RESUMO
Extraskeletal osteochondroma is a rare benign tumor that occurs predominantly in the soft tissues of the hands and feet. The congenital occurrence of this lesion in children is very rare. We report the case of a 9-year-old male who presented with slowly progressive swelling in his left third web space since birth that was painful with prolonged walking and had displaced his fourth toe further laterally, causing both functional and cosmetic problems. Radiographs and computed tomography revealed a well-circumscribed densely ossified lesion. Excision biopsy of the lesion showed a lobulated extraskeletal osteochondroma. At the end of 1 year of follow-up, the child had had no recurrence. To the best of our knowledge, this is the first report of congenital extraskeletal osteochondroma of the foot in English-language published studies.
Assuntos
Osteocondroma/patologia , Neoplasias de Tecidos Moles/patologia , Dedos do Pé/cirurgia , Criança , Humanos , Masculino , Osteocondroma/congênito , Osteocondroma/diagnóstico por imagem , Osteocondroma/cirurgia , Radiografia , Neoplasias de Tecidos Moles/congênito , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/cirurgia , Dedos do Pé/diagnóstico por imagemRESUMO
Giant cell tumour of the foot is very rare. Very few cases of first metatarsal giant cell tumour were reported. We report two cases of recurrent giant cell tumour in adolescent patients. One was treated with wide excision and fibula grafting. The second patient underwent Boyd's amputation because of superceded infection. Both had no pain, recurrence at the end of final follow up. Recurrent giant cell tumour of the first metatarsal in adolescents and its management is not described in English literature to the best of our knowledge.
Assuntos
Neoplasias Ósseas/cirurgia , Tumor de Células Gigantes do Osso/cirurgia , Ossos do Metatarso/cirurgia , Recidiva Local de Neoplasia/cirurgia , Adolescente , Neoplasias Ósseas/diagnóstico por imagem , Feminino , Tumor de Células Gigantes do Osso/diagnóstico por imagem , Humanos , Masculino , Ossos do Metatarso/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Radiografia , Adulto JovemRESUMO
Skeletal involvement occurs in 5% to 10% of reported cases of disseminated cryptococcal infection. We are reporting a very rare presentation of cryptococcal infection of the talus with pathological fracture, which healed with medical management. Our patient had pain and swelling around the ankle associated with fever. Radiologically, he had a lytic lesion of the talus with fracture of the talar neck. Biopsy and cultures revealed cryptococcal infection. He was treated with surgical debridement combined with antifungal therapy, and the fracture healed well by 5 months. At the end of the 1-year follow-up, he had painless ankle movement and there was no evidence of recurrence. He was able to walk without support or limp, and he could wear normal footwear.
Assuntos
Criptococose/tratamento farmacológico , Desbridamento/métodos , Fraturas Espontâneas/terapia , Fungemia/tratamento farmacológico , Tálus/lesões , Antifúngicos/uso terapêutico , Biópsia por Agulha , Terapia Combinada , Criptococose/complicações , Criptococose/diagnóstico , Seguimentos , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/etiologia , Fraturas Ósseas/cirurgia , Fraturas Espontâneas/diagnóstico por imagem , Fraturas Espontâneas/etiologia , Fungemia/complicações , Fungemia/diagnóstico , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Radiografia , Doenças Raras , Medição de Risco , Tálus/diagnóstico por imagem , Resultado do TratamentoRESUMO
Bone tumours arising from the coracoid process of the scapula are very rare. We present a case of a 19-year-old man with left shoulder pain for 1â year, with associated infraclavicular swelling for 8â months. Examination revealed a tender, bony, hard swelling measuring 3×4â cm. Imaging revealed an expansile osteolytic lesion arising from the coracoid process with loss of corticomedullary differentiation. MRI showed altered signal in the adjacent soft tissues. The patient underwent en bloc resection of the lesion. Histology was suggestive of osteoblastoma. At the end of 2â years follow-up, the patient had no pain or recurrence of the lesion. We present this case for its rare location and have briefly discussed the difficulties in diagnosis of this condition.
Assuntos
Neoplasias Ósseas/diagnóstico , Osteoblastoma/diagnóstico , Escápula/diagnóstico por imagem , Articulação do Ombro/patologia , Dor de Ombro/etiologia , Neoplasias Ósseas/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Osteoblastoma/cirurgia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Bilateral simultaneous fracture dislocation of the talus is a very rare injury. It occurs usually following high-velocity injuries. We report a 45-year-old man who presented with bilateral talar fracture dislocation following a heavy stone falling on him. On his right side, he had open talus dislocation with lateral process fracture and on his left side he had closed talar neck fracture dislocation. He underwent immediate debridement and external fixator application for his right side and open reduction and internal fixation for his left talus. At the end of 34â months' follow-up, he was able to walk up to 2â km without pain. His ankle range of movements were restricted bilaterally. Radiographs revealed bilateral avascular necrosis with right side showing complete collapse. We present this case for its rare presentation of bilateral talar fracture dislocation with bilateral avascular necrosis with sequential radiographs.