ABSTRACT
ABSTRACT Objective: To report an unusual case of oral hairy polyp (HP) and review the literature, providing epidemiological, clinical and histopathological information on this disease. Case description: A 12-year-old male patient was referred to a Stomatology department with a nodule in the posterior midline of the tongue. The patient did not know exactly when it arose or whether it had grown since then. Clinical exam revealed a bulky and mobile pedunculated mass lesion on the dorsum of the tongue, with a diameter of approximately 1 cm. The patient's mother reported no previous health problem. An excisional biopsy was performed, the surgical specimen was sent for anatomopathological analysis, and the findings were compatible with the diagnosis of HP. Comments: Hairy polyp is a rare lesion, especially in the oral region. The literature search revealed only 10 case reports of oral HP published between January 1999 and January 2019, and they revealed a predominance of the disease in female newborns. Two uncommon facts were presented in this case: the patient was male and diagnosis was made at 12 years old.
RESUMO Objetivo: Relatar um caso incomum de pólipo piloso (PP) oral e revisar a literatura para trazer informações epidemiológicas, clínicas e histopatológicas acerca da doença. Descrição do caso: Paciente do sexo masculino, 12 anos de idade, encaminhado ao Departamento de Estomatologia com nódulo na região posterior de linha média da língua. O paciente não soube relatar quando surgiu a lesão e se ela havia crescido desde então. O exame clínico revelou massa pedunculada, volumosa e móvel no dorso da língua, medindo aproximadamente 1,0 cm de diâmetro. A mãe do paciente relatou que ele nunca havia tido nenhum problema de saúde anterior. Foi realizada biópsia excisional e o material foi enviado para análise anatomopatológica, sendo os achados compatíveis com o diagnóstico de PP. Comentários: O pólipo piloso é uma lesão rara, especialmente na região oral. A pesquisa bibliográfica revelou apenas dez relatos de casos de PP oral, publicados entre janeiro de 1999 e janeiro de 2019, sendo observada predominância da doença em recém-nascidos do sexo feminino. Dois fatos incomuns ocorreram neste caso: tratava-se de um paciente do sexo masculino e o diagnóstico se deu aos 12 anos de idade.
Subject(s)
Humans , Male , Infant, Newborn , Infant , Child , Adult , Polyps/surgery , Polyps/diagnosis , Tongue/pathology , Mouth/pathology , Polyps/congenital , Polyps/pathology , Teratoma/diagnosis , Biopsy , Choristoma/diagnosis , Treatment Outcome , Aftercare , Dermoid Cyst/diagnosis , Diagnosis, Differential , Middle AgedABSTRACT
ABSTRACT An asymptomatic 79-year-old woman, with incidental finding on abdominal ultrasound of a solid nodule in the tail of the pancreas. Magnetic resonance imaging showed a 12mm solid tumor. The suggested diagnosis was pancreatic neuroendocrine tumor. The pathological examination showed an intrapancreatic splenic tissue. This is a rare ectopic location of spleen tissue and it should be considered in the differential diagnosis of pancreatic solid tumors.
RESUMO Mulher de 79 anos, com achado incidental em ultrassonografia de abdome de lesão sólida em cauda de pâncreas. Em ressonância magnética, foi confirmada lesão de 12mm. Foi aventada a hipótese diagnóstica de tumor neuroendócrino não secretor, sendo realizada pancreatectomia distal laparoscópica. Em estudo anatomopatológico, diagnosticou-se tecido esplênico, configurando baço acessório intrapancreático. Este tipo de manifestação topográfica de baço é rara, mas deve fazer parte dos diagnósticos diferenciais em tumores sólidos do pâncreas.
Subject(s)
Humans , Female , Aged , Pancreatic Cyst/diagnosis , Spleen , Choristoma/diagnosis , Pancreas/pathology , Pancreatectomy , Pancreatic Diseases/surgery , Pancreatic Diseases/diagnosis , Choristoma/surgery , Incidental Findings , Diagnosis, DifferentialABSTRACT
Primary hyperparathyroidism due to ectopic parathyroid adenoma is not infrequent. Primary hyperparathyroidism caused by unusual thymic nonadenomatous nonencapsulated parathyroid tissue has been reported before. Both can cause unsuccessful neck explorations. Here we presented for the first time a patient with hyperparathyroidism due to ectopic parathyroid adenoma concomitant to the presence of thymic nonadenomatous nonencapsulated parathyroid tissue.
