1/25. Highly aggressive brown tumour of the maxilla as first manifestation of primary hyperparathyroidism.A case is presented of a 62-year-old man with a right maxillary swelling for the previous three months. The lesion was expansive and osteolytic, with invasion of the adjacent maxillary sinus, nasal and pterygomaxillary fossae and floor of the orbit. histology revealed the presence of an intrabony giant cell lesion. blood tests demonstrated elevations in calcium (16.2 mg/dl) and parathyroid hormone (PTH) concentrations (841 pg/ml). This suggested the diagnosis of hyperparathyroidism initially manifesting as a brown tumour of the maxilla. Posterior explorations confirmed the existence of an underlying ectopic parathyroid adenoma as the cause of the condition.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/25. Extensive osteolytic cystlike area associated with polyethylene wear debris adjacent to an aseptic, stable, uncemented unicompartmental knee prosthesis: case report.We present the case of a patient who after uncemented unicompartmental knee arthroplasty developed a large osteolytic cystlike area in the lateral aspect of the tibial metaphysis, contralateral to a well-fixed tibial component at revision surgery. The lesion contained fibrotic soft tissue, evidence of a foreign-body giant cell reaction and polyethylene particles, but no metal wear debris, infection, or malignancy. This case demonstrates that there is a direct communication between the joint cavity and the cyst.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/25. Fine-needle aspiration biopsy of solid aneurysmal bone cyst in the humerus.We report the fine-needle aspiration biopsy (FNAB) cytology findings of a solid aneurysmal bone cyst in the left humerus of a 69-yr-old woman. Radiographically, the lesion showed an extensive, relatively well-defined osteolysis in the diaphysis, with a pathologic fracture. FNAB smears of the lesion consisted of benign, mononuclear cells and numerous osteoclast-like multinucleated giant cells. Some clusters of the mononuclear cells were closely associated with dense, homogeneous, extracellular, matrix material. To our knowledge, the FNAB features of solid ABC of the long bones have not been described previously in the English-language literature. The cytologic features are indistinguishable from those of giant cell tumors of bone and brown tumors of hyperparathyroidism.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
4/25. erdheim-chester disease: a unique presentation with liver involvement and vertebral osteolytic lesions.erdheim-chester disease is a very rare xanthogranulomatous, non-Langerhans cell systemic histiocytosis with an unknown etiology and pathogenesis. Histologically, it is characterized by a diffuse infiltration with large, foamy histiocytes, rare Touton-like giant cells, lymphocytic aggregates, and fibrosis. The histiocytes differ from the Langerhans cell group in ontogenesis, immunohistochemistry (positive for CD68 and negative for CD1a and S100 protein), and ultrastructural appearance (lack of Birbeck granules). Although most of the cases have symmetric osteosclerosis of the long bones, an involvement of the axial skeleton has also been described. Extraskeletal lesions are present in more than 50% of the patients and may involve the retroperitoneal space, lungs, kidneys, brain, retro-orbital space, and heart. This study presents the case of a patient with erdheim-chester disease with vertebral destruction and, for the first time, to our knowledge, involvement of the liver. The diagnosis is based on radiologic, histologic, immunohistochemical, and ultrastructural findings.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/25. Benign fibrous histiocytoma of the posterior arch of C1 in a 6-year-old boy: a case report.STUDY DESIGN: Presented is a unique case report of a rare bone tumor: a benign fibrous histiocytoma (BFH) located in the posterior arch of C1 in a 6-year-old child. OBJECTIVE: To describe a benign fibrous histiocytoma of bone and the differential diagnostic considerations based on the authors' case report. SUMMARY OF BACKGROUND DATA: A BFH is a rare tumor composed of varying degree of fibroblast-like spindle cells, foam cells, and multinucleated giant cells. Approximately 86 cases have been reported in literature. Its exact nature remains somewhat controversial. A lesion may be designated a benign fibrous histiocytoma based on clinical, radiographic, and microscopic criteria. MATERIALS AND methods: The clinical symptoms, plain radiographs, computerized tomography (CT), magnetic resonance images (MRI), bone scintigraphy, and histologic section of the lesion are discussed, evaluated, and compared with other benign bone lesions. RESULTS: This case is, to the best of the authors' knowledge, the first benign fibrous histiocytoma to be reported in the cervical spine of a child. Various benign lesions such as nonossifying fibroma, giant-cell tumor, fibrous dysplasia, aneurysmal bone cyst, osteoblastoma, and eosinophilic granuloma are included in the differential diagnosis. CONCLUSION: Benign fibrous histiocytoma is a rare skeletal tumor. Because of this and its nonpathognomonic microscopic features, the diagnosis can be somewhat troublesome. However, by systematically reviewing patient's symptoms, tumor location, and radiographic and microscopic characteristics, other benign lesions can be eliminated. The diagnosis of a BFH is one of exclusion.