Atypical presentation of non-ossifying fibroma.

Non-ossifying fibroma is a common benign bone lesion but extensive involvement of almost whole of the shaft of right tibia is a rare presentation. The patient was a young lady of 35 years admitted at the department of Orthopaedics in Bangabandhu Sheikh Mujib Medical University (BSMMU) on June 2006 with pain and swelling of right distal tibia and unable to walk without support, was diagnosed clinico-radiologically as a case of fibrous dysplasia. The lady was undergone surgery and biopsy confirmed a case of non-ossifying fibroma. Within the follow up period of 28 months, the patient was well with full functional limb and the lesion was also healed radiologically.

Application of mixed bone graft (autograft+allograft) in the management of giant cell tumor of bone.

Giant cell tumor is a common bone neoplasm. We have initiated a prospective study for the treatment of giant cell tumor of bone by mixed (Autograft+Allograft) bone graft in the department of orthopaedics, Bangabandhu Sheikh Mujib Medical University (BSMMU), during January 2002 to March 2008. A total 28 patients of giant cell tumor of bone were operated. In this study out of 28 cases, male were 11(39.28%) and female were 17(60.72%). Female were predominant. Age of the patients ranging from 11 years to 49 years, mean age 27.03 years. More common in 21 years to 30 years 16(57.14%) of cases. Common sites of lesion were distal & proximal end of femur 11(39.28%), proximal end of tibia 6(21.43%), proximal humerus 3(10.71%) and distal radius 3(10.71%). Final clinical outcome of giant cell tumor of bone treated by thorough curettage of the cavity and filled with mixed bone graft (freeze dried radiation sterilized bone allograft+autogenous bone graft) in which success rate is 75%(21) and recurrence rate is 25%(7). P is <0.001. Follow up period was 4 months to 4 years. From this study it was realized that mixed bone graft is useful graft material for enhancing osteogenic potential as well as maintaining structural integrity for the treatment of giant cell tumor of bone.

Is gross total removal necessary for paediatric posterior fossa tumour?

This prospective study was done in Neurosurgery department, Dhaka Medical College Hospital. It was conducted from December 2002 to October 2005. During this period 40 paediatric posterior fossa tumour patients was admitted. The mean age of the patients were 8.31+/-3.1 years ranging from 3.5 to 15 years. The main complaints were headache with vomiting (100%), dimming of vision (70%), Ataxia (52.5%), Blindness (25%). All cases had a definite diagnostic investigation at the time of admission. Plain x-ray skull was done in all patients followed by MRI scan (42.5%), CT scan (37.5) and both CT and MRI scan (20%). In all cases CSF diversion (VP shunt) were instituted. All patients were operated by suboccipital craniectomy followed by gross total removal of tumour in (62.5%) and subtotal removal in (37.5%). In all cases diagnosis was confirmed by histopathological examination. In cases of subtotal resection, symptoms (headache, vomiting) appeared during 7-9 months follow up period in (7.5%) and subsequent follow up in (12.5%). But in gross total removal symptoms appeared in one case (2.5%) in 13-15 months follow up period.