O hiperparatireodismo primário devido a adenoma ectópico paratireoidiano não é raro. O hiperparatireodismo primário causado por tecido tímico paratireoidiano não edematoso e não encapsulado incomum já foi relatado anteriormente. Ambos podem levar à exploração cervical malsucedida. Apresentamos aqui, pela primeira vez, uma paciente com hiperparatireoidismo decorrente de um adenoma paratireoidiano concomitante com a presença de tecido tímico paratireoidiano não edematoso e não encapsulado.
Subject(s)
Female , Humans , Young Adult , Adenoma/complications , Choristoma/complications , Hyperparathyroidism, Primary/etiology , Lymphatic Diseases/complications , Parathyroid Glands , Parathyroid Neoplasms/complications , Thymus Gland , Adenoma/pathology , Adenoma/surgery , Choristoma/diagnosis , Lymphatic Diseases/diagnosis , Parathyroidectomy , Parathyroid Neoplasms/pathology , Parathyroid Neoplasms/surgery , Treatment Outcome , Thymus Gland/pathologyABSTRACT
La cefalea es un síntoma que conlleva un malestar signifcativo y deterioro funcional en quienes lo sufren con frecuencia, tanto en la infancia como en la edad adulta. Algunas afecciones se asocian con una mayor frecuencia de cefaleas. La ectopia amigdalina cerebelosa borderline, defnida como la protrusión de las amígdalas cerebelosas por foramen magnum), es una de esas afecciones. Aunque no está claro el signifcado clínico de esta entidad como causa de cefalea, hay estudios que informaron su asociación en el 16% de los pacientes. Se presenta el caso de un paciente de 9 años que acudió a la consulta por padecer una cefalea frontal de 5 años de evolución. Se diagnosticó ectopia amigdalina cerebelosa borderline mediante una resonancia magnética. Se describe este caso dado lo atípico de la presentación de esta entidad en la infancia.
Frequent headache is a symptom that leads to signifcant distress and functional impairment, both in childhood and in adulthood. Some medical conditions are associated with a higher frequency of headaches. Borderline cerebellar tonsillar ectopia which may be defned as the downward extension of cerebellar tonsils of < 5 mm below the foramen magnum is among these conditions. Although questions persist about the clinical signifcance of this rare entity on headache, there are studies reporting severe headache syndrome in 16% of these patients. We report a 9-year old male patient, who presented to our clinic with a frontal headache of 5 years' duration, and was found to have borderline cerebellar tonsillar ectopia on magnetic resonance imaging. To the best of our knowledge, there has not been a reported case of this coexistence at this early stage of life. We would like to contribute to the literature, owing to the very rare and atypical presentation of this entity in the early childhood period.
Subject(s)
Child , Humans , Male , Cerebellar Diseases/diagnosis , Choristoma/diagnosis , Palatine Tonsil , Cerebellar Diseases/complications , Choristoma/complications , Headache/etiologyABSTRACT
The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma.
Os autores apresentam tomografia de coerência óptica com profundidade de imagem aprimorada (EDI OCT) e autofluorescência de fundo (FAF) características de um paciente com osteoma de coroide bilateral e tentam correlacionar as duas técnicas de imagem. Dois olhos de um paciente com osteoma de coroide foram submetidos a exame oftalmológico completo. Tomografia de coerência óptica com profundidade de imagem aprimorada revelou padrão em gaiola, correspondente à região de calcificação do tumor. Imagens de autofluorescência de fundo da mesma área mostraram ligeira autofluorescência positiva. Três padrões de refletividade diferentes foram definidos na área descalcificada. Nas áreas com fluido sub-retiniano, foram observados prolongamentos dos segmentos externos semelhantes aos da coroidorretinopatia serosa central. Manchas autofluorescentes positivas foram evidentes em autofluorescência de fundo na mesma área. Porções calcificadas e descalcificadas do osteoma de coroide, bem como a atrofia da camada coriocapilar, demonstraram diferentes padrões de tomografia de coerência óptica com profundidade de imagem aprimorada e de imagens de autofluorescência de fundo. Ambas as técnicas se mostraram úteis no diagnóstico e acompanhamento de osteoma de coroide.
