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Huang Y, Shu SN, Zhou H, Liu LL, Fang F. Infant biliary cirrhosis secondary to a biliary inflammatory myofibroblastic tumor: A case report and review of literature. World J Clin Cases 2022; 10:8375-8383. [PMID: 36159551 PMCID: PMC9403675 DOI: 10.12998/wjcc.v10.i23.8375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/25/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A biliary inflammatory myofibroblastic tumor (IMT) is a rare type of mesenchymoma that, although it has a broad age spectrum, usually occurs in adults. Diagnosis is difficult because biliary IMTs often exhibit nonspecific clinical symptoms and imaging features, resulting in delayed or inappropriate treatment. Although most IMTs are benign, some show malignant properties such as infiltration, recurrence, and metastasis.
CASE SUMMARY Here, we retrospectively describe a 10-month-old infant who was admitted to our hospital due to stubborn jaundice. The patient responded poorly to routine medical treatment and his clinical manifestations and laboratory tests lacked specificity, so we turned to repeated ultrasound scans and other imaging examinations. As both hepatosplenic ultrasonography and diffusion-weighted magnetic resonance imaging demonstrated a space-occupying lesion, an exploratory laparotomy was performed. The final diagnosis made over two mo after the disease onset was infant biliary cirrhosis caused by a biliary IMT, which partially infiltrated into the liver. This infant is the youngest case of biliary IMTs that has been reported till now. The patient underwent an incomplete resection of the mass and Kasai Portoenterostomy. However, because of cirrhosis, he also received a paternal liver transplant. Since some IMTs show malignant properties, we proceeded with a three-year of follow-up; however, no recurrence or metastasis has been noted.
CONCLUSION Neoplastic disease such as IMTs should be considered when routine medical treatment of obstructive jaundice is not successful. Observation of dynamic imaging changes is helpful for diagnosis. Periodic follow-up is necessary for IMTs.
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Affiliation(s)
- Yuan Huang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Sai-Nan Shu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Hua Zhou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Ling-Ling Liu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Feng Fang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Takai Y, Sano T, Watanabe T. A case of hepatic leiomyosarcoma with osteosarcomatous differentiation (malignant mesenchymoma) in a dog. J Toxicol Pathol 2020; 33:33-37. [PMID: 32051664 PMCID: PMC7008204 DOI: 10.1293/tox.2019-0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/18/2019] [Indexed: 01/07/2023] Open
Abstract
A rare spontaneous hepatic leiomyosarcoma with osteosarcomatous differentiation was
observed in a female beagle dog and its morphological and immunohistochemical
characteristics were examined. Upon necropsy, an endoceliac mass originating from the
liver was detected, which was composed of hematoid fluid-filled cysts and white to grayish
solid tissue. There were no macroscopic findings in other organ systems.
Histopathologically, the hepatic mass consisted of two different mesenchymal components.
One form was spindle cells arranged in interlacing fascicles immunohistochemically
positive for smooth muscle actin (SMA) and smoothelin, indicating leiomyosarcomatous
differentiation. The other form was composed of short spindle cells positive for S-100 and
was producing various amounts of eosinophilic osteoid and trabecula-like matrices positive
for osteocalcin, indicating osteosarcomatous differentiation. In addition, invasive growth
in the hepatic parenchyma and cell atypia were observed. Based on these findings, the mass
was diagnosed as hepatic leiomyosarcoma with osteosarcomatous differentiation (malignant
mesenchymoma), which might be derived from undifferentiated mesenchymal cells.
