Intraosseous glomus tumor of the ulna: a case report with radiographic findings and a review of the literature

Intraosseous glomus tumors of bone are extremely rare. We report a case of an intraosseous glomus tumor of the ulna. The patient was a 25-year-old woman who had a three-month history of a palpable mass in her right forearm with spontaneous pain. Radiographs showed cortical hypertrophy and a shell-like bone formation surrounding the small osteolytic lesion within the cortex of the ulna diaphysis. The differential diagnosis included benign bone-forming tumors, such as osteoid osteoma. The patient was treated with an en-bloc resection and filling with beta-TCP. Up to one year after the operation there has been no evidence of recurrence.     

Osteoid osteoma: an uncommon cause of foot pain

An osteoid osteoma located in the forefoot can be difficult to diagnose, and the diagnosis is frequently delayed. We present a clinical case of a patient with pain, erythema, and swelling of the left forefoot with no history of trauma. Although rarely seen in the metatarsal, osteoid osteoma should be included in the differential diagnosis of foot pain. Findings from radiographs, magnetic resonance images, and a detailed clinical history led to the diagnosis of osteoid osteoma of the left second metatarsal. The lesion was surgically excised using curettage. This process significantly weakened the lateral cortex of the metatarsal shaft. To correct this surgically induced stress riser, an external fixator was applied to provide stability, allow for callus distraction, and allow the patient to walk as early as possible. We review osteoid osteoma, including the classic clinical presentation and treatment associated with this benign bone tumor.     

Aggressive scapular chondroblastoma with secondary metastasis--a case report and review of literature

Chondroblastoma is a benign bone tumor, accounting for approximately one percent of all benign bone tumors. It mostly occurs in typical locations such as long bones. Malignant transformation including metastasis has been described in only a few cases. Therefore, we report a unique case of chondroblastoma with tumor manifestation in the 7th decade of life, location of the tumor in the scapula and occurrence of metastasis in the soft tissue of the mandible branch. Due to aggravation of the clinical course, a scapula en bloc resection was performed. The differential diagnosis is discussed and the current literature concerning malignant transformation of chondroblastoma is reviewed.     

Osteoid osteoma of the hand and wrist: a report of 25 cases

Background

The hand and wrist bones are infrequent sites for osteoid osteoma, and its diagnosis can be difficult. This paper reports 25 cases of osteoid osteoma in the hand and wrist.

Methods

Records of the 25 patients who had pathological conditions of osteoid osteoma of the hand and wrist were reviewed and analyzed.

Results

Twenty-five cases of osteoid osteoma of the hand and wrist were treated in 20 years period. The average age was 25.2±7.6 years (range, 16 to 46 years) with men to women and right to left side ratio of 5.25 and 4 respectively. The most common site was in the proximal phalanx (ten cases). The diagnosis was made using x-rays, three- phase Technetium bone scans, CT, and MRI and all the diagnoses were confirmed by histological examination. The average time from the onset of symptom to successful treatment was 16.3±11.1 months, and at a mean follow-up of 36.6±46.9 mouths. Five recurrences of disease took place in which three of them were operated elsewhere. All five patients subsequently were treated and cured by reoperation.

Conclusion

Osteoid osteoma is relatively rare lesions in the hand and wrist that can be a persistent source of hand and wrist pain. Patients under age of 40 who have otherwise unexplained pain should be evaluated.     

SURFACE CONFIGURATION OF BONE AND JOINT TUMOR AND TUMOROUS CONDITION PRELIMINARY SCANNING ELECTRON MICROSCOPIC STUDY OF 5 CASES

This paper describes the ult.rastruotural sur- face configurations of 5 cases with bone and joint tumors and tumorous conditions, observed by scanning electron microscopy (SEM). The study of pleomorphism of malignant bone tumor cells and their surface ultrastructures shows that there is increas.ed cell surface activity to meet heightened malignancy metabolism; Osteoid osteoma and pigmented villonoclular synovitis have no malignant tendencies, according to their surface ultrastructure. SEM iS valuable in in- vestigating tumor cell surface ultrastructure and the intercellular substances an.d in differentiat- ing malignant bone and ja:int tumo,rs from benign ones and tumorous conditions.     

