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Post-mortem detection of a calcifying fibrous pseudotumor at a rare site-A case report
Jhansi L Mylapalli1, Hemlata Jangir2, Meenakshi Sharma1
1Division of Forensic Pathology and Molecular DNA Laboratory, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
We report the case of a 48 year old man brought-in-dead to the trauma unit following an alleged accidental fall from a multi-storied building. Autopsy findings were consistent with traumatic injuries to the head, chest and spine. Incidentally, a bit of the diaphragm with a pearly white lobulated mass over the pleural surface was observed. Histopathological examination detected a calcifying fibrous pseudotumour (CFPT), confirmed by positive immunostaining for cluster of differentiation protein-34 (CD34) and vimentin (focally). CFPTs are slow-growing pseudotumours that are clinically benign with extremely low rate of recurrence and this might just be the first reported case of CFPT on the diaphragm. This shall further aid clinicians to diagnose these rare yet significant soft tissue tumors in uncommon sites.
Insights
A rare calcifying fibrous pseudotumor (CFPT) was incidentally discovered on the diaphragm during an autopsy of a trauma victim. This finding highlights CFPTs as benign soft tissue tumors that can occur in unusual locations.
Area of Science:
- Pathology
- Oncology
- Surgical Pathology
Background:
- Calcifying fibrous pseudotumors (CFPTs) are rare, benign neoplasms characterized by fibrous proliferation and calcification.
- These tumors typically occur in the soft tissues, with rare occurrences reported in unusual locations.
- Accurate diagnosis is crucial for appropriate management, although CFPTs have a low recurrence rate.
Observation:
- An autopsy revealed a pearly white, lobulated mass on the pleural surface of the diaphragm in a 48-year-old male trauma victim.
- Histopathological examination identified the mass as a calcifying fibrous pseudotumor (CFPT).
- Immunohistochemical staining confirmed the presence of CD34 and focal vimentin.
Findings:
- The autopsy case represents a potentially novel site for calcifying fibrous pseudotumor (CFPT) occurrence – the diaphragm.
- Histopathology and immunohistochemistry confirmed the diagnosis of CFPT, characterized by calcification and specific protein markers.
- The tumor exhibited features consistent with a slow-growing, clinically benign nature.
Implications:
- This case expands the known anatomical distribution of calcifying fibrous pseudotumors (CFPTs).
- Increased awareness of CFPTs in rare locations like the diaphragm can improve diagnostic accuracy for clinicians.
- Further documentation of CFPTs in diverse sites aids in understanding their behavior and clinical management.
