Fibroma mole gigante vulvar: relato de caso / Giant soft vulvar fibroma: case report

Fibroma mole, ou pólipo fibroepitelial, é uma lesão de proporções geralmente reduzidas, de cor hiperpigmentada ou igual à da pele, localizando-se frequentemente na face, pescoço, tronco e regiões intertriginosas. É um tumor classificado como benigno e pode acometer tanto homens quanto mulheres em idade reprodutiva e depois da quarta década de vida. Ocorre principalmente em obesos, diabéticos e durante a gestação. Com menor frequência, podem alcançar dimensões que excedem 5 cm. Seu crescimento pode ser lento ou rápido e comumente são assintomáticos, mas podem promover sangramentos por conta de ulcerações decorrentes de traumas repetidos. Apresentamos neste relato um fibroma mole, gigante, de localização vulvar, com 11 cm de comprimento, 11 cm de largura e 5 cm de espessura, pesando 500 g.

Giant soft vulvar fibroma is a fibroepithelial polyp lesion with generally reduced proportions, with a hyperpigmented color or similar to that of the skin, frequently located on the face, neck, trunk and intertriginous regions. It is a tumor classified as benign, can affect both men and women, of reproductive age and after the fourth decade, mainly obese, diabetic and during pregnancy. However, less frequently, they can reach dimensions that exceed 5 cm, may have a slow or accelerated evolution. They are commonly asymptomatic, but bleeding may be present due to ulcerations resulting from repeated trauma. In the current study, we describe a giant soft fibroma with a vulvar location measuring 11 cm in length, 11 cm in width, 5 cm in thickness and weighing 500 grams.

Pathological features and clinicopathological significance of TERT promoter mutation in breast fibroepithelial tumors without definite diagnosis / 中华病理学杂志

Objective: To investigate the pathological features and the clinicopathological significance of TERT detection in those tumors that were difficult to diagnosis. Methods: A total of 93 cases of fibroepithelial tumors without definite diagnosis were collected from the Affiliated Hospital of Qigndao University between 2013 and 2021. The clinical details such as patients' age and tumor size were collected. All slides were re-reviewed and the pathologic parameters, including stromal cellularity, stromal cell atypia, stromal cell mitoses, and stromal overgrowth were re-interpreted. Sanger sequencing was used to detect TERT promoter status, and immunohistochemistry was performed to detect TERT protein expression. The relationship between TERT promoter mutation as well as protein expression levels and the clinicopathological parameters were also analyzed. Results: The patients' ages ranged from 30 to 71 years (mean of 46 years); the tumor size ranged from 1.2 to 8.0 cm (mean 3.8 cm). These tumors showed the following morphologic features: leafy structures in the background of fibroadenoma, or moderately to severely abundant stromal cells. The interpretations of tumor border status were ambiguous in some cases. The incidence of TERT promoter mutation was high in patients of age≥50 years, tumor size≥4 cm, and stromal overgrowth at ×4 or ×10 objective, and these clinicopathologic features were in favor of diagnosis of phyllodes tumors. TERT protein expression levels was not associated with the above clinicopathologic parameters and its promoter mutation status. Conclusions: The diagnostic difficulty for the breast fibroepithelial tumors is due to the difficulty in recognition of the leafy structures or in those cases with abundant stromal cells. A comprehensive evaluation combined with morphologic characteristics and molecular parameters such as TERT promoter may be helpful for the correct diagnosis and better evaluating recurrence risk.

