Cases reported "Ossification, Heterotopic"

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1/29. Basal cell carcinoma with massive ossification.

    We report a case of basal cell carcinoma with massive ossification in a 66-year-old white man. Ossification in various benign and malignant neoplasms have been reported including basal cell carcinomas, in which ossifications are seen in small foci or peripheral rim of the tumor. However, in our case, massive ossification is seen throughout the tumor, and only small areas of the periphery of the tumor show diagnostic histology. Therefore, this case might have presented a diagnostic difficulty or been misdiagnosed as an osteoma cutis if a smaller incisional or punch biopsy had been performed. The phenomenon of bone formation itself is not specific for any diagnostic entity, and therefore an underlying lesion should be carefully sought in case of secondary ossification.
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2/29. Aggressive ossifying fibroma of the maxilla: review of the literature and report of case.

    A case of a large aggressive ossifying fibroma of the maxilla has been presented. review of the literature shows the literature shows the difficulty in establishing a definitive diagnosis through any single diagnostic modality. Much of this is due to the confusion surrounding classification of the tumor. Adjunctive radiographic and nuclear medicine diagnostic aids were utilized, as were clinical, laboratory, and histopathologic studies, in resolving the diagnostic questions posed by this large and aggressive tumor. Surgical intervention through conservative enucleation produced few operative or postoperative difficulties and minimal residual deformity. Differentiation of ossifying fibroma from other benigh and malignant neoplasms as well as fibrous dysplasia is important in the correct management of this lesion.
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3/29. Extensive ossification in a craniopharyngioma.

    A rare extensive ossification occurred in a suprasellar craniopharyngioma of a man who died at 21 years of age. The tumor produced headache, retarded physical and mental development, visual disturbances, and increased intracranial pressure. The neoplasm recurred after surgical and roentgenological treatments. Differentiation of multipotential mesenchymal cells or mesenchymal type cells within the tumor has been suggested as the mode of occurrence of bone in this craniopharyngioma.
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4/29. Fine needle aspiration cytology of the malignant variant of ossifying fibromyxoid tumor of soft parts: a case report.

    BACKGROUND: Ossifying fibromyxoid tumor (OFMT) of soft parts is a rare, recently defined, fibroosseous neoplasm, generally regarded as clinically benign; however, one-third of cases recur locally, and several malignant examples have been reported. Fine needle aspiration (FNA) cytology of the tumor is rarely described in the literature. We provide the first cytomorphologic study of the malignant variant. CASE: A 70-year-old man presented with an intramuscular mass in the right buttock. Computed tomography revealed ossification within the mass and multiple pulmonary nodules. FNA biopsy showed round and polygonal to spindled tumor cells, arrayed singly, cordlike or in small aggregates, with scattered dense stromal fragments and a slightly myxoid background. The nuclei showed significant pleomorphism accompanied by coarse chromatin with clumping, irregular contours, and one to two distinct nucleoli. The tumor cells were recognizable as sarcoma, with no evidence of high grade malignancy. The tumor was totally excised, histopathologically confirmed as the malignant variant of OFMT of soft parts, and immunohistochemically and ultrastracturally analyzed as of neural origin. CONCLUSION: The FNA specimen revealed that the cytomorphology was consistent with the histologic features of the malignant variant of OFMT, but several characteristic histologic parameters, such as multilobular proliferation and peripherally placed mature, bony trabeculae, were not reflected in the aspirates. Although FNA cytologic findings may be of limited diagnostic utility in OFMT, radiographic evidence of calcification/ossification suggests that OFMT should be subjected to differential diagnosis with fine needle aspiration biopsy of soft tissue tumors. Additional studies will be required for further clarification.
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5/29. Osseous metaplasia of the breast: diagnosis with stereotactic core biopsy.

    There are approximately 200 reported cases of breast tumors containing areas of bone. The majority of the neoplasms are sarcomas, phylloides tumors, or fibroadenomata. We present a case of osseous metaplasia mammographically detected by clustered heterogeneous calcifications. Stereotactic core biopsy revealed the presence of well-formed bone tissue without associated neolplasia. The case represents the first reported case of mammographically detected osseous metaplasia confirmed by core biopsy.
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6/29. Nerve cell markers in ossifying fibromyxoid tumour of soft parts.

