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Wilson MK, Goldberg E, Fantin A, Erdag G. "Low-fat" intradermal spindle cell lipoma of the upper eyelid: a case report. Digit J Ophthalmol 2024; 30:70-74. [PMID: 40207302 PMCID: PMC11977295 DOI: 10.5693/djo.02.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2025]
Abstract
Spindle cell lipomas are slow-growing, benign tumors composed of bland spindle cells, adipocytes, and collagen bundles. They are typically found on the posterior neck, shoulder, or upper back. Spindle cell lipomas represent only a small percentage of reported lipomatous tumor types. We report the case of a 90-year-old white man who presented with a solid mobile lesion on his right upper eyelid. Histopathological and immunohistochemical analysis of the lesion led to a diagnosis of a "low-fat," intradermal, spindle cell lipoma. This case underscores the importance of considering spindle cell lipoma in the differential diagnosis for atypical eyelid lesions.
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Affiliation(s)
- Mary Kate Wilson
- Department of Ophthalmology, University of Florida, Gainesville, Florida
| | - Elizabeth Goldberg
- Department of Ophthalmology, University of Florida, Gainesville, Florida
| | - Aldo Fantin
- North Florida / South Georgia Veterans Health System, Gainesville, Florida
| | - Gulsun Erdag
- North Florida / South Georgia Veterans Health System, Gainesville, Florida
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Narasimhamurthy M, Savant D, Shreve L, Rosen MA, Lee MK, Cooper K, Furth EE, Zhang PJ, Yang Z. Myofibroblastoma in the Liver: A Case Report and Review of Literature. Int J Surg Pathol 2023; 31:1559-1564. [PMID: 36917841 PMCID: PMC10616985 DOI: 10.1177/10668969231160262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 03/15/2023]
Abstract
Myofibroblastoma is a rare benign mesenchymal tumor first described in the breast. It is also known as mammary-type myofibroblastoma outside of the breast, more frequently located along the embryonic milk line. Exceptionally, myofibroblastoma can occur at visceral locations. We present a case of myofibroblastoma detected incidentally in the liver. A well-circumscribed mass, grossly measuring 6.2 cm in the liver parenchyma, was found on imaging studies. Histologically, the lesion is characterized by benign spindle cells in a hyalinized collagenous stroma, with positive staining for SMA and ER, focal positivity for CD34, negative for desmin, and loss of RB1. This rare tumor at such an unusual location makes it diagnostically challenging, especially on core biopsy of the lesion. To our knowledge, this is the second case of myofibroblastoma in the liver reported in the English literature and the first such case with a detailed pathology description.
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Affiliation(s)
- Mohan Narasimhamurthy
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Deepika Savant
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Anatomic Pathology, Zucker School of Medicine at Hofstra/Northwell, Greenvale, New York, USA
| | - Lauren Shreve
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mark A. Rosen
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Major Kenneth Lee
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kumarasen Cooper
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Emma E. Furth
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Paul J. Zhang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zhaohai Yang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Periasamy S, Mani A, Stewart GJ, Hampton JP. Identifying the uncommon solitary fibrous tumour in a rare location – A case report. Int J Surg Case Rep 2022; 94:107058. [PMID: 35439727 PMCID: PMC9026918 DOI: 10.1016/j.ijscr.2022.107058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 10/25/2022] Open
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Naito A, Takeshima Y, Takahashi S. Mammary‐type myofibroblastoma of the perineum: Typical or rare location? IJU Case Rep 2022; 5:161-164. [PMID: 35509779 PMCID: PMC9057743 DOI: 10.1002/iju5.12423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/12/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Mammary‐type myofibroblastoma is a rare benign tumor, mainly arising along the embryonal mammary ridge. We report a rare case of mammary‐type myofibroblastoma of the perineum. Case presentation A 37‐year‐old Japanese man presented with a 20 mm, progressively‐growing painless mass in the right perineum. Computed tomography showed a subcutaneous tumor with a strong contrast effect. Upon total resection, pathology showed a spindle‐cell tumor positive for desmin but negative for CD34. Further immunohistochemistry showed loss of Rb expression, leading to differential diagnosis. We could not evaluate the exact rarity of the perineal location due to categorization in past reports. Conclusion Due to the similarities between mammary and anogenital tissue, we suggest that tallying perineal and vulvar areas separately from the embryonic mammary ridge sites may be beneficial in gaining insight into the pathophysiology of this tumor.
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Affiliation(s)
- Akihiro Naito
- Department of Urology IMSUT Hospital The Institute of Medical Science The University of Tokyo TokyoJapan
| | - Yuta Takeshima
- Department of Urology IMSUT Hospital The Institute of Medical Science The University of Tokyo TokyoJapan
- Division of Innovative Cancer Therapy Advanced Research Center The Institute of Medical Science The University of Tokyo Tokyo Japan
| | - Sayuri Takahashi
- Department of Urology IMSUT Hospital The Institute of Medical Science The University of Tokyo TokyoJapan
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Akhlaq N, Purgina B, Werier J, Jibri Z. Mammary-type myofibroblastoma of the thigh mimicking liposarcoma. Skeletal Radiol 2022; 51:441-445. [PMID: 34430996 DOI: 10.1007/s00256-021-03891-9] [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: 05/24/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/02/2023]
Abstract
Myofibroblastoma is a rare tumor that was originally described in the breast but has since been found in extra-mammary locations, where it been renamed mammary-type myofibroblastoma (MTM). We describe a case of MTM occurring in the anterior compartment of the thigh, which was initially interpreted as a possible a liposarcoma on MRI. Two subsequent biopsy samples and eventual excision revealed the tumor to have the characteristic pathology of MTM. This benign tumor, albeit rare, needs to be considered in the imaging differential diagnosis of fat containing deep soft tissue masses of the extremity.