Core needle biopsy in fibroepithelial tumors: predicting factors for phyllodes tumors

OBJECTIVES: This study aimed to evaluate the clinical and imaging predictive factors for the diagnosis of phyllodes tumors in patients with inconclusive results from core needle biopsy (fibroepithelial lesions). METHODS: We retrospectively analyzed data of patients who underwent surgical excision of breast lesions previously diagnosed as fibroepithelial lesions. Numeric variables were analyzed using the Shapiro-Wilk and t-tests, and categorical variables were analyzed using the chi-square and Fisher's exact tests. Multivariate logistic regression was performed to calculate odds ratios and detect predictive factors for the diagnosis of PT. RESULTS: A total of 89 biopsy samples were obtained from 77 patients, of which 43 were confirmed as fibroadenomas, 43 as phyllodes tumors, and 3 as other benign, non-fibroepithelial breast lesions. The mean tumor size was 3.61 cm (range, 0.8-10 cm) for phyllodes tumors and 2.4 cm (range, 0.8-7.9 cm) for fibroadenomas. The predictive factor for phyllodes tumor diagnosis was lesion size >3 cm (p<0.001). CONCLUSION: Our data indicate that fibroepithelial lesions of the breast larger than 3 cm are more likely to be phyllodes tumors.

Tumor Phyllodes: revision de la literatura / Phyllodes tumor: literature review

Resumen El tumor phyllodes de mama es un tumor fibroepitelial raro, pero clínicamente importante, que representa menos del 1% de las neoplasias de mama. Histológicamente, los tumores phyllodes se clasifican en tres; como: benignos, limítrofes o malignos, basándose en una combinación de criterios histológicos y patológicos. Esta clasificación del tumor phyllodes de mama es precisamente relevante en su clínica. Si bien la recurrencia local del tumor phyllodes puede ocurrir en todos los grados, la metástasis se limita principalmente a casos malignos y pocos casos limítrofes, por lo general siendo estos dos últimos los que presentan un peor pronóstico de la enfermedad. El tratamiento es principalmente quirúrgico ya que los tumor phyllodes no responden bien a la terapia sistémica. Esta revisión del tumor phyllodes de mama permite orientar a toda la comunidad médica, con base en la evidencia más reciente, a diagnosticar y así poder manejar esta patología, evitando sus complicaciones.

Abstract Phyllodes tumor of the breast is a rare, but clinically important fibroepithelial tumor, accounting for <1% of breast tumors. Histologically, phyllodes tumor is classified into three; as: benign, borderline or malignant, based on a combination of histological and pathological criteria. This classification of the phyllodes breast tumor is precisely relevant in the clinic. While local recurrence of phyllodes tumor may occur in all grades, metastasis is mostly limited to malignant and few borderline cases, usually the latter two types having a worse prognosis of the disease. Treatment is mainly surgical as phyllodes tumor doesn´t respond well to systemic therapy. This review of the phyllodes tumor allows to guide the entire medical community based on the most recent evidence to diagnose and thus be able to manage this pathology, avoiding its complications.

Atypical presentation of fibroepithelial polyp: a report of two cases / Apresentação atípica de pólipo fibroepitelial: um relato de dois casos

ABSTRACT Fibroepithelial polyps are benign non-epithelial tumors arising from mesodermal tissue and are commonly found on the skin. They can develop on the eyelid and surrounding area and rarely appear at other sites. While most cutaneous cases are diagnosed incidentally, the lesions may be symptomatic based on their location. The etiology of fibroepithelial polyps is not fully understood but may involve trauma, chronic irritation, allergic factors, and developmental or congenital causes. Although fibroepithelial polyps are benign lesions, they can be malignant in extremely rare cases. Herein we discuss 2 cases of fibroepithelial polyp with an atypical presentation and their treatment.

RESUMO Pólipos fibroepiteliais são tumores benignos não-epiteliais que surgem do tecido mesodérmico e são comumente encontrados na pele. Eles podem se desenvolver na pálpebra e na área adjacente, e raramente aparecem em outros locais. Embora a maioria dos casos cutâneos seja diagnosticada incidentalmente, as lesões podem ser sintomáticas com base em sua localização. A etiologia dos pólipos fibroepiteliais não é completamente compreendida, mas pode envolver trauma, irritação crônica, fatores alérgicos e causas de desenvolvimento ou congênitas. Apesar dos pólipos fibroepiteliais serem lesões benignas, podem ser malignos em casos extremamente raros. Aqui discutimos 2 casos de pólipo fibroepitelial com uma apresentação atípica e seu tratamento.

Tumores infrecuentes en pediatría: tumor de ovario: caso clínico / Infrequent tumors in pediatrics: ovarian tumor presentation of a case and bibliographic review

Introducción: Los tumores malignos de ovario son raros en la edad pediátrica, con una incidencia de 1-2 por cada 1 000 000 habitantes, caracterizados por dolor abdominal y efecto de masa, cuya edad de diagnóstica varia teniendo dos picos de incidencia entre 8 a 9 años de vida y entre los 13 a 17 años. Objetivo: Identificar los puntos critico que influyeron en el diagnóstico y tratamiento de niña con tumor de ovario. Descripción del caso: Referimos el caso de una adolescente de 14 años que ingresa al servicio de pediatría, por presentar dolor abdominal, distención abdominal y vómito. Al ser evaluada se encuentra una gran distención abdominal con una masa dura que abarca especialmente hemi-abdomen derecho. La TAC y ECO revelan masa quística dependiente de ovario derecho que desplaza asas intestinales, además la presencia de derrame pleural bilateral que lleva al diagnóstico de metástasis pulmonar. No se realiza examen histopatológico debido a que la paciente acude a recibir atención médica especializada en estadios avanzados de la enfermedad al proceder de área rural. Conclusiones: Se describe un caso de niña a la que se le realiza diagnóstico de tumor de ovario avanzado y metástasis pulmonar, que no se realiza examen histopatológico por provenir de área rural, recibir tratamientos naturales por periodo prolongado lo que impidieron realizar diagnóstico y tratamiento oportuno

Introduction: Malignant ovarian tumors are rare in the pediatric age, with an incidence of 1-2 per 1 000 000 persons. Introduction: Malignant ovarian tumors are rare in the pediatric age, with an incidence of 1-2 per 1 000 000 inhabitants, characterized by abdominal pain and mass effect, whose diagnostic age varies with two peaks of incidence between 8 to 9 years of life and between 13 to 17 years. Objetive: To identify the critical points that influenced the diagnosis and treatment of a girl with an ovarian tumor. Case description: We report the case of a 14-year-old girl who enters the pediatric service, due to abdominal pain, abdominal distention and vomiting. When evaluated, a large abdominal distension is found with a hard mass that especially includes the right hemi-abdomen. CT and ECO reveal cystic mass dependent on the right ovary that displaces intestinal loops, in addition to the presence of bilateral pleural effusion that leads to the diagnosis of pulmonary metastasis. Histopathological examination is not performed because the patient goes to receive specialized medical attention in advanced stages of the disease when coming from rural area. Conclusions: We describe a case of a girl who is diagnosed with advanced ovarian tumor and pulmonary metastasis, who did not undergo histopathological examination due to being from rural areas, receiving natural treatments for a prolonged period, which prevented diagnosis and timely treatment

Fibroadenoma vulvar: a propósito de un caso clínico / Vulvar fibroadenoma: about a clinical case

RESUMEN El fibroadenoma vulvar es un tumor benigno poco frecuente con muy pocos casos descritos en la literatura. Por lo general, se diagnostica entre los 20 y 70 años. Tiene un buen pronóstico y rara vez recurre después de la escisión. Presentamos un caso de fibroadenoma vulvar, en una mujer de 33 años, manifestado como un tumor localizado, bien definido de partes blandas en el labio mayor izquierdo. La lesión fue extirpada completamente y la histología confirmó un fibroadenoma con marcador de estrógeno positivo.

