Chondrosarcoma occurring in a patient with polyostotic fibrous dysplasia

A 36-year-old white man with polyostotic fibrous dysplasia was found to have a high-grade chondrosarcoma arising from the left ilium. Although a left hemipelvectomy was performed, the patient subsequently developed sacral and pulmonary metastases and succumbed to his disease. This patient represents the first documented example of an unequivocally high-grade chondrosarcoma arising in an area of fibrous dysplasia without prior irradiation.     

Positive gallium-67 citrate uptake in a patient with polyostotic fibrous dysplasia

Fibrous dysplasia is an uncommon bone condition with characteristic radiologic features. It is well known that there is increased uptake of Tc-99m hydroxymethylene diphosphonate (HMDP) and methylene diphosphonate (MDP) in fibrous dysplasia. There are no reports of uptake of Ga-67 citrate by fibrous dysplasia. A case is reported in which positive Ga-67 uptake was seen in a patient with polyostotic fibrous dysplasia.     

Malignant fibrous histiocytoma associated with a bone infarct in a patient with hereditary bone dysplasia

Hereditary bone dysplasia (HBD) is an extremely rare clinicopathological entity manifested by diaphyseal medullary stenosis and cortical bone thickening associated with a propensity for fractures affecting the long tubular bone. Malignant transformation has been reported to occur at an alarming frequency. The hereditary pattern appears to be autosomal dominant. In this paper we present the case of a 19-year-old man with hereditary bone dysplasia who was unaware of his underlying condition until he presented with malignant transformation arising in an area of bone infarct of the left tibia.     

Bone metastasis detected by FDG PET in a patient with breast cancer and fibrous dysplasia

Bone scintigraphy is sensitive for detecting bone metastases in patients with malignancies. However, it is often difficult to differentiate bone metastases from other nonmalignant lesions. We encountered a patient with a history of breast cancer who showed substantial elevation of tumor markers 4 years after surgery. Although there were no subjective symptoms and the bone scan showed multiple hot spots, which were similar to previous scans and which had been diagnosed as fibrous dysplasia on radiographs, a whole-body FDG PET scan showed a solitary area of intense uptake at the site of one of the hot spots in the bone scan. A solitary bone metastasis was confirmed by MRI and the patient then received radiation therapy and the elevated tumor markers of CEA and CA 15-3 were normalized after the therapy.     

A rare spontaneous osteosarcoma of the calvarium in a patient with long-standing fibrous dysplasia: CT and MR findings

A 52-year-old man with long-standing craniofacial polyostotic fibrous dysplasia (FD) and no history of prior radiation therapy developed a spontaneous right temporal bone osteosarcoma. Such spontaneous sarcomatous degeneration of FD is rare, particularly in the calvarium/skull, where, to our knowledge, only six prior cases have been reported in the literature. We report this case because it is a rare entity with well-documented CT and MR images, and to emphasize the importance of depicting imaging features of sarcomatous degeneration among the complex imaging findings of FD.     

颈椎2～7椎弓根的测量对后入路椎体成形术的意义

目的 为颈椎C2～C7后入路椎体成形术提供解剖学基础.方法 CT下测量上海地区成人C2～C7 40例,测量项目为颈椎左右椎弓根的横径及上下径.结果 C2～C7椎弓根左右径为(5.13±1.13)mm,上下径为(6.61±1.23)mm.结论 本文数据测量为颈椎椎体成形术选择新的入路提供了解剖学依据.     

Combined use of percutaneous cryoablation and vertebroplasty with 3D rotational angiograph in treatment of single vertebral metastasis: comparison with vertebroplasty

Introduction

This study aims to assess the effectiveness of combined procedure of cryoablation and vertebroplasty (CVT) for reduction of pain and improvement of the quality of life in patients with single painful metastatic vertebral fractures.

Methods

We retrospectively analyzed data from 23 patients with single vertebral metastasis treated with combined procedure of CVT, compared with those obtained in 23 patients treated by vertebroplasty. Pain intensity was evaluated by a visual analog scale (VAS) score administered before and 1 day, 1 week, and 1, 3, and 6 months after procedure. Quality of life was evaluated by an Oswestry Disability Index (ODI) score administered before and at 3 and 6 months after procedure.

Results

Procedural success was achieved in all patients without any complications. The VAS and ODI scores showed a reduction in both groups during follow-up (VAS score, p?<?0.05 and p?<?0.001, respectively; ODI score, p?<?0.0001). No difference of the VAS and ODI scores were observed before treatment (p?=?0.33 and 0.78, respectively). VAS score showed a difference at 1 week and 1, 3, and 6 months after treatment (p?<?0.001). ODI score showed a difference at 3 and 6 months after treatment (p?<?0.001).

Conclusion

Our findings suggested that combined procedure of CVT is safe and effective for pain relief in single metastatic vertebral fractures, especially when other standard palliative treatments have failed, and improves disability. Careful needle positioning and accurate fluoroscopic and CT guidance are mandatory for a complication-free treatment.     

