A Simple Bone Cyst of the Acromion: Case Report / Cisto ósseo simples do acrômio: Relato de caso

Abstract Simple bone cysts rarely occur in the scapula, and, to our knowledge, they have not been reported in the acromion. In the present report, we present the case of a 24-year-old female patient who was successfully treated by curettage and grafting using xenografting. No recurrence findings were observed during the follow-up six months postoperatively, the patient had recovered full range of motion, and she was able to perform all routine activities satisfactorily.

Resumo Cistos ósseos simples são raros na escápula, e, pelo que sabemos, não foram relatados no acrômio. Aqui, apresentamos uma paciente do sexo feminino, de 24 anos, submetida com sucesso ao tratamento composto por curetagem e xenoenxerto. Não foram observados achados de recidiva no acompanhamento pós-operatório de seis meses, quando a paciente apresentou amplitude total de movimento e foi capaz de realizar todas as atividades rotineiras de maneira satisfatória.

One patient, one bone, and two different tumoral lesions.

In this article, we report a 67-year-old female patient who has two different tumoral lesions located in left humerus with clinical and radiological findings. Previously, the patient was diagnosed as impingement syndrome in shoulder, but, tumoral lesions were detected on the radiograms incidentally during evaluation.

Radioterapia de las áreas ganglionares locorregionales en el cáncer de mama / No disponible

La radioterapia constituye una parte fundamental en el tratamientoconservador del cáncer de mama. La irradiación dela mama restante tras una tumorectomía o una cuadrantectomíaha demostrado aumentar tanto el control local como la supervivenciaglobal y causa específica en las pacientes con cáncerde mama. De igual forma, cuando existe afectacióntumoral de las áreas ganglionares regionales puede ser necesariola realización de radioterapia sobre las mismas. En el presenteartículo se revisan las indicaciones de radioterapia en loscasos de cáncer de mama con afectación no sólo local sinotambién de las cadenas ganglionares axilar, supraclaviculary/o mamaria interna(AU)

Radiotherapy alter breast conserving surgery remains as afundamental aspect of breast cancer management. The treatmentof the whole breast after lumpectomy or quadrantectomyis associated with a significant improvement in local control,cancer survival and even overall survival. Irradiation ofregional lymphatic areas is a challenging issue subjected tocontinuous revision. The aim of this paper is to review the roleof the radiation therapy of the lymphatic areas of the axilla,supraclavicular fossa and internal mammary node chain in thetreatment of breast cancer(AU)

Treatment of benign diseases with megavoltage X-ray beams: is there a risk for gonadal damage?

AIMS: To measure the testicular and ovarian doses and to assess the risk for gonadal damage to patients treated with megavoltage X-ray beams for benign diseases. MATERIALS AND METHODS: Radiation therapy of benign diseases was simulated on an anthropomorphic phantom with a 6MV photon beam. The gonadal dose was calculated during the irradiation of heterotopic ossification, liver and vertebra haemangiomas, bone cysts, Graves' ophthalmopathy and gynaecomastia. Dose measurements were carried out using thermoluminescent dosimeters. For the radiotherapy of heterotopic ossification, the effect of using lead blocks to spare lymphatic drainage on the gonadal dose was determined. RESULTS: The ovarian and testicular total doses were found to be 2.00-680 and 2.0-39.0 mGy, respectively, depending on the gonadal location in respect to the treatment volume. The introduction of blocks into the primary beam resulted in an increase in gonadal dose up to a factor of 1.7. The radiation-induced risk of hereditary disorders in future generations was (1.0-40.8) x 10(-4) and (1.0-23.4) x 10(-4) for women and men, respectively. CONCLUSIONS: Radiation therapy of benign diseases always resulted in gonadal doses below 1 Gy and therefore there was no risk for permanent gonadal failure. The excess risk of radiation-induced hereditary disorders in offspring was low in comparison with the natural frequency of these effects. However, there was a considerable excess in risk after irradiation in the hip bone.

Hemophilic pseudotumor of the ulna treated with low dose radiation therapy: a case report.

