Cases reported "Bone Neoplasms"

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1/387. A rotating-hinge knee replacement for malignant tumors of the femur and tibia.

    We evaluated the 2- to 7-year results of a rotating-hinge knee replacement after excision of malignant tumors of the knee joint. There were 25 distal femoral and 7 proximal tibial replacements. The 5-year prosthetic survival for distal femoral replacements was 88%, compared with 58% for proximal tibial replacements. Seven patients underwent prosthetic exchange: 1 for aseptic loosening, 2 for wound slough and perioperative infection, and 4 for articulating component failure. One patient underwent above-knee amputation owing to skin necrosis. The median functional scores at the latest follow-up were 27 by the International Society of limb salvage evaluation system and 80 by the Hospital for Special Surgery Knee Score system. This implant is a promising choice for joint reconstruction after excision of tumors at the knee joint.
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2/387. Intracortical osteoblastic osteosarcoma with oncogenic rickets.

    Intracortical osteosarcoma is the rarest variant of osteosarcoma, occurring within, and usually confined to, the cortical bone. Oncogenic osteomalacia, or rickets, is an unusual clinicopathologic entity in which vitamin d-resistant osteomalacia, or rickets, occurs in association with some tumors of soft tissue or bone. We present a case of oncogenic rickets associated with intracortical osteosarcoma of the tibia in a 9-year-old boy, whose roentgenographic abnormalities of rickets disappeared and pertinent laboratory data except for serum alkaline phosphatase became normal after surgical resection of the tumor. Histologically, the tumor was an osteosarcoma with a prominent osteoblastic pattern. An unusual microscopic feature was the presence of matrix mineralization showing rounded calcified structures (calcified spherules). Benign osteoblastic tumors, such as osteoid osteoma and osteoblastoma, must be considered in the differential diagnosis because of the relatively low cellular atypia and mitotic activity of this tumor. The infiltrating pattern with destruction or engulfment of normal bone is a major clue to the correct diagnosis of intracortical osteosarcoma. The co-existing radiographic changes of rickets were due to the intracortical osteosarcoma.
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keywords = tibia
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3/387. Doppler duplex color localization of osteoid osteomas.

    We present two cases of osteoid osteoma in adolescent boys. The lesions were located in the proximal metaphysis of the right tibia and left femoral diaphysis respectively. Doppler duplex color study demonstrated clearly the highly vascular nidus and its feeding artery in one case and only the feeding artery in the second. We believe these are the first descriptions of osteoid osteomas assessed with Doppler duplex color, which was also used as guidance for the percutaneous localization and biopsy.
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keywords = tibia
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4/387. Hemorrhagic epithelioid and spindle cell hemangioma: a newly recognized, unique vascular tumor of bone.

    BACKGROUND: Epithelioid vascular tumors of bone are uncommon and include epithelioid hemangioma, epithelioid hemangioendothelioma, and epithelioid angiosarcoma. It is important to distinguish among them because they have significantly different biologic potential and require different forms of therapy. In the current study the authors describe six cases of a distinct benign epithelioid and spindle cell vascular tumor of bone that, because of their unusual morphology, were confused with aggressive vascular neoplasms. methods: Cases were retrieved from the surgical pathology files of the Department of pathology or from the consultation files of one of the authors. hematoxylin and eosin stained slides were examined. immunohistochemistry was performed on two cases and electron microscopy was performed on one case. RESULTS: The tumors arose in the small bones of the hands and feet and the tibia. Three patients had multifocal bone disease at the time of presentation. Histologically, all lesions were comprised of lobules of spindle cells that grew focally in a fascicular pattern and were associated with abundant hemorrhage. Plump epithelioid cells were intermixed and were present focally in the interlobular areas as well, in which they lined larger, more well developed vascular spaces, often protruding into the vascular lumen in a "tombstone" fashion. Immunohistochemically and ultrastructurally the neoplastic cells had features of endothelium. One case was treated by amputation, one by resection, three by curettage, and one by curettage plus radiation therapy. None of the lesions was locally aggressive nor did any metastasize. CONCLUSIONS: The authors believe that hemorrhagic epithelioid and spindle cell hemangioma of bone is a histologically benign bone tumor. It should be distinguished from malignant epithelioid vascular tumors of bone, which have metastatic potential and need to be treated more aggressively.
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keywords = tibia
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5/387. Primary epithelioid leiomyosarcoma of bone. Case report and literature review.

