We report the case of a 43-year-old man who came to our service for evaluation of a 6-month history left frontal tumor without previous trauma at this level.
The patient reported no pain in the tumor, only a feeling of heaviness and left fronto-occipital headache.
Physical examination revealed a 1 cm diameter tumor with minimal perilesional erythema.
The fixation is presented as a hard mass, not adhered to the bony plane without alteration of the frontal branch of the facial nerve.
The patient also presented a similar nodule in the right costal region.
CT and aspiration biopsy guided by ultrasound (ECO-PAAF) of the costal tumor were requested.
CT shows a mass of approximately 0.7 cm at the level of the left frontal region, well defined that does not present adjacent tissues and does not present bone destruction.
The ECO-FNA of the right costal region was informed about prescriptions.
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It was decided to perform a biopsy-exeresis of the tumor under local anesthesia.
Intraoperatively, a lesion firmly adhered to the fascia of the frontal and pericranial muscles is observed.
Subpericranial dissection including frontal and periictal muscle was performed, and no erosion of the underlying frontal bone was observed.
The closure of the surgical defect was direct and simple.
The postoperative course was uneventful and there was no recurrence after 18 months of postoperative follow-up.
The anatomopathological study describes at the macroscopic level an irregular white-to-parduscus nodular fragment of 0.9 × 0.7 × 0.4 cm. At the microscopic level, there is a connective tissue with a circumscribed nodular lesion, poorly defined mononuclear matrix.
Immunohistochemistry showed positivity for CD68 antibody and vimentin protein in giant cells and less intense in oval cells.
S-100 protein binding.
Ki 67 antibody positivity represents a proliferative index of less than 5%.
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The study concludes with the diagnosis of benign neoplasm of mesenchymal origin type FN.
