Infantile Fibrosarcoma in Older Child at Right Lower Leg: A Case Report.

BACKGROUND Infantile fibrosarcoma (IFS) is a rare tumor. The highest prevalence is in the first 2 years of life. Cases typically manifest in the extremities, with rapid initial growth, are non-tender, and are a poorly delimited masses that vary in size or consistency and lack sensitivity. The treatment for IFS is a multimodal approach, and surgical excision has become the main treatment. This report aims to present the results of our work on IFS cases. CASE REPORT A 4-year-old girl was admitted to our hospital with a chief concern of a mass in the right lower leg that first appeared 3 years ago. Physical examination showed a single mass with dense-rubbery consistency, tenderness, and limited range of motion. Plain radiography was performed, and a soft-tissue mass was seen on the anterior 1/3 distal cruris of the right side. CT angiography showed a bulging soft-tissue mass, solid (38 HU), with size ±2.8×3.1×4.7 cm. MRI examination revealed an aggressive superficial soft-tissue mass in the cutaneous-subcutaneous compartment. Biopsy and immunohistochemistry were performed, and the results were consistent with IFS. A local excision was made to assess for pathological anatomy. CONCLUSIONS Infantile fibrosarcoma (IFS) is an uncommon tumor in early childhood. It tends to mimic other tumors, which may interfere with the correct diagnosis, which may contribute to its rarity. Local excision is the first treatment choice, with a good prognosis for IFS.

Study epidemiology of risk fracture in osteoporosis based on frax score, and osta score, with risk of fall using Ontario score in elderly Indonesia.

Background: Osteoporosis is characterized by a low bone mass of bone tissue. If osteoporosis is not treated properly, it will increase the high risk of fracture. The common causes of fracture on osteoporosis condition due to falls. This study aims to find the correlation between the risk of osteoporosis with fall risk (ONTARIO) based on osteoporosis fracture risk (FRAX). Methods: This study is an analytic study with a cross-sectional method. We collected the sample using random cluster sampling in the six primary health care in Malang on different times service since August-September 2021. Total patient 139, however only 132 patients were included in this study. After collecting data is complete, we analyze using Chi-square tests. Results: The mean age of participants was 63.9 ± 7.14. with the age group was dominated by the range of 60-64. It was found that the result of the FRAX SCORE had a low-risk category for major fracture osteoporosis and risk hip fracture. In contrast, from the OSTA score in this study, more than 68 participants (50.8%) were found medium and high-risk scores. Then, in ONTARIO score of the risk fall assessment, and high score in 57 participants (43.2%). If compared between OSTA and ONTARIO, there was a significant relationship between OSTA score and ONTARIO score (p < 0.000) with high-risk OSTA have a significant relationship with a high risk of falling and vice versa. Conclusion: In this study, there was a relationship between the risk of high osteoporosis and the risk of falling.

Free non-vascularized fibular graft reconstruction after resection of metacarpal unicameral bone cyst: A case report.

Unicameral bone cyst (UBC) or simple bone cyst (SBC) is a benign cystic lesion commonly found in the humerus and femur that is mainly encountered during childhood. The currently available treatments for UBC of the hand commonly involve curettage, bone grafting, partial resection with or without grafting, multiple drilling, fracture immobilization and observation alone, and steroid injection. We herein report a case treated with total resection of the cyst and non-vascularized fibular graft in a 9-year-old right-handed female patient. The patient presented with a chief complaint of a large, fast growing lump over the first metacarpal of the left hand. Flexion of the first metacarpophalangeal joint was limited. After the diagnosis was established with plain radiographs followed by biopsy, the cyst was completely removed by resecting the shaft of the metacarpal bone with preservation of the epiphyseal plate. A bone graft was obtained from the fibula and inserted in the gap, distally attached to the epiphyseal plate of the metacarpal and fixed with a Kirshner wire proximally. Radiographs revealed solid union of the bone graft to the epiphyseal plate at the head after 7 weeks, with improving function of the thumb. SBC or UBC of the metacarpal bone is very rare. A more aggressive method, such as in the case presented herein, may be necessary to treat this condition.