Our experiences in the reconstruction of bone stock deficiency with allogenous lyophilized bone graft after surgical resection of the giant-cell tumour

Introduction. The aim of this work is to evaluate lyophilized bone graft addressed in deficiency of bone stock after surgical resection of the giant-cell tumour. The adaptive remodeling of the graft in a function of time was screened as well.
Material and Methods. Research is based on 12 patients who underwent resection of the giant-cell tumour. Postresectional bone stock deficit was reconstructed with autogenous lyophilized bone graft. In 4 cases the changes was situated in distal part of femur, in 5 cases in proximal femur and in 3 cases in distal radius. Mean observation time was 5,1 years (1-11 years). The functional outcome was evaluated on the scale proposed by Enneking and al. The adaptive remodeling and osseointegration of the graft has been evaluated by densitometric analysis of X-rays.
Results. In the functional outcome we gained good and very good results in 9 cases after resection of tumor from knee joint ends, two fair and one poor results after tumour resection from distal radius. In one case of reconstruction in distal radius we could not identify osseointegration. The rests of the cases have had full bone remodeling with graft osseointegration 12 month after operation.
Conclusions. Solid, lyophilized human bone grafts osseointegrate with surrounded bone and are very good biological material for bone reconstructive surgery.     

Prostate stromal tumor with prostatic cysts after transurethral resection of the prostate: A case report

BACKGROUNDA prostatic stromal tumor is deemed to be a rare oncology condition. Based on the retrospective analysis of clinical data and scientific literature review, a case of prostatic stromal tumor was reported in this article to explore the diagnosis, treatment and prognosis of this rare disease.CASE SUMMARYThe present case involved an older male patient who was admitted to our department for a medical consultation of dysuria. Serum prostate-specific antigen was 8.30 ng/mL, Ultrasound and magnetic resonance imaging suggested evident enlargement of the prostate and multiple cystic developments internally. Considering that the patient was an elderly male with a poor health status, transurethral resection of the prostate was performed to improve the symptoms of urinary tract obstruction. Furthermore, based on histopathologic examination and immunohistochemical staining, the patient was pathologically diagnosed with prostatic stromal tumor. The patient did not receive any further adjuvant therapy following surgery leading to a clinical recommendation that the patient should be followed up on a long-term basis. However, during the recent follow-up assessment, the patient demonstrated recurrence of lower urinary tract symptoms and gross hematuria.CONCLUSIONReferring to scientific literature review, we believe that the management of these lesions requires a thorough assessment of the patient. Furthermore, the treatment of prostate stromal tumors should be based on the imaging examination and pathological classification. Active surgical treatment is of great significance to the prognosis of patients, and subsequent surveillance after the treatment is warranted.     

Reconstruction of the chest wall after resection of malignant peripheral nerve sheath tumor: A case report

BACKGROUNDMalignant peripheral nerve sheath tumors (MPNSTs) are a group of rare and aggressive sarcomas that often arise from major peripheral nerves and represent a notable challenge to efficacious treatment. MPNSTs can occur in any body surface and visceral organs with nerve fiber distribution. The treatment options for MPNSTs include surgery, chemotherapy, and adjuvant radiotherapy. CASE SUMMARYA 26-year-old female cellist presented with chest pain on her left side when she squatted to lift the cello. One week later, a chest X-ray was performed and revealed fracture of the fourth rib on the left side. Three months later, the patient inadvertently touched a mass on the left side of the chest wall. Chest computed tomography (CT) three-dimensional reconstruction of the ribs revealed bone destruction of the fourth rib on the left side with a soft tissue mass shadow measuring 5.7 cm × 3.7 cm. CT-guided puncture biopsy of the tumor showed that heterotypic cells (spindle cells) tended to be nonepithelial tumor lesions. PET-CT demonstrated bone destruction and a soft tissue mass with avid 18F-fluorodeoxyglucose activity (SUV_max7.5) in the left fourth rib. The tumor of the left chest wall was resected under general anesthesia, and reconstruction of the chest wall was performed. The postoperative pathological report exhibited an MPNST.CONCLUSIONMPNSTs are relatively chemo-insensitive tumors. The mainstay of treatment for MPNSTs remains resection with tumor-free margins.     

