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Tokunaga K, Nagoshi N, Ohara K, Shibuya M, Suzuki S, Tsuji O, Okada E, Fujita N, Yagi M, Watanabe K, Nakamura M, Matsumoto M. Recurrence of cervical intramedullary gliofibroma. Spinal Cord Ser Cases 2021; 7:97. [PMID: 34741004 DOI: 10.1038/s41394-021-00461-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/25/2021] [Accepted: 10/26/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Gliofibroma is a rare tumor that develops in the brain and spinal cord. Due to the rarity of its nature, its pathophysiology and appropriate treatment remain elusive. We report a case of intramedullary spinal cord gliofibroma that was surgically treated multiple times. This report is of great significance because this is the first case of recurrence of this tumor. CASE PRESENTATION A 32-year-old woman complained of gait disturbance and was referred to our institution. At the age of 13 years, she was diagnosed with intramedullary gliofibroma and underwent gross total resection (GTR) in another hospital. Based on imaging findings, tumor recurrence was suspected at the level of cervical spinal cord, and surgery was performed. However, the resection volume was limited to 50% because the boundary between the tumor and spinal cord tissue was unclear and intraoperative neuromonitoring alerted paralysis. At 1 year postoperatively, the second surgery was performed to try to resect the residual tumor, but subtotal resection was achieved at most. At 2 years after the final surgery, no tumor recurrence was observed, and neurologic function was maintained to gait with cane. DISCUSSION Although complete resection is desirable for this rare tumor at the initial surgery, there is a possibility to recur even after GTR with long-term follow-up. During surgical treatment for tumor recurrence, fair adhesion to the spinal cord is expected, and reoperation and/or adjuvant therapy might be considered in the future if the tumor regrows and triggers neurological deterioration.
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Affiliation(s)
- Keita Tokunaga
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan.
| | - Kentaro Ohara
- Department of Pathology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Makoto Shibuya
- Central clinical laboratory, Hachioji medical center, Tokyo medical university, Tokyo, 193-0998, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Osahiko Tsuji
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Aichi, 470-1192, Japan
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, 160-8582, Japan
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Successful Treatment of a Massive Desmoplastic Fibroma of the Ilium without Surgery: A Case Report with Long-Term Follow-Up. Case Rep Orthop 2020; 2020:5380598. [PMID: 32292618 PMCID: PMC7148584 DOI: 10.1155/2020/5380598] [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: 09/02/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022] Open
Abstract
Desmoplastic fibroma of the bone (DFB) is a notably rare, lytic, locally aggressive but nonmetastatic, primary benign bone tumor in patients less than 30 years old. As the recommended primary treatment for DFB, wide resection is preferred to curettage from the perspective of recurrence but wide resection of DFB in the pelvis such as in the acetabulum could result in greater functional loss, suggesting the need for conservative treatments. However, there is no report on long-term follow-up following conservative treatment for DFB. The present case involved a 21-year-old woman with right hip pain. Radiological evaluation revealed a massive lesion throughout the right ilium and acetabulum with partial osteolysis, cortical destruction, marginal sclerosis, slight pseudotrabeculation, and bone expansion. Open biopsy from the ilium showed the proliferation of spindle cells in an abundant collagenous matrix without atypia and mitosis, suggesting a diagnosis of DFB. Conservative treatment was selected considering the risk of greater functional loss following wide ilium resection. An evaluation 10 years after follow-up showed a partially sclerotic lesion of the ilium and the absence of pain. The current case demonstrates that conservative therapy may be effective even in some cases of aggressive DFB.
