Parosteal osteosarcoma of the ulna: a rare low-grade malignant neoplasm. Case report and review of the literature

Parosteal osteosarcoma is a rare low-grade malignant neoplasm. A case localized at the distal ulna is reported, and the tumour's radiological and histological features are described. Wide enbloc resection without postoperative adjuvant chemotherapy was the treatment. Good clinical function without signs of local recurrence was observed at the 3-year follow-up.     

Inflammatory Pseudo-Tumour as an Unusual Cause of Colonic Obstruction: a Case report

Inflammatory pseudo-tumour (IPT), also known as inflammatory myofibroblastic tumour or plasma cell granuloma, is a benign inflammatory solid tumour that may mimic malignancy. The etiology is obscure. Lung, spleen and mesentery are common sites of involvement. Colonic occurence is rare. Herein we report a case of IPT arising from the hepatic flexura with regard to its radiological, operative and histologic findings, that lead to colonic obstruction.     

Enterolith Containing Uric Acid: An Unusual Cause Of Intestinal Obstruction

Enterolith is a rare clinical entity that may be found on imaging or at surgery. We report an unusual case of intestinal obstruction caused by a large uric acid containing enterolith which was formed in the absence of any bowel inflammation, stricture or diverticulum.     

Antegrade Jejunojejunal Intussusception After Roux-en-Y Esophagojejunostomy as an Unusual Cause of Postoperative Intestinal Obstruction: Report of a Case

Postoperative intestinal obstruction in adults is rarely caused by intussusception. A case of antegrade jejunojejunal intussusception that occurred after Roux-en-Y esophagojejunostomy is described, followed by a discussion of the literature on this unusual entity. Received: January 7, 2000 / Accepted: September 26, 2000     

Parosteal osteosarcoma: case report and review of the literature

BACKGROUND: The majority of osteosarcoma cases of the head and neck are high-grade lesions. We present a case and discuss the diagnostic and therapeutic implications of a rare low-grade parosteal osteosarcoma of the maxilla. METHODS: A 32-year-old man presenting to the Head and Neck Surgical Oncology clinic with a 1-year history of a firm palatal mass. Evaluation clinically and radiographically raised the suspicion of an osteosarcoma. RESULTS: A partial maxillectomy revealed a parosteal osteosarcoma with negative margins. No adjuvant therapy was recommended, and the patient remains without evidence of local recurrence after 3 years. CONCLUSIONS: Parosteal osteosarcomas of the head and neck region are rare, low-grade variants of osteosarcoma, but have the potential to recur with simple local excision. Clinical and radiographic features are diagnostically helpful. Definitive diagnosis comes from histopathology, and wide local resection should be employed as the optimal treatment.     

Adjuvant Interferon Treatment and the Late Development of Cerebral Metastases in a Patient with Osteosarcoma

A consecutive series of patients with osteosarcoma have been receiving adjuvant interferon therapy at the Karolinska Hospital in Stockholm. We report here a case of tibial chondroblastic Grade III osteosarcoma, a boy aged 17 years, who received interferon therapy for 15 months and survived more than 5 years. the first sign of tumour spread was multiple cerebral metastases—an observation suggesting an antitumour effect of human leucocyte interferon on osteosarcoma.     

Giant Bladder Diverticulum as a Rare Cause of Intestinal Obstruction: Report of a Case

We report a case of intestinal obstruction as an unusual manifestation of bladder diverticulum. To our knowledge, this is the first report of a giant bladder diverticulum causing acute abdomen as a result of mechanical bowel obstruction.     

Establishment and Characterization of a Recurrent Osteosarcoma Cell Line: OSA 1777

Osteosarcoma (OSA) is the most common primary bone malignancy overall and is responsible for considerable adolescent mortality. Approximately 850 patients are newly diagnosed with OSA in the United States each year. While the 5-year survival rate for localized OSA has improved from <20% over 40 years ago to over 65% today, progress has dwindled over the past three decades. Therapeutic stagnation has occurred, in part, as a result of limited preclinical models and the overall heterogeneity of OSA among patients. In this study, we report the establishment and characterization of a novel OSA cell line: OSA 1777. This cell line was isolated from the recurrent tumor specimen of a 19-year-old female who initially experienced 99% tumor necrosis after neoadjuvant chemotherapy and eventually had local recurrence and metastases. We present OSA 1777 growth characteristics, tumor markers, chemotherapeutic sensitivities, and oncogenic spheroid formation. In a two-dimensional (2D) monolayer culture, OSA 1777 exhibited a spindle shape and 60 h doubling time. STR DNA profiling revealed a unique genomic identity not matching any existing human cancer cell lines from the ATCC or DSMZ databases. Consistent with the mesenchymal origin, western blot was positive for vimentin and negative for the carcinoma marker cytokeratin. Within three-dimensional (3D) culture, the cells formed spheroids of similar patterning and smaller size compared with MNNG-HOS and U2OS cell lines. The chemotherapeutic drug sensitivity of OSA 1777 was evaluated in both 2D and 3D culture systems. In summary, we report OSA 1777 as a novel biological model of OSA amenable to future studies focused on OSA that recurs despite an initially strong chemotherapeutic response. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:902-910, 2020     

