1/30. Development of a desmoid tumor at the site of a total hip replacement.Extra-abdominal desmoid tumors are locally aggressive benign soft tissue tumors arising from the connective tissue of muscle and overlying fascia or aponeuroses. Location around the hip occurs in about 10% of all desmoid tumors. The authors report the development of a desmoid tumor around the hip 45 months after implantation of a total hip prosthesis. Endocrine and physical factors seem to play an important role in the development of the disease. Moreover, an association has been reported between trauma and desmoid tumor. Desmoid tumors developing around silicon implants have also been described. However, no association between hip prostheses and desmoid tumors has been published in the world literature. Although soft tissue tumors induced by metallic implants have been observed clinically, we still seek a coherent explanation for the exact pathogenesis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/30. Primary mediastinal giant cell tumors: a clinicopathologic and immunohistochemical study of two cases.Two cases of posterior mediastinal giant cell tumors are presented. The patients are a woman and a man, 31 and 18 years old, respectively. One of the patients had symptoms of paresthesias while the other was completely asymptomatic. Complete physical examination did not disclose evidence of tumor elsewhere. Neither patient had a previous history of malignancy. Surgical resection was performed. Histologically, both tumors were composed of a proliferation of osteoclast-like giant cells associated with a mononuclear cell population composed of oval and spindle cells. Mitotic activity and mild cellular atypia were present in the mononuclear cell component. No evidence of necrosis or hemorrhage could be demonstrated in either case. Immunohistochemically, both tumors showed strong positive reaction in the mononuclear component for antibodies against vimentin and CD68, while keratin, epithelial membrane antigen, CD45, S-100 protein, and desmin were negative. On clinical follow-up, both patients are alive and well without evidence of recurrence or metastasis 6 and 108 months after surgery. The present cases highlight the ubiquitous distribution of soft tissue giant cell tumors and the importance of considering these tumors in the differential diagnosis of posterior mediastinal neoplasms.- - - - - - - - - - ranking = 12.518824609734keywords = physical examination, physical (Clic here for more details about this article) |
3/30. Bilateral elastofibroma dorsi: proper positioning for an accurate diagnosis.Elastofibroma dorsi is a rare, slow-growing, ill-defined soft tissue tumor of the chest wall, most commonly located beneath the rhomboid major and latissimus dorsi muscles. It is usually unilateral, and bilateral involvement occurs in only 10% of patients. We report herein a case of a 56-year-old woman with bilateral elastofibroma dorsi. The patient was found to have bilateral involvement of the tumor following a physical examination with proper positioning. An elastofibroma should be considered in the differential diagnosis of tumors deeply located at the periscapular area. Meticulous physical examination may reveal a nonpalpable coexisting tumor with deep subscapular location and help the accurate diagnosis of bilateral elastofibroma dorsi, hence preventing a secondary operation.- - - - - - - - - - ranking = 25.037649219467keywords = physical examination, physical (Clic here for more details about this article) |
4/30. Extraskeletal mesenchymal chondrosarcoma.Extraskeletal mesenchymal chondrosarcoma is a rare malignancy. It is characteriged by a bimorphic histologic pattern, with a mesenchymal tissue mixed with malignant hyaline cartilage. It also has high incidence of local recurrence and distant metastasis. All cases have been reported fatal associated with this tumor in spite of complete surgical excision. A 35-year-old female presented with a palpable mass about 5 x 3 x 2.5 cm3 in size over her left forearm and was reported to be an extraskeletal mesenchymal chondrosarcoma. Marginal resection followed by regional radiotherapy was done. No local recurrence or distant metastasis was found two years after surgery. Thorough physical examination, series radiographic studies, and multiple sites of tumor biopsies before radical resection of the tumor may decrease the misdiagnostic rate for extraskeletal mesenchymal chondrosarcoma. Appropriate tumor treatment, close patient follow-up and timely treatment for local recurrence or distant metastasis may increase the survival rate.- - - - - - - - - - ranking = 12.518824609734keywords = physical examination, physical (Clic here for more details about this article) |