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Affiliation(s)
- Yuichi Takai
- Drug Safety Research and Evaluation, Takeda Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2 Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Tomoya Sano
- Drug Safety Research and Evaluation, Takeda Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2 Chome, Fujisawa, Kanagawa 251-8555, Japan
| | - Takeshi Watanabe
- Drug Safety Research and Evaluation, Takeda Pharmaceutical Company Limited, 26-1 Muraoka-Higashi 2 Chome, Fujisawa, Kanagawa 251-8555, Japan
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Henriksen MDL, Sharkey L, Franzen-Klein D, Wünschmann A, Teixeira LBC, Dubielzig R, Willette M. Bilateral Anterior Uveitis in a Northern Saw-whet Owl ( Aegolius acadicus) With a Metastatic Pectoral Malignant Mesenchymoma. J Avian Med Surg 2020; 33:171-178. [PMID: 31251505 DOI: 10.1647/2017-326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A captive, adult, male northern saw-whet owl (Aegolius acadicus) was examined for blepharospasm of the left eye. The owl was diagnosed with bilateral anterior uveitis and a corneal ulceration in the left eye. It was treated with oral and topical nonsteroidal anti-inflammatory medications and a topical antibiotic. Multiple recheck examinations and medication adjustments were performed over the next 4 months, at the end of which time the bilateral anterior uveitis was controlled with a topical nonsteroidal anti-inflammatory applied 3 times per week to both eyes. The owl was re-examined 2 months later after 2 suspected neurologic episodes. On physical examination, the owl was quiet and had difficulty standing and ambulating. Five firm multilobular and immobile masses were identified overlying the pectoral muscle and sternum. Fine-needle aspiration from 1 mass revealed neoplastic cells consistent with a sarcoma. The owl was euthanatized. On the basis of results of histopathologic examination, the mass was diagnosed as a pleomorphic spindle cell sarcoma with features of rhabdomyosarcoma, liposarcoma, and osteosarcoma. Numerous tumor cells were immunopositive for myoglobin and desmin, indicating striated muscle origin. Although a metastatic lesion was present in 1 adrenal gland, lesions of inflammation or neoplasia were absent in either eye on histopathologic examination. This report describes an apparent ocular manifestation of systemic disease in an avian species with clinically diagnosed recurrent anterior uveitis.
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Affiliation(s)
- Michala de Linde Henriksen
- Comparative Ophthalmology, Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, MN 55108, USA
| | - Leslie Sharkey
- Clinical Pathology, Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, MN 55108, USA
| | - Dana Franzen-Klein
- The Raptor Center, College of Veterinary Medicine, University of Minnesota, St Paul, MN 55108, USA
| | - Arno Wünschmann
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, MN 55108, USA
| | - Leandro B C Teixeira
- Department of Pathobiology Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Richard Dubielzig
- Department of Pathobiology Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Michelle Willette
- The Raptor Center, College of Veterinary Medicine, University of Minnesota, St Paul, MN 55108, USA
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魏 慧, 刘 蕊, 王 占, 姚 中. [Hypophosphatemic osteomalacia caused by urinary mesenchymal tumor: A case report]. Beijing Da Xue Xue Bao Yi Xue Ban 2019; 51:1169-1172. [PMID: 31848524 PMCID: PMC7433593 DOI: 10.19723/j.issn.1671-167x.2019.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Indexed: 06/10/2023]
Abstract
This case report concerns a 34-year-old woman who had been diagnosed with ankylosing spondylitis (AS), fibromyalgia syndrome (FMS), osteoarthritis (OA), lumbar disc herniation and the like in different hospitals during the past 18 months. She had progressive osteoarthrosis, significant muscle weakness, gait abnormalities in weightbearing areas, however without typical inflammatory low back pain, while the treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was invalid, with normal inflammation index, negative results for rheumatic factor (RF) and human leukocyte antigen (HLA)-B27, and normal erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). She had hyphosphatemia, normal serum calcium, 1,25-(OH)2-D3 reduction, elevated alkaline phosphatase (ALP) and normal parathyroid hormone (PTH), however with elevated urinary phosphorus. Finally, the medial thigh nodule was found in the subcutaneous of her inner leg by careful examination and imaging scans including B-ultrasound and PET/CT. The final pathology confirmed that the nodule was phosphate urinary mesenchymal tumors. After the tumor was removed, the patient was treated with anti-osteoporosis and phosphorus supplementation. The symptoms of bone pain and muscle weakness were alleviated, and hypophosphatemia was corrected. It was confirmed that the patient had low-phosphorus osteomalacia due to tumor. Tumor-induced hypophosphatemia osteomalacia (TIO) was a rare paraneoplastic syndrome which was caused by excessive phosphorus excretion induced by the tumor, and was thus categorized as an acquired hypophosphatemic osteomalacia. TIO had an occult onset and was associated with a high rate of misdiagnosis, although TIO has some typical clinical features. Early diagnosis, correctly positioning of the tumor, and surgical resection can achieve good outcomes.
