Ultrasonographic imaging of calcifying fibrous tumor of cervical esophagus

Abstract

Rationale: Calcifying fibrous tumor (CFT) is a rare benign mesenchymal tumor characterized by cytologically benign fibroblasts that produce abundant collagen with scattered lymphocytes, plasma cells, and psammomatous or dystrophic calcifications. Patient concerns: A 37 years old women was initially diagnosed thyroid nodule in local hospital. She was referred to receive microwave ablation of the nodule in our hospital. The patient was in good health with occasional foreign body sensation in the neck. Routine laboratory examination was normal. Diagnosis: The lesion was suspected benign and originating from the esophagus rather than the thyroid gland by conventional ultrasound and contrast-enhanced ultrasound in our hospital and was finally proved to be CFT by pathology. Interventions: The lesion was surgically removed. Outcomes: The patient recovered well and was followed up for 2 years without recurrence. Lessons: Although imaging diagnosis of CFT is difficult, the findings of clear border, coarse calcification on conventional ultrasound and peripheral hypoenhancement without central enhancement on contrast-enhanced ultrasound (CEUS), together with real-time evaluation of the relationship between the tumor and esophagus help to distinguish CFT of cervical esophagus from other lesions in the neck.

Pseudotumor fibroso calcificante de cuello en una paciente adolescente

“…Se reportan pocas recurrencias y no se registran muertes relacionadas [9]. Sin embargo, otros investigadores sugieren el tratamiento con corticosteroides, pero la extirpación de tumores radicales mediante cirugía es el principal método de tratamiento porque la histopatología postoperatoria y la inmunohistoquímica permiten obtener un diagnóstico definitivo [10,12].…”

Calcifying fibrous tumor of the gastrointestinal tract: A clinicopathologic review and update

“…Imaging findings show evidence of a mass lesion but are not specific for CFT. The clear border, coarse calcification on conventional ultrasound and peripheral hypoenhancement without central enhancement on contrast-enhanced ultrasound may help to distinguish CFT from other lesions[ 7 ].…”

Histopathological landscape of rare oesophageal neoplasms

“…Clinical features and diagnostic approach: Due to the possible different locations, calcifying fibrous tumours may cause a wide range of symptoms that are generally nonspecific. A subset can be multifocal and may be associated with other diseases, such as Castleman disease, inflammatory myofibroblastic tumour, vascular anomaly and sclerosing angiomatoid nodular transformation[ 24 , 25 ]. OCFTs described in the medical literature were generally clinically silent and discovered incidentally as a mass located in the deep mucosa, submucosa and/or the muscularis propria; one patient reported a foreign body sensation in the throat[ 22 , 24 ].…”

“…A subset can be multifocal and may be associated with other diseases, such as Castleman disease, inflammatory myofibroblastic tumour, vascular anomaly and sclerosing angiomatoid nodular transformation[ 24 , 25 ]. OCFTs described in the medical literature were generally clinically silent and discovered incidentally as a mass located in the deep mucosa, submucosa and/or the muscularis propria; one patient reported a foreign body sensation in the throat[ 22 , 24 ]. EUS, doppler flow imaging, contrast-enhanced CT scan and/or MRI can be helpful in the clinical assessment, but the final diagnosis of OCFT is made after histopathological evaluation[ 23 - 25 ].…”