Total en bloc vertebrectomy and immunochemotherapy for chondrosarcoma colliding with intraosseous lymphoma.

A 59-year-old woman diagnosed with a Grade I chondrosarcoma in T7 underwent total en bloc vertebrectomy. Analysis of the surgical piece established diagnosis of a Grade 1 chondrosarcoma confined to T7. Surprisingly, an infiltration with diffuse large B-cell lymphoma was found. Systemic disease was ruled out and diagnosis was established as intracompartmental Grade 1 chondrosarcoma colliding with intraosseous extranodal diffuse large B-cell lymphoma. Resection of chondrosarcoma was considered complete and treatment with four cycles of RCHOP was indicated. Two years after surgery, the patient remains at complete metabolic response. To date, this is the first reported case of chondrosarcoma colliding with lymphoma. Although Grade 1 chondrosarcoma is typically managed with local control through complete surgical resection, the mentioned finding of the lymphoma indicated the need for systemic treatment with immunochemotherapy.

Fractura aislada de troquín. Presentación de un caso y revisión bibliográfica / Isolated troquin fracture. Presentation of a case and bibliographic review

La fractura avulsión de la tuberosidad menor humeral aislada es extremadamente rara.Es una lesión difícil de diagnosticar pasando, muchas veces, desapercibida.Se presenta el caso de una paciente de 64 años con una fractura aislada de troquín.El tratamiento que se decidió en esta paciente fue quirúrgico mediante reducción abierta y os- teosíntesis con tornillos además de suturas quirúr- gicas de los fragmentos.Existe evidencia a favor de que cualquier des- plazamiento es susceptible de tratamiento quirúr- gico con el fin de evitar un desplazamiento ma- yor de la misma, la pseudoartrosis del fragmento avulsionado, un pinzamiento anteromedial y una posible luxación del tendón del bíceps, además de la limitación funcional para la rotación interna del brazo. (AU)

Isolated humerus lesser tuberosity avulsion fracture is extremely rare.It is a difficult injury to diagnose, often going unnoticed.The case of a 64-year-old patient with an iso- lated troquin fracture is presented.The treatment that was decided in this patient was surgical by means of open reduction and oste- osynthesis with screws in addition to surgical su- turing of the fragments.There is evidence that any displacement is susceptible to surgical treatment in order to avoid further displacement of the displacement, pseu- doarthrosis of the avulsed fragment, an anterome- dial impingement and a possible dislocation of the biceps tendon, in addition to functional limitation for the internal rotation of the arm. (AU)

Fracturas de columna posterior de acetábulo tratadas mediante tornillo ilioisquiático retrógrado percutáneo. Serie de casos / Posterior spine acetabulum fractures treated with percutaneous retrograde ilioischial screw. Number of cases

Introducción: Las fracturas de acetábulo suponen un reto para los traumatólogos. Tradicionalmente el tratamiento de estas fracturas ha sido la reducción abierta y fijación interna, sin embargo, recientemente se han popularizado técnicas percutáneas para el tratamiento de fracturas no desplazadas o mínimamente desplazadas. En este estudio exponemos nuestros resultados en pacientes tratados mediante fijación percutánea con un tornillo ilioisquiático retrógrado de fracturas no desplazadas de columna posterior. Material y Métodos: Desde 2016 a 2020, Ocho varones con una edad media de 59,75 años (27-79), fueron intervenidos en nuestro centro de fracturas simples o combinadas de columna posterior no desplazadas mediante tornillo ilioisquiático retrógrado percutáneo. Realizamos una evaluación postoperatoria mediante el WOMAC Score y el Oxford Hip Score. Registramos complicaciones. Resultados: Los resultados postoperatorios del cuestionario WOMAC fueron 81,24 de media (50-100) y los resultados del Oxford Hip Score 36,42 de media (22-45). Un paciente desarrolló una coxartrosis secundaria a infección del material de osteosíntesis que requirió de artroplastia total de cadera. Un paciente falleció por motivos no relacionados con la fractura. Conclusiones: El tratamiento percutáneo constituye una de las herramientas terapéuticas para el manejo de estas fracturas, con bajas tasas de lesiones neurovasculares, calcificaciones heterotópicas, infecciones, y escaso sangrado quirúrgico.(AU)

