Multicentric myxoid liposarcoma; a case report and literature review

Llposarcoma is a common malignant soft tissue tumor, accounting for 10% to 16% of all sarcomas. Multicentric myxoid liposarcoma is an uncommon condition. Differentiation between several primary tumors and metastasis of a single liposarcoma represents the main difficulty in diagnosis. A 47-years old woman presented with right thigh myxoid liposarcoma and underwent wide margin tumor resection. Other investigations like CXR, abdominal and pelvic CT-scans were negative. After 18 months another myxoid liposarma was found in her ipsi-lateral breast without any evidence of other organs metastasis. Second lesion location, time between two presentation and cytogenetic differences are accepted criteria to site a sarcoma in multicentric category, but in myxoid liposarcoma these can be explained by the special features inherent to this tumor

Is [99m]Tc-MIBI scintigraphy a predictor of response to pre-operative neoadjuvant chemotherapy in osteosarcoma?

Multidrug resistance [MDR], which may be due to the over expression of P-glycoprotein [Pgp] and/or MRP, is a major problem in neoadjuvant chemotherapy of osteosarcoma. The aim of this study was to investigate the role of Tc-99m MIBI scan for predicting the response to pre-operative chemotherapy. Twenty-five patients [12 males and 13 females, aged between 8 and 52y] with osteosarcoma were studied. Before the chemotherapy, planar [99m]Tc-MIBI anterior and posterior images were obtained 10-min [tumor-to-background ratio: [T[1]/B[1]][10min]] and 3-hr after tracer injection. After completion of chemotherapy, again [99m]Tc-MIBI scan was performed at 10-min after tracer injection. In addition to calculation of decay corrected tumor to background [T/B] ratios, using the 10-min and 3-hr images of the pre-chemotherapy scintigraphy, percent wash-out rate [WR%] of [99m]Tc-MIBI was calculated. Using the 10-min images of the pre- and post-chemotherapy scans, the percent reduction in uptake at the tumor site after treatment [Red%] was also calculated. Then after surgical resection, tumor response was assessed by percentage of necrosis. All patients showed significant [99m]Tc-MIBI uptake in early images. Only 9 patients showed good response to chemotherapy [necrosis >/= 90%] while 16 patients were considered as non-responder [necrosis <90%]. There was no statistical significant difference between non-responders and responders in [T[1]/B[1]] [10min].There was a significant negative correlation between WR% and percentage of necrosis [P=0.001]. On the other hand, there was a significant correlation between Red% and percentage of necrosis [P<0.001].There was also statistical significant difference in WR% and Red% between non-responders and responders [both P< 0.001]. Washout rate of [99m]Tc-MIBI in pre-chemotherapy scintigraphy as well as Red% using pre- and post-chemotherapy MIBI scintigraphy are useful methods for predicting response to neoadjuvant chemotherapy

[Assessment of sonographic measurement of carpal tunnel diameters with clinical and electrodiagnostic findings in carpal tunnel syndrome]

Thalassemia major is a hereditary anemia that becomes blood transfusion dependent. Iron overload consequence leads to multiple organ dysfunction and endocrinopathy. So deferoxamine [desferal] is used for chelation therapy. The aim of this study was to evaluate the growth rate of these patients and its correlation with endocrine complications and determine the role of secondary iron overload in these situations. This cross-sectional study was performed for a year [2010] on 280 patients [aged 3.5- 56 years] who received blood transfusion and chelation therapy at Amirkola Thalassemia Center. After basic evaluations, determination of height standard deviation, they were divided by serum ferritin level into two groups [good and poorly controlled]. They were evaluated for hypothyroidism, diabetes mellitus, hypoparathyroidism and hypogonadism. Next, data were analyzed. A p <0.05 was considered significant. From 280 patients with mean age of 19.6 +/- 8.5 years, 161 [57.5%] cases were female, short stature [<-2 SDS] was present in 90 cases [32.1%]. Their mean height was 151.4 +/- 17.3 cm. 162 cases [57.9%] had endocrinopathy. There was a relationship between short stature and hypoparathyroidism [p= 0.009] and hypogonadism [p= 0.005] and also diabetes mellitus [p= 0.003]; but no relationship was found between short stature and hypothyroidism [p=1.000] and serum ferritin level [p=0.091]. According to higher prevalence of hypoparathyroidism, hypogonadism and diabetes mellitus in short statured thalassemic patients, screening should be done for such disorders with more sensitivity in these patients

prospective study of closed and open reamed intramedullary nailing of 136 femoral shaft fractures in adults

Femoral shaft fractures are major causes of mortality and morbidity and are managed with intramedullary nailing [IMN]. In this study we compared the results of open and closed nailing in femoral shaft fractures. Between 1993 and 2001 we managed 136 femoral shaft fractures by IMN [81 closed and 55 open nailings] in 120 patients with mean age of 36.2 years. The mean time of follow up was two years. Radiologic and clinical results were analyzed with SPSS software using student-t and Fisher test. 93.2% healed within six months. 2.9% required dynamization; total union rate was 96%. Full weight bearing was permitted between 5-16 weeks [mean of 10.62 weeks] in the closed method, and 10-20 weeks [mean of 12.83 weeks] in the open method [P<0.001]. Complications included 4.41% nonunions, 2.9% shortening, 10.8% limited range of movement, 1.47% deep infection, and 6.6% malunion. Nonunion was observed in 2 cases in closed and in 4 patients in open method [P = 0.039]. Closed series showed higher rate of malunion [P = 0.181, P = 0.221]. In closed method attention should be paid to malalignment while locking the nail