Myositis ossificans of the left medial pterygoid muscle: case report and review of the literature of myositis ossificans of masticatory muscles.
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SUBMITTER: Boffano P
PROVIDER: S-EPMC3931776 | biostudies-other | 2014 Mar
REPOSITORIES: biostudies-other
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Project description:BACKGROUND:Myositis ossificans describes a heterotopic bone formation within a muscle. Thereby myositis ossificans is classified in two different groups: myositis ossificans progressiva (MOP) which describes a genetic autosomal dominant rare disease and myositis ossificans traumatica (MOT). The exact pathogenesis of MOT is unclear. The aim of this article was to analyse and interpret the existing literature reporting MOT of masticatory muscles and compare the results with our own clinical experience with MOT. Risk-factors, etiology, clinical features, diagnostic imaging, as well as different treatment options were evaluated and recommendations for the prevention, diagnosis, and therapy of MOT of the masticatory muscles were given. METHODS:Following the PRISMA-Guidelines, a systematic search within the PubMed/Medline database with a view to record literature of MOT of the masticatory muscles was performed. Furthermore, the database of our own clinic was screened for cases of MOT. RESULTS:In total, 63 cases of MOT of the masticatory muscles which were reported in English-based literature were included in this study. Overall, 25 female and 37 male patients could be analysed whereas one patient's gender was unknown. Complication of wisdom-tooth infection (n =?3) as well as the results of dental procedures like dental extraction (n =?7), mandibular nerve block (n =?4), periodontitis therapy (n =?1) were reported as MOT cases. From the 15 reported cases that appeared after dental treatment like extraction or local anesthesia the medial pterygoid (n =?10) was the most affected muscle. Hereof, females were more affected (n =?9) than males (n =?6). The most reported clinical symptom of MOT was trismus (n =?54), followed by swelling (n =?17) and pain (n =?13). One clinical case provided by the authors was detected. CONCLUSIONS:Dental procedures, such as local anesthesia or extractions, may cause MOT of the masticatory musculature. Demographical analyses demonstrate that females have a higher risk of developing MOT with respect to dental treatment. The most important treatment option is surgical excision. Subsequent physical therapy can have beneficial effects. Nevertheless, a benefit of interpositional materials and drugs as therapy of MOT of the masticatory muscles has not yet been proven. Myositis ossificans progressiva has to be excluded.
| S-EPMC6206835 | biostudies-literature
Project description:Case summaryAn 8-year-old spayed female domestic shorthair cat was referred for trismus of progressive onset, which had started at least 1 month previously. The patient presented with weakness, anorexia, chronic bilateral purulent nasal discharge and concurrent reduced nasal airflow. Upon physical examination, painful mouth opening, bilateral swelling of the temporal areas, with an inability to open and close the mouth completely, were apparent. A vertical mandibular range of motion (vmROM) of 22 mm was noted. Complete blood count, biochemistry, electrolytes and various serology tests were unremarkable. CT revealed multiple mineralised lesions within the masticatory muscles. Histopathological features were consistent with those seen in the human disease fibrodysplasia ossificans progressiva (FOP). Supportive treatment did not improve the vmROM, eventually resulting in a 13 mm open bite, and total inability to close and open the mouth. Cardiac arrest occurred at the induction of an anaesthesia procedure aiming to perform tracheostomy and nasal lavage. Despite emergency tracheotomy and cardiac resuscitation, humane euthanasia was elected by the owners. Post-mortem molecular investigations highlighted a heterozygous deletion, compatible with a splicing site mutation in ACVR1, which is also associated with FOP in humans.Relevance and novel informationThis is the first report in the veterinary literature of FOP-like disease selectively affecting the masticatory muscles. This condition is associated with a poor prognosis, as no medical or surgical treatment has currently proven to be of any prophylactic or curative benefit. Although rare, FOP-like disease should be included in the differential diagnosis of trismus in the cat. Any further muscle injury should be avoided.
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Project description:Fibrodysplasia ossificans progressiva (FOP) is an autosomal dominant disease, characterized by the formation of heterotopic ossification (HO) in muscles, ligaments, and tendons. Flare-ups, an inflammatory process that often precedes the formation of HO, can occur spontaneously, but trauma is also a common trigger. It is not known whether radiotherapy, especially in higher doses, might cause sufficient trauma or inflammation to trigger a flare-up and subsequent HO in FOP patients. We report the case of a patient undergoing radiotherapy for the treatment of a 1-cm-wide basal cell carcinoma (BCC) of the lower lip. In addition, we present a systematic review of the available literature. Our patient received 54 Gy in 18 fractions with orthovoltage therapy, resulting in a clinical complete response of the tumor. Six months after treatment, there were no signs of HO either clinically or on [18F]NaF PET/CT. The systematic review identified 11 publications describing either radiation treatment in FOP or radiation therapy as a cause of HO in non-FOP patients. Six case reports described the use of radiation in FOP patients for various reasons, including one with a high-dose treatment of a lip BCC using superficial X-ray therapy. The remaining five studies described the use of low-dose radiotherapy to prevent or treat either an FOP flare-up or HO formation. None of these cases showed worsening of disease that could be attributed to the use of radiation therapy. Radiation induced HO in non-FOP patients was rare and occurred in five studies. The largest of these studies suggested that HO was induced after treatment with high doses, resulting in more widespread evidence of tissue damage, potentially being the end result of this damage. In conclusion, available reports suggest no contraindication to radiotherapy in FOP patients; although the number of cases was small, systematic toxicity reports often were not available, and none of the reports described high-dose, high-energy radiation treatment at locations such as muscle and joint regions.
