Aspectos clínicos, radiográficos e estratégias terapêuticas da Síndrome de Eagle: revisão de literatura / Clinical, radiographic aspects and therapeutic strategies of Eagle Syndrome: literature review

Objetivo: Este trabalho tem como propósito fornecer uma análise abrangente das características anatômicas, clínicas e radiográficas da Síndrome de Eagle, além de abordar os métodos de diagnóstico e estratégias terapêuticas. Materiais e métodos: Foi realizada uma busca por artigos científicos publicados no período de 2016 a 2024, utilizando as bases de dados Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) e Google Scholar. A coleta de artigos foi realizada nos idiomas inglês e português, utilizando as palavras-chave: "síndrome de eagle", "síndrome estiloide", "síndrome da artéria carótida", "estilalgia", "eagle syndrome", "styloid syndrome", "carotid artery syndrome" e "stylalgia". Conclusão: Os profissionais devem estar atentos à síndrome de Eagle em casos de dor unilateral ao realizar atividades como engolir, bocejar e chorar, sem causa aparente, especialmente em mulheres adultas que não encontram alívio com analgésicos. Devido à frequência de casos assintomáticos, a realização precoce de exames radiológicos desempenha um papel crucial na avaliação diagnóstica. É essencial que profissionais de Otorrinolaringologia, Neurologia e Odontologia estejam cientes dessa síndrome, pois está associada a uma significativa deterioração na qualidade de vida. (AU)

Objective: This work aims to provide a comprehensive analysis of the anatomical, clinical and radiographic characteristics of Eagle Syndrome, in addition to addressing diagnostic methods and therapeutic strategies. Materials and methods: A search was carried out for scientific articles published between 2016 and 2024, using the Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) and Google Scholar databases. Articles were collected in English and Portuguese, using the keywords: "eagle syndrome", "styloid syndrome", "carotid artery syndrome", "stilalgia", "eagle syndrome", "styloid syndrome", "carotid artery syndrome" and "stylalgia". Conclusion: Professionals should be aware of Eagle syndrome in cases of unilateral pain when performing activities such as swallowing, yawning and crying, without an apparent cause, especially in adult women who do not find relief with analgesics. Due to the frequency of asymptomatic cases, early radiological examinations play a crucial role in diagnostic evaluation. It is essential that Otorhinolaryngology, Neurology and Dentistry professionals are aware of this syndrome, as it is associated with a significant deterioration in quality of life. (AU)

Fibrodisplasia osificante progresiva en pediatría: a propósito de un caso clínico / Fibrodysplasia ossificans progressiva in pediatrics: a case report

Introducción: La Fibrodisplasia osificante progresiva es una enfermedad congénita autosómica dominante poco frecuente, caracterizada por malformaciones esqueléticas y osificación heterotópica progresiva e invalidante. Caso clínico: Niño de 11 años consulta por múltiples lesiones osificadas en tronco y región cervical con importante limitación en su movilidad. En el examen físico destaca un ortejo mayor corto. Estudio genético muestra mutación del gen ACVR1. Recibe tratamiento con periodos cortos de corticosteroides posterior a traumas y previo a procedimientos, asociado a un manejo multidisciplinario. Revisión de la literatura: A la fecha el principal tratamiento es la prevención de los brotes de osificación y el uso de corticosteroides o antiinflamatorios cuando los brotes ya se iniciaron. Están en curso ensayos clínicos con bifosfonatos y anticuerpos anti-activina A. Conclusión: En la actualidad no existe un tratamiento específico, sin embargo, un diagnóstico precoz, la prevención de brotes y nuevas terapias podrían mejorar el pronóstico de los pacientes.

ntroduction: Fibrodysplasia ossificans progressiva is a rare autosomal dominant congenital disease characterized by skeletal malformations and progressive disabling heterotopic ossification. Clinical case: An 11-year-old boy consulted with multiple ossified lesions in the trunk and cervical regions associated with significant limitation in mobility. On physical examination, the big toe is short. Genetic study shows ACVR1 gene mutation. He received treatment with short corticosteroid periods after traumas and prior to clinical procedures, as well as a multidisciplinary management.Literature review: To date the main treatment is the prevention of ossification flare-ups and the use of corticosteroids or anti-inflammatories when they have already started. Clinical trials are ongoing with bisphosphonates and anti-activin A antibodies.Conclusion: There is currently no specific treatment, however, early diagnosis, prevention of flare-ups and new therapies could improve the prognosis of patients.

