Giant Myxofibrosarcoma in the Lower Limb: An Overview of Diagnostic and Clinical Management.

Myxofibrosarcoma (MFS), an aggressive soft tissue sarcoma, is one of the undifferentiated pleomorphic sarcomas; it has a low incidence, affecting people in the sixth to eighth decades of life. It usually involves the extremities and is painless with a slow-growing pattern. Based on the case of a 52-year-old female patient who presented with a painful, massive, rapid-growing, ulcerated tumor of the anterior surface of the left thigh, we performed a literature review regarding the current standard of care for patients with MFS. Computed tomography examination, followed by magnetic resonance imaging and surgical biopsy with histopathological examination, confirmed the diagnosis and the presence of lung and inguinal lymph node metastases. Due to the rapid-growing pattern and the local aggressiveness, our tumor board team recommended emergency excisional surgery, with subsequent reconstructive procedures followed by referral to an oncological center. This review emphasizes the importance of proper and rapid diagnosis, followed by multidisciplinary management, for MFS cases with atypical presentation and distal metastases to improve overall outcomes.

Acute cellulitis as local reaction to orthopedic implant - case presentation.

Due to increasing number of arthroplasties and osteosynthesis, foreign body reaction to implants is a major problem for orthopedic surgeons, since it is considered to be responsible for severe complications impairing the outcome of the treatment and requiring multiple surgery. Different mechanisms have been described as being involved, and research is focused on finding biomaterials with increased biocompatibility in order to minimize these complications. The clinical aspect of this reaction is usually dominated by chronic pain, with mild functional deficits, and the diagnosis results from excluding other causes of chronic pain, such as infection, osteoarthritis, peripheral neuropathies or angiopaties. The authors present a case with unusual clinical aspect, that of acute cellulitis, when early proper treatment, represented by implant removal, allowed healing without the onset of infection or other complications; histological evaluation confirmed the reaction to implant, thus concluding that surgical treatment when intolerance to implant is suspected is the only method to prevent future negative events.

Morphological landmarks of proximal humerus with impact in post-traumatic outcome.

As one of the fundamental requirements for an optimal function of the locomotive system is the integrity of the skeleton, the morphology of proximal humerus is crucial for upper limb performance. Not only that the bone is the support for muscle insertion, but its particular form is responsible especially for the complex movement of the shoulder joint, so that any pathological features of this morphology results in different degrees of dysfunction. Since trauma is the most frequent cause for morphological changes of this area, this paper studies the anatomical landmarks, which are affected by proximal humeral fractures and must be targeted when treating these injuries, for they influence the functional outcome. Evaluating the results from a Level 1 Trauma Centre, the authors underline the importance of these anatomical landmarks in approaching proximal humeral fractures and aim to establish a morphology-based therapeutic algorithm, crucial for optimal functional restoration.