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The uterine leiomyomas are monoclonal tumours of myometrial smooth muscle cells that are oestrogen dependent. A 43-year-old patient was referred by her gynaecologist under a suspected diagnosis of ovarian tumour. She complained of prolonged and profuse, regular menstrual bleeding that leaded to anaemia. The ultrasound examination showed a complex tumour mass with dimensions 68 x 85 mm, with several cystic formations fulfilled with clear fluid, which protrudes from the posterior wall of the uterus. Therefore, the diagnosis of leiomyoma with a cystic degeneration was considered preoperatively. In the case of cystic degeneration of the myoma, the ultrasound shows a combination of cystic and solid components with irregular shape and variable echogenicity. The ovarian malignancy should be ruled out in the presence of a large cystic mass with irregular septa and solid nodular parts filling the small pelvis. Ultrasound characteristics of degenerative myomas should always be considered, so as not to replace it with an ovarian mass, especially if it is subserosal and on the loop.

Introduction: Leiomyomas are usually asymptomatic. Symptoms may be seen depending on their size, location and hormonal effects. It is the most common uterine tumour seen in gynaecological practice. Knowledge of clinical features and histopathological changes are helpful. Methods: The present cross-sectional study included 109 cases of uterine fibroid. Clinical details and findings of histopathological examination were noted. Results: Most of the patients belonged to the age group of 50-60 years. Menstrual irregularities were seen in 71.6% of cases. 39.4% suffered from abdominal pain and infertility was seen in 11.9% cases. In 70.6% of cases, proliferative endometrium was found. Secretory endometrium was seen in 13.8% and atrophic in 10.1%. Most of the cases had intramural fibroid (58.7%). It was subserosal in 19.3% cases and submucosal in 4.6%. Hyaline degeneration was seen in 20.2% cases, cystic degeneration in 4.6% and myxoid degeneration in 3.7%. 67.9% of cases did not show any degeneration. Conclusion: Hyaline degeneration, myxoid degeneration and cystic degeneration are the commonly seen secondary changes. Proper diagnosis and timely management are essential for the management of these tumours.

Ganglion cysts are common periarticular/peritendinous masses, which are thought to form from myxoid degeneration of collagen that becomes encased by connective tissue.1 This differentiates them from synovial cysts, which are lined by synovium.2,3 The presence of numerous ganglion cysts in multiple locations is very rare and has been termed cystic ganglionosis 4.

A 78-year-old Caucasian man with significant vascular disease reported sudden onset of worsened vision during a routine wound-care appointment for nonhealing necrotic leg ulcers. He described painless blurring of vision with grey scotomas in his right eye, his only well-seeing eye, after trauma to the left eye as a child. He presented with retinal ischemia, a cotton wool spot, and optic nerve swelling. Temporal artery biopsy showed myxoid degeneration and extensive calcium deposition, which also was present on imaging throughout his carotid and vertebral arterial system-the clinical picture of calciphylaxis.

A 45-year-old multipara woman was referred due to the rapid enlargement of an asymptomatic pelvic mass that was detected during a regular check up. She had undergone laparoscopic-assisted myomectomy 15 years previously. At the time, the uncontained extraction of an intraligamental myoma with electric power morcellation had been performed. Multimodal imaging revealed a heterogeneous mass in the vesicouterine pouch that was found to be supplied by the left gastro-omental and superior vesical arteries. Although malignancy could not be completely denied, parasitic peritoneal myoma with myxoid degeneration was the most probable diagnosis. Single-port laparoscopic excision of the peritoneal mass was performed along with laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy. The excised peritoneal mass was placed into a retrieval bag and extracted through the vagina. The pathological diagnosis was a parasitic peritoneal myoma with myxoid degeneration. The postoperative course was uneventful, and there was no recurrence of parasitic myoma in the 1-year follow up after surgery.

