[Show abstract][Hide abstract]ABSTRACT: A rare case of ossifying cementicular fibroma of the left orbitofrontal bone that developed in a 12-year-old boy is presented. A hard, painless mass that was incidentally noticed gradually enlarged over 2 years. Skull X-rays showed a well-demarcated lesion with mixed sclerotic and osteolytic radiolucent changes in the left orbitofrontal bone. Computed tomography revealed an expansile intradiploic multilocular mass that was separated by bony trabeculae. T1-weighted magnetic resonance imaging demonstrated a multi-cystic iso-intense mass with homogeneous contrast enhancement. Left external carotid angiograms revealed a vague tumor stain that was mainly fed by the middle meningeal artery. Systemic bone scintigrams revealed a single abnormal uptake in the lesion. The skull tumor was totally removed. Histological examination demonstrated two different characteristic findings that were composed of fibrous dysplasia and cementifying fibroma, although most of the tumor appeared to be a highly cementicular form of fibro-osseous lesion. The pathological diagnosis was a cementicular variant of fibrous dysplasia.
[Show abstract][Hide abstract]ABSTRACT: A rare case of sellar chordoma occurring in a 67-year-old woman who survived for more than 10 years is presented. Clinical signs and symptoms masqueraded as a non-functioning pituitary adenoma with visual disturbance and hypopituitarism. Initial computed tomography (CT) showed an intrasellar mixed dense mass with suprasellar extension, accompanied by non-homogeneous contrast enhancement. Partial removal of the mass was accomplished via right fronto-temporal craniotomy. Histological examination revealed a typical chordoma with no malignancy. After postoperative irradiation, the patient was discharged with clinical improvement. Serial CT and magnetic resonance imaging 8 years after treatment disclosed a regrowth of the intrasellar lesion, which extended to the sphenoid sinus and clivus, accompanied by non-homogeneous contrast enhancement. The patient underwent subtotal removal of the recurrent tumor through a sublabial transsphenoidal approach. Histological examination confirmed the previous diagnosis. Immunohistochemical study demonstrated positive cytoplasmic expression of vimentin, epithelial membrane antigen, keratin and S-100 protein, in contrast with a lack of appearance of carcinoembryonic antigen. After reoperation, she completely recovered and has survived for more than 10 years with good quality of life.