Introduction: Acetabulum fractures present a challenge for orthopedic surgeons. Traditionally the usual treatment of these fractures has been open reduction and internal fixation. However, percutanous techniques have recently become popular for the treatment of minimally displaced fractures. In the present paper the results in a group of patients treated by percutaneous fixation with a retrograde ilioischial screw are reported. Material and methods: From 2016 to 2020, Eight men with a mean age of 59.75 years (27-79) were operated on in our center for undisplaced simple or combined posterior column fractures using a percutaneous retrograde ilioischial screw. We performed a postoperative evaluation using the WOMAC Score and the Oxford Hip Score. The number and kind of complications are analyzed. Results: The postoperative results of the WOMAC questionnaire were 81.24 on average (50- 100) and the results of the Oxford Hip Score were 36.42 on average (22-45). One patient developed coxarthrosis secondary to infection of the osteosynthesis material that required total hip arthroplasty. One patient died for reasons unrelated to the fracture. Conclusions: Percutaneous treatment constitutes one of the therapeutic tools for the management of these fractures, with low rates of neurovascular injuries, heterotopic calcifications, infections, and little surgical bleeding.(AU)

Presentación de un caso de luxación abierta periastragalina y revisión bibliográfica / Epidemiology and Treatment of fracture-dislocations of the midfoot

La luxación periastragalina lateral abierta es una entidad infrecuente dentro de las lesiones que afectan al pie y tobillo. Se presenta el caso de una luxación periastragalina lateral abierta que se trató mediante reducción abierta por interposición del tendón del tibial posterior y posterior inmovilización con una férula suropédica. A los 7 meses el rango de movilidad era completo, sin inestabilidades y no doloroso. Este artículo remarca la importancia de cómo actuar de forma emergente con esta patología y realizar una reducción precoz para evitar problemas mayores. El uso de antibiótico precoz y de un lavado abundante de la luxación son los primeros pasos a seguir

Open lateral periastral dislocation is an infrequent entity within injuries that affect the foot and ankle. The case of an open lateral peritalar dislocation that was treated by open reduction by interposition of the posterior tibial tendon and posterior immobilization with a surpedic splint is presented. At 7 months the range of motion was complete, without instability and painless. This article highlights the importance of how to act emergently with this pathology and carry out an early reduction to avoid major problems. The use of early antibiotics and abundant lavage of the dislocation are the first steps to follow

Multiple Xanthogranulomas in an Adult Patient with Myelodysplastic Syndrome.

Adult multiple xanthogranuloma (XG) is a rare late-onset variant of juvenile XG. It is characterized by the appearance of papules or nodules located preferably on the trunk. A case of a 54-year-old man with myelodysplastic syndrome is presented as a history of interest, who consulted due to the appearance of multiple brownish papules distributed mainly in the trunk. So far, there are only 22 cases of this clinical form reported in the literature, 9 of them associated with malignant hematological processes. We highlight the importance of this entity as a possible cutaneous marker of blood dyscrasias.

Factores de riesgo perinatales y maternofetales predictivos en el diagnóstico de Displasia de Cadera del recién nacido / Predictive perinatal and maternal-fetal risk factors in the diagnosis of newborn hip displasia