Dolor cervical atípico: síndrome de Eagle / Atypical neck pain: Eagle syndrome

Presentamos el caso de un varón de 45 años con dolor cervical derecho muy localizado, característico y persistente. El estudio radiológico nos permitió diagnosticar claramente un síndrome de Eagle. Por lo anterior el paciente fue sometido a cirugía de extirpación de apófisis estiloides derecha. El paciente evolucionó sin mayores complicaciones ni incidencias, y obteniendo la resolución del cuadro.

Here we introduce a 45-year-old man suffering from an intense, unique and permanent pain, located in his right neck. Radiology showed us signs leading to the diagnosis of Eagle Syndrome. Surgery of right Styloid apophysis removal, with no complications, letting the patient free of symptoms.

Osificación heterotópica de cicatriz de laparotomía / Heterotopic ossification in laparotomy scar

Se presenta el caso de un paciente masculino de 54 años de edad operado en dos ocasiones por adenocarcinoma gástrico, a quien se le encontró una masa ósea de la cicatriz de la línea media abdominal que fue resecada. El análisis histológico confirmó una formación ósea madura. Este hallazgo llama la atención sobre la formación ósea en las cicatrices quirúrgicas. Debe hacerse diagnóstico diferencial con recidivas metastásicas de la cicatriz quirúrgica de aparición posterior a cirugía abdominal por cáncer. Se analizó la patogenia según la literatura especializada. El objetivo del trabajo fue presentar una entidad poco frecuente y revisar las teorías etiopatogénicas actuales de esta condición morbosa(AU)

A case is reported of a 54-year-old male patient operated twice for gastric adenocarcinoma, who was found to have a bone mass of the midline abdominal scar that was removed. Histological analysis confirmed mature bone formation. This finding draws attention to bone formation in surgical scars. Differential diagnosis should be made with metastatic relapses of the surgical scar that appears after abdominal surgery for cancer. Pathogenesis was analyzed according to the specialized literature. The objective of this study was to present a rare entity and to review current etiopathogenic theories of this morbid condition(AU)

Eagle syndrome: a narrative review / Síndrome de Eagle: una revisión narrativa

Abstract: painful disorders in the maxillofacial region are common in dental practice. Most of these conditions are not properly diagnosed because of inadequate knowledge of craniofacial and cervico-pharyngeal syndromes such as Eagle Syndrome. The aim of this review is to describe the general aspects, diagnosis and treatment of Eagle syndrome. Eagle syndrome or stylohyoid syndrome was first described by Watt W. Eagle in 1937. It was defined as orofacial pain related to the elongation of the styloid process and ligament stylohyoid calcification. The condition is accompanied by symptoms such as dysphonia, dysphagia, sore throat, glossitis, earache, tonsillitis, facial pain, headache, pain in the temporomandibular joint and inability to perform lateral movements of the neck. Diagnosis and treatment of Eagle syndrome based on symptoms and radiographic examination of the patient will determine the need for surgical or nonsurgical treatment. Eagle syndrome is a complex disorder demanding a thorough knowledge of its signs and symptoms to make a correct diagnosis and provide an appropriate subsequent treatment. Disseminating information about this syndrome among medical-dental professionals is essential to provide adequate dental care to patients.

Resumen: en la práctica odontológica, es frecuente encontrar alteraciones con sintomatología dolorosa en la región maxilofacial, las cuales no son apropiadamente diagnosticadas, a causa del desconocimiento de síndromes craneofaciales y cervicofaríngeos, como el Síndrome de Eagle. El objetivo de esta revisión es describir los aspectos generales, diagnóstico y tratamiento del Síndrome de Eagle. El Síndrome de Eagle o estilalgia es la entidad nosológica, descrita por Watt W. Eagle en 1937, definida como aquel dolor orofacial relacionado con la elongación de la apófisis estiloides y calcificación del ligamento estilohioideo; el cual está acompañado de síntomas como: disfonía, disfagia, dolor faríngeo, glositis, otalgia, tonsilitis, dolor facial, cefalea, odinofagia, dolor en la articulación temporomandibular e imposibilidad de realizar movimientos laterales del cuello. El diagnóstico y tratamiento del Síndrome de Eagle está basado en la sintomatología y el examen radiográfico del paciente, lo cual determinará el tratamiento quirúrgico o no quirúrgico. El Síndrome de Eagle es una patología compleja que requiere un conocimiento amplio de sus signos y síntomas, para establecer un correcto diagnóstico y posteriormente un adecuado tratamiento. Para ello, es necesario difundir la información sobre este síndrome entre los profesionales médico-odontológico y así brindar una atención adecuada a cada uno de los pacientes.

