1/6. rhabdomyosarcoma, wilms tumor, and deletion of the patched gene in Gorlin syndrome.BACKGROUND: A 5-year-old year girl with a medical history of mental retardation, physical abnormalities and a known interstitial deletion of chromosome 9q22-q32 presented with a palpable suprapubic mass. During ultrasound investigation, a left renal mass was also detected. The patient underwent surgical removal of both neoplasms, which were diagnosed as a rhabdomyosarcoma and a wilms tumor. Seven years later, she presented with macroglossia and a benign mandibular cyst. INVESTIGATIONS: physical examination, karyotyping, abdominal and pelvic ultrasound, brain CT scan, anatomic pathology analysis with immunohistochemistry, and typing of polymorphic markers in the patched (PTCH) gene region. diagnosis: Gorlin syndrome with synchronous rhabdomyosarcoma and wilms tumor. MANAGEMENT: Left nephrectomy, excision of paravesical tumor, excision of mandibular cysts, chemotherapy, and radiotherapy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/6. Vascular pedicle fibular transplantation as treatment for bone tumor.In 4 cases of bone tumor in which extensive bone defects resulted from removal of the tumorous focus, vascular pedicle free fibular transplantation was performed using microsurgical techniques together with filling the defects with iliac bone. Early bone union was achieved. atrophy and fracture were avoided. Early postoperative physical therapy was possible. The vessels selected in the recipient site are dependent upon the location of the graft bed, but the anastomosed site of the vessels should be kept outside of the graft bed. It is important to plan the operation so as to avoid motion at the site of callus formation and tension at the anastomosis site.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/6. Fracture of bone with an aneurysmal bone cyst during lactation.A case is presented of a 28-year-old lactating Nigerian mother who developed a pathological fracture of the left humerus following inapparent physical stress. There was radiographical and histological evidence of aneurysmal bone cyst disease involving both humerus. A possible pathogenetic role of bone-calcium dyshomeostasis during pregnancy and, indeed, lactation is entertained. A strong case is made for calcium supplementation in the pregnant and/or lactating mother, especially in the developing countries with an increased probability of marginal nutrition status.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/6. Steroid injection of a unicameral bone cyst of the calcaneus: literature review and two case reports.Two interesting cases are presented, describing the diagnosis and treatment of unicameral bone cysts of the calcaneus. The first case report presents a patient who had a 5-month history of a painful right heel. The pain had been getting progressively worse and was aggravated by prolonged walking and physical activity. The second case report presents a patient whose unicameral bone cyst was discovered as a relatively incidental finding on radiographs; however, the patient later admitted that he had mild tenderness upon the plantar-lateral aspect of his right calcaneus with weightbearing. The authors reviewed the literature concerning the etiology and treatment of unicameral bone cysts. attention is directed to the use of injectable steroid as an alternative means to open surgical intervention. Certain potential problems exist, in spite of the various surgical approaches utilized, including infection, postoperative fracture, recurrence, immobilization, and prolonged hospitalization.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/6. Simple bone cyst of the calcaneus. A case report and literature review.The authors presented a case report of a patient presenting with heel pain symptoms and physical findings similar to those associated with a heel spur syndrome. With a standard x-ray, the presence of a simple bone cyst was evident. Although mainly reported in tubular bones, steroid injection therapy has been successful and appears to be replacing surgical curettage and packing as the preferred choice of treatment in many cases. As more reports of the successful eradication of simple bone cysts of the calcaneus with steroid injections are reported, greater confidence for using it as a treatment choice for this particular lesion may be gained. The surgical approach in the patient presented here was chosen because of factors that the authors believe increased the likelihood of a pathologic fracture, such as size and extent of the lesion, history of progressive pain, and activity level of the patient. The larger body weight and the resulting stress of the patient more likely to present with a calcaneal cyst may also be factors to consider.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/6. Maxillary giant cell reparative granuloma."Giant cell reparative granuloma" was introduced into medical literature by Jaffe in 1953. Prior to that time most authors considered this lesion to be a variant of the benign giant cell tumor of the long bones, or a giant cell variant of osteitis fibrosa. Bernier and Cahn established the subdivision between the rare central giant cell reparative granuloma and the common peripheral epulis. In the past, considerable emphasis has been placed on the importance of differentiating the true giant cell tumor from the giant cell reparative granuloma of the jaw bones. Most authors now believe the true giant cell tumor does not appear in the jaw bones except in rare cases associated with Paget's disease of the skull. Developing from membranous, rather than cartilaginous, ossification might account for this. Both peripheral and central intraosseous lesions, parathyroid osteopathy and the pathologic tissue of cherubism show no appreciable histologic difference. These tumefactions are histologically a proliferative fibroblastic lesion with multinucleated giant cells. The histopathology of the giant cell tumor of the long bones is probably identical to the histopathology of the giant cell reparative granuloma of the jaw bones. The diagnosis of giant cell reparative granuloma must be made by physical examination, history, laboratory, X-ray parameters and clinical follow-up. Localized maxillary swelling is the most important clinical feature. The swelling is smooth and palpation can reveal a rubbery, elastic sensation where bone has been thinned. There are no specific radiographic signs. Conservative surgical management is indicated and adequate for giant cell reparative granulomas. radiation is not indicated because of long term risks. steroids have not been proven useful.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |