Prolonged activated partial thromboplastin time due to plasma prekallikrein deficiency: a case study and literature review on its clinical significance.

: Activated partial thromboplastin time is a test assessing the intrinsic and common pathways of the coagulation cascade. We presented an asymptomatic case with isolated activated partial thromboplastin time prolongation. After excluding coagulation factor deficiency and lupus anticoagulant, the patient was diagnosed with plasma prekallikrein (PPK) deficiency. We reviewed the literature regarding effects of PPK deficiency which could have both antithrombotic and prothrombotic effects. At the moment, research supports that PPK deficiency in healthy adults rarely causes bleeding as it is not a major contributor of hemastasis; whereas in adults with multiple comorbidities or with predominant systemic inflammation, effects of PPK deficiency remain debatable. Further research is needed to clarify impacts of PPK deficiency in clinical settings.

Bisphosphonate therapy is effective in the treatment of sacral giant cell tumor.

BACKGROUND: Sacral giant cell tumors are particularly challenging to treat as they are often quite extensive and surround the sacral nerve roots, making surgical extirpation very difficult without high morbidity and frequent local recurrence. CASE REPORT: We report on a 33-year old male patient with sacral giant cell tumor treated with intravenous bisphosphonate therapy after early failure of embolization procedures. At 3 years follow-up, the patient had no pain, no neurological deficits, and no local recurrence. CONCLUSION: To our knowledge, this is one of the first reported cases of bisphosphonate therapy after failed embolization for control of a difficult giant cell tumor.