Florid Cemento-Osseous Dysplasia with a Concurrent Glandular Odontogenic Cyst

The presence of non-odontogenic cysts associated with benign fibro-osseous lesions of the jaws has been well documented. However, literature is scant when describing benign fibro-osseous lesions with associated odontogenic cysts. This case report highlights the presence of a concurrent developmental odontogenic cyst, glandular odontogenic cyst with extensive squamous metaplasia, in a patient with florid cemento-osseous dysplasia (COD). The postulated pathogenesis of these synchronous lesions is discussed along with a review of current literature. Surgical treatment is discouraged for florid COD, however, radiological follow-up is recommended, especially in lesions with associated cysts.     

Cemento-Osseous Dysplasia-Like Lesion and Complex Odontoma Associated with an Impacted Third Molar

We present a case of a 36-year-old female with a benign fibro-osseous lesion consistent with cemento-osseous dysplasia (COD) that was located coronally to the crown of an impacted mandibular third molar tooth and was associated with a complex odontoma. The pathogenesis of this unusual association is discussed and the odontogenic origin of COD is suggested.     

Osseous involvement in rhinosporidiosis

Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. It usually affects the mucocutaneous tissue of the nose. Bone involvement is rare. We report a case of Rhinosporidiosis of the nasopharynx which later involved the right little finger where ray amputation was performed.     

菲立磁增强MRI对局灶性肝病的定性诊断价值

目的　对比分析菲立磁增强扫描与螺旋CT增强扫描对局灶性肝病的定性诊断价值。方法　收集经本院完成螺旋CT增强扫描及菲立磁增强MRI扫描且临床、手术病理证实为局灶性肝病者 2 6例 5 7个病灶 ,采用分组盲法受试者操作特性 (ROC)曲线分析对比评价菲立磁增强MRI与螺旋CT增强扫描对局灶性肝病的定性诊断价值。结果　平扫 菲立磁增强MRI组ROC曲线下面积 (Az值 )最大 ,为 0 .92 6 0 ,准确性为 86 .8% ,差异有显著性意义 (P<0 .0 5 )。螺旋CT增强扫描、MRI平扫及单独分析菲立磁增强MRI 3种方法之间差异无显著性意义 (P>0 .0 5 )。结论　菲立磁增强MRI对肝局灶性病变的定性诊断价值高于螺旋CT增强扫描。联合分析平扫 菲立磁增强MRI较单独分析菲立磁增强能明显改善病灶的定性诊断能力。     

Osseous sarcoidosis: A multicenter retrospective case-control study of 48 patients

ObjectiveTo describe the clinical presentation, distribution of lesions, treatment, and outcomes of osseous sarcoidosis.MethodsA French retrospective multicenter study of patients with biopsy-proven sarcoidosis analyzed patients with 1) a biopsy-proven granuloma without caseous necrosis, and either 2) osseous clinical manifestations, or 3) abnormal osseous imaging. Sarcoidosis patients with osseous involvement (cases) were compared with 264 age- and sex-matched sarcoidosis patients with no osseous manifestations (controls).ResultsIn the osseous sarcoidosis group (n = 88), forty-two (48%) patients had osseous-related symptoms involving the axial (69%) and/or appendicular (58%) skeleton. On imaging, the most commonly affected bones were in the spine (52%), pelvis (42%), hands (22%) and femur (19%). Compared with controls, cases had higher rates of mediastinal (93% vs. 47%) and extra-thoracic lymph node involvement (66% vs. 21%), pulmonary (90% vs. 65%) and cutaneous involvement (44% vs. 23%) (all P < 0.0001), and hypercalcemia (8.5% vs. 2%, P = 0.014). Spleen/liver and gastrointestinal involvement were less frequent in the osseous sarcoidosis group (29% vs. 45%, and 1% vs. 17%, respectively, P < 0.0001). Response rates to with glucocorticoids alone, glucocorticoids plus methotrexate or glucocorticoids plus hydroxychloroquine were 23/44 (52%), 9/13 (69%) and 4/6 (67%), respectively.ConclusionIn patients with osseous sarcoidosis the spine and pelvis were the most commonly affected bones. Compared with controls, cases with osseous sarcoidosis have higher rates of thoracic and extra-thoracic lymph node involvement, pulmonary and cutaneous involvement, and hypercalcemia. Most patients with osseous sarcoidosis had a good response to glucocorticoids in combination with methotrexate or hydroxychloroquine.     

Dysplasia in the gastrointestinal tract: definition and clinical significance

Summary The term dysplasia is used increasingly in gastrointestinal pathology. Dysplasia denotes an unequivocal neoplastic epithelial alteration without invasive growth and is synonymous with the term intraepithelial neoplasia. Dysplasia is the paradigm of a precancerous lesion. Confusion arises because some pathologists do not use the term in the above-defined sense but to describe regenerative, inflammatory and reactive changes. It is essential to separate these kinds of non-neoplastic epithelial changes from neoplastic dyplasia because the clinical consequences are completely different. The general morphology and the grading of dysplasia are described. Most dysplasias in the gastrointestinal tract are the polypoid lesion; dysplasias in flat mucosa are uncommon. Knowledge of the incidence of dysplasia in the gastrointestinal tract is important for the concept of secondary cancer prevention.     

