1/353. Giant cell tumor of the sternum. Report of a case with a 17q isochromosome.We report a case of giant cell tumor of the manubrium with radiological evidence of aggressiveness. Few cases of giant cell tumor of the sternum have been published. Extensive surgery offers the best hopes of recovery. Cytogenetic studies evidenced several clonal abnormalities including a 17q isochromosome. The TP53 suppressor gene is located at 17q13.1. Whether loss of one of the TP53 alleles may have contributed to the aggressive behavior of our patient's tumor is discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/353. Pseudoanaplastic giant cell tumor of bone.Marked nuclear atypia can be found in a variety of benign mesenchymal tumors, including ancient schwannomas, symplastic leiomyomas, osteoblastomas, and chondromyxoid fibromas. Such nuclear atypia is believed to represent a degenerative phenomenon and does not indicate aggressive behavior. Separation of these pleomorphic but benign lesions from true sarcomas may be difficult. We are aware of only one prior description of such degenerative atypia in benign giant cell tumor of bone. We report a benign giant cell tumor of bone arising in the sacrum of a 21-year-old white female. Preoperative embolization of this lesion had been performed, and subsequent curetting revealed marked atypia suggestive of an anaplastic malignancy. However, only very rare mitotic figures were present, and the radiographs were consistent with a benign giant cell tumor. A diagnosis of benign giant cell tumor was made, and no recurrence or metastases have been observed during the 4-year postoperative period.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
3/353. Bone tumors in the pelvis presenting growth during pregnancy.Among 56 cases of a giant cell tumor of bone (GCT) and 52 cases of chondrosarcoma (CSA) in our series, four patients were discovered to have a tumor in the pelvic bone that grew in size during pregnancy. These four rare cases are described here. They include three cases of a GCT in the sacrum and one case of a CSA in the innominate bone. The dextran-coated charcoal assay and immunohistochemical techniques demonstrated the independence of these tumors from hormonal regulation despite the growth stimulated during pregnancy. It was concluded that the delay in detection of these tumors in the pelvis was just related to the opportunity afforded for unexpected growth during pregnancy. Surgical management was difficult due to the delay in tumor detection. The initial complaints such as pain, discomfort, or numbness around the pelvis were misinterpreted as symptoms of pregnancy. It should be kept in mind that during pregnancy, any pain or numbness in the pelvic region could be the direct result of a tumor in the pelvic bone.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
4/353. Vascularized fibular graft after excision of giant cell tumor of the distal radius. A case report.Although hemiarthroplasty of the wrist using vascularized proximal fibula has been described often, long term results with documentation of results are insufficient. A case of giant cell tumor of the distal radius with remarkable extraskeletal extension is reported. Vascularized fibula including its proximal head was used to replace the defect created after en bloc resection of the tumor. There was no deterioration in radiographic findings or function of the new joint at the time of the 10-year followup. Satisfactory range of motion of the wrist and the forearm was maintained. There was no instability in the joint, and grip strength measured 65% of the opposite side. Postoperative magnetic resonance imaging showed survival of the whole graft, including the subchondral portion. In addition to thorough revascularization of the graft, appropriate soft tissue reconstruction using dynamic tendon transfer contributed to the success. When these requirements are fulfilled, the graft can provide a functional and durable result. Although this is a single experience, the authors recommend wrist arthroplasty, rather than arthrodesis, in carefully selected patients.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
5/353. Bone giant cell tumour in neuropathological practice. A fifty year overview.We report a case of a 29-year-old female patient who suffered from visual disturbance, resulting from a lesion in the sphenoid bone which, histologically, proved to be a giant cell tumour. Reviewing our laboratory practice over a 50 year period, only 7 cases of true giant cell tumour were found and they were in two major locations, i.e. the skull and vertebrae. These few cases led us to focus on the problem raised by the lack of histological patterns of malignancy. In agreement with Mazabraud's theory, it seems that a vertebral location is associated with a good prognosis and that gene mapping of chromosome 17 in relation to p53 mutations could be a valuable tool in the diagnosis of potential malignant behaviour.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
