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Calcifying fibrous tumor: a rare case in the foot. Skeletal Radiol 2023:10.1007/s00256-023-04282-y. [PMID: 36695882 DOI: 10.1007/s00256-023-04282-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: 06/28/2022] [Revised: 12/27/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023]
Abstract
Calcifying fibrous tumor is a rare fibroblastic tumor with distinctive histological presentation that shows benign characteristics. To our knowledge, there are no prior reports that have documented imaging findings of calcifying fibrous tumor in the distal lower extremity. We report the case of a 25-year-old man who presented with a mass in the medial aspect of the right foot that was first noted 4 years earlier. Medical attention was sought due to perceived increase in size as well as increasing pain in the right foot. The patient had no limitations in activity but reported worsening discomfort while walking. An anteroposterior radiograph obtained at first presentation demonstrated a large calcified soft mass in the medial aspect of the foot. Contrast-enhanced MRI showed a mildly enhancing 6.5 cm × 2.5 cm × 8.5 cm mass, hypointense on T1- and T2-weighted images, infiltrating the adjacent abductor hallucis and flexor digitorum brevis muscles. Histopathology demonstrated multiple irregular fragments of white-tan firm tissue with a gritty cut surface, positive for CD34 on immunohistochemistry and consistent with calcifying fibrous tumor. Although rare in the extremities, this diagnosis should be considered in patients with a calcifying soft tissue mass. Low signal intensity with low-grade enhancement on MRI as well as stable disease course could prompt a diagnosis of calcifying fibrous tumor even in previously unmanifested locations.
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Runyan C, Patel M, Youssfi M, Taylor S, Biyyam D. Calcifying nested stromal-epithelial tumor of the liver: Case report of a rare primary liver tumor. Radiol Case Rep 2021; 16:2337-2342. [PMID: 34306277 PMCID: PMC8258647 DOI: 10.1016/j.radcr.2021.04.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 12/21/2022] Open
Abstract
Calcifying nested stromal epithelial tumor is a very rare primary liver tumor in children. To our knowledge, few cases have been reported in literature. We describe the imaging appearance and histopathologic features of this tumor incidentally detected in a 2-year-old girl. This tumor should be considered in the differential when a large heterogeneous liver tumor with central scar and coarse/chunky calcifications is identified at imaging in the absence of elevated alpha-fetoprotein in a child.
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Affiliation(s)
- Charles Runyan
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, USA
| | - Mittun Patel
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, USA
| | - Mostafa Youssfi
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, USA
| | - Steve Taylor
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, USA.,Department of Pathology, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, USA
| | - Deepa Biyyam
- Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Rd., Phoenix, AZ 85016, USA
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Abstract
A 19 year old otherwise healthy male presented with a history of acute onset left neck pain with subsequent swelling and development of a left neck mass that progressively enlarged over a two month period. Imaging studies revealed a solid heterogeneous mass with prominent calcifications displacing normal structures. The lesion was resected via transcervical approach and a diagnosis of calcifying fibrous tumor (CFT) was rendered. The clinical, radiographic, histologic and immunophenotypic features of CFT are discussed. CFT is a rare benign soft tissue tumor with distinctive histologic findings. They present as well-circumscribed but unencapsulated, paucicellular lesions consisting of hyalinized fibrous tissue with chronic lymphoplasmacytic inflammation and variable amounts of both psammomatous and dystrophic calcifications distributed throughout. They are found in numerous locations throughout the body, most often in the gastrointestinal tract or subcutaneous soft tissue, but are relatively uncommon in the neck. This article describes a case of CFT which presented as an enlarging neck mass in a young male.
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Liu Y, Lu Q, Wu XL, Shen GJ, Luo T. Ultrasonographic imaging of calcifying fibrous tumor of cervical esophagus: A case report. Medicine (Baltimore) 2019; 98:e16425. [PMID: 31305462 PMCID: PMC6641661 DOI: 10.1097/md.0000000000016425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Calcifying fibrous tumor (CFT) is a rare benign mesenchymal tumor characterized by cytologically benign fibroblasts that produce abundant collagen with scattered lymphocytes, plasma cells, and psammomatous or dystrophic calcifications. PATIENT CONCERNS A 37 years old women was initially diagnosed thyroid nodule in local hospital. She was referred to receive microwave ablation of the nodule in our hospital. The patient was in good health with occasional foreign body sensation in the neck. Routine laboratory examination was normal. DIAGNOSIS The lesion was suspected benign and originating from the esophagus rather than the thyroid gland by conventional ultrasound and contrast-enhanced ultrasound in our hospital and was finally proved to be CFT by pathology. INTERVENTIONS The lesion was surgically removed. OUTCOMES The patient recovered well and was followed up for 2 years without recurrence. LESSONS Although imaging diagnosis of CFT is difficult, the findings of clear border, coarse calcification on conventional ultrasound and peripheral hypoenhancement without central enhancement on contrast-enhanced ultrasound (CEUS), together with real-time evaluation of the relationship between the tumor and esophagus help to distinguish CFT of cervical esophagus from other lesions in the neck.
