非骨化性纤维瘤1例诊治报告

患儿,男,11岁,因"左股骨上端骨折术后2周,复查X线片发现左股骨下端内侧骨破坏4月余"于2013年3月入院。入院时症见:左大腿外侧有手术瘢痕,左下肢活动无异常。查体:左股骨外侧大粗隆下可见一长约10 cm的纵形切口瘢痕,局部无环形压痛及纵轴叩击痛,左股骨下端内侧深压痛阳性,局部皮温如常。实验室检查:血常规、CRP、血清钙、血清磷、血沉、碱性磷酸酶均正常。X线片(图1a,1b)示:左股骨上端骨折钢板内固定术后,断端对位对线     

股骨下段非骨化性纤维瘤1例报道

<正>患者,女,17岁,因右大腿内侧局部隐痛不适2个月入院。患者入院2个月前感右大腿下段内侧隐痛,活动后疼痛明显,休息后好转,X线片检查发现右股骨下段异常信号影。专科检查:右大腿内侧局部无包块,无红肿,无感觉异常,压痛(-),右下肢纵向叩击痛(-),足趾感觉活动可,末梢血运良好。辅助检查:(1)     

长骨的非骨化性纤维瘤9例报告

非骨化性纤维瘤（Ｎｏｎｏｓｉｆｙｉｎｇｆｉｂｒｏｍａ）是一种纤维组织所构成的良性肿瘤〔１〕,临床上不多见〔２～４〕,对该肿瘤的本质尚有争论。作者于１９８８年６月～１９９７年１月共收治经临床病理确诊的非骨化性纤维瘤９例,其中２例呈多发性,国内仅见１例...     

右胫骨骨化性纤维瘤1例

骨化性纤维瘤多发生于颌骨、颅骨 ,少见于四肢长骨 ,作者诊治 1例 ,报道如下。1　临床资料患者 ,男 ,2 7岁 ,因右小腿酸痛、劳累后加重 3年 ,门诊以骨囊肿收入院。查体 :心肺、肝脾未见异常 ,右小腿上段胫骨压痛 ,皮肤颜色正常 ,无红肿。Ｘ线片示 :右胫骨上段近干骺端有 7 5ｃｍ× 2 5ｃｍ大小类圆形密度减低区 ,密度不均匀 ,呈毛玻璃样改变 ,散在有沙砾样钙化点 ,边缘呈花边样硬化。见图 1。图 1　右胫骨骨化性纤维瘤　　术前Ｘ线正侧位片　　手术行开窗病灶清除。术中见病灶区为灰白色肉芽组织 ,质地较韧 ,界限清 ,周围骨质硬化。刮除后…     

股骨下段非骨化性纤维瘤1例

患者,男性,22岁。因右股骨干中上段骨折髓内针内固定术后16个月,髓内针取出术后1个月余出现右股部疼痛、跛行来诊收住院。入院查体:右股部无明显肿胀,皮温不高,无血管充盈。右股部下段外侧略有压痛。膝关节活动好,纵向叩击痛(一)。X线片示右股骨下段外后侧有一约8.0cm×2.8cm大小长椭圆透光病变,局部膨胀、皮质变薄但完整,病变长轴与骨     

非骨化性纤维瘤的诊断与治疗

目的：探讨非骨化性纤维瘤的本质和属性、临床特点及诊治方法。方法：总结１９９３～１９９９年收治的非骨化性纤维瘤２４例。其中男１６例，女８例，平均１５．６岁。多发性２例，合并其他良性肿瘤２例。病灶多发生于四肢长骨的干骺端，以膝关节周转最常见。全部病例均行手术治疗，术式包括单纯病灶刮除术、病灶刮除自体髂骨或加异体骨移植术。结果：全部病例均经病理证实为非骨化性纤维瘤，随访最长６ａ ３个月，无一例复发。结论     

长骨多发性骨化性纤维瘤一例报告

长骨多发性骨化性纤维瘤一例报告张华俦黄建发黄公怡患者男，５７岁。因外伤摄右髋部及右小腿正侧位片偶然发现右股骨颈及右胫骨中下段骨结构异常，于１９９５年６月１４日收治入院。查体示右髋部及右小腿无红肿，无静脉怒张，触之局部皮温不高，局部有轻压痛，右髋关节及...     

