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1.
Stomatologiia (Mosk) ; 100(6): 92-96, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34953196

RESUMO

The article reports a patient with an unusually large synovial chondromatosis of the temporomandibular joint. In this clinical case, the extremely rare sizes of chondral bodies are given, because of which it was required to expand the standard access to the TMJ with the isolation of the trunk and branches of the facial nerve.


Assuntos
Condromatose Sinovial , Transtornos da Articulação Temporomandibular , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Humanos , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia
2.
BMJ Case Rep ; 14(6)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34167980

RESUMO

Synovial chondromatosis (SC) is a rare benign disorder, usually found in larger joints. This case report describes an elderly woman with a bulging mass behind the left eardrum, slowly progressing in size. On surgical exploration and biopsy, the patient was diagnosed with SC of the incudomalleolar joint. Imaging and histopathological findings, surgical management and follow-up are being discussed. SC is a very rare finding in the middle ear and a differential diagnosis to cholesteatoma.


Assuntos
Colesteatoma , Condromatose Sinovial , Idoso , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Diagnóstico Diferencial , Orelha Média/diagnóstico por imagem , Orelha Média/cirurgia , Feminino , Humanos , Articulações
3.
Foot (Edinb) ; 49: 101804, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34016505

RESUMO

Synovial chondromatosis is a rare condition consisting of metaplasia of the synovial tissue that usually presents in large joints such as the knee and hip. The reported occurrence of synovial chondromatosis in the foot and ankle joints is rare in the literature. In this case report, the successful surgical management of two patients presenting with this condition using open ankle arthrotomy & synovectomy is described. These two cases are presented to provide added depth to the current literature, as well as presenting a review of published literature to further guide clinicians in the management of this rare condition. LEVEL OF EVIDENCE: 4 (case study).


Assuntos
Condromatose Sinovial , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Humanos , Sinovectomia
4.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(2): 209-214, 2021 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-33834677

RESUMO

OBJECTIVES: To evaluate the value of arthroscopy in the diagnosis and treatment of synovial chondromatosis of the temporomandibular joint (TMJSC). METHODS: The cases of 16 patients preliminarily diagnosed with TMJSC by magnetic resonance imaging (MRI) from July 2011 to December 2018 were analyzed retrospectively. If the diagnosis was confirmed by arthroscopy, the opening operation was performed. The preoperative MRI, arthroscopy and opening operation, postoperative pathology and postoperative MRI of confirmed cases were analyzed, and clinical follow-up was performed to evaluate the curative effect of open surgery. The degree of mouth opening and visual analogue scale (VAS) scores for pain pre-operation and during follow-up of the confirmed cases were analyzed by t-test. RESULTS: Fourteen cases of TMJSC were diagnosed by arthroscopy, consistent with the postoperative pathological diagnosis. Postoperative MRI examination showed that articular cavity lesions basically disappeared. Ten patients with synovial chondromatosis were followed-up (follow-up rate, 71.4%) from 6 months to 7 years and 8 months (average follow-up time, 17.6 months); no recurrence was found, and clinical symptoms improved by varying degrees. Before operation and at follow-up, t-test results of opening degree difference were t=7.757, P<0.05; t-test results of VAS were t=-3.274, P<0.05. CONCLUSIONS: Arthroscopy is essential in the diagnosis and treatment of TMJ synovial chondromatosis.


Assuntos
Condromatose Sinovial , Transtornos da Articulação Temporomandibular , Artroscopia , Condromatose Sinovial/diagnóstico , Condromatose Sinovial/cirurgia , Humanos , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/cirurgia
5.
BMJ Case Rep ; 14(4)2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827875

RESUMO

Unconscious biases may influence clinical decision making, leading to diagnostic error. Anchoring bias occurs when a physician relies too heavily on the initial data received. We present a 57-year-old man with a 3-year history of unexplained right thigh pain who was referred to a physiatry clinic for suggestions on managing presumed non-organic pain. The patient had previously been assessed by numerous specialists and had undergone several imaging investigations, with no identifiable cause for his pain. Physical examination was challenging and there were several 'yellow flags' on history. A thorough reconsideration of the possible diagnoses led to the discovery of hip synovial osteochondromatosis as the cause for his symptoms. Over-reliance on the referral information may have led to this diagnosis being missed. In patients with unexplained pain, it is important to be aware of anchoring bias in order to avoid missing rare diagnoses.