Background Data: Ligamentum flavum cysts have rarely been reported, it is believed to be a result of degenerative process. Complete excision of the cyst leads to excellent results. Ligamentum flavum cysts have rarely been reported worldwide and never published as an Egyptian case. Purpose: To report a case of ligamentum flavum cysts in the lumbar spine. Study Design: Case Report. Patients and Methods: We reported a case of ligamentum flavum cyst at the level of L4-5 in a 45 year old Egyptian woman, meticulous complete excision of the cyst without any durotomy or CSF leakage. Histopathological examination reported myxoid degeneration of the ligamentum flavum with no synovial cells. Results: the patient was satisfied and all her symptoms were completely resolved with 1 year follow up. Conclusion: ligamentum flavum cyst should be put in mind when reading the MRI. Complete surgical excision should be carried meticulously. (2016ESJ123)

Introduction: Oral focal mucinosis (OFM) is an uncommon soft tissue lesion of unknown etiology. It is presented as a harmless swelling that can be sessile or pedunculated. Histologically, OFM is characterized by focal myxoid degeneration of the connective tissue. The diagnosis of the lesion is established based on the histopathological analysis. OFM is treated with surgical excision and its recurrence is unreported. Case Presentation: In the present case report, a 53-year-old female presented with a lesion on the gingiva around the dental area of 44 and 45 that was clinically similar to irritation fibroma. An excisional biopsy was performed and the diagnosis was OFM based on the clinical and pathological findings. Conclusions: This case report emphasizes that it is nearly impossible to predict the detection of OFM. Therefore, although OFM is a rare lesion, it should be distinguished from other similar soft tissue lesions in the oral cavity.

Ganglion cysts are benign cystic masses that occur in association with musculoskeletal structures. The aetiology of ganglion cysts is controversial; however, it is generally thought to result from myxoid degeneration of connective tissue associated with joint capsules or tendon sheaths, to which the lesions are usually attached. They may occur in any part of the extremities within muscles, menisci, tendons or bones. Hereby, we present a rare case of intra-tendinous location of a ganglion cyst of the semimembranosus tendon occurring within the tendon substance itself. To date, there have only few cases reports in the literature reviewing intra-tendinous ganglion cysts occurred in the lower limbs.

Uterine leiomyomas are the most common benign lesions of the uterus. This tumour can vary in size, location, presentation and degenerations. In most cases, they are easy to diagnose clinically with help of imaging. We present a case of a fibroid with excessive myxoid degeneration where the preoperative diagnosis was haemangio/angiosarcoma. Whereas, cellular leiomyomas are a variant of leiomyoma with increased cellular component, myxoid degeneration in leiomyoma is uncommon and has to be differentiated from leiomyosarcoma. Histopathology and immunohistochemical analysis is confirmatory in arriving at this diagnosis.

Background: Leiomyomas are the most common benign uterine neoplasms arising from smooth muscle cells. Magnetic resonance (MR) imaging is the most accurate imaging technique for detecting and localizing leiomyomas. As leimyomas grow, they may outgrow their blood supply resulting in various types of degeneration such as myxoid, hyaline, cystic, red, and calcification. Degenerated leiomyomas have variable appearances on T2-weighted images and contrast-enhanced images. Materials and Methods: This was a retrospective hospital-based study done in Government Medical College, Srinagar, from January 2018 to December 2019. The study included 78 patients with more than 2 cm pathologically proven fibroids who underwent myomectomy or hysterectomy and preoperative MR imaging (MRI). We assessed the accuracy of MR for picking degeneration in fibroids. Aim and Objective: The aim and objective of this study is to determine the sensitivity, specificity, positive, and negative predictive value of MRI in assessing degeneration in uterine fibroids. Results: The sensitivity, specificity, positive and negative predictive values of MRI in assessing degeneration in uterine fibroids were 60%, 93.7%, 85.7%, and 78.9% respectively. Menorrhagia followed by dysmenorrhea was the most common presenting symptom. Conclusion: MRI has average sensitivity and very good specificity for picking fibroid degenerations. MRI has high accuracy for picking up myxoid, cystic, and red degeneration.

A ganglion cyst is a very rare lesion associated with the temporomandibular joint (TMJ). This lesion filled with viscoid fluid or gelatinous material arises from myxoid degeneration of the connective tissue of the joint capsule. A 40-year-old Chinese woman with ganglion cyst of the left TMJ is presented, and the differential diagnosis, histological characteristics and management of the ganglion cyst are discussed. A review of the literature is also presented.