Osteoid osteoma of the patella: report of two cases

Osteoid osteoma is very rarely located in the patella, and can represent a significant diagnostic challenge, resulting in a delay of treatment. Patients with osteoid osteoma of the patella often present with knee pain that is also a typical symptom of trauma or of other diseases such as arthritis, which are much more common than osteoid osteoma. We present two young male patients diagnosed with osteoid osteoma of the patella. Each of these patients had a history of intense knee pain; however, accurate diagnosis of osteoid osteoma in the patella had been delayed for more than one year. Computed tomography (CT) scans or magnetic resonance imaging (MRI) showed a circumscribed lesion of the patella in both patients, whereas X-ray examination (posteroanterior projection) was not able to detect the tumor. Different surgical procedures were performed in these patients for resection of the tumors, and the pathology findings confirmed the diagnosis of osteoid osteoma. Both patients recovered completely from surgery.

     

COA: 髌骨骨样骨瘤2例报告

位于髌骨的骨样骨瘤非常罕见,会导致诊断上的困难以及治疗的延误。此类患者通常有膝关节疼痛的症状,此症状更常见于外伤或骨关节炎。我们报告了2例年轻男性病例,都有明显的疼痛症状,但得到明确诊断时距症状出现时间均已超过一年。膝关节正位X线无法显示病灶,而CT或MRI可以提示病灶位置。此2例患者采取了不同的手术方式,均完全切除了病灶,且诊断得到了病理证实为骨样骨瘤。患者术后功能恢复良好。     

距骨和跟骨良性肿瘤或肿瘤样病变的影像分析

目的分析距骨或跟骨良性肿瘤或肿瘤样病变的影像学表现及特征。方法回顾性分析经手术病理证实的11例距骨或跟骨良性肿瘤或肿瘤样病变的影像学表现。全部病例均行X线检查,8例行CT检查,6例行MRI检查（有3例两项均检查）。结果动脉瘤样骨囊肿4例,骨巨细胞瘤3例（合并动脉瘤样骨囊肿2例）,腱鞘囊肿1例,错构瘤1例,骨样骨瘤1例,脂肪瘤1例。影像学表现显示出其各自的相对特征。结论距骨或跟骨良性肿瘤或肿瘤样病变的影像学表现有一定的特征性,CT和MRI能提供非常有价值的诊断征象,还能补充X线平片的影像信息。     

CT guided radiofrequency ablation of intra-articular osteoid osteoma of the hip

Background  

Osteoid osteoma is a painful benign bone tumour. Previously the standard therapy was surgical excision. Image guided radiofrequency ablation can be clinically applied to ablate the tumour in a minimally invasive manner.     

Technique for curettage and grafting of an intramedullary tibial bone cyst

During examination of an 11-year-old boy who had injured his right ankle, a benign tibial bone tumor was incidentally discovered. The bone tumor was initially treated with conservative care. When the patient returned with pain and an enlarging lesion, surgery was performed to prevent pathologic fracture. This case demonstrates the use of an allograft and synthetic bone graft material with growth factors in the treatment of a benign tibial bone tumor, avoiding the comorbidity and risk factors associated with autogeneic grafting.     

颅面部肿瘤所致低磷软骨病2例并文献复习

目的通过对肿瘤相关性低磷软骨病（tumor-induced osteomalacia,TIO）的病例报道并文献复习,深化对该疾病的认识。方法本文报告2例中年女性病例,以往被误诊为类风湿关节炎,最终确诊为颅面部肿瘤所致TIO。病例1表现为弥漫性骨痛及肌无力4年,右眼内斜复视1个月;病例2表现为腰部及髋部骨痛伴进行性加重。生化检查均提示低血磷及尿磷排出增加。影像学检查在病例1和病例2中分别发现右侧颞骨岩尖部浸润性肿块和左侧鼻腔及筛窦软组织肿块。结果病例2的肿物被完全切除而病例1的肿物切除不完全。术后病理诊断均为混合结缔组织亚型的磷酸盐尿性间叶肿瘤。结论若患者表现为无法解释的持续低磷软骨病,应想到TIO的可能性（包括颅面部肿瘤引起的TIO）,确诊依据病理,主要依靠手术治疗。     

