ABSTRACT
El tumor fibromixoma lipoesclerosante óseo (TFMLE) fue descrito inicialmente por Ragsdale en 1986, como una lesión fibroósea polimórfica de hueso con una mezcla de elementos histológicos incluyendo lipoma, fibroxantoma, mixoma, mixofibroma, necrosis grasa, osificación isquémica, áreas de displasia fibrosa y rara vez cartílago o cambios quísticos. La localización más frecuentemente descrita es en la región intertrocantérica del fémur. Es un hallazgo en pacientes asintomáticos o bien estar asociado a fractura. Radiológicamente es una lesión lítica, geográfica, de margen bien definido y habitualmente esclerótico, en algunos casos puede observarse mineralización en el interior de la lesión o un cierto grado de expansión en el contorno. Se ha descrito la estrecha relación del TFMLE con la displasia fibrosa por las características histológicas y la presencia de una mutación Gsα, otra hipótesis de la etiología de la lesión incluye la reacción de la displasia fibrosa a la fatiga por estrés.
The bone liposclerosing myxofibrous tumor (LSMFT) was initially described by Ragsdale in 1986 as a polymorphic fibroosseous bone lesion with a mix of histologic elements that include lipoma, fibroxanthoma, myxoma, myxofibroma, fat necrosis, ischemic ossification, areas of fibrous dysplasia, and infrequent presence of cartilage or cystic changes. The most frequently reported location is the intertrochanteric area of the femur. Radiologically it is a lytic, geographic lesion, with well-defined margins and usually sclerotic. In some cases findings include mineralization inside the lesion or a certain degree of expansion to the contour. The close relationship between LSMFT and fibrous dysplasia has been described based on the histologic characteristics and the presence of the Gsα mutation. Another hypothesis of the etiology of the lesion is the reaction of fibrous dysplasia to stress.
Subject(s)
Aged, 80 and over , Humans , Male , Bone Neoplasms/diagnosis , Femoral Neoplasms/diagnosis , Lipoma/diagnosis , Myxoma/diagnosis , Bone Neoplasms/pathology , Femoral Neoplasms/pathology , Fibroma/diagnosis , Fibroma/pathology , Fibrous Dysplasia of Bone/diagnosis , Fibrous Dysplasia of Bone/pathology , Lipoma/pathology , Myxoma/pathology , Xanthomatosis/diagnosis , Xanthomatosis/pathologyABSTRACT
Percutaneous osteoplasty (POP) as a technical extension of percutaneous vertebroplasty (PVP) has been used to treat malignant disease that affects the skeletal system. POP has demonstrated good outcome for pain relief and functional improvement. Few studies have reported on the efficiency of POP to treat malignancies located in the femoral head. We designed a pilot study with the use of POP to treat intractable pain caused by a femoral head metastatic tumor in a 43-year-old man. During the follow-up period, the patient experienced sustained pain relief and improvement of quality of life that persisted for more than three months.
Subject(s)
Adult , Humans , Male , Diagnosis, Differential , Femoral Neoplasms/diagnosis , Lung Neoplasms/pathology , Magnetic Resonance Imaging , Tomography, Emission-Computed , Tomography, X-Ray ComputedSubject(s)
Humans , Female , Adult , Femoral Neoplasms/diagnosis , Pain/etiology , Knee , Femoral Neoplasms/complicationsABSTRACT
Apresentamos um caso de um paciente de 21 anos de idade, portador de osteossarcoma primário de fêmur, que iniciou com dor na coluna torácica. A metástase de osteossarcoma primário tem maior incidência para os pulmões, raramente acometendo vértebras. Revisamos a literatura a respeito dessa enfermidade e enfatizamos as características das imagens nos diversos métodos empregados (exames radiográficos convencionais, cintilografia óssea, tomografia computadorizada, ressonância magnética) e os principais diagnósticos diferenciais.
We present a case of a 21-year-old patient, bearer of femur primary osteosarcoma, who began with pain in the thoracic column. The metastasis of primary osteosarcoma has greater incidence on lungs, rarely affecting vertebras. We reviewed the literature about this disease and emphasized the image's characteristics on the several methods used (traditional radiographic exams, bone scintigraphy, computed tomography, magnetic resonance) and the main differential diagnostics.
