股骨重建钉治疗多发性骨软骨瘤患者粗隆间骨折合并同侧粗隆下骨折

目的 探讨股骨重建钉治疗多发性骨软骨瘤患者粗隆间骨折合并同侧粗隆下骨折的临床疗效.方法 2009年1月至2010年6月我科使用股骨重建钉治疗多发性骨软骨瘤患者粗隆间骨折合并同侧粗隆下骨折18例,男13例,女5例;其中右侧10例,左侧8例;年龄23～69岁,平均（48.5±2.7）岁.股骨粗隆间骨折按Evans标准分类,Ⅰ型1例,Ⅱ型2例,Ⅲ A型6例,Ⅲ B型4例,Ⅳ型3例,Ⅴ型2例.全部合并同侧粗隆下骨折,根据Russell-Taylor分型,Ⅰ A型6例,Ⅰ B型8例,Ⅱ B型4例.所有患者的影像学资料均提示为全身多发性骨软骨瘤.随访患者骨折术后并发症的发生情况、临床愈合时间及功能评分.结果 18例患者均获得随访,随访时间12-30个月,平均（24.2±0.8）个月.手术时间75-135min,平均（105±6.5）min.术后住院时间为7-12d,平均（9.3±1.2）d.末次随访时的Harris评分为65～95分,平均（86.6±3.4）分,其中优7例,良8例,中2例,差1例,优良率83.33﹪.骨折愈合时间12-20周,平均为（16.2±1.8）周.末次随访时除1例出现头钉切割股骨头和1例出现髋内翻外,无骨折再移位,无内固定失效,无股骨头缺血性坏死,无感染发生等并发症.结论股骨重建钉治疗多发性骨软骨瘤患者粗隆间骨折合并同侧粗隆下骨折取得良好临床效果,具有手术相对简单,创伤小,固定牢固,患者可早期功能活动且并发症少等优点.     

老年性原发骨肉瘤五例报告

目的探讨老年人原发性骨肉瘤的临床特点及诊治方法？方法回顾分析5例老年原发性骨肉瘤患者的临床特点及诊断和治疗方法，5例患者年龄53～61岁。男3例，女2例。病变部位：肱骨近端2例，骨盆及胫骨近端各1例；多发性病灶1例x线检查见：病灶为成骨、溶骨混合性骨破坏，可见骨膜反应．周围见巨大的软组织肿块，基质内可见钙化；CT、MRI、ECT均有不同程度的骨质破坏及核素浓聚信号改变。病理镜下见典型的恶性梭形成骨细胞及肿瘤性骨样基质的组织特征发病首诊时均被误诊或漏诊。确诊后2例接受了新辅助化疗及保肢手术：1例给予化疗及放疗（DT6000cGy）；1例单纯化疗；另1例单纯放疗（DT6000cGy）结果5例患者均获随访．2例分别于确诊后8个月及10个月死于肺转移．3例仍在治疗随访中，2例接受保肢（全膝，半肩）手术者，患肢功能恢复满意。结论老年人原发性骨肉瘤较为少见，临床上容易误诊或漏诊，确诊后给予积极的个体化综合治疗．可以缓解症状，获得相对满意的治疗效果．     

Osteosarcoma arising in Paget's disease of the mandible

Although osteosarcoma is a well-known complication of Paget's disease of bone, it uncommonly develops in the jaw bones. We present an osteosarcoma arising in Paget's disease of the mandible with unique features of a normal serum alkaline phosphatase level, and histologic features of telangiectatic change in the osteosarcoma and association with cemento-osseous dysplasia. Sixteen reported cases of osteosarcoma arising in Paget's disease of the jaw bones (OPJ) are also reviewed and compared to osteosarcoma arising in Paget's disease occurring in the entire skeleton (OPS) and osteosarcoma arising de novo in the jaw bones (OJ). Females are more commonly involved in OPJ in contrast to a male predominance in OPS and OJ. OPJ also has a distinctively higher percentage involving blacks compared to OPS. The prognosis of OPJ is poor, with 69% of patients dying within two years after diagnosis. Early recognition, early and aggressive treatment are important to improve the prognosis and are hence emphasized.     