Assuntos
Condromatose Sinovial , Dor Crônica , Viés , Condromatose Sinovial/diagnóstico , Condromatose Sinovial/diagnóstico por imagem , Dor Crônica/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exame Físico , Coxa da Perna
6.
Int Orthop ; 45(11): 2819-2824, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33877408

RESUMO

PURPOSE: In the present study, we aimed to evaluate the clinical outcomes of surgical hip dislocation in patients with synovial chondromatosis (SC) of the hip. METHODS: Seven patients with primary SC of the hip treated with open synovectomy and removal of loose bodies by surgical hip dislocation from 2016 to 2019 were retrospectively reviewed. All patients had numerous and widespread loose bodies based on pre-operative images, including routine radiographs, CT, and MRI. The visual analog scale (VAS) score and Harris hip score (HHS) were collected and analyzed before and after surgery. The post-operative radiographs were reviewed to evaluate disease recurrence and osteoarthritis progression. RESULTS: The mean operative time was 61 minutes (range, 42-75 min). An average of 33 loose bodies in each patient (range, 16-67) was removed, and extra-articular pathology was found in one patient. Patients were followed up for a mean duration of 30 months (range, 18-42 months). The average VAS scores were decreased from 3.7 (range, 2-6) pre-operatively to 0.9 (range, 0-2) at the last follow-up, and the HHS was improved from 60.1 (range, 50-73) to 90.1 (range, 82-95). All results demonstrated significant improvements (P < 0.05). Post-operative radiographs showed no recurrence, osteoarthritis progression, or osteonecrosis of the femoral head in all hips. CONCLUSIONS: Surgical hip dislocation was a practical approach for managing both intra-articular and extra-articular pathologic lesions around the hip. It was an effective treatment for SC of the hip with short surgical time, good joint functions, a lower recurrence rate, and few complications.


Assuntos
Condromatose Sinovial , Luxação do Quadril , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Quadril , Luxação do Quadril/diagnóstico por imagem , Luxação do Quadril/cirurgia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/cirurgia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
7.
J Int Med Res ; 49(3): 3000605211000526, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33752510

RESUMO

Synovial chondromatosis (SC) is a benign condition characterized by the formation of metaplastic cartilage in the synovial membrane of the joint, resulting in numerous attached and unattached osteocartilaginous bodies. SC mostly affects the large synovial joints, especially the knee, hip, elbow, and ankle, whereas involvement of the temporomandibular joint (TMJ) is rare. Approximately 240 cases of SC of the TMJ have been reported in the English-language literature to date. The number of loose bodies varies among patients but usually ranges from the dozens to around 100. We herein report a case of SC of the TMJ accompanied by approximately 400 loose bodies in a healthy 53-year-old woman. Such a high number of loose bodies within a small space is extremely rare. We also include a brief discussion about the differential diagnoses and current diagnostic approaches to SC of the TMJ. Notably, delayed diagnosis or misdiagnosis is common because of the nonspecific nature of the presenting complaints.


