Fibular reconstruction for giant cell tumor of the distal radius

The management of giant cell tumors involving the distal radius has always been a difficult problem. After resection to eradicate a primary or recurrent lesion, transplantation of a nonvascularized fibular autograft was used in 12 patients. Of these patients, ten had good to excellent functional results. The procedure can restore a functionally useful wrist.     

Atypical lipomatous masses of the extremities: outcome of surgical treatment

Atypical lipomatous tumors occur predominantly in middle-aged patients and often present as painless, slow-growing masses in the extremities. The clinical outcomes of surgically treated superficial or deep atypical lipomas of the extremities were reviewed. Thirty-one patients were included in this study. There were 16 men and 15 women, with an average age of 57 years (range, 32-87 years). The mean followup was 7 years (range, 1-28.8 years). Twenty-five tumors occurred in the lower extremity and six in the upper extremity. Sixteen patients (52%) had a recurrence at an average of 4.7 years after resection. Twelve (39%) patients required additional surgical procedures to treat their tumor. Occurrence of a deep lesion and positive margins at the time of the initial surgery correlated closely with the rate of recurrence and need for additional surgical treatment. Dedifferentiation to high-grade liposarcoma developed in four (13%) patients. Atypical lipomas have a high propensity for local recurrence and a potential for malignant dedifferentiation. Patients with atypical lipomas require careful evaluation, complete surgical excision when possible, and close clinical followup extending beyond 5 years.     

An undescribed cause of patellar tendon rupture

We present a rare case of a myxoid-feature lipoma that arose in the patella fat pad and caused patellar tendon rupture.     

Concurrent administration of vinorelbine with recombinant human granulocyte colony-stimulating factor: an effective method of increasing dose intensity

Thirty-three patients with incurable neoplasms resistant to standard therapy received vinorelbine 8 mg/m2 to 10 mg/m2 per day by continuous infusion with concurrent administration of recombinant human granulocyte colony-stimulating factor 5 microm/m2 per day. The duration of the vinorelbine infusion was individualized; the infusion was continued until early evidence of hematopoietic toxicity was noted. The concurrent administration of recombinant human granulocyte colony-stimulating factor permitted a substantial increase in dose intensity of the anticancer agent without a corresponding increase in drug toxicity. There was no evidence that the antitumor effect of vinorelbine was compromised by the concurrent administration of recombinant human granulocyte colony-stimulating factor.     

Is maternal serum heat stable alkaline phosphatase an index of fetal maturity?

A cross sectional estimation of serum heat stable alkaline phosphatase (HSAP) levels in 145 women with uncomplicated pregnancies between 24-41 weeks gestation showed increasing levels with advancing gestation and a steep rise at about 34 weeks gestation from a mean level of 17.3 +/- 6.5 micrograms/ml to a mean level of 36.1 +/- 1.5 micrograms/ml (t = 7.4 p less than .001) at about 37 weeks gestation. Ninety-three point seven percent (93.7%) and 24.4% of women between 31-35 weeks gestation and 27-34 weeks gestation respectively had levels equal to or exceeding 20 micrograms/ml. It is postulated that serum HSAP represent stages of fetal maturity rather than gestational age per se and that there is a possible relationship between serum HSAP and amniotic fluid lecithin viewed against a background of a similar rise of amniotic fluid lecithin levels at about 33 weeks gestation and the common role of steroid receptor sites in the formation of both HSAP and Lecithin.