Journal of Pathology and Translational Medicine

Heterotopic mesenteric ossification: a report of two cases: Hisham F. Bahmad, Olga Lopez, Tyson Sutherland, Marisa Vinas, Kfir Ben-David, Lydia Howard, Robert Poppiti, Sarah Alghamdi; J Pathol Transl Med. 2022;56(5):294-300. Published online September 13, 2022; DOI: https://doi.org/10.4132/jptm.2022.07.23

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Abstract PDF: Heterotopic mesenteric ossification (HMO) is abnormal bone formation in tissues which usually do not undergo ossification. There are approximately 75 cases reported worldwide. We present two cases of HMO. The first case is that of a 39-year-old man who presented with abdominal pain and a computerized tomography scan of the abdomen and pelvis revealed an apple core lesion resulting in small bowel obstruction. The second case is that of a 36-year-old woman who presented 2 months after undergoing robotic gastric sleeve resection complaining of weakness and emesis. An esophagogram revealed kinking at the distal esophagus. Surgical resection was performed in both, yielding the diagnosis of HMO. There are various theories as to the pathophysiology of HMO, but no clearly defined mechanism has been established. Management should be conservative whenever possible to prevent further ossification with subsequent surgical intervention.

Fibrocartilaginous mesenchymoma with an unusual location in the rib: Sun-Ju Oh; J Pathol Transl Med. 2021;55(1):75-78. Published online December 3, 2020; DOI: https://doi.org/10.4132/jptm.2020.10.08

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Fibrocartilaginous mesenchymoma is a rare bone tumor, with fewer than 35 cases reported in the literature since 1984. This tumor usually occurs in the long bones of children and adolescents. In the current case, the tumor affected a rib. A 17-year-old boy presented with a mass in the right fifth rib. Radiologic findings revealed an osteolytic mass with cortical destruction and calcification; en bloc resection was performed. The tumor showed three distinct histologic features: bland spindle cell proliferation, benign cartilage nodules, and epiphyseal plate-like enchondral ossification. The pathologic diagnosis was fibrocartilaginous mesenchymoma. The patient remains free of disease 1 year after the surgery. Pathological diagnosis of fibrocartilaginous mesenchymoma can be challenging, especially when the tumor occurs in an unusual site. When any fibro-osseous lesion with a cartilaginous component is encountered, the possibility of fibrocartilaginous mesenchymoma should be considered because of its locally aggressive behavior.

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Fibrocartilaginous mesenchymoma of pelvis—a potential diagnostic pitfall
Monalisa Hui, Shantveer G. Uppin, Ramakrishna Narayanan, K. Nageshwara Rao, B. Aravind Kumar
Skeletal Radiology.2023; 52(4): 791. CrossRef

Endometrial Ossification: Clinical and pathological analysis of 7 cases.: Kyu Rae Kim, Dong Hee Choi; Korean J Pathol. 1996;30(3):238-244.

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Abstract PDF: Endometrial ossifications in seven patients who presented with secondary or primary infertility were described. Herein, we described step-by-step bone forming process in the endometrium and we compared the clinicopathological features of metaplastic ossification and fetal remnants. In five of seven patients, metaplasia was unquestionable etiology of ossification, which was ocquired in the healing process of postabortion endometritis. Ossifications were recurred during the follow-up periods after total hysteroscopic removal in 2 cases. Three cases were followed by normal pregnancy, after total hysteroscopic removal of bony spicules in 2 cases and with retaining of bony spicules in 1 case. In one other case, bony spicules of fetal remnants were verified by multiple fetal hair shafts and endochondral bone formation. Therefore, the cause of endometrial ossification can only be determined by histological findings and careful past obstetric history.

Giant Cell Tumor of the Larynx: Report of a case.: Soya Paik, Yoon Mee Jeen, Woo Ick Yang, In Joon Choi, Young Ho Kim; Korean J Pathol. 1997;31(1):75-78.