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Kaneva K, Yeo KK, Hawes D, Ji J, Biegel JA, Nelson MD, Bluml S, Krieger MD, Erdreich-Epstein A. Rare Pediatric Invasive Gliofibroma Has BRAFV600E Mutation and Transiently Responds to Targeted Therapy Before Progressive Clonal Evolution. JCO Precis Oncol 2019; 3. [PMID: 31179415 DOI: 10.1200/po.18.00138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kristiyana Kaneva
- Division of Hematology, Oncology, and Blood and Marrow Transplant Program, Children's Center for Cancer and Blood Diseases, Department of Pediatrics, Children's Hospital Los Angeles
| | - Kee Kiat Yeo
- Division of Hematology, Oncology, and Blood and Marrow Transplant Program, Children's Center for Cancer and Blood Diseases, Department of Pediatrics, Children's Hospital Los Angeles
| | - Debra Hawes
- Department of Pathology, University of Southern California, Los Angeles, CA
| | - Jianling Ji
- Department of Pathology, University of Southern California, Los Angeles, CA
| | - Jaclyn A Biegel
- Department of Pathology, University of Southern California, Los Angeles, CA
| | - Marvin D Nelson
- Department of Radiology, University of Southern California, Los Angeles, CA
| | - Stefan Bluml
- Department of Radiology, University of Southern California, Los Angeles, CA
| | - Mark D Krieger
- Division of Neurosurgery, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Anat Erdreich-Epstein
- Division of Hematology, Oncology, and Blood and Marrow Transplant Program, Children's Center for Cancer and Blood Diseases, Department of Pediatrics, Children's Hospital Los Angeles.,Department of Pathology, University of Southern California, Los Angeles, CA.,Department of Pediatrics, University of Southern California, Los Angeles, CA.,Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Abstract
RATIONALE Desmoplastic fibroma of the bone (DFB) is an extremely rare benign bone tumor, which can occur in any bone at all ages. Herein, we report a case of non-specific imaging findings. PATIENT CONCERNS A 25-year-old female patient was consulted in the Armed Police General Hospital (Beijing, China) due to repeated pain in the right thigh lasting over 1 year. Imaging examination revealed a space-occupying lesion in the right femur. DIAGNOSIS Desmoplastic fibroma of the femur INTERVENTIONS:: Wide surgical resection OUTCOMES:: At the 1-year follow-up visit, no relapse in the tumor was observed. LESSONS In this case report, we described and emphasized the particularity of the case examined and the possible non-specificity of the imaging results of some DFB cases.
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Affiliation(s)
- Yongming Xu
- Postgraduate Training Base, Armed Police General Hospital of Jinzhou Medical University
| | - Yaoting Wang
- Department of Orthopedics, Chinese People's Armed Police Force General Hospital; No. 69, Yongding Road, Haidian District, Beijing, China
| | - Jun Yan
- Department of Orthopedics, Chinese People's Armed Police Force General Hospital; No. 69, Yongding Road, Haidian District, Beijing, China
| | - Xiaodong Bai
- Department of Orthopedics, Chinese People's Armed Police Force General Hospital; No. 69, Yongding Road, Haidian District, Beijing, China
| | - Gengyan Xing
- Department of Orthopedics, Chinese People's Armed Police Force General Hospital; No. 69, Yongding Road, Haidian District, Beijing, China
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Amoroso R, Weiss A, Pieri F, Zucchi V, Bosio M, Stasi I, Santonocito O. Fronto-mesial-pericallosal gliofibroma. J Neurosurg Sci 2018; 64:302-304. [PMID: 29671292 DOI: 10.23736/s0390-5616.18.04378-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Rosina Amoroso
- Unit of Neurosurgery, Livorno Civil Hospital, Livorno, Italy -
| | | | - Francesco Pieri
- Department of Neurosciences, University of Pisa, Pisa, Italy
| | - Vanna Zucchi
- Unit of Neurosurgery, Livorno Civil Hospital, Livorno, Italy
| | - Manrico Bosio
- Unit of Neurosurgery, Livorno Civil Hospital, Livorno, Italy
| | - Irene Stasi
- Unit of Neurosurgery, Livorno Civil Hospital, Livorno, Italy
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