RESUMEN
INTRODUCTION: Primary bone liposarcoma are extremely rare tumors and their location in the fibular head is exceptional. CASE REPORT: A 19 year-old patient with a pain on the lateral of the proximal leg. The X-ray found an osteolytic lesion; MRI of the knee revealed a proximal epiphyseal-metaphyseal lesion process of the right fibula contours with cortical lysis and local medullary damage. The pathological study, follow by the immunohistochemical exam and the FISH concluded in an amplification of MDM2 (Murine double minute 2) confirming the presence of a liposarcoma. DISCUSSION: The primary bone localization of liposarcomas remains rare. Their localization at the level of the fibular head is exceptional. The proximal fibula is mainly affected by benign tumors, in particular giant cell. Malignant tumors localized to the head of the fibula as well as aggressive benign tumors most often require en bloc resection. CONCLUSION: Although rare, primary liposarcomas can localize to the head of the fibula. It is necessary to establish a clinical, radiological and histological diagnosis for adequate management.
RESUMEN
The tendinous sheath fibroma (TSF) is a rare benign tumor, exceptionally responsible for carpal tunnel syndrome and "trigger" wrist: we found this association less than ten times in the English and French literature. We report the case of a 63-year-old right-handed carpenter who featured a triggering phenomenon of the right wrist during the flexion-extension movements and compression of the median nerve at the carpal tunnel, secondary to a TSF of the flexor digitorum superficialis. The diagnosis was suspected at the sonography and MRI, the tumor was excised and proven histologically to be a TSF. One year later, the patient remained free of symptoms.
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Síndrome del Túnel Carpiano/etiología , Fibroma/diagnóstico , Fibroma/cirugía , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/cirugía , Articulación de la Muñeca/cirugía , Fibroma/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de los Tejidos Blandos/complicaciones , Tendones/cirugía , Resultado del TratamientoRESUMEN
The amputation of the finger complicating an ophidian bite is rare. It is due to virulence of the venom, its concentration in a small volume of tissue and use of a tourniquet. Support of the victim seeks to save his life and function of his(her) hand. Antivenin immunotherapy is the only specific treatment for ophidian envenimation. It is indicated in case of general signs showing a serious bite, but also if local signs could lead to loss of limb function. The authors report three cases of snakebite complicated by amputation of a finger.
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Amputación Quirúrgica , Traumatismos de los Dedos/cirugía , Mordeduras de Serpientes/complicaciones , Adolescente , Adulto , Animales , Niño , Fasciotomía , Femenino , Traumatismos de los Dedos/etiología , Dedos/patología , Dedos/cirugía , Antebrazo/cirugía , Humanos , Masculino , Necrosis/etiología , Necrosis/cirugíaRESUMEN
Schwannoma is a tumor that develops from nerve sheath. The authors report an original observation of a giant schwannoma developed in the arm depending on the musculocutaneous nerve. The diagnosis was based on MRI appearance. Confirmation of the diagnosis was made by histological examination. Surgical treatment was resection, taking care preserving adjacent nerve fibers. This allowed recovery without any sequela. Recurrence rate and potential for malignant transformation of this type of tumor is low.
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Nervio Musculocutáneo/cirugía , Neoplasias de la Vaina del Nervio/patología , Neoplasias de la Vaina del Nervio/cirugía , Neurilemoma/patología , Neurilemoma/cirugía , Adulto , Brazo/cirugía , Biopsia , Humanos , Imagen por Resonancia Magnética , Neoplasias de la Vaina del Nervio/diagnóstico , Neurilemoma/diagnóstico , Procedimientos Neuroquirúrgicos , Pronóstico , Resultado del TratamientoRESUMEN
Penetrating wounds of the foot are not uncommon. Many are caused by thorns or by fragments of wood that are retained in the foot, creating a foreign-body granuloma. The differential diagnosis for bony reaction to an unrecognised organic foreign body includes osteoid osteoma, chronic and acute osteomyelitis, tuberculosis granuloma, bone cyst, aneurysmal bone cyst, cortical fibrous defect, and neoplasm. We report the case of a boy suffering from a thorn inducing a lytic lesion of the fifth metatarsal that demonstrates the diagnosis difficulties of foreign body granuloma.
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Giant cell tumour of tendon sheath is a benign proliferative lesion of synovial origin that may affect the joints, bursae and tendon sheaths. It is the second most common soft tissue tumor of the hand after ganglion cyst. The localised (nodular) form is the most common. However, the less-common diffuse-type giant cell tumour is usually located in the peri-articular soft tissue. The authors report the case of a giant cell tumor of the tendon sheath arising from the carpal tunnel of the wrist in a 42-year-old woman. The patient presented a mild carpal tunnel syndrome and a mid-palmar swelling. We present an unusual localization of giant cell tumor of the tendon sheath, causing carpal tunnel syndrome.
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Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Carpiano/etiología , Tumores de Células Gigantes/complicaciones , Tumores de Células Gigantes/diagnóstico , Neoplasias de los Tejidos Blandos/complicaciones , Neoplasias de los Tejidos Blandos/diagnóstico , Articulación de la Muñeca/patología , Adulto , Síndrome del Túnel Carpiano/cirugía , Femenino , Estudios de Seguimiento , Tumores de Células Gigantes/cirugía , Humanos , Imagen por Resonancia Magnética , Neoplasias de los Tejidos Blandos/cirugía , Tendones/patología , Resultado del Tratamiento , Articulación de la Muñeca/cirugíaRESUMEN
Lipomas are benign tumors composed of mature fat. They rarely arise in the hand and are even rarer in the fingers. The lipoma is called "giant" when the resected specimen exceeds 5 cm in diameter. We report a rare case of giant lipoma in a finger.
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Dedos/patología , Lipoma/patología , Neoplasias Cutáneas/patología , Dedos/cirugía , Estudios de Seguimiento , Humanos , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Neoplasias Cutáneas/cirugía , Resultado del TratamientoRESUMEN
Juxta articular myxomas are rare tumors. The treatment is surgical with a high recurrence rate. A location proximal to the wrist joint is exceptional. We report a case of juxta articular myxoma of the wrist in a 30-year-old patient, with no recurrence four months after surgical excision.
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Mixoma , Neoplasias de los Tejidos Blandos , Articulación de la Muñeca , Adulto , Femenino , Humanos , Mixoma/patología , Mixoma/cirugía , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/cirugía , Resultado del Tratamiento , Articulación de la Muñeca/patología , Articulación de la Muñeca/cirugíaRESUMEN
The schwannoma is a benign tumour that can be eradicated; it usually occurs in the peripheral nerves of the upper limb. We report an exceptional localization in the axillary nerve. The diagnosis is based on the typical MRI appearance: in addition, confirmation of the diagnosis has to be made by histological examination. The surgical treatment by resection, taking care to preserve adjacent nerve fibres. This allows recovery without any after-effects since the recurrence rate as well as the potential for malignant transformation of this type of tumour is low.