Cervical leiomyoma consists 1-2% of all leiomyoma and myxoid degeneration of cervical fibroid is very rare. We present an old neglected case of huge necrotic cervical leiomyoma presenting with prolapse of mass and pelvic organs in a woman with multiple co-morbidities. Early management was necessary for improving her quality of life and controlling blood sugar. In lack of fitness for anaesthesia we performed her vaginal myomectomy under Intravenous Sedation. Prolapse was reducible and in absence of septic foci blood sugar profile improved. Vaginal myomectomy is a safe and quick procedure with least surgical morbidity and should be considered in cervical fibroids.

The classification systems of meniscal tears strengthen the importance of the anatomical and biomechanical particularities of meniscus tissue, regarding the pattern and configuration of a meniscal tear. Each system of classification approaches a particular aspect of the meniscal structure according to its morphology, proximity to the blood supply, anatomical site, and injury pattern. Meniscal traumatic lesions are characterized arthroscopically, as a lesion produced by a specific, well-known trauma on normal meniscal tissue, while degenerative meniscal tears are often related to a decompensation after minor trauma or even no known traumatic event. Moreover, in the degenerative condition, the meniscus substance exhibits macroscopic and microscopic alterations called myxoid degeneration. Classifying meniscal tears offers the knee surgeon the opportunity to identify and define an adequate treatment approach based on the literature for each specific meniscal tear. Moreover, it allows the surgeon to group meniscal tears, analyze their outcomes, and share their personal experience on different meniscal tears with other knee surgeons.

Leiomyomas are the most common pelvic tumors in women. About 20–30% of women older than 35 are affected. Rare conditions of leiomyomas have extrauterine locations. Myxoid degeneration is a rare type of leiomyoma degeneration. We report a case of solid-cystic myxoid leiomyoma in a 53-year-old woman complained of constipation, urinary hesitation, and malodorous vaginal discharge with palpable17×12 cm mass between vagina and rectum. Regarding the inferior location of the mass, a perineal approach was used to enucleate it. This rare location has not been mentioned before. The woman was finally diagnosed by pathologists which was myxoid leiomyoma.

Leiomyomas are known to arise from uterus, but rarely from broad ligament. Further, cellular leiomyoma of broad ligament is the least common variant reported in literature. The diagnostic dilemma arises when leiomyomas undergo degenerative changes. This poses both clinical and radiological difficulty in differentiating with an ovarian tumour. We present an unusual case of a huge broad ligament mass measuring 29x19x09cm, mimicking an ovarian tumour both clinically and radiologically. Histopathology revealed cellular leiomyoma of broad ligament with cystic and myxoid degeneration hereby being the second case reported in literature. This case is being presented not only because of the rare incidence but also due to its diagnostic confusion with ovarian malignancy on clinical evaluation and radiological findings.

Intrapulmonary solitary fibrous tumor is an extremely rare mesenchymal neoplasm about which very few references can be found in the literature. We present the case of a young woman with hemoptysis in whom plain-film chest radiographs showed a pulmonary mass. Contrast-enhanced MDCT showed a solid lung tumor with well-defined margins and heterogeneous enhancement. Histological study after surgical resection of the lesion revealed an intrapulmonary solitary fibrous tumor with an area of myxoid degeneration. We describe the clinical, radiological, and histological findings for this rare entity and review the relevant literature.

Giant cell tumor of the distal phalanx of a toe is rather unusual. We report an unusual case of giant cell tumor arising at the distal phalanx of the left biphalangeal fifth toe in a 13-year-old boy. This was treated successfully with curettage and packing with bone substitution.

