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1.
J Hand Surg Am ; 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39269373

RESUMO

PURPOSE: The goal of the study was to assess the result of en bloc resection and matched nonvascularized toe phalangeal transfer in Campanacci grade 2 or 3 giant cell tumors of the phalanges. METHODS: Seven patients with Campanacci grade 2 and 3 phalangeal giant cell tumors were treated by en bloc resection and matched nonvascularized toe phalangeal transfer between June 2004 and May 2021. The patients were followed up by X-rays, Patient-Rated Hand and Wrist scores, Foot Function Index, Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, and total active motion measurements. RESULTS: The minimum follow-up was 18 months (range: 18-230 months; mean: 110 ± 81). There were three males and four females, with age ranging from 13 to 48 years (mean: 24.14 ± 11.74). The right:left hand ratio was 3:4. The thumb was involved in one patient, the index finger in two, the middle finger in one, and the ring finger in three patients. The mean total active motion was 201.70 (range: 190°-240°). The mean patient-rated hand and wrist score was 15.2 (range: 10-35). The mean quick disabilities of the arm, shoulder and hand questionnaire score was 1.3 (range: 0-9). The mean foot function index on follow-up was 2.86 (range: 2-3). There was no tumor recurrence. One patient had a pathological fracture with resultant shortening of the finger on follow-up. CONCLUSIONS: In our series en bloc resection and matched nonvascularized toe phalangeal transfer resulted in a functional tumor-free digit with a low complication rate and no recurrences. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic V.

2.
Surg Oncol ; 55: 102101, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39018867

RESUMO

INTRODUCTION: Giant cell tumors of the bone (GCTB) are aggressive neoplasms, with rare occurrences in the posterior pelvis and sacral area. Surgical challenges in this region include the inability to apply a tourniquet and limited cementation post-curettage due to proximity to neurovascular structures, leading to potential complications. This case-control study explores the impact of preoperative embolization on GCTB located in the iliosacral region. METHODS: Five surgeries (January-December 2021) for pelvic GCTB (3 sacrum, 2 posterior ilium) were performed on four patients. Diagnosis was confirmed through preoperative CT-guided biopsies. One surgery involved curettage with PMMA cement filling, while four surgeries had curettage without cavity filling. Preoperative embolization of the tumor feeding vessel occurred approximately 16 h before surgery in two cases. Denosumab treatment was not administered. RESULTS: Tumor volume, assessed by preoperative MRI, was comparable between patients with and without preoperative embolization (p = .14). Surgeries without embolization had a mean intraoperative blood loss of 3250 ml, erythrocyte transfusion volume of 1125 ml, and a mean surgical time of 114.5 min for two surgeries. Surgeries with preoperative embolization showed a mean intraoperative blood loss of 1850 ml, no erythrocyte transfusion requirement, and a mean surgical time of 68 min. CONCLUSION: Curettage of GCTB in the posterior pelvis and sacrum presents challenges, with significant intraoperative blood loss impacting surgical time and transfusion needs. Preoperative embolization may be beneficial in reducing blood loss during surgery in these cases.


Assuntos
Neoplasias Ósseas , Embolização Terapêutica , Tumor de Células Gigantes do Osso , Cuidados Pré-Operatórios , Sacro , Humanos , Embolização Terapêutica/métodos , Tumor de Células Gigantes do Osso/patologia , Tumor de Células Gigantes do Osso/cirurgia , Tumor de Células Gigantes do Osso/terapia , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/terapia , Feminino , Adulto , Estudos de Casos e Controles , Masculino , Sacro/cirurgia , Sacro/patologia , Ílio/patologia , Pessoa de Meia-Idade , Seguimentos , Prognóstico , Adulto Jovem , Ossos Pélvicos/patologia , Ossos Pélvicos/cirurgia , Curetagem/métodos
4.
Cureus ; 16(4): e59195, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38807802

