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2.
BMC Musculoskelet Disord ; 22(1): 381, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892701

RESUMO

BACKGROUND: Chondroblastoma (CB) is a rare, primary, benign bone tumor that commonly affects men aged 15-20 years. It is usually detected in the epiphysis of the long bones, such as the proximal femur, humerus, and tibia. The patella is an infrequent site. CB with secondary aneurysmal bone cyst (ABC) is extremely rare in the patella, which can be easily confused with other common bone tumors of the patella. Thus, it is necessary to make the right diagnosis to get a good outcome. CASE PRESENTATION: We have presented here the case of a 30-year-old man who was suffering from anterior knee pain for the past 6 months that had aggravated 2 weeks before the presentation. Osteolytic bone destruction in the patella could be detected in both his X-ray and computed tomography (CT) examinations, while the magnetic resonance imaging (MRI) detected a fluid level. Accordingly, secondary ABC was presumed. We diagnosed the condition as giant cell tumor (GCT) with secondary ABC and, accordingly, performed curettage inside the focus region with autogenous bone grafting following the patient's medical history, physical manifestations, results of physical and ancillary examinations, and the disease characteristics. However, the intraoperative and postoperative outcomes indicated that the patient's histopathology was consistent with that of typical CB, suggesting a definitive error in diagnosis. Accordingly, the patient was finally diagnosed with patella CB along with secondary ABC. CONCLUSIONS: Past studies have demonstrated that the 3 commonest bone tumors affecting the patella are GCT, CB, and ABC. CB with secondary ABC can be easily misdiagnosed as GCT with secondary ABC or ABC. Performing incision biopsy or excision biopsy and conducting histological examination may be the most effective method for suspected CB with secondary ABC.


Assuntos
Cistos Ósseos Aneurismáticos , Neoplasias Ósseas , Condroblastoma , Adolescente , Adulto , Cistos Ósseos Aneurismáticos/diagnóstico , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Condroblastoma/complicações , Condroblastoma/diagnóstico por imagem , Condroblastoma/cirurgia , Erros de Diagnóstico , Humanos , Masculino , Patela/diagnóstico por imagem , Patela/cirurgia , Adulto Jovem
3.
BMC Cancer ; 21(1): 375, 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827467

RESUMO

BACKGROUND: Pulmonary metastasectomy (PM) is an established treatment for selected patients with metastatic sarcomas. The aim of this study was to examine our institutional experience and evaluate factors predicting outcome. METHODS: We retrospectively reviewed all patients undergoing PM for bone sarcoma in our center from 2001 to 2019. Survival was calculated from the date of PM. Impact on survival of clinical parameters was assessed. RESULTS: Thirty-eight patients (27 males, 71%) were included. Histology was osteosarcoma (n = 20, 53%), Ewing sarcoma (n = 13, 34%) and chondrosarcoma (n = 5, 13%). Twelve patients (31.5%) had synchronous metastases, all received chemotherapy before PM. Median number of metastases was 3 (1 to 29). Twenty (53%) patients had mediastinal lymph node sampling. One patient had positive lymph nodes. Ninety-day mortality was 0%. Three and 5-year PFS were 24.5 and 21%, respectively. Three and 5-year OS were 64.5 and 38.5%, respectively. More than three metastases and progression under chemotherapy were significant independent predictors for OS. CONCLUSION: PM is a safe procedure and encouraging long-term outcome can be achieved. Patients with progression of pulmonary metastases under chemotherapy as well as patients with more than three metastases had significantly worse OS.