    Reported herein are two benign ossifying fibromyxoid tumors (OFMTs) of the soft tissues in axilla and terminal phalanx respectively. Both cases on immunohistochemistry (IHC) showed reactivity for vimentin, S-100 protein and glial fibrillary acidic protein (GFAP) antibodies. In addition, a focal/diffuse strong positivity for neurofilament (NF) and neuron specific enolase (NSE) was observed. Electron microscopy in one instance revealed abundant intermediate filaments, primitive cell junctions and a focally present external lamina. In the light of nerve cell differentiation of these tumors and the similarity of IHC profile and EM features of OFMT to a poorly differentiated malignant peripheral nerve sheath tumor (MPNST); it is suggested that OFMT is a variably differentiated PNST rather than a simple Schwannian neoplasm as is believed.
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7/29. Ossifying malignant mixed epithelial and stromal tumor of the liver: a case report of a previously undescribed tumor.

    BACKGROUND: Malignant mixed tumors of the liver in adults are rare. To the authors' knowledge, twenty-four cases of primary malignant mixed hepatic tumors have been reported in the literature since the first description by Walter in 1896. Many of the previously reported cases are now considered mixed hepatoblastoma, primary hepatocellular carcinomas with focal sarcomatous metaplasia, or epithelioid hemangioendothelioma. methods: Clinical, radiologic, histologic and immunohistochemic methods were used to characterize an unusual example of a mixed malignant tumor of the adult liver that the authors descriptively refer to as "ossifying malignant mixed epithelial and stromal tumor" of the liver. RESULTS: In contrast to previously reported cases, the tumor in question was morphologically distinct. It was composed of three distinct neoplastic phenotypes: malignant spindle cells, with adenocarcinomatous differentiation, and extensive osteoid formation. The tumor was treated by partial hepatectomy. The patient was alive 8 years postoperatively as of December 2001. The distinctive combination of morphologic features and prolonged survival are much different from previously reported cases of mixed malignant hepatic tumors, which were typically rapidly fatal. CONCLUSIONS: The authors believe that the clinical and pathologic features of this patient's tumor are sufficiently distinctive to exclude it from the well-established categories of hepatic neoplasms. Histologically, the authors suggest the descriptive name "ossifying malignant mixed epithelial and stromal tumor of the liver" as a preliminary description for this tumor until the origin and relationship to other hepatic neoplasms are further characterized.
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8/29. Ossifying luteinized thecoma of the ovary.

    A 51-year-old woman presented with lumbar backache leading to the preoperative diagnosis of a right solid adnexal mass with calcification on computed tomographic scan. Histological examination revealed a right ovarian luteinized thecoma characterized by extensive calcification and metaplastic ossification. osteoblasts and osteoclasts surrounded the surface of the heterotopic bone. Haversian canals were occasionally identified in the bony trabeculae. Ossifying ovarian neoplasms are extremely rare and this case is the first to demonstrate the osseous metaplasia in ovarian luteinized thecoma.
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9/29. Cytologic diagnosis of ossifying fibromyxoid tumor of soft tissue: a case report.

    Ossifying fibromyxoid tumor (OFMT) of soft tissue is an uncommon, recently described neoplasm. It is usually, but not universally, a benign neoplasm and cases of metastatic so-called "malignant OFMT" have been reported. Although the histopathologic features of OFMT are well characterized, the same is not entirely true so far as the cytology literature is concerned. There are only three cytologic descriptions of OFMT to date to the best of our knowledge. A 62-year-old woman presented with a subcutaneous well-circumscribed nodular soft tissue mass at the upper end of the shoulder. X-ray and computed tomography revealed an incomplete shell of calcification surrounding the nodular mass along with foci of ossification within it. Fine-needle aspiration (FNA) cytology showed round to polygonal to spindle shaped neoplastic cells arranged in clusters, cords, and small aggregates and lying discretely in a mucoid background. Some osteoid-like material was also seen. The tumor was completely excised and histopathologic examination confirmed the diagnosis of OFMT. OFMT should be considered as a possibility in FNA cytology of myxoid soft tissue tumor especially with radiologic evidence of ossification.
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10/29. Metaplastic ossification in a cutaneous pyogenic granuloma: a case report.

    Cutaneous ossification may occur in association with a variety of cutaneous neoplasms and inflammatory conditions, such as pilomatricomas, basal cell carcinomas, nevi, chondroid syringomas, venous stasis, and scars. However, it has rarely been reported in pyogenic granuloma, a relatively common benign vascular tumor of the skin and mucous membranes. We herein presented a rare case of cutaneous pyogenic granuloma with ectopic ossification on the big toe of a 37-year-old man, with high recurrence despite repeated CO2 laser ablations. We propose the hypothesis that vascular endothelial growth factor (VEGF) and bone morphogenetic proteins (BMPs) play pathologic roles in the development of ectopic bone formation in pyogenic granuloma.
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