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Wang X, Guan W, Bao L, Li Q, Wang X. Desmoplastic fibroma of the pediatric cranium with CTNNB1 mutation: case report and literature review. Childs Nerv Syst 2024:10.1007/s00381-024-06375-y. [PMID: 38635072 DOI: 10.1007/s00381-024-06375-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Desmoplastic fibroma (DF) is an uncommon intermediate bone tumor rarely involving the skull with unidentified pathogenesis. We report the first case of pediatric temporoparietal cranial desmoplastic fibroma (DF) with a CTNNB1 gene mutation and review the previous literature. CASE PRESENTATION A 3-year-old boy had a firm, painless mass on the right temporoparietal region for 22 months. The cranial CT scan showed isolated osteolytic destruction in the outer plate and diploe of the right temporoparietal bone. Gross total resection of the lesion and cranioplasty were performed. After that, a growing epidural hematoma was observed so another operation was performed to remove the artificial titanium plate. Postoperative pathology indicated a DF diagnosis and molecular pathology suggested a missense mutation in exon 3 of the CTNNB1 gene (c.100G > A,p.Gly34Arg). CONCLUSION Pediatric cranial DF is rare and easy to be misdiagnosed before operation. For cranial DF, lesion resection can be performed and perioperative management should be strengthened. Mutations in the CTNNB1 gene might be one of the molecular pathologic features of DF.
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Affiliation(s)
- Xinyao Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbin Guan
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Bao
- Department of Imaging, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqiang Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Desmoplastic fibroma of the temporal bone. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Desmoplastic fibroma of the occipital bone in adult female: A case report. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Lucke-Wold B, Samaka RM, Refaat BF, Zwayed ARH. Desmoplastic Fibroma of the Skull in an Infant: A Case Report. NEUROLOGICAL SCIENCES AND NEUROSURGERY 2020; 1:108. [PMID: 33103158 PMCID: PMC7581284 DOI: 10.47275/2692-093x-108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Desmoplastic fibromas are rare benign bone tumors occurring primarily in long bones and mandible. In this case report, we present a desmoplastic fibroma originating from the left frontal bone. This is an exceptionally rare presentation of this pathology and the associated imaging and pathologic slides are highly educational. We discuss the relevance to the literature and how to manage these patients clinically.
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Affiliation(s)
- Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, United States
- Correspondence to: Brandon Lucke-Wold, Department of Neurosurgery, University of Florida, United States;
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KOISO T, MUROI A, YAMAMOTO T, SAKAMOTO N, MATSUMURA A. Desmoplastic Fibroma of the Pediatric Cranium: An Aggressive Skull Tumor with Local Recurrence. Neurol Med Chir (Tokyo) 2016; 56:85-8. [PMID: 26804188 PMCID: PMC4756249 DOI: 10.2176/nmc.cr.2015-0167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/17/2015] [Indexed: 11/20/2022] Open
Abstract
Cranial desmoplastic fibroma (DF) is extremely rare and only 20 cases, including only 7 pediatric cases, have been reported previously. We describe the first case of a child with cranial DF that increased in size over a short-term and recurred after resection. The aim of this case report was to discuss the clinical, radiological, and histological characteristics and optimal treatment for this rare and aggressive skull tumor.
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Affiliation(s)
- Takao KOISO
- Department of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki
| | - Ai MUROI
- Department of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki
| | - Tetsuya YAMAMOTO
- Department of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki
| | - Noriaki SAKAMOTO
- Department of Diagnostic Pathology, University of Tsukuba, Tsukuba, Ibaraki
| | - Akira MATSUMURA
- Department of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki
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Park B, Abode-Iyamah K, Lee SL, Kirby P, El-Khoury G, Wilson S. Fibro-osseous lesion of the cranium in an adolescent patient. Surg Neurol Int 2015; 6:12. [PMID: 25657865 PMCID: PMC4310058 DOI: 10.4103/2152-7806.149848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 11/18/2014] [Indexed: 12/14/2022] Open
Abstract
Background: Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare benign calvarial lesions, which can have local aggressive behavior. These tumors can present with similar clinical and radiologic characteristics making diagnosis difficult at times. Case Description: A 16-year-old male presents after noting an indentation of his skull. Comparison with current and previous imaging revealed progressive erosion of the skull underlying the indentation. Conclusion: Fibrous dysplasia, ossifying fibroma, and desmoplastic fibroma are rare fibro-osseous tumors with similar characteristics radiographically. Accurate diagnosis of these tumors can be difficult even with the combination of clinical presentation, imaging, and pathology. The treatment of choice is resection and cranial reconstruction, if necessary, with close follow-up as recurrence can occur.