RESUMO

Primary giant cell tumors of soft tissues (GCT-ST) are rare neoplasms that share histopathological and immunohistochemical characteristics with osseous giant cell tumors. While GCT-ST generally exhibits a benign progression and can affect individuals of various ages, older patients may face a higher risk of recurrence and aggressive disease progression. In this case report, we present the case of a 63-year-old woman who experienced recurrent GCT-ST nine months after the complete excision of an initially localized tumor. Despite the mainstay treatment of GCT-ST being tumor-free margin surgical excision, this case demonstrates the occurrence of recurrences. The etiology of recurrence in GCT-ST remains unclear, highlighting the need for further studies and careful patient follow-up to prevent potential complications such as lung metastasis or widespread metastasis. Thus, this report aims to raise awareness of these tumors and emphasize the importance of diligent patient follow-up to facilitate early identification and management, thereby preventing potential complications such as lung or widespread metastasis.

5.
J Bone Oncol ; 46: 100606, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38778836

RESUMO

Objective: This study aims to explore an optimized deep-learning model for automatically classifying spinal osteosarcoma and giant cell tumors. In particular, it aims to provide a reliable method for distinguishing between these challenging diagnoses in medical imaging. Methods: This research employs an optimized DenseNet model with a self-attention mechanism to enhance feature extraction capabilities and reduce misclassification in differentiating spinal osteosarcoma and giant cell tumors. The model utilizes multi-scale feature map extraction for improved classification accuracy. The paper delves into the practical use of Gradient-weighted Class Activation Mapping (Grad-CAM) for enhancing medical image classification, specifically focusing on its application in diagnosing spinal osteosarcoma and giant cell tumors. The results demonstrate that the implementation of Grad-CAM visualization techniques has improved the performance of the deep learning model, resulting in an overall accuracy of 85.61%. Visualizations of images for these medical conditions using Grad-CAM, with corresponding class activation maps that indicate the tumor regions where the model focuses during predictions. Results: The model achieves an overall accuracy of 80% or higher, with sensitivity exceeding 80% and specificity surpassing 80%. The average area under the curve AUC for spinal osteosarcoma and giant cell tumors is 0.814 and 0.882, respectively. The model significantly supports orthopedics physicians in developing treatment and care plans. Conclusion: The DenseNet-based automatic classification model accurately distinguishes spinal osteosarcoma from giant cell tumors. This study contributes to medical image analysis, providing a valuable tool for clinicians in accurate diagnostic classification. Future efforts will focus on expanding the dataset and refining the algorithm to enhance the model's applicability in diverse clinical settings.

6.
Curr Med Imaging ; 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454770

RESUMO

INTRODUCTION: Diffuse-type tenosynovial giant cell tumor (D-TGCT) originates from synovial cells in tendon sheaths and bursae and rarely presents as a calcaneal mass. CASE REPORT: A 44-year-old female presented with left heel pain that had persisted for over a year and had worsened over the past six months. A mass was found on the Lateral radiograph of the calcaneus, which was diagnosed as an aneurysmal bone cyst. Non-contrast computed tomography (CT) and magnetic resonance imaging (MRI)diagnosed a benign tumor. Based on light microscopy, special stains, and immunohistochemistry, a final diagnosis of diffuse tenosynovial giant cell tumor (D-TGCT) was rendered. RESULTS: D-TGCT is a slow-growing, infiltrative tumor that can form single or multiple masses outside the joint, and can also involve adjacent jointsmainly affects weight-bearing joints such as the knee, hip, and ankle. However, D-TGCT presents as a calcaneal mass, which poses a diagnostic challenge for all radiologists. CONCLUSION: A calcaneal mass exhibiting well-defined borders, focal cortical destruction, a sclerotic rim, and T2WI hypointensity, the possibility of D-TGCT should be considered.