Subject(s)
Humans , Male , Young Adult , Magnetic Resonance Spectroscopy , Femoral Neoplasms/diagnosis , Spinal Neoplasms/secondary , Osteosarcoma , Radiography, Thoracic , Radionuclide Imaging , Tomography, X-Ray Computed , Diagnosis, Differential , Neoplasm MetastasisSubject(s)
Adult , Femur Neck/pathology , Lipoma/surgery , Lipoma/diagnosis , Femoral Neoplasms/diagnosisABSTRACT
Chondroblastoma accounts for less than one percent of osseous neoplasms, and is one fifth as common as giant cell tumor, a lesion with which it is very frequently confused. It has a marked predilection for the epiphysis of long bones. Radiologically, these are lytic lesions with a thin margin of increased density. A majority of chondroblastomas have an entirely benign course and are successfully treated by curettage and bony chip grafts. Clinically, chondroblastomas may be confused with other neoplasms, both benign and malignant. Fine needle aspiration is fast gaining acceptance as an accurate and rapid technique for diagnosing osseous neoplasms. The cytological features of chondroblastoma like individually lying chondroblasts, nuclear grooves, chodroid matrix and chicken-wire calcification are diagnostic of this neoplasm and may allow fine needle aspiration to become a valuable pre-operative technique in the management of these patients.
Subject(s)
Adolescent , Biopsy, Fine-Needle , Chondroblastoma/diagnosis , Femoral Neoplasms/diagnosis , Humans , MaleABSTRACT
Severe parathyroid bone disease is a rare clinical presentation of primary hyperparathyroidism. Double parathyroid adenomas are even more rare cause of primary hyperparathyroidism. The authors present a case of double parathyroid adenomas in a 48-year-old man, who presented with painful left lower limb swelling, which was slowly growing in size in the last 20 years. Magnetic resonance imaging revealed a cystic bony lesion and coincidentally, a urinary bladder calculus. Biopsy of the mass revealed giant cell lesion. Laboratory investigations showed hypercalcemia and hypophosphatemia with elevated parathyroid hormone level. A computerized tomography scan of the neck delineated an adenoma of the left superior parathyroid gland, which was surgically removed. The left inferior parathyroid was also enlarged and was removed. Histological diagnosis confirmed double parathyroid adenomas. The rarity and the interesting clinical presentation of such association are discussed
Subject(s)
Humans , Male , Femoral Neoplasms/diagnosis , Adenoma , Parathyroid Neoplasms/pathology , Hyperparathyroidism/etiology , Neoplasms, Multiple Primary , Bone Cysts/diagnosis , Femur/pathology , Tomography, X-Ray ComputedABSTRACT
The coexistence of two different types of benign cartilaginous tumours of bone in the same patient has not been reported in literature. We report a case in which a sixteen-year-old male had a benign chondroblastoma of the proximal left humerus and an osteochondroma of the distal left femur. Both originated at the same time and had a progressive increase in size with growth.
Subject(s)
Adolescent , Arthrodesis/methods , Biopsy, Needle , Bone Neoplasms/diagnosis , Chondroblastoma/diagnosis , Femoral Neoplasms/diagnosis , Humans , Humerus , Immunohistochemistry , Male , Neoplasms, Multiple Primary/diagnosis , Osteochondroma/diagnosis , Prognosis , Tomography, X-Ray ComputedABSTRACT
Os autores apresentam estudo cooperativo entre várias instituiçoes que avaliaram 80 portadores de osteosarcoma que nao compromete o esqueleto axial e nao metastático no estadiamento inicial. O estadiamento foi realizado através de radiografias, tomografia, mapeamento ósseo, exames laboratoriais e confirmado por biópsia. O fêmur foi o local de maior acometimento (57,5 por cento), seguido de tíbia (27,5 por cento), úmero (7,5 por cento) e fíbula (5,0 por cento). As cirurgias de preservaçao do membro foram realizadas em 50 (62,5 por cento) dos pacientes e corresponderam principalmente a endopróteses totais de joelho em 22 (27,7 por cento), substituiçao por fíbula livre em oito (10,0 por cento) e endoprótese parcial de tíbia em seis (7,5 por cento). Trinta pacientes foram submetidos a cirurgias radicais, entre elas a amputaçao da coxa em 20 (25,0 por cento), desarticulaçao do quadril e amputaçao interescapulatorácica em três (3,8 por cento). Os resultados das cirurgias foram satisfatórios em 56 (70,0 por cento) dos pacientes. Nos tumores menores do que 12cm o número de cirurgias conservadoras foi significativamente maior (43,8 por cento) do que nos maiores (22,5 por cento). Quanto à sobrevida total, livre de doença, encontrou-se percentagem de 42,9 por cento aos três anos. Os autores salientam que os pacientes submetidos a tratamento conservador apresentaram sobrevida significativamente maior (64,7 por cento) do que os que sofreram amputaçao (17,9 por cento). Da mesma forma, os pacientes com melhor grau de necrose tumoral após a quimioterapia apresentaram melhor sobrevida (76,0 por cento) em relaçao aos de pior grau de resposta (37,0 por cento).