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Affiliation(s)
- Natasha Akhlaq
- Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Bibianna Purgina
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Joel Werier
- Department of Surgery, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Zaid Jibri
- Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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Ishihara A, Yasuda T, Sakae Y, Sakae M, Hamada T, Tsukazaki H, Tsukazaki T, Furumoto M. A case of mammary-type myofibroblastoma of the inguinal region. Int J Surg Case Rep 2018; 53:464-467. [PMID: 30567070 PMCID: PMC6275203 DOI: 10.1016/j.ijscr.2018.11.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/10/2018] [Accepted: 11/18/2018] [Indexed: 11/30/2022] Open
Abstract
Mammary-type Myofibroblastoma of the Inguinal Region is very rare. Prognosis of this disease is good after surgical resection. The correct diagnosis and treatment is important. We think that it is useful to share knowledge widely about this disease.
Introduction Myofibroblastoma is usually occurred in the breast and extra-mammary disease is rare. Presentation of case A 38-year-old man was admitted to our hospital for further examination of the left inguinal tumour, present and enlarging for 16 months. The tumor was 50 mm in diameter, well-circumscribed, firm, and painless. Ultrasonogaphy, computed tomography(CT) and magnetic resonance imaging (MRI) could not provide the definitive diagnosis. Surgical exploration confirmed a 50 mm tumour with a clear surface with a thin capsule. Complete excision was achieved. Histopathology confirmed the tumor had oval and spindle shaped fibroblastic cells with rich collagen deposition. It stained positive for ER, CD34, desmin and CD10 but negative for -smooth muscle actin and S-100. A mammary-type myofibroblastoma was diagnosed based on these results. Discussion An extra-mammary myofibroblastoma is very rare and first reported in 2001. Since then, over 160 cases have been reported. On immunohistochemistry, these lesions are characteristically positive for CD34 and desmin, with variable staining for α-smooth muscle actin. Once the diagnosis is made, regardless of size or location, this tumour behaves in a benign fashion after surgical excision reported so far. Conclusion This case is rare, but the correct diagnosis and treatment is important for good prognosis.
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Affiliation(s)
- Atsushi Ishihara
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Takeo Yasuda
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan.
| | - Yukari Sakae
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Masayuki Sakae
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Tooru Hamada
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Hideki Tsukazaki
- Department of Urology, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | | | - Masaru Furumoto
- Department of Pathology, Tsukazaki Hospital, Himeji, 671-1227, Japan
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Kuyumcu G, Rubin BP, Winalski C. Imaging features of mammary-type myofibroblastoma of soft tissue: a case series with literature review. Skeletal Radiol 2017; 46:1283-1291. [PMID: 28573464 DOI: 10.1007/s00256-017-2678-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/10/2017] [Accepted: 05/16/2017] [Indexed: 02/02/2023]
Abstract
Mammary-type myofibroblastoma (MTM) is a rare, benign neoplasm that is histologically identical to myofibroblastoma of the breast, but occurring in an extramammary site. The masses have been reported in superficial and deep soft tissue sites and visceral locations with the inguinal area and lower extremities are the most common. Most previous reports of MTMs have concentrated on clinical and pathological findings, with very limited information regarding imaging characteristics. Here, we describe three cases of MTM diagnosed at our institution, with a focus on imaging findings. We compare our findings with previously reported cases. Although MTM is rare, radiologists should be aware of this benign diagnosis as imaging characteristics can mimic those of liposarcomas and atypical lipomatous tumor/well-differentiated liposarcoma. Unlike those tumor types, MTM virtually never recurs post-resection, even when there are positive margins. Biopsy is necessary for proper diagnosis and recommended as an initial step to avoid overly aggressive treatment.
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Affiliation(s)
- Gokhan Kuyumcu
- Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA.
| | - Brian P Rubin
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44106, USA
| | - Carl Winalski
- Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA
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Rochlis E, Germaine P. Radiologic presentation of a myofibroblastoma of the adult male breast. Radiol Case Rep 2017; 12:439-442. [PMID: 28828098 PMCID: PMC5552016 DOI: 10.1016/j.radcr.2017.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/25/2017] [Accepted: 04/29/2017] [Indexed: 12/19/2022] Open
Abstract
We present the case of a 50-year-old male with bilateral gynecomastia who was incidentally found to have 0.8-cm subareolar mass on computed tomography. Mammographic and sonographic characteristics of the lesion are described as well as a brief historical review of myofibroblastoma, a rare mesenchymal tumor.
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Affiliation(s)
- Evan Rochlis
- Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103, USA
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Abstract
Mammary myofibroblastoma is a rare, benign, mesenchymal neoplasm that was first described in the breast in 1987. However, extra-mammary-type myofibroblastoma (MTMF) was not described until 2001 as a distinct entity. We report a case of extra-MTMF arising from the retroperitoneum, which was encountered in our clinic. We also completed a review of the literature using PubMed in patients with extra-MTMF.
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Affiliation(s)
- Kamran Khan
- Department of General Surgery, Sinai Center for Geriatric Surgery, Baltimore, Maryland, USA
| | - Arun A Mavanur
- Department of General Surgery, Johns Hopkins University, Baltimore, Maryland, USA Department of Surgical Oncology, Sinai Hospital, Baltimore, Maryland, USA
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