8.
Bioact Mater ; 34: 338-353, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38274295

RESUMO

The osteochondral defects (OCDs) resulting from the treatment of giant cell tumors of bone (GCTB) often present two challenges for clinicians: tumor residue leading to local recurrence and non-healing of OCDs. Therefore, this study focuses on developing a double-layer PGPC-PGPH scaffold using shell-core structure nanofibers to achieve "spatiotemporal control" for treating OCDs caused by GCTB. It addresses two key challenges: eliminating tumor residue after local excision and stimulating osteochondral regeneration in non-healing OCD cases. With a shell layer of protoporphyrin IX (PpIX)/gelatin (GT) and inner cores containing chondroitin sulfate (CS)/poly(lactic-co-glycolic acid) (PLGA) or hydroxyapatite (HA)/PLGA, coaxial electrospinning technology was used to create shell-core structured PpIX/GT-CS/PLGA and PpIX/GT-HA/PLGA nanofibers. These nanofibers were shattered into nano-scaled short fibers, and then combined with polyethylene oxide and hyaluronan to formulate distinct 3D printing inks. The upper layer consists of PpIX/GT-CS/PLGA ink, and the lower layer is made from PpIX/GT-HA/PLGA ink, allowing for the creation of a double-layer PGPC-PGPH scaffold using 3D printing technique. After GCTB lesion removal, the PGPC-PGPH scaffold is surgically implanted into the OCDs. The sonosensitizer PpIX in the shell layer undergoes sonodynamic therapy to selectively damage GCTB tissue, effectively eradicating residual tumors. Subsequently, the thermal effect of sonodynamic therapy accelerates the shell degradation and release of CS and HA within the core layer, promoting stem cell differentiation into cartilage and bone tissues at the OCD site in the correct anatomical position. This innovative scaffold provides temporal control for anti-tumor treatment followed by tissue repair and spatial control for precise osteochondral regeneration.

9.
Artigo em Inglês | MEDLINE | ID: mdl-38024102

RESUMO

This is the first report on a localized pigmented villo-nodular synovitis (PVNS or TSGCT) occurring in the trochanteric bursa. Bursal involvement in PVNS is extremely rare. Most often PVNS occurs either as a localized or diffuse lesion in a major synovial joint, such as the knee, ankle joint or hip joint. In principle, all synovial structures can be involved. The case reported here is remarkable regarding the long period between the occurrence of the first symptoms and the final diagnosis as well as the age of the female patient (75 yrs). Therapeutically a complete resection was performed in order to avoid recurrence. More then three years later the patient did well and there has been no evidence of recurrence yet.

10.
J Cardiothorac Surg ; 18(1): 296, 2023 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-37848912

RESUMO

BACKGROUND: Giant cell tumor (GCT) is a relatively common and locally aggressive benign bone tumor that rarely affects the sternum. CASE PRESENTATION: We report a case of giant cell tumor of the sternum in a 28-year-old Saudi with painful swelling at the lower part of the sternum. Subtotal sternectomy and reconstruction with a neosternum using two layers of proline mesh, a methyl methacrylate prosthesis, and bilateral pectoralis muscle advancement flaps were performed. CONCLUSIONS: Giant cell tumor of the sternum is a rare diagnosis. Surgical resection with negative margins is the ideal management. To avoid defects or instability of the chest wall, reconstruction of the chest wall with neosternum should be considered.


Assuntos
Neoplasias Ósseas , Tumores de Células Gigantes , Humanos , Adulto , Arábia , Arábia Saudita , Esterno/cirurgia , Esterno/patologia , Retalhos Cirúrgicos , Tumores de Células Gigantes/cirurgia , Tumores de Células Gigantes/patologia , Neoplasias Ósseas/patologia
11.
J Orthop Surg (Hong Kong) ; 31(3): 10225536231202157, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37726111