Assuntos
Neoplasias Ósseas/complicações , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Sarcoma/complicações , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estudos Retrospectivos , Adulto Jovem
4.
J Orthop Surg (Hong Kong) ; 29(1): 23094990211005900, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33910414

RESUMO

OBJECTIVE: To investigate the neurological recovery of Frankel A spinal giant cell tumor (GCT) patients after they had received a Total En Bloc Spondylectomy (TES). MATERIALS AND METHODS: We retrospectively recorded data of three patients (two females) with mobile spine GCT (T6, T10, and L2) Enneking stage III with complete paralysis before surgery, who had undergone TES in our institute from January 2018 to September 2020. The duration of neurologic recovery to Frankel E was the primary outcome. The intra-operative blood loss, operative time, operative-related complications, and the local recurrence were the secondary outcomes. RESULTS: The duration of suffering from Frankel A to TES surgery was 2 months for the T6 patient, 3 weeks for the T10 patient, and 1 month for the L2 patient. Three patients had achieved full neurological recovery to Frankel E within 6 months after TES (T6 for 5 months, T10 for 3 months, and L2 for 3 months). The average blood loss was 2833.33 ml and the mean operative time was 400 min. Up until the last follow-up (13-25 months), no evidence of local recurrences had been found in any of the three patients. CONCLUSION: Frankel A spinal GCT patients can achieve full neurological recovery after TES, if the procedure is performed within 3 months after complete paraplegia. TES can effectively control any local recurrences.


Assuntos
Neoplasias Ósseas/cirurgia , Discotomia/métodos , Tumor de Células Gigantes do Osso/cirurgia , Paralisia/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Neoplasias Ósseas/complicações , Feminino , Seguimentos , Tumor de Células Gigantes do Osso/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Paralisia/etiologia , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/complicações , Coluna Vertebral/cirurgia , Resultado do Tratamento
6.
JAMA Netw Open ; 4(3): e210845, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33666664

RESUMO

Importance: Host-related immune factors have been implicated in the development and progression of diverse malignant neoplasms. Identifying associations between immunologic laboratory parameters and overall survival may inform novel prognostic biomarkers and mechanisms of antitumor immunity in localized bone and soft tissue sarcoma. Objective: To assess whether lymphopenia at diagnosis is associated with overall survival among patients with localized bone and soft tissue sarcoma. Design, Setting, and Participants: This retrospective cohort study analyzed patients from the Stanford Cancer Institute with localized bone and soft tissue sarcoma between September 1, 1998, and November 1, 2018. Patients were included if laboratory values were available within 60 days of diagnosis and, if applicable, prior to the initiation of chemotherapy and/or radiotherapy. Statistical analysis was performed from January 1, 2019, to November 1, 2020. Exposures: Absolute lymphocyte count within 60 days of diagnosis and antimicrobial exposure, defined by the number of antimicrobial agent prescriptions and the cumulative duration of antimicrobial administration within 60 days of diagnosis. Main Outcomes and Measures: The association between minimum absolute lymphocyte count at diagnosis and 5-year overall survival probability was characterized with the Kaplan-Meier method and multivariate Cox proportional hazards regression models. Multivariable logistic regressions were fitted to evaluate whether patients with lymphopenia were at greater risk of increased antimicrobial exposure. Results: Among 634 patients, the median age at diagnosis was 53.7 years (interquartile range, 37.5-66.8 years), and 290 patients (45.7%) were women, with a 5-year survival probability of 67.9%. There was a significant inverse association between lymphopenia at diagnosis and overall survival (hazard ratio [HR], 1.82; 95% CI, 1.39-1.40), resulting in a 13.5% 5-year survival probability difference compared with patients who did not have lymphopenia at diagnosis (60.2% vs 73.7% for those who never had lymphopenia). In addition, poorer survival was observed with higher-grade lymphopenia (grades 3 and 4: HR, 2.44; 95% CI, 1.68-3.55; grades 1 and 2: HR, 1.60; 95% CI, 1.18-2.18). In an exploratory analysis, patients with increased antibiotic exposure were more likely to have lymphopenia (odds ratio, 1.96; 95% CI, 1.26-3.07 for total number of antimicrobial agents; odds ratio, 1.70; 95% CI, 1.10-2.57 for antimicrobial duration) than antimicrobial-naive patients. Conclusions and Relevance: This study suggests that an abnormally low absolute lymphocyte count at diagnosis is associated with higher mortality among patients with localized bone and soft tissue sarcoma; therefore, lymphopenia may serve as a reliable prognostic biomarker. Potential mechanisms associated with host immunity and overall survival include a suppressed antitumor response and increased infectious complications, which merit future investigation.


