1/361. Basal cell carcinoma with massive ossification.We report a case of basal cell carcinoma with massive ossification in a 66-year-old white man. Ossification in various benign and malignant neoplasms have been reported including basal cell carcinomas, in which ossifications are seen in small foci or peripheral rim of the tumor. However, in our case, massive ossification is seen throughout the tumor, and only small areas of the periphery of the tumor show diagnostic histology. Therefore, this case might have presented a diagnostic difficulty or been misdiagnosed as an osteoma cutis if a smaller incisional or punch biopsy had been performed. The phenomenon of bone formation itself is not specific for any diagnostic entity, and therefore an underlying lesion should be carefully sought in case of secondary ossification.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
2/361. spinal cord compression caused by unusual location and extension of ossified ligamenta flava in a Caucasian male. A case report and literature review.STUDY DESIGN: A case report of a spinal cord compression caused by ossification of the ligamenta flava is presented together with a review of the literature. OBJECTIVE: To present the diagnosis of ossification of the ligamenta flava in a Caucasian man with a proximal thoracic myelopathy. SUMMARY OF BACKGROUND DATA: This case shows that the upper parts of the thoracic spine can be involved in ossification of the ligamenta flava, which never before has been reported in Caucasian individuals. Furthermore, it is advised that computed tomography scanning and magnetic resonance imaging be combined to provide an accurate diagnosis and proper preoperative evaluation of the bony changes, spinal cord, and compression of the spinal cord. methods: A patient with a thoracic spinal cord compression caused by ossification of the ligamenta flava was treated surgically and made a good clinical recovery. Imaging studies, surgical findings, and results of histopathologic investigations were analyzed to substantiate the diagnosis. RESULTS: The results of the surgical findings seemed to be in contrast with those of the imaging studies. This contrast was occasioned by the uncommon perioperative finding of a fusion of the completely ossified upper and lower parts of the involved adjacent ligamenta flava. Ossification of the ligamenta flava was diagnosed by histopathologic examination, which revealed endochondral ossification and lamellar bone formation without fragments of ligamenta flava. CONCLUSION: Although rarely reported in whites, ossification of the ligamenta flava should be considered in all patients presenting with a spinal cord compression, even at high thoracic levels. The prognosis after decompressive surgery can be good, especially if intramedullary hyperintensities are absent on preoperatively performed T2-weighted magnetic resonance images.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
3/361. Ossified intratesticular mucinous tumor.We report a case of an ossified primary intratesticular mucinous tumor in a 69-year-old man, which was discovered incidentally during a consultation for erectile dysfunction. The 7.5 x 4.8 x 4-cm, predominantly solid, and partially cystic mass completely replaced the testis with no extension to tunica albuginea and epididymis. The multiloculated area was mostly covered by a single layer of bland mucinous epithelium with few areas of epithelial tufting, stratification, and nuclear atypia. The solid areas consisted of mature bone and fibrous stroma with cholesterol clefts, some multinucleated giant cells, moderate infiltration of lymphocytes, and foamy vacuolated macrophages. The bone showed occasional rimming of osteoblasts and rare osteoclasts. Rare foci of mature bone were found in the nonfibrosed wall and lumen cysts. The patient is alive and well 3 years after right orchiectomy with spermatic cord resection.- - - - - - - - - - ranking = 3keywords = bone (Clic here for more details about this article) |
4/361. Fibro-osseous lesions of the external auditory canal.OBJECTIVES: To differentiate a novel type of benign circumscribed bone lesion of the external auditory canal from those described previously, such as exostoses and osteomas. STUDY DESIGN: Information was obtained from computed tomography (CT) images, surgical findings, and pathologic study. methods: Five patients (26 to 82 years old) who presented a hard, round, unilateral, skin-covered mass occluding the external auditory canal to varying degrees were studied. A CT study carried out before resection of the lesions by curettage disclosed the absence of a bony connection to the underlying structures. All the tissue specimens underwent pathologic study. RESULTS: CT and surgical findings demonstrated the absence of a connective pedicle. The pathologic findings showed lesions consisting of an osteoma-like bone formation with sparse osteoblastic areas; mature lamellar bone was observed in three cases, bone marrow containing adipose tissue and hematopoietic remnants in two, and a dense, collagenous stroma in another. They all showed irregular trabeculae, bordered by osteoid osteoblasts. In no case was there evidence of a relationship to the cartilaginous tissue or to the bony structures of the external auditory canal. CONCLUSIONS: The data obtained from the clinical, CT, surgical, and pathologic findings suggest the existence of a lesion unlike those previously known, possibly related to ossifying reactions in other parts of the organism.- - - - - - - - - - ranking = 4keywords = bone (Clic here for more details about this article) |
5/361. Preoperative interactive 2D-3D computed tomography assessment of heterotopic bone.Total hip arthroplasty is a common orthopaedic procedure in this country. Postoperative heterotopic bone formation may be seen in anywhere from 5% to 76% of such procedures. Only a small subgroup of these patients are symptomatic. Approximately 6% of arthroplasty patients require evaluation of heterotopic bone. In such patients, computed tomography may be useful in staging the extent of bone formation and in helping to plan surgical or radiotherapy treatment. Reformatting transaxial data into coronal and sagittal planar images and into simulated three-dimensional images provides the most comprehensive overview and maximizes communication of relevant findings.- - - - - - - - - - ranking = 7keywords = bone (Clic here for more details about this article) |
