1/10. Surgical removal of orbital osteoma; case report.Thr authors report a patient with a large orbital osteoma causing marked physical deformity and diplopia but with preservation of visual acuity. A combined transorbital and transcranial operative approach was used for total tumor removal and cosmetic repair.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/10. Intestinal metastasis causing intussusception in a patient treated for osteosarcoma with history of multiple metastases: a case report.Intestinal intussusception caused by metastatic tumors is a very rare condition. Preoperative diagnosis is not easy because of the condition's rarity and because of mild abdominal physical presentation. We report on a patient with osteosarcoma who suffered from abdominal pain and emesis during the period of autologous peripheral blood stem cell transplantation. He had undergone tumor excision and radiotherapy several times prior to autologous peripheral blood stem cell transplantation because of multiple metastases. Intestinal metastasis was suspected initially by computed tomographic scan and sonogram and was proved by surgical resection and pathological findings. Clinicians caring for pediatric patients with osteosarcoma with a history of multiple metastases should consider the possibility of intestinal metastases when equivocal abdominal symptoms develop after intensive chemotherapy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/10. Thyroid carcinoma after successful treatment of osteosarcoma: a report of three patients.We report three cases of papillary thyroid carcinoma occurring after successful treatment of osteosarcoma. Only one of the three patients received radiation therapy (to the chest) as part of the primary treatment of osteosarcoma. The onset of thyroid carcinoma occurred between 8 and 16 years from the cessation of osteosarcoma therapy. All patients are alive and disease-free from both malignancies. Whereas the association between osteosarcoma and thyroid carcinoma has not previously been recognized, there have been five case reports of these two entities occurring in the same patient. Three of these cases occurred in patients with werner syndrome. None of the patients reported here had physical stigmata of werner syndrome or a family history consistent with a hereditary cancer syndrome. Thyroid carcinoma occurs infrequently in patients with osteosarcoma, but in view of the rarity of these two disorders, this association may represent an inherited predisposition to these malignancies.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/10. pathology quiz: small cell osteosarcoma.A 15-year-old black male presented with shortness of breath, leg weakness, and pain in his back and rib cage. Four years previously he had noticed a lump in his upper back and complained of pain when playing basketball, especially on contact to that area. Recently, the pain had become more constant and increased in intensity. This was associated with loss of control in his legs, weakness, and paraesthesia. General physical examination revealed a palpable mass in the right midline upper back. Laboratory results were within normal limits. Radiographic scans demonstrated a destructive soft tissue mass at T6 vertebral body with scattered stippled calcification (Figure 1). The patient underwent a biopsy followed by excision of the mass (Figure 2) and decompressive laminectomy with reconstruction.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/10. Osteogenic sarcoma of the sella after radiation treatment of a pituitary adenoma.OBJECTIVE: To report an uncommon case of osteogenic sarcoma of the sella turcica after radiation treatment of a pituitary adenoma. methods: We present the clinical history, physical findings, laboratory data, imaging studies, and pathologic findings in a patient found to have osteogenic sarcoma of the sella after radiation therapy for a nonfunctioning pituitary adenoma. RESULTS: Six years after transsphenoidal resection and postoperative fractionated radiation therapy for a nonfunctioning pituitary adenoma that extended to the cavernous sinus, a 45-year-old man presented with a sinus infection, diplopia, and ophthalmoplegia of the right eye. A computed tomographic scan of the head showed a mass in the sella with involvement of the optic chiasm and right cavernous sinus. Transsphenoidal resection and debulking of the tumor revealed an osteogenic sarcoma. The patient was discharged from the hospital with residual diplopia and ophthalmoplegia. He was treated with levothyroxine, testosterone, and hydrocortisone. Six weeks later, the patient was readmitted after he was found unresponsive, and computed tomographic scans disclosed a massive cerebrovascular accident. He died a few days later. CONCLUSION: Osteogenic sarcoma is a rare, late complication of radiation treatment of pituitary adenoma. Although radiotherapy remains an effective adjunctive treatment in patients with pituitary adenomas, particularly those with residual or recurrent tumor, potential complications must be acknowledged.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/10. Rotationplasty--a unique surgical procedure with a functional outcome.ROTATIONPLASTY is a surgical procedure that may be appropriate for children with severe congenital femoral deficiency or children with malignant tumors of the femur or proximal tibia. OSTEOTOMIES AND RESECTION of the femur and tibia are performed, allowing the patient's foot to be rotated 180 degrees and reattached while preserving the nerves, muscles, and blood supply. THE POSTERIOR-FACING foot functions as the patient's knee joint in a specially fitted prosthesis. Although the outcome is visually unusual, for some children, regaining function and physical capabilities outweighs cosmetic concerns. The surgical procedure is technically challenging and requires a multidisciplinary approach.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/10. Fat embolism syndrome complicating intraarterial chemotherapy with cis-platinum.A 19-year-old man with telangiectatic osteosarcoma of the left proximal femur was started on a course of neoadjuvant chemotherapy consisting of intraarterial administration of cis-platinum. Within 72 hours of receiving the first intraarterial dose, the patient developed signs and symptoms of fat embolism syndrome (FES). A physical examination revealed cyanosis, tachycardia, and seizure activity. Laboratory studies demonstrated a pO2 of less than 65 mmHg, lipuria, and a drop in hematocrit of three percentage points. There was no clinical or roentgenographic evidence of pathologic fracture. Tumor necrosis secondary to intraarterial cis-platinum therapy in this patient with osteosarcoma may have caused a sudden release of free fatty acids and embolization of fat macroglobules that precipitated this episode of FES. FES in association with the intraarterial administration of cis-platinum seems not to have been previously reported.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/10. Polyostotic fibrous dysplasia and chronic osteomyelitis in a 12-year-old boy. Diagnostic difficulties in double bone pathology.A twelve-year-old boy with double bone pathology (polyostotic fibrous dysplasia and chronic monofocal osteomyelitis), causing radiologic diagnostic difficulties is reported. The nuclear scan which was interpreted with disregard of the patient's history and physical examination lead to erroneous conclusions. Basic clinical signs and symptoms should always be taken into account when more sophisticated examinations are performed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/10. Sudden cardiac death following adriamycin therapy.An 18-year-old man had had an osteogenic sarcoma of the distal tibia at age 16. Below-knee amputation was carried out and followed by adjuvant chemotherapy with Adriamycin, vincristine, methotrexate, Cytoxan, and melphalan. One month after termination of chemotherapy, he died suddenly while playing tennis. Documented ventricular fibrillation was unresponsive to cardiopulmonary resuscitation. Myocardial fibrosis ("cardiomyopathy") was the only significant anatomic finding at autopsy. The occurrence of sudden death without antecedent cardiac failure may have been related to strenuous physical activity in this patient who had received combined adjuvant chemotherapy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/10. Solitary adenocarcinoma metastasis mimicking sarcomatous degeneration in Paget's disease.A rare case of mucinous adenocarcinoma presented as a solitary, metastatic deposit to a region of Paget's disease within the peripheral skeleton. Historical, physical, radiographic, and scintigraphic findings were indistinguishable from those of sarcomatous degeneration arising from pagetoid bone. This case supports the idea that when a painful, osteolytic lesion is discovered within a region of Paget's disease, bone scintigraphy has greater value of disclosing potential multifocal or multicentric disease than for providing etiologic specificity for the principal lesion.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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