Focal Myxoid Degeneration Research Articles

Rarely Observed Histopathological Subtypes of Endometrial Malignant Tumors in a Tertiary Care Center: A Case Series.

Introduction Endometrial cancer, one of the most prevalent gynecological malignancies, represents a significant contributor to global mortality and morbidity. The histological subtype of this cancer is pivotal in treatment planning and patient risk stratification. This case series, comprising seven cases, underscores the significance of rare endometrial cancer variants and the importance of ancillary studies, specifically immunohistochemistry, in comprehending and diagnosing the condition. Materials and methods The data of all the rare histological subtypes of malignant endometrial tumors encountered from April 2021 to April 2024 were collected. The data collected included age; risk factor; histological type; tumor, node, metastasis (TNM) stage; the International Federation of Gynecology and Obstetrics (FIGO)grade; P53; and mismatch repair (MMR) status. The histopathology specimens were reviewed using a Labomed microscope (LX500) manufactured in India. Images were taken and added wherever necessary, and the results were studied, analyzed, clinically correlated, and are shown in tables. Results Seven rare histopathological subtypes of malignant endometrial tumors were encountered in this period in this tertiary care center. This included mesonephric like adenocarcinoma, high-grade carcinosarcoma, carcinosarcoma with the serous and chondrosarcomatous components, clear cell carcinoma of endometrium, endometrial stromal sarcoma with smooth muscle differentiation, endometrial stromal sarcoma, and undifferentiated sarcoma with focal myxoid degeneration. Conclusion Diagnosis of uncommon endometrial carcinomas proves to be challenging due to their various histological subtypes, most often with overlapping features. The cornerstone of effective care lies in collaboration with clinicians, radiologists, and pathologists to identify these lesions as early as possible using a multidisciplinary approach for optimal patient outcome management.

Mitral Valve Culture Negative Endocarditis Complicated by Severe Mitral Regurgitation and Chordae Tendinea Rupture

Infective endocarditis has a high mortality rate. Criterion for diagnosis is a positive blood culture, however, some cases present with negative blood culture. We present a 65-year-old male complaining of palpitations. EKG showed atrial fibrillation with RVR. Transthoracic echocardiogram showed severe mitral regurgitation and possible vegetation. Transesophageal echocardiogram revealed endocarditis with ruptured chordae and vegetation on the posterior leaflet. All obtained blood cultures remained negative. Cardiothoracic surgery and infectious disease specialties were consulted. Patient was started on broad spectrum antibiotics. Patient underwent a mitral valve replacement and pathology showed focal myxoid degeneration with no inflammation and cultures of the specimen were negative. The hospital course was complicated by hemopericardium, treated by pericardial window, and drain placement. The patient was ultimately discharged to an acute rehabilitation center. Culture-negative endocarditis presents a diagnostic and therapeutic dilemma for clinicians and should be promptly identified and treated to avoid complications.

A Case of Oral Focal Mucinosis on Hard Palate: A Lesion Derived from the Periodontal Ligament

Oral Focal Mucinosis (OFM) manifests on the gingiva as a painless mass, asymptomatic except for the presence of a fibrous mass, and is of the same colour as the surrounding mucosa. It is commonly reported on the gingiva. Histologically, it is characterised by focal myxoid degeneration of connective tissue. Its diagnosis seldom can be made clinically and predominantly relies on histopathological analysis. This case report is about a 40-year-old female who had a gradually increasing swelling on the palate in relation to upper right posterior teeth, for 4-5 months. The lesion was excised and sent for histopathological and immunohistochemical analysis. There was presence of foci of loose mucinous connective tissue stroma interspersed within dense connective tissue stroma. The mucinous stroma showed numerous stellate and spindle-shaped fibroblasts evident between thin collagen fibres with evidence of separation of collagen fibres.