| S-EPMC7028822 | biostudies-literature
Project description:Immune checkpoint inhibitors (ICIs) have substantially changed the treatment of a variety of malignant tumors. With the increasing of their usage, the unique immune-mediated toxicity profile of ICIs has become apparent. We report a case of esophageal squamous cell carcinoma in a patient who received anti-programmed cell death protein 1 (PD-1) (camrelizumab) therapy and the occurrence of sequential immune-related adverse events (irAEs). Although many irAEs have been reported, severe myositis caused by camrelizumab with simultaneous involvement of multiple organs, including the myocardium, respiratory muscles, and skeletal muscles, has rarely been described in literature. This 69-year-old male patient developed a grade 4 camrelizumab-induced adverse reaction according to the Common Terminology Criteria for Adverse Events (CTCAE) and was successfully treated with methylprednisolone and immunoglobulins. The early identification of irAEs, immediate discontinuation of immunotherapy, use of steroids and/or immunosuppressants, and adjuvant supportive treatment are critical to the clinical prognosis of patients. It should be aware that autoimmune complications can occur even when ICI treatment is ceased.
| S-EPMC8761813 | biostudies-literature
Project description:Masticatory muscle activity during teeth clenching is associated with changes in many physiological parameters throughout the body. Clenching can improve muscle activity, force production, rate of force development, and joint fixation. Hence, teeth clenching and masticatory muscle activity can be important in competitive sports activities. Sport climbing is becoming increasingly popular and will be included for the first time in the Summer Olympic Games, Tokyo, 2020. However, masticatory muscle activity in sport climbers has not yet been studied. The aim of the presented study is to compare the bioelectrical activity of the masticatory muscles in sport climbers and non-climbers in order to determine the relationship between these muscles and climbing activity. 44 subjects without masticatory system disorders (16 women and 28 men, average age 26.3) were divided into two groups of 22 sport climbers (8 women, 14 men, climbing experience >4 years), while 22 people (8 women, 14 men, with no regular sports activity) were assigned to the control group. Electromyographic examination of temporalis anterior (TA) and masseter muscle (MM) was evaluated in three conditions: during resting mandibular position, during maximum intercuspation clenching, and during maximum voluntary clenching with cotton rolls between teeth. For statistical analysis, the W Shapiro-Wilk test and the Mann-Whitney U test were used. Sport climbers showed significantly higher bioelectrical activities of MM during maximum intercuspation clenching (238.45 ?V vs. 83.87 ?V, p = 0.002), and during maximum voluntary clenching with cotton rolls between teeth (300.01 ?V vs. 101.38 ?V, p = 0.001) compared to controls. The differences between groups in relation to the resting bioelectrical activity of the MM muscles, and TA muscles in all conditions were not statistically significant (p > 0.05). Higher bioelectrical activity of masseter muscles during clenching in climbers can be associated with this sports activity. However, the mechanism remains unknown and requires future research.
| S-EPMC7068301 | biostudies-literature
Project description:RationaleCardiac primary spindle cell sarcoma is 1 of the rarest cardiac malignancies, with only a few cases reported so far. Herein, we reported a case of left atrial spindle cell sarcoma diagnosed and treated by a multidisciplinary approach, and retrospectively reviewed other reported cases.Patient concernsA 49-year-old woman presented to our hospital with 2 weeks of gradual onset of dyspnea on exertion, dry cough and subacute fever.DiagnosisThe patient was initially revealed a left atrium mass by 2-dimensional transthoracic echocardiography. Based on the contrast-enhanced echocardiography and cardiac magnetic resonance imaging, she was subsequently suggested to have a cardiac malignant tumor. And the post-operative histopathology confirmed the tumor to be a cardiac primary spindle cell sarcoma.InterventionsThe tumor was completely resected using autotransplantation. The patient was referred for polychemotherapy afterwards.OutcomesOur patient underwent the tumor resection, with subsequent adjuvant polychemotherapy, and the tumor has not recurred during 12 months of follow-up.LessonsDue to the rarity of these tumors and nonspecific symptoms, they are often difficult to diagnose preoperatively and missed occasionally. Thus, improving our understanding of the disease and facilitating its early diagnosis are essential.