Breast cancer developing after chemotherapy for osteosarcoma: a case report.

A 24-year-old patient who developed breast cancer 16 years after chemotherapy for osteosarcoma is presented. She had no family history of cancer. She had also not had radiotherapy. She had been given chemotherapy consisting of VAOMT (vincristine 10.2 mg, cyclophosphamide 900 mg, mitomycin C 15.2 mg, chromomycin A3 25.8 mg) pre- and post-operatively in the treatment of her osteosarcoma. Careful long-term follow-up is required after treatment of malignant neoplasms because there is a possibility of developing a second malignancy.     

Glioblastoma in multiple sclerosis: a case report

Cerebral tumor and multiple sclerosis (MS) relapses can show overlapping clinical and magnetic resonance imaging features. In a previous study we observed in relapsing MS patients increased T-bet, pSTAT1, and pSTAT3 expressions in circulating mononuclear cells. During the data analysis we observed that T-bet, pSTAT1, and pSTAT3 expression was not increased in circulating mononuclear cells from a relapsing-remitting (RR)MS patient with recent onset of new neurological signs due to glioblastoma multiforme. In conclusion, our patient represents an exemplary case which suggests that T-bet, pSTAT1, and pSTAT3 expression in peripheral blood mononuclear cells (PBMCs) might be useful to differentiate MS relapses from other noninflammatory diseases.     

同时性多原发癌伴肝转移1例并文献复习

目的 探讨同时性多发性骨髓瘤和结肠癌的病因、诊断及治疗方法.方法 对1例同时诊断为多发性骨髓瘤和结肠癌并继发肝转移患者的临床资料及相关文献进行回顾性分析.结果 患者以贫血为首发症状,骨髓穿刺术提示多发性骨髓瘤,荧光原位杂交检测示14q32 IgH基因重排阳性,肠镜及病理活检明确诊断结肠癌,数月后继发肝占位.给予VTD方...     

Coincidence of central neurocytoma and multiple glioblastomas: a rare case report

Coincidence of parenchymal primary brain tumors of different histogenesis is extremely rare. To the best of our knowledge, the present case of simultaneous appearance of a central neurocytoma and multiple glioblastomas is the first to be reported. Multiple intraaxial brain neoplasms were disclosed in a 39-year-old man and were surgically resected. Histological diagnosis of the tumor located in the right lateral ventricle was central neurocytoma whereas two tumors of the left temporal lobe were glioblastomas. The latter were located in close proximity to the subarachnoid space, had atypical radiological appearance, and were slightly positive for synaptophysin and neurofilament protein. It can be speculated that both malignant neoplasms were, in fact, dedifferentiated central neurocytoma, which developed from distant tumor deposits. This case seems to be in agreement with the hypothesis that central neurocytoma arises from the progenitor cells with potential for both neuronal and glial differentiation. Better understanding of histogenesis of this tumor is definitely needed.     

A case of multiple metastatic low-grade endometrial stromal sarcoma arising from an ovarian endometriotic lesion

The development of endometrial stromal sarcomas (ESSs) in foci of endometriosis is extremely rare, and few cases have been reported in the literature to date, particularly with regard to multiple extrauterine ESS. Here we report a case of endometrial stromal sarcoma with multiple metastasis that arose from an ovarian endometriotic lesion. The literature is also briefly reviewed.     

Mucinous adenocarcinoma arising from a tailgut cyst: A case report

BACKGROUNDRetrorectal hamartomas or tailgut cysts (TCs) are rare. In most cases, they are asymptomatic and benign; however, rarely, they undergo malignant transformation, mainly in the form of adenocarcinoma.CASE SUMMARYA 55-year-old woman presented to our hospital with lower back pain. On magnetic resonance imaging, a large pelvic mass was found, which was located on the right of the ischiorectal fossa, extending to the minor pelvis. The patient underwent extensive surgical resection of the lesion through the right buttock. Histological examination confirmed the diagnosis of a retrorectal mucinous adenocarcinoma originating from a TC. Surgical resection of the tumour was complete, and the patient recovered without complications. The pilonidal sinus was then excised. One year later, semi-annual positron emission tomography-computed tomography and magnetic resonance imaging scans did not reveal any evidence of local recurrence or metastatic disease.CONCLUSIONPreoperative recognition, histological diagnosis, and treatment of TCs pose significant challenges. In addition, the possibility of developing invasive mucinous adenocarcinoma, although rare, should be considered.     