Myxoid degeneration of the aortic valve as a cause of acute aortic valve regurgitation in young age is uncommon. We report a 39-year-old African-American man with a history of epilepsy and hypertension who presented with a 1-month history of worsening shortness of breath. He was diagnosed with acute pulmonary oedema. Transoesophageal echocardiogram showed normal ejection fraction but severe aortic valve insufficiency with small masses on the ventricular side of the right and non-coronary cusps, small vegetations cannot be ruled out but other valves were normal. Subsequent cultures were negative for endocarditis. Myocardial positron emission tomography (PET) scan was strongly suggestive of cardiac sarcoidosis. However, this diagnosis was ruled out as well when he underwent aortic valve replacement with bioprosthetic valve as he did not want to take long-term anticoagulation. Histological examination of the aortic valve showed myxoid degeneration. The patient was doing very well 1 year after the surgery.

Introduction: The spectrum of myofibroblastic lesions of the oral cavity ranges from reactive to benign to malignant lesions with overlapping histopathologic and immunohistologic characteristics posing a diagnostic dilemma. Observation: A 30-year-old male presented with a spontaneous swelling over the right lower buccal gingiva giving a clinical suspicion of a benign mesenchymal tumor. The lesion presented with a varied biphasic microscopic appearance that posed as a challenge for diagnosis. Commentaries: The incisional biopsy of the lesion showed a highly collagenous stroma with spindle-shaped cells, while the excision biopsy revealed myxoid and hyalinized stroma. A panel of markers comprising of SMA (smooth muscle actin). CD-34, β-Catenin, and Alcian blue stain was employed to arrive at a diagnosis. Conclusion: Most myofibroblastic lesions present with diverse histological appearance which warrants a thorough assessment of the cellular and stromal components for an accurate diagnosis.

Parasitic leiomyoma is a rare, benign smooth muscle tumor occurring in an extrauterine location. Their unusual growth pattern may mimic malignancy and, hence, could pose diagnostic and management challenges. Myxoid degeneration is further rarer finding in leiomyoma. There are few published cases of parasitic leiomyoma in our setting, hence, this report. A 52-year-old female presented with 4-year history of painless, progressive abdominal swelling with associated anorexia, weight loss, and body weakness. Abdominal examination revealed non-tender, nodular mass of 24 weeks size. Ultrasound scan showed a large well-defined heterogeneously hyperechoic right pelvic tumor crossing the midline. She had exploratory laparotomy; however, the histology confirmed parasitic leiomyoma with myxoid degeneration. Parasitic leiomyoma is an uncommon extrauterine benign tumor that mimics abdominopelvic malignancies. Meticulous clinical evaluation with radiologic and pathologic findings is the key to the otherwise challenging diagnosis.

Leiomyomas from the fallopian tube are very rare and usually asymptomatic but may cause symptoms by torsion or obstruction. Herein, we describe the detailed imaging findings of tubal leiomyoma with myxoid degeneration. Tubal leiomyoma appeared as a well-defined juxtauterine tumor marginated by low-signal rims with intervening bridging vessels between the tumor and uterus. A tubal mass showing heterogeneous speckled high signals with intermediate signal background on T2-weighted image without diffusion restriction could suggest the probability of tubal leiomyoma with mxoid degeneration.

Dermatofibrosarcoma protuberans (DFSP) is a slow-growing dermal spindle cell tumor. Its rare myxoid variant is characterized by extensive myxoid degeneration. We report a case of myxoid DFSP of the lower abdomen in a 35-year-old man. Histopathologically, the tumor consisted of spindle-shaped cells that were strongly positive for CD34 with a typical storiform pattern and myxoid stromal changes.

Dermatofibrosarcoma protuberans is a slow growing dermal spindle cell tumor seldom seen in the vulva and its myxoid variant, a rare type of dermatofibrosarcoma protuberans is characterised by extensive myxoid degeneration. We present the case of a 62 year old woman with an enlarging vulval swelling. Mass was excised surgically. Histopathologically the tumor consisted of uniform spindle-shaped cells showing strong positivity with CD34. In addition to the typical storiform pattern and lace like infiltration, prominent myxoid stromal changes were seen. Herein we report an interesting case of myxoid dermatofibrosarcoma protuberans, uncommonly reported in the dermatopathology literature.

