Intraosseous Calcaneal Lipoma with Subtalar Perforation through Cystic Degeneration: A Case Report / 대한족부족관절학회지

Intraosseous lipoma is a benign tumor that originates from proliferating mature lipocytes. It often occurs in the metaphysis of long bones of the lower extremity, and also in the calcaneus, humerus, mandible, sacrum, and rib bones. Frequently, it involutes spontaneously through a process of infarction, calcification, and cyst formation. It can either present as pain, or be asymptomatic and only discovered through an incidental radiological finding. In our case, the patient presented with heel pain. Intraoperatively, it was found that the intraosseous cavity was filled with fat along with an adjacent but separate area of cystic degeneration. There was also a cortical perforation at the cystic lesion which was communicating with the subtalar joint. This cortical breach is most likely the cause of diffuse lateral heel pain experienced by our patient, and such a pathological fracture due to intraosseous lipoma has never been reported.

Unusual Aggressive Radiographic Appearance of Simple Bone Cyst (A Case Report and Review of Literature).

Aim: This study reports a rare case of simple bone cyst (SBC) with a radiographic behavior similar to malignancies and a mixed internal structure in a 43 year-old woman who presented to a dental office with clinical symptoms. Presentation of Case: A 43 year-old woman presented to a dental office with chief complaint of pain at left mandibular molars for almost 2 months. She was wearing a cervical collar for some spine problems. The panoramic x-ray showed a radiolucent lesion with well defined non-corticated borders in periapical region of the mandibular left first molar (tooth 36). The tooth was vital. Cone Beam Computed Tomography (CBCT) images showed a lytic lesion with well defined noncorticated borders that destructs the lingual cortical wall without any sign of expansion to soft tissues. The upper border of the mandibular canal was unclear and seemed destructed by the lesion. The internal structure of the lesion seemed mixed. Three months later, the patient reported numbness of her lower lip. CBCT showed an enlargement of the lesion and the presence of buccal cortical perforation was seen. On biopsy the lesion was diagnosed as a Simple Bone Cyst (SBC). Discussion: SBC is often a benign lesion which appears as a radiolucent lesion with scalloped corticated borders. Adversely, current case showS a mixed lesion with buccal and lingual cortical perforation and rapid growth .the concomitant pain, the lower lip numbness and the radiographic appearance suggest the probability of an aggressive local condition or a malignancy Conclusion: SBC may have various radiographic presentations, unusual SBCs (or Traumatic bone cysts TBCs) may show aggressive radiographic characters. In these cases, biopsy and pathological features are necessary for diagnosis.

Comparison the Cortical Perforation of both the Recipient Beds and Grafts with the Cortical Perforation of Only the Recipient Beds

PURPOSE: The aim of this study is to compare volume and revascularization of autogenous block bone grafts in simultaneously cortical perforation of recipient beds and grafts, and only cortical perforation of recipient beds. MATERIALS AND METHODS: Two block bone in 8mm diameter was harvested in both skull using trephine bur on 20 New Zealand white rabbits. Harvested block bone was grafted on both inferior border of mandible. On the left side(experimental side), cortical bone of recipient beds and graftwere perforated, and on the right side(control side), the only recipient bed was perforated. The rabbits had been sacrificed and infused the India ink for the observation of revascularization at 20 day and 40 day after surgery. The specimens were processed for H-E staining and quantitative analysis(independent t-test, p<0.01) was made under an optical microscope. In additional, specimens were processed for the observation of revascularization. RESULTS: After 20 days, more bone volume was observed in experimental group, but no significant difference between two groups(p=0.106). There were significantly more bone volume in the experimental group at 40 days after surgery(p<0.01). After 20 days, more discrete vascular sprouts were observed in experimental side, but no difference at 40 days after surgery. CONCLUSION: We conclude that the cortical perforation of both the recipient beds and grafts improve revascularization at early stage and overall graft persistence.