1/10. Solitary lymphangioma of the femur. A case report.lymphangioma of the bone is a benign lesion, characterized by newly formed lymph vessels. It usually occurs in a diffuse manner or as multiple lesions. Solitary lymphangioma of the bone is an extremely rare condition. We herein describe a case of solitary lymphangioma of the femur in a 55-year-old woman who presented with knee pain. Radiographs showed an eccentric osteolytic lesion in the distal femur. This is the first reported case of solitary lymphangioma of the bone occurring in the femur.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/10. Microvascular anastomosis of a rectus abdominis free flap into a prosthetic vascular bypass graft.Distal bypass grafts are frequently employed to revascularize lower extremities and to replace major peripheral vessels following excision of large soft-tissue or bone tumors. Autogenous vein grafts are generally used for such bypasses, when available. Large wounds associated with peripheral vascular disease or excision of massive tumors frequently require concomitant free-tissue transfers. Anastomosis of a free-tissue transfer pedicle to a vein bypass graft has been reported. The first successful case of an anastomosis of a flap pedicle to a Gore-tex bypass graft is presented.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/10. Segmental amputation with re-implantation in the treatment of malignant bone tumours of the limbs.Stage 2 B malignant skeletal tumours are currently treated by amputation or disarticulation of the limb. The present paper describes a surgical technique for complete removal of the neoplasm and surrounding soft tissues by resection of a cylinder of the limb complete with skin. The resection of bone and adjacent soft tissues is extended sufficiently proximal and distal to the neoplasm to ensure complete removal of neoplastic tissue. The authors describe two cases; an osteosarcoma of the distal third of the femur and a malignant fibrous histiocytoma of the lower radius. After removing the affected cylinder of the limb, osteosynthesis is performed by one of a variety of methods. The main vessels and nerves are dealt with according to the findings revealed by pre-operative investigations or per-operative findings. If they have to be sacrificed, end to end suture is performed, but if main nerves can safely be spared (as in Case 1) it greatly enhances the functional prognosis. The value of this operation is that it is as radical as amputation while the aesthetic and functional results are equivalent to those of a resection-arthrodesis. The operation has therefore been designated segmental amputation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/10. Application of the free vascularized bone graft in the treatment of malignant or aggressive bone tumors.Although recent advances in clinical microsurgery have made free tissue transfer a clinical reality, the value of free bone transfers in the reconstructive tumor surgery of long bones has not been reported to our knowledge. Two patients with malignant or aggressive bone tumors who underwent en bloc resection of their tumors and reconstruction with free vascularized bone grafts are presented. In the first case, a giant cell tumor of the distal radius was resected, and a 10 cm free vascularized fibular graft was performed as a reconstructive procedure; in the second case a chondrosarcoma of the femur was excised and replaced by a 20 cm segment of free vascularized fibula. Postoperatively, these patients were followed with arteriograms and sequential bone scans. The indications for the procedure and the operative technique are discussed. A comparison of the merits of free rib versus free fibular transfers is presented with emphasis on bony architecture, vessel characteristics, dissection required and the options available for reconstructive surgery. The advantages and disadvantages of free vascularized bone grafts with respect to conventional methods and the potential applicability of this technique are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/10. The histiocytoid hemangiomas. A unifying concept embracing several previously described entities of skin, soft tissue, large vessels, bone, and heart.The proposal is made that a number of previously described entities of skin, soft tissue, large vessels, bone, and heart actually constitute different manifestations of the same basic process, characterized by the proliferation of a highly distinctive type of cell descriptively identified as a "histiocytoid endothelial cell." The entities in question are angiolymphoid hyperplasia with eosinophilia and related cutaneous and subcutaneous disorders, atypical vascular proliferation of large vessels, hemangioendothelioma of bone, and endocardial benign angioreticuloma of the heart. The main cell that proliferates in all these conditions has the basic features of an endothelial cell, but also exhibits histochemical and ultrastructural characteristics that are more akin to those of a histiocyte. These unusual features could be the expression of a morphologic abnormality or represent an overgrowth of a specific and as yet undefined subpopulation of endothelial cells, such as Majno's "contractile endothelial cell." Whether this group of proliferative diseases is of a reactive or a neoplastic nature is not immediately apparent, although the latter seems more likely. However, it is clear that the behavior of these lesions, as a group, is quite indolent and even self-limited, in contrast to the aggressive behavior and often fatal outcome of the true angiosarcomas that they so closely resemble on microscopic grounds. The term "histiocytoid hemangioma" is suggested for this group of disorders.- - - - - - - - - - ranking = 6keywords = vessel (Clic here for more details about this article) |