Subject(s)
Adult , Female , Humans , Choristoma/diagnosis , Choroid Neoplasms/diagnosis , Image Enhancement/methods , Osteoma/diagnosis , Tomography, Optical Coherence/methods , Fluorescein Angiography , Reproducibility of Results , Visual AcuityABSTRACT
Mediastinal ectopic thyroid is a very rare condition, with few reported cases in the literature and no reported cases in Korea. This report describes an asymptomatic 65-year-old man with a right paratracheal mass compressing the superior vena. Additionally, the epidemiology, clinical manifestation, diagnosis, and management of mediastinal ectopic thyroids are discussed. A mediastinal ectopic thyroid should be considered in the differential diagnosis of all mediastinal masses. Surgical excision is recommended for both the diagnosis and treatment of this condition, because of its potential for malignancy and compression of mediastinal structures. This case demonstrates the clinical importance of mediastinal etopic thyroid.
Subject(s)
Aged , Humans , Male , Choristoma/diagnosis , Incidental Findings , Mediastinal Diseases/diagnosis , Thyroid GlandABSTRACT
Malformations of cortical development (MCD) result from disruptions in the complex process of the human brain cortex formation and are highly associated to severe epilepsy, neurodevelopmental delay and motor dysfunction. Nowadays, magnetic resonance imaging (MRI) is the cornerstone of the work-up of patients with epilepsy and modern advanced imaging techniques have improved not only our ability to detect and characterize cortical malformations, but also in identifying associated functional abnormalities that are far beyond the structural visualized lesions. Herein, we address the most currently used classifications of MCD and make a concise review of the embryological process of cortical development. Our main goal is to summarize recent advances and new trends in diagnostic imaging techniques concerning MCD. Thereafter, follows a brief discussion of specific disorders and their radiological features.
As malformações do desenvolvimento cortical (MDC) resultam de distúrbios no complexo processo do desenvolvimento do córtex cerebral humano e estão comumente associadas a epilepsia severa e disfunções neuropsicomotoras. Atualmente, as imagens por ressonância magnética (RM) são a pedra angular no manejo de pacientes com epilepsia e modernas técnicas avançadas de imagem melhoraram não só a nossa capacidade de detectar e caracterizar as malformações corticais, mas também levaram ao reconhecimento de anomalias funcionais associadas que estão muito além das lesões estruturais visibilizadas. Abordaremos as classificações mais utilizadas de MDC e revisaremos a embriologia do desenvolvimento cortical. Nosso principal objetivo é destacar os avanços recentes e as novas tendências em técnicas de diagnóstico por imagens relacionadas às MDC. Em seguida, faremos uma breve discussão sobre alguns transtornos específicos e suas características radiológicas.
Subject(s)
Female , Humans , Male , Cerebral Cortex/abnormalities , Diagnostic Imaging/methods , Epilepsy/etiology , Malformations of Cortical Development/etiology , Cerebral Cortex/embryology , Choristoma/diagnosis , Choristoma/etiology , Gyrus Cinguli/abnormalities , Gyrus Cinguli/embryology , Malformations of Cortical Development/diagnosisSubject(s)
Aged , Choristoma/diagnosis , Choristoma/pathology , Female , Femur/pathology , Femur/diagnostic imaging , Histocytochemistry , Humans , MicroscopyABSTRACT
No abstract available.
Subject(s)
Female , Humans , Middle Aged , Biopsy, Fine-Needle , Choristoma/diagnosis , Thyroglossal Cyst/diagnosis , Thyroid Dysgenesis/diagnosis , Thyroid Nodule/diagnosisABSTRACT
OBJETIVO: Analisar as características clínico-patológicas do tecido pancreático heterotópico em órgãos digestivos abdominais. MÉTODOS: Realizamos estudo retrospectivo analisando 18 portadores de pâncreas heterotópico diagnosticados histologicamente. Seus dados clínicos e histopatológicos foram revistos. O tecido pancreático heterotópico foi classificado em três modelos histológicos: tipo I constituído por três componentes do pâncreas normal (ácinos, ductos e ilhotas), tipo II com dois componentes e tipo três com somente um componente. RESULTADOS: A média de idade foi de 52,7 anos, variando de 34 a 73 anos, com nove homens e nove mulheres. Sintomas foram observados em somente quatro doentes, sendo suas lesôes diagnosticadas por gastroscopia. Os 14 restantes eram assintomáticos e suas anomalias descobertas acidentalmente. A maioria das lesões situava-se no trato superior: sete (38,9%) no estômago, seis (33,3%) no duodeno e três (16,6%) no jejuno. A heterotopia localizou-se preferencialmente na submucosa (83,3%), mas também foi observada na muscular própria e na sub-serosa. Em sete (38,9%) espécimes todos os componentes pancreáticos foram constatados (tipo I), em oito (44,4%) estavam presentes glândulas exócrinas e ductos excretores (tipo II) e em três (16,7%) somente o tecido exócrino foi observado (tipo III). CONCLUSÃO: A heterotopia pancreática é rara. Doentes com ectopia pancreática diagnosticadas pelo estudo patológico, assintomáticos ou com sintomas discretos devem permanecer em observação. As lesões detectadas acidentalmente durante procedimentos cirúrgicos necessitam ser removidas por procedimentos conservadores.
OBJECTIVE: To analyze the clinical and pathological features of heterotopic pancreatic tissue in abdominal digestive organs. METHODS: We retrospectively studied 18 patients with histologically diagnosed heterotopic pancreas. Clinical and histopathologic data were reviewed. Heterotopic pancreatic tissues were classified in three histological models: Type I consists of three components of normal pancreas (acini, ducts and islets), type II with two components and type three with only one component. RESULTS: The mean age was 52.7 years, ranging from 34 to 73 years, nine of them men and nine women. Symptoms were observed in only four patients, and their lesions were diagnosed by gastroscopy. The remaining 14 were asymptomatic and their anomalies were discovered accidentally. Most of the lesions were located in the upper gastrointestinal tract: seven (38.9%) in the stomach, six (33.3%) in the duodenum and three (16.6%) in the jejunum. Heterotopia was mostly located in the submucosa (83.3%) but was also observed in the muscularis propria and in the sub-serosa. In seven specimens (38.9%) all pancreatic components were found (type I), in eight (44.4%) exocrine glands and excretory ducts were present (type II) and in three (16.7%) only exocrine tissue was observed (type III). CONCLUSION: Pancreatic heterotopia is rare. Patients with pancreatic ectopia diagnosed by pathological study, whether asymptomatic or with mild symptoms, should be observed. Lesions incidentally detected during surgeries need to be removed by conservative procedures.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Choristoma/diagnosis , Digestive System Diseases/pathology , Pancreas , Abdomen , Digestive System Diseases/surgery , Retrospective StudiesABSTRACT
This report describes a case of pleomorphic adenoma of an ectopic lacrimal gland arising subconjunctivally in the lateral fornix in a 13-year-old girl. The tumor was removed surgically in toto with the capsule. This is probably the first reported case.
