Aggressive gluteal fibromatosis: a rare case associated with spontaneous superior gluteal artery pseudoaneurysm.

Deep fibromatosis is a locally aggressive neoplasm commonly involving the extremities. Several authors have described imaging features and complications associated with deep fibromatosis. We present the case of a 33-year-old man who presented with a right gluteal fibrous mass identified on magnetic resonance imaging (MRI), which was associated with a pseudoaneurysm originating from the right superior gluteal artery on serial follow-up with MRI and computed tomography. No intervention was done, and after conservative management, spontaneous thrombosis of the pseudoaneurysm was developed. Such imaging finding is the first report of a spontaneous development of pseudoaneurysm caused by deep fibromatosis, which could be a life-threatening condition and should be considered when dealing with deep fibromatosis and deciding on the appropriate treatment.

Giant cell tumor of bone following denosumab treatment: assessment of tumor response using various imaging modalities.

BACKGROUND: Giant cell tumor (GCT) is a nonmalignant neoplasm composed of multinucleated giant and mononuclear stromal cells. This study aimed to compare imaging findings of GCT pre- and post-denosumab treatment, including lesion size, percentage of signal intensity/density change, and time of initial objective tumor response. This will have a great impact on selection of most appropriate imaging technique to accurately measure therapy response and its related complications, which would influence the physicians to tailor the treatment regimen to suit each patient. RESULTS: As per inverse Choi density/size (ICDS), 16 patients (84.2%) had an objective tumor response and 15 (78.9%) had an increase in density or decrease in signal intensity, and the mean of signal intensity decrease in the treated lesions was 32.4% (95% CI, 18-46.7). Only seven patients (36.8%) had tumors demonstrating ≥ 10% decrease in size, all of which showed a positive change in signal/density except for one. Moreover, 17 patients (89.4%) showed a clear demarcation/low signal intensity margin surrounding ≥ two third of the lesion periphery. The median time to first objective tumor response was approximately 23 weeks. CONCLUSION: Based on the ICDS criteria, most patients with giant cell tumor of bone show objective tumor response to denosumab. Modification of ICDS to include marginal sclerosis or clear demarcation of the lesions might be considered as a separate response criterion to accurately assess the treatment response in patients with GCT.

Melorheostosis of The Leg: A Case Report.

Melorheostosis is a benign hyperostotic disease of the peripheral skeleton, rarely involving the axial skeleton. This disease is associated with ossified and non-ossified soft tissue masses surrounding the joints. We report the case of a 28-year-old male who presented to an orthopedic clinic with a chronic history of right leg pain. Radiological evaluation using X-ray, computed tomography, and magnetic resonance imaging showed features consistent with that of melorheostosis. Recognition of this entity by clinicians can avoid unnecessary investigations and biopsy.