Sialolipoma is a rare tumor found within both major and minor salivary glands. Here we discuss sialolipoma of the parotid gland and briefly review the English literature. Including our case, a total of 35 sialolipomas have been reported, 18 within major salivary glands and 17 within minor salivary glands. Major gland sialolipomas most often are presented in the parotid gland (77%) and those from minor glands were most often seen in the palate (41%). All lesions were well circumscribed and contained mature adipose tissue intimately admixed with benign salivary gland components. Ductal dilatation was found in 100% of minor salivary gland sialolipomas but in only 28% of major salivary gland tumors. Nerve entrapment has also rarely been noted in major salivary glands (14%) whereas myxoid degeneration has been identified in rare minor salivary glands tumors (13%). Treatment is surgical excision and is curative with no reports of recurrence.

Oral focal mucinosis (OFM) is an uncommon soft tissue lesion of unknown aetiology. Clinically, it is most commonly found on the gingiva and presents as a painless, sessile or pedunculated mass that is the same colour as surrounding mucosa. Histologically, it is characterized by focal myxoid degeneration of connective tissue. OFM occurs predominantly in adults during the fourth and fifth decade of life, although it has been reported infrequently in children and adolescents. Diagnosis relies on histological analysis and treatment involves complete surgical excision. Recurrence is unreported. This case report describes the clinical and histological presentation and subsequent management of OFM in an adolescent female patient.

Dermatofibrosarcoma protuberans (DFSP) is a slowly growing dermal spindle cell tumor and its myxoid variant, a rare type of DFSP, is characterized by extensive myxoid degeneration. We present the case of a 69-year-old woman with a multinodular reddish plaque on her trunk. Histopathologically, the tumor was located in the dermis and consisted of uniform spindle-shaped cells, showing strongly positive reaction for CD34, and negative for both S-100 and desmin. In addition to the typical storiform pattern, prominent myxoid stromal changes were demonstrated. Herein, we report an interesting case of myxoid DFSP, rarely reported in the dermatology literature.

We report the case of a 44-year-old man who experienced a fatal and untreatable delayed vasospasm after resection of a recurrent temporal IV grade primitive neuroectodermal tumor (PNET). The histological analysis demonstrated a rare rhabdoid variant of the tumor with a diffuse myxoid degeneration; molecular investigations demonstrated an upregulation of IL-1β and IL-6 expression in the recurrence. We reviewed the pathophysiology of the vasospasm that occurs after tumors resection, and due to the rarity of case, we speculated on the possibility that specific histological and molecular features of the tumor could have contributed to the delayed and fatal complication.

We encountered a surgical case of aortic valve prolapse caused by a fissure formed in the commissural region and coronary cusp, and we achieved a favorable outcome. On pathologic examination, the fissured valve was found to be myxoid degeneration with ruptured elastic fibers and clustering of foamy macrophages, and it was diagnosed as an atherosclerotic change not associated with rheumatic change. The fissure appeared to develop because of hypertensive stress in a region rendered vulnerable by atherosclerosis. Although this mechanism is atypical, it should be recognized that poorly controlled hypertension can cause aortic valve prolapse and induce acute heart failure.

A 29-year-old man presented with a mass in the left lower lung field on a chest radiograph obtained during a medical checkup. Computed tomography revealed a tumor adjacent to the diaphragm. A sessile tumor measuring 10.5 x 8.5 x 4.5 cm arising from the parietal pleura was resected. The tumor was accompanied by several little tumors on the nearby diaphragm. Pathologically, the major tumor consisted of typical spindle-shaped cells with myxoid degeneration. There was no increased cellularity, cellular pleomorphism, or a high mitotic count. In immunohistochemical studies, the spindle cells showed positive staining for CD34 and were negative for bcl-2. The smaller tumors also consisted of myxoid degeneration. We diagnosed benign solitary fibrous tumor of the pleura with satellite tumors. We must be aware of the possibility of satellite tumors when we treat patients with a benign solitary fibrous tumor.

Ganglia represent the most common soft-tissue tumour in the hand. They usually occur singly and although they arise in specific locations, they have been reported to arise from almost every joint of the hand and wrist. The aetiology of ganglia remains controversial. They may develop from connective tissue by myxoid degeneration and disintegration of collagen fibres. However, there is no evidence in the literature to support trauma as an aetiologic factor.

