Cases reported "Osteolysis"

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1/8. Seventeen-year follow-up of massive osteolysis of the scapula.

    A 14-year-old boy with massive osteolysis of the right scapula was treated by irradiation with a total dose of 58 Gy, using cobalt 60 (2 Gy per fraction) in 1983 and 1984. Histopathology in a biopsy specimen revealed hemangiomatosis associated with few osteoclasts and a lining of oval or spindle-shaped endothelial-like cells. The osteolysis has been interrupted since the last irradiation. In January 2000, 17 years after the initial treatment, the patient is working as a public officer, and shows no clinical signs of postradiation sarcoma. Radiographs show a residual scapula with sclerotic margin, associated with marked hypoplasia and atrophy of the right humerus. Ranges of motion of the right shoulder are 100 degrees on anterior elevation, 40 degrees on posterior elevation, and 70 degrees on abduction. The patient experiences no problems in daily living, except for difficulty in lifting.
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ranking = 1
keywords = angiomatosis
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2/8. Use of bisphosphonate to manage avulsion fracture of tibial tuberosity with underlying angiomatosis: a case report.

    An unusual case of avulsion fracture of the tibial tuberosity with underlying angiomatosis in a middle-aged man is described, with particular emphasis on the successful use of bisphosphonate in its treatment and the value of serial dual energy X-ray absorptiometry in its subsequent disease monitoring. This case illustrates the importance of careful correlation of the clinical, radiological, and histological findings in the management of skeletal tumour and tumour-like lesions. The differential diagnosis of osteolysis with vascular ectasia is discussed.
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ranking = 5
keywords = angiomatosis
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3/8. Disappearing calvarium in Gorham disease: MR imaging characteristics with pathologic correlation.

    Gorham disease is a rare condition characterized by intraosseous neoplastic proliferation of hemangiomatous tissue with progressive, massive osteolysis. We present a pathologically proved case of Gorham disease that involved the left parietal bone in a 23-year-old man. Imaging studies including conventional radiography of the skull, CT, MR imaging, and technetium-99 m (Tc-99 m) scintigraphy demonstrated a large skull defect without associated soft tissue mass over the left parietal skull. Contrast enhancement and increased isotope uptake along the margin of the defect were shown at gadolinium-enhanced T1-weighted MR imaging and Tc-99 m methylene diphosphate (Tc-99 m MDP) bone scintigraphy. Pathologic study revealed intraosseous angiomatosis at the periphery of the osteolytic skull lesion.
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ranking = 1
keywords = angiomatosis
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4/8. Bone lymphangiomatosis: treatment with percutaneous cementoplasty.

    STUDY DESIGN: Case report, minimally invasive technique. OBJECTIVES: Disseminated lymphangiomatosis is a rare disorder that can produce clinical manifestation secondary to soft tissue, visceral and bone involvement. The overall prognosis of this disorder is usually poor, and the current treatment options for its sequelae are limited and only palliative. In this report, we present the use of cementoplasty in the percutaneous treatment of a sacral lymphangiomatous bone lesion producing severe pain. SUMMARY OF BACKGROUND DATA: Disseminated lymphangiomatosis is a rare disorder that can produce clinical manifestation secondary to soft tissue, visceral, and bone involvement. Major morbidity related to skeletal involvement requiring surgical intervention is less common than that related to visceral involvement, but it has been reported in a few case reports to palliate neurologic sequelae secondary to vertebral involvement. We present case of osteoplasty used to treat a painful osteolytic sacral lesion in a patient with diffuse lymphangiomatosis. Computed tomography guided osteoplasty injecting acrylic bone cement into the lesion resulted in almost immediate reduction in pain. methods: The technique and results of minimally invasive percutaneous computed tomography-guided cementoplasty of a painful osteolytic sacral lesion resulting from chylous reflux in a patient with lymphangiomatosis is presented. RESULTS: Computed tomography was used to accurately position a 13-gauge needle into a dominant sacral osteolytic lesion. The injection of bone cement into the sacral lesion was then monitored by intermittent CT imaging. The patient reported substantial pain relief within several hours of the procedure. CONCLUSION: The case presented demonstrates the feasibility and efficacy of computed tomography-guided cementoplasty used to palliate unusual causes of benign osteolytic bone lesions. These procedures can be performed as outpatients with minimal recovery.
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ranking = 8
keywords = angiomatosis
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5/8. Lymphangiomatosis of the arm with massive osteolysis. A case report.

    A case of massive osteolysis of the arm is described where the typical bony lesions were associated with soft tissue lymphangiomatosis.
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ranking = 5
keywords = angiomatosis
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6/8. "Disappearing bone disease" in the hand.

    "Disappearing bone disease" is a rare entity that is characterized by extensive osteolysis associated with hemangiomatosis. A case affecting a 13-year-old girl, with wide-spread hand involvement is reported. She did not respond to bone grafting but the condition was arrested after a course of radiation therapy.
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ranking = 1
keywords = angiomatosis
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7/8. Lymphangiomatosis and massive osteolysis of the cervical spine. A case report and review of the literature.

    On the basis of clinical, radiographic, and pathologic evidence, massive osteolysis can be divided into two forms: Gorham's disease and angiomatosis. The present case is the first report of massive osteolysis of the lymphangiomatosis type involving the cervical spine but without visceral involvement. Originally, plain lymphangiomatosis was diagnosed, but the diagnosis was changed to massive osteolysis. Only one other case of lymphangiomatosis with cervical involvement was found, but in that case the viscera were also involved. Both cases exemplify a prolonged progressive pattern, recalcitrant to treatment and with a devastating outcome. diagnosis by biopsy is difficult, and incremental radiation therapy early in the disease process should be considered.
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ranking = 8
keywords = angiomatosis
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8/8. Cystic angiomatosis of bone with massive osteolysis of the cervical spine.

    The case of a 2 1/2-year-old boy with diffuse cystic angiomatosis of bone is presented. No evidence of visceral involvement was recorded. The clinical, radiographic and histologic findings during the course of the disease process are discussed. At the age of 15 years the patient died of neurologic alterations developed due to massive osteolysis and collapse of the cervical spine, and severe dyspnoea, secondary to persistent bilateral pleural effusions.
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ranking = 5
keywords = angiomatosis
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