Subject(s)
Adenoma, Pleomorphic/diagnosis , Adolescent , Choristoma/diagnosis , Conjunctival Diseases/diagnosis , Female , Humans , Lacrimal ApparatusABSTRACT
CONTEXT: Neuroglial ectopia has been defined as a mass composed of differentiated neuroectodermal tissue isolated from the spinal canal or cranial cavity and remains rare. This lesion has to be considered in the differential diagnosis among newborn infants with classical symptoms of respiratory distress, neck mass and feeding difficulties. We present a rare case of extensive parapharyngeal and skull base neuroglial ectopia in 6-month-old girl who presented respiratory and feeding obstruction at birth. CASE REPORT: A six-month-old girl who presented upper respiratory and feeding obstruction at birth and was using tracheostomy and gastrostomy tubes was referred to our institution. Complete surgical excision of the mass consisted of a transcervical-transparotid approach with extension to the infratemporal fossa by means of a lateral transzygomatic incision, allowing preservation of all vital neurovascular structures. The anatomopathological examination showed a solid mass with nests of neural tissue, with some neurons embedded in poorly encapsulated fibrovascular stroma, without mitotic areas, and with presence of functioning choroid plexus in the immunohistochemistry assay. Neurovascular function was preserved, thus allowing postoperative decannulation and oral feeding. Despite the large size of the mass, the child has completed one year and six months of follow-up without complications or recurrence. Neuroglial ectopia needs to be considered in diagnosing airway obstruction among newborns. Surgical treatment is the best choice and should be performed on clinically stable patients. An algorithm to guide the differential diagnosis and improve the treatment was proposed.
CONTEXTO: Tecido neuroglial ectópico é definido como uma massa composta de tecido neuroectodermal diferenciado, isolado do canal espinhal ou da cavidade craniana e permanece raro. Esta lesão tem de fazer parte do diagnóstico diferencial em neonatos com os clássicos sintomas de obstrução respiratória, massa cervical e dificuldade para alimentação. Descreve-se um raro caso de tecido neuroglial ectópico extensor em parafaringe e base de crânio em uma menina de seis meses de idade que apresentou os sintomas de obstrução respiratória e alimentar ao nascimento. RELATO DE CASO: Menina de seis meses de idade que apresentou obstrução respiratória alta e alimentar ao nascimento, usando traqueostomia e gastrostomia, foi encaminha à instituição. A ressecção cirúrgica completa da massa utilizou um acesso transcervical-transparotídeo com extensão para fossa infratemporal pela incisão lateral transzigomática, permitindo identificação e preservação das estruturas neurovasculares vitais. O exame anatomopatológico evidenciou uma massa sólida com ninhos de tecido neuronal com alguns neurônios imersos em estroma fibrovascular, de pouca cápsula, sem áreas de mitoses e presença de plexo coroide funcionante ao exame imunoistoquímico. As funções neurovasculares foram preservadas na cirurgia, permitindo a decanulação e alimentação via oral no pós-operatório. Apesar do grande tamanho da massa, a criança completou um ano e meio de acompanhamento sem quaisquer complicações ou recorrência. O tecido neuroglial ectópico deve ser considerado no diagnóstico de obstruções de vias aéreas no neonato. O tratamento cirúrgico é o melhor e deve ser feito no paciente clinicamente estável. Um algoritmo para orientar o diagnóstico diferencial e melhorar o tratamento foi proposto.
Subject(s)
Female , Humans , Infant , Choristoma/diagnosis , Neuroglia , Pharyngeal Diseases/diagnosis , Pharynx , Skull Base , Algorithms , Choristoma/congenital , Diagnosis, Differential , Pharyngeal Diseases/congenitalABSTRACT
We report a case of an adenoma arising from an ectopic adrenal gland mimicking a hepatocellular carcinoma in a heavy alcohol abuser. A MDCT showed a 2.7 low-attenuating nodule in segment VII of the liver through all CT phases. Compared to a precontrast image, however, a subtle enhancement was noted on the arterial phase CT image. On T1 weighted in- and opposed-phase MR images, an abundant fat component within the lesion was seen. Dynamic contrast-enhanced MR images after administration of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) more clearly depicted hypervascularity and wash-out of the lesion on arterial and portal phases, respectively. On delayed hepatobiliary phase MR images, obtained 20 minutes after Gd-EOB-DTPA administration, subtle uptake or retention of the contrast agent by the lesion was suspected. A tumorectomy was performed and adrenal adenoma from an ectopic adrenal gland within the liver was confirmed.