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Abstract PDF: Giant cell tumor arising in the osteocartilaginous tissue of the larynx is extremely rare. The few reported cases have all occurred in men older than 20 years and the site of origin has been exclusively localized to the thyroid and cricoid cartilages that are known to undergo enchondral ossification. The formation of giant cell tumor in larynx is thought to be related to this enchondral ossification process. We report a case of giant cell tumor arising in the thyroid cartilage of a 39 year old man. CT scan of the neck revealed a well defined mass of soft tissue density replacing the right thyroid cartilage. Grossly the tumor was well demarcated with a distinctive pushing margin except for the area bordering the submucosa of the larynx where it showed focally an infiltrative pattern of growth. Microscopically multinucleated giant cells were found dispersed regularly among the spindle cells. Although mitoses were frequently noted in the spindle cells there was no atypicality or pleomorphism. Total laryngectomy was performed without further treatment. Postoperative follow up for 6 months has proved the patient to be alive and well without recurrence.

Heterotopic Enchondral Ossification in Metastatic Colonic Adenocarcinoma: A case report .: So Yeon Park, Yong Il Kim, Woo Ho Kim; Korean J Pathol. 2000;34(7):531-533.

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Abstract PDF: Calcification and ossification of colon cancer is frequently encountered, especially in the mucinous carcinoma. However, cartilage formation or enchondral ossification has rarely been described in human colon cancer. This report describes a case of a 59-year-old man with retroperitoneal metastasis of mucinous adenocarcinoma of colon, which showed a widespread heterotopic ossification through membranous or enchondral ossification. The ossification appeared in apposition to tumor cell nests and in the organized mucin pool. In our knowledge, this is the first case showing enchondral ossification in gastrointestinal carcinoma in Korea.

Dendriform Pulmonary Ossification: A case report.: Chan Kwon Jung, Kyo Young Lee, Chang Suk Kang, Sang In Shim, Byung Kee Kim; Korean J Pathol. 2000;34(11):950-952.

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Abstract PDF: The dendriform pulmonary ossification (DPO) is a rare condition of unknown origin in which branching mature bony spicules, usually containing marrow, are found within the alveolar septa. DPO manifests slow progression over many years or may remain unchanged; spontaneous regression has not been recorded. Most patients have no symptoms directly attributed to the ossification, although they may have symptoms due to the underlying fibrotic process. We experienced a case of DPO in 38 year-old-man who presented with cough and sputum for a month. The chest X-ray showed marked coarsened interstitial lung markings in both lungs, especially in the lower lobes. Open lung biopsy was done. Grossly, there were significant dendriform osseous structures. Histologically, branching arrays of mature bone were found in the interstitium and occasionally in alveolar spaces. Some bony trabeculae contained fatty or cellular marrow. The alveolar septa showed fibrous thickening with chronic inflammation. The transition between fibrosis and bone tissue was observed. Our case suggests that dendriform pulmonary ossification may be a rare special manifestation of chronic fibrosing interstitial inflammation of the lung. Osseous structures seem to derive from metaplastic bone formation in the vicinity of undergoing fibrous process.

Heterotopic Mesenteric Ossification: A Case Report.: Hoon Kyu Oh, Jong Yup Bae; Korean J Pathol. 2006;40(1):70-72.

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Abstract PDF: Heterotopic mesenteric ossification is a very rare reactive lesion in the small bowel mesentery, and it is related with trauma or surgical operation. It is pathologically characterized by well formed bone trabeculae and prominent osteoblastic rimming and is clinically related to rapid and recurrent bowel obstruction symptoms. This unusual reactive process shares many clinical and pathologic features with myositis ossificans. We report here on a rare case of heterotopic mesenteric ossification in 28-year-old man who underwent a delayed small bowel resection 15 days after trauma.

Intraocular Ossification: A Case Report.: Ho Sung Park, Tae Shik Kong, Kyu Yun Jang, Myoung Ja Chung, Woo Sung Moon, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2004;38(3):188-190.

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Abstract PDF: Heterotopic bone formation in the eyeball is a rare finding. Some etiologic factors, such as trauma, chronic inflammation, and long-standing retinal detachment have been associated with the onset of intraocular ossification. We report here on a case of a 21-year-old woman with a history of blunt trauma fifteen years ago, who complained of right eye blindness. When the right eyeball eviceration was done, a hard, grayish mass was found. On histopathologic examination, the mass showed lamellar bone with fatty marrow and hyalinized tissue with dystrophic calcification. We diagnosed her case as intraocular ossification.

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