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Affiliation(s)
- Brian Park
- University of Iowa, Carver College of Medicine, Iowa City, IA, USA
| | - Kingsley Abode-Iyamah
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Siang Liao Lee
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Patricia Kirby
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - George El-Khoury
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Saul Wilson
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Cho BH, Tye GW, Fuller CE, Rhodes JL. Desmoplastic fibroma of the pediatric cranium: case report and review of the literature. Childs Nerv Syst 2013; 29:2311-5. [PMID: 23812628 DOI: 10.1007/s00381-013-2210-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 06/13/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Desmoplastic fibromas are primary bone tumors that seldom occur in the cranial bones. Furthermore, reports of desmoplastic fibromas of the skull in children are exceedingly rare. Although desmoplastic fibromas are histologically benign, they are locally aggressive and have a propensity to reoccur. Their radiographic appearance may mimic other more common central nervous system and bone neoplasms. There are only 19 reported cases of desmoplastic fibroma of the cranium in the literature, and only seven occurred in the pediatric age group. We present a case report of an 11-year-old female patient with a desmoplastic fibroma of the parieto-occipital region and review the literature. CASE REPORT An 11-year-old female presented to the craniofacial clinic complaining of intermittent pain and a soft mass in the occipital region. There was a distant history of trauma to the region that did not require medical intervention. Computed tomography imaging revealed a lytic bone lesion overlying the sagittal sinus in the parieto-occipital region. Surgical resection with wide margins and immediate autologous reconstruction was performed. Pathological analysis revealed a desmoplastic fibroma. At 4 months of follow-up, no recurrence has been noted. CONCLUSION Desmoplastic fibroma of the cranium is rare. Complete surgical resection with careful follow-up is the treatment of choice.
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Affiliation(s)
- Brian H Cho
- Virginia Commonwealth University School of Medicine, Richmond, VA, 23298, USA,
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Klimo P, Jha T, Choudhri AF, Joyner R, Michael LM. Fibromyxoma of the lateral skull base in a child: case report. J Neurol Surg Rep 2013; 74:105-10. [PMID: 24303345 PMCID: PMC3836972 DOI: 10.1055/s-0033-1351115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/14/2013] [Indexed: 10/29/2022] Open
Abstract
Purpose Fibromyxomas and myxomas are benign tumors of mesenchymal origin usually found outside the nervous system, most commonly in the atrium of the heart. They can also arise in the mandible or maxilla, but it is exceedingly rare to find them within the skull base. The history, histologic features, and the literature, with emphasis on other pediatric cases, are reviewed for this uncommon skull base neoplasm. Methods We describe the case of a 13-year-old girl who presented with a 1-year history of facial weakness, numbness, and hearing loss. A large locally destructive tumor centered in the petrous bone was found on magnetic resonance imaging. Results A mastoidectomy combined with a middle fossa craniotomy was performed for gross total resection. The child is disease free 12 months after surgery. Conclusion Diagnosis could not be made solely on radiographic studies because of the lack of pathognomonic imaging features. Radical resection provided the patient the best chance of cure. Long-term surveillance is necessary to monitor for tumor recurrence.
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Affiliation(s)
- Paul Klimo
- Murphey Neurologic & Spine Institute, Semmes, Memphis, Tennessee, United States ; Le Bonheur Children's Hospital, Memphis, Tennessee, United States ; Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States ; St. Jude Children's Research Hospital, Memphis, Tennessee, United States
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Deniz K, Ceylan D. Desmoplastic fibroma of the skull. Acta Neurochir (Wien) 2008; 150:285-90. [PMID: 18193151 DOI: 10.1007/s00701-007-1399-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Accepted: 09/13/2007] [Indexed: 10/22/2022]
Abstract
Desmoplastic fibroma is a primary bone tumour which occurs exceedingly rarely in the cranial bones. We report a histopathologically confirmed example in a 21 year old man with a painless swelling over the sagittal suture. In the light of our experience and reports of previous examples, we review the features of the condition and its management.