Assuntos
Condromatose Sinovial , Corpos Livres Articulares , Transtornos da Articulação Temporomandibular , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Feminino , Humanos , Corpos Livres Articulares/diagnóstico por imagem , Corpos Livres Articulares/cirurgia , Pessoa de Meia-Idade , Membrana Sinovial , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia
8.
Clin Radiol ; 76(8): 627.e1-627.e11, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33762137

RESUMO

AIM: To investigate the imaging features of synovial chondromatosis of the temporomandibular joint (TMJ), which is a rare benign arthropathy with cartilaginous proliferation. MATERIALS AND METHODS: Computed tomography and magnetic resonance imaging examinations of 34 patients with histopathologically confirmed primary synovial chondromatosis of the TMJ were reviewed retrospectively. Imaging features including the lesion epicentre, destruction/sclerosis of surrounding bone, calcification, periosteal reaction, osteophyte, lesion size, and joint space dimensions were assessed. RESULTS: Thirty-one of thirty-four patients (91.2%) showed the superior joint space as the lesion epicentre. For the mandibular condyle, more than one-third of patients (14/34; 41.2%) showed no destruction, and more than half of patients (19/34; 55.9%) showed no sclerosis. Conversely, >70% of patients showed destruction and sclerosis of the articular eminence/glenoid fossa, while >80% of patients (28/34; 82.4%) presented with various calcifications, including the ring-and-arc (9/34; 26.5%) and popcorn (13/34; 38.2%) types. The mean joint space on the affected side was significantly larger than that of the unaffected side (p<0.001). More than three-fourths of patients (76.9%) experienced no interval increase in lesion size during an average of 1.6 years of follow-up. CONCLUSION: Synovial chondromatosis of the TMJ demonstrated several imaging features, including the lesion centre being located in the superior joint space, resultant articular eminence/glenoid fossa-oriented bone changes, ring-and-arc and popcorn calcification, joint space widening, and self-limiting growth. These imaging features may be helpful in differentiating synovial chondromatosis from other lesions of the TMJ.


Assuntos
Condromatose Sinovial/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Articulação Temporomandibular/diagnóstico por imagem , Adulto Jovem
9.
Orthopedics ; 44(3): e454-e457, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33561871

RESUMO

Synovial chondromatosis of the finger is a rare metaplasia affecting either the finger joint or the tendon sheath. It is a benign extraosseus cartilage tumor that often occurs in numbers and is not solitary in nature. This accumulation of masses within the finger can lead the patient to seek medical care. Symptoms are often painful and functionally disabling. Although rare, synovial chondromatosis must be considered in the differential diagnosis for patients with multiple lesions or masses within the hand and finger. Patient workup involves advanced imaging, including magnetic resonance imaging, ultrasonography, and computerized tomography. However, the results of these studies may be inconclusive. Conservative management can be discussed with the patient but has proven to be ineffective. Surgical excision is the recommended first-line treatment. Whether the surgery is arthroscopic or open, with or without synovectomy, is at the surgeon's discretion. Mass recurrence after surgery is an unfortunate complication, and subsequent treatment strategies are undefined. Recurrence may not occur at the same anatomical site. This condition can be intra-articular (within the figure joint) or extra-articular (within the tendon sheath or bursa). Revision surgery in the form of open excision with synovectomy is the mainstay of treatment. There have been only a few case reports of synovial chondromatosis involving the finger. This case series and up-to-date review of the literature presents a discussion of current surgical care. [Orthopedics. 2021;44(3):e454-e457.].


Assuntos
Condromatose Sinovial , Dedos , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Dedos/diagnóstico por imagem , Dedos/patologia , Dedos/cirurgia , Humanos , Recidiva , Sinovectomia
10.
Foot Ankle Int ; 42(4): 440-447, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33203258

RESUMO

BACKGROUND: Primary synovial chondromatosis (PSC) is a progressive disorder of unknown etiology resulting in formation of multiple loose bodies. If left untreated, it may lead to degenerative changes or malignant transformation to chondrosarcoma. METHODS: Seventeen patients who underwent combined posterior and anterior ankle arthroscopy within the same operative session and had histologically confirmed PSC were included in this retrospective study. American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate ankle function preoperatively and at a final follow-up. A 3-question survey was used to evaluate patient's satisfaction at the final follow-up. RESULTS: In 14 patients, loose bodies were found in both compartments of the ankle, in 2 only in the anterior compartment, and in 1 only in the posterior compartment. All patients had evident signs of synovial inflammation in both compartments. The AOFAS Ankle-Hindfoot score increased from the preoperative median score of 65 (range, 29-90) to 95 (range, 65-100) at the final follow-up. Fourteen patients reported they were extremely satisfied with the outcome, 1 was moderately satisfied, and 2 were dissatisfied. No cases of recurrence of synovitis or loose body formation were noted, nor any signs of malignant transformation during the follow-up period. CONCLUSION: We believe the risk of recurrence of PSC, which is in close relation to malignant transformation, can be minimized by performing a complete synovectomy of the ankle. Our experience and review of literature makes us believe that ankle PSC should be regarded as a whole joint disorder. Performing a combined posterior and anterior arthroscopic procedure within the same operative session should always be considered in patients with ankle PSC. LEVEL OF EVIDENCE: Level IV, retrospective case series.


