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22 August 2012 - Case of the Week #249
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Thanks to Dr. Beata Maksymiuk, Institute of Tuberculosis and Lung Diseases (Poland), for contributing this case. To contribute a Case of the Week, follow the guidelines on our Case of the Week page.
(1) The Forensics chapter is now complete, written by Lindsey Harle, M.D.
(2) Our Feature Page for the month highlights Books and Journals, and includes Laboratory Investigation, Lippincott, Williams & Wilkins and Modern Pathology. Also check out our new monthly Mystery Image, on the right side of the Home Page.
Case of the Week #249
A 32 year old woman had surgery for a gangrenous appendicitis. During surgery, a 3 x 2.5 cm pedunculated tumor was discovered in the cecal region. Grossly it was compact, well-circumscribed and unencapsulated with a white whirled cut surface.
What is your diagnosis?
Calcifying fibrous tumor of omentum
The tumor was hypocellular with sclerotic fibrous tissue with occasional fibroblastic cells with bland nuclei. Focally, psammomatous and dystrophic calcifications were seen. Focal lymphoplasmacytic infiltrates with lymphoid aggregates were also seen.
Calcifying fibrous tumor is a soft tissue or visceral mass that occurs in children and young adults (extremities and trunk) or in adults (pleura, peritoneum, mediastinum, adrenal gland, lung). Pleural and peritoneal tumors are often multiple. There is no gender predilection.
Calcifying fibrous tumor may be due to prior inflammation and trauma. It overlaps with IgG4-related sclerosing diseases, and may be related. In this case, tumor cells were occasionally IgG4 immunoreactive:
Treatment is simple excision, and the prognosis is excellent, but recurrence can occur.
J Med Case Rep 2011 Sep 28;5:487, J Cancer Res Ther 2011;7:500, Indian J Radiol Imaging 2011;21:306
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and Liz Parker, B.A., Associate Medical Editor
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