Assuntos
Neoplasias Ósseas/sangue , Neoplasias Ósseas/complicações , Linfopenia/etiologia , Sarcoma/sangue , Sarcoma/complicações , Neoplasias de Tecidos Moles/sangue , Neoplasias de Tecidos Moles/complicações , Adulto , Idoso , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/mortalidade , Estudos de Coortes , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoma/diagnóstico , Sarcoma/mortalidade , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/mortalidade , Taxa de Sobrevida
7.
Bone ; 147: 115907, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33676057

RESUMO

The skeleton is the most common site of secondary disease in breast cancer and prostate cancer, with up to 80% of patients with advanced disease developing bone metastases (BM). The proportion is also substantial in advanced lung cancer (20%-40%). Because of the high prevalence of cancers of the breast, prostate and lung, these cancers account for more than 80% of cases of metastatic bone disease occurring in solid tumours. Metastatic bone disease is associated with greatly increased bone resorption by osteoclasts, leading to moderate to severe pain and other skeletal complications, with major impact on quality of life (QoL). Skeletal Related Events (SREs) have been defined as: pathological long bone or vertebral fractures; spinal cord compression; need for radiation for pain relief or to prevent fracture/spinal cord compression, need for surgery to bone and hypercalcaemia. More recently, Symptomatic Skeletal Events (SSEs) have been defined to monitor QoL. Although there are currently no curative treatments for metastatic bone disease, patients with breast or prostate cancer and BM are now surviving for several years and sometimes longer, and prevention of SREs is the key aim to optimization of QoL. Since their discovery 50 years ago and their introduction more than 30 years ago into the field of metastatic bone disease, a range of oral and intravenous bisphosphonate drugs have made a major contribution to prevention of SREs. Large trials have clearly demonstrated the clinical value of different bisphosphonate-based drugs (including the oral drugs ibandronate and clodronate and intravenous agents such as zoledronate and pamidronate), in treatment of hypercalcaemia of malignancy and the reduction of SREs and SSEs in a range of cancers. Despite the success of denosumab in reducing osteolysis, bisphosphonates also remain mainstay drugs for treatment of metastatic bone disease. Recognizing the 50th Anniversary of the discovery of bisphosphonates, this review focuses on their continuing value in BM treatment and their future potential, for example in providing a bone-targeting vehicle for cytotoxic drugs.


Assuntos
Conservadores da Densidade Óssea , Neoplasias Ósseas , Neoplasias da Mama , Conservadores da Densidade Óssea/uso terapêutico , Neoplasias Ósseas/complicações , Neoplasias Ósseas/tratamento farmacológico , Difosfonatos/uso terapêutico , Humanos , Masculino , Qualidade de Vida , Ácido Zoledrônico
8.
Br J Radiol ; 94(1120): 20210043, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33571003

RESUMO

OBJECTIVE: A new Bayesian penalized likelihood reconstruction algorithm for positron emission tomography (PET) (Q.Clear) is now in clinical use for fludeoxyglucose (FDG) PET/CT. However, experience with non-FDG tracers and in special patient populations is limited. This pilot study aims to compare Q.Clear to standard PET reconstructions for 18F sodium fluoride (18F-NaF) PET in obese patients. METHODS: 30 whole body 18F-NaF PET/CT scans (10 patients with BMI 30-40 Kg/m2 and 20 patients with BMI >40 Kg/m2) and a NEMA image quality phantom scans were analyzed using ordered subset expectation maximization (OSEM) and Q.Clear reconstructions methods with B400, 600, 800 and 1000. The images were assessed for overall image quality (IQ), noise level, background soft tissue, and lesion detectability, contrast recovery (CR), background variability (BV) and contrast-to-noise ratio (CNR) for both algorithms. RESULTS: CNR for clinical cases was higher for Q.Clear than OSEM (p < 0.05). Mean CNR for OSEM was (21.62 ± 8.9), and for Q.Clear B400 (31.82 ± 14.6), B600 (35.54 ± 14.9), B800 (39.81 ± 16.1), and B1000 (40.9 ± 17.8). As the ß value increased the CNR increased in all clinical cases. B600 was the preferred ß value for reconstruction in obese patients. The phantom study showed Q.Clear reconstructions gave lower CR and lower BV than OSEM. The CNR for all spheres was significantly higher for Q.Clear (independent of ß) than OSEM (p < 0.05), suggesting superiority of Q.Clear. CONCLUSION: This pilot clinical study shows that Q.Clear reconstruction algorithm improves overall IQ of 18F-NaF PET in obese patients. Our clinical and phantom measurement results demonstrate improved CNR and reduced BV when using Q.Clear. A ß value of 600 is preferred for reconstructing 18F-NaF PET/CT with Q.Clear in obese patients. ADVANCES IN KNOWLEDGE: 18F-NaF PET/CT is less susceptible to artifacts induced by body habitus. Bayesian penalized likelihood reconstruction with18F-NaF PET improves overall IQ in obese patients.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Radioisótopos de Flúor , Interpretação de Imagem Assistida por Computador/métodos , Obesidade/complicações , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Fluoreto de Sódio , Algoritmos , Teorema de Bayes , Neoplasias Ósseas/complicações , Neoplasias Ósseas/secundário , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Imagem Corporal Total/métodos
10.
Virchows Arch ; 478(6): 1125-1134, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33420836

