Subtalar joint pigmented villonodular synovitis misdiagnosed at the first visit: A case report.

BACKGROUND: Pigmented villonodular synovitis (PVNS) is an uncommon disease that usually occurs in large joints, and involvement of the subtalar joint is rare. The lack of comprehensive knowledge of subtalar joint PVNS could lead to misdiagnosis. CASE SUMMARY: We present a 64-year-old woman who, at her first visit, complained of discomfort in the right ankle when she walked. Based on the physical signs and X-ray report, the physician failed to make the suspected diagnosis of PVNS. Eighteen months later, the patient returned with a complaint of a mass in her right lateral malleolus with intermittent blunt pain. The X-ray presented an osteophyte formation and soft tissue calcification at the margin of the subtalar joint. The laboratory tests were normal, whereas magnetic resonance imaging (MRI) showed a low-intensity area on both T1- and T2-weighted images. A suspected diagnosis of PVNS was made and later confirmed by postoperative pathology. Subsequently, the patient received radiotherapy with 32 Gy in 16 fractions. At 6 mo postoperatively, the patient only complained of discomfort after walking three blocks. The American Orthopedic Foot and Ankle Society Ankle-Hindfoot score was 97. CONCLUSION: MRI is necessary for the diagnosis of PVNS. Early soft tissue calcification and painless joint swelling should be of concern.

[Expression of mucin-l and beta-catenin in papillary thyroid carcinoma and the clinical significance thereof].

OBJECTIVE: To investigate the expression levels of mucin-1 (MUC1) and beta-catenin in papillary thyroid carcinoma, the significance thereof in the carcinogenesis and development of tumor. METHODS: Specimens of thyroid tissues were collected from 53 patients of papillary thyroid carcinoma, and 20 patients of nodular goiter, including 20 specimens of the tissues with thyroid nodules and 20 specimens of normal thyroid tissues adjacent to the nodules (as controls). Immunohistochemistry was used to detect the expression of MUC1 and beta-catenin in these tissues. The correlation of the expression of MUC1/beta-catenin with different clinico-pathological parameters of the papillary thyroid carcinoma patients was analyzed. RESULTS: The MUC1 expression level of the tissues of the papillary thyroid carcinoma tissue was (134 +/- 10, gray scale), significantly higher than those of nodular goiter group (101 +/- 7, gray scale) and the control group (99 +/- 6, gray scale) (both P < 0.01). The positive expression rate of MUC1 in the tissues of papillary thyroid carcinoma was 56.6%, significantly higher than those in the nodular goiter and control groups (15.0% and 5.0% respectively, both P < 0.01). The positive beta-catenin expression rate of the papillary thyroid carcinoma group was 71.7%, significantly higher than those of the nodular goiter and control groups (40.0% and 20.0% respectively, both P < 0.05). The positive MUC1 expression rate of the papillary thyroid carcinoma patients with lymph node metastasis was 68.4% (26/38), significantly higher than that of the patients without lymph node metastasis (26.7%, 4/15, P < 0.05), however, there were no significant differences in the MUC1 expression rate among the papillary thyroid carcinoma patients different in sex, age, and tumor size (all P > 0.05). The beta-catenin expression rates of the papillary thyroid carcinoma patients different in sex, age, tumor size, and lymph node metastasis status were not significantly different (all P > 0.05). Binary Logistic regression analysis showed that abnormal expression of MUC1 and beta-catenin were positively correlated with the pathogenesis of papillary thyroid carcinoma (all P < 0.05), and lymph node metastasis status and abnormal expression of beta-catenin were positively correlated with MUC1 expression (P < 0.05). CONCLUSION: Playing an important role in the carcinogenesis and development of papillary thyroid carcinoma, MUC1 can be used as a biomarker in this carcinoma. There was a significant positive correlation between MUC1 expression and beta-catenin expression.

Association of p73 and MDM2 polymorphisms with the risk of epithelial ovarian cancer in Chinese women.

OBJECTIVE: This study was to investigate the association of p73 G4C14-to-A4T14 and Murine Double Minute2 (MDM2) 309T/G, Del1518+/- single nucleotide polymorphisms with the risk of epithelial ovarian cancer (EOC) in Chinese. MATERIALS AND METHODS: This hospital-based case-control study included 257 ovarian cancer patients and 257 healthy women who were matched for age. p73 and MDM2 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: There were no significant differences in allele frequencies and genotype distributions of the p73 G4C14-to-A4T14 polymorphism between cases and control women (P = 0.55 and 0.20, respectively). The frequencies of the G allele of the MDM2 309T/G polymorphism were significantly lower in ovarian cancer cases (46.7%) than those in healthy controls (54.7%), there was a statistical difference between the 2 groups (P = 0.01). Compared with the T/T genotype, the G allelotype (T/G+G/G genotype) significantly decreased the risk of developing EOC (odds ratio, 0.65; 95% confidence interval, 0.44-0.97). Although MDM2 Del1518+/- genotypes and allele frequencies did not differ between the case and the control groups (P = 0.68 and P = 0.45), Del1518 +/+ genotype tended to increase the risk of mucinous ovarian cancer or earlier ovarian cancer by stratification analysis according to histological subtypes or clinical stage. Besides, there was a significant interaction between p73 G4C14-to-A4T14 and MDM2 309T/G polymorphisms by the likelihood ratio test (P = 0.03; odds ratio, 0.89; 95% confidence interval, 0.80-0.99). CONCLUSION: The MDM2 SNP309G allele significantly decreased the risk of EOC and might be a potentially protective factor for EOC development in Chinese women.