Objetivos El objetivo de este estudio es analizar los factores de riesgo asociados a la Displasia de Desarrollo de la Cadera con la intención de elaborar un screening con finalidad diagnóstica y terapéutica precoz. Pacientes y Métodos Se trata de un estudio multietápico. Primero, se ha realizado un estudio transversal y observacional. Para ello se incluyeron 114 recién nacidos del Hospital Universitario Reina Sofía entre el 1 de marzo del 2015 y el 28 de febrero del 2016 con dos o más factores de riesgo (sexo femenino, madre primípara, gestación múltiple, parto por cesárea y antecedentes familiares de displasia) y/o presentación podálica y/o exploración física positiva para displasia de cadera. En segundo lugar, con los pacientes seleccionados, se ha realizado un estudio de casos y controles prospectivo, siendo los casos aquellos neonatos diagnosticados por ecografía de displasia y los controles los no diagnosticados. El método estadístico comprende un estudio descriptivo y un estudio analítico (análisis bivariante y análisis logístico múltiple). Conclusiones Establecer un protocolo de screening de DDC es de gran dificultad dada la discrepancia entre los factores de riesgo estudiados. En el presente estudio consideramos la primiparidad como factor de riesgo, el cual podría ser incluido en un screening para seleccionar aquellos pacientes que serían beneficiarios de la realización de una ecografía coxofemoral bilateral

Objetives: The objective of this study is to analyse the risk factors associated to developmental hip dysplasia in order to design a screening program to ensure early diagnosis and treatment. Patients and methods: This is a multiphase study. First, we performed a transverse and observational study. A total of 114 newborns from the Reina Sofía University Hospital between March 1st 2015 and February 28th 2016 with two or more risk factors (female sex, primiparous mother, multiple pregnancy, caesarean birth and family hip dysplasia history) and/or breech presentation and/or suggestive physical examination for hip dysplasia were included. In second place, a prospective case - control study was performed on selected patients. Case were new-borns diagnosed with dysplasia with ultrasound and controls were those without this diagnosis. The statistical method included a descriptive study and an analytical study (bivariate analysis and multiple logistic regression analysis). Results: The multiple logistic regression analysis showed that primiparous state and breech presentation are risk factors for the appearance of developmental hip dysplasia. The rest of variables were non-significant

Urticaria vasculitis in a child: a case report and literature review.

Annular urticarial lesions in a child must establish a main differential diagnosis with urticaria multiforme, common urticaria, acute hemorrhagic edema of infancy, erythema marginatum, erythema annulare centrifugum, annular erythema in childhood, erythema multiforme, Sweet's syndrome, Schönlein-Henoch purpura, erythematosus lupus, several systemic vasculitis, and serum sickness.

An Unusual Location of Subungual Warty Dyskeratoma: A Case Report and Review of the Literature.

Warty dyskeratoma is an uncommon entity characterized by a solitary keratotic papule or nodule usually located in the head and neck of young adults. The histopathology shows a pattern of acantholytic dyskeratosis. We report a 32-year-old man who presented pain, serous exudation, a distal onycholysis with subungual hyperkeratosis, and roundish erythronychia in the nail plate of his left first toe 2 years ago. A histopathologic diagnosis of subungual warty dyskeratoma was made. When dealing with focal acantholytic dyskeratosis several differential diagnoses should be considered including Darier's disease, transient focal acantholytic dyskeratosis or Grover disease, and Hailey-Hailey disease. We present an unusual location of warty dyskeratoma in the nail bed using a clinicohistopathological correlation for the diagnosis.

Manifestaciones cutáneas y mucosas asociadas al consumo de cocaína / Cutaneous and mucosal manifestations associated with cocaine use

Las complicaciones secundarias a la cocaína constituyen un problema de salud pública. La manifestación cutánea característica es la vasculitis leucocitoclástica y/o la vasculopatía trombótica habitualmente poco agresiva que afecta principalmente a los pabellones auriculares. No suele presentar afectación sistémica intensa, pero puede acompañarse de múltiples manifestaciones cutáneas, mucosas y sistémicas. Otros hallazgos asociados como las artralgias, la neutropenia o la agranulocitosis, los anticuerpos antinucleares positivos a títulos bajos, y la positividad para anticuerpos antifosfolipídicos y anticuerpos anticitoplasma de neutrófilos frente a múltiples antígenos ayudan al diagnóstico. Esta entidad requiere un diagnóstico precoz, siendo fundamental la sospecha clínica, realizar una adecuada anamnesis, una exploración física completa y un diagnóstico diferencial amplio. El curso suele ser autolimitado. En la mayoría de los casos el único tratamiento necesario es la interrupción del consumo de cocaína asociado a un tratamiento sintomático, sin beneficio demostrado de los corticoides sistémicos (AU)

