 32224649 DOI: 10.2106/jbjs.cc.19.00525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 14-year-old boy presented with an 18-month history of progressive left wrist drop. Magnetic resonance imaging studies were concerning for mass infiltration of the posterior interosseous nerve (PIN). Surgical resection and pathology confirmed a variant of neuromuscular choristoma (NMC), infiltrated with and surrounded by proliferation of smooth muscle, rather than skeletal muscle. Given the wide-spanning nerve involvement, the patient underwent tendon transfers at the time of surgical resection. CONCLUSION We report here the first case report of a NMC in the PIN and the first pathologically confirmed case with exclusive smooth muscle involvement without a skeletal muscle component.
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Affiliation(s)
- Behnam Sharareh
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas
| | - John Hicks
- Department of Pathology, Texas Children's Hospital, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Eumenia Castro
- Department of Pathology, Texas Children's Hospital, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Bryce Bell
- Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas.,Department of Orthopedic Surgery, Texas Children's Hospital, Houston, Texas
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Maldonado AA, Spinner RJ, Carter JM, Stone JJ, Howe BM. Clinical and Magnetic Resonance Imaging Longitudinal Follow-up of Neuromuscular Choristomas. World Neurosurg 2019; 129:e761-e766. [DOI: 10.1016/j.wneu.2019.06.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 12/01/2022]
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Leclerc J, Morice A, Belhous K, Pierron G, Kadlub N, Galmiche L. [A rare neonatal tumor of the head and neck region]. Ann Pathol 2018; 39:60-63. [PMID: 30553639 DOI: 10.1016/j.annpat.2018.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 08/13/2018] [Accepted: 09/03/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Julie Leclerc
- Service d'anatomopathologie, hôpital Necker Enfants-malades, 149, rue de Sèvres, 75015 Paris, France.
| | - Anne Morice
- Service de chirurgie maxillofaciale et chirurgie plastique, hôpital Necker Enfants-malades, 149, rue de Sèvres, 75015 Paris, France; Université Paris Descartes, 12, rue de l'École-de-médecine, 75005 Paris, France
| | - Kahina Belhous
- Service de radiologie, hôpital Necker Enfants-malades, 149, rue de Sèvres, 75015 Paris, France
| | - Gaëlle Pierron
- Unité de génétique somatique, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Natacha Kadlub
- Service de chirurgie maxillofaciale et chirurgie plastique, hôpital Necker Enfants-malades, 149, rue de Sèvres, 75015 Paris, France; Université Paris Descartes, 12, rue de l'École-de-médecine, 75005 Paris, France
| | - Louise Galmiche
- Service d'anatomopathologie, hôpital Necker Enfants-malades, 149, rue de Sèvres, 75015 Paris, France
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O'Brien TG, Spinner RJ, Boon AJ. Neuromuscular choristoma presenting with unilateral limb hypoplasia in a 3-year-old boy. Muscle Nerve 2016; 54:797-801. [DOI: 10.1002/mus.25177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Travis G. O'Brien
- Department of Physical Medicine and Rehabilitation; Mayo Clinic; 200 First Street Rochester Minnesota 55905 USA
| | - Robert J. Spinner
- Department of Neurologic Surgery; Mayo Clinic; Rochester Minnesota USA
| | - Andrea J. Boon
- Department of Physical Medicine and Rehabilitation; Mayo Clinic; 200 First Street Rochester Minnesota 55905 USA
- Department of Neurology; Mayo Clinic; Rochester Minnesota USA
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