A portable surgical navigation device to display resection planes for bone tumor surgery

Introduction: Surgical navigation has been used in musculoskeletal tumor surgical procedures to improve the precision of tumor resection. Despite the favorable attributes of navigation-assisted surgery, conventional systems do not display the resection margin in real time, and preoperative manual input is required. In addition, navigation systems are often expensive and complex, and this has limited their widespread use. In this study, we propose an augmented reality surgical navigation system that uses a tablet personal computer with no external tracking system.

Material and methods: We realized a real-time safety margin display based on three-dimensional dilation. The resection plane induced by the safety margin is updated in real time according to the direction of sawing. The minimum separation between the saw and the resection plane is also calculated and displayed. The surgeon can resect bone tumors accurately by referring to the resection plane and the minimum separation updated in real time.

Results: The effectiveness of the system was demonstrated with experiments on pig pelvises. When the desired resection margin was 10?mm, the measured resection margin was 9.85?±?1.02?mm.

Conclusions: The proposed method exhibits sufficient accuracy and convenience for use in bone tumor resection. It also has favorable practical applicability due to its low cost and portability.     

Intravesical explosion during transurethral resection of bladder tumor: A case report

BACKGROUNDIntravesical explosion during transurethral resection of bladder tumor (TUR-BT) is a very rare complication, and it may result in rupture of the bladder, which usually requires surgical correction and causes a potential threat to the patient’s life.CASE SUMMARYThis paper reports a case of intravesical explosion during TUR-BT. Combined with the literature review, the risk factors are analyzed and measures of prevention and treatment are discussed.CONCLUSIONAlthough rare, intravesical explosions can cause serious consequences, and the loud explosion can also lead to a profound psychological shadow on the patient. Urologists must be aware of this potential complication. Careful operative techniques and special precautions can reduce the risk of this complication.     

Innovative chest wall reconstruction with a locking plate and cement spacer after radical resection of chondrosarcoma in the sternum: A case report

BACKGROUNDChondrosarcoma, a cartilage matrix producing tumor, is the second most commonly observed primary bone tumor after osteosarcoma, accounting for 15% of all chest wall malignancies. We herein report the case of a patient with chondrosarcoma of the sternum and our management of the chest wall defects that presented following radical tumor resection.CASE SUMMARYA 31-year-old patient presented to our hospital with dull pain and a protruding mass overlying the chest for 3 mo. The presence of nocturnal pain and mass size progression was reported, as were overhead arm elevation-related limitations. Computed tomography showed a focal osteoblastic mass in the sternum with bony exostosis and adjacent soft tissue calcification. Positron emission tomography-computed tomography revealed hypermetabolic activity with a mass located over the upper sternum. Magnetic resonance imaging showed a focal ill-defined bony mass of the sternum with cortical destruction and periosteal reaction. Preoperative biopsy showed a consistent result with chondrosarcoma with immunohistochemical positivity for S100 and focal positivity for IDH-1. The grade II chondrosarcoma diagnosis was confirmed by postoperative pathology. The patient underwent radical tumor resection and chest wall reconstruction with a locking plate and cement spacer. The patient was discharged 1 wk after surgery without any complications. At the 1-year follow-up, there was no local recurrence on imaging. The functional scores, including Constant Score, Nottingham Clavicle Score, and Oxford Shoulder Score, showed the absence of pain in the performance of daily activities or substantial functional disabilities.CONCLUSIONThe diagnosis of chondrosarcoma must be considered when chest wall tumors are encountered. The surgical reconstructive materials, with a locking plate and cement spacer, used in our study are cost-effective and readily-available for the sternum defect.     

腹腔镜胃良性肿瘤手术28例报告

目的 探讨腹腔镜在胃良性肿瘤手术中的应用。方法 对28例胃良性肿瘤在腹腔镜下实施手术。其中胃平滑肌瘤23例、神经纤维瘤3例、脂肪瘤2例。根据肿瘤直径和部位，分别行胃楔形切除（17例）和胃大部切除术（11例）。结果 28例手术均获成功。26例手术在完全腹腔镜下完成，2例行手助腹腔镜手术，手术平均140min（60-310min），平均出血量160mL（80-400mL），无吻合口瘘、术后大出血等并发症发生。术中均送快速冰冻明确病变为良性，且得到常规病理证实。结论 腹腔镜手术对治疗胃良性肿瘤是可行的，在不断积累经验的基础上，腹腔镜胃手术必将得到更快的发展。     

Acute appendicitis after colorectal endoscopic mucosal resection: a case report

Endoscopic mucosal resection (EMR) was originally described in 1973 and is currently a popular practice used in treating polyps, small adenomas, and early cancers. Although the safety of EMR has been proven in numerous studies, complications occur occasionally. We report a case in which the patient complained of severe upper abdominal pain and who was diagnosed with acute appendicitis after colorectal EMR. The patient recovered well after surgery. Cautious observation is necessary when resuming oral intake in patients who undergo colorectal EMR and who complain of postoperative abdominal pain. Observation is especially important for patients with a fecalith that may have originally existed in the appendix or in the colon near the appendix.     