RESUMO

This systematic review evaluates the effects of heat treatments in de novo, residual and recurrent giant cell tumors of bone (GCTB). Studies were eligible for inclusion if one of the following treatments was administered: radiofrequency ablation (RFA), microwave ablation, argon cauterization, electrocauterization and hot liquid treatment. The primary outcome was recurrence. Secondary outcomes were complications, pain, function, and quality of life. Recurrence rates for microwave ablation as an adjuvant to intralesional curettage were 0%, 4% and 10% (3 retrospective single-group studies); for argon cauterization 4%, 8% and 26% (3 cohort studies); electrocauterization 0% to 33% (8 cohort studies); and hot liquid 9.5% and 24% (2 cohort studies). Follow-up was generally ≥24 months. Data on pain, function and quality of life were scarce. Complications included infection and secondary osteoarthritis. Current evidence does not demonstrate or exclude an effect of heat treatments on recurrence in GCTB. Further research should objectify if (subgroups of) patients benefit from these treatments.


Assuntos
Neoplasias Ósseas , Tumor de Células Gigantes do Osso , Humanos , Estudos Retrospectivos , Argônio , Temperatura Alta , Qualidade de Vida , Tumor de Células Gigantes do Osso/cirurgia , Tumor de Células Gigantes do Osso/patologia , Curetagem/efeitos adversos , Dor/etiologia , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/patologia , Recidiva Local de Neoplasia/cirurgia
12.
Cureus ; 15(8): e43101, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37692670

RESUMO

Giant cell tumors (GCTs) are rare, benign, and locally invasive tumors, typically found in the epiphysis of long bones, most commonly at the distal femur and proximal tibia. To date, GCTs of the distal end of the ulna have been very rare. We document a case of a 38-year-old female with a distal ulna GCT, managed with en-bloc resection of the tumor with flexor carpi ulnaris and extensor carpi ulnaris tendon stabilization. The main aim of the GCT treatment is to prevent local recurrence and to maintain the function of the limb. Physical therapy was also given to the patient which helped in relieving pain, reducing edema, and increasing strength and range of motion. The patient was able to perform activities of daily living with the help of physical therapies and exercises. More research is needed to determine if broad excision of the distal ulna alone is a successful therapy for primary bone cancers affecting the distal ulna, including GCTs.

13.
World Neurosurg ; 178: e165-e173, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37451361

RESUMO

OBJECTIVE: Surgery for spinal giant cell tumors (GCTs) is challenging because these tumors often exhibit a poor clinical course owing to their locally aggressive features. This study aimed to investigate the prognostic factors of GCT recurrence in the spine by focusing on surgical factors. METHODS: We retrospectively reviewed patients who underwent surgery for spinal GCTs between January 2005 and December 2016. Using the Kaplan-Meier method, surgical variables were evaluated for disease-free survival (DFS). Since tumor violation may occur at the pedicle during en bloc resection of the spine, it was further analyzed as a separate variable. Multivariate Cox proportional hazard regression analysis was performed for other clinical and radiographic variables. A total of 28 patients (male:female = 8:20) were included. The mean follow-up period was 90.5 months (range, 15-184 months). RESULTS: Among the 28 patients, gross total resection (GTR) was the most important factor for DFS (P = 0.001). Any form of tumor violation was also correlated with DFS (P = 0.049); however, use of en bloc resection technique did not show a significant DFS gain compared to piecemeal resection (P = 0.218). In the patient group that achieved GTR, the mode of resection was not a significant factor for DFS (P = 0.959). In the multivariate analysis, the extent of resection was the only significant variable that affected DFS (P = 0.016). CONCLUSIONS: Conflicting results on tumor violation from univariate and multivariate analyses suggest that GTR without tumor violation should be the treatment goal for spinal GCTs. However, when tumor violation is unavoidable, it would be important to prioritize GTR over adhering to en bloc resection.