| S-EPMC7808516 | biostudies-literature
Project description:Several cases of vaccine-associated manifestations have been published including cases of inflammatory myositis. Herein, we comprehensively review the literature on the occasion of case of a woman with inflammatory myositis following COVID-19 vaccination. A 67-year-old woman presented with left arm edema, rash, and weakness after the 2nd dose of the BTN162b2 vaccine. Raised muscle enzymes and inflammatory markers with muscle edema on MRI and myositis findings on the electromyogram established the diagnosis. She was successfully treated with methylprednisolone pulses, intravenous immunoglobulin, methotrexate, and hydroxychloroquine. Cases of inflammatory myositis, dermatomyositis, or interstitial lung disease with myositis-specific autoantibodies or myositis-associated autoantibodies within 12 weeks from SARS-CoV-2 vaccination were included. Cases with malignancy, prior or subsequent COVID-19 infection, preexisting myositis/interstitial lung disease (ILD)/dermatomyositis (DM), or other connective tissue diseases were excluded. From our search, 49 cases were identified (mean age: 56.55 + 17.17 years), 59% were women, while 12 patients received the ChAdOx1 vaccine, 27 the BNT162b2, 8 the mRNA-1273, 1 the DB15806, and 1 the Ad26.COV2.S (overall, 70% received mRNA vaccines). Muscle involvement was the most common manifestation (79.5%), followed by skin involvement (53%) and ILD (34.6%), which were more common in the m-RNA vaccinees. Muscle biopsy, MRI findings, and autoantibody profile varied significantly, while successful immunosuppressive treatment was applied in most cases. Inflammatory myositis after COVID-19 vaccination has been well documented worldwide. Current evidence in support of a pathogenic link is challenging due to significant variation in clinical manifestations, radiological, histopathological, and immunological features.
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Project description:BackgroundCardiac myxomas are considered the most common benign heart tumours. The clinical manifestations mainly depend on the size of the tumour. They usually vary from asymptomatic, mild non-specific symptoms, to severe obstructive cardiac and systemic findings. We describe herein a significantly large left atrial myxoma in a patient misdiagnosed with respiratory asthma.Case summaryA 54-year-old lady, was diagnosed previously with asthma, presented with a history of dyspnoea on exertion, palpitations, and mild peripheral oedema. Chest X-ray suggested pulmonary congestion. Due to high suspicion of cardiac issues, transthoracic echocardiography was done revealing giant left atrial mass. Consequently, the mass was approached and excised surgically through the inverted T biatrial incision. Grossly, the mass measured 10 × 8 × 6 cm, and it had a smooth surface and was filled with gelatinous material. The histopathology confirmed benign myxoma without malignant features.DiscussionOur article mainly focuses on the diagnostic challenges of a patient with atrial myxoma. The major discrepancy between the tumour size and the severity of the patient's symptoms should draw physicians' attention to consider atrial myxoma over a long list of differentials, in order to take immediate action to reduce the mortality and improve the overall prognosis.
| S-EPMC7891267 | biostudies-literature
Project description:BackgroundAnti-mitochondrial antibody (AMA)-positive myositis is an atypical inflammatory myopathy characterized by chronic progression of muscle atrophy and cardiac involvement. Few detailed reports have shown the clinical course of the cardiac complications of AMA-positive myositis.Case summaryA 47-year-old man presented with shortness of breath on exertion. Cardiac dilatation was visible on chest X-ray, and echocardiography demonstrated diffuse hypokinesis with a reduced left ventricular (LV) ejection fraction of 30%. He had mild muscle weakness in the bilateral iliopsoas muscles, and his creatine kinase (CK) and anti-mitochondrial M2 antibody levels were elevated. A liver biopsy showed no findings of primary biliary cholangitis. Coronary angiography revealed normal coronary arteries. An endomyocardial biopsy showed interstitial fibrosis and marked degeneration of the mitochondria. Fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography showed circumferential abnormal accumulation in the LV myocardium, and he was diagnosed with cardiomyopathy associated with AMA-positive myositis. Optimal drug therapy for heart failure was started, and a cardiac resynchronization therapy-defibrillator was implanted. However, his cardiac function did not improve, and he was hospitalized due to ventricular tachycardia storm 5 years after the diagnosis. Ventricular tachycardia was terminated by radiofrequency catheter ablation on the LV-anterior papillary muscle. Steroid therapy was initiated and resulted in a decreased uptake of FDG and a normalized CK level at 3 months after his second discharge; however, LV systolic dysfunction remained 1 year later.DiscussionAnti-mitochondrial antibody-positive myositis can affect the myocardium and cause severe LV dysfunction and life-threatening ventricular arrhythmia over time.KeywordsAnti-mitochondrial antibody-positive myositis • Endomyocardial biopsy • Ventricular tachycardia • Left ventricular dysfunction • Case report • Magnetic resonance imaging • Near-infrared spectroscopy-intravascular ultrasound.
| S-EPMC8759524 | biostudies-literature
Project description:Extraocular Muscle is Defined by a Fundamentally Distinct Gene Expression Profile. Adult mouse extraocular, masticatory, and hindlimb (gastrocnemius/soleus) muscles of adult mice were compared using Affymetrix microarrays. Data form part of publication: Proceedings of the National Academy of Sciences USA 98:12062-12067, 2001. Keywords: parallel sample
2004-02-27 | GSE1062 | GEO