Osseous integration in porous tantalum implants

Porous tantalum is a biomaterial that was recently introduced in orthopedics in order to overcome problems related to implant loosening. It is found to have osteoconductive, and possibly, osteoinductive properties hence useful in difficult cases with severe bone defects. So, it is of great interest to shed light on the mechanisms through which this material leads to new bone formation, after being implanted. Porous tantalum is biologically relatively inert, with restricted bonding capacity to the bone is restricted. In order to overcome this obstacle, it undergoes thermal processing in an alkaline environment. This process leads to extensive hydroxyapatite formation on its surface, and thus, to better integration of porous tantalum implants. Apart from this, new bone tissue formation occurs inside the pores of the porous tantalum after its implantation and this new bone retains the characteristics of the normal bone, that is, bone remodeling and Haversian systems formation. This finding is enhanced by the observation that porous tantalum is an appropriate substrate for osteoblast adherence, proliferation, and differentiation. Furthermore, the finding that osteoblasts derived from old women (> 60 years old) and cultivated on porous tantalum may grow faster than osteoblasts taken from younger women (< 45 years old) and cultivated on other substrates, can partially explain porous tantalum''s good performance in cases of patients with severe bone defects. In conclusion, porous tantalum''s chemical and mechanical properties are those that probably define the already noticed good performance of this material. However, further research is needed to totally clarify the mechanisms.     

Osseous metaplasia of the breast: diagnosis with stereotactic core biopsy

There are approximately 200 reported cases of breast tumors containing areas of bone. The majority of the neoplasms are sarcomas, phylloides tumors, or fibroadenomata. We present a case of osseous metaplasia mammographically detected by clustered heterogeneous calcifications. Stereotactic core biopsy revealed the presence of well-formed bone tissue without associated neolplasia. The case represents the first reported case of mammographically detected osseous metaplasia confirmed by core biopsy.     

Benign Fibro-Osseous Lesions of the Craniofacial Complex A Review

Benign fibro-osseous lesions of the craniofacial complex are represented by a variety of disease processes that are characterized by pathologic ossifications and calcifications in association with a hypercellular fibroblastic marrow element. The current classification includes neoplasms, developmental dysplastic lesions and inflammatory/reactive processes. The definitive diagnosis can rarely be rendered on the basis of histopathologic features alone; rather, procurement of a final diagnosis is usually dependent upon assessment of microscopic, clinical and imaging features together. Fibrous dysplasia and osteitis deformans constitute two dysplastic lesions in which mutations have been uncovered. Other dysplastic bone diseases of the craniofacial complex include florid osseous dysplasia, focal cemento-osseous dysplasia and periapical cemental dysplasia, all showing a predilection for African descent individuals; although no specific genetic alterations in DNA coding have yet to be uncovered and most studies have been derived from predominant high African descent populations. Ossifying fibromas are neoplastic lesions with four subtypes varying with regard to behavior and propensity for recurrence after surgical excision. The clinicopathologic and molecular features of this unique yet heterogeneous group of diseases are reviewed.     

The Development of Leg Length Difference and Influence on Persistent Dysplasia in Patients with Developmental Dysplasia of the Hip

IntroductionLeg-length difference (LLD) is common in patients with developmental dysplasia of the hip (DDH). LLD of > 1 cm at skeletal maturity is reported in > 40% of patients, with the majority related to ipsilateral overgrowth. A longer DDH leg might lead to excessive mechanical loading at the acetabular margin, resulting in compromised acetabular development. We hypothesised that the LLD would negatively influence acetabular development. If so, it would be advantageous to identify such patients early in the course of follow-up, and address this if necessary.MethodsA retrospective study was conducted on a consecutive series of DDH patients managed surgically at the Royal National Orthopaedic Hospital, Stanmore, United Kingdom. We included patients with adequate long-leg radiographs at the age of 4–8 years (early-FU) and skeletal maturity (final-FU). Bilateral cases and those who underwent surgical procedures for hip dysplasia during the follow-up period were excluded. Measurements including leg length and centre-edge-angle (CE-angle) were obtained at the 2 time points.ResultsTwenty-seven patients were included, mean age at early-FU 5.7 (± 0.9) years, and 13.9 (± 1.0) years at final-FU. Mean LLD at early-FU was 9.5 (± 7.6) mm and 10.9 (± 9.4) mm at final-FU, p = 0.337. Correlation between early- and final-FU LLD was 0.68 (p < 0.001). The mean CE-angle at early follow-up was 14.6° (± 9.8), this improved to 23.2° (± 8.2) at skeletal maturity (p = 0.003, paired samples t-test). Linear regression analysis showed a non-significant trend towards less CE-angle improvement in patients with more initial residual dysplasia and more initial LLD.ConclusionMost leg-length differences can be identified early in the follow-up period, nevertheless, considerable individual changes in LLD are observed on continued follow-up. Furthermore, a trend was observed towards impaired acetabular improvement in patients with more LLD. These findings justify careful clinical and radiological monitoring of LLD from an early stage in the follow-up period.Supplementary InformationThe online version contains supplementary material available at 10.1007/s43465-021-00492-5.     