Interposition of a Jejunal Segment as an Alternative One-Stage Operation for Acute Left Colon Obstruction

Purpose: Much debate surrounds the one-stage surgical management of acute left colon obstruction. Many surgeons are still reluctant to perform primary anastomosis in unprepared bowel fearing the risk of anastomotic dehiscence. Although intraoperative lavage and subtotal colectomy have recently proved effective for preventing fecal loading, both of these procedures have drawbacks and the search for additional alternative surgical procedures continues. We conducted an experimental study to examine a new one-stage operation, consisting of the interposition of a jejunal segment to the resection site of the colon, to manage acute left colon obstruction. Methods: The colons of 20 domestic pigs were obstructed, and 2 days later, segmental resection and either primary colo-colonic anastomosis or interposition of a jejunal segment was performed. Autopsies were done 6 weeks after the operations and the anastomotic regions were subjected to bursting pressure analysis. Results: The operating time was longer in the interposition group at 49 ± 14 vs 38 ± 12 min (P < 0.01). There was no mortality or clinical signs of anastomotic dehiscence in either group. A perianastomotic abscess was detected on autopsy in one animal from the primary colo-colonic anastomosis group. The bursting pressures of the jejunocolic anastomoses were significantly higher (P < 0.001) than those of the primary colo-colonic anastomoses. Conclusions: These experimental results suggest that jejunal interposition may be a feasible alternative to primary colonic anastomosis to create intestinal continuity after resection for acute obstruction of the left colon. Received: September 20, 2001 / Accepted: March 5, 2002     

Isolated Mesosigmoidal Hydatid Cyst as an Unusual Cause of Colonic Obstruction: Report of a Case

We report herein an unusual case of primary mesosigmoidal hydatid cyst that presented as acute left colonic obstruction mimicking sigmoid colon cancer. A 61-year-old man with a 3-day history of abdominal pain, distention, obstipation, vomiting, and fever was admitted to the emergency department of our hospital. Surgery was performed under a presumptive diagnosis of acute left colonic obstruction. The intraoperative findings were highly suggestive of sigmoid colonic carcinoma and Hartmann's procedure was performed. Histopathological examination of the pathological specimen revealed an isolated hydatid cyst embedded in mesosigmoid which had caused mechanical sigmoidal obstruction. Primary extrahepatic, intra-abdominal localization of a hydatid cyst is not unusual. Therefore, as a hydatid cyst may cause a wide variety of clinical syndromes, it should be kept in mind in the differential diagnosis of mechanical bowel obstruction, especially in endemic regions. Received: December 11, 2000 / Accepted: May 15, 2001     

Transplantable Osteosarcoma in Mice: Structural Characterization of a Transplantable Osteosarcoma Obtained in an Allogenic System

Light microscopic, histochemical and ultrastructural studies of a transplantable mouse osteosarcoma were carried out. The osteosarcoma grew in CBA mice after injection of cultured cells derived from a Dunn osteosarcoma. The tumour differed from the original Dunn osteosarcoma with respect to metastatic potential and structural features.

The transplantable tumour was an anaplastic, richly vascularized, fibroblastic osteosarcoma with alkaline phosphatase activity and rather sparse osteoid formation, resulting in death of the animals within 6 to 8 weeks. Virus particles were found intracellularly, mainly localized to cisterns of rough endoplasmic reticulum, and extracellularly often close to plasma membranes and collagen fibres. Signs suggestive of formation of collagen fibres by tumour cells were observed. A possible viral influence upon the tumour was suggested also by its growth behaviour in vitro.

The results indicate that this new transplantable tumour, obtained in an allogenic system, represents a clonal derivative of the original Dunn osteosarcoma.     

