Ewing sarcoma of the left big toe with trans-articular skip lesion: A case report.

We report the case of the patient who had Ewing Sarcoma in whom radiological and hystopathological appearances revealed a tumor mass in the left big toe along with trans-artikular skip lesion on the left diaphysis of tibia. In Cipto Mangunkusomo Hospital since 1995 until 2004 we have found 20 Ewing sarcoma cases, but only one skip lesion Ewing sarcoma was found. The diagnosis of transarticular skip lesion in association of Ewing sarcoma was confirmed in clinicopathological conferrence. The initial evaluation of all patients included the recording of the medical history, physical examination, and hematological studies. Radiographs of the chest and the site of the primary tumor were made routinely. Systemic staging was performed with use of total-body bone scan. Ray amputation of left big toe and open biopsy from mass of mid-shaft of tibia had been done to confirm the diagnosis. The patient underwent induction chemotherapy and above knee amputation. Ten months after diagnosis, he died because of advanced-distant metastasis.

The safety and efficacy of feracrylum as compared to silver sulfadiazine in the management of deep partial thickness burn: A clinical study report.

Instead of haemostatic effect, feracrylum provides antibacterial activity; wound improvement has been clinically proven. Feracrylum is a water soluble mixture of incomplete ferrous salt of polyacrylic acid containing 0.05 to 0.5% of iron in physiologic solution (0.85% solution of sodium chloride). A clinical study on safety and efficacy of feracrylum compared to silver sulfadiazine (SSD) was conducted in burn management, since with the widely use of SSD, the sulfadiazine’s disadvantages lead to wound healing impairment. In this open, randomized, controlled study, feracrylum and SSD were topically applied, each on different side of the burnt areas in parts of body for a treatment period of eleven days. Of eight enrolled patients, seven patients completed the study; one patient withdrew due to acute burn complication. On day 7th and 11th, the re-epithelialization in group receiving feracrylum increased as the raw surface area reduced. Mean percentages of epithelialization on both evaluation days in Feracrylum group were 70.53±24.298 and 81.71±28.922, respectively, which were higher than SSD group (66.15±25.080 and 64.64±74.684 respectively). Feracrylum was found to be safe and well tolerated. This study showed a clinical difference although it was not significant statistically.

Hepatoid carcinoma of the gallbladder.

Hepatoid carcinoma is a special type of extrahepatic tumor associated with hepatic differentiation, and has the morphological and functional features of hepatocellular carcinoma. Hepatoid carcinoma of the gallbladder is very rarely reported in the literature. We report a case of hepatoid carcinoma of the gallbladder in a 71-year-old female who presented with abdominal pain and was first diagnosed as cholelithiasis with cholecystitis. The microscopic findings of the gallbladder after cholecystectomy showed an area of tumor with polygonal cells, eosinophilic cytoplasm, distinct cell borders, round vesicular nuclei and prominent nucleoli, arranged in trabecular pattern resembling hepatocellular carcinoma intermingled with areas of adenocarcinoma or cholangiocarcinoma. The specimen from the pancreas also showed the same type of tumor cells. Histochemically, some of tumor cells were positive for Victoria Blue, Stein, and PAS. The immunohistochemistry for alpha-fetoprotein (AFP) showed strong intra cytoplasmic positivity, both in tumor cells with hepatic differentiation and tumor cells with bile duct epithelium differentiation. Based on these findings, this case was diagnosed as hepatoid carcinoma of the gallbladder with metastasis to the pancreas. This is the first case that has been reported in our department.

Periosteal Osteosarcoma: A Case report.

Periosteal osteosarcoma is a rare type of malignant bone neoplasm, with predominantly cartilaginous component and arising on the bone surface. Reports of the case in the literature were rare. Last case was reported by Mayo Clinic in 1999. We report a case of periosteal osteosarcoma in a 17-year-old male, who was treated surgically with a limb salvage procedure, neoadjuvant and adjuvant chemotherapy were also given to the patient. There was no local recurrence and lung metastases up to 14 months after surgery.

Primary malignant mesenchymoma of bone: A case report.

Primary malignant mesenchymoma of bone (PMMB) is an exceedingly rare neoplasm consisting of two or more unrelated malignant mesenchymal components other than fibrosarcoma or malignant fibrous histiocytoma. Review of the literature reports only 16 cases, most of which were composed of osteosarcoma and liposarcoma. We report a case af PMMB composed of liposarcoma, rhabdomyosarcoma and high grade chondrosarcoma arising within the left distal femur in a 52-year-old male, resulting in the patient's death 3 months after presentation.

Metastatic chondroblastoma.

A case of chondroblastoma, which is a benign tumor of the bone, with distant metastases to the lung and abdominal wall is reported. The clinical course of the disease was progressive like that of malignant process.