ORAL FOCAL MUCINOSIS: A SYSTEMATIC REVIEW

<h3>Objectives</h3> The aim of the present study was to systematically review the available data on oral focal mucinosis (OFM) to integrate demographic and clinicopathologic data on this condition. <h3>Study Design</h3> Electronic searches were carried out in PubMed, Scopus, Web of Science, and Embase. Reports and case series describing OFM were included. <h3>Results</h3> The search yielded 380 references. After the removal of 79 duplicates, 301 references were assessed according to the inclusion and exclusion criteria. Thirty-five articles were included in the qualitative synthesis, for a total of 106 cases of OFM. Females were more affected (70%), with a mean age of 40.66 ± 17.95 years. Clinically, the lesions frequently presented a symptomatic (<i>n</i> = 14; 17.5%) nodule (<i>n</i> = 71; 79.99%) in the gingiva (<i>n</i> = 54; 52%). The evolution time ranged from 1 month to 10 years. Surgical removal was the treatment choice in the most cases (<i>n</i> = 89; 94%). Histopathologically, the injury was characterized by focal myxoid degeneration of connective tissue. <h3>Conclusions</h3> Because OFM has no peculiar clinical or radiologic features, histopathologic and immunohistochemical examination is necessary to establish the diagnosis. This systematic review provides information that could help oral pathologists and clinicians in the identification and management of OFM.

A Case of Oral Focal Mucinosis

Introduction: Oral focal mucinosis (OFM) is an uncommon soft tissue lesion of unknown etiology. It is presented as a harmless swelling that can be sessile or pedunculated. Histologically, OFM is characterized by focal myxoid degeneration of the connective tissue. The diagnosis of the lesion is established based on the histopathological analysis. OFM is treated with surgical excision and its recurrence is unreported. Case Presentation: In the present case report, a 53-year-old female presented with a lesion on the gingiva around the dental area of 44 and 45 that was clinically similar to irritation fibroma. An excisional biopsy was performed and the diagnosis was OFM based on the clinical and pathological findings. Conclusions: This case report emphasizes that it is nearly impossible to predict the detection of OFM. Therefore, although OFM is a rare lesion, it should be distinguished from other similar soft tissue lesions in the oral cavity.

Percutaneous Endoscopic Lumbar Surgery via the Transfacet Approach for Lumbar Synovial Cyst

There are currently no high-quality studies on the optimal therapeutic approach for juxtafacet cyst, as treatment guidelines have not been developed. Herein, a novel technique in which we used an endoscopic transfacet approach to treat a patient with symptomatic lumbar synovial cyst is presented. An 87-year-old man presented with severe dull pain in the right anterior thigh. Lumbar magnetic resonance imaging revealed disc extrusion over the central canal zone at the L2-L3 and L4-L5 levels and an ovoid lesion with a hyperintense center plus a hypointense rim on the T2-weighted image. The lesion was located over the medial side of the right juxtafacet region at the L2-L3 level, causing thecal sac compression. After the operation, the visual analog pain scale improved with a value of 0-1/10, and straight leg raise test was negative. Microscopically, cystic fibrous tissue with focal myxoid degeneration, fibrin exudate, and scant synovial-like lining was observed. These findings were consistent with clinical synovial cyst. Three months later, lumbar magnetic resonance imaging was performed, and no evidence of cyst was disclosed. Lumbar computed tomography revealed the upper part of left L2-L3 facet joint was removed. The patient did not report any radicular pain during the 6-month follow-up period. Percutaneous endoscopic lumbar surgery could be a new option for the management of lumbar synovial cysts, especially when general anesthesia is not appropriate for the patient.

Oral focal mucinosis of gingiva - a rare case report and review of literature

Oral focal mucinosis (OFM) is a rare soft-tissue lesion of unknown etiology. Clinically it appears as asymptomatic round lesions and histologically, characterized by focal myxoid degeneration of connective tissue with presence of stellate shaped fibroblasts which were also evident in the present case. This case report stresses on the fact that diagnosis of OFM is almost impossible hence diagnosis should be confirmed by histopathological examination following incisional or excisional biopsy. Through this article we present a rare case of one such lesion on the gingiva and enumerate the most characteristic and myxomatous lesions. Thus though rare, OFM must be considered in the differential diagnosis of soft tissue overgrowths in oral cavity. Here, we describe the clinical and histopathological  presentation and subsequent management of OFM in a female patient.