Síndrome de Eagle: revisión de la literatura / Eagle syndrome: literature review

El síndrome de Eagle es una condición infrecuente caracterizada por una elongación de la apófisis estiloides y/o una calcificación del ligamento estilohioideo. Clinicamente los pacientes presentan una larga historia de dolor crónico cervicofacial, tratado por múltiples especialistas y mediante variadas estrategias terapéuticas. El diagnóstico requiere de un alto índice de sospecha, basado fundamentalmente en la anamnesis y el examen físico. Presentamos una revisión y actualización sobre el síndrome de Eagle, abarcando sus aspectos clínicos relevantes, su diagnóstico y tratamiento.

Eagle syndrome is a rare condition characterized by an elongation of the styloid process and /or calcification of the stylohyoid ligament. Clinically, patients present with a history of chronic cervicofacial pain, treated by multiple specialists and through various therapeutic strategies. The diagnosis requires a high index of suspicion, based primarily on the history and physical examination. We review and update on Eagle syndrome, covering their relevant clinical aspects, diagnosis and treatment.

Tuberculosis osteoarticular y osificaciones heterotópicas: reporte de un caso / Heterotopic ossification and osteoarticular tuberculosis: case report

La osificación heterotópica es una condición patológica que conduce al desarrollo de hueso en el tejido blando. En la piel se denomina osteoma cutis. Estas lesiones se clasifican en primarias o secundarias. Las causas secundarias constituyen el 85% y son consecuencia de enfermedades inflamatorias, infecciones, tumores, traumatismos, lesiones de médula espinal y cirugías. Si bien la osificación heterotópica es benigna e infrecuente, puede ser una enfermedad debilitante que, asociada a dolor y rigidez, provoque mayor comorbilidad en relación con la enfermedad que la desencadenó. Comunicamos el caso de un paciente que padeció osteoma cutis asociado a tuberculosis osteoarticular

Heterotopic ossification is a patologic condition that leads bone formation in soft tissue. In particular, osteoma curtis, which can be primary or secundary, occurs when ossification if found in the skin. Secondary lessions account 85% of the cases described and they are by inflammatory diseases, infections, tumors, traumas, spinal cord lesions and surgeries. Whereas heterotopic ossification is benign and rare, it may result in wasting sickness that in combination with pain and stiffness, adding comorbidity to the disease that triggers. We report here a patient suffering osteomas cutis and osteoarticular tuberculosis. (AU)

Osificación hetertópica neurogénica bilateral de cadera / Bilateral neurogenic heterotopic ossification of hip

La osificación heterotópica es una verdadera actividad osteoblástica con formación anormal de hueso lamelar maduro en tejidos blandos extraesqueléticos donde el hueso no existe normalmente. Se presenta un paciente con afección de ambas caderas, pretendiendo realizar una breve revisión sobre diagnóstico, seguimiento y tratamiento de esta patología.

Síndrome Eagle: reporte de un caso / Eagle Syndrome: a case report

Como Estilalgia o Síndrome Eagle se entiende a una entidad nosológica descripta por W.W Eagle en el año 1937, definida como la elongación de la apófisis estiloides y/o calcificación del ligamento estilohioideo.Si bien dicho síndrome no es frecuente, el profesional debe tenerlo en cuenta en aquellos casos de dolor en la región maxilofacial sin una etiología clara.El presente trabajo reporta el caso de una paciente de sexo femenino de 58 años, cuyo motivo de consulta fue dolor en la región maxilofacial. Consideramos interesante el caso por tratarse de una estilalgia bilateral, forma aún menos frecuente de presentación

Eagle Syndrome is considered as a nosological entity described by W.W. Eagle in 1937. It is defined as the elongation of the styloid apophysis or the calcification of the styloid ligament. Even if said syndrome is quite rare among the patients, professionals must keep it in mind when facing cases of pain in the maxillofacial area that has no clear etiology. This present work reports the case of a 58 year old female patient whose concern was pain in the maxillofacial area. We consider this case interesting due to the fact that it exposes a bilateral Eagle syndrome, an even more uncommon presentation of this disease

Oropharyngeal styloids: An unusual presentation.

