Early arthroscopic debridement of posterior cruciate ligament calcification after symptom presentation led to immediate recovery: a case report.

BACKGROUND: We report a rare case of posterior cruciate ligament (PCL) calcification, which has only been reported in two case studies on PubMed. CASE PRESENTATION: A 71-year-old man developed left popliteal pain in the morning without any history of trauma and the pain became severe that night. On the following day, he presented to our department. The patient could not flex his left knee at all due to pain and swelling. CT and MRI scans showed calcification behind the PCL with mild osteoarthritic changes and accumulation of synovial fluid in the joint. Synovial fluid analysis did not reveal any crystals. Blood tests at first admission showed inflammation, hyperglycemia, and low blood uric acid levels. Although the patient's knee joint was injected with steroids, his symptoms did not improve. Thus, we performed arthroscopic surgery two days after symptoms had appeared. Intraoperatively, we observed a white, soft tissue in the synovial membrane behind the PCL. Part of this tissue was collected for histological analysis, which revealed sparse fibers with calcium deposits. Immediately after surgery, the patient's symptoms were completely gone. Afterward, the patient remained asymptomatic one month after surgery. CONCLUSION: This is the first reported case of debridement of PCL calcification and ossification that was performed soon after symptoms appeared. In addition, we demonstrated that early debridement led to complete recovery.

[A case of pleomorphic malignant fibrous histiocytoma with multiple lung metastases with bilateral pneumothorax after chemotherapy].

A 70-year-old man diagnosed with pleomorphic malignant fibrous histiocytoma of the left thigh underwent tumor resection. After 10 months, he underwent extended resection due to local recurrence. However, because multiple lung metastases was detected at this time, chemotherapy with ifosfamide and doxorubicin was administered. After three courses of chemotherapy, the lung metastases enlarged and the patient received ifosfamide and etoposide as second line chemotherapy. Even after three courses of second line treatment, the disease progressed, for which docetaxel and gemcitabine were administered as third line chemotherapy. After three courses of third line treatment, multiple lung metastases reduced and were replaced with scar and cystic lesions (reduction ratio 85.9%). After four courses of treatment, the patient developed left pneumothorax. Partial resection of the left upper lobe was performed by thoracoscopic surgery. Histopathological examination revealed rupture of the visceral pleura in a scar lesion leading to air leakage. After 13 courses of treatment, he developed right pneumothorax. Partial resection of the right middle lobe was performed. Histopathological examination revealed a cystic lesion without tumor remnants. After 15 courses of third line treatment, lung metastasis could be controlled. Chemotherapy with docetaxel and gemcitabine resulted in few adverse effects that were within tolerance limits.