Condroma de partes moles relato de caso e revisão da literatura / Soft tissue chondroma case report and review of the literature

O presente estudo tem o objetivo de apresentar um relato de caso sobre condroma extra-esquelético ou de partes moles, uma lesão rara e benigna diagnosticada através da clínica, radiologia e exame histopatológico. O paciente (24 anos) compareceu ao Setor de Ortopedia do Hospital Unimed Betim com queixa de aumento de volume no polegar esquerdo, indolor há aproximadamente um ano. Durante o exame físico verificou-se presença de uma lesão nodular, de consistência dura, móvel, indolor que não acarretava em alteração funcional do dedo. O paciente foi encaminhado para setor de radiologia do hospital onde foi realizado RX e posteriormente ultrasonografia e ressonância magnética do polegar esquerdo. Diante dos achados dos estudos de imagem a equipe optou pela biópsia excisional da lesão. O exame histopatológico confirmou o diagnóstico de condroma extra-esquelético. Os elementos definidores do condroma de partes moles são: 1) curso clinico benigno e sintomatologia frusta; 2) ausência de conexão entre o tumor e estruturas adjacentes como periosteo, capsula articular ou osso; 3) crescimento lento; 4) ausência de prevalência por sexo; 5) características radiológicas e histológicas do tumor. O diagnóstico raramente é aventado quando confrontamos tumores de partes moles das mãos. A excisão é simples e deve ser completa para se evitar recorrências. A avaliação histopatológica deve ser realizada para confirmação diagnóstica.

The present study presents a case report of extraskeletal chondroma or soft tissue chondroma, a rare and benign lesion, diagnosed by clinical findings, imaging studies and histopathological exam. The 24-year-old patient presented at the Orthopedics Section of Unimed Betim Hospital with a slow painless growth on the left thumb about 1 year ago. During the physical examination, a nodular lesion was noted; it had a hard consistency, was mobile and painless, and didn't cause functional impairment for the finger. The patient was referred to the imaging unit of the hospital, where an X-ray was performed; later on, ultrasound and magnetic resonance imaging of the left thumb was done. After the imaging studies, the medical team chose excisional biopsy of the lesion. The histopathological examination confirmed the diagnosis of extra-skeletal chondroma or soft-tissue chondroma. Soft tissue chondroma is usually not considered for a soft-tissue tumor of the hand. Excision is easy and must be complete if recurrences are to be avoided. Histopathological evaluation is required for the final diagnosis.

MR Imaging of Soft-Tissue Vascular Lesions: Pathologic Correlation

In the evaluation of vascular lesions, MR can be used to distinguish slow- from high-flow lesions on the basis of the observed spin-echo MR signal characteristics. MR imaging can also represent features of the static tissues of the vascular lesions that are composed of fibrofatty components, as well as thromboses, phleboliths and muscle atrophy. This paper illustrates the MR findings of various vascular lesions, correlating them with the pathologic specimen and emphasizing on the static tissues.

An Experimental Study on the Intraarterial cis-platinum Chemotherapeutic Response of Musculoskeletal Tumor Using MR Imaging and Digital Subtraction Angiography

PURPOSE: To determine MRI features of tumor response in the early phase of preoperative chemotherapy in malignant tumors after intraarterial chemotherapy of VX-2 tumor in the rabbit thigh. MATERIALS AND METHODS: VX-2 tumors were induced in the thighs of eleven New Zealand white rabbits and intraarterial infusion of Cis-Platinum (3mg/kg) was performed in six. Pre- and post-contrast enhanced MR images and angiographies were obtained prior to and two weeks after chemotherapy. Five rabbits with VX-2 tumors were imaged at these same interval. Difference in MRI changes between the two groups were analysed and MRI findings were compared with angiographic and histologic findings. RESULTS: All VX-2 tumors showed rapid extensive necrosis, the most prominent MRI change in the chemotherapeutic group was decreased thickness of the enhancing rim which in the control group had increased (p = 0.083 and p = 0.374, respectively). The enhancing rim reflected the peripheral capsule with surrounding edema, inflammatory change, and tumors which were histologically viable. On angiography, it coincided with tumor staining. Change in tumor size was not significantly different between the two groups. In the chemotherapeutic group, a marginal necrotic band was the most prominent histologic feature. CONCLUSION: In the VX-2 tumor, chemotherapeutic response is seen on MRI as decreased thickness of the rim, and this reflects the tumor capsule and viable tumors. MRI can provide guidance in planning the treatment of malignant soft tissue tumors.