1/19. Osteoblastic response to successful treatment of metastatic cancer of the prostate.Increasing sclerosis of bone in patients with prostatic cancer most commonly is associated with disease progression. In a study of serial radiographs in a group of 18 patients who experienced objective clinical remission after treatment of metastatic cancer of the prostate, eight (44%) showed an osteoblastic response as part of their healing reaction to successful therapy. The importance of a blastic response as a possible sign of clinical improvement is emphasized. Clinical, biochemical, and bone scan correlations are discussed as they apply to patients who respond favorably to treatment of metastatic cancer of the prostate.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
2/19. Imaging spectrum in sclerotic myelomas: an experience of three cases.The classic radiographic presentation of multiple myeloma is lytic skeletal lesions. Primary sclerotic manifestations are rare and occur only in 3% of cases. The imaging spectrum in three cases of multiple myeloma with primary osteosclerosis is described. The first patient had spiculated sclerosis of the orbit, which is an uncommon site for myeloma. The second patient with poems syndrome had multiple, scattered, skeletal lesions with sclerotic margins. The third patient presented with a chest wall mass and had an expansile thick spiculated sclerosis in the rib. The wide imaging spectrum possible in sclerotic myelomas and their relevant differential diagnosis is emphasized.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
3/19. osteosarcoma in blood relatives.osteosarcoma is an uncommon tumor. family occurrence of osteosarcoma is even rarer. Four cases of osteosarcoma in two siblings and in a father and son treated at our Institute with surgery and chemotherapy are reported. These patients had no other tumors in their family history, and had negative p53 mutations in exons 5-9 by SSCP analysis. RB, CDK4, MDM2, c-myc, c-fos, and p53 gene expression, which are the major genes involved in osteosarcoma susceptibility, were studied. Our results revealed an inactive form of p53 sporadically seen in the samples, a total loss of Rb protein expression, an increased expression of Cdk4, MDM2, c-fos, and c-myc proteins which literature currently reports being the principal alterations found in osteosarcoma. These findings confirm that specific genetic alterations occur in osteosarcoma pathogenesis.- - - - - - - - - - ranking = 3.9264625002611keywords = sample (Clic here for more details about this article) |
4/19. osteopoikilosis: report of a clinical case and review of the literature.osteopoikilosis is an uncommon benign sclerosing bone dysplasia. Herein we present a case of osteopoikilosis with characteristic roentgenographic findings and clinical findings of cervical myelopathy. The importance of the differential diagnosis in symptomatic cases of osteopoikilosis is emphasized with the review of the literature.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
5/19. Psychoneuroendocrine disturbances in a patient with a rare granulomatous disease.erdheim-chester disease (ECD) and Langerhans' cell histiocytosis (LCH) are rare granulomatosis-like diseases of unknown etiology which are characterized by lipoidgranulomatous infiltrates in various organs. Contrary to LCH, endocrine and cerebral lesions were infrequently observed in ECD. We report on a patient with the clinical diagnosis of ECD displaying endocrine and cerebral manifestations and skeletal, pulmonary and soft tissue involvement. Disturbance of the endocrine system was revealed by enlargement of the pituitary, partial deficiency of growth hormone (GH), hyperprolactinemia and testosterone deficiency. Cerebral involvement included sinus vein thrombosis, pathologic acoustic evoked potentials, persistence of gadolinium enhancement after magnetic resonance imaging and hypomania. These findings emphasize the importance to assess endocrine and cerebral function in patients with rare granulomatous diseases like ECD and multiorgan involvement.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
6/19. Dense bone island: clinical features and possible complications.A case of dense bone island in a girl aged 10 years, 1 month old is presented. The lesion was asymptomatic and was an incidental finding on a radiograph taken for another purpose. Nine months after the patient's first visit, an obvious inclination of adjacent teeth was identified. The size and density of the lesion had increased by 10 and 7%, respectively. As the patient was still in adolescence, the lesion may increase in size and density, potentially resulting in further problems such as increased inclination of the adjacent teeth. In addition, the presence of the lesion may complicate any future orthodontic treatment. The lesion should be kept under observation until its growth ceases.- - - - - - - - - - ranking = 2keywords = size (Clic here for more details about this article) |
