Cases reported "Chondrosarcoma"

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1/20. Parachordoma of the tibia: report of a rare case.

    We report a case of recurrent parachordoma of the left anterior tibial region in a 64-year-old male patient. The tumor was a periosteal tender mass, and, histologically, displayed vague nodules of spindle to rounded eosinophilic cells embedded in a myxoid matrix. Large vacuolated (physalphorouslike) cells were noted as in sacrococcygeal chordoma. This tumor should be differentiated from myxoid chondrosarcoma, myxoid liposarcoma, chondromyxoid fibroma, and metastatic chordoma. The presence of physaliphorous cells in the tumor with positive immunoreactions caused by cytokeratin rules out the diagnosis of another myxoid tumor. The differential diagnosis from metastatic chordoma is basically made by clinicians. Even though parachordoma is usually regarded as a benign soft tissue neoplasm, two recurrences occurred in our case. Since the reported cases, including ours, have diverse clinical courses, it is essential to follow-up the patient carefully.
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2/20. Malignant progression in multiple enchondromatosis (Ollier's disease): an autopsy-based molecular genetic study.

    Multiple enchondromatosis (Ollier's disease) is a nonhereditary disease characterized by multiple central (medullary) cartilaginous bone tumors of unknown pathogenesis. It usually involves the extremities with a unilateral predominance, and sarcomatous transformation may occur. We report an autopsy-based genetic study of a 34-year-old man presenting in early adolescence with multiple enchondromas of the extremities, predominantly left-sided, compatible with Ollier's disease. Twelve years after presentation, malignant transformation to a high grade chondrosarcoma occurred in a tibial enchondroma. The patient died after widespread metastatic disease. loss of heterozygosity (LOH), in the tibial chondrosarcoma and its metastases, was identified exclusively on chromosome bands 13q14 and 9p21, while being absent in the femoral enchondroma analyzed. Similarly, p53 overexpression was identified immunohistochemically in the tibial chondrosarcoma and its metastases, while being absent in the femoral enchondroma; LOH at 17p13 however, was not demonstrable. It is hypothesized that inactivation of putative tumor suppressor genes at 9p21 and 13q14, and overexpression of p53, identified in the chondrosarcoma and its metastases, but absent in enchondroma, may be related to sarcomatous transformation in Ollier's disease.
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keywords = tibia
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3/20. Extracorporeal irradiation for malignant bone tumors.

    PURPOSE: Extracorporeal irradiation (ECI) has been used selectively in the management of primary malignant bone tumors since 1996. We report our techniques for ECI and the short-term oncologic and orthopedic outcomes. methods AND MATERIALS: Sixteen patients with primary malignant bone tumors were treated with ECI from 1996 to 2000. The median age was 14 years. The histologic diagnoses were Ewing's sarcoma (11), osteosarcoma (4) and chondrosarcoma (1). The treated sites were femur (7), tibia (4), humerus (2), ilium (2), and sacrum (1). Following induction chemotherapy in Ewing's sarcomas and osteosarcoma, en bloc resection of the tumor and tumor-bearing bone was performed. A single dose of 50 Gy was delivered to the bone extracorporeally using either a linear accelerator (9 cases) or a blood product irradiator (7 cases). The orthopedic outcome was recorded using a standard functional scale. RESULTS: At a median follow-up of 19.5 months, there were no cases of local recurrence or graft failure. One patient required amputation due to chronic osteomyelitis. For the 10 patients with follow-up greater than 18 months, the functional outcomes were graded good to excellent. CONCLUSION: The short-term oncologic and orthopedic results are encouraging and suggest that ECI provides a good alternative for reconstruction in limb conservative surgery in selected patients. This technique should only be used in a multidisciplinary setting, where careful follow-up is available to assess the long-term outcomes.
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keywords = tibia
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4/20. Intermediate grade osteosarcoma and chondrosarcoma arising in an osteochondroma. A case report of a patient with hereditary multiple exostoses.

    A 40 year old man with hereditary multiple exostoses (HME), affecting predominantly his left proximal tibia, distal femur, and proximal femur, underwent resection of an osteochondroma near the trochanter major of his left proximal femur because of malignant transformation of the cartilaginous cap towards secondary peripheral chondrosarcoma. The patient had a history of a papillary thyroid carcinoma four years previously. At examination of the resected specimen, a third malignant tumour, an intermediate grade osteosarcoma (grade II/IV), was found in the osseous stalk of the osteochondroma. Although no mutations were found in the EXT1 and EXT2 genes, the genes involved in HME, or in exons 5-8 of the p53 gene, the development of three malignancies before the age of 40 suggests that this patient is genetically prone to malignant transformation.
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keywords = tibia
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5/20. The feasibility of hind foot amputation in selected sarcomas of the foot.