6/10. Lymphangiomatosis of bone and soft tissue (results of lymphangiographic examinations).The results of clinical roentgenologic examination of 2 patients with lymphangiomatosis are discussed. The analysis of angiographic findings has shown that arteries and veins remained unchanged in affected area. lymphography revealed fully changed lymphatics in affected areas. Numerous markedly dilated lymph vessels and cystic cavities of different shape and size were noted. In bony spongiosus substance the fissural spaces were filled with oily contrast medium. Roentgenologically, they appeared as numerous small conglomerates limited to bone contours.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/10. Primary leiomyosarcoma of bone: a study of five cases.Five cases of leiomyosarcoma of bone are described. The patients, 3 men and 2 women, ranged in age from 24 to 74 years. Four of the five tumors were located in the distal half of the femur. Radiographically, all tumors presented as purely osteolytic lesions. angiography, performed in 3 cases, revealed hypervascularity and the presence of irregular, tortuous vessels at the site of the lesion in 1, but not in 2 others. Histologically, the five tumors showed features characteristic of leiomyosarcomas. The most prominent features were blunt-ended, cigar-like, chromatin-rich nuclei in elongated acidophilic cells arranged in bundles which intersected each other at wide angles. The importance of trichrome stains, such as van Gieson stain, for th recognition of leiomyosarcomas is emphasized. Electron microscopic examination, performed in 3 cases, showed as the most prominent features spindle-shaped cells in parallel arrangement containing abundant myofilaments which elongated densities, pinocytotic vesicles, and basal lamina structures.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/10. Arterial and venous compromise by an osteochondroma.A 9.5-year-old girl had popliteal arterial and venous compression by a distal femoral osteochondroma. magnetic resonance imaging demonstrated the relation of the vessels to the osteochondroma and a three-phase bone scintigram showed asymmetry of arterial perfusion and evidence of venous stasis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/10. Malignant glomus tumor: a case report and review of the literature.This report concerns a malignant glomus tumor, a rare soft tissue tumor that was examined immunohistochemically and ultrastructurally. It occurred in a 44-year-old male patient who had suffered from dull pain and stiffness in the right thigh for 10 months. Radiographic examination revealed a well-defined osteolytic lesion in the diaphysis of the right femur. Hypervascularity of the tumor was observed angiographically. Computed tomographic and magnetic resonance examinations showed an intramuscular mass invading the marrow space of the femur. Wide resection was performed after open biopsy. Histologically, round to polygonal tumor cells revealed a uniform appearance of round to ovoid nuclei with single large nucleoli and slightly eosinophilic cytoplasm, forming solid sheets of cells interrupted by vessels of varying size. A few mitotic figures and vascular invasion were observed. Immunohistochemically, vimentin and alpha-smooth muscle actin were stained intensely, and muscle actin was positive for tumor cells of the perivascular area. Tumor cells were negative for desmin, factor viii-related antigen, S-100 protein, neurofilament, cytokeratin, and epithelial membrane antigen. Ultrastructurally, tumor cells were characterized by many cytoplasmic processes, pinocytotic vesicles, plasmalemmal dense plaques, and scattered microfilaments in the cytoplasm. Few cell junctions and focal basement membrane-like structures were observed. No recurrence or metastasis was noted 57 months after operation. This case was considered to be a malignant glomus tumor, that is, a glomangiosarcoma arising de novo.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/10. rotation plasty for osteosarcoma of the femur.A 20-year-old female with right femoral osteosarcoma noted severe pain and swelling of the right thigh, and was transferred to the authors' hospital after suffering a pathologic fracture of the right femur. Plain x-ray disclosed a tumor shadow extending from the pathologic fracture of the distal portion of the femur to the center of the diaphysis. MRIs showed a broad lesion and hematoma, and invasion to the femoral vascular bundle was suspected. Angiograms revealed vascularization coincidental to the tumor, and an irregular vascular wall of the femoral artery, which was shifted posteriorly. After consultation with the patient and her family, rotation plasty was performed. The sciatic nerve was isolated and preserved; major vessels were sectioned proximally and distally because of tumor tissue invasion to the femoral artery and vein. After wide excision of the tumor, the leg was rotated outward 180 degrees, and osteosynthesis was performed between the remaining femur and the tibia, followed by microsurgical anastomosis of vessels. Five years postoperatively, no local recurrence or metastasis has been observed. The patient has excellent functional recovery without pain, and no other complications.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
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