14.
BMC Musculoskelet Disord ; 24(1): 607, 2023 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-37491225

RESUMO

BACKGROUND: The objective of this study was to assess the expression profile of CD44v6, a potential cancer stem cell marker, and its diagnostic and predictive significance in three distinct types of primary bone tumors. METHODS: In this study, we utilized real-time qRT-PCR and immunohistochemistry to examine the gene and protein levels of CD44v6 in a total of 138 fresh bone tissues. This included 69 tumor tissues comprising osteosarcoma (N = 23), chondrosarcoma (N = 23), and GCT (N = 23), as well as 69 corresponding non-cancerous tumor margins. Furthermore, we investigated the circulating level of CD44v6 by isolating peripheral blood mononuclear cells from 92 blood samples. Among these, 69 samples were obtained from patients diagnosed with primary bone tumors, while the remaining 23 samples were from healthy donors. The primary objectives of our investigation were to assess the correlation between CD44v6 expression levels and clinic-pathological features of the patients, as well as to evaluate the diagnostic and predictive values of CD44v6 in this context. RESULTS: In patients with osteosarcoma and chondrosarcoma tumors, both the gene and protein expression of CD44v6 were found to be significantly higher compared to the GCT group. Furthermore, the circulating level of CD44v6 was notably elevated in patients diagnosed with osteosarcoma and chondrosarcoma in comparison to the GCT group and patients with malignant tumor characteristics. Additionally, we observed a strong correlation between the gene and protein levels of CD44v6 and important tumor indicators such as tumor grade, metastasis, recurrence, and size at the tumor site. CD44v6 shows potential in differentiating patients with bone tumors from both control groups and tumor groups with severe and invasive characteristics from those with non-severe features. Importantly, the expression level of CD44v6 also demonstrated predictive value for determining tumor grade and the likelihood of recurrence. CONCLUSION: CD44v6 is likely to play a role in the development of primary bone tumors and has the potential to serve as a diagnostic biomarker for bone cancer. However, to obtain more accurate and conclusive findings, further mechanistic investigations involving larger population samples are necessary.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Osteossarcoma , Humanos , Relevância Clínica , Leucócitos Mononucleares/metabolismo , Leucócitos Mononucleares/patologia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/genética , Neoplasias Ósseas/patologia , Osteossarcoma/diagnóstico , Osteossarcoma/genética , Osteossarcoma/patologia , Condrossarcoma/diagnóstico , Condrossarcoma/genética , Biomarcadores Tumorais/genética
15.
Acta Ortop Bras ; 31(spe2): e264305, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37323147

RESUMO

Objective: Present the preliminary results of a case series using the surgical ankle arthrodesis technique with an intramedullary retrograde nail for bone tumors. Methods: We present the preliminary data of 4 patients, 3 males and 1 female, with a mean age of 46,2 (range 32 to 58) years, with histology proven Giant Cell Tumour of bone in 3 and osteosarcoma in 1. The mean resection length of distal tibia was 11,75 (range 9 to 16) cm, and all the patients underwent reconstruction with a tibiotalocalcaneal arthrodesis with an intercalary allograft fixed by a retrograde intramedullary nail. Results: Oncological follow-up evolved without evidence of local recurrence or disease progression in all patients. After a mean time of 69.5 (range 32 to 98 months), patients had a mean MSTS12 functional score of 82.5% (range 75 to 90). All tibial arthrodesis and diaphyseal osteotomy sites were fused within 6 months with a return to activities without complications related to coverage skin or infection. Conclusion: No complications were recorded; all arthrodesis and diaphysial tibial osteotomy sites fused by 6 months, and the mean follow-up of those patients was 69,5 (range 32 to 988) months, with a mean functional MSTS score of 82,5% (range 75-90). Level of Evidence: IV; Retrospective Case Series.


