RESUMEN
Periosteal chondroma is a rare, slow-growing, benign cartilaginous tumor that develops between the periosteum and cortex, but thereare no reports of multiple periosteal chondroma of the toes. A 19-year-old male presented with a palpable mass of the right fourth toewith tenderness for one year. A radiology examination revealed multiple, radio-lucent lesions with mild cortical irregularity. The magneticresonance imaging findings were chondrogenic tumors with multiple, well-defined T1-low and T2-high signal enhanced lesions involvedin the fourth proximal, middle, and distal phalanges. The tumors were removed by a surgical resection and curettage. Histologically, thetumors were proven to be periosteal chondroma.
RESUMEN
Malignant hyperthermia is a metabolic and genetic disease which present with multiple signs of variable intensity and time course. Most of signs are nonspecific to malignant hyperthermia an4 it is not unusual for malignant hyperthermia-susceptible patients to under- go their first anesthesia uneventfully. Thus,the accurate prediction of preanesthetic susceptibility and early diagnosis of malignant hyperthermis can be lifesaving. Recently, some episodes of signs and symptoms suggestive of malignant hyperthemia after spinal an- esthesia those were suspected to be malignant hyperthermia have been reported. In our hospital, two patients suffered from signs and symptoms suggestive of malignant hyperthermia after spinal anesthesia. One patient showed severe muscle rigidity on the un- blocked upper extremities and thorax, tachycardia (120-160beat/min) and hypertension (180-160/120-100mmHg) and later he showed high fever(38-40degrees C), generalized seizure and severe acidosis. He expired the next day of operation in spite of intensive care. The other patient showed shivering, high fever(39degrees C) and elevated serum CPK level(more than 1,500IU/ L) after spinal anesthesia. Intensive treatment with cooling was immediately initiated. Then, he recovered completely 6 hours later. His mother and a brother showed increased serum CPK level(91,112IU/L, respectively), too. Although we could not performed confirmatory diagnostic test, signs and symptoms were very similar to those of malignant hyperthermia. So, we suspected that it might be malignant hyperthermia.