Spontaneous resolution of proximal humerus sessile osteochondroma: A report of case and literature review.

Key Clinical Message: In managing a child with a solitary osteochondroma, the most advisable course of action involves vigilant observation and regular follow-up, given the potential for spontaneous resolution. Abstract: The most frequent benign cartilage tumors in children are osteochondromas, which develop when the growth plate herniates during bone development. Treatment depends on the symptoms, with asymptomatic cases requiring monitoring and symptomatic patients requiring surgical intervention. Rarely, an asymptomatic osteochondroma may spontaneously disappear. We report the case of a 3-year-old male who presented with left arm swelling and pain due to trauma while playing football. X-rays revealed a proximal humerus posterolateral sessile osteochondroma. After 6 months of observation, the boy tolerated activity and had no pain. Five years later, the osteochondroma was resolved spontaneously both clinically and radiologically. Our study suggests that annual observation of child patients with osteochondroma is more effective than surgical intervention due to the possibility of spontaneous resolution.

Malignant, fungating giant-cell tumor of the tendon sheath (GCT-TS) of the foot: A case report.

Giant-cell tumors of the tendon sheath (GCT-TS) are relatively common benign tumors that arise in close proximity to joints and tendons. Malignant GCT-TS are extremely rare. Surgery with wide resection remains the cornerstone for treating malignant giant-cell tumors of the tendon sheath especially in large tumor cases.

A bilateral asymmetrical hip dislocation: A rare case report.

A 17-year-old male was ejected from the motorcycle and brought to the Emergency Department with bilateral hip dislocation and absence of pelvic or femur fractures or sciatic nerve injury. Closed reduction and postreduction examination were performed with a bilateral stable full range of motion in all directions.

Wide resection and reconstruction in a low resource area, cemented nail technique knee arthrodesis; a report of case and surgical technique.

INTRODUCTION AND IMPORTANCE: Osteosarcomas are primary malignant bone tumors that are driven from bone-forming mesenchymal cells and account for nearly 20 % of primary bone tumors. CASE PRESENTATION: A 16-year-old female presented with chief complaint of pain and swelling on her right knee for 6 months with history of trauma. Her knee mobility and ROM was limited due to pain and the mass. Physical examination revealed a 15 × 22 cm mass on distal part of right femur with visible dilated veins. There was normal distal motor, sensory functions. Imaging revealed distal femur mass with mixed lytic and blastic features, wide transitional zone with hair and periosteal reaction; features suggestive of osteosarcoma that was confirmed by histopathological examinations as intramedullary osteosarcoma. She undergone surgical treatment consisting of surgical excision of the mass with safety margins and knee reconstruction by knee arthrodesis using femoral-nail and bone cement technique with excellent outcome. CLINICAL DISCUSSION: Osteosarcoma is best investigated through plain imaging, MRI and possible CT with histology being confirmatory. It is best approached with meticulous dissection to ensure clear margins or if necessary, amputation. Following resection, reconstruction can be done. In this specific case, the tumor was on the distal femur and the underlying knee was arthrodesed using cemented nail technique in which a cemented intramedullary nail was inserted with excellent clinical outcome. CONCLUSION: Surgical approach to osteosarcoma can be performed through limb salvage or amputation. Arthrodesis with cemented nail technique using an intramedullary nail can be performed in some patients with excellent clinical outcome.

Osteosarcoma of the distal fibula and reconstruction of the ankle using inverted fibula, a case report.

INTRODUCTION AND IMPORTANCE: Osteosarcomas are malignant primary bone tumors of mesenchymal origin producing osteoid material and has peak incidence in adolescents. Distal lower limb tumors are rare and can negatively affect ankle joint stability. CASE PRESENTATION: A 24-year-old female who has newly graduated from college presented with distal fibular mass measuring around 5 × 15 cm located on the lateral aspect of the right ankle over a period of 2 months. The mass located on the lateral aspect of the right ankle that was hard, oval and measuring around 5 × 15 cm and originating from the fibula. The overlying skin was normal with no discharging sinuses. Distal neurovascular examination was normal with no lymphadenopathy. Imaging using X-rays and MRI as well as pathological examinations thereafter has proven the diagnosis. She was planned for wide surgical resection at distal fibula and ankle reconstruction after neoadjuvant chemotherapy, then for adjuvant chemotherapy. Ankle reconstruction using fibular autograft was used after its reversal and was then stabilization by syndesmotic screws. She has clinically good outcome. CLINICAL DISCUSSION: Surgery with extensive and meticulous dissection remains the cornerstone for treating osteosarcomas affecting distal fibula. Neoadjuvant and adjuvant chemotherapy are important for managing micro-metastasis. Ankle reconstruction and be performed using different methods with good outcomes. CONCLUSION: Lesson learnt is that ankle reconstruction using fibular autograft can be used after reversal and stabilization by screws with good outcome for managing distal fibular osteosarcomas. However, this finding needs to be strengthened with future reports.