Cases reported "Osteolysis"

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11/540. Osteolytic extra-axial sacral myxopapillary ependymoma.

    The authors report an unusual case of sacral osteolytic myxopapillary ependymoma treated with curettage and radiotherapy. There is no evidence of recurrence 8 years after treatment. A review of the literature is presented on sacral ependymomas presenting with an osteolytic radiographic appearance (24 cases in 18 reports). The differential diagnosis with other sacral neoplasms is discussed. ( info)

12/540. Acute promyelocytic leukaemia complicating multiple myeloma: evidence of different cell lineages.

    The association of leukemia and multiple myeloma is well described usually as a complication of chemotherapy but also in the absence of chemotherapy or at diagnosis. Such leukemias are typically acute myeloid leukemia (AML), particularly myelomonocytic subtype, and cases of acute promyelocytic leuke (APL) are rarely reported. Controversy exists as to whether myeloma and AML originate from a single haematopoietic progenitor or arise from different cell lineages. We report a case of a 58 year old female who developed APL 10 months following diagnosis of nonsecretory light chain (kappa) myeloma which had been treated with local spinal irradiation and low dose oral melphalan and prednisone. Clonality had originally been demonstrated by light chain restriction (kappa) of her bone marrow plasma cells whilst immunoglobulin heavy chain and T cell receptor genes were germ line. At development of APL cytogenetics revealed t(15;17) and PML-RAR fusion gene was detected by RT-PCR. The patient was treated with all-trans retinoic acid (ATRA) and received 2 cycles of consolidation chemotherapy with idarubicin. Following this therapy the t(15;17) and PML-RAR were both undetectable whilst the clonal population of kappa staining plasma cells persisted. This particular patient represents a rare case of APL complicating multiple myeloma with persistence of the myeloma clone but disappearance of PML-RAR alpha rna following therapy. This case study appears to support the argument that the APL and myeloma originated from distinct cell lineages. ( info)

13/540. Severe osteoporosis in familial hajdu-cheney syndrome: progression of acro-osteolysis and osteoporosis during long-term follow-up.

    hajdu-cheney syndrome is an autosomal dominant inherited osteodysplastic bone disease with the hallmarks of acro-osteolysis, skull deformations, and generalized osteoporosis. Very few patients have been followed long-term with respect to the prognosis of acro-osteolysis and osteoporosis. Here we describe a 39-year-old woman and her 19-year-old daughter who are both affected with the hajdu-cheney syndrome. Skeletal lesions were followed in the mother between the ages of 22 and 39 years. The acro-osteolytic lesions progressed markedly and caused shortening of several fingers; some end phalanges had completely disappeared. Severe spinal osteoporosis with serial vertebral fractures was found at the age of 22 years. New vertebral fractures developed until the age of 33 years, but did not progress afterward. High turnover osteoporosis was found in the bone histology of iliac crest biopsies performed at the ages of 22 and 34 years. Bone mineral content (BMC) was strikingly decreased at the age of 34 years (T score -5.1 SD) and did not significantly change during further follow-up. In the daughter, BMC failed to increase between the ages of 12 and 19 years and was also markedly decreased (T score -4.4 SD). This suggests that osteoporosis in hajdu-cheney syndrome is related to a low peak bone mass and a high bone turnover, leading to insufficient bone formation compared with the increased bone resorption. ( info)

14/540. Acute periprosthetic fracture of the acetabulum associated with osteolytic pelvic lesions: a report of 3 cases.

    Three cases of acute acetabular fracture around uncemented porous-coated acetabular components associated with osteolytic lesions of the pelvis are reported. In each case, the fracture occurred through an area of severe osteolysis that contributed to the structural failure of the pelvis. None of the fractures were associated with significant trauma, and none of the implants demonstrated evidence of loosening before the fracture. When marked pelvic osteolysis develops around the acetabular component of a total hip arthroplasty, the possibility of pelvic fracture must be considered. Total hip arthroplasty patients with osteolysis should be followed with radiographs at regular and frequent intervals. When osteolysis progresses, early intervention should be strongly considered because appropriate treatment may prevent fracture occurrence. ( info)

15/540. Distal clavicle osteolysis unrelated to trauma, overuse, or metabolic disease.

    Osteolysis of the distal clavicle has been reported to occur from traumatic, atraumatic (overuse), or systemic causes. Three patients with bilateral osteolysis of the distal clavicles whose osteolysis did not fit these etiologic categories were evaluated. Clinical, imaging, and laboratory evaluations were nonspecific, and histologic sections of the distal clavicle showed evidence of chronic inflammation with reactive change of the articular surface. patients either had complete resolution or marked improvement of their symptoms after bilateral distal clavicle resection at mean followup of 5 years 3 months. These cases of osteolysis of the distal clavicle represent a category of this disorder not previously described. ( info)

16/540. Bilateral intraosseous lipoma of the calcaneus. A case report.

    A case of bilateral intraosseous lipomas of the calcaneus is presented. The bilateral localization of calcaneal intraosseous lipomas is extremely rare. ( info)

17/540. Intraosseous venous drainage anomaly of the tibia treated with imaging-guided sclerotherapy.

    A 23-year-old man presented with a pre-tibial soft tissue mass. Magnetic resonance images demonstrated the subcutaneous, intracortical and intramedullary components of an intraosseous venous drainage anomaly, which was confirmed by direct venography. sclerotherapy using absolute alcohol was subsequently performed under imaging guidance with complete resolution of the subcutaneous component of the lesion. ( info)

18/540. Case report: natural development of osteosarcoma from precancerous lesion.

    We encountered a very rare case that suggested the natural development of osteosarcoma from a precancerous lesion. The patient presented with a huge osteosarcoma in the distal femur on the initial consultation to our hospital. He had undergone X-ray examination twice previously, due to a knee injury. The findings of the lesion detected by the first X-ray examination were similar to a fibrous cortical defect (FCD), differing from those of an osteosarcoma lesion detected by second and last X-ray examinations. We retrospectively estimated the growth rate of the FCD-like and osteosarcoma lesions and found that FCD-like lesion was not osteosarcoma, but might have been a precancerous lesion. We also speculated that this osteosarcoma lesion might have appeared 18 months before the patient consulted our hospital. ( info)

19/540. Osteolysis of the pelvis presenting as insufficiency fracture in a patient with rheumatoid arthritis.

    Physician awareness of the risk of osteoporosis and subsequent fractures in a patient with a history of long-term steroid treatment is high. The tendency to assume that a fracture is owing to steroid-induced osteoporosis may result in an unnecessarily intense antiresorptive treatment regimen for a patient who may not have osteoporosis. I report here about a patient with rheumatoid arthritis who presented with bone fracture despite antiresorptive therapy and without evidence of osteoporosis by bone mineral density testing. ( info)

20/540. Osseous lesion simulating a bone tumour due to an unsuspected fragment of wood in the foot.

    A case is reported in which an osteolytic lesion in the third metatarsal bone was proved at operation to be the result of an injury by a splinter of wood which had remained embedded in the tissues. A short review of the relevant literature is appended. ( info)
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