The close proximity of the styloid process to many of the vital neurovascular structures in the neck makes it clinically significant. The styloid process is said to be elongated if it is longer than 3.0 cm in length. Anatomical variations are very common and clinical symptoms arising from such variations have to be recognized. Elongated styloid processes may cause chronic throat pain along with foreign body sensation, dysphagia, vague facial pain, and otalgia. Surgical excision of an elongated styloid is considered as a satisfactory treatment for such cases. Here, we present a unique case of bilaterally elongated styloids that could be visualized just by depressing the tongue, when they appeared like the tusks of an elephant in the oropharyngeal region.

Traqueobroncopatía osteocondroplástica: reporte de dos casos y revisión de la literatura / Tracheobronchopathia osteochondroplastica: presentation of two cases

Tracheobronchopathia osteochondroplastica is a rare disease characterized by oteocartilagenous tissue bulking from the submucous layer into the lumen of large airways. We present two patients whose etiologic study for unrelated reasons rendered characteristic findings of this pathology. The literature about this disease is reviewed.

La traqueobroncopatía osteocondroplástica es una enfermedad poco frecuente, caracterizada por la proliferación de tejido óseo y cartilaginoso en la submucosa de las vías aéreas mayores. Presentamos dos casos de pacientes en cuyo estudio por distintos motivos etiológicos se encontraron lesiones compatibles con esta patología, y se revisa el tema.

Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects

Knowledge of the Eagle's syndrome shows that its symptoms can be very easily confused with other types of craniomandibular disorders, especially temporomandibular disorders (TMD). The aim of this study was to find a possible correlation between the presence of TMD and elongation of the styloid process as well relate to presence of calcification of the stilohyoid chain. Fifty patients with TMD, confirmed from the RDC/TMD, were examined clinically and radiographically. Radiographic documentation consisted of digital panoramic radiograph and digital lateral cephalometric radiograph. Radiocef software (Radiomemory) was used for the analysis of radiographs by means of specific cephalometric tracing and linear measurements of the styloid process. Each radiograph was traced and measured three times with intervals of 1 month to spread the error. Statistical analysis was performed by Pearson's test (p=0.001) using Biostat 4.0 statistical software. Result showed an incidence of 76% elongation of the styloid process in the sample. There was a correlation between the bilateral measures taken in panoramic radiographs (?<0.001) and also for measures of styloid process length carried out in different panoramic radiographs and lateral cephalometric radiographs (?<0.001). It was concluded that there is prevalence of elongated styloid process in patients with TMD. However, no relationship was found between measurements on the stylohyoid chain and symptoms of headache, orofacial pain, tinnitus and vertigo.

O conhecimento adquirido sobre a síndrome de Eagle demonstra que sua sintomatologia pode ser confundida muito facilmente com outros tipos de desordens craniomandibulares, principalmente a disfunção temporomandibular (DTM). O objetivo do estudo foi encontrar uma possível correlação entre a presença de DTM e o alongamento do processo estilóide, assim como a relação com a calcificação da cadeia estilo-hiódea. Para tanto foram analisados 50 pacientes com DTM, confirmada a partir do RDC/TMD. Foi realizado o exame clínico e documentação radiográfica de cada paciente, composta por: radiografia panorâmica digital e cefalométrica lateral digital. Para a análise das radiografias foi utilizado o programa computacional Radiocef (Radiomemory), onde foram realizados traçados cefalométricos por análise específica e medidas lineares do processo estilóide. Cada radiografia foi traçada e medida por três vezes, com intervalos de tempo de 1 mês entre as medições a fim de diluir o erro. Foi realizada a estatística através do Programa Biostat 4.0 e o teste de Pearson (?=0,001). Como resultado foi encontrada uma incidência de 76% de alongamento do processo estilóide na amostra. Houve correlação positiva para as medidas bilaterais realizadas na radiografias panorâmicas (?<0,001) e também para as medidas de comprimento do processo estilóide realizados nas diferentes tomadas radiográficas panorâmicas e cefalométricas laterais (?<0,001). Concluiu-se que há prevalência de alongamento do processo estilóide em pacientes com DTM, embora não tenha sido encontrada relação entre as medidas realizadas na cadeia estilo-hióidea com os sintomas de cefaléia, dor orofacial, zumbido e vertigem.