Lesiones lipomatosas uterinas: presentación de un caso y revisión de la literatura

Uterine fatty lesions are a rare variant of benign mesenchymal tumours. They are divided into pure and lipomatous lesions (diffuse or focal) within a leiomyoma. We report the case of a 70 year old woman who underwent a simple hysterectomy after an ultrasound diagnosis of «giant leyomioma». Macroscopically the lesion corresponded to a lipomatous formation of 13.8cm maximum diametre. Histologically the lesion consisted of mature adipose cells without septa and traumatic and atrophic changes. There was focal myxoid degeneration, but necrosis and hemorrhage were not observed. The cells were S100 and vimentin positive on immunochemistry. MDM2 and CDK4 were negative by immunochemistry and fluorescence in situ hybridization. The ultrastructural study was consistent with a cell proliferation with adipose differentiation.

Lobular Caplillary Haemangioma

Clinical Presentation: A 16 year old female presented to the Department of Dentistry and Faciomaxillary Surgery complaining of discomfort in the region between labial surface of lower anterior teeth and inner mucosal layer of lower lip in relation to third quadrant. General health examination revealed that the patient was conscious, oriented, afebrile and vitals were stable. On intraoral clinical examination, a pedunculated mass was observed labially in relation to left lower canine tooth. Patient stated that the swelling has started as a pinpoint lesion before 1 year and progressed to the size of 1 cm × 5 cm × 1 cm as seen during clinical examination. The colour of the mass was of coral pink, smooth and symptomatic during contact between lower left canine and inner mucosal layer of lower lip (Figure A). Biolase EPIC diode laser 10 watts was used for excision (Figures B-D) followed by histopathological examination (Figure E) presenting features such as stratified squamous epithelium, acanthosis, focal ulceration, lobular proliferation of capillary sized vasculature, fibrotic stroma, necrotic debris, lymphoplasmacytic infiltrate and focal myxoid degeneration characteristic of lobular capillary haemangioma. Postoperative review was after 1 month with good prognosis thereby facilitating successful outcome.

Oral Focal Mucinosis: A Painful Lesion of the Palate

Background: Oral focal mucinosis (OFM) is a rare disease of unknown etiology, in which the connective tissue undergoes a focal myxoid degeneration. It was first described in 1974 by Tomich. Its pathogenesis is related to overproduction of hyaluronic acid by fibroblasts during the collagen production, resulting in focal myxoid degeneration. It has no distinctive features and diagnosis depends on histological analysis. Case: This paper reports a case of a 30 years old female treated at the Ambulatory of Stomatology of the Clinical Hospital - CH/UNICAMP, with a lesion growth and progressive pain in the palate, after performing dental treatment and discusses the clinical characteristics and differential diagnosis of myxomatous lesions of the oral cavity. Discussion: Since oral focal mucinosis has no distinguishing clinical features and the diagnostic is based on a histopathological examination, we ratify the importance of this procedure to confirm the diagnosis. This article is based on literature review and reports a case of oral focal mucinosis, its clinical and surgical outcome and demonstrates the importance of biopsy and pathological examinations in differential diagnosis of nodular masses in the oral cavity. Keywords: Focal mucinosis, polyp of the oral cavity, oral tumor, stomatology, oral lesions. Read more →

Oral focal mucinosis: Case report

Oral focal mucinosis (OFM) is an uncommon disease of unknown aetiology. It is considered to be the oral counterpart of cutaneous focal mucinosis and cutaneous myxoid cyst and it is characterized by a focal myxoid degeneration of the connective tissue. A preoperative diagnosis is almost impossible, and the clinical suspicion, usually made by exclusion, must be confirmed by a bioptic examination followed by histological observations.The Authors report a case of focal oral mucinosis diagnosed and treated in a male adult patient.

Oral focal mucinosis in an adolescent: a case report

Oral focal mucinosis (OFM) is an uncommon soft tissue lesion of unknown aetiology. Clinically, it is most commonly found on the gingiva and presents as a painless, sessile or pedunculated mass that is the same colour as surrounding mucosa. Histologically, it is characterized by focal myxoid degeneration of connective tissue. OFM occurs predominantly in adults during the fourth and fifth decade of life, although it has been reported infrequently in children and adolescents. Diagnosis relies on histological analysis and treatment involves complete surgical excision. Recurrence is unreported. This case report describes the clinical and histological presentation and subsequent management of OFM in an adolescent female patient.

