ABSTRACT
Brown tumors are erosive bony lesions caused by rapid osteoclastic activity and peritrabecular fibrosis due to hyperparathyroidism, resulting in a local destructive phenomenon. Although brown tumors are the most pathognomonic sign of hyperparathyroidism, they are very rarely observed at present as a result of early detection of hypercalcemia and elevated parathyroid hormone levels. The rare appearance of this entity in everyday practice is troublesome for both patients and physicians, because whenever it emerges, diagnosis could be mistaken for a giant cell tumor of the bone. However, clinical, biochemical, and radiologic findings can easily guide the diagnosis if one considers the full continuum of findings and their association with subject's medical history, instead of focusing only on bone lesion. In this report we present a case of brown tumor in the fibula with a short literature review, whose aggressive presentation and unawareness of the skeletal findings of hyperparathyroidism puzzled the caring doctors. This case illustrates the need for continuous vigilance of any physician, regardless of his specialty or his position in medical services structures.
Subject(s)
Fibula , Osteitis/diagnosis , Adult , Diagnosis, Differential , Female , Giant Cell Tumor of Bone/diagnosis , Humans , Hyperparathyroidism/complications , Magnetic Resonance Imaging , Osteitis/pathology , Tomography, X-Ray ComputedABSTRACT
BACKGROUND/AIMS: This reports presents the results of a prospective randomized controlled study of combined locoregional targeted immuno-chemotherapy for treatment of patients with liver metastasis from primary colorectal malignancies. MATERIALS AND METHODS: Forty eight patients were randomly assigned into one of two groups. Group A (n = 15) included patients who had post-operatively locoregional chemotherapy and Group B (n = 33) included patients who had combined locoregional immuno-chemotherapy. RESULTS: Statistical analysis shows a clear superiority in the survival and responses of patients treated with immuno-chemotherapy versus chemotherapy alone. Forty five percent of patients in Group B are alive with a mean survival of 20.3 months, ranging from 13 to 29 months, as opposed to no survivors from Group A and a mean survival of only 9.9 months, ranging from 3.6 to 22.5 months. Additionally, 64% of the immuno-chemotherapy group had a positive response while only 13% of the chemotherapy had such a response. CONCLUSIONS: Our data supports the value of combined immuno-chemotherapy as a treatment for advanced metastatic liver disease.
Subject(s)
Adenocarcinoma/secondary , Adenocarcinoma/therapy , Colorectal Neoplasms/pathology , Liver Neoplasms/secondary , Liver Neoplasms/therapy , Adenocarcinoma/pathology , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Colorectal Neoplasms/mortality , Combined Modality Therapy , Diatrizoate Meglumine/administration & dosage , Fluorouracil/administration & dosage , Humans , Immunotherapy , Interleukin-2/therapeutic use , Iodized Oil/administration & dosage , Leucovorin/administration & dosage , Liver Neoplasms/mortality , Middle Aged , Mitomycin/administration & dosage , Prospective Studies , Survival RateABSTRACT
We describe a case of mesenchymal tumor induced osteomalacia. Our patient presented a typical clinical and radiological picture of osteomalacia, with low serum phosphate. With the excision of the tumor, which was located in the right forearm, the serum phosphate concentrations increased to normal values within a week postoperatively and the symptoms improved dramatically.
Subject(s)
Forearm , Osteomalacia/etiology , Soft Tissue Neoplasms/complications , Calcium/therapeutic use , Humans , Hydroxycholecalciferols/therapeutic use , Magnetic Resonance Imaging , Male , Middle Aged , Osteomalacia/blood , Osteomalacia/diagnostic imaging , Phosphates/blood , Radiography , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/surgeryABSTRACT
A case of a false femoral aneurysm in a young man is reported. The diagnosis was made by MRA and was confirmed by conventional arteriography. MRA was found to be superior to angiography in demonstrating the exact size of the aneurysm. No MRA image of a false aneurysm of the lower extremities has been, to our knowledge, previously reported.