ABSTRACT Vulvar fibroadenoma is a rare benign tumor with few cases reported in the literature. It usually occurs between 20 and 70 years of age. It has a good prognosis and rarely recurs following excision. We present a case of vulvar fibroadenoma as a localized, well-defined soft tissue mass in the left labium majus of a 33-year-old woman. The mass was excised completely, and histology demonstrated a fibroadenoma positive for estrogen receptor.

Unusual size, topography, and surgical resolution of an acquired fibrokeratoma

Abstract: Acquired fibrokeratoma is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digits. We report a case of plantar acquired fibrokeratoma evidencing its atypical size and topography, in addition to the treatment with simple surgical excision followed by healing by second intention. Nondigital fibrokeratomas may occur in 18% of cases and rarely affect the palmoplantar region. These lesions are usually asymptomatic and show ≥ 3cm in size at the time of diagnosis due to delayed diagnosis. Complete surgical excision is the treatment of choice, which is usually curative. In general, primary closure is chosen; however healing by second intention becomes an option in regions of difficult approach.

CD13 Expression in Onychomatricoma: Association with Nail Matrix Onychodermis

No abstract available.

Distant metastases in phyllodes tumours of the breast: an overview

Phyllodes tumours (PTs) of the breast are uncommon fibroepithelial neoplasms, comprising 0.3 ­ 1.0% of all primary breast malignancies in Western countries, but accounting for a higher proportion of primary breast tumours in Asian countries. They are graded as benign, borderline or malignant based on the World Health Organisation (WHO) classification, according to a constellation of 5 histologic parameters. While most PTs carry a good prognosis, malignant and occasionally borderline PTs have the potential to metastasize to distant sites. Although events of distant metastasis are few, the prognosis for such patients is dismal, as they are often unresponsive to chemotherapy with high mortality. This review seeks to provide an overview of this rare but important phenomenon of distant metastases in PTs of the breast (AU)

Fibroepithelial polyp of the vulva accompanied by lymphangioma circumscriptum

Fibroepithelial polyp (FEP) and lymphangioma circumscriptum (LC) of the vulva are rare diseases that occur generally in young to middle-aged women. The pathogenesis of FEP is not clearly understood. Several previous cases have suggested that a hormonal influence may be a predisposing condition for developing FEP with or without chronic inflammation. A 68-year-old postmenopausal woman presented with a history of multiple raised lesions on the vulva with a 1-year duration. Additionally, a pedunculated mass had appeared 6 months earlier in the left lower labia minora. The patient underwent simple excision by electrocautery. The final pathological diagnosis was FEP with LC. In this case, the development of FEP was associated only with chronic inflammation induced by LC. Therefore, the case supports the hypothesis that a chronic inflammatory process may be related to the development of FEP even without hormonal influence.

Tumor filoide. Estado del arte / Phyllodes tumour. State of the art

El tumor filoide (TF) es una neoplasia fibroepitelial con una baja incidencia a nivel mundial, lo que limita el poder contar con estudios prospectivos acerca de su abordaje diagnóstico y terapéutico. Se hace una revisión actualizada de su presentación, diagnóstico y tratamiento. Con las características histopatológicas disponibles actualmente se puede subdividir el TF en: de histología benigna, limítrofe y maligna. Esta subclasificación permite establecer el abordaje quirúrgico, que es la base del manejo terapéutico, la indicación de terapias adyuvantes, y finalmente establecer el pronóstico de la paciente.

Phyllodes tumour is a fibroepithelial neoplasm of the breast, with a low world incidence, and with few prospective trials on its diagnosis and treatment. A review is presented of the available world medical literature on this topic. Phyllodes tumours can currently be classified as benign, borderline and malign. This classification helps to determine the surgical treatment, which is the cornerstone of the treatment of Phyllodes tumour, as well as the adjuvant treatment, and finally it helps to determine the patient's prognosis.