6/361. Elongated stylohyoid process: a report of three cases.The stylohyoid process is part of the stylohyoid chain--the styloid process, the stylohyoid ligament, and the lesser cornu of the hyoid bone. The stylohyoid chain is derived from the second branchial arch. Mineralisation of the stylohyoid ligament and ossification at the tip may increase the length of the styloid process. An elongated stylohyoid or styloid process is considered to be the source of craniofacial and cervical pain commonly known as Eagle's syndrome. In some instances the stylohyoid process may be considerably elongated, yet remain asymptomatic. This paper reports three patients with elongated stylohyoid processes discovered incidentally on routine radiographic examination.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
7/361. Implantation of the CLARION cochlear implant in an ossified cochlea.This report describes the successful implantation of the CLARION Multi-Strategy Cochlear Implant electrode in the totally ossified cochlea of a 5-year-old child via a radical mastoidectomy approach. Postoperatively, the child demonstrated responses to auditory stimuli, even though the electrode array contacted only bone and muscle graft tissue with no visible evidence of nerve fibers or cochlear lumen. Responses to sound did not begin to emerge until 10 weeks following initial stimulation and improved slowly over time. Although the child's postoperative auditory performance is more limited than that of most implanted children, she derives substantially more benefit from her implant than she did from conventional hearing aids.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
8/361. Heterotopic bone formation in association with pelvic fracture and urethral disruption.PURPOSE: The initial and secondary management of pelvic fracture associated with disruption of the membranous urethra is the subject of a wide literature containing varied and controversial viewpoints. We have noted the presence of heterotopic bone formation surrounding the area of urethral injury in patients undergoing delayed repair. We investigated the etiology, incidence and risk factors associated with such an injury, as well as potential means of prophylaxis. MATERIALS AND methods: We reviewed the current literature on heterotopic bone formation with similar traumatic injury. While instances of severe urethral disruption of this type are fortunately rare in children we describe prepubertal boys with such an injury complicated by heterotopic ossification. RESULTS: The incidence of heterotopic ossification reported in children and adolescents is 3 to 15%, which is less than 15 to 80% reported in adults. risk factors associated with traumatic heterotopic ossification include prolonged operating time, hematoma formation, degree of bony debris, devitalized muscle and concomitant infection. Prophylaxis with single low dose radiation or nonsteroidal anti-inflammatory drugs has been shown to be effective in the prevention of heterotopic ossification and may be beneficial in this patient population. CONCLUSIONS: Heterotopic bone formation associated with severe traumatic injury in the presence of devitalized tissue resulting in the pathological formation of new bone is rare. This complication is only associated with the most severe pelvic fractures. Prophylaxis in these most severe cases with low dose radiation or nonsteroidal anti-inflammatory drugs can prevent the formation of heterotopic bone.- - - - - - - - - - ranking = 9keywords = bone (Clic here for more details about this article) |
9/361. Current therapy in the management of heterotopic ossification of the elbow: a review with case studies.Heterotopic ossification, or the appearance of ectopic bone in para-articular soft tissues after surgery, immobilization, or trauma, complicates the surgical and physiatric management of injured joints. The chief symptoms of heterotopic ossification are joint and muscle pain and a compromised range of motion. Current therapies for prevention or treatment of heterotopic ossification include surgery, physical therapy, radiation therapy, and medical management. Unlike heterotopic ossification of the hip, heterotopic ossification of the elbow has not been extensively investigated, leaving its optimal management ill-defined. To remedy this deficiency, we review risk factors, clinical anatomy, physical findings, proposed mechanisms, and current practice for treatment and prevention of heterotopic ossification. We then consider and draw conclusions from four cases of elbow injury treated at our institutions (three complicated by heterotopic ossification) in which treatment included surgery, radiation therapy, physical therapy, and medical therapy. We summarize our institutional practices and conclude with a call for a randomized clinical trial to better define optimal management of heterotopic ossification of the elbow.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
10/361. Juvenile ossifying fibroma: an ultrastructural study.The ultrastructural features of a juvenile ossifying fibroma of the maxilla are described. The stromal portion of the tumor was composed of osteoblasts and to a lesser extent of fibroblasts. The bone spicules were rimmed by osteoblasts and osteoclasts. Calcification was seen to occur along the collagen fiber matrix, corresponding to calcification of osteoid, and also in the form of intracellular and extracellular crystallization. The latter form of calcification corresponded to so-called psammoma-like bodies, and was considered characteristic of this subtype of ossifying fibroma.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
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