A large fibroma polyp of labia majora

Fibroepithelial stromal polyps are benign proliferations which are usually polypoid or pedunculated, and less than 5cm in size. They are generally single lesions but can be multiple during pregnancy. They can be polypoid or pedunculated and are usually solitary. Symptoms usually include bleeding, discharge and general discomfort with sensation of a mass. They typically have a central fibrovascular core and contain stellate and multinucleated stromal cells which are best seen beneath the surface epithelium. True myxoid stroma is absent. Although vulvovaginal fibroepithelial stromal polyps are well documented, a giant variant such as the one authors report here is rather rare. To the knowledge, present case is the largest fibroepithelial stromal polyp compared to others reported in the literature.

Prevalence of Geriatric Giants Among Older People in Kelantan Malaysia

@#Introduction: Geriatric Giants are the impairment that appear in older people. It comprises of impaired cognition, urinary incontinence, instability, fall and immobility. The aim of this study is to determine the prevalence of Geriatric Giants among older people living in three different living environment; own home, pondok and old folks home. Methods: This comparative study involved 471 respondents from Kelantan. There were 157 participants each from own home, pondok and old folks home. The prevalence of Geriatric Giants were determine by 10 minutes comprehensive screening which was developed to diagnose and manage the Geriatric Giants (WHO, 2007) and prevalence were compared using chi-square tests or Fisher exact test. Results: Prevalence of dementia among respondents of old folks home (11.5%), pondok (6.4%) and own home (0.6%). Prevalence of urinary incontinence among respondents of own home (22.3%), old folks home (16.6%) and pondok (14.0%). Prevalence of instability among respondents of old folk home (31.2%), pondok (27.4%) and own home (14.0%). Prevalence of fall among respondents of pondok (33.1%), old folks home (24.25) and own home (19.7%). Old folk home respondents had the highest prevalence of moderate and severe immobility There were significant difference in prevalence of dementia ((Fisher exact p value <0.001), instability (χ2(2)=13.957,p=0.001), fall (χ2(2)=7.629,p=0.022) and mild and moderate immobility. Conclusion: Old folks home respondents had more prevalence of Geriatric Giants compared to their other counter parts.

Caso Clínico: Uso de Aloinjerto Óseo Estructural en Tumor de Células Gigantes de Fémur / Case Report: Use Of Structural Bone Allograft In Giant Cell Tumor Of The Femur

INTRODUCCIÓN: El tumor de células gigantes óseo es muy raro y controversial en su comportamiento por lo que es predecible. El diagnóstico requiere biopsia previa antes de proceder al tratamiento.CASO CLÍNICO: Paciente masculino de 43 años de edad, mestizo, sin antecedentes personales o familiares de relevancia. Acude a consulta externa de ortopedia oncológica por presentar masa dura y dolorosa con aumento gradual de tamaño a nivel de rodilla derecha, deformidad, limitación funcional y crepitación. EVOLUCIÓN: El paciente fue sometido a biopsia de lesión a nivel de fémur distal derecho con reporte de anatomía patológica de tumor de células gigantes. Se realizó una resección ósea a nivel de tumor y tratamiento mediante colocación de aloinjerto estructural óseo, con un seguimiento de 2 años y obteniendo como resultado funcional una puntuación de 14/15 según la escala de Makin, se evidencio además osteointegración del injerto al hueso autógeno a los 15 meses. No presento infección, ni reabsorción del injerto, ni fatiga del material.CONCLUSIÓN: La cirugía de conservación de la extremidad utilizando los aloinjertos estructurales es una técnica favorable con funcionalidad y osteointegración adecuada, aumentando las expectativas y calidad de vida. Evitando amputaciones, artrodesis o prótesis tumorales cuyo costo beneficio con los años subsecuentes terminan siendo altos y deteriorando al paciente.

BACKGROUND: Bone giant cell tumor (GCT) is one of the least frequent, most controversial and least predictable tumors in its behavior. We present a case of GCT in the lower limb, which implied the distal femur. The diagnosis required a previous biopsy before proceeding with its en bloc resection, and treatment based on bone allograft. CASE REPORT: Male patient of 43 years of age, mestizo, with no relevant personal or family history. He went to the oncology orthopedics outpatient clinic for presenting a hard and painful mass with gradual increase in size at the level of the right knee, deformity, functional limitation and crepitus in that region, which is why he attends his assessment. EVOLUTION:The patient underwent a lesion biopsy at the level of the distal femur with a pathological anatomy report of giant cell tumor. Bone resection was performed at the tumor level and treatment was performed by allografting the bone structural allograft. A 2-year follow-up was performed and a score of 14/15 according to the Makin scale was obtained as functional results. Osteointegration of the graft to autogenous bone was also evidenced. Excellently at 15 months. We did not find infection, graft resorption or fatigue of the material. CONCLUSIONS: Limb preservation surgery represented by structural allografts is a favorable technique with adequate functionality and osteoingration, increasing the life expectancy of our patients and future revision possibilities. Avoiding amputations, arthrodesis or tumor prosthesis whose cost benefit with the subsequent years end up being high and deteriorating the quality of life in the patient.