1/18. 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 = 1keywords = giant (Clic here for more details about this article) |
2/18. Fine-needle aspiration cytology of chondroblastoma of soft parts: case report and differential diagnosis with other soft tissue tumors.chondroblastoma is a benign tumor arising in the epiphysis of long bones. The extraskeletal presentation is most unusual. We report the first cytological description of a soft tissue chondroblastoma. It was a subcutaneous mass in the leg of a 62-yr-old man. Fine-needle aspiration (FNA) rendered a highly cellular material with grouped and single polygonal or round cells with a uniform, sometimes eccentric nucleus. Microvacuolated cytoplasm and hemosiderin pigment were frequent findings. There were rare nuclear grooves and mitoses. A metachromatic, focally calcified stroma was present, occasionally surrounding the cells. There were also numerous multinucleated osteoclast-like giant cells. Histological evaluation was diagnostic of chondroblastoma. The tumor was locally aggressive. A review of other soft tissue masses with similar cytological findings is included in the discussion. FNA cytology is very helpful in the diagnosis of soft tissue chondroblastoma, but additional studies may be necessary for a definitive diagnosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/18. Subungual chondroblastoma in a 9-year-old girl.chondroblastoma is an uncommon primary bone tumor, mainly found in the epiphyses of long bones. We describe a 9-year-old girl who presented with a chondroblastoma as a subungual mass in the fifth toe. Radiographs showed an expansive, calcified tumor of the distal phalanx. Histologic examination after excision revealed chondroid differentiation, active mitosis, multinucleated giant cells, calcification, and necrosis. There was no recurrence of the lesion after surgical excision. The purpose of this report is to document this unusual event that occurred in such a short bone as the distal phalanx of the fifth toe, mimicking a dermatologic entity.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/18. chondroblastoma of the rib presenting as an intrathoracic mass. Report of a case with fine needle aspiration biopsy, immunocytochemistry and electron microscopy.We describe an unusual case of chondroblastoma of the rib, initially presenting as a mediastinal mass eroding a vertebra, in which the preoperative diagnosis was made by fine needle aspiration (FNA) cytology and confirmed by histology and electron microscopy of the surgical specimen. Cytologic study of the smears revealed osteoclastlike giant cells and dishesive, mononucleate tumor cells; sections of the paraffin-embedded, aspirated material showed the chondroid matrix and typical chicken wire calcific deposits. Supporting diagnostic evidence was provided by immunohistochemical demonstration of S-100 protein. Unusual features were the presence of intranuclear pseudoinclusions and cytoplasmic granular deposits, which proved to contain iron on histochemical staining, ultrastructural morphology and x-ray analysis. This case emphasizes the value of FNA cytology in providing a correct diagnosis of chondroblastoma as well as the utility of embedding the aspirated material for histologic, immunohistochemical and ultrastructural studies.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/18. temporal bone chondroblastoma: a review.The objective of this paper was to review temporal bone chondroblastomas in regard to their presentation, radiographic findings, histopathology, and treatment. A case report of a 38-year-old man who presented with the left-sided hearing impairment and temporal swelling was reviewed. A CT scan revealed an osteolytic lobulated expansile mass. MRI depicted two cystic components with fluid-fluid level and enhanced solid mass. Immunohistochemical study of S-100 was performed using avidinbiotin-complex method. The tumor was totally removed, with eroded squamous bone and temporal muscle, via the left zygomatic-extended middle fossa approach. The pathology of the tumor showed that the tumor cell was spindle-shaped, along with multinucleated giant cells. These cells had oval to polygonal nuclei; some cells showed grooved nuclei. Intercelluar calcification and hemorrhagic components were also observed in the tumor. Tumor cells were strongly positive for S-100 protein. temporal bone chondroblastomas are extremely rare osseous tumors with only 45 cases previously reported in the published literature. They may be confused with more common lesions seen in the temporal bone. Diagnostic radiology, including CT and/or MRI, as well as immunohistochemical staining with S-100 protein, may assist in making the diagnosis. Treatment is complete surgical excision with preservation of vital neurovascular structures.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/18. Fine needle aspiration cytology of chondroblastoma--a case report.chondroblastoma accounts for less than one percent of osseous neoplasms, and is one fifth as common as giant cell tumor, a lesion with which it is very frequently confused. It has a marked predilection for the epiphysis of long bones. Radiologically, these are lytic lesions with a thin margin of increased density. A majority of chondroblastomas have an entirely benign course and are successfully treated by curettage and bony chip grafts. Clinically, chondroblastomas may be confused with other neoplasms, both benign and malignant. Fine needle aspiration is fast gaining acceptance as an accurate and rapid technique for diagnosing osseous neoplasms. The cytological features of chondroblastoma like individually lying chondroblasts, nuclear grooves, chodroid matrix and chicken-wire calcification are diagnostic of this neoplasm and may allow fine needle aspiration to become a valuable pre-operative technique in the management of these patients.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/18. Chondroblastomalike extraskeletal chondroma.An unusual extraskeletal tumor occurring in the right thumb of a 44-year-old man exhibited histologically a chondroblastomalike appearance. The tumor was characterized by dense proliferation of chondroblastic cells admixed with a few multinucleated giant cells of osteoclast type. The patient had no evidence of local recurrence or metastasis three-and-a-half years after a simple excision.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/18. chondroblastoma of temporal bone: unusual histologic features.chondroblastoma of bone only rarely affects the skull and, depending on its location, may have an uncertain prognosis. The histologic spectrum demonstrated by this tumor has been a source of diagnostic confusion, which still persists. A case of chondroblastoma of the temporal bone with unusual histologic features is presented and discussed. chondroblastoma must be included in the differential diagnosis of bone tumors of the skull containing giant cells. Radical excision is suggested as the treatment of choice in view of unanswered questions regarding its tendency to recur or to progress to frank malignancy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/18. Benign chondroblastoma of the temporal bone.Benign chondroblastoma is a rare tumor in the temporal bone. It occurs preponderantly in middle-aged men as a mass in the postero-superior region of the ear canal and is accompanied by hearing loss. On pathologic examination, giant cells and focal regions of chondroid differentiation are noted. After the extent of the tumor has been determined, the treatment is surgical removal. Preoperative irradiation may be helpful. Long-term follow-up is essential.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/18. Human osteogenic sarcoma: fine structure of the chondroblastic type.The fine structure of representative regions of four chondroblastic osteogenic sarcomas was studied. These regions contained four morphologically distinguishable subtypes of chondroblastlike cells. In addition, multinucleated giant cells, fibroblastlike cells, and macrophagelike cells were present, along with small populations of unclassifiable cells forming at least two subgroups of cells likely to be of a neoplastic nature. With only one exception, all types of chondroblastlike cells were separated by wide zones of extracellular matrix. The large multinucleated cells showed a fine structure that differed from that seen in multinucleated giant cells of other tissues. The evidence suggested that the multinucleated cells in the chondroblastic osteogenic sarcomas were active in phagocytic functions. It is not clear whether or not they are neoplastic in nature. Osteoblastlike cells were not encountered in the chondroid areas of the osteogenic sarcomas studied. On the basis of the findings it is concluded that the observed fine structural polymorphism of the chondroblastlike cells may reflect differences in maturation and differentiation among these cells. The most well-differentiated cells (type 1) appear to be able to exert secretory functions.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
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