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Affiliation(s)
- 慧 魏
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
| | - 蕊 刘
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
| | - 占辉 王
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
| | - 中强 姚
- />北京大学第三医院风湿免疫科,北京 100191Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China
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Kitazawa T, Shiba M. Osteochondrolipoma of the Mandible. Eplasty 2017; 17:e35. [PMID: 29238440 PMCID: PMC5712529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: Lipomas are very common benign tumors located in any part of the body in which fat is normally present, but lipomas containing both osseous and cartilaginous elements are rare. Methods: A case of osteochondrolipoma in a 72-year-old man is reported. The tumor in the mental region was 2×1.5×1.5 cm. Results: After resection of the tumor, there has been no recurrence during the 6-month postoperative follow-up. Histological examination confirmed the definitive diagnosis. Conclusions: Osteochondrolipoma is an extremely unusual lesion that should be kept in mind in the differential diagnosis of soft-tissue tumors.
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Affiliation(s)
- Takeshi Kitazawa
- Department of Plastic and Reconstructive Surgery, Matsunami General Hospital, Gifu, Japan,Correspondence:
| | - Masato Shiba
- Department of Plastic and Reconstructive Surgery, Matsunami General Hospital, Gifu, Japan
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Abstract
RATIONALE Malignant mesenchymoma (MM) is defined as a heterogeneous malignant soft tissue tumor that consists of 2 or more distinctly different mesenchymal components in addition to fibrosarcomatous elements. Bladder MM was rarely reported in the literature and there are only 5 cases of primary bladder MM documented in English literature to date. PATIENT CONCERNS A 58-year-old male complained of difficulty in urination and intermittent gross hematuria for 3 months. Doppler ultrasound scan revealed an avascular and homogeneous hypoechoic mass measured 6.5 × 9 cm in the bladder. Computed tomography showed a homogeneous solid mass in the bladder. DIAGNOSES Pathology revealed spindle-shaped tumor and proliferation of poorly differentiated immature mesenchymal cells rich in eosinophilic cytoplasm with hyperchromatic sticklike nuclei. Immunohistochemical examinations were positive for CD117. INTERVENTIONS The patient was diagnosed with presence of bladder tumor and underwent radical cystectomy; the optimal treatment strategy was reviewed and discussed. OUTCOMES There was no recurrence or metastasis during a 16-month follow-up. LESSONS Our case study demonstrated bladder MM with a relatively indolent clinical course. A multidisciplinary approach including surgery, radiotherapy, and chemotherapy may be useful. Radical resection is the most important determinant of clinical outcome. Generally, the clinical outcome and prognosis of mesenchymoma are favorable.
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Affiliation(s)
- Zecheng Yang
- Department of General Surgery, The Second Hospital of Jilin University, Changchun City, Jilin Province
| | - Xiaodong Yang
- Department of Urology, Dezhou People Hospital, Dezhou City, Shandong Province
| | - Xianqi Lu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin City
| | - Lijian Gao
- Department of Urology, Dezhou People Hospital, Dezhou City, Shandong Province
| | - Gang Li
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin City
| | - Xuefeng Zhang
- Department of Urology, Weihai Central Hospital, Weihai City, Shandong Province, China
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