Lesões múltiplas de osteoma cutis na face: terapêutica minimamente invasiva em pacientes com sequela de acne - relato de casos / Multiple injuries of osteoma skin in the face: therapeutical least invasive in patients with acne sequela - case report

Osteoma cutis é a formação óssea no interior da pele, podendo ser primária ou secundária. Única ou múltipla, de tamanhos variados e acometendo ambos os sexos, é uma lesão cutânea rara, de etiopatogenia e classificação ainda discutidas. Nosso objetivo foi relatar o diagnóstico e a terapêutica minimamente invasiva de lesões múltiplas de osteoma cutis na face em pacientes com sequelas de acne. Fizemos a retirada dos osteomas com agulhas BD 0,70 x 25 22G1, sem anestésicos tópicos ou injetáveis no local. As pequenas incisões foram deixadas expostas, com pomada cicatrizante. Obteve-se um excelente resultado estético em 15 dias.

Osteoma cutis is a bone formation in the dermis can to be primary or secondary forms. Only, multiples, many forms, occurring on either sex, they are a rare cutaneous disease. The pathogenesis and classification remains unclear. Our objective was the diagnostic and small invasive surgery treatment of the osteoma cutis multiple of the face, in patients as a sequel of acne. To remove the osteoma we used needle BD 0,70x25 22G1, without anesthetic topic or inject able site. The small wounds were exposed with scarring balsam. We got an excellent esthetic result after 15 days.

Análisis de la longitud del ligamento estilohiodeo mediante sistema cone beam / Analysis of the stylohyoid ligament's in cone beam images

Introducción y Objetivo: La elongación y/o osificación del ligamento estilohioideo es una patologíapoco conocida, con un diagnóstico difícil de establecer. El propósito del presente estudio fuerealizar un análisis retrospectivo de exámenes para evaluar la presencia de variaciones en la longitud del ligamento estilohiodeo, según edad y género, mediante un Sistema de tomografía de alta resolución Cone Beam debido a su gran confiabilidad dimensional. Materiales y Métodos: La muestra consistió en 82 exámenes imagenológicos, los cuales fueron obtenidos con fines de estudios Ortodóncicos, de Implantología o de Diagnóstico general, durante el año 2008-2009. Se realizó el análisis retrospectivo de la muestra, y se clasificó según edad, género, y se individualizó el análisis cuantitativo tridimensional de los procesos estilohioideos. Resultados: El análisis realizado no mostró diferencias significativas en las variables relacionadas con el género, sin embargo en los pacientes mayores de 50 años, hubo un incremento importante en la longitud del ligamento estilohioideo. Conclusión: Los resultados obtenidos difieren con los resultados de trabajos anteriores analizados mediante ortopantomografía. Esto se explicaría por la gran sensibilidad diagnóstica del método utilizado.

Introduction and Objetive: This paper analyzes the existence of variations in the length of the stylohyoid ligament, according to age a genre, by using the high resolution Cone Beam System. Materials and Methods: The research was based in a sample of 82 imagenology examinations taken during the period 2008-2009 for routine studies in orthodontics, implantology and general diagnosis. The sample was examined with 3D measurements of the styloid process considering aprevious classification by age a genre, to establish if there is difference through these variables. Results: We found no significant difference in the length of the stylohyoid ligament by genre. However, there is evidence of an increase of the lengths of the ligament in patients over 50 years old. Conclusion: Our findings differ from previous documentation by using less accurate systems like orthopantomography.

Metaplasia óssea endometrial: quadro clínico e seguimento após tratamento / Endometrial osseous metaplasia: clinical presentation and follow-up

OBJETIVO: apresentar o quadro clínico das pacientes com metaplasia óssea e avaliar os fatores de risco, as mudanças dos sinais e sintomas após a retirada do fragmento ósseo. MÉTODOS: foi realizado um estudo transversal com 16 pacientes diagnosticadas com fragmentos ósseos na cavidade uterina no período de julho de 2006 a janeiro de 2009. O critério de inclusão foi o achado de fragmento ósseo retirado da cavidade uterina. Todas as pacientes tiveram confirmação histológica de presença de tecido ósseo na cavidade endometrial. Obtivemos os dados de todas as pacientes antes e depois da retirada por meio de um questionário para avaliar o efeito da retirada sobre a sintomatologia das pacientes, além da pesquisa de possíveis fatores relacionados ao aparecimento da doença. RESULTADOS: metade das pacientes (8/16) tinha sintomas hemorrágicos e um terço (6/16) apresentava infertilidade. A retirada dos fragmentos foi efetiva na melhora das queixas, havendo desaparecimento dos sintomas em todos os casos de menorragia e dor pélvica. CONCLUSÃO: A retirada do fragmento ósseo pode restaurar a fertilidade em pacientes selecionadas e que tenham como causa a metaplasia óssea, além de ser bastante efetiva em proporcionar melhora nos casos que cursam com dor pélvica e menorragia.