We report a case of hemophilic pseudotumor in the ulna of a 6-year-old boy treated with radiation therapy. A total dose of 900 cGy in 6 fractions was given in 6 consecutive days. Progression of cystic changes was halted within a month. New bone formation and trabeculation were found on the 4th month. Complete healing of the lesion and bony replacement were found on the 12th month. The patient was followed up to 72 months and there was no evidence of recurrence and no bone growth disturbance. Radiation therapy can be an effective alternative modality in treating hemophilic pseudotumor.

Hemophilic pseudotumor of the ulna treated with low dose radiation therapy: a case report

We report a case of hemophilic pseudotumor in the ulna of a 6-year-old boy treated with radiation therapy. A total dose of 900 cGy in 6 fractions was given in 6 consecutive days. Progression of cystic changes was halted within a month. New bone formation and trabeculation were found on the 4th month. Complete healing of the lesion and bony replacement were found on the 12th month. The patient was followed up to 72 months and there was no evidence of recurrence and no bone growth disturbance. Radiation therapy can be an effective alternative modality in treating hemophilic pseudotumor.

Aneurysmal bone cyst treated by high-energy, low-dose radiation therapy: a case report.

Aneurysmal bone cysts (ABC) are frequently treated surgically, but recurrence is not uncommon and surgery is hazardous when the lesion is large and adjacent to the growth plate. High-energy, low-dose radiation to an 8-year-old girl with ABC of the distal tibia was found to be successful, with no recurrence during the five-year follow up. No complications have ensued, and excellent function has been sustained. Further evaluation of this radiation treatment is important for similar situations in which surgical excision of ABC may involve high risk.

[Clivus C2 aneurysmal bone cyst--contribution to problems of surgical treatment, radiotherapy and individually determined growth trends]. / Aneurysmatische Knochenzyste Clivus-C2--Beitrag zu Problemen der operativen Behandlung, der Strahlentherapie und der individuell unterschiedlichen Wachstumstendenz.

A man of 46 years of age had recurrences of an aneurysmatic bone cyst (Clivus C1/2) despite of repeated radical operations (3 times, transoral approach). Additional radiotherapy resulted in stabilization and cure. Problems of surgical treatment, radiotherapy and of tendency to growth inherent in the lesion are discussed.

[Use of Co2-laser in the treatment of bone tumors in children]. / Ispol'zovanie Co2-lazera pri lechenii opukholei kostei u detei.

By means of the recognized methods, 229 children with benign tumors and tumor-like dysplasia of the skeleton were treated. In 59 patients, the CO2-laser scanning of the residual osteal bed was used. This permitted to reduce considerably the volume of surgical intervention, and provide its radicality.

High-energy, low-dose radiation therapy for aneurysmal bone cyst. Report of a case.

Whereas curettage and bone grafting of aneurysmal bone cysts (ABC) are generally accepted, recurrence is not uncommon and surgery is hazardous when the lesion is large and adjacent to the growth plate. High-energy, low-dose radiation in an eight-year-old girl with this lesion of the distal tibia was successful with no recurrence at the three-year follow-up examination. No complications have ensued, and excellent function has been sustained. Further evaluation of this form of radiation treatment is important in similar situations in which surgical excision of ABC may carry high risks.

[Secondary malignant fibrous histiocytoma of bone 11 years after radiation exposure]. / Sekundäres malignes fibröses Histiozytom des Knochens 11 Jahre nach Strahlenexposition.

We report about a secondary malignant fibrous histiocytoma of bone which is most frequently found in distal femur. It appears as a malignant form of a giant-cell tumor after the exposure to radiation. The typical symptoms given in literature publications: pain, swelling and the pathological fracture were present. After amputation there was no metastasis for 15 months.

[Aneurysmal bone cyst of C5. Complete 2-stage excision]. / Kyste anévrysmal osseux de C5. Exérèse complète en deux temps.

