Cases reported "Osteolysis"

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21/540. Mesenteric venous thrombosis attributed to docetaxel.

    We present a case of a 57-year-old woman with metastatic breast cancer unresponsive to several chemotherapeutic and hormonal regimens. Because of progressive pulmonary metastases and a painful osteolytic metastasis in the sternum, treatment with docetaxel was initiated. She developed mesenteric venous thrombosis within 1 week after the first dose of docetaxel. Although docetaxel may be regarded as an important advancement in the chemotherapeutic treatment of several cancers, ongoing and future trials must assess its position in the standard chemotherapeutic treatment of cancer. Well-documented adverse reactions, either common or rare, may contribute to a balanced risk-benefit profile of docetaxel. ( info)

22/540. Destructive hip disease complicating traumatic paraplegia.

    Recent progress in the management of spinal cord injury has provided longer survivals, and as a result the incidence of secondary bone and joint disorders has increased. Joint lesions due to syringomyelia complicating a cervical spinal cord injury are the most common of these disorders. We report a case of destructive hip disease 7 years after an injury responsible for complete paraplegia with sensory loss. The joint lesions were painless, and there was no local evidence of inflammation. hip radiographs disclosed atrophic osteoarthropathy with complete destruction of the femoral neck and head. This unusual case raises questions about the pathophysiology of neuropathic osteoarthropathy in paraplegics. ( info)

23/540. Underestimation of pelvic osteolysis: the value of the iliac oblique radiograph.

    Periacetabular osteolysis is recognized as a complication of cementless total hip arthroplasty. Routine follow-up radiographs are recommended by most joint reconstructive surgeons to detect osteolytic lesions that may remain asymptomatic. These studies usually consist of an anteroposterior (AP) pelvic and lateral radiograph of the hip. Three male cadaver pelves were used to evaluate whether a routine AP pelvic radiograph was adequate to show certain osteolytic lesions. This study involved creation of progressively enlarging defects simulating an osteolytic lesion of the posterior wall. The extent of involvement of the lesion as shown by an AP pelvic radiograph and iliac oblique views was then compared. By the time the posterior column lesion could be estimated to the same extent on both the AP pelvic and iliac oblique radiographs, the lesion had become uncontained in the posterior medial direction. The evaluation of pelvic osteolysis with biplanar imaging provides a 3-dimensional understanding of the lesion. This study shows the inadequacy of a single AP pelvic radiograph in showing and localizing periprosthetic osteolytic lesions in the posterior column. ( info)

24/540. Late recurrence of small-cell lung cancer: a case report.

    A 67-year-old man was admitted with small-cell lung cancer (SCLC). The patient was given four courses of platinum-containing chemotherapy followed by chest irradiation, and good partial response (PR) was obtained. The patient did well for 4 years, until he sought treatment for a painful subcutaneous tumor. Chest computed tomography scan revealed the mass extending from the tumor in lung parenchyma with osteolytic lesion of the third rib bone. Pathologic examination of the subcutaneous lesion revealed SCLC. The patient was given two courses of the same combination chemotherapy administered as initial therapy. Regression of the mass was observed, and the response was evaluated as a good PR. How to approach late recurrence of SCLC is discussed. ( info)

25/540. Non-Hodgkin's lymphoma presenting with osseous lesions.

    Eight cases of non-Hodgkin's lymphoma presenting with bone symptoms are reported. The radiological appearances of these tumours are described. The importance of radiology in differentiating a primary lymphoma of bone from a lymphoma arising from other organs which has subsequently metastasised to the skeleton is briefly discussed. ( info)

26/540. osteosarcoma in blood relatives.

    osteosarcoma is an uncommon tumor. family occurrence of osteosarcoma is even rarer. Four cases of osteosarcoma in two siblings and in a father and son treated at our Institute with surgery and chemotherapy are reported. These patients had no other tumors in their family history, and had negative p53 mutations in exons 5-9 by SSCP analysis. RB, CDK4, MDM2, c-myc, c-fos, and p53 gene expression, which are the major genes involved in osteosarcoma susceptibility, were studied. Our results revealed an inactive form of p53 sporadically seen in the samples, a total loss of Rb protein expression, an increased expression of Cdk4, MDM2, c-fos, and c-myc proteins which literature currently reports being the principal alterations found in osteosarcoma. These findings confirm that specific genetic alterations occur in osteosarcoma pathogenesis. ( info)

27/540. Tumor-like tuberculosis of the sacrum.

    Isolated tuberculosis of the sacrum in a 43-year-old woman manifested as functional impairment of the right lower limb. Sacral tuberculosis is rare in patients with no history of tuberculosis. Another unusual feature was the tumor-like aspect of the lesion, with diffuse, ill-defined osteolysis of a large part of the sacrum and extension to the presacral soft tissues responsible for rectal displacement. ( info)

28/540. Chronic cerebrospinal fluid leak into skull base causing intramedullary osteolysis.

    We present the rare case of a 74-year-old woman with extensive intramedullary osteolysis of the petroclival skull base straddling both sides of the basi-occiput and basi-sphenoid. She presented with clinical features of recurrent spontaneous cerebrospinal fluid (CSF) otorrhoea despite three previous attempts at repair of the CSF leak. Recent advances in imaging techniques enable accurate radiological diagnosis of skull base lesions. We performed T1- and T2-weighted magnetic resonance (MR) images, a fluid attenuated inversion recovery (FLAIR) sequence MR, and a diffusion scan to study the characteristics of the skull base pathology. This revealed extensive osteolysis, with cystic spaces within the clivus and the petrous pyramid extending also to the basi-occiput. The leak was sealed using the technique of subtotal petrosectomy with obliteration of the eustachian tube and blind pit closure of the ear canal. The patient has been followed up for six months with no recurrence of symptoms. ( info)

29/540. Early failure associated with the use of Hylamer-M spacers in three primary AMK total knee arthroplasties.

    We report 3 cases of early failure associated with AMK total knee arthroplasties with the use of Hylamer-M spacers. In 2 of these cases, massive osteolysis of the posterior condyles was noted; revision with the use of allograft bone to fill in the cavitary defects yielded excellent results. In all cases, large areas of pitting and delamination of the Hylamer spacers were noted. Given these cases and the previous literature on early failure of hip arthroplasties with Hylamer inserts, we recommend caution in using Hylamer for knee arthroplasty surgery. ( info)

30/540. 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. ( info)
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