Objetivo: Apresentar os resultados preliminares de uma série de casos utilizando a técnica cirúrgica de artrodese do tornozelo com haste intramedular retrógada para tumores ósseos. Métodos: Apresentamos os dados preliminares de quatro pacientes, três homens e uma mulher, com idade média de 46,2 (variação de 32 a 58) anos, com histologia comprovada de tumor de células gigantes em três e osteossarcoma em um. O comprimento médio de ressecção da tíbia distal foi de 11,75 (variação de 9 a 16) cm, e todos os pacientes foram submetidos à reconstrução com uma artrodese tibiotalocalcaneana com um aloenxerto intercalar fixado por uma haste intramedular retrógrada. Resultados: O acompanhamento oncológico evoluiu sem evidências de recidiva local ou progressão da doença, em todos os pacientes. Após um tempo médio de 69,5 (variação de 32 a 98 meses), os pacientes tiveram uma pontuação média funcional MSTS12 de 82,5% (variação de 75 a 90). Todos os locais de artrodese e osteotomia diafisária tibiais foram fundidos em 6 meses com retorno às atividades de vida diária sem complicações relacionadas à cobertura ou infecção. Conclusão: Não foram registradas complicações; todos os locais de artrodese e osteotomia diafisária da tíbia fundiram-se em 6 meses, e o acompanhamento médio desses pacientes foi de 69,5 (variação de 32 a 988) meses, com uma pontuação média funcional MSTS de 82,5% (variação de 75-90). Nível de Evidência IV; Série de Casos Retrospectivos.

16.
Surg Neurol Int ; 14: 121, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37151473

RESUMO

Background: Giant cell tumors (GCTs) are locally aggressive benign primary bone tumors that rarely occur in the spine. Their treatment methods include denosumab, bisphosphonates, and/or different surgical techniques. Here, we present the successful treatment of a sacral GCT in a 13 years old. Case Description: A 13-year-old male presented with back pain and paraparesis of 3-week duration. Radiological studies demonstrated an S1 lytic lesion. He underwent an excisional biopsy and anterior and posterior resection combined with a lumbopelvic fusion. One year later, there has been no tumor recurrence. Conclusion: We successfully treated an S1 sacral GCT in a 13-year-old male utilizing a wide anteriorand posterior excision combined with a lumbopelvic fusion.

17.
J Orthop Surg Res ; 18(1): 346, 2023 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-37165403

RESUMO

BACKGROUND: Increasing evidence suggests that microRNAs (miRNAs) play a crucial role in cancer development and progression. Our previous study showed remarkably lower levels of miR-217 in GCT cells and tissues, and miR-217 re-expression inhibited the occurrence and development of GCT in vitro; however, the associated mechanisms remain unknown. Thus, this study aimed to explore the mechanisms underlying the proliferation inhibitory effect of miR-217 in GCT cells. METHODS: The proliferative potential of the GCT cells was measured with an MTT assay and BrdU straining. Changes in GCT cell migration and invasion was assessed by a transwell assay. Finally, Western blot and RT-PCR assays were employed to evaluate OPG/RANKL/RANK signaling pathway-related protein expression. RESULTS: The excessive upregulation of miR-217 markedly suppressed GCT cell proliferation and tumorigenesis both in vitro and in vivo. miR-217 overexpression could inhibit the OPG/RANKL/RANK signaling pathway in vitro and in vivo. Furthermore, ALP activity was significantly decreased in GCT cells following miR-217 treatment. Importantly, miR-217 could inhibit autophagy-related protein expression and autophagosome/autolysosome formation in GCT cells and tissues. CONCLUSION: These results suggest that miR-217 upregulation could inhibit the occurrence and development of GCT by blocking autophagy. These findings offer an effective therapeutic target to improve the survival rates of patients with CGT in the future.


