Gorham-Stout Disease: A Case Report and Review of the Literature.

Gorham-Stout disease causes gradual bone loss (osteolysis) due to an abnormal overgrowth of lymphatic vessels. This rare disease is usually seen in younger people. The etiopathology of Gorham-Stout disease remains unclear. The disease is pathologically characterized by the proliferation of the vascular or lymphatic vessels and, finally, bone matrix destruction. These pathological changes lead to the presence of massive osteolysis on plain radiographs. Thus, plain radiograph findings may lead physicians to consider tumoral conditions, especially metastasis. There are several other conditions on the differential diagnosis list of massive osteolysis, such as metabolic, infectious, malignant, and immunological conditions. After excluding all possible disorders, the disease can be considered in the differential diagnosis. The treatment of the disease is symptom-based, but there is no consensus. Pharmacological methods should be considered first-line treatment. If there is no regression in the course of the disease despite pharmacological treatment, radiotherapy and resection arthroplasty are the treatment of choice in the later stages. In this case report, we present a case of Gorham-Stout disease, which was treated by pharmacological methods. During the one and half year follow-up, the local control of the disease was achieved without any surgical intervention.

Buschke-Ollendorff Syndrome: A Rare Cause of Unilateral Genu Valgum.

Buschke-Ollendorff syndrome is a rare, often benign, autosomal dominant skin disorder. This syndrome commonly presents with non-tender connective tissue nevi and sclerotic bony lesions. Characteristic skeletal findings such as melorheostosis and hyperostosis are usually present. Most cases are detected incidentally. Skin lesions appear first and become less noticeable with age. Bone lesions occur in the later decades of life. Another rarely associated symptom, melorheostosis, is manifested by the appearance of wax running through the cortex of the bone. Plain radiographs usually show cortical hyperostosis. This study aims to present a case report of Buschke-Ollendorff syndrome from an orthopedic aspect and emphasize the importance of the disease since it can be easily assessed as a bone tumor. Second, to the best of our knowledge, this is the first case presented with a unilateral genu valgum deformity with a long-term follow-up in the relevant literature.

Osteosarcoma of the Proximal Fibula: A Case Report and Review of the Literature.

Osteosarcoma is the most common primary malignant bone tumor, especially in younger patients. Diagnosis is based on the combined evaluation of radiological, clinical, and pathological examinations. It is usually located in the distal femur, proximal tibia, and proximal humerus. The fibula is a rare localization for osteosarcoma. Surgery in this region is challenging due to the complex anatomic structures around the knee. Especially the peroneal nerve, lateral collateral ligament (LCL), and popliteal vessel branches are of critical importance. However, additional structures such as the arcuate ligament, biceps femoris, and iliotibial band play an essential role in the stabilization of the knee. Thus, these structures must be protected as much as possible. This case report aims to present the diagnosis and treatment process of conventional osteosarcoma in the proximal fibula, which was located close to the peroneal nerve and required LCL reconstruction after the resection.

A Study to Determine the Incidence and Distribution Patterns of Foot and Ankle Tumors in Bone and Soft Tissue.

OBJECTIVES: The aim of this study is to determine the incidence and distribution patterns of foot and ankle tumors in bone and soft tissue in a university tumor institute, to help the correct evaluation of uncertain masses, to take the right steps in advanced diagnosis and treatment, and to contribute to future research. MATERIALS AND METHODS:  A retrospective analysis of a total of 164 foot and ankle cases examined by a multidisciplinary bone and soft-tissue tumors care team between January 2004 and December 2021 was performed from a database in which patient information was recorded in our tertiary university hospital. Thirty-three (20.1%) of 164 patients were discussed in the tumor council and evaluated as having the non-tumor disease. All of these patients were excluded from the study. A total of 131 patients diagnosed with tumors were included in this study. RESULTS:  The lesion was determined as a benign tumor in 84 (64.1%) cases of 131 tumor patients included in the study. Of these 84 patients, 40 (47.6%) were identified as benign bone lesions and 44 (52.4%) as benign soft-tissue lesions. Malignancy was determined in 47 (35.9%) of 131 patients, affecting the bone in 14 (29.8%) patients and the soft tissue in 33 (70.2%). The malignant soft-tissue lesion most determined was malignant mesenchymal tumor in 10 (30.3%) patients, of which one had lung metastasis and one was determined with multiple metastases. Metastasis was detected in eight patients in total, including three metastatic malignant bone tumors and five metastatic malignant soft-tissue tumors. CONCLUSIONS: Tumors involving the foot and ankle are not frequently encountered, and most tumors in this region are benign. The anatomic structure of the foot allows early diagnosis, but for diagnosis to be made, there must first be clinical suspicion. The first symptom is generally swelling. Early diagnosis can prevent several complications. Therefore, patients with foot and ankle complaints must be taken seriously and evaluated with advanced tests if necessary.