Extraskeletal cutaneous chondroblastic osteosarcoma: a case report.

Extraskeletal osteosarcoma is an uncommon neoplasm that usually arises in the deep soft tissues, especially in the lower extremities, with rare cases involving the subcutis or dermis. We report a 60-year-old man with an enlarging cutaneous mass in the right lower thigh. An incisional skin biopsy showed a well-defined, but non-encapsulated neoplasm, characterized by extensive cartilage with marked cellularity, atypia and high mitotic activity, involving the dermis and subcutis. Although osteoid or bone was not observed, a diagnosis of cutaneous chondroblastic osteosarcoma was suggested after excluding an origin in bone or other primary tumor sites by imaging techniques. Histopathologic features of the surgical specimen were characteristic, with a predominant high-grade chondroid component together with focal fibrosarcomatous zones, areas of multinucleated giant cells and foci of bone and osteoid formation. The patient underwent postoperative chemotherapy and is currently alive with pulmonary metastases 15 months after surgery. In summary, we report a unique case of cutaneous osteosarcoma of the chondroblastic subtype, diagnosed on incisional skin biopsy despite the absence of osteoid or bone during tumor sampling. As a rule, when an obviously malignant 'chondrosarcoma' is identified, one should always consider this entity.

Cytologic features of hepatoid carcinoma of the ovary: a case report with immunocytologic evaluation of HepPar1.

BACKGROUND: Hepatoid carcinoma is a rare, primary neoplasm of the ovary characterized by histologic, immunobistochemical and analytical evidence of hepatic differentiation. Reflecting the rarity of this entity, few cytologic descriptions are available. CASE: A 65-year-old woman presented with an abdominopelvic mass, peritoneal implants and elevated levels of CA-125 and a-fetoprotein (AFP). Cytologic examination of the ascitic fluid revealed cellular samples of polygonal cells in trabecular and papillary groups. Neoplastic cells were predominantly monomorphous, but some groups exhibited marked cellular atypia. A few trabecular groups showed peripheral endothelial rimming. Histologically, the neoplasm had evident hepatocellular differentiation, with a solid, trabecular growth of polygonal, eosinophilic cells with well-defined boundaries. The cells were immunoreactive with keratins, AFP and HepPar1. Retrospectively, HepPar1 was tested in cytologic samples, with a positive result. CONCLUSION: As occurs with other hepatocellular neoplasms, the hepatic differentiation that characterizes this unusual neoplasm may not be easily recognizable in effusion samples. However, there are some features that, in addition to an elevated AFP value, may help to suggest the diagnosis. A predominant trabecular arrangement with occasional endothelial rimming and HepPar1 immunoreactivity, consistent with hepatic differentiation, are unusual in common surface epithelial ovarian tumors.

Aortitis due to giant cell arteritis and psoriatic arthritis: An uncommon association. / Aortitis por arteritis de células gigantes y artritis psoriásica: una asociación infrecuente.

We report the case of a 65-year-old woman with psoriatic arthritis who developed aortitis secondary to giant cell arteritis. She presented with a 2-mounth history of dry cough, fever and fatigue. There was no evidence of tumor or infectious processes. Abdominal computed tomographic and computed tomography coronary angiographic findings were suggestive of aortitis. Histological study of a temporal artery biopsy confirmed temporal arteritis. We also review the available literature on this uncommon condition.

Aortitis por arteritis de células gigantes y artritis psoriásica: una asociación infrecuente / Aortitis due to giant cell arteritis and psoriatic arthritis: an uncommon association

Presentamos el caso de una mujer de 65 años seguida por artritis psoriásica, que desarrolló una aortitis por arteritis de células gigantes, con un comienzo de tos seca, fiebre y astenia de 2 meses de evolución. Se realizó estudio descartando procesos tumorales e infecciosos y evidenciándose en la TAC abdominal y la angio-TAC datos indicativos de aortitis. Se realizó biopsia de arteria temporal con confirmación histológica de arteritis de células gigantes. Realizamos una revisión de la información disponible sobre esta infrecuente asociación (AU)

We report the case of a 65-year-old woman with psoriatic arthritis who developed aortitis secondary to giant cell arteritis. She presented with a 2-mounth history of dry cough, fever and fatigue. There was no evidence of tumor or infectious processes. Abdominal computed tomographic and computed tomography coronary angiographic findings were suggestive of aortitis. Histological study of a temporal artery biopsy confirmed temporal arteritis. We also review the available literature on this uncommon condition (AU)

Lumbalgia inflamatoria en varón de 44 años / Inflammatory back pain in a 44 year old male

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Tratamiento percutáneo mediante radiofrecuencia del osteoma osteoide / Percutaneous radiofrequency ablation of osteoid osteoma

Objetivo: Presentar nuestra experiencia inicial en el tratamiento percutáneo del osteoma osteoide mediante radiofrecuencia. Material y métodos: Se han tratado tres pacientes, todas del sexo femenino con edades comprendidas entre 5 y 19 años, que presentaban el tumor en fémur proximal, tibia y calcáneo. El procedimiento se realizó con anestesia general en dos casos y con sedación activa en uno. Mediante control de imagen con tomografía computarizada, se introdujo un trépano que sirvió de guía para colocar la punta del electrodo en el nidus. Durante ocho minutos se conecta el electrodo al generador de radiofrecuencia. Resultados: En las tres pacientes desapareció el dolor antes de 48 horas y sólo estuvieron ingresadas 24 horas. La actividad física normal se restableció sin restricciones tras el alta. Entre tres y cuatro meses después permanecen asintomáticas. Conclusiones: La ablación percutánea de osteomas osteoides mediante radiofrecuencia es un método eficaz y seguro que evita las complicaciones derivadas de la cirugía (AU)