Cases reported "Sarcoma"

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1/20. Modified dorsalis pedis flap for coverage of a pretibial pressure sore after hip rotationplasty.

    Rotationplasty is a well-established procedure after total femur resection, especially in children. rehabilitation is superior to disarticulation of the hip or hemipelvectomy because patients regain hip and knee function.(1) A tight fit of the prosthetic shaft is essential. The pretibial area has a low physiological resistance to pressure and shear forces, and is thus at increased risk of developing pressure-related complications.skin defects with exposure of skeletal elements require flap coverage. The dorsalis pedis flap is one of the surgical options available for skin coverage of the proximal anterior leg. It can be rotated to cover almost any site on the anterior aspect of the leg if the pedicle is mobilised up to the anterior tibial artery.(2)Since donor site complications are common, this flap has few indications.(3) copyright 2001 The British association of Plastic Surgeons.
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keywords = tibia
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2/20. 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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ranking = 0.16666666666667
keywords = tibia
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3/20. Bone infarct-associated osteosarcoma.

    Reported is a patient with an osteosarcoma arising in a medullary infarct of the humerus. Infarct-associated sarcoma (IAS) of bone is rare. In a collective review of 50 cases reported in the medical literature, only 37 were fully documented. Including our patient, 26 men and 12 women, ranging in age from 18 to 82 years (mean, 53.4 years) have been reported. Black patients appeared to be disproportionately represented, accounting for 36% of the group. In most patients, there was no known cause for the infarct, whereas in the remainder, the most common underlying condition was a prior dysbaric event or alcoholism. Approximately 75% of the patients had multiple bone infarcts. The femur was involved in 21 patients, the tibia in 14, the humerus in 2, and the radius in 1. Among 40 sarcomas in these patients, 7 (18.4%) were osteosarcomas, and 29 (72.5%) were malignant fibrous histiocytomas. The survival rate in patients with IAS is poor: 5 of the 7 patients with osteosarcoma (71%) and 20 of the 31 other patients (65%) died of tumor. Eight patients are alive and well, all for longer than 5 years.
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ranking = 0.16666666666667
keywords = tibia
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4/20. Synovial sarcoma associated with osteofibrous dysplasia. A case report and review of the literature.

    We report on a 14-year-old boy who demonstrated an unusual association between osteofibrous dysplasia and synovial sarcoma. This case suggests that a patient who presents with osteofibrous dysplasia of the tibia can eventually develop a malignant musculoskeletal tumor in the same anatomical location (same limb). This experience suggests that a patient who presents with osteofibrous dysplasia should be followed up for the possibility of a coexisting synovial sarcoma in the same leg.
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ranking = 0.16666666666667
keywords = tibia
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5/20. Use of a vascularized fibula bone flap and intercalary allograft for diaphyseal reconstruction after resection of primary extremity bone sarcomas.

    BACKGROUND: The standard treatment for primary bone sarcomas of the extremities has become chemotherapy and limb salvage surgery. However, the difficulties in achieving reliable long-term healing with allograft reconstruction have led us to use vascularized fibula transfer to enhance healing. methods: From 1992 to 2003, 14 vascularized fibula transfers were performed at our institution for bone reconstruction in 12 patients with bone sarcoma. Free vascularized fibula transfers were performed in 13 cases, and a pedicled vascularized fibula transfer in one case. The mean age was 25 years (range, 6 to 71 years). Locations included the femur (n = 10), humerus (n = 1), and tibia (n = 3). The mean length of the vascularized fibula transfer was 17.4 cm (range, 10 to 24 cm). Indications for use of a vascularized fibula transfer included allograft nonunion (n = 8), and primary diaphyseal bone defect reconstruction combined with an intercalary allograft (n = 6). For all allograft nonunions, a vascularized fibula transfer was used with an onlay technique. For segmental bone defects, an intramedullary technique was used in three cases and an onlay technique in two cases. RESULTS: The overall mean time for bone union after a vascularized fibula transfer was 8.6 months (range, 3 to 24 months): 10 months (range, 5 to 24 months) for patients with allograft nonunions, and 6 months (range, 3 to 8 months) for patients who underwent immediate segmental bone reconstruction. All but one patient had successful bone union. One patient with persistent nonunion required a second vascularized fibula transfer. The mean time from initial limb salvage surgery to full use of the reconstructed limb without restrictions was 28 months (range, 13 to 45 months) for patients treated with a delayed vascularized fibula transfer for an allograft nonunion and 6 months (range, 3 to 8 months) for patients who underwent immediate reconstruction with a vascularized fibula transfer combined with an allograft. CONCLUSIONS: The use of a vascularized fibula transfer combined with an intercalary allograft to reconstruct bone defects after tumor resection can prevent allograft nonunion and result in decreased time to bone healing, leading to earlier patient recovery and return of function.
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ranking = 0.16666666666667
keywords = tibia
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6/20. Fine needle aspiration cytology of focal myositis: a case report.

