1/20. Ossified intratesticular mucinous tumor.We report a case of an ossified primary intratesticular mucinous tumor in a 69-year-old man, which was discovered incidentally during a consultation for erectile dysfunction. The 7.5 x 4.8 x 4-cm, predominantly solid, and partially cystic mass completely replaced the testis with no extension to tunica albuginea and epididymis. The multiloculated area was mostly covered by a single layer of bland mucinous epithelium with few areas of epithelial tufting, stratification, and nuclear atypia. The solid areas consisted of mature bone and fibrous stroma with cholesterol clefts, some multinucleated giant cells, moderate infiltration of lymphocytes, and foamy vacuolated macrophages. The bone showed occasional rimming of osteoblasts and rare osteoclasts. Rare foci of mature bone were found in the nonfibrosed wall and lumen cysts. The patient is alive and well 3 years after right orchiectomy with spermatic cord resection.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/20. Giant central ossifying fibroma of the mandible: report of case.A case is presented of a patient with a giant ossifying fibroma of the mandible that had been diagnosed earlier as fibrous dysplasia. Surgical resection of the tumor and involved bone was chosen as the mode of treatment because of the extent of the lesion and continued infection. Surgeons should be aware that ossifying fibroma is a very distinct possibility in large growing lesions in age groups older than is deemed compatible with fibrous dysplasia.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/20. Dysphagia in a patient with giant osteophytes: case presentation and review of the literature.A patient with increasing dysphagia due to external bone compression of the oesophagus is presented. Radiographic evaluation revealed the underlying condition to be a diffuse idiopathic skeletal hyperostosis with exuberant and bumpy change within the anterior longitudinal ligament.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
4/20. Giant-cell tumor of bone arising from the falx cerebri. A case report.The histological and ultrastructural features of a giant-cell tumor of bone arising in the falx cerebri of a 27 year-old man are described. The tumor was embedded in the medial aspect of the left frontal lobe and was not attached to any of the bones of the skull. At surgery, the tumor was lightly adherent to the falx and was easily extracted. Histologically, the tumor was composed of mononuclear spindle-shaped and ovoid stromal cells, multinuclear giant cells containing 20-30 nuclei, and foci of osteoid and bone production. Hemorrhagic and cystic areas were also present within the tumor. Ultrastructurally, the spindle-shaped cells resembled fibroblasts and were surrounded by small bundles of collagen fibrils. The ovoid cells contained numerous mitochondria, abundant rough endoplasmic reticulum, vesicles, lysosomes, phagosomes and osseous material in the cytoplasm suggesting their monocyte-macrophage lineage. These cells were closely apposed and displayed evidence of fusion in the form of focal and linear subplasmalemmal densities to form multinucleated giant cells with similar organelles and multiple nuclei. It is suggested that the primary giant cell tumor of the one arose from the metaplastic ossification of the falx. To our knowledge, a giant-cell tumor of bone arising from the falx cerebri has not been previously described.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
5/20. Cartilaginous differentiation in peritoneal tissues: a report of two cases and a review of the literature.Two cases of cartilaginous differentiation of the peritoneum not associated with an intraabdominal malignancy are described. This is the first detailed report of cartilaginous metaplasia of the peritoneum. The patients were female, ages 53 (Patient 1) and 77 years (Patient 2). Prior medical histories were significant for a culdotomy (to drain pelvic abscesses associated with pelvic inflammatory disease) in Patient 1 and for an open abdominal surgery in Patient 2. The peritoneal lesions were incidental findings in both cases. In Patient 1, surgery was performed for a septated ovarian cyst; the other patient underwent surgery to relieve obstructive bowel symptoms. In Patient 1, multiple firm, white lesions ranging from 2.0 to 7.0 mm were present on the serosal surfaces and the mesenteries of the small and large bowel. In Patient 2, a single firm, white lesion measuring 2 cm in maximum dimension was removed from the mesentery of the ileum. Microscopically, the lesions consisted of small nodules of mature hyaline cartilage surrounded by nondescript fibrous tissue and covered by mesothelium. There was no foreign body giant cell reaction, inflammation, or other reactive changes in the surrounding adipose tissue. These may represent metaplastic lesions of the secondary mullerian system, or a unique peritoneal response to previous surgical manipulation. Alternatively, these may represent benign neoplastic lesions (chondroma) of the submesothelium.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/20. Sialolith of the submandibular gland with bone formation.An unusual case of sialolith with bone formation, occurring in the submandibular gland of a 33-year-old woman, is reported. In addition to the irregularly laminated structure of sialolith, sparsely scattered foci of bone tissue were found. Some of them were mature, lamellar bone with lacunae containing osteocytes, endosteum and a bone marrow-like element. Others were immature bone associated with or without multinucleated giant cells. Foci of bone tissue were in contact with caliculi or fibrous tissue, and no epithelial component was seen around them. These observations suggest that bone formation in the present case may be in the nature of pathological ossification, and that in the earlier stage, the bone that is deposited is woven and is replaced through successive remodeling cycles by lamellar bone. This is the first case of sialolith with bone formation, although sialolithiasis is a common disease of the salivary glands.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/20. Massive osteolipoma of the skull.Osteolipoma is a very rare condition, and only a few cases affecting the head were found in the literature. None can be compared with the giant lesion of the side of the head developing in the left temporo-parietal region of an 8-year-old boy from Central africa. Under a huge lipoma, an irregular bony mass was found. Contouring resection was performed with an uneventful recovery. Technique and pathology are discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/20. A living case of pulmonary ossification associated with osteoclast formation from alveolar macrophage in the presence of T-cell cytokines.A 61-year-old woman had been coughing up blood-tinged sputum since May 1998. Chest radiography and computed tomography (CT) scans revealed a solitary mass (3 cm in greatest dimension) in the right lower field, accompanied by a surrounding area of ground glass and reticular appearance. Surgical lung biopsy was performed to the surrounding area. The pathological diagnosis was pulmonary ossification of the dendriform type. Alveolar macrophages obtained from her lung differentiated into tartrate-resistant acid phosphatase (TRAP)-positive multinucleated giant cells (MGCs) in the presence of autologous T cells or of macrophage colony stimulating factor (M-CSF) and interleukin-4 (IL-4). This results suggest the possibility that monocytes/macrophages may have the ability to form osteoclasts in the presence of cytokines that may be involved in the development of pulmonary ossification.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/20. A variant of nephrogenic fibrosing dermopathy with osteoclast-like giant cells: a syndrome of dysregulated matrix remodeling?nephrogenic fibrosing dermopathy (NFD) is a disorder characterized by dramatic thickening and hardening of skin in the extremities and trunk, which occurs in individuals on dialysis for renal disease. The pathophysiology is unknown. Increased transforming growth factor-beta (TGF-beta) and collagen deposition have been reported in a small group of patients studied by Jimenez et al.1 We report two patients with NFD and osteoclast-like giant cells in the fibrotic dermis; one patient also had dystrophic cutaneous calcification. These findings have been seen in a small percentage of NFD patients (estimated 2-5%) and may represent a variant of the disease. The hypothesis of altered matrix dysregulation due to altered TGF-beta, metalloproteinases, and activation of osteoclasts as an explanation for this variant is proposed.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
10/20. Ossified soft tissue recurrence of giant cell tumor of bone.We report 3 cases of soft tissue recurrence of giant cell tumor of bone. A peripheral rim of ossification in the soft tissue mass is pathognomonic of recurrence in the patients after resection of giant cell tumor.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
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