    The treatment of foot sarcomas is generally a below knee amputation. In selected sarcomas of the forefoot, however, a transtarsal amputation according to Chopart, a calcaneotibial arthrodesis according to Pirogoff, or a supramalleolar amputation according to Syme can be considered the treatment of choice, leading to an optimal functional outcome.
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6/20. chondrosarcoma in association with primary hyperparathyroidism.

    We describe two female patients, 66 and 36 years of age, with both primary hyperparathyroidism and chondrosarcoma. Case 1 had a chondrosarcoma of the right scapula, and case 2 had chondrosarcoma of the left proximal tibia. Both patients underwent surgical resection of their chondrosarcoma and subsequent parathyroid surgery. Histological analysis of the excised parathyroid in case 1 showed a parathyroid carcinoma and in case 2 showed a parathyroid adenoma. Including these two patients, there is now a total of six cases that have been reported in the literature describing the association between hyperparathyroidism and bone malignancy. We believe that this small number makes it unlikely that there is an association between these two conditions, although we speculate that there may be an underlying genetic basis.
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keywords = tibia
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7/20. Histological findings in a human autogenous pasteurized bone graft.

    BACKGROUND: Autogenous bone graft after pasteurization is one of the most valuable procedures for reconstruction of large bone defects following excision of malignant musculoskeletal tumors. To date, there have been no documented histological reports on pasteurized bone grafts, apart from short-term histological results. CASE REPORT: We treated a 27-year-old male with a periosteal chondrosarcoma of the tibia by wide excision and reimplantation of the large pasteurized bone. biopsy specimens harvested from the pasteurized bone over 3 years after reimplantation were evaluated histologically. The graft cortices remained totally necrotic with empty osseous lacuna, whereas the architecture of the acellular cortical bones was still maintained without microfractures. Deposited seams of woven bone existed focally on the surface of the acellular trabeculae. CONCLUSION: Our medium-term histological outcome suggests the limitations of incorporating a pasteurized hone graft, but also advocates its role as a useful temporary material for the reconstruction of massive bone defects.
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keywords = tibia
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8/20. Bilateral multiple malignant transformation of Ollier's disease.

    We treated a 26-year-old man with a 19-year history of Ollier's disease. Secondary chondrosarcomas developed metachronously at four separate locations: both femora, left proximal tibia and fibular head. All four lesions were surgically excised, and each specimen was histologically identified as grade 1 or 2 chondrosarcoma. Clinical follow-up for 20 years beginning at the time of first tumor surgery has shown no evidence of local recurrence or metastasis. This is the first report of multiple bilateral metachronous malignant transformation of multiple chondromatoses in a patient with Ollier's disease.
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keywords = tibia
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9/20. chondrosarcoma, lupus anticoagulant and cerebral ischaemia.

    chondrosarcoma is a malignant disease of cartilage. Systemic embolisation usually arises from cancerous invasion of pulmonary vessels or the left atrium but cerebral embolisation or ischaemia is rarely recognised. We report a man with left leg amputation for tibial myxoid chondrosarcoma who suffered multiple cerebral embolisms one year later. cerebral angiography and aortogram did not reveal luminal stenosis and a cardiac survey was normal. Lupus anticoagulant (LAC) and a prolonged activated partial thromboplastin time were detected. A molecular mimicry between prothrombin and paracrine hormones may have accounted for his LAC. A procoagulant autoantibody reacting against metastatic cancer cells may contribute to cancerous thrombosis, such as in chondrosarcoma.
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ranking = 0.2
keywords = tibia
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10/20. Intra-articular recurrence of benign chondroblastoma with articular involvement at initial presentation--a case report.

    We report a case of chondroblastoma involving the upper tibial epiphysis, which had an unusually aggressive course, with articular involvement at initial presentation. Intra-articular and soft tissue recurrence occurred after treatment consisting of curettage and bone grafting. Although the incidence of local intraosseous recurrence of chondroblastoma is relatively high, intra-articular and soft tissue implantation is rare and is usually due to intra-articular spillage during surgery. Spontaneous articular involvement is rarely seen.
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keywords = tibia
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