- Calcified or ossified benign soft tissue lesions that may simulate malignancy. [Review]
- SRSkeletal Radiol 2019 Jul 10
- The purpose of this article is to review calcified or ossified benign soft tissue lesions that may simulate malignancy. We review the clinical presentations, locations, imaging characteristics, and d…
The purpose of this article is to review calcified or ossified benign soft tissue lesions that may simulate malignancy. We review the clinical presentations, locations, imaging characteristics, and differential diagnostic considerations of myositis ossificans, tophaceous gout, benign vascular lesions, calcific tendinopathy with osseous involvement, periosteal chondroma, primary synovial chondromatosis, Hoffa's disease, tumoral calcinosis, lipoma with metaplasia, calcifying aponeurotic fibroma, calcific myonecrosis, ancient schwannoma, and Castleman disease.
- Fibrodysplasia Ossificans Progressiva - A Rare Genetic Disorder and the Role of Technetium-99m Methylene Diphosphonate Bone Scan. [Case Reports]
- IJIndian J Nucl Med 2019 Jul-Sep; 34(3):209-212
- Fibrodysplasia ossificans progressiva is a rare genetic disease believed to occur in approximately 1 in 2 million people worldwide and is characterized by progressive extraosseous ossification over t…
Fibrodysplasia ossificans progressiva is a rare genetic disease believed to occur in approximately 1 in 2 million people worldwide and is characterized by progressive extraosseous ossification over the course of a lifetime in an inevitable and unpredictable episodic manner, with most patients being confined to a wheelchair by the third decade of life and requiring life-long care. The extraosseous calcification involves ligaments, tendons, muscles, and connective tissue leading to severe restriction of movements. Another hallmark of this condition is abnormal great toes. The diagnosis is often made on clinical and radiological examination, but Technetium-99m methylene diphosphonate (Tc-99m MDP) bone scan is usually indicated to determine the extent of the disease. We hereby present a case series comprising of four patients suffering from this debilitating illness who underwent Tc99m MDP bone scan for initial diagnosis and localizing sites of heterotopic ossification.
- Pseudomalignant myositis ossificans of the neck in a child. Description of a case and review of the literature. [Journal Article]
- WNWorld Neurosurg 2019 Jun 28
- CONCLUSIONS: Myositis ossificans circonscripta is rare in children , especially in the neck region. The diagnostic challenge is to differentiate it from bone and soft tissue malignancies. Appropriate management including surgery if needed leads to an excellent outcome. Another concern is to exclude fibrodysplasia ossifying progressiva when atraumatic MO develops in a young child in the neck or shoulder region.
- Expression Profiling of Receptor-Activator of Nuclear Factor-Kappa B Ligand in Soft Tissue Tumors. [Journal Article]
- TJTohoku J Exp Med 2019; 248(2):87-97
- Bone and soft tissue tumors are derived from mesenchymal cells, and they are hard to treat. Receptor-activator of nuclear factor-kappa B ligand (RANKL) is an essential cytokine for osteoclast differe…
Bone and soft tissue tumors are derived from mesenchymal cells, and they are hard to treat. Receptor-activator of nuclear factor-kappa B ligand (RANKL) is an essential cytokine for osteoclast differentiation and activation and is expressed on the surface of osteoblasts or stromal cells. In this study, to explore the potential of denosumab treatment for soft tissue tumors, we analyzed the expression profiles of RANKL mRNA in 425 tumor specimens of 33 histological types by real-time RT-PCR. Denosumab is a monoclonal antibody that prevents the binding of RANKL to receptor-activator of nuclear factor-kappa B (RANK). For comparison, the relative expression levels of RANK and osteoprotegerin (OPG) mRNAs were also measured. OPG functions as a soluble decoy receptor for RANKL. Higher expression levels of RANKL mRNA were detected in calcifying aponeurotic fibroma, fibrosarcoma, calcifying epithelioma, myositis ossificans, heterotopic calcification, giant cell tumor of the tendon sheath (GCTTS), and pigmented villonodular synovitis (PVNS), compared with the levels of other tumor types. Moreover, the expression levels of RANK mRNA were highest in GCTTS, followed by myositis ossificans and PVNS, whereas the expression levels of OPG mRNA were greatly varied among these histological types. We then analyzed RANKL protein expression by immunohistochemistry in 57 tumor specimens with higher expression levels of RANKL mRNA. RANKL-positive cells were detected in GCTTS, PVNS, myositis ossificans, heterotopic calcification, and calcifying aponeurotic fibroma. In conclusion, RANKL is expressed in subsets of soft tissue tumors with calcification, and denosumab is a potential therapeutic option for soft tissue tumors expressing RANKL.
- Fibrodysplasia ossificans progressiva at whole-body low-dose computed tomography. [Letter]
- JBJoint Bone Spine 2019 May 20
- Non-traumatic myositis ossificans of the thigh. A case report. [Journal Article]
- AIAnn Ital Chir 2019 Mar 05; 8
- CONCLUSIONS: A non-traumatic MO is scarcely described in the literature. A chronic microtrauma, tissue ischaemia and inflammation are listed as causal mechanisms of a non-traumatic MO. MO non-traumatica occurs more often in patients with a parallel, subdural or epidural haemorrhage and a hip surgery. Our case did not present any family history, trauma or associated anomalies of hands or fingers.Myositis ossificans should be considered as the differential diagnosis of all soft tissue tumor masses, even if known risk factors are not present in the anamnesis. Surgery is a reasonable therapeutic strategy in the presence of a tumor mass in soft tissues, and definite diagnosis can be set only based on pathohistological findings.