A case of aneurysmal bone cyst of the fifth cervical vertebra was unusual in that it occurred in a 35 year old man treated initially by radiotherapy (3,800 rads), within 3 years, worsening of clinical and radiologic signs led to a complete two-stage exeresis because of extension of lesion to body and posterior arch of C5. This male patient was 35 years old at diagnosis and 38 at time of surgery (respectively 1.2 and 2.5% of cases in the Hay series and 1.9% in the Ruiter series), this lesion affecting mainly age groups under 20 years. Aneurysmal bone cyst (ABC) constitutes 1.4% of primary bone tumors (Dahlin), and spinal localizations 3% (Biesecker), 14% (Reiter) or 20% (Tillman) of total ABC. The cervical lesion represents 13% (Reiter) or 22% (Hay) of spinal localizations, C5 being affected twice in the 17 cases reported by Ameli, and fills, according to Hay, 3.3% of all spinal column lesions and 15% of cervical lesions. Initial treatment applied in another center was by radiotherapy alone at the dose of 3,800 rads (the recommended dose-level in the literature being 20 to 30 Grays). Neither clinical nor radiologic improvement was reported. The recurrence rate after all types of treatment for ABC was 12.6%, and after radiotherapy alone was 11% in the Hay series, MacCarty reporting only one recurrence among 9 patients treated with irradiation alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Aneurysmal bone cysts of the pelvis.

Twenty-three cases of pelvic aneurysmal bone cysts treated at the Istituto Ortopedico Rizzoli were reviewed after a mean follow-up of 7 years. Eighteen cysts involved the anterior arch, four extended into the iliac wing and the anterior arch, and one invaded the entire hemipelvis. The acetabulum was involved in 56.5% of the cases. Fourteen patients were treated with surgery (curettage 11; resection 3), and five with radiation therapy; two patients had both modalities; two additional patients refused any treatment after biopsy. The overall recurrence rate was 13% (one case after curettage, one after radiation therapy, and one after combined treatment). Significant complications affected the final functional result in four of seven patients who received radiation therapy, while only one minor complication was seen in the surgical group.

Aneurysmal bone cyst of the spine.

The cases of twenty-two patients with an aneurysmal bone cyst of the spine above the sacrum were analyzed with regard to sex, age, site, symptoms, and radiographic findings. Four patients had extension of the lesion to the adjacent vertebra or rib, and twelve patients had neurological deficits. The primary treatment was either radiotherapy or surgery alone, or surgery and radiotherapy combined. No recurrences were found in patients who were treated with surgery alone or with surgery and radiotherapy, while three of the six patients who were treated with radiotherapy had a local recurrence, two of which were fatal. The patients with neurological deficits recovered after healing of the cyst.

[Radiographic aspect of aneurysmal cysts of the spine]. / Aspetto radiografico delle cisti aneurismatiche del rachide.

Aneurysmal bone cyst is a pseudoneoplastic skeletal disorder. The material of the Tumor Center at the Rizzoli Orthopaedic Institute refers to 198 cases, 25 (12.6%) with spinal localization. The X-ray pattern of aneurysmal bone cyst is represented by an osteolytic area more or less evidently involving the vertebra, with frequent extension to the surrounding soft tissues. Its maturing evolution is typical, and occurs both spontaneously and after surgical and/or radiation therapy.

An unusual intraosseous lesion with fibroblastic, osteoclastic, osteoblastic, aneurysmal and fibromyxoid elements. "Solid" variant of aneurysmal bone cyst.

Four examples are reported of an unusual noncystic intraosseous lesion which does not conform to any hitherto recognized entity and which can be mistaken, not only by the general histopathologist but by the osteoarticular pathologist, for a variety of other conditions, including sarcoma and giant-cell tumor. They were in patients aged 5 to 13 years; three in the spine, one in the ethmoid. Local excision, supplemented by low-dose radiotherapy in cases with cord compression, produced a satisfactory outcome in all cases. At presentation the radiologic findings were nonspecific but, following treatment, an eggshell rim of bone developed in those lesions which had been incompletely excised. Histologically, they are characterised by florid fibroblastic or fibrohistiocytic proliferation, osteoblastic differentiation with osteoid production, areas rich in osteoclast-type giant cells, aneurysmal sinusoids, and occasional foci of degenerate calcifying fibromyxoid tissue. Because this combination of histologic features can be found in the solid parts of aneurysmal bone cyst and in no other condition, at this centre we have regarded this lesion as a variant of aneurysmal bone cyst devoid of any cystic component.