RESUMO

Pediatric primary lung carcinomas are extremely rare. Apart from known associations with congenital adenomatoid malformations, cases of primary lung adenocarcinomas after prolonged treatments of pediatric malignancy have been reported. We describe the morphological and molecular features of three cases of lung adenocarcinoma developed in adolescents aged 8 to 17 years during progression of their bone osteosarcoma or Ewing sarcomas. The morphological features overlapped those of adult lung adenocarcinoma including in situ, minimally invasive, and invasive forms. EGFR gene mutations were found in all three cases by targeted next-generation sequencing. The two patients with Ewing sarcoma had no progression of their lung cancer and no further progression of the metastatic bone tumor after additional chemo- and radio-therapy. Conversely, the osteosarcoma patient refused further treatments after thoracic surgery for metastatic osteosarcoma and locally advanced adenocarcinoma and died 2 years later of widespread distant metastases. Our results indicate that primary lung cancer might originate in pediatric patients during prolonged adjuvant therapies for primary bone neoplasm, and this possibility should be considered in the presence of suspected lung disease progression to correctly monitor the primary tumor evolution and define the appropriate therapeutic strategy at each time point. If appropriately treated, second primary lung cancer may not affect the patients' prognosis. The pathogenetic mechanisms of these rare lung adenocarcinomas are not clear, but the presence of EGFR mutations in all three cases indicates an oncogene addiction of the lung tumor, rather than a direct cancerogenic effect of the sarcoma-related treatment.


Assuntos
Adenocarcinoma de Pulmão/patologia , Neoplasias Ósseas/patologia , Neoplasias Pulmonares/patologia , Osteossarcoma/patologia , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Adenocarcinoma de Pulmão/complicações , Adolescente , Neoplasias Ósseas/complicações , Neoplasias Ósseas/genética , Criança , Feminino , Humanos , Neoplasias Pulmonares/complicações , Masculino , Mutação/genética , Segunda Neoplasia Primária , Osteossarcoma/complicações
12.
BMC Urol ; 21(1): 1, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407372

RESUMO

BACKGROUND: Osteochondroma is the most common benign bone neoplasm and is sometimes referred to as osteocartilaginous exostosis. The symptoms caused by osteochondroma are rare, especially the urogenital complications. Therefore, this tumour is sometimes misdiagnosed. CASE PRESENTATION: This report described a 70-year-old woman with hematuria who was initially misdiagnosed with a bladder tumour in the outpatient department by a urologist. However, during cystoscopy, we found that the mass did not resemble a bladder tumor. Multidisciplinary approach with careful analysis of the imaging data suggested the diagnosis of osteochondroma. Open surgical excision of the mass was done and histology confirmed the diagnosis of benign osteochondroma. After 6 months of follow-up, the patient was still asymptomatic. CONCLUSIONS: This case illustrates that hematuria is caused by not only urogenital disease but also osteochondroma. We present this case to draw the attention of clinicians to osteochondroma of the pubic symphysis.