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Gibson SE, Prayson RA. Primary Skull Lesions in the Pediatric Population: A 25-Year Experience. Arch Pathol Lab Med 2007; 131:761-6. [PMID: 17488162 DOI: 10.5858/2007-131-761-pslitp] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2006] [Indexed: 11/06/2022]
Abstract
Abstract
Context.—Primary skull lesions are rare in the pediatric population. The differential diagnosis of these lesions is broad and includes both congenital and acquired lesions. Previous studies of skull lesions in the pediatric population suggest that dermoid/epidermoid tumors are the most common childhood skull tumors.
Objective.—To review the clinicopathologic features of primary skull lesions identified within the pediatric population of an academic tertiary medical center.
Design.—A retrospective review of surgical pathology reports during a 25-year period identified 19 primary skull lesions occurring in the pediatric population. Lesions were excluded if they were of known soft tissue or intracranial origin with secondary calvarial involvement, or if they represented a metastasis from a known primary malignancy.
Results.—Nineteen primary skull lesions were identified in 11 male (58%) and 8 female (42%) patients, with a median age at diagnosis of 9.5 years. These lesions were usually benign and most commonly presented as a painless mass (n = 8). The lesions were located in the occipital bone (n = 7), frontal bone (n = 5), parietal bone (n = 2), and temporal bone (n = 1). Diagnoses included epidermoid/ dermoid cyst (n = 8), Langerhans cell histiocytosis (n = 6), intraosseous hemangioma (n = 2), osteoblastoma (n = 1), infantile myofibroma (n = 1), and fibroma (n = 1). Intracranial extension was identified in 1 case, and recurrence was found in only 2 cases.
Conclusions.—Epidermoid/dermoid cysts and Langerhans cell histiocytosis are the most commonly encountered skull lesions in the pediatric population at our institution. Intracranial extension of these lesions is rare, and recurrence is uncommon following complete surgical resection.
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Affiliation(s)
- Sarah E Gibson
- Division of Pathology and Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio 44195, USA
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Yoon SH, Kim SH, Shin YS, Ahn YW, Cho KG, Lee KB, Cho KH. Desmoplastic fibroma of the skull in an infant. Childs Nerv Syst 2006; 22:176-81. [PMID: 15809820 DOI: 10.1007/s00381-004-1103-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2004] [Indexed: 11/25/2022]
Abstract
CASE REPORT A 1-year-old girl presented with a 10-month history of progressive protuberance of the left frontal skull. Magnetic resonance imaging and computed tomography demonstrated a large osteolytic interosseous mass extending to the frontal sinus and temporal base without any intracranial invasion. A fronto-temporo-parietal craniectomy of the outer skull table and excision of an interosseous tumor resulted in local dural exposure in the temporal area that was covered by cranioplasty. Pathological examination identified desmoplastic fibroma (DF) of the skull. The patient's cranial asymmetry was improved without recurrence of the tumor up to the 12th month after excision. DISCUSSION In the literature, 11 cases of DF of the skull have been reported, two of which have involved children (one an infant). We report the second known infantile case of DF of the skull.
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Affiliation(s)
- Soo-Han Yoon
- Department of Neurosurgery, School of Medicine, Ajou University, Paldal-Gu, Wonchon-Dong, San#5, Suwon, South Korea
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Rabin D, Ang LC, Megyesi J, Lee DH, Duggal N. Desmoplastic fibroma of the cranium: case report and review of the literature. Neurosurgery 2003; 52:950-4; discussion 954. [PMID: 12657192 DOI: 10.1227/01.neu.0000053025.36216.3c] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2002] [Accepted: 12/04/2002] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE AND IMPORTANCE Desmoplastic fibroma is a benign bone tumor that can be locally aggressive. It usually occurs in the long bones and mandible. We report on a patient with a desmoplastic fibroma arising in the temporal bone and review previously published cases of desmoplastic fibroma originating within the cranium. CLINICAL PRESENTATION A 43-year-old woman presented with a 12-year history of progressively worsening head asymmetry. Magnetic resonance imaging and computed tomography demonstrated a mass originating from the bone and involving the adjacent soft tissues. INTERVENTION A temporal parietal craniectomy was performed with excision of a large tumor involving the bone. An acrylic cranioplasty was used to replace the bone. Pathological examination of the lesion identified desmoplastic fibroma of the cranium. After surgery, the patient's cranial asymmetry was corrected. CONCLUSION Desmoplastic fibroma of the cranium is rare. Surgical resection is the treatment of choice.
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Affiliation(s)
- Doron Rabin
- Department of Clinical Neurological Sciences, Division of Neurosurgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
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