6/353. bone marrow metastases in disseminated alveolar rhabdomyosarcoma: case report with ultrastructural study and review.A case of desseminated alveolar rhabdomyosarcoma in an 18-year-old male with leuco-erythroblastic anaemia is described. Numerous bizarre malignant cells, including frequent multinucleated giant cells, were seen in bone marrow aspirates, and osteolytic lesions appeared late in the clinical course. The primary site of the neoplasm remained undertermined during life and also at necropsy, which revealed minute pulmonary metastases and extensive lymph nodal, pleural and skeletal deposits. The diagnosis was confirmed on necropsy tissue by ultrastructural examination which demonstrated numerous thin (5 nm) and thick (15 nm) intracytoplasmic filaments in tumour cells, sometimes organized in bundles; scattered dense Z-band-like bodies, and rod-shaped structures were also seen. The fine structure of the rhabdomyosarcoma in the present case is compared with previous ultrastructural studies. Elongated, thick intracytoplasmic filaments whose diameter corresponds to that of myosin myofilaments are strong evidence for rhabdomyoblastic differentiation and are considered to be the sine qua non of a positive electron microscopic diagnosis of rhabdomyosarcoma. Orgaized bundles of filaments and Z-band-like dense bodies are usually present, and rod-shaped structures are found infrequently, but none of these are necessary for the ultrastructural diagnosis.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
7/353. Giant cell tumor of the foot phalanges in children: a case report.Giant cell tumor of the bone is infrequent in the phalanges of the toes and is extremely rare in children. A case of giant cell tumor of the proximal phalanx of the big toe on the left foot in a 12-year-old boy is reported. The tumor was treated by partial resection of the phalanx and repair of the osseous defect with an autologous iliac crest graft. A literature review showed few cases of giant cell tumor at this site.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/353. Haemangioma of bone with radiographic appearances simulating a giant cell tumour.A case is described of haemangioma of the proximal end of the humerus which simulated a giant cell tumour on radiography. An attempt at biopsy, carried out elsewhere, had failed because of severe haemorrhage from the tumour during operation. It was treated by en bloc resection and endoprosthesis with a good result after one year.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
9/353. Use of polymethylmethacrylate in large osseous defects in the foot and ankle following tumor excision.foot and ankle surgeons are occasionally confronted with having to fill large defects following excision of osseous lesions. This can prove to be quite challenging to the surgeon in regards to the requirement of large amounts of autogenous, allographic, or synthetic bone graft material. The amount of time spent nonweightbearing postoperatively can be quite prolonged, and the evaluation for tumor recurrence at the graft--host interface is difficult to ascertain. Polymethylmethacrylate has been used extensively in orthopedic surgery for many years in a safe manner for total joint replacement. It has also been used to fill large defects following tumor excision (i.e., giant cell tumor) and as an alternative to bone graft. This article briefly reviews the concepts of using polymethylmethacrylate in this manner and presents the use of polymethylmethacrylate in the treatment of foot and ankle lesions with three case presentations. The authors' purpose for this paper is to simply expand on the current medical literature available regarding the use of polymethylmethacrylate in the foot and ankle and to increase the awareness of foot and ankle surgeons regarding its use as a treatment alternative. A follow-up to this article is planned to present a larger patient population, longer term follow-up, and outcomes data.- - - - - - - - - - ranking = 0.5keywords = giant (Clic here for more details about this article) |
10/353. Assessment of vascularized fibular graft one year after reconstruction of the wrist after excision of a giant-cell tumour.We report a patient in whom the distal radius was resected for a giant cell tumour and the bone defect was replaced using a vascularized proximal fibular graft. The graft was viable and hypertrophied and normal callus formed on the distal radius. Due to chronic instability of the wrist the patient underwent revision arthrodesis 1 year after resection. Microscopic studies of the epishyseal region of the fibula showed wide necrosis of the graft with active creeping substitution. Despite the good technical result of the vascularized fibular graft, the vascularization was incomplete in the proximal epiphysis. We discuss possible reasons for this.- - - - - - - - - - ranking = 2.5keywords = giant (Clic here for more details about this article) |
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