Assuntos
Neoplasias Ósseas/complicações , Hematúria/etiologia , Osteocondroma/complicações , Sínfise Pubiana , Idoso , Feminino , Humanos
13.
Z Rheumatol ; 80(1): 78-84, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33057785

RESUMO

CRMO is a rare form of nonbacterial osteomyelitis, which is mainly found in children. The diagnosis is complex because bone tumors or lymphoma must also be excluded. The case report describes the development of a solitary femoral lymphoma on the basis of a known CRMO disease as well as the differential diagnostic pitfalls.


Assuntos
Neoplasias Ósseas/complicações , Linfoma de Células B , Osteomielite , Doença Crônica , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Humanos , Linfoma de Células B/complicações , Osteomielite/complicações , Recidiva
14.
Laryngoscope ; 131(5): 1101-1109, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32940937

RESUMO

OBJECTIVES: To identify the frequency and primary site of metastatic pathologies to the temporal bone and characterize the associated symptomatology. METHODS: The MEDLINE, Embase, and Web of Science databases were systematically reviewed according to the PRISMA guidelines to identify all cases of pathologically confirmed distant temporal bone metastases published with English translation until October 2019. Descriptive statistics were performed. RESULTS: Out of 576 full-length articles included for review, 109 met final criteria for data extraction providing 255 individual cases of distant temporal bone metastases. There was a male predominance (54.9%) with median age of 59.0 years (range 2-90). The most common locations of primary malignancy included the breasts (19.6%), lungs (16.1%), and prostate (8.6%). Most tumors were carcinomas of epithelial origin (75.3%) and predominantly adenocarcinoma (49.4%). The commonest metastatic sites encountered within the temporal bone were the petrous (72.0%) and mastoid (49.0%) portions. Bilateral temporal bone metastases occurred in 39.8% of patients. Patients were asymptomatic in 32.0% of cases. Symptomatic patients primarily reported hearing loss (44.3%), facial palsy (31.2%), and otalgia (16.6%) for a median duration of 1 month. Petrous lesions were associated with asymptomatic cases (P = .001) while mastoid lesions more often exhibited facial palsy (P = .026), otalgia (P < .001), and otorrhea (P < .001). Non-carcinomatous tumors were associated with petrosal metastasis (P = .025) and asymptomatic cases (P = .109). Carcinomatous metastases more often presented with otalgia (P = .003). CONCLUSIONS: Temporal bone metastasis is uncommon but should be considered in patients with subacute otologic symptoms or facial palsy and history of distant malignancy. Laryngoscope, 131:1101-1109, 2021.


Assuntos
Adenocarcinoma/epidemiologia , Neoplasias Ósseas/epidemiologia , Neoplasias da Mama/patologia , Neoplasias Pulmonares/patologia , Neoplasias da Próstata/patologia , Osso Temporal/patologia , Adenocarcinoma/complicações , Adenocarcinoma/secundário , Neoplasias Ósseas/complicações , Neoplasias Ósseas/secundário , Dor de Orelha/epidemiologia , Dor de Orelha/etiologia , Paralisia Facial/epidemiologia , Paralisia Facial/etiologia , Feminino , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Masculino
15.
Int Orthop ; 45(1): 289-297, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33001283

RESUMO

PURPOSE: For the treatment of giant cell tumour of the bone (GCTB) around the knee, preserving the native joint confers advantages over scarifying it. But, there is a controversy about the efficacy of intralesional curettage versus en bloc resection for treatment of such lesions. In this study, we compared local recurrence, functional outcomes, and complications of extended curettage and en bloc resection in these lesions. METHODS: Patients with grade 3 GCTB of the distal femur or proximal tibia who were presented with a pathologic fracture and treated with either en bloc resection (n = 22) or extended curettage (n = 20) were included. The mean follow-up of the patients was 6.4 ± 1.9 years in the resection group and 5.5 ± 2.4 years in the extended curettage group. The primary outcome was a local recurrence. Secondary outcomes were limb function evaluated by the Musculoskeletal Tumor Society (MSTS) score and rate of complications. RESULTS: Local recurrence was seen in four (20%) patients of the curettage group and three (13.7%) patients of the resection group (P = 0.69). The mean MSTS score was 24 ± 1.9 in the resection group and 26.5 ± 1.3 in the curettage group (P < 0.001). The number of complications was not significantly different between the two study groups (P = 0.49). However, the number of complications that required revision surgery was significantly more in the resection group (P = 0.049). CONCLUSION: In grade 3 GCTB around the knee with pathologic fracture, extended curettage results in comparable oncologic outcomes to en bloc resection, while providing better function and a lower rate of revision.