Assuntos
Tumores de Células Gigantes , MicroRNAs , Humanos , Osteoprotegerina/genética , Osteoprotegerina/metabolismo , MicroRNAs/metabolismo , Transdução de Sinais/genética , Autofagia/genética , Proliferação de Células/genética , Movimento Celular/genética , Linhagem Celular Tumoral , Ligante RANK/metabolismo
18.
Cureus ; 15(3): e36398, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37090353

RESUMO

Background Skin and soft tissue swellings (SSTS) frequently present in dermatology, plastic surgery, and general surgery departments. While a general surgeon can take care of excisable lesions, people typically seek plastic surgery for cosmetic reasons. According to the signs and symptoms, soft tissue and skin lesions must be removed, and it is crucial to maintain cosmesis following their removal. Objective The aim of this article is to describe the clinical and histopathological types, sites, laterality, and postoperative complications of SSTS. Material and methods This retrospective study was conducted at the Department of Plastic and Reconstructive Surgery, Lahore General Hospital, Lahore, Pakistan in November 2022. We studied admitted patients from July 1, 2020 to June 30, 2022 for SSTS excision. Data on patients' demographics, associated features of SSTS, and their postoperative complications was gathered using Google Docs-generated proforma and sent to a statistician for the computation of results via a Microsoft Excel-generated spreadsheet. Results Out of the total 60 patients, 66.7% of the lesions were found in women. The mean age at presentation came out to be 34.16±17.42 years. Nevi with 16.7% were the most common SSTS in our study. The most common site of presentation of SSTS was the scalp and face in 63.3% of cases. Fever was the most frequently encountered post-excision complication in 40% of patients. Conclusion A comprehensive history, clinical examination, signs and symptoms, and the histology of the lesion, all play a crucial role in the management of such swellings. Surgery was the definitive treatment option for SSTS. There were very few major complications in a handful of patients.

19.
Rev Bras Ortop (Sao Paulo) ; 58(1): 141-148, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36969782

RESUMO

Objective This is the first study to establish the utility of extended curettage with or without bone allograft for Grade II giant cell tumors GCTs around the knee joint with the aim of exploring postoperative functional outcomes. Methods We retrospectively reviewed 25 cases of Campanacci grade II GCTs undergoing extended curettage between January 2014 and December 2019. The participants were divided into two groups: one group of 12 patients underwent extended curettage with bone allograft and bone cement, while the other group of 13 patients underwent extended curettage with bone cement only. Quality of life was assessed by the Revised Musculoskeletal Tumor Society Score and by the Knee score of the Knee Society; recurrence and complications were assessed for each cohort at the last follow-up. The Fisher test and two-sample t-tests were used to compare the categorical and continuous outcomes, respectively. Results The mean age was 28.09 (7.44) years old, with 10 (40%) males and 15 females (60%). The distal femur and the proximal tibia were involved in 13 (52%) and in 12 (48%) patients, respectively. There was no significant difference in the musculoskeletal tumor society score (25.75 versus 27.41; p = 0.178), in the knee society score (78.67 versus 81.46; p = 0.33), recurrence (0 versus 0%; p = 1), and complications (25 versus 7.69%; p = 0.21). Conclusions Extended curettage with or without bone allograft have similar functional outcomes for the knee without any major difference in the incidence of recurrence and of complications for Grade II GCTs. However, surgical convenience and cost-effectiveness might favor the bone cement only, while long-term osteoarthritis prevention needs to be investigated to favor bone allograft.

20.
Cureus ; 15(1): e33262, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36741639

RESUMO

Sacral giant cell tumors are a rare cause of low back pain and may be challenging to identify via routine clinical examination and radiography. A 47-year-old woman presented to a chiropractor with a one-month history of worsening low back pain with radiation to the posterior thighs, worsened with ambulation, and used a cane to walk. She previously saw an orthopedic surgeon and was diagnosed with lumbar spondylosis, having tried anti-inflammatory medications, exercises, and acupuncture without success. The chiropractor ordered lumbar magnetic resonance imaging which revealed an aggressive sacral lesion and referred the patient to an oncologist. The oncologist performed positron emission tomography/computed tomography and biopsy, confirming a sacral giant cell tumor. A surgical team recommended tumor resection, lumbosacral fusion, radiotherapy, and zoledronic acid infusion. Sacral giant cell tumors are rare and may be challenging to identify via routine radiography. These tumors are an important differential to consider for patients with unexplained lumbosacral symptoms unresponsive to care.

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