Complications due to cocaine are a public health problem. The typical cutaneous disease is leukocytoclastic vasculitis and/or thrombotic vasculopathy affecting mainly the ears. No intense systemic involvement is usually present, but there may be several cutaneous, mucosal and systemic manifestations. Other findings associated as arthralgia, neutropaenia or agranulocytosis, low titer positive antinuclear antibodies, antiphospholipid antibody positivity and neutrophil cytoplasmic antibodies against multiple antigens help the diagnosis. This disease requires a clinical suspicion with a clinical history, a complete physical examination and a broad differential diagnosis for an early and correct diagnosis. The course is usually self-limited. In most cases the only treatment is to discontinue the use of cocaine associated with symptomatic treatment, no proven benefit of systemic corticosteroids (AU)

Acquired Localized Hypertrichosis Induced by Rivastigmine.

Hypertrichosis is the excessive hair growth in any area of the skin surface. Acquired localized hypertrichosis may be secondary to multiple causes and there is a secondary form due to several drugs, which is usually reversible with discontinuation of the causative agent. Rivastigmine is a reversible and competitive inhibitor of acetylcholinesterase and butyrylcholinesterase used for symptomatic treatment of Alzheimer dementia and Parkinson's disease. It has an adequate safety profile and cutaneous side effects are unusual. Irritant contact dermatitis, allergic dermatitis, baboon syndrome, and cutaneous rash due to rivastigmine have been reported. We report on a Caucasian 80-year-old male with personal history of Alzheimer's disease. The patient started therapy with oral rivastigmine one month prior to clinical presentation of localized hypertrichosis on both forearms. Norgalanthamine has been shown to promote hair growth activity via the proliferation of dermal papilla. Acetylcholinesterase inhibitors can induce hair growth.

[Cutaneous and mucosal manifestations associated with cocaine use]. / Manifestaciones cutáneas y mucosas asociadas al consumo de cocaína.

Complications due to cocaine are a public health problem. The typical cutaneous disease is leukocytoclastic vasculitis and/or thrombotic vasculopathy affecting mainly the ears. No intense systemic involvement is usually present, but there may be several cutaneous, mucosal and systemic manifestations. Other findings associated as arthralgia, neutropaenia or agranulocytosis, low titer positive antinuclear antibodies, antiphospholipid antibody positivity and neutrophil cytoplasmic antibodies against multiple antigens help the diagnosis. This disease requires a clinical suspicion with a clinical history, a complete physical examination and a broad differential diagnosis for an early and correct diagnosis. The course is usually self-limited. In most cases the only treatment is to discontinue the use of cocaine associated with symptomatic treatment, no proven benefit of systemic corticosteroids.

Ungual squamous cell carcinoma mimicking a chronic paronychia: clinical, pathological and radiological correlation.

Squamous cell carcinoma is a malignant skin tumor that is rarely located in the nails. Its presentation, can sometimes be confused with an inflammatory process as onychomycosis or psoriatic onychopathy or other tumors as viral warts. We report the case of a 73-year-old woman with a locally invasive squamous cell carcinoma reaching the bone, simulating a chronic paronychia.

Tonsillar chancre as unusual manifestation of primary syphilis.

Primary syphilis with oropharyngeal manifestations should be kept in mind, though. Lips and tongue ulcers are the most frequently reported lesions and tonsillar ulcers are much more rare. We report the case of a 24-year-old woman with a syphilitic ulcer localized in her left tonsil.