Assuntos
Neoplasias Ósseas , Fraturas Espontâneas , Tumor de Células Gigantes do Osso , Neoplasias Ósseas/complicações , Neoplasias Ósseas/cirurgia , Curetagem , Fraturas Espontâneas/etiologia , Fraturas Espontâneas/cirurgia , Tumor de Células Gigantes do Osso/cirurgia , Humanos , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
16.
Eur J Ophthalmol ; 31(2): 766-773, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33008271

RESUMO

PURPOSE: To present clinical ocular manifestations, radiological features and surgical results of giant paranasal osteomas involving the orbit. DESIGN: Retrospective, interventional, case series. METHODS: The study included patients treated for giant paranasal osteoma involving the orbit. Total or subtotal excision of the tumor was performed via external approach. Clinical characteristics including presenting symptoms, radiologic investigation, histopathology and details of the surgery were recorded. RESULTS: Of the six patients included; four were male and two were female. Mean age was 46.8 years (range 12-70 years). Five patients had unilateral, one patient had bileteral disease. The presenting complaints included complete (n = 2/6) or partial (n = 4/6) limitation of eye movements depending on the location and size of the tumor, diplopia (n = 5/6), vision loss (n = 2/6) exophthalmos (n = 6/6) and reduced pupillary light reflex (n = 2/6). The presumed origin of the tumor was frontoethmoidal region (n = 2/6), frontal sinus (n = 3/6) and ethmoid sinus (n = 1/6). Total resection was achieved in three of the patients whereas partial resection was achieved in remaining three patients due to risk of incremental neurological damage. Mild ptosis was observed in all patients during the postoperative period (temporary, n = 4; permanent, n = 2). CONCLUSION: Despite the benign nature of osteomas, severe functional impairment including vision loss due to compression of the optic nerve and diplopia might occur in case of orbital involvement. Osteomas with an orbital extension > %50 of the bony orbit volume are more prone to cause irreversible visual loss. Surgical resection is still the mainstay of therapy.


Assuntos
Neoplasias Ósseas/complicações , Exoftalmia/etiologia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Osteoma/complicações , Neoplasias dos Seios Paranasais/complicações , Adolescente , Adulto , Idoso , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgia , Criança , Exoftalmia/diagnóstico , Exoftalmia/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoma/diagnóstico , Osteoma/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/cirurgia , Período Pós-Operatório , Estudos Retrospectivos , Adulto Jovem
17.
J Pediatr Hematol Oncol ; 43(4): e532-e534, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32769558

RESUMO

Rothmund-Thomson syndrome (RTS) is an autosomal recessive disorder associated with an increased predisposition to osteosarcoma (OS) when it is caused by concrete mutations in the RECQL4 gene. Most OSs arise sporadically, but it can also be the first manifestation of a cancer predisposition syndrome as Rothmund Thompson. The early onset, multifocality and metachronism, and a family history of the disease, may suggest a tumor predisposition syndrome. We present the case of a patient with a polymalformative syndrome, who, at 6 years of age, was diagnosed with OS in the right femur. This led to the diagnosis of a RTS type 2. She was cured and surveillance showed no sign of disease. Ten years later, the patient developed a second OS in the contralateral femur. Fortunately, she is in complete remission again after treatment. We describe our patient treatment and recommend a possible screening-surveillance for RTS type II patients.