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/25. Vertebral localization of a brown tumor: description of a case and review of the literature.The authors report a case of a female aged 45 years submitted to a long period of hemodialysis, affected with brown tumor of the lumbar spine. Brown tumor must be taken into consideration in the differential diagnosis of osteolytic lesions of the skeleton, particularly in young, nephropathic women undergoing hemodialysis. Brown tumor has a more favorable prognosis as compared to other lesions that have similar clinical and radiographic findings, such as metastatic lesions and giant cell tumors. In the case of brown tumor, in addition to treating lesion of the spine, treatment varying depending on neurological findings and biomechanical complications (structural collapse, segmental kyphosis, pathologic fracture, etc.), removal of the parathyroids and correction of the metabolic alterations is indispensable.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/25. osteolysis after silicone arthroplasty.A young woman with a silicone lunate prosthesis for avascular necrosis developed painful lytic lesions in the distal ulna and the triquetrum. At reoperation, abundant reactive synovitis was found extending into those bone lesions. Histologic examination of the curetting samples revealed granulation tissue with histiocytes and many multinucleated giant cells containing refractile particles consistent with silicone. The authors report a giant cell lesion of the bone that radiographically and microscopically mimicked a neoplasm.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
8/25. Bone scintiscanning in osteolytic lesions.Osteolytic lesions seen on plain radiographs can be caused by various disorders of the bones such as simple bone cyst, aneurysmal bone cyst, plasmacytoma, giant cell tumor, eosinophilic granuloma and tuberculosis. We studied prospectively Tc-99m-methylene diphosphonate bone scan findings in osteolytic lesions seen radiologically and followed them to histopathology. Interestingly, the scans in these patients helped to show if the lesions were monoostotic or polyostotic and, in some cases, ruled out malignant or infective etiology.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/25. Particle disease: cytopathologic findings of an unusual case.Particle disease is a rare lesion that results from an inflammatory response due to wear debris-induced osteolysis following arthroplasty. Particles resulting from the wear debris cause macrophage activation and phagocytosis. Particle disease often leads to joint loosening and implant failure. Radiologically, it often results in a well-defined osteolytic lesion-mimicking tumor. A 68-year-old man who presented with chronic hip pain following total hip replacement was studied by fine-needle aspiration. An ultrasound-guided aspiration revealed hypercellular smears consisting predominantly of proliferating mesenchymal cells, foamy macrophages, inflammatory cells, and background acellular debris. Numerous multinucleated giant cells were observed as well. Differential diagnosis includes primary or metastatic clear-cell tumors.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/25. Solid variant of aneurysmal bone cyst of the cervical spine.STUDY DESIGN: A case of the solid variant of aneurysmal bone cyst affecting the posterior component of the fourth cervical vertebra is reported. Imaging studies showed an expansile destructive lesion. After curettage, autologous iliac bone grafting with posterior fusion was performed. There was no sign of local recurrence 2 years after surgery. OBJECTIVES: To emphasize the occurrence of the solid variant of aneurysmal bone cyst in the cervical spine. SUMMARY OF BACKGROUND DATA: The solid variant of aneurysmal bone cyst is rare, and only 12 cases occurring in the vertebrae, including 3 in the cervical vertebrae, have been reported. The condition is difficult to diagnose radiologically before biopsy or surgery. methods: A 9-year-old girl presented with pain in the nape of the neck without any neurologic deficit. She was found to have the solid variant of aneurysmal bone cyst in the posterior component of the fourth cervical vertebra, which had destroyed the lamina and spinous process. Part of the posterior aspect of the C4 vertebral body was also involved. curettage of the lesion was performed, and the defect in the posterior component of the vertebra was reconstructed using an autologous iliac bone graft with posterior fusion using a halo vest. RESULTS: magnetic resonance imaging disclosed a homogeneous low intensity mass at the lamina, spinous process, and vertebral body of C4 on T1-weighted images. The mass showed heterogeneous high signal intensity on Gd-enhanced images. Histologically, the resected specimen showed predominant fibroblastic proliferation, with minor foci of reactive osteoid formation and an area of osteoclast-like giant cells. Neither cellular atypia nor mitotic figures were evident. There was no sign of local recurrence 2 years after surgery. CONCLUSIONS: The solid variant of aneurysmal bone cyst should be included in the differential diagnosis of any lytic expansile lesion of the spine, even though it is a destructive lesion. Gd-enhanced magnetic resonance imaging may be helpful for distinguishing the solid variant from conventional aneurysmal bone cyst.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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