ABSTRACT
Aggressive fibromatosis is a rare clonal proliferative tumor arising from mesenchymal cells in the fascia and musculoaponeurotic structures. The aim of the present study was to describe several cases of extra-abdominal recurrent aggressive fibromatosis. The present study was a single-center retrospective case series of patients with recurrent aggressive fibromatosis. The cases were managed at a single private facility. A total of 9 patients with recurrent fibromatosis were included. The mean and median ages of the patients were 29 and 30 years, respectively. In total, two thirds (66.67%) of the cases were female. A negative previous medical history was reported in 7 cases (77.7%), and diabetes and hypertension were reported in 1 case (11.1%). Overall, only 1 case (11.1%) had a family history of breast fibromatosis. The time interval between primary tumor resection and recurrent presentation was 28 months. In 6 cases (66.7%), the tumor was located in the extremities. Pain was the most common presenting symptom in 6 cases (66.7%). All patients had their recurring tumor surgically removed, followed by radiation in 5 cases. The resection margin was positive in 4 cases (44.4%). Each patient was subjected to a careful three-month follow-up for recurrences. On the whole, the present study demonstrates that despite the fact that several therapeutic approaches for extra-abdominal recurrent aggressive fibromatosis have been described in the literature, there is a significant likelihood of recurrence following resection.
ABSTRACT
De Quervain's tenosynovitis (DQT) is a painful stenosing tenosynovitis of the first dorsal compartment of the wrist, which may be refractory to conservative treatments. The present study aimed to evaluate the efficacy of ultrasound (US)-guided platelet-rich plasma (PRP) injection for the management of DQT. For this purpose, from January, 2020 to February, 2021, 12 patients with DQT who received the US-guided PRP injection were studied prospectively. All patients were evaluated clinically for pain intensity using the visual analog scale and sonographically prior to treatment. The patients were followed-up at 1 and 3 months after the procedure to evaluate the efficacy of the treatment. In total, 12 hands of 12 female patients with DQT were analyzed in the present study. The post-treatment clinical evaluation revealed complete recovery in 4 (33.3%) of the patients, and 6 (50%) of them had recovered and returned to their daily activities. The sonographic evaluation revealed a significant reduction in the mean retinaculum thickness from 1.84 to 1.069 mm, and mean tendon sheath effusion from 2.06 to 1.25 mm, with only 58% of the cases having tendon sheath effusion at 3 months post-treatment. On the whole, the findings of the present study demonstrate that US-guided PRP injection with needle tenotomy can be used as an alternative non-surgical therapy for patients who do not respond to conventional conservative treatments, particularly in cases with sub-compartmentalization. The use of US may play a crucial role in the treatment of DQT, as improved clinical outcomes can be obtained with US-guided injections, particularly in cases with sub-compartmentalization.
ABSTRACT
INTRODUCTION: and importance: Giant cell tumors of the tendon sheath in children have rarely been reported in the literature. This study aims to present a case of giant cell tumors of the tendon sheath on the big toe of a 5-year-old child. CASE PRESENTATION: A 5-year-old girl presented with a painless swelling over the dorsal aspect of right big toe for 2 weeks. Physical examination revealed non-tender rubbery like swelling over the dorsal aspect of the right big toe. Ultrasound scan of the swelling showed a 17 × 7 mm oval-shaped subcutaneous hypoechoic lesion. Magnetic resonance imaging showed evidence of 20× 8 mm well-defined fusiform soft tissue lesion scalloping the bone. Under general anesthesia, the mass was totally excised. Microscopic sectioning showed a mixture of fibroblasts and histiocyte like cells associated with multinucleated giant cells in the vascular connective tissue stroma with the definite diagnosis of the giant cell tumor of the tendon sheath. DISCUSSION: These tumors mostly compose of several types of cell like synovial, siderophages, foam, inflammatory and multinucleate giant cells. The major etiological factors that induce development of this tumor could be traumatic, inflammatory, metabolic or neoplastic disease. CONCLUSION: although it is a sporadic finding, giant cell tumors of the tendon sheath might affect the lower limb in children. Complete excision is the main modality of treatment.
ABSTRACT
INTRODUCTION: Pigmented villonodular synovitis (PVNS) of the hip joint associated with developmental dysplasia of the hip joint (DDH) is an extremely rare co-presentation. The aim of this study is to report a case of PVNS associated with DDH. PRESENTATION OF CASE: A 26-year-old women, a known case of DDH, presented with progressive right hip pain for one month duration. She was able to perform all the right hip movements with limitation due to pain. Plain radiographs showed a hip dislocation. Through a posterior incision, a mass of brown fibro-fatty soft tissue emerged. The specimen was sent for histopathological examination, The findings were variable mixture of giant cells, hemosiderin, and brown pigmentation in the synoviocyte cytoplasm. DISCUSSION: Although both conditions were previously described separately, the significance of co-incidence of DDH and PVNS is not well understood due to the rarity of the association. CONCLUSION: Co-incidence of DDH with PVNS is an extremely rare finding but could be safely managed if caught early in the beginning of the disease.