Assuntos
Neoplasias Ósseas/complicações , Osteossarcoma/complicações , Síndrome de Rothmund-Thomson/complicações , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/terapia , Criança , Feminino , Fêmur/efeitos dos fármacos , Fêmur/patologia , Humanos , Osteossarcoma/diagnóstico , Osteossarcoma/patologia , Osteossarcoma/terapia , Síndrome de Rothmund-Thomson/diagnóstico
18.
Laryngoscope ; 131(3): E966-E969, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32750153

RESUMO

A 63-year-old man presented with imbalance when coughing due to a respiratory tract infection. He had a history of multiple myeloma with a plasmacytoma of the left temporal bone. Examination revealed a positive leftward head impulse test, no spontaneous nystagmus, left-beating positional nystagmus, and left-beating Valsalva-induced nystagmus. Videonystagmography, audiology, and comprehensive vestibular function tests revealed a subtotal left peripheral audio-vestibular loss. Temporal bone computed tomography showed an unchanged bony erosion of the left labyrinth from 2 years prior. Vertigo subsided after treatment of the respiratory tract infection. Although no tumor progression was evident, coughing had triggered a preexisting third mobile window to declare itself. Laryngoscope, 131:E966-E969, 2021.


Assuntos
Neoplasias Ósseas/diagnóstico , Reabsorção Óssea/diagnóstico , Perda Auditiva/etiologia , Plasmocitoma/diagnóstico , Vertigem/etiologia , Vestíbulo do Labirinto/anormalidades , Neoplasias Ósseas/complicações , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Reabsorção Óssea/etiologia , Perda Auditiva/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Plasmocitoma/complicações , Plasmocitoma/patologia , Plasmocitoma/cirurgia , Osso Temporal/diagnóstico por imagem , Osso Temporal/patologia , Osso Temporal/cirurgia , Vertigem/diagnóstico , Testes de Função Vestibular
19.
Asian Cardiovasc Thorac Ann ; 29(2): 128-131, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33143433

RESUMO

Askin tumor (a Ewing sarcoma variant) is the most common tumor of the chest wall in the pediatric age group. Multimodal treatment is required, with complete resection being the cornerstone of effective management. We describe the case of a 13-year boy with a left paraspinal Ewing sarcoma with intraspinal extension and spinal cord compression with neurological weakness. He underwent complex surgical resection using thoracoscopic resection of multiple ribs along with vertebral resection and reconstruction, after neoadjuvant therapy.


Assuntos
Neoplasias Ósseas/cirurgia , Osteotomia , Procedimentos Cirúrgicos Reconstrutivos , Costelas/cirurgia , Sarcoma de Ewing/cirurgia , Neoplasias Torácicas/cirurgia , Cirurgia Torácica Vídeoassistida , Adolescente , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Quimiorradioterapia Adjuvante , Humanos , Masculino , Terapia Neoadjuvante , Costelas/diagnóstico por imagem , Costelas/fisiopatologia , Sarcoma de Ewing/complicações , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/patologia , Compressão da Medula Espinal/etiologia , Neoplasias Torácicas/complicações , Neoplasias Torácicas/diagnóstico por imagem , Neoplasias Torácicas/patologia , Resultado do Tratamento
20.
Clin Nucl Med ; 46(1): e11-e12, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33156043

RESUMO

McCune-Albright syndrome is a rare condition consisting of triad of fibrous dysplasia, hyperfunctioning endocrinopathy, and café au lait macules of skin. A 31-year-old man was diagnosed with fibrous dysplasia 18 years before presenting with pathologic fracture. No workup for polyostotic fibrous dysplasia was performed at that time. He now presented with left facial swelling and skeletal features of acromegaly. MRI revealed a 15-cm enhancing tumor diagnosed histopathologically as high-grade osteosarcoma. Tc-methylene diphosphonate bone scintigraphy revealed decreased uptake at the tumor site contrary to the usual finding of avid uptake by the neoplastic bone forming tumor.


Assuntos
Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico por imagem , Displasia Fibrosa Poliostótica/complicações , Mandíbula/diagnóstico por imagem , Osteossarcoma/complicações , Osteossarcoma/diagnóstico por imagem , Acromegalia/complicações , Adulto , Humanos , Imageamento por Ressonância Magnética , Masculino
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