Assuntos
Condromatose Sinovial , Corpos Livres Articulares , Tornozelo , Articulação do Tornozelo/cirurgia , Artroscopia , Condromatose Sinovial/cirurgia , Humanos , Corpos Livres Articulares/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
11.
Oral Radiol ; 37(2): 236-244, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32303973

RESUMO

OBJECTIVES: The present study aimed to clarify the characteristic computed tomography (CT) features that indicate synovial chondromatosis (SC) with a few small calcified bodies or without calcification on panoramic images, and to discuss their differences from the features of temporomandibular disorder (TMD). METHODS: Panoramic and CT images from 11 patients with histologically verified SC of the temporomandibular joint were investigated. Based on the panoramic images, the patients were classified into a distinct group (5 patients) with typical features of calcified loose bodies and an indistinct group (6 patients) without such bodies. On the CT images, findings for high-density structures suggesting calcified loose bodies, joint space widening, and bony changes in the articular eminence and glenoid fossa (eminence/fossa) and condyle were analyzed. RESULTS: All 5 distinct group patients showed high-density structures on CT images, while 2 of 6 indistinct group patients showed no high-density structures even on soft-tissue window CT images. A significant difference was found for the joint space distance between the affected and unaffected sides. A low-density area relative to the surrounding muscles, suggesting joint space widening, was observed on the affected side in 2 indistinct group patients. All 11 patients regardless of distinct or indistinct classification showed bony changes in the eminence/fossa with predominant findings of extended sclerosis and erosion. CONCLUSION: Eminence/fossa osseous changes including extended sclerosis and erosion may be effective CT features for differentiating SC from TMD even when calcified loose bodies cannot be identified.


Assuntos
Condromatose Sinovial , Corpos Livres Articulares , Transtornos da Articulação Temporomandibular , Condromatose Sinovial/diagnóstico por imagem , Humanos , Corpos Livres Articulares/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios X
12.
Cranio ; 39(4): 362-366, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31156068

RESUMO

Background: Synovial chondromatosis is usually detected at a late stage based on free bodies in joint space. The purpose of this study was to identify biomarkers for cell proliferation and chondrogenesis in the primary stage of synovial chondromatosis in the temporomandibular joint (TMJ).Clinical Presentation: A 67-year-old female was referred for right side TMJ pain. Magnetic resonance imaging (MRI) findings suggested an intra-joint space lesion, but no free bodies were observed intraoperatively. Pathological examination led to diagnosis of Milgram stage 1 synovial chondromatosis. Biomarkers related to mesenchymal stem cells (MSCs), cell proliferation, and chondrogenesis were observed in immunohistopathological examination of specimens.Clinical Relevance: The findings suggest that MSCs with chondrogenic potential and growth activity are present at the start of cartilage formation in the synovial membrane. These cells may be the origin of disease. Those findings improve understanding of the etiology and disease progression of synovial chondromatosis in the TMJ.


