RESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Fluordesoxiglucose F18/administração & dosagem , Fluordesoxiglucose F18/análise , Estadiamento de Neoplasias/instrumentação , Estadiamento de Neoplasias , Adamantinoma/complicações , Adamantinoma , Tomografia por Emissão de Pósitrons/instrumentação , Tomografia por Emissão de Pósitrons/métodos , Medronato de Tecnécio Tc 99m/administração & dosagem , Medronato de Tecnécio Tc 99m/análise , Tomografia por Emissão de Pósitrons/tendências , Tomografia por Emissão de Pósitrons , Seguimentos , Medicina Nuclear/métodos , Osso e Ossos/patologia , Osso e OssosRESUMO
A 21-year-old patient presented with an aggressive lesion of the left tibia associated to lymph nodes and lung metastasis. Histological examination revealed a high grade spindle cell sarcoma involving some areas of cytokeratine positive cells. Ultrastructural examination showed the presence of epithelial features in the sarcomatoid cells. The diagnosis of dedifferentiated spindle-celled adamantinoma was established. A second lesion of the right tibia was diagnosed as fibrous dysplasia. The patient had a leg amputation. He died 2 years later with multiple lung and bone metastases. The diagnosis of dedifferentiated adamantinoma should be considered when a clinician is confronted with a tibial biopsy of a "keratin-positive sarcoma". The association with fibrous dysplasia in this case is discussed.
Assuntos
Adamantinoma/diagnóstico , Neoplasias Ósseas/diagnóstico , Displasia Fibrosa Óssea/diagnóstico , Tíbia , Adamantinoma/complicações , Adamantinoma/patologia , Neoplasias Ósseas/complicações , Neoplasias Ósseas/patologia , Displasia Fibrosa Óssea/complicações , Displasia Fibrosa Óssea/patologia , Humanos , Neoplasias Pulmonares/secundário , Masculino , Adulto JovemAssuntos
Adamantinoma/tratamento farmacológico , Adamantinoma/patologia , Antineoplásicos/uso terapêutico , Indóis/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Pirróis/uso terapêutico , Acidentes de Trânsito , Adamantinoma/complicações , Apendicite/complicações , Inibidores Enzimáticos/uso terapêutico , Pé/patologia , Fraturas Ósseas/complicações , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Psoríase/complicações , Receptores Proteína Tirosina Quinases/antagonistas & inibidores , Fumar , Sunitinibe , Tomografia Computadorizada por Raios X , Deficiência de Vitamina B 12/complicaçõesRESUMO
A 27-year-old man presented with swelling and inflammation of his right tibia, which had been present for nearly 3 years. It apparently was associated with an injury that was sustained to the right leg when it was struck against a tree stump, which had led to immediate swelling. There were no other symptoms and no history of fever or weight loss. The right tibia was swollen to twice the size of the left and the skin was indurated with numerous crusted lesions and some sinus-like areas, but no ulceration of the skin surface was apparent. We report for the first time to our knowledge a unique case of both botryomycosis and adamantinoma in the right tibia of the same patient at an area of previous trauma. Pathologists, clinicians and radiologists should be aware that both lesions can occur together. Although both botryomycosis and adamantinoma usually have a history of trauma, as in our patient, a causal relationship will need more cases to establish a possible link.
