Multifocal calcifying fibrous tumor at six sites in one patient: a case report
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CASE REPORT
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Multifocal calcifying fibrous tumor at six sites in one patient: a case report Faisal Azam1*, Madhuchanda Chatterjee2, Sheila Kelly3, Maria Pinto3, Amey Aurangabadkar3, M Farooq Latif1 and Ernie Marshall2
Abstract Calcifying fibrous tumors (CFT) are rare benign tumors. They usually affect children and young adults and the incidence is equal in males and females. The usual clinical presentation is that of a painless mass. A computed tomography scan typically reveals a well-demarcated calcified lesion. CFT usually presents as a solitary mass and the commonest sites of occurrence are in soft tissues, the pleura, or the peritoneum. Multifocal occurrences at the same site have also been reported. The first case of CFT was reported in 1988. We present a rare case of multiple calcifying fibrous tumors at multiple sites in the same patient. To the best of our knowledge, this is the first ever reported case of multifocal CFT atsix different anatomical sites in one patient.
Background Calcifying fibrous tumors (CFT) are rare benign tumors. They usually affect children and young adults and the incidence is equal in males and females. The usual clinical presentation is that of a painless mass. A computed tomography scan typically reveals a well-demarcated calcified lesion. CFT usually presents as a solitary mass and the commonest sites of occurrence are in soft tissues, the pleura, or the peritoneum. Multifocal occurrences at the same site have also been reported. The first case of CFT was reported in 1988 [1]. We present a rare case of multiple calcifying fibrous tumors at multiple sites in the same patient. To the best of our knowledge, this is the first ever reported case of multifocal CFT at six different anatomical sites (the paraspinal, pelvis, lungs, spleen, right adrenal gland and liver) in one patient. Case presentation A 31-year-old caucasian man presented with a threeweek history of abdominal pain on urination and altered bowel habits. Apart from tenderness and fullness in the right loin, his clinical examination was unremarkable. There were no clinical signs of autoimmune disease. He was physically fit, with no history of major illness. The results of his renal function, liver enzyme, bone profile, * Correspondence: [email protected] 1 Department of Medical Oncology, North Wales Cancer Treatment Centre, Glan Clwyd Hospital, Rhyl LL18 5UJ, United Kingdom Full list of author information is available at the end of the article
thyroid function, and full blood count tests, as well as an ultrasound of his kidneys, were normal. A computed tomography (CT) scan of his chest, abdomen, and pelvis reported multiple calcified masses in his right adrenal gland, right paraspinal region, left pelvis, spleen, liver, and lung nodules (Figures 1, 2, 3, 4 and 5). He was initially investigated for metastatic adrenal cortical carcinoma, pheochromocytoma, or metastatic sarcoma due to the right adrenal mass found in his CT scan. His random serum cortisol levels were
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