阿帕替尼多重癌1例附文献回顾

多原发癌(Multiple primary carcinomas,MPC)又称多重癌,是指同一患者的单个或多个器官组织发生2个以上的原发癌。其中同时发现或在6个月内相继发现的多重癌为同时癌,超过6个月再发现的多重癌为异时癌。多重癌发病率低,其发病率很大程度上受放化疗的影响。多重癌在临床上容易与转移瘤相混淆,两者的治疗原则及预后有很大差异。因此及时诊治有利于提高患者生存期。现将我科收治的1例多重癌病例进行报道。     

Late-onset multiple sclerosis mimicking brain tumor: A case report

Multiple sclerosis (MS) is a demyelinating disease that predominantly affects those aged in their twenties to their forties. We recently observed a case of rapidly progressive late-onset MS in an elderly patient with a large, single lesion on magnetic resonance imaging (MRI), which was difficult to distinguish from a brain tumor. This case is reported here with a review of the literature. A 69-year-old woman who presented with left hemiparesis was admitted to our institute. A tumor lesion was strongly suspected from the MRI finding of a large solitary lesion adjacent to the right lateral ventricle. Her left hemiparesis became rapidly worse, so we decided to perform stereotactic biopsy. Histopathological examination indicated that the patient had a demyelinating disease such as multiple sclerosis. Steroid pulse therapy was started after the operation and led to a marked improvement of the symptoms. With follow-up for more than 1 year after discharge, she has shown no sign of relapse. Late-onset MS should be suspected if edema or mass effect is not visualized around the lesion on MRI, bearing in mind that late-onset MS can have a progressive course in elderly patients.     

Pulmonary cavernous hemangioma:a case report

We report a rare case of pulmonary cavernous hemangioma in a 51-year-old female. A computed tomographic scan of the chest showed an il-defined mass measuring 2.3 cm × 2.2 cm in the right lower lobe. Su...     

同时性多中心骨肉瘤一例报道并文献复习

目的 总结并探讨同时性多中心骨肉瘤(synchronous multifocal osteosarcoma,SMOS)的临床特征,探讨其发病机制及治疗与预后.方法 报告我院诊治的1例伴有肺转移的SMOS病例;计算机检索2001年至2021年,PubMed、中国知网、万方数据库、维普数据库等公开发表的文献,阅读全文进行二...     

Adenocarcinoma arising in mature cystic teratoma: a case report

Benign cystic teratoma is recognized as one of the most common tumors in women during the reproductive age and frequently is treated by pelviscopic operation. Malignant transformation of a benign cystic teratoma is a rare event, and adenocarcinoma is extremely rare, and distinguishing this malignant change from benign disease preoperatively is nearly impossible even by the use of radiological imaging or various tumor markers. Therefore, patients should be informed that if a laparoscopic cystectomy is undertaken, a prompt second staging operation should be performed if the definitive pathology reveals an unexpected malignancy. We present a case with thyroid papillary carcinoma of follicular variant arising from mature cystic teratoma removed by laparoscopic salpingo-oophorectomy followed by staging laparotomy. We briefly reviewed literatures with regard to malignant transformation of a benign cystic teratoma.     

Primary osteogenic sarcoma arising from the dura mater: case report

A 42-year-old woman who sought treatment for left drop foot was found to have a right frontoparietal parasagittal mass. Gross total resection of the tumor was performed and pathologic analysis revealed high grade osteoblastic osteosarcoma. The patient received adjuvant chemotherapy and continues to do well with no evidence of metastases or local recurrence 3 years after initial presentation.