Foreign-body granulomas in the trunk and extremities may simulate malignant soft-tissue tumors: report of three cases

Nakamura, Tomoki; Kusuzaki, Katsuyuki; Matsubara, Takehiro; Matsumine, Akihiko; Uchida, Atsushi

doi:10.1080/02841850701675727

Cited by 12 publications

(3 citation statements)

References 6 publications

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“…Klinikinė simptomatika įvairi -priklauso nuo to, kuri anatominė vieta paliesta, nuo paciento amžiaus, uždegiminės reakcijos laipsnio, nuo svetimkūnio dydžio, svorio, cheminės sudėties; ji gali svyruoti nuo besimptomės iki ūmios gyvybei pavojingos būklės. Užsilikęs svetimkūnis dažniausiai sukelia lėtinę uždegiminę [15] granuliominę aplinkinių audinių reakciją [16]; jis gali migruoti ir pažeisti šalia esančius organus [17,18]; dėl jo gali formuotis pūlinys [19], grybelinis kamuolys [20], neoplazma [10,21,22]; kartais jis pasišalina pats [23]. Tačiau apie svetimkūnį pagalvojama negreitai.…”

Section: įVadasunclassified

Retrobulbarinis Pseudotumoras Dėl Skruoste Užsilikusio Smulkaus Metalinio Svetimkūnio: Klinikinio Atvejo Aprašymas Ir Literatūros Apžvalga

Aleksiūnienė¹,

Justickis²

2013

Sveikatos Mokslai

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Aim: to present a patient’s clinical case; to demonstrate how important is to suspect rertrobulbar pseudotumor timely, why it is necessary to remove even the smallest metal foreign bodies from the jaw area; to show the importance of an integrated simultaneous clinical delivery on the spot during the investigation of a complex illness. Case report: presenting the clinical case – patient MA (66 years of age) right eye vision started to deteriorate 6 years ago, a small defect of a pupil (abnormal pupil shape) was found; after the remove a cataract operation, the vision improved (during the week after the operation the patient has not used prescribed corticosteroid drops in the eye, this incompliance with prescription caused the uveitis anterior, which went away in 2 months after relevant treatment started). One year after surgery a pain appeared in the area of the right cheek, teeth and beneath the right eye, manifested hearing weakness dextra side. Several dentists treated this patient. Also rhinologist, mouth, face, jaw surgeons and oncologists were involved. Diagnosis: alveolitis, sinusitis, osteomielitis sinus maxilaris dextra, a foreign body in a right maxillary sinus projection. Patient was examined for TBC, sarcoidosis, fungal illness, syphilis, all with negate results. Gradually right eye became blind. After the vision of the left eye began to deteriorate, further cataract surgery was undertaken. The further sudden deterioration in the general condition of the patient was treated in the neurological and supportive therapy departments for several months. Diagnosis: cerebellar degeneration and chronic polyneuropathy ataxia, unspecified dementia, extraocular palsies, metabolic hepatitis, chronic pancreatitis, bladder disturbance. During that time a protrusion of the right eye gradually enlarged and became more exposed. The left eye became blind several months later. KT and MRT: right eye’s retrobulbar tumor spread through eyehole slots intracranial and to left orbit; a small metal foreign body was found subcutaneously in the right cheek. A biopsy was taken from the para- and retrobulbar tissues: fibromatosis was diagnosed. Half a year later a sphenoorbital meningioma was suspected and the surgery aimed to partially remove a tumor from the right orbit was performed. During this stay under the neurosurgeons care it becomes clear that episodes of psychomotor agitation were also present. The eyelids of the right eye were sutured to protect the cornea against perforation. Histologic diagnosis: retrobulbar pseudotumor of both eyes. Metal foreign body remained untouched. The ophthalmologist removed the foreign metal body, which was situated in the cheek subcutaneously, close to N. infraorbitalis with capsule in a local polyclinic soon afterwards. The composition of the foreign metal object was investigated: it was found that 95% of it was iron with small amounts of rare metals usually found in steel alloy, calcium. Histology detected hemosiderosis in connective tissue of capsule. Patient was examined by a rheumatologist on the basis of the suspicion of Wegener granuliomatosis. Data to confirm Wegener’s granulomatosis was not enough; internal organs without lesions, it was diagnosed cholelithiasis and fibrotic lesions in the lungs. It was confirmed systemic transgression of connective tissue with retrobulbar pseudotumor diagnosis. Corticosteroid treatment was given for 1 month. Patient was examined 8, 15 and 27 month after foreign body removal later: the skin of the face was free of scars, eyelids of the right eye has been sutured; the left eye had no inflammation, refracto- and keratometry findings were the same, like 4 years before; levels of immunoglobulins G and E in blood decreased - normal; the systemic transgression of connective tissue remained. Patient walks with a wide-based gait, he becames totally dependent on care (he is blind and desorientated at place and time, his personality has changed; Mini Mental State Examination 13/30). This story showed, how it is important to have a complete understanding of the patients health from various medical specialists at the same physical place and at the same time. The case shows surprising differences of results of radiologic examination of the same case.

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Section: įVadasunclassified

Retrobulbarinis Pseudotumoras Dėl Skruoste Užsilikusio Smulkaus Metalinio Svetimkūnio: Klinikinio Atvejo Aprašymas Ir Literatūros Apžvalga

Aleksiūnienė¹,

Justickis²

2013

Sveikatos Mokslai

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“…[1] Un granulome à corps étranger, causé par une compresse laissée dans le foyer opératoire, est désigné par les termes synonymes de gossypibome ou textilome [1,2]. Un tel granulome se forme rarement dans les tissus mous du système musculosquelettique, probablement en raison du manque d'espace disponible dans cette région [3,4].…”

Section: Conflit D'intérêtunclassified

“…[1][2][3][4][5][6][7][8][9]. Ces patients sont atteints de douleurs modérées du squelette axial et n'ont pas d'anomalies biologiques particulières, mais l'analyse histologique osseuse en crête iliaque permet d'évoquer le diagnostic d'ostéomalacie.…”

Section: Conflit D'intérêtunclassified