Assuntos
Condromatose Sinovial , Condromatose , Transtornos da Articulação Temporomandibular , Idoso , Biomarcadores , Condromatose Sinovial/diagnóstico por imagem , Feminino , Humanos , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/diagnóstico por imagem
14.
JBJS Rev ; 8(9): e2000045, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33151646

RESUMO

BACKGROUND: Synovial chondromatosis (SC) of the ankle is a rare disorder in which metaplastic proliferation of synovia, tendon sheaths, and/or bursae leads to the formation of loose cartilaginous bodies within the joint space. While SC itself is a benign condition, its sequelae can be chronic and debilitating if left untreated, or if there is postoperative recurrence. Arthritic degeneration and malignant transformation to chondrosarcoma are among the more serious complications in the natural history of the disease; the latter occurs in approximately 5% of cases. We performed a systematic review of the literature on the arthroscopic management of ankle SC in order to better understand recurrence patterns and suggest an alternative approach to open arthrotomy. METHODS: Using predetermined inclusion and exclusion criteria, the PubMed and Embase databases were searched for relevant articles related to arthroscopic surgical management of patients with confirmed SC of the ankle. Article selection and data abstraction were performed in 3 steps by 3 independent reviewers. RESULTS: The initial search retrieved 116 articles, of which 15 were included. Those studies included 22 patients (14 to 63 years of age; 77% male) who were followed for a mean of 27 months (range, 8 weeks to 12 years) postoperatively. The cases represented a mix of primary and secondary SC etiologies, and almost entirely stage-III disease. Arthroscopic synovectomy with excision of loose bodies was a consistent feature of treatment, and bursectomy, debridement of osteochondral lesions or involved tendons, and osteophyte resection were performed as indicated. All but 1 case employed an anterior approach including anteromedial and anterolateral portals, and in several cases a 4-portal technique was used, which was subsequently proposed as a necessary approach for the definitive treatment of ankle SC. On the basis of the available data, complication and recurrence rates following arthroscopic management were very low. CONCLUSIONS: A growing pool of evidence is emerging to suggest favorable outcomes for arthroscopic treatment of SC of the ankle joint. However, more data on patient and surgical variables, as well as comparative studies with longer follow-up, are needed in order to draw definitive conclusions. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.


Assuntos
Articulação do Tornozelo/cirurgia , Artroscopia , Condromatose Sinovial/cirurgia , Humanos
15.
J Orthop Surg Res ; 15(1): 405, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32917234

RESUMO

PURPOSE: This retrospective study summarized the clinical, radiographic, and arthroscopic manifestation of synovial chondromatosis (SC) of the hip, along with the post-operative effect to discuss the curative effect of arthroscopic management of hip SC. METHODS: Twenty-one patients who underwent arthroscopic surgery from the same surgeon for hip SC were followed up for an average of 45 months. T-shaped capsulotomy was routinely performed in each case. Visual analog scale, range of motion, modified Harris Hip Score, and International Hip Outcome Tool score were collected preoperatively and at the time of the latest follow-up. All patients' demographics, radiographs, and arthroscopic images were collected to summarize and conclude the similarities and differences of their manifestation. RESULTS: Large wedged clumps of loose bodies demonstrated distinguishable radiographic, arthroscopic appearance and demanded a different surgical strategy. Postoperative scores were all significantly improved. One case of residual pain and two cases of residual loose bodies with no symptom related were reported at the final follow-up. All but one patient were satisfied with the outcome. CONCLUSION: Arthroscopy treatment of hip SC with T-shaped capsulotomy has demonstrated a good result in terms of clinical outcome score, recurrence rate, and complication rate. On the basis of this study, we concluded the clinical performance of large wedged clumps of loose bodies of hip SC.


Assuntos
Artroscopia/métodos , Condromatose Sinovial/cirurgia , Articulação do Quadril/cirurgia , Corpos Livres Articulares/cirurgia , Capsulotomia Posterior/métodos , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/patologia , Condromatose Sinovial/fisiopatologia , Feminino , Seguimentos , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/fisiopatologia , Humanos , Corpos Livres Articulares/diagnóstico por imagem , Corpos Livres Articulares/patologia , Corpos Livres Articulares/fisiopatologia , Masculino , Satisfação do Paciente , Amplitude de Movimento Articular , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
Ann R Coll Surg Engl ; 102(8): e213-e215, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32588651

RESUMO

Synovial chondromatosis is a rare benign condition. It most commonly affects the large joints. Presentation in the temporomandibular joint is rare. Our case was an incidental radiological finding and not diagnosed immediately, highlighting the ease with which conditions such as this can be missed, particularly in asymptomatic patients. Only 45% of patients with synovial chondromatosis show radiographic changes. Findings as significant as ours are unusual. An increased professional awareness of the radiological signs of synovial chondromatosis would be beneficial to improve diagnosis and prognosis for patients.