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Affiliation(s)
- Yan Liu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu
- Department of Ultrasound
| | - Qiang Lu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu
| | | | | | - Tao Luo
- Department of General Sugery, Panzhihua Municipal Central Hospital, Panzhihua, Sichuan Province, China
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Kimura M, Kato H, Sekino S, Ishida N, Murase K, Shimabukuro K, Sekino T, Doi K, Matsuo M. Radical resection of a giant retroperitoneal calcifying fibrous tumor combined with right hepatectomy and reconstruction of the inferior vena cava and bilateral renal veins. Surg Case Rep 2018; 4:7. [PMID: 29349591 PMCID: PMC5773466 DOI: 10.1186/s40792-018-0417-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/04/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND We report a case of a giant retroperitoneal calcifying fibrous tumor (CFT) treated by radical tumor resection combined with right hepatectomy and reconstruction of the inferior vena cava (IVC) and bilateral renal veins. Only three case reports of CFT arising in the retroperitoneum have been reported until today. CASE PRESENTATION In a 19-year-old female patient, computed tomography (CT) images showed a well-demarcated expansile lesion around the IVC accompanied by focal calcification, whereas the IVC that was circumferentially surrounded by the lesion was dilated due to the desmoplastic reaction. On magnetic resonance imaging (MRI), the lesion demonstrated heterogeneous hypointensity on T2-weighted images. Delayed enhancement was observed on dynamic contrast-enhanced CT and MRI. 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images showed increased FDG uptake [maximum standardized uptake values (SUVmax), early image 7.28; delayed image 7.40]. On operative examination, because the tumor adhered to the liver parenchyma, the right Glisson capsule, and the origin of bilateral renal veins, radical tumor resection combined with right hepatectomy and reconstruction of the IVC and bilateral renal veins was performed. CONCLUSIONS Radical tumor resection was successfully and appropriately performed for a young patient with a giant retroperitoneal CFT with a view to achieving complete venous reconstruction and safe surgical margins for a potentially malignant tumor.
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Affiliation(s)
- Masaki Kimura
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Hiroki Kato
- Department of Radiology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Seishiro Sekino
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Narihiro Ishida
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Katsutoshi Murase
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Katsuya Shimabukuro
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Takafumi Sekino
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Kiyoshi Doi
- Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Masayuki Matsuo
- Department of Radiology, Graduate School of Medicine, Gifu University, Gifu, Japan
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Miyashita S, Ryu Y, Takata H, Asaumi Y, Sakatoku M, Seike T, Okamura T, Inamura K, Kawai H, Okuno N, Terahata S. Imaging findings of gastric calcifying fibrous tumour. BJR Case Rep 2016; 2:20160064. [PMID: 30460039 PMCID: PMC6243330 DOI: 10.1259/bjrcr.20160064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/17/2016] [Accepted: 05/20/2016] [Indexed: 12/28/2022] Open
Abstract
Calcifying fibrous tumours (CFTs) are rare benign lesions that usually affect the soft tissues, the mesentery and the peritoneum. Gastric CFT is particularly rare. Here, we report a CFT found incidentally in a 31-year-old male. The mass was well circumscribed and showed partial calcification on the CT scan, with dark signal intensity seen on T2 weighted MRI. To the best of our knowledge, there is very limited published information concerning imaging findings of CFTs. We discuss the CT scan and MRI findings of this patient, which can be considered typical for gastric CFT, and present a review of the limited literature available.