A Surgical Case of Frontal Lobe Epilepsy Due to Focal Cortical Dysplasia Accompanied by Olfactory Nerve Enlargement: Case Report

A 45-year-old man came to our clinic due to refractory general tonic seizure and an attack of unintended yelling. Magnetic resonance imaging (MRI) demonstrated mild cortical hyperintensity on fluid attenuated inversion recovery (FLAIR) image in the left basal frontal area. Enlargement of the left olfactory nerve was also detected below the affected gyrus. Subtotal resection of the MRI-visible epileptogenic lesion was performed without any neurological deficit. The final pathological diagnosis was focal cortical dysplasia (FCD) type IIa. Seizures and yelling attacks subsided after surgery. Extracerebral abnormalities, including cranial nerve enlargement, are common in patients with hemimegalencephaly. However, such abnormalities are rare with FCD.     

颅骨锁骨发育不全综合征的临床分析

目的：探讨颅骨锁骨发育不全的临床特征和诊治特点,更好地指导临床医生工作。方法：借助典型病例及搜集到的资料进行综合分析。结果：颅骨锁骨发育不全是一种少见的临床综合征,具有典型的额部圆突、颌面部小、眼距过宽、鼻梁塌陷等特殊面容,常伴有乳牙滞留,恒牙迟萌、发育不全或阻生,身材矮小,颅缝增宽,前囟闭合不全,锁骨发育不良及肩关节活动范围增加,X线检查可确诊。结论：通过详细的询问病史,收集患者的临床特征结合X线检查提出诊断治疗原则。     

Une tumeur osseuse rare de la voûte crânienne : le fibrome chondromyxoïde. À propos d’un cas et revue de la littérature

Chondromyxoid fibroma is an uncommon benign bone tumor of cartilaginous origin. It is often located in long bone metaphysis. We report a case involving the left frontotemporal cranial vault in a 44-year-old woman. Fifteen cranial vault cases have been reported in the international literature. Surgical resection of the lesion with tumor-free margins is the key factor to cure it and avoid local recurrence.     

外侧小切口螺纹骨圆针内固定治疗跟骨骨折

目的 探讨外侧小切口螺纹骨圆针内固定治疗跟骨骨折的疗效.方法 对28例累及距下关节的跟骨骨折患者（32足）行外侧小切口,采用骨圆针牵引、撬拔、复位、固定治疗.结果 28例均获随访,时间6～36个月.根据Maryland足部评分系统评价：优24足,良7足,差1足.结论 外侧小切口螺纹骨圆针内固定治疗跟骨骨折创伤小,并发症少,骨折复位较好,愈合快,临床疗效满意.     

Osseous destruction and rupture of the extensor tendon caused by sarcoidosis of the finger

We describe a woman with osseous destruction and rupture of the extensor tendon as a result of sarcoidosis in the left third finger with no evidence of systemic involvement. The tendon was repaired and she was successfully treated with prednisone.     

Different Lengths of Percutaneous Transverse Iliosacral Screw in Geometric Osseous Fixation Pathway: A Finite-Element Analysis

ObjectiveTo evaluate the biomechanical performances of the sacroiliac screw fixation of the first sacral vertebra with different lengths of screws using the Finite-Element Method.MethodsFirst, pelvic CT images were generated from a healthy volunteer, and multislice sagittal views were produced to determine the axis for the first sacral vertebra geometric osseous fixation pathway (GOFP). Subsequently, according to the geometric size and mechanical parameters of the iliosacral screw, the screw models with the same diameter of 7.3 mm and different lengths of 80 mm, 90 mm, 100 mm, 110 mm, 120 mm, 130 mm and 140 mm were built. Then the seven screws were assembled with the pelvic model. The maximum von Mises stress and the shape variables were evaluated for the pelvis and the screws.ResultsResults are shown for the pelvic and GOFP screw, respectively. The simulation results show that the maximum von Mises stress in the cortex of the pelvic ring of the pelvis with the 130-mm length screw is the lowest among the pelvic models with different screws. Moreover, the peak displacement of the pelvis with the 130-mm length screw is the smallest. These results indicate that under the standing condition, a 130-mm length screw can decrease the stress concentration and result in a more effective transfer of stress within the reconstructed pelvis. In addition, the displacement of the screw with a 130-mm length is the smallest among all the considered screws. The peak von Mises stresses in the 130-mm length screw and the cortex are still within a low and elastic range below the yielding strengths of the materials.ConclusionThrough the finite element analysis, the GOFP can be used as a safe and effective way for iliosacral screw fixation. The optimal length of the screw may be 130 mm length.