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Gross Anatomy of Bone01:17

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Bone formation, or ossification, begins around the sixth to seventh week of embryonic development. Most bones develop from a cartilaginous template through the process of endochondral ossification. Cartilage formation begins when clusters of mesenchymal cells differentiate into chondrocytes. These chondrocytes proliferate rapidly and secrete an extracellular matrix that becomes encased in a membrane called the perichondrium. The resulting cartilage model provides a template that resembles the...
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Robotic Enucleation of Esophageal Leiomyoma
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Primary cervical leiomyoma with remarkable calcification and ossification.

Takahiro Yamanishi1, Kaname Sakamoto1, Hiroyuki Watanabe1

  • 1Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan.

Case Reports in Otolaryngology
|April 9, 2014
PubMed
Summary

A rare case of cervical leiomyoma with extensive calcification and ossification was diagnosed in a 68-year-old man. Surgical resection confirmed the benign smooth muscle tumor, aiding diagnosis and treatment.

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Area of Science:

  • Pathology
  • Oncology
  • Head and Neck Surgery

Background:

  • Leiomyomas are benign tumors originating from smooth muscle.
  • Cervical leiomyomas are rare, and those with significant calcification and ossification are exceptionally uncommon.
  • Preoperative diagnosis of such lesions can be challenging due to their varied presentation.

Purpose of the Study:

  • To report an extremely rare case of primary cervical leiomyoma with remarkable calcification and ossification.
  • To highlight the diagnostic challenges and successful management of this unusual presentation.
  • To emphasize the role of histopathological and immunohistochemical analysis in definitive diagnosis.

Main Methods:

  • Computed Tomography (CT) for initial lesion detection and characterization.
  • Fine Needle Aspiration Biopsy (FNAB) for preliminary assessment.
  • Surgical resection of the submandibular lesion for definitive diagnosis and treatment.
  • Histopathological examination including immunohistochemistry (IHC) for cell characterization.

Main Results:

  • CT revealed nodular lesions with calcifications in the submandibular region and upper mediastinum.
  • FNAB excluded malignancy in the submandibular lesion.
  • Resected specimen showed a solid tumor with marked calcification and ossification.
  • Histopathology and IHC confirmed proliferating spindle cells consistent with leiomyoma, positive for α-SMA and h-caldesmon.
  • The patient opted for follow-up for the mediastinal lesion.

Conclusions:

  • Primary cervical leiomyoma with extensive calcification and ossification is an extremely rare entity.
  • Preoperative differentiation from other head and neck tumors can be difficult.
  • Surgical resection combined with histopathological and immunohistochemical analysis provides definitive diagnosis and treatment.
  • A conservative follow-up approach may be considered for asymptomatic mediastinal lesions of similar nature.