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Femoral Neoplasms/surgery , Bone Neoplasms/surgery , Osteosarcoma/surgery , Fibula/surgery , Humerus/surgery , Femoral Neoplasms/diagnosis , Bone Neoplasms/diagnosis , Osteosarcoma/diagnosis , Disease-Free SurvivalABSTRACT
Os autores apresentam uma indicaçäo para artroscopia do quadril com diagnóstico de condroma, confirmado por exame anatomopatológico. A indicaçäo do procedimento artroscópico se deu após realizaçäo de diversos exames e constataçäo, à ressonância magnética, de imagem anormal intra-articular na regiäo da fóvea. O objetivo era a biópsia e, se possível, ressecçäo artroscópica, para evitar-se, assim, artrotomia ampla e possibilitar reabilitaçäo mais rápida e menos traumática. Após seguimento aproximado de um ano, o paciente encontra-se assintomático
Subject(s)
Humans , Male , Middle Aged , Chondroma/surgery , Femoral Neoplasms/surgery , Hip Joint/surgery , Hip/surgery , Arthroscopy , Chondroma/diagnosis , Chondroma/pathology , Femoral Neoplasms/diagnosis , Femoral Neoplasms/pathologyABSTRACT
Os autores relatam três casos de artrite ocasionada por osteoma osteóide. Essas lesöes foram observadas dentro da cápsula articular: dois casos em coxofemoral e um caso em joelho. O diagnóstico foi realizado por raio X convencional, tomografia computadorizada e confirmado por exame histológico. O atraso no diagnóstico e características clínicas e radiológicas säo discutidos neste trabalho
Subject(s)
Humans , Male , Female , Child , Adolescent , Arthritis/diagnosis , Femoral Neoplasms/diagnosis , Osteoma, Osteoid/diagnosis , Arthritis/etiology , Arthritis/surgery , Diagnosis, Differential , Femoral Neoplasms/complications , Femoral Neoplasms/surgery , Osteoma, Osteoid/complications , Osteoma, Osteoid/surgeryABSTRACT
El sarcoma osteogénico u osteosarcoma es un tumor maligno de huesos que ocurre en la segunda o tercera década de vida y en muy raras ocasiones ocurre en niños menores de 5 años. Presentamos el caso de un niño de 3 9/12 años de edas, uno de los pacientes más jóvenes descritos en la literatura. En este paciente el tumor fue muy agresivo, con metástasis al pulmón al momento del diagnóstico y una progresión muy rápida a pesar de quimioterapia y cirugía. El diagnóstico de este paciente fue algo tardío por la presentación poco usual a esta edad
Subject(s)
Child, Preschool , Child , Humans , Male , Femoral Neoplasms/diagnosis , Lung Neoplasms/secondary , Osteosarcoma/diagnosis , Lung Neoplasms , Magnetic Resonance Imaging , Osteosarcoma/secondary , Tomography, X-Ray ComputedABSTRACT
Se presenta el caso de un paciente de 12 años de edad atendido en el Hospital Pediátrico Docente Provincial "Eliseo (Noel) Caamaño", de Matanzas, por presentar un sarcoma parostal de l/3 superior del fémur izquierdo. Se hace una somera revisión de esta categoría poco frecuente de neoplasia