Gastric glomus tumor resection using laparoscopic endoscopic cooperative surgery: A case report

Gastric glomus tumors are rare submucosal mesenchymal neoplasms that are difficult to diagnose preoperatively. We present a case of a 60-year-old woman who was diagnosed with a gastric glomus tumor using endoscopic ultrasonography-guided fine-needle aspiration biopsy. The tumor was successfully resected with laparoscopic endoscopic cooperative surgery (LECS). LECS could be an effective method for the resection of gastric glomus tumors.     

Intra‐abdominal desmoid tumor after laparoscopic low anterior resection for rectal cancer: A case report

Desmoid tumors are monoclonal fibroblastic proliferations arising from soft tissue classified as intra‐abdominal, extra‐abdominal and abdominal wall types. We present a patient with an intra‐abdominal desmoid tumor diagnosed 20 months after laparoscopic resection of rectal cancer. A 70‐year‐old woman with hematochezia was diagnosed with advanced rectal cancer. Preoperative chemoradiotherapy followed by laparoscopic low anterior resection was performed. During follow‐up, a nodular soft‐tissue density measuring 28 mm was detected in the presacral region. Metastasis from rectal cancer was diagnosed and four courses of chemotherapy were given, including capecitabine, oxaliplatin and bevacizumab. Computed tomography scan showed that the mass slightly decreased in size and surgical resection was performed. Histopathological examination revealed a proliferation of spindle‐shaped cells and collagenous stroma diagnosed as a desmoid tumor. This report highlights the possibility of a desmoid tumor in the differential diagnosis of an intra‐abdominal mass found during follow‐up after resection of colorectal cancer including following laparoscopic resection.     

Laparoscopic repair of a large perineal hernia after laparoscopic abdominoperineal resection: A case report

A 75‐year‐old woman underwent laparoscopic abdominoperineal resection. Four months after abdominoperineal resection, the patient complained of a perineal bulge and urination disorder. Abdominal CT showed protrusion of the small intestine and bladder to the perineum. The patient underwent laparoscopic hernia repair with mesh. The size of the hernial orifice was 7.0 × 9.0 cm, and it had no solid rim. The mesh was tacked ventrally to the pectineal ligament and dorsally to the sacrum, and then sutured on the lateral side. The hernia has not recurred 10 months after the operation. Laparoscopic repair is a good treatment choice for secondary perineal hernia and fixing the mesh to the pectineal ligament, and the sacrum prevents the mesh from sagging.     

Delayed complications of intradural cement leakage after percutaneous vertebroplasty: A case report

BACKGROUNDIntradural cement leakage following percutaneous vertebroplasty is a rare but acute and devastating complication that usually requires emergent treatment. Here, we report a delayed complication of intradural leakage after percutaneous vertebroplasty.CASE SUMMARYA 71-year-old female patient with an L1 osteoporotic compression fracture underwent percutaneous vertebroplasty in 2014. She was referred to our hospital 5 years later due to complaints of progressive weakness and numbness in both legs combined with urinary incontinence and constipation. Initially, she was suspected to have a spinal meningioma at the level of L1 according to imaging examinations. Postoperative pathological tests confirmed that cement had leaked into the dura during the first percutaneous vertebroplasty.CONCLUSIONGuideline adherence is essential to prevent cement from leaking into the spinal canal or even the dura. Once leakage occurs, urgent evaluation and decompression surgery are necessary to prevent further neurological damage.     

博宁完全缓解乳腺癌多发骨转移性骨痛25个月个案报告

Bone metastasis of mammary tumor is common in clinic and comprehensive treatment concentrated on chemotherapy is suggested. Short term relief such as pain decrease,improvement of symptoms is available but long term relief was unavailable. In the current study, a case with multiple bone metastasis of mammary tumors showed favorable relief including bone pain relief, complete absorption of bone metastasis loci.This patients has survived for 25 months healthfully.Here is the report.