Leukemic synovitis as a presentation of myelomonocytic blast crisis of chronic myeloid leukemia

We describe a patient with a 2-month history of right shoulder monoarthritis and fever as the presenting symptoms of a subsequent diagnosis of chronic myeloid leukemia in blast crisis. Imaging studies showed changes consistent with leukemic infiltration of the soft tissues around the right shoulder joint and the proximal humerus. Immunophenotypic and morphologic analysis of the large number of cells obtained from the synovial fluid confirmed the shoulder synovitis to be an extramedullary manifestation of myelomonocytic blast crisis of chronic myeloid leukemia. The patient was not a candidate for aggressive chemotherapy treatment because of her poor overall condition, and she had no compatible donor for allogenic bone marrow transplantation. Her painful arthropathy was refractory to standard pain management but she achieved excellent pain relief with palliative radiation therapy. We conclude that the involvement of extramedullary sites by chronic myeloid leukemia blast cells can predate hematological blast crisis in some of chronic myeloid leukemia cases. Also, painful leukemic synovitis can be managed by low dose radiotherapy in a candidate who is refractory to chemotherapy and other medical therapy.     

CT诊断骨样骨瘤的应用价值

目的分析骨样骨瘤的CT征象,探讨CT的应用价值。方法回顾性分析手术或穿刺并经病理证实的19例骨样骨瘤的临床和CT表现,并与X线检查进行对比;其中男13例,女6例,好发年龄10～20岁。结果发病于股骨干6例,股骨颈和胫骨干各4例,肱骨2例,腓骨、跟骨及腰椎椎板各1例;骨样骨瘤的CT特征为圆形或类圆形的瘤巢及周围的骨质硬化,瘤巢直径0.3～1.8cm,大部分瘤巢内可见形态不一的钙化,病灶位于关节内时关节腔可见积液。结论瘤巢是诊断骨样骨瘤的关键,与X线相比,CT更易发现瘤巢和钙化。     

骨样骨瘤的诊治体会

目的探讨骨样骨瘤的诊断与治疗方法。方法9例患者均以疼痛为主要症状，以X线片加CT扫描获得诊断。采用CT定位切除瘤巢。结果全部患者术后随访9～24个月，疼痛缓解，CT复查见瘤巢已切除。结论骨样骨瘤的瘤巢小，易于漏诊，利用X线片加CT检查有助诊断，利用CT定位可以准确切除肿瘤。     

骨样骨瘤的诊治体会

目的探讨骨样骨瘤的诊断与治疗方法。方法9例患者均以疼痛为主要症状,以X线片加CT扫描获得诊断。采用CT定位切除瘤巢。结果全部患者术后随访9～24个月,疼痛缓解,CT复查见瘤巢已切除。结论骨样骨瘤的瘤巢小,易于漏诊,利用X线片加CT检查有助诊断,利用CT定位可以准确切除肿瘤。     

骨样骨瘤的MSCT诊断与CT引导下切除的疗效分析

目的分析骨样骨瘤的CT表现并探讨其诊断及治疗价值。方法回顾性分析12例经手术病理证实的骨样骨瘤,12例均行普通X线及CT检查,其中3例同时行MRI检查,分析比较X线、CT和MRI对瘤巢及瘤巢周围骨质改变的显示能力。结果瘤巢均表现为圆形或卵圆形透亮区,直径小于20mm,8例中心可见钙化,呈牛眼征。4例呈环征。瘤巢周围可有不同程度的骨质硬化、骨膜反应、骨髓水肿、软组织肿胀及相邻关节腔积液。CT术前诊断正确11例（91.7%）,普通X线术前诊断正确7例（58.3%）,3例MRI检查中1例增强扫描术前诊断正确,2例平扫只提示诊断。7例行CT导引下瘤巢毁损,5例CT引导定位后手术治疗,追访6个月-3年未见疼痛复发及明显并发症。结论瘤巢是骨样骨瘤的特征性表现,CT对瘤巢显示最准确,MRI则对显示瘤巢周围骨髓、软组织及关节腔情况敏感。CT引导下经皮穿刺切除骨样骨瘤是一种简单有效、安全可靠的微创性治疗方法。     