5/30. Congenital giant aneurysm of the left innominate vein: is surgical treatment required?Congenital aneurysms of the thoracic venous system are rare. In particular, innominate venous aneurysms are extremely rare. We describe a 16-year-old girl whose chest x-ray suggested a mediastinal tumor. Three-dimensional contrast-enhancement magnetic resonance venography showed a giant sacciform aneurysm of the left innominate vein and dilatation of the right innominate vein. The patient was asymptomatic, and there were no significant physical findings. Therefore, the patient is being followed without surgical treatment.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/30. Juxta-articular myxoma of the wrist: a case report.A 16-year-old boy with a 4-month history of pain and a palpable mass in the right wrist was presented to our clinic. Preoperative diagnosis was a ganglion cyst according to symptoms and physical examination. The lesion was removed by marginal resection and histopathologic examination revealed a juxta-articular myxoma. No recurrence was detected at 1-year follow-up evaluation. We report a case of juxta-articular myxoma of the wrist joint.- - - - - - - - - - ranking = 12.518824609734keywords = physical examination, physical (Clic here for more details about this article) |
7/30. leiomyosarcoma of the femoral vein in a marathon runner.leiomyosarcoma of the femoral vein is a rare tumor. physicians involved in the care of athletic patients must not be cavalier in evaluating overuse injuries and should endeavor to make a specific diagnosis. If atypical findings, such as generalized extremity swelling, are present, the physician must consider systemic illness including malignancy in apparently healthy, physically active individuals.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/30. What should be the treatment modality in giant cutaneous lipomas? review of the literature and report of 4 cases.We present three females (20, 39 and 58 years old) and one male patient (47 years old), admitted to our clinic with 3-20 years history of giant lipomas on periscapular (n = 2), posterior cervical (n = 1) and abdominal areas (n = 1), respectively. The sizes of the tumours ranged from 15 x 14 cm(2) to 35 x 25 cm(2) weighing 1900-12 350 g. In all cases, the diagnosis of the lesions was by physical examination and confirmed with computed tomography, magnetic resonance imaging and ultrasonography. Incisional biopsy or aspiration cytology were used to exclude liposarcoma. Three lesions with surrounding capsule formation and lipofibromatous changes underwent open surgery. In one case, as the capsule formation was not evident, suction assisted lipectomy was attempted. However, no aspirate could be evacuated possibly due to the fibrotic nature of the lesion and open surgery was performed. The follow-up period was 14 months to 5 years and no recurrence was noted.- - - - - - - - - - ranking = 12.518824609734keywords = physical examination, physical (Clic here for more details about this article) |
9/30. Persistent popliteal pain derived from cavernous hemangioma involving gracilis tendon and tendon sheath.Hemangiomas arising from tendon and tendon sheath are rarely reported, and may be confused with other lesions of tendons. In this case report, a 19-year-old woman was diagnosed with a cavernous hemangioma originating in the left gracilis tendon and tendon sheath. When her symptoms initially developed, MRI did not delineate the lesion due to the relatively small size of the tumor. Nine years after the onset of the patient's complaints of knee pain and swelling, the tumor was adequately diagnosed on physical examination and MRI, and was resected with complete relief of symptoms.- - - - - - - - - - ranking = 12.518824609734keywords = physical examination, physical (Clic here for more details about this article) |
10/30. hemorrhage simulating tumor growth in malignant fibrous histiocytoma at MR imaging.During the course of preoperative chemotherapy for treatment of malignant fibrous histiocytoma of the lower extremity, the mass in three patients was found to be enlarged at physical examination. Magnetic resonance (MR) imaging demonstrated, and subsequent pathologic examination of resected specimens proved, that the enlargement was caused by extensive hemorrhage within the masses, rather than by tumor growth. MR imaging can demonstrate this phenomenon well, particularly on T1-weighted images.- - - - - - - - - - ranking = 12.518824609734keywords = physical examination, physical (Clic here for more details about this article) |
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