Summary Primary ciliary dyskinesia (PCD) is a disease characterized by symptoms of upper and lower respiratory tract infections due to abnormal structure and function of cilia. Cardiac involvement is characterized by situs inversus (Kartagener's syndrome in PCD) and other congenital cardiovascular abnormalities. We describe a 34-year-old female with a history of recurrent sinusitis and bronchiectasis but without situs inversus or other congenital cardiac anomalies in whom an association between mitral regurgitation secondary to myxoid degeneration and primary ciliary dyskinesia was suggested.

A case of Dermatofibrosarcoma Protuberans (DFSP) with unusual clinical and histological features is presented. The lesion recurred one year after surgical removal and showed myxoid degeneration of the entire lesion. Only a few cases with myxoid degeneration of the entire lesion are described in the literature. We found CD 34 stain, in combination with a panel of antibodies including fXIIIa, S100 and actin, useful in the diagnosis of this type of tumor in order to differentiate it from other neural, fibrous or muscular neoplasms.

Oral focal mucinosis (OFM) is a rare connective tissue disorder characterized by myxoid degeneration of submucosal connective tissue. It usually presents as gingival or mucosal overgrowth. Due to its uncommon occurrence and lack of pathognomonic clinical or radiological features, diagnosis mainly relies on histopathological evaluation. The paper reports a rare case of large OFM in a 58-year-old female patient involving the posterior maxilla and hard palate. Diagnosis of the lesion was established based on histopathological and immunohistochemical analysis. The lesion was excised surgically and showed no recurrence at 1 year follow-up. The cases presented intend to bring OFM to the attention of oral pathologists and clinicians while considering the differential diagnosis of myxoid lesions of oral cavity.

Barlow’s disease is an important cause of mitral valve prolapse and may result in mitral regurgitation. Repair of the valve using the MitraClip is more complex but technically possible. This chapter uses two case examples to illustrate some of the technical and procedural concerns and strategies when using the MitraClip to treat patients with Barlow’s disease.

Macroscopic degenerative lesions of non-disrupted menisci present as yellow, opaque areas of meniscal tissue, which correspond to myxoid degeneration, perimeniscal cysts and meniscal calcifications. Microscopically, the following findings can be noted: (a) acellular eosinophilic hyaline degeneration often associated with fissural or horizontal lesions; (b) myxoid degeneration, which is a collection of a normal mucoid substance. It can be located within the meniscus and is graded according to its severity. It has been found in more than half the cases in a study of Ferrer-Roca and Vilalta [17], who considered it to be a normal condition. Myxoid degeneration can also affect the perimeniscal zone and give rise to tears and pseudocysts, which can lead to the formation of perimeniscal cysts; (c) regeneration zones: peripheral lesions situated within the vascularized zone, which can heal spontaneously forming a scar that is often surrounded by proliferating chondrocytes.

Idiopathic deformation of the pinna is not widely reported in the current literature. We present a series of cases in which patients have required surgery for spontaneous thickening and deformation of the auricular cartilage, and a description of a technique for surgical correction. Four cases of idiopathic deformation of the pinna are reported. Our preferred technique of scaphoid rim incision and anterior carving of the cartilage is described, with intra-operative photographs. Each patient reported spontaneous swelling of the upper poles of the ears beginning in the second or third decade of life. In 3 cases the deformity was bilateral, although in each of these cases one side was more severely affected than the other. Histology for these cases was reported as myxoid degeneration of the ear. All of the reported patients were pleased with the aesthetic outcome of their auricular remodelling. Currently, there are no typical patient demographics for idiopathic myxoid degeneration of the ear. We have achieved good aesthetic results by hand carving the anterior aspect of the deformed cartilage via scaphoid rim incisions.

We present a rare case of a mediastinal liposarcoma concomitant with aortic insufficiency due to myxoid degeneration of the aortic valve. Because the patient's left ventricle was in moderate dilatation and a posterolateral thoracotomy combined with median sternotomy was required in order to perform a complete resection of a mediastinal liposarcoma, it was decided to carry out aortic valve surgery and tumor excision in one operation.