    BACKGROUND: Focal myositis is an unusual inflammatwy lesion of the skeletal muscle first described by Heffizer. It is a benign condition and usually involves the muscles of the limbs. CASE: A man presented with a palpable mass in the left leg of 6 months' duration. Nuclear magnetic resonance of the leg showed a mass in the tibial muscle; the presumptive diagnosis was sarcoma of the muscle. Smears showed inflammatory cells, skeletal muscle fibers with degenerative and regenerative changes, and fibrous tissue, suggesting a diagnosis of focal myositis. An incisional muscle biopsy was performed, confirming the diagnosis. CONCLUSION: Focal myositis should always he considered when aspirating muscle masses because it is a clinical mimic of a neoplasm. The prognosis is good, and all cases reported in the literature were self-limiting and gradually resolved.
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ranking = 0.16666666666667
keywords = tibia
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7/20. Primitive multipotential primary sarcoma of bone: a case report and immunohistochemical study.

    A tumor initially presenting as a round cell sarcoma in the proximal tibia of a 42-yr-old male disseminated to involve the femur, multiple tarsal bones, and the lungs. In addition to round cell areas resembling lymphoma, other areas of the tumor produced osteoid matrix and still other areas suggested epithelial differentiation. Immunohistochemical staining revealed the presence of epithelial markers in areas of epithelial differentiation, leukocyte markers in areas of lymphomatous differentiation, and neither marker in areas of osteosarcomatous differentiation. The finding of epithelial elements in a primary bone tumor is rare, and this report is one of the first confirming their presence using immunohistochemical markers. The findings are consonant for neither epithelial nor lymphoid neoplasms and in all probability represent multipotential differentiation in a primitive mesenchymal tumor.
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ranking = 0.16666666666667
keywords = tibia
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8/20. Malignant (fibrous) histiocytoma arising in association with a bone infarct in sicle-cell disease: coincidence or cause-and-effect?

    A patient with homozygous-S sickle-cell disease complicated by malignant (fibrous) histiocytoma arising within a tibial medullary infarct is reported. This is the ninth reported case of human sarcoma associated with bone infarct and the first associated with sickle-cell disease. Evidence for a causal relationship is presented.
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ranking = 0.16666666666667
keywords = tibia
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9/20. Malignant fibrous histiocytoma and pleomorphic sarcoma in association with medullary bone infarcts.

    A malignant fibrous histiocytoma arose in the proimal tibia of a 40-year-old man who had multiple, symmetrically distributed, medullary bone infarcts of unknown etiology, involving the distal femora and the tibiae. Despite amputation and chemotherapy, widespread metastases developed and death occurred 19 months after surgery. A polemorphic sarcoma, probably representing an anaplastic malignant fibrous histiocytoma, arose in association with a single medullary infarct in the proximal humerus of a 33-year-old woman. She remains well without evidence of disease five years after treatment by radical radiotherapy followed by shoulder disarticulation. Sarcoma arising in association with bone infarction is a rare entity. Sixteen cases reported in the medical literature, including our own, are reviewed. The sarcomas arose in the tibia in nine cases, the femur in six cases and the humerus in one case. The patients were usually older individuals and 13 of the 16 were male. All but two had multiple bone infarctions. Four of the patients had caisson disease, three had what is probably an hereditary bone dysplasia, one had sickle cell disease and eight had infarcts of unknown etiology. Most patients have had a rapidly fatal outcome. Thirteen of the sarcomas have been fibrosarcomas or malignant fibrous histiocytomas, both of which are rare primary bone tumors. Analysis of the published cases of bone infarction-related sarcomas suggests that the risk of developing a sarcoma is greatest in infarcts with large medullary components.
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ranking = 0.5
keywords = tibia
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10/20. Malignant transformation of fibrous dysplasia. A case report and review of the literature.

    A 34-year-old man developed a spindle-cell sarcoma originating in a preexisting lesion of monostotic fibrous dysplasia. A review of the literature reveals 83 cases of a malignant degeneration in fibrous dysplasia; osteosarcoma was the most common type of tumor. The next most common were fibrosarcoma and chondrosarcoma. The malignant tumor usually developed in the third or fourth decade of life. The most frequent anatomic sites were the craniofacial bones, the femur, and the tibia. Twenty-three of the 83 cases were treated with local radiation. In fibrous dysplasia, any abrupt alteration in the clinical course, manifested by pain and swelling, raises the possibility of malignant degeneration.
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ranking = 0.16666666666667
keywords = tibia
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