Tumores benignos de vulva: revisión y caso clínico de acrocordón / Benign tumors of vulva: review and case report of achrocordon

La región vulvovaginal es una zona muy compleja por todos los elementos que la conforma y puede ser origen de un gran número de tumores benignos y en menor frecuencia de tumores malignos. En las últimas décadas, los tumores vulvovaginales han tenido un avance significativo en cuanto a su diagnóstico y tratamiento, dado por las aportaciones de la biología celular y molecular. El presente artículo pretende ser una referencia práctica para el diagnóstico clínico e histopatológico de estos tumores benignos así como en el tratamiento ambulatorio de algunos de ellos y su vigilancia.

The vulvovaginal region is a very complex area because of its anatomy and the fact that it can be source of a large number of benign tumors and less frequent malignant tumors. In recent decades, there have been significant gains in the diagnosis and treatment of vulvovaginal tumors, thanks to the contributions of cellular and molecular biology. The purpose of this review article is to serve as a practical reference for clinical and pathological diagnosis as well as in the outpatient treatment and monitoring of these benign tumors.

Clinicopathologic observation of carcinomas arising in fibroepithelial neoplasms of the breast / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the pathology, diagnosis and differential diagnosis of carcinomas arising in fibroepithelial neoplasms of the breast.</p><p><b>METHODS</b>Morphological observation and immunohistochemistry using MaxVision method were performed in fifty-four cases of carcinoma arising from fibroepithelial neoplasms of the breast from January 2003 to February 2014.</p><p><b>RESULTS</b>Thirty-eight cases of carcinoma arose from fibroadenomas. Twelve cases were classical lobular carcinoma in situ (LCIS). Twenty-one cases were ductal carcinoma in situ (DCIS), including four cases of low-grade, ten cases of intermediate-grade, six cases of high-grade and one case of apocrine. One case was mixed DCIS and LCIS. Three cases were infiltrating ductal carcinoma (IDC) accompanied with DCIS. One case was spindle cell metaplastic carcinoma. Sixteen cases arose from phyllodes tumours. Six cases arose from benign phyllodes tumours, including four cases of low-grade DCIS, one case of high-grade DCIS, and one case of classical LCIS with micro-invasion (diameter 0.9 mm). Three cases arose from borderline phyllodes tumours, including one case of classical LCIS, one case of intermediate-grade DCIS, and one case of invasive lobular carcinoma (ILC) with LCIS. Seven cases arose from malignant phyllodes tumours, including two cases each of low-grade DCIS and intermediate-grade DCIS, one case of high-grade DCIS, one case of apocrine DCIS, and one case of mixed IDC with DCIS. By immunohistochemistry, LCIS and ILC were diffusely positive for ER and PR. Low-grade DCIS was diffusely positive for ER and PR ( > 90%), intermediate-grade DCIS was 70%-90% positive, high-grade DCIS was negative for ER and 20%-30% positive for PR, apocrine DCIS was both negative, and IDC was 40%-90% positive. The spindle cell metaplastic carcinoma was negative for ER and PR, but showed diffuse or scattered positivity for CK5/6 and p63.</p><p><b>CONCLUSIONS</b>Carcinomas arising from fibroepithelial neoplasms of the breast are rare, showing unusual clinical presentation, and are characterized by in situ or invasive carcinomas in a background of fibroepithelial neoplasms. The accurate diagnosis depends on the recognition of the background fibroepithelial neoplasms and assessment of the nature of the epithelial proliferation, supplemented by immunohistochemistry when necessary.</p>

A giant fibroepithelial polyp mimicking a subepithelial tumor

No abstract available.

Tracheal polyp treated with endobronchial electrocautery.

Fibroepithelial polyps of trachea are extremely rare. Here, we report a case of tracheal polyp in a 40-year-old woman that was managed successfully with endobronchial electrocautery with a review of the relevant literature.