Pediatric trigger finger is rarely seen in clinical practice and when seen is the trigger thumb mostly. A myxoid degeneration of the tendon in the nodule has been detected at superficial flexor tendon of third finger on left side of a 12 year old child who underwent surgery with a diagnosis of trigger finger. The patient is free of pain and triggering after the excision of this degeneration. The aim of this report is to remind that rare pathologies as tendon tumors (or myxoid degeneration, as in our case) of the tendon may be the cause of pediatric trigger finger with most of them requiring surgery. J Clin Exp Invest 2014; 5 (1): 106-107

Ganglion cysts of the temporomandibular joint are rare and arise from myxoid degeneration of die collagenous tissue of the capsule of the joint as a result of trauma.

We report an unusual case of mesenteric cystic lymphangioma presenting as a large multilocular mass with a well-enhanced solid component and a central cleft, which were were pathologically correlated to the prominent stromal myxoid degeneration interspersed with abundant capillaries and the central fibrosis, respectively. The findings of computed tomography and magnetic resonance imaging are illustrated. Recognition of the multilocular configuration of the enhanced stroma may help to make the correct preoperative diagnosis.

Myxoid degeneration of the appendix wall without accompanying acute appendicitis (AA) is rare. We report two cases of myxoid degeneration of appendix associated with appendiceal adhesions. Both the cases showed marked splitting and disruption of smooth muscle fibers of muscularis propria by abundant myxoid ground substance and dispersed degenerated hypereosinophilic myofibers with pyknotic nuclei. Scattered degenerated myocytes with vacuolated cytoplasm were also identified. Focal serosal fibrosis was observed in both cases. We reviewed other pathologic processes that involve the appendix such as fibrous obliteration, AA, and appendiceal mucinous neoplasm (AMN) and conclude that the constellations of pathologic findings described herein are unique. Nonneoplastic dissecting myxoid degeneration of the appendix muscularis propria has not been reported in the pathology literature to date. The pathologic nature of appendiceal mucinous stromal change remains unclear; however, we hypothesize that the lesion occurs as a consequence of traction related injury to the appendix.

Children with Marfan syndrome rarely undergo surgery for annuloaortic ectasia and aortic regurgitation in the first decade. A 7-year-old girl presented with congestive heart failure due to severe aortic regurgitation associated with annuloaortic ectasia (6 cm). She also had funnel chest. She underwent a Bentall operation and sternal turn-over with a satisfactory result. Since the aortic valve cusps had rolled edges, the aortic valve was not spared. Histology of the aortic valve cusps showed myxoid degeneration and fragmentation of elastic fibers.

Giant fibroids are known to arise from the uterus, although very rarely from extra-uterine sites. Among extra-uterine fibroids, broad ligament fibroids generally achieve enormous size and generally present with pressure symptom like bladder and bowel dysfunction. Myxoid degeneration is a rare complication of benign fibroid, where presence of cystic changes mimics the metastatic malignant ovarian tumor. We report a case of true broad ligament fibroid measured about 13 kg. This case is reported for its rarity and the diagnostic difficulties in differentiating malignant ovarian tumor and benign fibroid with myxoid degeneration.

Purpose : To evaluate the effectiveness of treatments for enchondromas of the hand with heterograft bone substitute instead of bone autograft. Materials and Methods : We reviewed the radiographs of 15 patients that were followed for a minimum of 6 months. From January 1995 to May, 2000, fifteen patients that were treated with heterograft bone and could be followed-up for at least 6 months were retrospectively studied. Clinical, radiological and histological results were evaluated. Results : Clinically excellent in 5, good in 10. Radiologic result was 12 in Group 1, 3 in Group 2, the average consolidation duration was 8 months (5-11 months). The typical histologic findings of enchondroma by intraoperative specimens were hyaline cartilage, myxoid degeneration, calcification, and enchondral ossification. Grafted heterograft bone was incorporated via physiologic remodelling without significant problems. No signigicant complications occurred. Conclusion : We believe that heterograft bone is a good treatment option for enchondromas of the hand, given the disadvantages of bone autografts or allografts.