PURPOSE: to describe the clinical signs and symptoms of patients with bone metaplasia and to assess the risk factors for changes in these symptoms after removal of the bone fragment. METHODS: a cross-sectional study was conducted on 16 patients with a diagnosis of bone fragments in the uterine cavity during the period comprising July 2006 to January 2009. The inclusion criterion was the detection of a bone fragment removed from the uterine cavity. The presence of bone tissue in the endometrial cavity was histologically confirmed in all patients. The data of all patients were obtained before and after removal by means of a questionnaire for the evaluation of the effect of removal on the symptoms and for the search of possible factors related to the onset of the disease. RESULTS: half the patients (8/16) had hemorrhagic symptoms and one third (6/16) were infertile. Removal of the fragments was quite effective in improving the complaints, with the disappearance of symptoms in all cases of hemorrhage and of pelvic pain. CONCLUSION: removal of bone fragments can restore the fertility of selected patients whose infertility is caused by bone metaplasia and is quite effective in leading to improvement in patients with pelvic pain and menorrhage.

Heterotopic intraabdominal ossification: report of a case and review of the literature / Ossificação mesentérica heterotópica: relato de caso e revisão da literatura

There are 28 unequivocal reports of heterotopic mesenteric ossification (HMO) in the medical literature. Most cases are poorly defined lesions in intra-abdominal structures that cause intestinal obstruction. A small well-delineated solid mass was reported in only one patient with no previous history of trauma. We report herein the case of a 67 year-old female patient with calcified mass in the left adnexal region. The awareness of HMO may avoid an erroneous diagnosis of extraskeletal osteosarcoma. This case differs from most cases of HMO as it is the third one reported in females and does not present a diffuse involvement, which leads to obstructive symptoms.

A literatura médica apresenta 28 relatos inequívocos de ossificação mesentérica heterotópica (OMH). A maioria apresenta-se como lesões mal definidas em estruturas intra-abdominais causando obstrução intestinal. Em apenas um caso a lesão apresentava-se como uma pequena massa bem delimitada, num paciente sem histórico de trauma. Apresentamos o caso de uma paciente de 67 anos com massa calcificada em topografia anexial esquerda. O conhecimento da entidade OMH previne eventual diagnóstico errôneo de osteossarcoma extraesquelético. Esse caso difere da maioria dos casos de OMH visto que é apenas o terceiro relatado no sexo feminino, e não apresentava envolvimento difuso levando aos sintomas obstrutivos.

Miositis osificante postraumática / Post traumatic myositis ossificans

La miositis osificante postraumática circunscripta es un proceso proliferativo benigno en el cual la formación metaplásica ocurre en tejido no óseo. No es una enfermedad inflamatoria, por lo que es más apropiado llamarla osificación heterotópica. Reportamos un caso de osificación heterotópica en el músculo gastrocnemio, como complicación de una contusión con edema y hematoma.

Pulmonary Adenocarcinoma with Heterotopic Ossification

Pulmonary adenocarcinoma is a common malignancy that often involves calcification; however, bone formation in primary lung adenocarcinoma is extremely rare. In ten cases of primary pulmonary adenocarcinoma with heterotopic ossification, we detected immunoreactivity against TGF-beta1, osteopontin, osteocalcin and Runx2 in the fibroblastic stroma and tumor cells within the area of ossification. Our results suggest that in primary pulmonary adenocarcinoma, heterotopic ossification occurs via intramembranous bone formation. To our knowledge, only 11 other cases of pulmonary adenocarcinoma with heterotopic ossification have been reported. Here, we present ten cases of pulmonary adenocarcinoma showing heterotopic ossification with a description of previously published results and the histogenesis of heterotopic bone formation.

Pulmonary Adenocarcinoma with Heterotopic Ossification

Pulmonary adenocarcinoma is a common malignancy that often involves calcification; however, bone formation in primary lung adenocarcinoma is extremely rare. In ten cases of primary pulmonary adenocarcinoma with heterotopic ossification, we detected immunoreactivity against TGF-beta1, osteopontin, osteocalcin and Runx2 in the fibroblastic stroma and tumor cells within the area of ossification. Our results suggest that in primary pulmonary adenocarcinoma, heterotopic ossification occurs via intramembranous bone formation. To our knowledge, only 11 other cases of pulmonary adenocarcinoma with heterotopic ossification have been reported. Here, we present ten cases of pulmonary adenocarcinoma showing heterotopic ossification with a description of previously published results and the histogenesis of heterotopic bone formation.