7/19. Bone densitometry of a patient with osteosclerosis.A 30-yr-old Caucasian man with a history of dorsal and lumbar back pain, which responded partially to antiinflammatory agents, was seen at our Unit. The biochemical bone markers showed an increment in bone alkaline phosphatase and urinary CTX. serum phosphate tended to be low. Radiographic abnormalities were marked osteosclerosis in the pelvis and vertebral bodies without changes in size. Bone scintigraphy results were normal. The increase in bone mineral density (BMD) was greater in L2-L4 ( 3.9 SDs) than in total skeleton ( 1.4 SDs). Analysis of skeletal subareas showed a marked increase in axial skeleton BMD: trunk, 4.0 SDs; spine, 2.5 SDs and pelvis, 4.5 SDs. BMD of the remaining subareas was found to be normal: skull, 0.04 SDs; arms, -0.3 SDs and legs, -0.05 SDs. The patient refused to have a bone biopsy. The radiologic, densitometric, and biochemical findings in the patient presented herein are compatible with axial osteomalacia. Evaluation of total skeleton BMD, and especially skeletal subareas, clearly indicated that the abnormal BMD was restricted to the spine and pelvis whereas the rest of the skeleton was not affected.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
8/19. pycnodysostosis: some aspects concerning kinetics of calcium metabolism and bone pathology.A 23-year-old white woman suffering pycnodysostosis whose parents and five siblings were unaffected was investigated. Chromosomal morphology was normal. Histologic examination of a biopsy specimen obtained from the distal phalanx of the left thumb, corresponding to an area on an x-ray film of osteolysis, showed a fibrous dysplasia-like picture. Kinetic studies of calcium metabolism revealed that exchangeable pool size, turnover, and bone accretion rate were all decreased. Intestinal calcium absorption was investigated simultaneously by a double isotope technique and by deconvolution of the plasmatic specific activity curve of 47Ca given per os. Results obtained by both methods coincided in that values were found to be similarly increased. Endogenous fecal calcium was also determined and revealed a similar increase. Some physiopathological implications of these findings are discussed.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
9/19. Osteopathia striata with cranial sclerosis: clinical, radiological, and bone histological findings in an adolescent girl.Osteopathia striata with cranial sclerosis (OS-CS) is a rare skeletal dysplasia characterized by linear striations of the long bones, osteosclerosis of the cranium, and extra-skeletal anomalies. We provide a comprehensive description of the skeletal phenotype in a French-Canadian girl with a moderate to severe form of sporadic OS-CS. Multiple medical problems, including anal stenosis and the Pierre-Robin sequence, were evident in the first few years of life. At 14 years, she was fully mobile, with normal intellect and stature. She suffered chronic lower extremity pain in the absence of fractures, as well as severe headaches, unilateral facial paralysis, and bilateral mixed hearing loss. Biochemical indices of bone and mineral metabolism were within normal limits. Bone densitometry showed increased areal bone mineral density in the skull, trunk, and pelvis, but not in the upper and lower extremities. An iliac bone biopsy specimen revealed an increased amount of trabecular bone. Trabeculae were abnormally thick, but there was no evidence of disturbed bone remodeling. In a cranial bone specimen, multiple layers of periosteal bone were found that covered a compact cortical compartment containing tightly packed haversian canals. Bone lamellation was normal in both the iliac and skull samples. Osteoclast differentiation studies showed that peripheral blood osteoclast precursors from this patient formed functional osteoclasts in vitro. Thus, studies of bone metabolism did not explain why bone mass is increased in most skeletal areas of this patient. Cranial histology points to exuberant periosteal bone formation as a potential cause of the cranial sclerosis.- - - - - - - - - - ranking = 3.9264625002611keywords = sample (Clic here for more details about this article) |
10/19. Polyneuropathy with osteosclerotic myeloma--poems syndrome.A 55-years-old male, who presented with insidious onset gradually progressive sensorimotor polyneuropathy, POEMS-syndrome was diagnosed based on polyneuropathy, splenomegaly, hypothyroidism, the presence of IgG-monoclonal serum protein with osteosclerotic lesions and hyperpigmention of skin. biopsy of the osteosclerotic lesion from the right superior pubic rami was consistent with plasmocytoma. Electrophysiological studies revealed demyelinating sensorimotor neuropathy and biopsy from sural nerve showed demyelinating neuropathy with secondary axonopathy. The patient showed improvement with radiotherapy. This is a rare systemic disease from the clinical spectrum of plasma cell dyscrasias with polyneuropathy. The importance of poems syndrome in the differential diagnosis of polyneuropathies has been emphasized.- - - - - - - - - - ranking = 1keywords = size (Clic here for more details about this article) |
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