非骨化性纤维瘤的临床诊断与治疗

目的探讨非骨化性纤维瘤的临床特点、影像学特征及手术疗效。方法回顾分析2000年1月至2006年4月收治的15例非骨化性纤维瘤患者的临床表现及影像学特征并评价手术疗效。结果13例患者得到随访,平均随访时间6.2个月,病灶处骨性愈合者9例,不完全骨性愈合者4例(股骨2例,胫骨2例)。4例不完全骨性愈合患肢均能完全负重,邻近关节活动度与健肢比较无明显差异。结论非骨化性纤维瘤是一种良性溶骨性病变,临床上应结合影像及病理的特征来做出诊断,本瘤经病灶清除植骨后预后良好。     

Cutaneous Ewing's sarcoma secondary to chemotherapy given for testis tumor: Case report

INTRODUCTION

Testicular cancer has high cure rates, especially after the adjuvant use of chemotherapy. Secondary tumors may develop months and years after the primary tumor. We aimed to report a case of cutaneous Ewing''s sarcoma at the site of surgery 3 years after BEP chemotherapy.

PRESENTATION OF CASE

21 year old male underwent radical orchiectomy in 2008. After one year surgical site complaints brought him to same hospital. A limited surgical resection was made. As his complaints continued he applied to our clinic. We resected the lesion with a 5 cm safety margin with the light of previous medical history. Pathology revealed cutaneous Ewing''s sarcoma, and patient received VACD-IE chemotherapy. He is free of recurrence till now.

DISCUSSION

Chemotherapy may cause secondary cancer especially in long term. In this case secondary tumor is diagnosed three years after surgery. Patient underwent therapeutic surgery and received chemotherapy (VACD-IE) for secondary Ewing''s sarcoma. Early diagnosis and definitive treatment provide recurrence free survival in the patient.

CONCLUSION

Secondary tumors can emerge months or years after primary tumor therapies, and are not related with the primary tumors. Any lesion or sign should be investigated carefully. Early diagnosis and correct treatment could prevent dramatic results.     

Ewing's sarcoma of proximal phalanx of the hand with skip metastases to metacarpals

Ewing''s sarcoma is the second most common malignant primary bone tumor of childhood and adolescence affecting mainly the diaphysis of long bones and flat bones. This tumor is extraordinarily rare in small bones of the hand and presents as a swelling with atypical radiological features of cystic and lytic lesion with scant periosteal reaction. The common differential diagnosis include osteomyelitis, tuberculosis, enchondroma and benign tumors. Moreover, skip metastasis to adjacent bones is even rarer. The prognosis of this condition is greatly influenced by the presence of metastasis at presentation, further emphasizing the importance of early diagnosis. Multimodality treatment using surgery, radiotherapy and chemotherapy is currently recommended though no consensus exists. We report a case of Ewing''s sarcoma of the little finger proximal phalanx which was initially missed and developed skip metastasis to several metacarpals within 4 months.     

Case report: HIV negative isolated scrotal Kaposi's sarcoma

INTRODUCTION

Kaposi''s sarcoma (KS) is a rare angioproliferative disorder of the vascular endothelium. The development of KS requires Human Herpes Virus 8 (HHV-8) infection. An associated HIV infection is usually seen. Isolated scrotal KS has rarely been reported. In this article, we present a case of KS that primarily involved the scrotum in a HIV negative patient.