Subject(s)
Humans , Male , Middle Aged , Adrenal Cortex Neoplasms/diagnosis , Adrenal Glands , Adrenocortical Adenoma/diagnosis , Carcinoma, Hepatocellular/diagnosis , Choristoma/diagnosis , Contrast Media , Diagnosis, Differential , Gadolinium DTPA , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
A ectopia de tireoide é rara, e a sua localização no mediastino anterior é excepcional, estando descritos apenas 5 casos nos últimos 30 anos. Os autores apresentam 2 casos clínicos, além de uma revisão da literatura abordando a etiologia, a embriologia e manifestações clínicas de ectopia de tireoide.
Ectopic thyroid is a rare condition, and its location in the anterior mediastinum is even rarer, there having been only 5 reported cases in the past 30 years. Here, we describe 2 clinical cases and present a review of the literature regarding the etiology, embryology and clinical manifestations of ectopic thyroid.
Subject(s)
Adult , Female , Humans , Middle Aged , Choristoma/diagnosis , Mediastinal Diseases/diagnosis , Thyroid Gland , Diagnosis, Differential , Mediastinal Neoplasms/diagnosisABSTRACT
Choristoma is a benign tumor where new bone formation occurs. It occurs exclusively in the flat bones of the skull and face. These are slow growing lesions that are usually completely asymptomatic and only present when there is a disruption in the function of the organ due to its large size as it grows. These choristomas can rarely occur in soft tissues especially in the head, eye, tongue, or extremities. Choristomas of the soft tissues are very rare. Only 61 cases of choristomas of the tongue have been reported in literature. Here we report a case of choristoma in the base of the tongue in a 25-year-old Malay female.
Subject(s)
Adult , Choristoma/diagnosis , Female , Humans , Tongue/pathology , Tongue Neoplasms/diagnosisABSTRACT
A 43-year-old woman presented with headache, nausea, severe visual impairment and galactorrhea and decreased visual acuity. A 4 x 3.5 x 3 cm mass completely filling the sphenoid sinus, elevating the pituitary gland and stalk was observed. The patient underwent transsphenoidal removal of the lesion to alleviate visual loss. The tumor cells showed strong positivity for thyroglobulin and TTF-1. This patient was followed up for 2 years after the operation; the laboratory study and computed tomography showed no lesions. In conclusion, this is a rare benign finding in which complete surgical resection achieves a cure
Subject(s)
Humans , Female , Thyroid Gland/embryology , Choristoma/diagnosis , /diagnosis , Sella Turcica/abnormalities , Sella Turcica/surgery , Cytological Techniques/statistics & numerical data , Vision, Low/etiology , Pituitary Gland/abnormalities , ThyroglobulinABSTRACT
Coristoma ósseo é uma massa semelhante a um tumor contendo estrutura óssea normal em posição anormal. O objetivo deste artigo é relatar um caso de coristoma ósseo na cavidade bucal. Ao exame clínico, observou-se lesão nodular, pediculada, consistência firme, coloração rósea, medindo aproximadamente 10mm, assintomática, no terço posterior da língua, com diagnóstico presuntivo de aumento de tecido linfóide. Foi realizada biópsia excisional, tendo como resultado do exame anátomo-patológico o diagnóstico de coristoma ósseo. Em retorno com 6 meses, não foi observada recorrência.
Subject(s)
Humans , Female , Adult , Bone and Bones , Choristoma/diagnosis , Choristoma/etiology , MouthABSTRACT
Ectopic decidual reaction is commonly seen in the ovary and cervix; however, peritoneal localization is rare. Peritoneal deciduosis is usually an incidental histological finding. It may present a diagnostic dilemma by mimicking grossly peritoneal carcinomatosis or tubercles and deciduoid mesothelioma, microscopically. We report three cases of ectopic decidual reaction discovered incidentally during caesarian sections, as whitish yellow nodules resembling tubercles. Histology revealed extensive decidualisation. To the best of our knowledge, this is the first report of ectopic decidua mimicking peritoneal tubercles.