- Heterotopic Ossification: A Comprehensive Review. [Review]
- JPJBMR Plus 2019; 3(4):e10172
- Heterotopic ossification (HO) is a diverse pathologic process, defined as the formation of extraskeletal bone in muscle and soft tissues. HO can be conceptualized as a tissue repair process gone awry…
Heterotopic ossification (HO) is a diverse pathologic process, defined as the formation of extraskeletal bone in muscle and soft tissues. HO can be conceptualized as a tissue repair process gone awry and is a common complication of trauma and surgery. This comprehensive review seeks to synthesize the clinical, pathoetiologic, and basic biologic features of HO, including nongenetic and genetic forms. First, the clinical features, radiographic appearance, histopathologic diagnosis, and current methods of treatment are discussed. Next, current concepts regarding the mechanistic bases for HO are discussed, including the putative cell types responsible for HO formation, the inflammatory milieu and other prerequisite "niche" factors for HO initiation and propagation, and currently available animal models for the study of HO of this common and potentially devastating condition. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
- Feasibility of bisphosphonate therapy in an Indian pediatric patient of fibrodysplasia ossificans progressiva. [Case Reports]
- IJInt J Appl Basic Med Res 2019 Apr-Jun; 9(2):118-120
- Fibrodysplasia ossificans progressiva, also known as myositis ossificans progressiva, is a rare autosomal dominant disorder (1 in 2 million). It produces a catastrophic and crippling illness in young…
Fibrodysplasia ossificans progressiva, also known as myositis ossificans progressiva, is a rare autosomal dominant disorder (1 in 2 million). It produces a catastrophic and crippling illness in young people for which there is no effective treatment. This case report presents a case of 7-year-old child misdiagnosed as osteogenesis imperfecta admitted with severe disability and pain. He was diagnosed by clinical and radiological methods, treated with bisphosphonates for pain relief along with calcium and Vitamin D, and followed till 4 years.
- Fibro-osseous pseudotumor of digits and myositis ossificans show consistent COL1A1-USP6 rearrangement: a clinicopathological and genetic study of 27 cases. [Journal Article]
- HPHum Pathol 2019; 88:39-47
- Myositis ossificans (MO) and fibro-osseous pseudotumor of digits (FOPD) are localized, self-limiting bone-producing pseudosarcomatous lesions characterized by nodular fasciitis-like proliferation and…
Myositis ossificans (MO) and fibro-osseous pseudotumor of digits (FOPD) are localized, self-limiting bone-producing pseudosarcomatous lesions characterized by nodular fasciitis-like proliferation and osteoid and immature woven bone production, which may eventually develop into more mature lamellar bone. Traditionally, MO and FOPD were thought to be of reactive, non-neoplastic nature. USP6 gene rearrangement was recently reported as a consistent finding in MO and FOPD, thus expanding the spectrum of transient, USP6-rearranged neoplasms. COL1A1 was described as the fusion partner of USP6 in a subset of MO cases, but the fusion partners of USP6-rearranged FOPD have not been uncovered so far. Initially, we carefully reviewed all 27 cases of MO/FOPD from our archives, documenting the remarkable morphological overlap between both lesions. Sixteen cases were seen in consultation, and our review was requested to rule in or rule out tentative diagnoses by referring pathologists. Malignant diagnosis (osteosarcoma) was suggested by the submitting pathologists in 3 cases, whereas 7 cases were sent by the referring pathologists to "rule out sarcoma." In the following step, using next-generation sequencing, we confirmed the COL1A1-USP6 rearrangement in 5/7 cases of MO and found the same abnormality in 4/5 of FOPD. Overall, 9 of the 12 analyzable cases (75%) of MO and FOPD harbored this gene fusion. The presence of COL1A1-USP6 gene rearrangement in MO/FOPD links these lesions to other USP6-driven tumors and represents a very useful supportive marker, which may help to avoid overdiagnosis of MO/FOPD as a sarcoma.
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- A Case of Progressive Ossifying Fibrodysplasia of Tracheobronchial Respiratory Muscles. [Case Reports]
- CRCase Rep Radiol 2019; 2019:5095343
- The authors report a case of progressive ossifying myositis (POM) in a 13-year-old boy, revealed by dry cough and dyspnea. Conventional chest x-rays and whole-body CT showed extraskeletal ossificatio…
The authors report a case of progressive ossifying myositis (POM) in a 13-year-old boy, revealed by dry cough and dyspnea. Conventional chest x-rays and whole-body CT showed extraskeletal ossification that seems to affect the left bronchial strain and trachea. This lesional topography, if established, not yet described to our knowledge, contrasts with the observations of all the authors, including Munchmeyer, for whom smooth muscles and muscles attached to the skeleton by a single end are spared by the heterotopic ossifications characteristic of the disease. Therefore, this observation raises the question of the ubiquity of muscle ossifications during POM.