Assuntos
Condromatose Sinovial , Articulação Temporomandibular , Humanos , Masculino , Pessoa de Meia-Idade , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/patologia , Articulação Temporomandibular/cirurgia
19.
Acta Biomed ; 91(4-S): 267-270, 2020 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-32555108

RESUMO

Synovial chondromatosis is a rare benign disease, the aetiology of which is not clear. It can arise in the synovial membrane of joints, tendon sheaths, or bursae. Synovial chondromatosis is characterized by multiple loose bodies that can grow and cause symptoms such as pain, swelling and a limited range of motion. It can also result in joint damage. We describe the case of a 48-year-old male dancer with ankle synovial chondromatosis. Diagnosis by radiograph and MRI showed multiple lesions in anterior and posterior ankle compartments. The patient was successfully treated with arthroscopic removal of all loose bodies and partial synoviectomy. Clinical follow-ups at one, four and 12 months and again at 10 years, showed the ankle had a full range of motion without pain or swelling. Post-operative radiographs at one month and at 10 years showed no lesions. Synovial chondromatosis is a benign condition with several loose bodies that must be removed to relieve symptoms and avoid future joint damage. The ankle is a rare location for chondromatosis and arthroscopic removal is the treatment of choice with good results.


Assuntos
Articulação do Tornozelo , Condromatose Sinovial , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
20.
Histopathology ; 77(3): 391-401, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32506447

RESUMO

AIMS: To evaluate the available diagnostic histological criteria for synovial chondrosarcoma and to screen for the presence of IDH1/IDH2 mutations in a series of cases of this malignant cartilaginous neoplasm. METHODS AND RESULTS: Ten cases of synovial chondrosarcoma diagnosed at our institute were reviewed. At presentation, all tumours occurred in adults (median age, 62 years). The most common location was the knee joint (five cases), and the size at diagnosis ranged from 30 mm to 170 mm. Eight patients had secondary synovial chondrosarcomas associated with pre-existing/recurrent or concomitant synovial chondromatosis. Five patients had local recurrences and three had lung metastases. All patients with intralesional excisions developed local recurrences, whereas those who underwent wide resections did not. At last follow-up (mean, 91 months), available for nine patients, seven patients were alive and disease-free, one patient had died of disease, and one was alive with paravertebral metastases. Frequent histological features observed included loss of clustering of chondrocytes (nine cases), the presence of variable amounts of myxoid matrix (eight cases), peripheral hypercellularity (eight cases), tumour necrosis (six cases), and spindling of chondrocytes (four cases). Of the seven cases for which it was possible to evaluate bone permeation, six showed infiltration of bone marrow. All seven cases screened for mutations of exon 4 of IDH1 and IDH2 were found to be wild-type. CONCLUSIONS: Histological criteria in correlation with clinical and radiological features allow the recognition of synovial chondrosarcoma. IDH1/IDH2 mutations were not present in synovial chondrosarcoma. Adequate surgical margins are important for disease control.


Assuntos
Condrossarcoma , Adulto , Idoso , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/genética , Neoplasias Ósseas/patologia , Cartilagem/patologia , Condromatose Sinovial/complicações , Condromatose Sinovial/patologia , Condrossarcoma/diagnóstico , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/genética , Condrossarcoma/patologia , Feminino , Histologia , Humanos , Isocitrato Desidrogenase/genética , Articulação do Joelho/patologia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Mutação , Metástase Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
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