外周性原始神经外胚层肿瘤的影像学表现

目的：探讨外周性原始神经外胚层肿瘤（pPNET）的临床和影像学表现，以提高对该病的进一步认识。方法：分析6例经手术病理证实pPNET的临床和X线、CT及MRI表现。结果：6例中，男2例，女4例，发生于胸壁2例，纵隔、肾脏、脊柱、肩背部各1例。临床以局部疼痛（4例）伴肿块（3例）为主诉，年龄（15～39）岁，X线检查4例，均见软组织肿块，伴溶骨性骨质破坏3例。CT扫描5例，软组织肿块边缘模糊4例，边界清楚l例，3例伴溶骨性骨质破坏，均未见骨膜反应。MRI扫描2例，在T1WI病变为中等信号，T2WI为高信号。结论：pPNET影像学检查以软组织肿块，常伴溶骨性骨质破坏为主要表现，缺乏特征性，但有助于了解病变范围、良恶性鉴别、远处转移和评价治疗效果。     

肺原发唾腺型肿瘤12例诊治分析

目的探讨肺原发唾腺型肿瘤的临床特点,总结其诊治方法。方法对12例肺原发唾腺型肿瘤的临床表现和诊治结果进行回顾性分析。结果12例肺原发唾腺型肿瘤中,腺样囊性癌6例,黏液表皮样癌4例,黏液性腺瘤和混合瘤各1例。患者多表现为咳嗽及痰中带血,偶有胸痛、胸闷、发热,盗汗、消瘦等症状不明显。行肿物单纯切除2例,袖式肺叶切除1例,单纯肺叶切除7例,全肺叶切除2例。结论肺原发唾腺型肿瘤属良性或低度恶性,好发于气管及支气管;主要表现为干咳及痰中带血;X线检查对该病的诊断有一定的局限性,支气管镜检查并活检通常可获得明确诊断;治疗主要为外科手术切除。     

Lingual osteoma: case report

Lingual osteoma, a rare clinical entity, has been found mainly in the posterior region of tongue. It mostly affects women in their third and fourth decades of life and occurs less frequently in men. We report an unusual case of a 42-year-old male patient who developed a lingual osteoma near the foramen cecum. The patient underwent excision of the tumor mass under local anesthesia and had an uneventful postoperative course. Symptoms of the mass effect were noted to resolve after surgical intervention. Histologically, mature lamellar bone with haversian systems was seen. The pathogenesis of this rare tumor is a controversial problem and its nomenclature also remains an issue of debate. Discussion of the controversial pathogenesis of lingual osteoma and a review of the literature on its clinical characteristics are included in this report.     

A so-called carcinosarcoma of the gallbladder in a patient with multiple anomalies--a case report

The patient was a 65-year-old woman with a chief complaint of right upper quadrant pain. Under the diagnosis of gallbladder tumor, preduodenal portal vein and absence of the pancreatic tail, cholecystectomy was performed. Intraoperative findings resulted in a diagnosis of gallbladder tumor, absence of the pancreatic tail, presence of preduodenal portal vein, and malrotation of the intestine. Histological examination of the resected specimens showed a so-called carcinosarcoma. Carcinosarcoma of the gallbladder is a rare tumor of the hepatobiliary region. The present case differs from previously reported cases in its presentation with multiple anomalies including the presence of preduodenal portal vein. Many cases of preduodenal portal vein in an association with duodenal stenosis in children have been reported, but reports of cases of preduodenal portal vein in adult patients are rarely seen in the literature.