Duodenal Obstruction by Gallstone in the Absence of Cholecystoenteric Fistula,an Unusual Complication of Total Gastrectomy: Report of a Case

We present a case of gallstone obstruction of the duodenum in a post total gastrectomy patient without a cholecystoenteric fistula. The patient presented with epigastric pain. On abdominal computed tomography and percutaneous transhepatic choangiography imaging, the patient was found to have duodenal obstruction. At operation, the cause of obstruction was found to be a large gallstone in the third part of the duodenum, but there was no associated cholecystoenteric fistula. This report is the first to describe duodenal obstruction by a gallstone formed within the duodenum, in a patient post total gastrectomy with Roux-en-Y reconstruction, and highlights what can be a difficult diagnosis in such patients.     

Granular Cell Tumor as an Unusual Cause of Obstruction at the Hepatic Hilum: Report of a Case

A diagnosis of malignancy is reasonably assumed when a lesion is found at the hilum or bile ducts in a patient with jaundice who has never undergone biliary surgery. Although benign tumors occasionally develop in this location, preoperative recognition is difficult and most are treated as malignant lesions. We illustrate this clinical scenario in this case report of a granular cell tumor (GCT) that developed at the biliary bifurcation, necessitating right hemi-hepatectomy with extrahepatic biliary tree excision. We describe the clinical presentation, imaging findings, treatment, and histological findings of this tumor. Although rare, a GCT can develop at the hilum and mimic a malignant lesion such as cholangiocarcinoma (CC) radiologically. To our knowledge, this is the fourth report of a GCT at the hilum of the liver. However, the possibility of this tumor should be considered in the differential diagnosis of a lesion in this location.     

Port Site Metastasis of Sigmoid Colon Cancer After a Laparoscopic Sigmoidectomy: Report of a Case

A 75-year-old woman with TNM stage I (T2, N0, M0) sigmoid colon adenocarcinoma underwent a laparoscopy-assisted sigmoidectomy. Five months later, the patient developed two subcutaneous metastases at two trocar sites. A second operation was performed and two abdominal wall masses were resected, but the operation revealed no evidence of peritoneal dissemination, liver metastasis, or lymph node metastasis. The histological findings confirmed the diagnosis of metastatic carcinoma of the sigmoid colon. Large-scale studies have shown the actual rate of port site metastasis to be similar to that observed in open surgery, and therefore the rate is much lower than that initially reported in small studies. However, the metastatic mechanism has not yet been clarified. These results suggest that port site metastasis can be prevented as effectively as during open surgery by utilizing accurate operating skills based on the sound principles of tumor surgery. Therefore, it is very important that appropriate operating procedures and an effective training system are established. Received: April 19, 2002 / Accepted: September 3, 2002 Reprint requests to: O. Itano     

Annular Pancreas: A Rare Cause of Duodenal Obstruction in Adults

Annular pancreas is an uncommon congenital anomaly which usually presents itself in infants and newborn. Rarely it can present in late adult life with wide range of clinical severities thereby making its diagnosis difficult. Pre-operative diagnosis is often difficult. CT scan can illustrate the pancreatic tissue encircling the duodenum. ERCP and MRCP are useful in outlining the annular pancreatic duct. Surgery still remains necessary to confirm diagnosis and bypassing the obstructed segment.We report a case of 61 year female presenting with duodenal obstruction due to annular pancreas.     

Osteosarcoma of the Metatarsal Bones: Review of the Literature and Report of a Case

A case of osteosarcoma affecting the third metatarsal bone is submitted. Below-knee amputation was performed, but the patient developed pulmonary metastases and died 1 year after the operation. The six cases of osteosarcoma in the metarsal bones published 80 far are reviewed. The prognosis for cases with this localization does not appear to differ from that for osteosarcoma in general.     

Acute Renal Infarction: An Unusual Cause of Abdominal Pain

Acute renal infarction is an uncommon and under-diagnosed disease. Its clinical presentation is nonspecific and often mimics other more common disease entities. The diagnosis is usually missed or delayed, which frequently results in irreversible renal parenchyma damage. High index of suspicion is required for early diagnosis, as timely intervention may prevent loss of kidney function. We report a case of acute renal infarction following coronary angiography in a patient with paroxysmal atrial fibrillation who initially presented with acute abdominal pain mimicking appendicitis.     

Solitary Colonic Metastasis of Renal Cell Carcinoma Seven Years after Nephrectomy: A Case Report

An 83-year-old man, who had undergone right radical nephrectomy for renal cell Carcinoma about 7 years previously, experienced melena and abdominal mass. Barium enema, colonoscopy, computed tomography, and arteriography showed a hypervascular mass on the transverse colon, and a partial transverse colectomy was performed. The postoperative histologic examination revealed that the tumor was a metastatic clear cell carcinoma.