Invasive Cribriform Carcinoma Arising in Malignant Phyllodes Tumor of Breast: A Case Report

Phyllodes tumor is an uncommon fibroepithelial neoplasm of the breast. And it is characterized by expanded stroma with increased cellularity and elongated epithelium-lined clefts. Mammary carcinomas within phyllodes tumors have been rarely reported. To date, however, no reports have described the invasive cribriform carcinoma arising in malignant phyllodes tumor. Here, we report a 62-year-old woman who presented with a large breast mass. Microscopically, the mass was a typical malignant phyllodes tumor showing well developed leaf-like architecture and stromal overgrowth with high cellularity and nuclear pleomorphism. In a portion of the tumor, however, the epithelial component showed a cribriform pattern of proliferation in the absence of myoepithelial cells, suggestive of the invasive cribriform carcinoma. To our knowledge, this is rare and it is difficult to make a differential diagnosis of it. Here, we report our case with a review of literatures.

Fibroepithelial Polyp of the Bronchus: CT and Histopathologic Findings

A fibroepithelial polyp of the bronchus is a rare, benign, and endobronchial tumor, histologically consisting of fibrovascular stroma covered by normal respiratory epithelium. We report a case of a fibroepithelial polyp arising from the left main bronchus. On CT, a characteristic lobulating contour of the endobronchial nodule was well visualized, which histopathologically represented a typical papillary growth pattern of the nodule. Such a lobulating contour of the nodule might help make a correct diagnosis of this rare disease among other various endobronchial neoplasms.

Fibroepithelial tumors of female breast: a review of 250 cases of fibroadenomas and phylloides tumors

Fibroepithelial tumors of the breast including fibroadenomas and phylloides tumors arise from epithelial and stromal components of the terminal duct-lobular unit. Fibroadenoma is the commonest benign neoplasm of the female breast. These tumors are found as early as puberty. Mammary phylloides tumors are uncommon stromal-epithelial neoplasms and are divided into benign, borderline malignant and frankly malignant groups on the basis of their histological features. The aim of this study is to evaluate the role of morphologic diagnosis in a series of fibroepithelial [biphasic] tumors of the breast including fibroadenoma and phylloides tumor, highlighting the morphological and Histopathological variants of fibroadenoma, and the most recent histological classification criteria of phylloides tumors. This is a retrospective study including 250 cases of fibroepithelial tumors of the female breast, from October 2007 to September 2008. Cases were taken from private laboratories. All cases were excisional biopsy, the specimens were already fixed in 10% formalin and paraffin embedded.Sections of 4 microns were made from the paraffin blocks and stained with hematoxyllin and eosin stain and examined microscopically. Two-hundred and fifty cases of mammary fibroepithelial tumors were reviewed in this study. The age of the patients ranged between 14-49 years, and the tumor size ranged between 1.5-20 cm. The cases were histologically classified into: 220[88%] cases of fibroadenoma[FA] and 30[12%] cases of phylloides tumor[PT]. Additional morphological features of fibroadenoma were: fifteen[6.8%]cases juvenile fibroadenoma, infarction in eight[3.6%] cases, lactational changes in ten[4.5%] cases, multinucleated giant cells in the stroma in six[2.7%] cases, prominent myxoid changes in three[1.4%] cases, features of fibrocystic changes in the surrounding in 14[6.4%] cases, cellular stroma in eight [3.6%] cases, apocrine metaplasia in 26[11.9%] cases, hyalinization and calcification of the stroma in 14[6.4%] cases, presence of adipose tissue, muscle or cartilage in 18[8.2%] cases, atypical epithelial hyperplasia in four[1.8%] cases, and ordinary fibroadenomas [non-otherwise specific] in 94[42.7%] cases. Multiple fibroademnomas were found in 20[9.1%] cases. Histological classification of the phylloides tumors showed 20[66.7%] benign cases, six[20%] cases borderline malignant and four[13.3%] malignant cases. Filroadenoma is the commonest fibroepithelial tumor of female breast, phylloides tumor is an uncommon neoplasm which is usually benign but malignant variant exists