    We describe an epithelioid leiomyosarcoma of bone located in the right knee of a 51-year-old woman. Plain radiograph and CT scan revealed a poorly defined lytic and destructive mass in the upper metaepiphyseal right tibia which involved surrounding soft tissues. The lesion was composed of proliferating monotonous round cells with a high mitotic activity with scanty intersecting spindle cell fascicles. immunohistochemistry of both areas demonstrated a strong positivity for actin (HHF-35 and alpha-SMA) and vimentin, and negative reactions for desmin, keratin (AE1 AE3), epithelial membrane antigen, S-100 protein, factor viii-related antigen, CD 31 and CD 34. Ultrastructural study confirmed a diagnosis of leiomyosarcoma. This is the first detailed description of the microscopic and radiological features of primary epithelioid leiomyosarcoma of bone.
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keywords = tibia
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6/387. Acetabular osteoblastoma: description of a case.

    osteoblastoma is a slow-progressing, benign bone tumor, that is not frequently observed in clinical orthopaedics (approximately 1% of all primary bone tumors). There is predilection for the vertebrae (posterior arch), the femur, the tibia, and the cranium; it affects young subjects (from 10 to 35 years), with predilection for males (males: females = 2:1). Symptoms are not very specific, characterized essentially by moderate, discontinuous pain, that is responsive to treatment by NSAIDS; it may, at times, be asymptomatic. On radiographic assessment it is viewed as a lytic area that is rounded, greater than 2 cm in size, with unclear margins, with or without peripheral bone reaction. It is not easy to diagnose osteoblastoma, particularly if it is localized in unusual sites, such as in the pelvis. The authors present a case of osteoblastoma of the acetabular bottom in a subject aged 22 years, that was not diagnosed unrecognized for about 2 years from the onset of symptoms.
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keywords = tibia
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7/387. An extra-articular cause of locking knee.

    We report an uncommon case of locking of the knee in a 23-year-old girl. It was due to an osteochondroma at the medial aspect of the proximal tibia.
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keywords = tibia
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8/387. Malignant haemangioendothelioma of bone in a HbSC disease patient--a case report.

    We report here a 35-year-old man with sickle cell disease (SCD), who presented in 1989 with pain in the (R) hip of 7 years duration and swelling of the (R) calf of 3 months duration. Clinical examination revealed a hard tender mass in the (R) calf. histology of the (R) calf mass revealed haemangioendothelioma (HE), similar to the histology of the (R) iliac bone mass obtained in another institution previously. He was treated with external radiotherapy with the 1.25 megavoltage beam to antero-posterior fields of the (R) hemipelvis and (R) calf, with good response. Chemotherapy was subsequently administered using 6 cycles of VAC regime. The patient remained in remission for 12 months. In 1991 he had lymphoedema of (R) lower limb and received further radiotherapy and chemotherapy after an isotope bone scan had revealed disease activity in the (R) hemipelvis, (R) femur and (L) upper tibia. He responded again with complete regression of the lymphoedema and remained well until April 1993 when the lymphoedema recurred. He died while being evaluated for further treatment. Although there is no evidence to suggest that SCD confers any protection from development of neoplasms, the co-existence of SCD with a neoplasm is not common. We consider the occurrence of HE of bone, a rare malignancy, in a HbSC patient worthy of reporting.
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keywords = tibia
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9/387. Primary lymphoma of the calcaneus with recurrence in the distal tibia: a case report.

    Primary lymphoma of bone in general is a very rare condition which represents approximately 3% of all primary malignant bone tumors. Of these, less than 1% originate in the foot. The following case presentation demonstrates a patient who presented with primary lymphoma of the calcaneus, diagnosed by open bone biopsy and treated with radiation therapy. The patient remained disease free for almost 3 years, at which time recurrence to the contralateral distal tibia was diagnosed again through open biopsy.
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keywords = tibia
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10/387. Dysplasia epiphysealis hemimelica of the proximal tibia showing epiphyseal osteochondroma in an adult.

    A 33-year-old woman was referred to our hospital complaining of pain and a tumorous lesion in her left knee joint in the absence of any history of trauma. Radiological examinations demonstrated an osseous mass originating from the epiphysis of the proximal tibia, with a continuous osteoblastic lesion involving the lateral half of the epiphysis. The pathological diagnosis of these lesions was compatible with that of osteochondroma. The clinical and pathological features of this case were considered to be identical with those of dysplasia epiphysealis hemimelica, although this patient was older than patients described in previous reports, and demonstrated no other symptoms such as valgus or varus deformity or limb-length discrepancy.
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ranking = 0.83333333333333
keywords = tibia
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