Document Type : Case Reports

Authors

1 Dept. Of Pathology, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Dept. Of Otolaryngology, Tischreen University of Medical Sciences, Lattakia, Syria

Abstract

We describe a rare case of laryngeal fasciitis ossificans. A 58-year-old man presented with hoarseness and a nodule was found in the larynx. Excisional biopsy was performed, and follow-up laryngoscopy showed complete resolution of this reactive lesion, and normal laryngeal function. The 0.6 cm diameter nodule was well circumscribed and histologically, the lesion was composed of uniform woven bone trabeculae with rimming of osteoblasts and cellular stroma. At the periphery, uniform spindle cells actively proliferated in edematous stroma. Spindle cells were immunoreactive for vimentin and α-smooth muscle actin, suggesting myofibroblastic differentiation. Fasciitis ossificans is histologically identical to myositis ossificans, but tends to present no zonation phenomenon. Fasciitis ossificans is a rare form of heterotopic bone formation, commonly presenting with signs of local inflammation or pain. This patient's successful outcome suggests that conservative resection may be both diagnostic and curative.
 

Keywords

  1. Kwittken J, Branche M. Fasciitis ossificans. Am J Clin Pathol 1969 Feb;51(2):251-5.
  2. Brown V, Carty NJ. A case of nodular fascitis of the breast and review of the literature. Breast 2005 Oct;14(5):384-7.
  3. (3)        Carlos F, Vida ML, Duarte BB, Sakae FA, Marone SA. Inflammatory myofibroblastic    tumor: a rare laryngeal case. Braz J Otorhinolaryngol. 2010;76(2):271.
  4. Rosai J, Sobin L. Tumors of the Soft Tissues: Atlas of Tumor Pathology.  395-418. 2001. Armed Forces Institute of Pathology, Armed Forces Institute of Pathology.
    Ref Type: Serial (Book,Monograph)
  5. Wong NL, Goldblum J. Enzinger and Weiss's Soft Tissue Tumors. 4 ed. St. Louis: Mosby; 2001.
  6. Alaani A, Hogg R, Warfield AT, Olliff J, Jennings C. Air bag injury as a cause of inflammatory myofibroblastic pseudotumour of the subglottic larynx progressing to myositis ossificans. Acta Otolaryngol 2005 Jun;125(6):674-7.
  7. Stark WH, Krechel SW, Eggers GW, Jr. Anesthesia in 'stone man': myositis ossificans progressiva. J Clin Anesth 1990 Sep;2(5):332-5.
  8. Kaplan FS, Glaser DL, Hebela N, Shore EM. Heterotopic ossification. J Am Acad Orthop Surg 2004 Mar;12(2):116-25.
  9. Geschickter C, Maseritz I. Myositis Ossificans. J Bone Joint Surg Am 938 May 11;(20):661-74.
  10. Tarantino R, Esposito V, Missori P, Cantore G. Occipitocervical pseudomalignant osseous tumor of the soft tissue (Fasciitis ossificans). Case report. J Neurosurg 2001 Jul;95(1 Suppl):143-5.
  11. Lidang JM, Schumacher B, Myhre JO, Steen NO, Keller J. Extraskeletal osteosarcomas: a clinicopathologic study of 25 cases. Am J Surg Pathol 1998 May;22(5):588-94.
  12. Naraghi FF, DeCoster TA, Moneim MS, Miller RA, Rivero D. Heterotopic ossification. Orthopedics 1996 Feb;19(2):145-51.
  13. Sumiyoshi K, Tsuneyoshi M, Enjoji M. Myositis ossificans. A clinicopathologic study of 21 cases. Acta Pathol Jpn 1985 Sep;35(5):1109-22.
  14. Reavey-Cantwell JF, Garonzik I, Viglione MP, McCarthy EF, Belzberg AJ. A brachial plexopathy due to myositis ossificans. Case report and review of the literature. J Neurosurg 2001 Sep;95(3):525-8.
  15. Fitzsimmons AS, O'Dell MW, Guiffra LJ, Sandel ME. Radial nerve injury associated with traumatic myositis ossificans in a brain injured patient. Arch Phys Med Rehabil 1993 Jul;74(7):770-3.
  16. Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg 2005 Feb;102(2):256-66.
  17. Velagaleti GV, Tapper JK, Panova NE, Miettinen M, Gatalica Z. Cytogenetic findings in a case of nodular fasciitis of subclavicular region. Cancer Genet Cytogenet 2003 Mar;141(2):160-3.
  18. Wong NL. Fine needle aspiration cytology of pseudosarcomatous reactive proliferative lesions of soft tissue. Acta Cytol 2002 Nov;46(6):1049-55.