PRESENTATION OF CASE

A 71-year old male patient admitted to the outpatient department due to nodular lesions on the scrotum. The patient declared that these lesions were present for nearly 5 years. Past medical history revealed that he underwent left thoracotomy and upper lobectomy in 2006 for adenosquamous lung carcinoma. Then, he received a single cycle of adjuvant chemotherapy consisted of docetaxel and cisplatin. Physical examination revealed 3 black small nodules on the scrotum. The anti-HIV test was negative. All scrotal lesions were surgically excised. The pathological investigation revealed KS of the lymphangioma-like type.

DISCUSSION

The pathogenesis of KS has still not been clearly elucidated. However, it is known that all forms of KS are associated with HHV-8 infections. A defect in immune system was almost always necessary. Therefore, KS is usually associated with HIV infection. KS of the penis has been reported in HIV negative patients. Very few cases of scrotal KS have been presented. In a recent review, only 1 patient had scrotal KS out of 32 cases with HIV negative KS. In our case, the patient received a cycle of chemotherapy that might affect his immune system. The lymphangioma-like type is a common morphological sub-type. While lymph edemas are commonly observed in this sub-type, no edema in the lymphs was present in our case.

CONCLUSION

Classical KS is generally observed in the lower extremities, it can rarely affect scrotal skin as isolated lesions. Therefore, a careful physical examination should also include scrotum for these patients.     

骨肉瘤与尤文肉瘤关键基因CDC5L及其生物学功能的生物信息学分析

目的:利用生物信息学方法筛选骨肉瘤(osteosarcoma,OS)和尤文肉瘤(Ewing's sarcoma,EWS)关键基因及通路预测.方法:检索GEO数据库OS(GSE16088)及EWS(GSE45544)数据集,利用GEO2R分析差异基因,韦恩图筛选共同参与两者发生的关键基因,对该基因进行GO、KEGG通路分...     

Van Nes rotationplasty as a treatment method for Ewing's sarcoma in a 14-month-old

INTRODUCTIONIn recent years, the rotationplasty procedure has become popular amongst tumour surgeons as an alternative to endoprosthetic replacement or amputation. There are very few documented cases of this technique in young patients with malignancy.PRESENTATION OF CASEWe describe an extremely rare case of Ewing's sarcoma in a 14-month-old boy that involved the entire length of the left femur. At initial presentation, pulmonary metastatic spread had occurred and there was no neurovascular involvement. Complete response to neo-adjuvant chemotherapy was achieved prior to performing the definitive surgical procedure.DISCUSSIONThis case highlights the many reconstructive options and difficulties encountered in managing such extremely young patients with aggressive malignant disease. In this case, a complete femoral excision was necessary and various treatment options were explored. These included irradiation and re-implantation, endoprosthetic replacement and manufacturing a custom growing prosthesis. Taking future functional, psychological and social implications into consideration, we performed a total femoral excision and Van Nes rotationplasty of the tibia at our institute. Histological analysis of the tumour resection showed clear tumour margins and at 1 year clinical review, the patient demonstrates good functional outcome with no evidence of disease recurrence.CONCLUSIONVan Nes rotationplasty is a viable reconstructive option in young patients with sarcoma of the femur. We believe this to be the youngest reported case of rotationplasty in current literature.     

Combined modality treatment of Ewing's sarcoma of the maxilla

BACKGROUND: Primary bone sarcomas arising in osseous structures of the head and neck are rare. These tumors are often incompletely resected and treated with radiotherapy for local control. METHODS: We report a case of a 9-year-old girl with a maxillary Ewing's sarcoma. This patient was successfully treated with neoadjuvant chemotherapy followed by surgical resection and prosthetic reconstruction of the primary site. The surgical approach that was used consisted of a subtotal maxillectomy by means of a facial degloving approach, sparing the orbital contents and the inferior orbital rim and orbital floor. RESULTS: This approach produced excellent cosmetic, functional, and oncologic outcome. The patient remains without evidence of disease recurrence more than 4 years after surgery. CONCLUSIONS: This case illustrates a novel surgical approach to the resection of a maxillary Ewing's sarcoma and highlights the need for a multidisciplinary team approach to the management of head and neck sarcomas in children.