1/103. Ewing's sarcoma recurrence vs radiation necrosis in dynamic contrast-enhanced MR imaging: a case report.PURPOSE: We report a case of Ewing's sarcoma in the right distal femur in a 6-year-old male to demonstrate how dynamic contrast-enhanced magnetic resonance imaging (DEMRI) findings predicted histopathology. MATERIALS AND methods: DEMRI was performed at presentation and during and after completion of chemotherapy and radiation therapy. Histopathologic studies were done at presentation, at 77 weeks (20 weeks after a pathological fracture), and from the en bloc resection at 104 weeks. RESULTS: DEMRI predicted the early tumor response, absence of tumor recurrence, presence of necrosis and lack of fracture healing, confirmed by histopathology. CONCLUSION: DEMRI is a clinically useful tool in managing Ewing's sarcoma.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/103. Synovial desmoplastic fibroblastoma of hip joint with bone erosion.A 78-year-old woman presented with pain at the left hip. Initial radiographs showed minimal age-related changes. Over the next 2 years she developed large erosions in the left femoral neck and proceeded to hip replacement. Histological examination showed bland spindle cells in a loose and hyalinised collagenous stroma considered to represent a desmoplastic fibroblastoma (collagenous fibroma). This is the first reported case of synovial desmoplastic fibroblastoma.- - - - - - - - - - ranking = 42.677560570417keywords = femoral neck, neck (Clic here for more details about this article) |
3/103. Extraskeletal myxoid chondrosarcoma with multiple skeletal metastases.Pulmonary metastases are not unusual in extraskeletal myxoid chondrosarcoma; however, only two patients have been reported with multiple bony metastases. We report here one patient with extraskeletal myxoid chondrosarcoma associated with lung and multiple bony metastases. After chemotherapy, the primary lesion was resected, but lung and multiple bony metastases were found 20 months later. The bony metastases were in the right femur, right humerus, and at multiple vertebral levels. Because of a pathologic fracture of the right femur, the metastases in the right femur and right humerus were surgically stabilized. After chemotherapy, the lung metastases were resected, and those in the vertebral bodies were treated with radiotherapy.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
4/103. Metastatic disease of the femur. Surgical management.Treatment of actual or impending pathologic fractures of the femur provides the senior author with some of the most rewarding surgical interventions of his practice. The patients' survival outlook is not changed, but their quality of life is enhanced significantly. Most health care providers usually provide the metastatic cancer patient only temporary symptomatic relief, at best, and often at the expense of continued pain, suffering, or sickness, such as is seen with chemotherapy-associated morbidity. patients with metastatic bone disease are usually incredibly grateful for the restoration of function and diminution of their pain that results from the proper operation on metastatic bone disease. These patients typically are among the most appreciative patients and often express their gratitude when seen in follow-up in the clinic or office. Despite their metastatic disease state, their usual enthusiasm is uplifting to the surgeon and to the staff. To help a patient be pain-free and functional in the waning days of his or her life affords the patient, the physician, and the physician's staff with an emotionally rewarding experience and one that is well worth the time and effort required to care for these patients. By following the techniques outlined in this article, most patients with metastatic disease of the femur can be appropriately managed with excellent results.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
5/103. Allograft-allograft healing? Salvage of massive allografts after fracture.Two cases are presented in which an allograft was inserted to salvage a previous allograft bone reconstruction that had followed resection for osteosarcoma. In each instance an allograft-allograft junction was created and, with time, healed. In the first case, a fracture of a distal femoral osteoarticular allograft was salvaged by adding a second allograft and a total knee arthroplasty. This construct preserved the majority of the allograft and allowed rapid rehabilitation. In the second case, an allograft arthrodesis of the knee was salvaged after fracture by replacing the distal portion of the fractured allograft with a new allograft. Again, an allograft-allograft junction was created and healed within 6 months. Allograft fractures pose challenging reconstructive problems. In these two cases, the addition of more allograft facilitated continued limb salvage and function.- - - - - - - - - - ranking = 4keywords = fracture (Clic here for more details about this article) |
6/103. Arthroscopically assisted excision of osteoid osteoma involving the hip.Two cases of arthroscopically assisted excision of osteoid osteoma involving the femoral neck and acetabulum are presented. This technique allows for percutaneous excision of this benign bone lesion in those rare circumstances when it occurs in an intra-articular location. The approach enables direct visualization of the tumor as well as histologic confirmation. There was minimal morbidity, excellent relief of symptoms, and rapid functional restoration.- - - - - - - - - - ranking = 42.677560570417keywords = femoral neck, neck (Clic here for more details about this article) |
7/103. Cotton-induced pseudotumor of the femur.Twenty-five years prior to presentation a 41-year-old man had a femoral fracture stabilized with a 4.5 mm AO/ASIF steel plate. The femur healed uneventfully and the patient was asymptomatic for the following 20 years. He then noticed a slow-growing swelling of the left thigh associated with a degree of weakness. Radiographs of the femur 25 years after fracture stabilization showed a massive expansive osteolytic process surrounded by a rim of bone. magnetic resonance imaging (MRI) confirmed the presence of a large tumor. Since malignancy could not be excluded the patient underwent incisional biopsy. The histologic findings were nonspecific. Because of persistent symptoms the lesion was marginally excised. Intraoperatively a folded cotton sponge was found adjacent to the femur. Histopathologic investigation confirmed a foreign body reaction probably related to the retained cotton sponge. Reactive, foreign-body-induced change may mimic bone and or soft tissue malignancies.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
8/103. Primary leiomyosarcoma with the invasion into the intertrabecular space of bone: a case report and the review of the literatures.Primary leiomyosarcoma of bone is very rare. Most of reported cases were osteolytic. We report a primary leiomyosarcoma arising from the neck of the femur of a 43-year-old woman who had no remarkable abnormalities on plain radiographs. magnetic resonance imaging (MRI) clearly depicted the lesion. biopsy revealed it leiomyosarcoma. Gynecological and gastrointestinal examinations ruled out metastatic leiomyosarcoma. Wide excision of the tumor was performed and followed by endoprosthetic replacement of the proximal femur. Microscopic examination revealed tumor cells infiltrating into the intertrabecular space.- - - - - - - - - - ranking = 0.019967532472885keywords = neck (Clic here for more details about this article) |
9/103. Pathological fracture complicating epidural local anaesthetic opioid infusion for cancer pain.Two cases of severe bone pains from metastatic cancer, without clinical or radiological evidence of fractures on admission, are presented. pain control and mobilization were achieved initially with local anaesthetic-opioid epidural infusion. Subsequent loss of analgesia prompted a re-examination, which revealed pathological fractures of the femur. Internal fixation of the fractures resulted in good control such that strong opioids were no longer required.- - - - - - - - - - ranking = 3.5keywords = fracture (Clic here for more details about this article) |
10/103. Metal-associated angiosarcoma of bone: report of two cases and review of the literature.Angiosarcoma is an extremely rare bone tumor. The authors report two cases of patients with angiosarcoma that developed adjacent to a stainless steel plate used for fixation of a femur fracture. In both patients, the interval between fracture treatment and the development of the neoplasm was more than 40 years. A review of the literature found 36 previously reported cases of malignancy arising adjacent to an orthopaedic implant. Despite any evidence directly linking these implants to the development of cancer, continued vigilance is warranted.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
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