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Affiliation(s)
- Sae Miyashita
- Department of Radiology, Tonami General Hospital, Tonami, Japan
| | - Yasuji Ryu
- Department of Radiology, Tonami General Hospital, Tonami, Japan
| | - Harumi Takata
- Department of Radiology, Tonami General Hospital, Tonami, Japan
| | | | | | - Takuya Seike
- Department of Gastroenterology, Tonami General Hospital, Tonami, Japan
| | - Toshiyuki Okamura
- Department of Gastroenterology, Tonami General Hospital, Tonami, Japan
| | - Katsuhisa Inamura
- Department of Gastroenterology, Tonami General Hospital, Tonami, Japan
| | - Hiroshi Kawai
- Department of Gastroenterology, Tonami General Hospital, Tonami, Japan
| | - Noriko Okuno
- Department of Pathology, Tonami General Hospital, Tonami, Japan
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Schaffer LR, Shehata BM, Yin J, Schemankewitz E, Alazraki A. Calcifying nested stromal-epithelial tumor (CNSET) of the liver: a newly recognized entity to be considered in the radiologist's differential diagnosis. Clin Imaging 2015; 40:137-9. [PMID: 26589005 DOI: 10.1016/j.clinimag.2015.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 09/24/2015] [Accepted: 10/16/2015] [Indexed: 02/08/2023]
Abstract
Calcifying nested stromal-epithelial tumor (CNSET), an extremely rare tumor found in the liver, was first described in 2001 by Ishak et al. The characteristic imaging features include large size, well-circumscribed, enhancing mass with calcification. To our knowledge, since 2001, there have been 29 reported. Typically arising from the right hepatic lobe, it is primarily found in children and shows clear predilection for females. Emphasizing imaging, we report a 14-year-old female with Beckwith-Wiedemann syndrome who presented with CNSET.
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Affiliation(s)
- Lauren R Schaffer
- Children's Healthcare of Atlanta and Emory University, Department of Pathology
| | - Bahig M Shehata
- Children's Healthcare of Atlanta and Emory University, Department of Pathology
| | - Julie Yin
- Children's Healthcare of Atlanta and Emory University, Department of Pathology
| | - Erwin Schemankewitz
- Children's Healthcare of Atlanta and Emory University, Department of Pathology
| | - Adina Alazraki
- Children's Healthcare of Atlanta and Emory University, Departments of Pediatrics and Radiology and Imaging Sciences.
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Zhuang KD, Tandon AA, Ho BCS, Chong BK. MRI features of soft-tissue lumps and bumps. Clin Radiol 2014; 69:e568-83. [PMID: 25256016 DOI: 10.1016/j.crad.2014.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 08/18/2014] [Accepted: 08/20/2014] [Indexed: 12/28/2022]
Affiliation(s)
- K D Zhuang
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.
| | - A A Tandon
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - B C S Ho
- Department of Pathology, Tan Tock Seng Hospital, Singapore
| | - B K Chong
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
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Cao KX, Rosenberg AE, Hakim J, Masiakos PT. Axillary calcifying fibrous tumor (CFT) in an 8 year old girl. J Pediatr Surg 2012; 47:2341-4. [PMID: 23217902 DOI: 10.1016/j.jpedsurg.2012.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 10/04/2012] [Accepted: 10/05/2012] [Indexed: 11/15/2022]
Abstract
Calcifying fibrous tumors (CFTs) are benign soft tissue masses that can occur at many sites. This case report outlines the diagnostic workup for this rare, fast-growing, solitary mass in an otherwise healthy 8 year old patient. We also describe the radiographic and pathological characteristics unique to this lesion.
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Affiliation(s)
- Kevin Xi Cao
- Department of Pediatric Surgery, Massachusetts General Hospital, Boston, MA 02114, USA
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Giardino AA, Ramaiya NH, Shinagare AB, Jagannathan JP, Stachler MD, Raut CP. Case report: Calcifying fibrous tumor presenting as an asymptomatic pelvic mass. Indian J Radiol Imaging 2012; 21:306-8. [PMID: 22223947 PMCID: PMC3249950 DOI: 10.4103/0971-3026.90700] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Calcifying fibrous tumor (CFT) is a rare benign mesenchymal tumor most commonly found in the soft tissues of the extremities and pleura. It is characterized by hyalinized collagenous fibrous tissue, with bland spindle cells, psammomatous or dystrophic calcifications, and focal lymphoplasmacytic infiltrate. CFT of the gastrointestinal tract is exceedingly uncommon. We report a case of CFT arising from the small intestine and associated mesentery; this case was identified incidentally in an otherwise healthy 45-year-old man.
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Affiliation(s)
- Angela A Giardino
- Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02115
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