Oral focal mucinosis of palatal mucosa: A rare case report

Oral focal mucinosis (OFM), an oral counterpart of cutaneous focal mucinosis, is a rare disease of unknown etiology. Its pathogenesis may be due to the overproduction of hyaluronic acid by a fibroblast, at the expense of collagen production, resulting in focal myxoid degeneration of the connective tissue, primarily affecting the mucosa overlying the bone. It has no distinctive clinical features, as the diagnosis is solely based on the histopathological features. This article reports of a 32-year-old female having the rare disease of oral focal mucinosis, involving the posterior palatal mucosa, and discusses its clinicopathological features and differential diagnosis of myxomatous lesions of the oral cavity.

Nodular pulmonary ossifications in differential diagnosis of solitary pulmonary nodules

To the Editors: When considering a solitary pulmonary nodule or coin lesion, the differential diagnosis comprises a lot of different disease entities. Although uncommon, in specific patient groups, pulmonary ossifications should also be considered. We report two patients in whom the diagnosis of pulmonary ossification was confirmed pathologically and present a general discussion on this subject. First, in a 68-yr-old patient with a history of hypercholesterolaemia and hypertension, a suspicious right mediastinal shadow was incidentally found on chest radiography after insertion of a central venous line. Personal history revealed poliomyelitis, retinal detachment and, especially, ventricular flutter for which he was resuscitated. Afterwards, he suffered from memory disturbances and even a frontal syndrome. A cardioverter–defibrillator was implanted. Chest radiography revealed a nodular aspect in the right lung hilum, which was not seen on a previous radiogram. Subsequent chest computed tomography (CT) demonstrated enlarged lymph nodes but no apparent ossifications. The mediastinum showed high metabolic activity on positron emission tomographic scan. Transbronchial biopsy was not conclusive. Cervical mediastinoscopy was negative. Subsequently, the right hilum was explored by thoracotomy. Enlarged lymph nodes were discovered and a wedge resection of the right middle lobe was performed to remove a calcified nodule of ∼1 cm, surrounded by other small calcified lesions. Pathology demonstrated metaplastic bone tissue in the alveolar spaces and cores of ossification were diffusely spread across the pulmonary parenchyma. Diagnosis of diffuse nodular pulmonary ossification was made. Signs of pulmonary hypertension, such as intimal proliferation and focal myxoid degeneration of the parenchymal blood vessels …

Sonographic features of an umbilical cord abnormality combining a cord pseudocyst and a small omphalocele; a case report

The perinatal findings of a pregnancy complicated by an umbilical cord abnormality associated with a small omphalocele are presented. The lesion was first observed at 18 weeks of gestation and was associated with elevated maternal serum α-fetoprotein. Serial ultrasound examinations showed major changes in the cord appearances and an associated small omphalocele was identified during the third trimester. Colour flow imaging showed no blood flow within the lesion and no obstruction nor involvement of the main umbilical vessels. Postnatal investigations demonstrated focal myxoid degeneration of the cord, a small omphalocele and no other fetal abnormalities.

Graft tension in anterior cruciate ligament reconstruction. An in vivo study in dogs.

The purpose of this study was to examine the effect of initial tensioning on the outcome of reconstruction of the ACL. The ACLs of 15 adult mongrel dogs were excised and reconstructed. In the first five dogs, the ACLs of both knees were reconstructed using the medial one-third of the patellar tendon. The graft was fixed under a tension of 1 N (0.22 pounds) in one knee and 39 N (8.8 pounds) in the opposite knee. In the remainder of the dogs, the reconstructions were augmented with Dacron prostheses. Tensioning of both graft components in the augmented reconstructions was either with 1 N in one knee and 39 N in the contralateral knee or disproportionate tensions of 1 N and 39 N applied to the autogenous material and to the prosthesis. Sacrifice was 3 months postsurgery and results were examined with microangiography/history and mechanical testing. In the reconstructions with the patellar tendon alone, the biologic study showed poor vascularity and focal myxoid degeneration within the graft pretensioned with a load of 39 N. In the augmented reconstructions, the knees in which both graft materials were fixed with 1 N tension showed the strongest and stiffest reconstruction at 3 months. The study suggests that minimal tension should be applied to the graft materials during surgical reconstruction of the ACL.