Primary intraosseous papillary intralymphatic angioendothelioma of the distal femoral epiphysis: a case report with literature review.

INTRODUCTION: Papillary intralymphatic angioendothelioma (PILA) is an exceptionally rare metastasizing soft tissue tumor. It tends to arise in the subcutaneous tissues of distal extremities in children. Only four intraosseous PILA cases have been reported until now in English language literature. CASE REPORT: We present a case of PILA arising in the distal femoral epiphysis of a 50-year-old female patient. It started as a relentless pain in her left knee. A plain radiography revealed a radiolucent area in the left internal femoral condyle. Computerized tomography revealed a 1-cm lytic lesion with a sclerotic rim. Magnetic resonance images showed a significant bone marrow edema signal focused on a 1-cm subchondral lesion suggestive of an intraarticular osteoid osteoma. Histologically, the tumor contained vascular channels covered by a single endothelial layer with intraluminal papillary endothelial structures lined with hobnail cells. Immunohistochemically, the cells were positive for ERG, CD31, and D2-40. The tumor underwent cryoablation and 6 months later, after local recurrence or tumor persistence, a wide tumor resection was referred. After 7 years of follow-up, the patient displayed neither local recurrence nor distant metastases. CONCLUSION: Primary intraosseous PILAs are exceedingly rare tumors that should be considered in the differential diagnosis of vascular bone tumors.

Chronic expanding hematoma.

Chronic expansive hematoma (CEH) is a rare lesion, characterized by the persistence and increase in size of an hematoma for a period greater than one month since the initial hemorrhage. The clinical importance of this pathology is due to the fact that it can simulate malignant soft tissue neoplasms, both clinically as a result of its progressive growth and radiologically for its findings in imaging studies. This article will review three cases of CEH in different scenarios, explaining the radiological findings in different imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and PET-CT.

Osteomielitis pélvica y piomiositis del músculo obturador interno. Revisión del tratamiento a propósito de un caso / Pelvic osteomyelitis and obturator internus muscle pyomyositis. Revision of the treatment with regard to a case

La osteomielitis pélvica asociada a infección del músculo obturador interno es una infección poco difundida en la literatura científica. Presentamos el caso de un adolescente con ambas infecciones y una revisión del abordaje terapéutico de ambas patologías

Pelvic osteomyelitis associated with pyomyositis of the obturador internus muscle is rarely reported. We present the case of a teenager with both infections and a review of the therapeutic approach of both pathologies

Tumor benigno de células notocordales / Benign notochordal cell tumors

Los tumores benignos de células notocordales (TBCN) son lesiones con diferenciación notocordal que afectan al esqueleto axial. Se caracterizan por cursar asintomáticos o con sintomatología inespecífica, y por pasar desapercibidos radiológicamente por su pequeño tamaño, o bien por ser confundidos con otras lesiones óseas benignas, como hemangiomas vertebrales. Cuando son grandes o sintomáticos pueden plantear el diagnóstico diferencial con metástasis, tumores óseos primarios y cordomas. Presentamos el caso de un TBCN de difícil diagnóstico, en una mujer de 50 años de edad, con una lesión sacra vista en la resonancia magnética (RM). Se programó una biopsia guiada por tomografía computarizada (TC) para filiar la lesión, pero la tumoración no era claramente identificable en la TC, por lo que se utilizaron las referencias anatómicas de la RM para seleccionar el plano adecuado. Tanto la planificación del abordaje como la correlación radiopatológica fueron determinantes para llegar al diagnóstico definitivo

Benign notochordal cell tumors (TBCN) are lesions with notochordal differentiation which affect the axial skeleton. They are characterized by asymptomatic or non-specific symptomatology and are radiologically unnoticed because of their small size, or because they are mistaken with other benign bone lesions, such as vertebral hemangiomas. When they are large, or symptomatic, can be differential diagnosis with metastases, primary bone tumors and chordomas. We present a case of a TBCN in a 50-year-old woman, with a sacral lesion seen in MRI. A CT-guided biopsy was scheduled to analyze the lesion, finding that the tumor was not clearly recognizable on CT, so the anatomical references of MRI were used to select the appropriate plane. The planning of the approach and the radio-pathological correlation were determinant to reach the definitive diagnosis

Benign notochordal cell tumors. / Tumor benigno de células notocordales.

Benign notochordal cell tumors (TBCN) are lesions with notochordal differentiation which affect the axial skeleton. They are characterized by asymptomatic or non-specific symptomatology and are radiologically unnoticed because of their small size, or because they are mistaken with other benign bone lesions, such as vertebral hemangiomas. When they are large, or symptomatic, can be differential diagnosis with metastases, primary bone tumors and chordomas. We present a case of a TBCN in a 50-year-old woman, with a sacral lesion seen in MRI. A CT-guided biopsy was scheduled to analyze the lesion, finding that the tumor was not clearly recognizable on CT, so the anatomical references of MRI were used to select the appropriate plane. The planning of the approach and the radio-pathological correlation were determinant to reach the definitive diagnosis.