C形臂X线机与CT联合导向在经皮椎体成形术中的应用

目的探讨在移动式C形臂X线机与16排CT联合导向下,经皮椎体成形术中在治疗骨质疏松性椎体压缩骨折的操作方法及优势。方法将移动式C形臂X线机与16排CT置于同一机房,组成组合机。16排CT扫描病变椎体及相邻椎体,确定穿刺点及穿刺路径,评价术后椎体情况;移动式C形臂X线机实时透视监视注射聚乙烯吡咯烷酮(骨水泥)。结果在组合机引导下对12例单椎体压缩骨折的患者行经皮椎体成形术成功率100%,无并发症发生。结论移动式C形臂X线机与16排CT联合导向在经皮椎体成形术中的操作简便、定位准确、监视实时、导向安全,特别提高了L4椎体平面以上各椎体行椎体成形术的安全性。     

Skull infarction in a patient with malignant fibrous histiocytoma

The authors describe a case of a skull infarction initially suspected to be an isolated, remote metastasis in a patient diagnosed with soft tissue malignant fibrous histiocytoma. Osseous malignant fibrous histiocytoma has been reported to occur within a bone infarction but the presence of a benign bone infarction remote from a soft tissue malignant fibrous histiocytoma has not been reported previously. Bone infarctions and malignant fibrous histiocytomas are briefly reviewed.     

Considerations on bone volume normalization in quantifying skeletal burden in fibrous dysplasia using sodium fluoride PET/CT

European Journal of Nuclear Medicine and Molecular Imaging -     

Vertebroplasty at L5 with a transiliac transpedicular approach in a patient with osteogenesis imperfecta: technical note

The present report describes the use of a modified transpedicular vertebroplasty approach via the iliac bone for treatment of a painful osteoporotic L5 vertebral body fracture in a 66-year-old woman with osteogenesis imperfecta. As a result of altered osseous morphology of the pelvic girdle and lumbosacral junction secondary to the patient's condition, vertebroplasty at L5 was successfully performed by entering the needle into the adjacent superomedial aspect of iliac bone before passing through the pedicle and then into the vertebral body. This modified vertebroplasty approach provides an interesting alternative for fractures involving the frequently less accessible lowermost lumbar vertebral body.     

Sixty-four-multislice computed tomography in a patient with arrhythmogenic right ventricular dysplasia

Arrhythmogenic right ventricular dysplasia (ARVD) is an inheritable cardiomyopathy that is characterized by fibrofatty infiltration of the RV myocardium, often resulting in arrhythmias and sudden cardiac death. The diagnosis often requires imaging of the right ventricle, typically by magnetic resonance imaging. We describe a case of AVRD in which cardiac computed tomography was used as the imaging method for the right ventricle. The CT images showed changes consistent with ARVD to include RV enlargement, excessive trabeculations, fatty infiltration, and marked RV hypokinesia. We believe these images show a novel use for multislice CT in the diagnostic evaluation of patients with suspected ARVD.     

Assessment of some problematic factors in facial image identification using a 2D/3D superimposition technique

The number of criminal cases requiring facial image identification of a suspect has been increasing because a surveillance camera is installed everywhere in the city and furthermore, the intercom with the recording function is installed in the home. In this study, we aimed to analyze the usefulness of a 2D/3D facial image superimposition system for image identification when facial aging, facial expression, and twins are under consideration. As a result, the mean values of the average distances calculated from the 16 anatomical landmarks between the 3D facial images of the 50s groups and the 2D facial images of the 20s, 30s, and 40s groups were 2.6, 2.3, and 2.2 mm, respectively (facial aging). The mean values of the average distances calculated from 12 anatomical landmarks between the 3D normal facial images and four emotional expressions were 4.9 (laughter), 2.9 (anger), 2.9 (sadness), and 3.6 mm (surprised), respectively (facial expressions). The average distance obtained from 11 anatomical landmarks between the same person in twins was 1.1 mm, while the average distance between different person in twins was 2.0 mm (twins). Facial image identification using the 2D/3D facial image superimposition system demonstrated adequate statistical power and identified an individual with high accuracy, suggesting its usefulness. However, computer technology concerning video image processing and superimpose progress, there is a need to keep familiar with the morphology and anatomy as its base.     

Benign fibrous dysplasia on [11C]choline PET: a potential mimicker of disease in patients with biochemical recurrence of prostate cancer

We present the case of a 74-year-old male with biochemical recurrence of prostate cancer who underwent [(11)C]choline PET/CT. The PET/CT demonstrated an intense focus of uptake within the skull base that was initially felt to potentially represent metastatic disease. Subsequent evaluation with MRI and dedicated thin-section CT revealed this area to be benign fibrous dysplasia of the bone. The focal uptake on PET/CT with [(11)C]choline in benign fibrous dysplasia represents a potential mimicker of metastatic disease. Due to recognizing this benign process, our patient was able to avoid systemic treatment and/or focal radiation and was treated with cryotherapy for biopsy-proven local recurrence within the prostate bed. While benign fibrous dysplasia can demonstrate increased radiotracer uptake on other modalities (i.e., bone scintigraphy, FDG PET/CT), its appearance on [(11)C]choline PET/CT has been largely overlooked in the literature. With the increasing use of [(11)C]choline PET/CT for biochemical recurrent prostate cancer evaluation, it is important to understand this potential mimicker of disease.