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Scientific Reports Jan 2024Bone cancer is a rare in which cells in the bone grow out of control, resulting in destroying the normal bone tissue. A benign type of bone cancer is harmless and does...
Bone cancer is a rare in which cells in the bone grow out of control, resulting in destroying the normal bone tissue. A benign type of bone cancer is harmless and does not spread to other body parts, whereas a malignant type can spread to other body parts and might be harmful. According to Cancer Research UK (2021), the survival rate for patients with bone cancer is 40% and early detection can increase the chances of survival by providing treatment at the initial stages. Prior detection of these lumps or masses can reduce the risk of death and treat bone cancer early. The goal of this current study is to utilize image processing techniques and deep learning-based Convolution neural network (CNN) to classify normal and cancerous bone images. Medical image processing techniques, like pre-processing (e.g., median filter), K-means clustering segmentation, and, canny edge detection were used to detect the cancer region in Computer Tomography (CT) images for parosteal osteosarcoma, enchondroma and osteochondroma types of bone cancer. After segmentation, the normal and cancerous affected images were classified using various existing CNN-based models. The results revealed that AlexNet model showed a better performance with a training accuracy of 98%, validation accuracy of 98%, and testing accuracy of 100%.
Topics: Humans; Deep Learning; Early Detection of Cancer; Neural Networks, Computer; Tomography, X-Ray Computed; Computers; Bone Neoplasms; Osteosarcoma; Image Processing, Computer-Assisted
PubMed: 38273131
DOI: 10.1038/s41598-024-52719-8 -
Journal of Clinical Medicine Jan 2024The rarity of foot and ankle tumours, together with the numerous histological entities, presents a challenge in accumulating sufficient patients to draw reliable...
The rarity of foot and ankle tumours, together with the numerous histological entities, presents a challenge in accumulating sufficient patients to draw reliable conclusions. Therefore, we decided to present an update of a retrospective analysis of their distribution patterns, comprising 536 cases of foot and ankle tumours presented to our tumour board between June 1997 and June 2023. Our aim was to provide a comprehensive overview of the prevalence and distribution patterns of benign and malignant bone and soft tissue tumours of the foot and ankle. A total of 277 tumours involved bone (51.7%). Of these, 242 (87.4%) were benign and 35 (12.6%) were malignant. In addition, 259 soft tissue tumours (48.3%) were found, of which 191 (73.7%) were benign and 68 (26.3%) were malignant. The most common benign bone tumours were simple bone cysts, enchondromas, osteochondromas, aneurysmal bone cysts, and lipomas of bone. Common benign soft tissue tumours included a tenosynovial giant cell tumour, haemangioma, plantar fibromatosis, schwannoma, and lipoma. The most common malignant soft tissue tumours were synovial sarcoma, malignant melanoma, and myxofibrosarcoma. In terms of anatomical location, the hindfoot was the most common site (28.7%), followed by the midfoot (25.9%), ankle (25.4%), and forefoot (20.0%). The distribution of benign entities often follows typical patterns, which may facilitate an early diagnosis even without biopsy (e.g., simple bone cyst, plantar fibromatosis). On the other hand, the distribution patterns of many rare or malignant entities are inconsistent. Individual soft tissue malignancies occur very sporadically, even over long periods of time and in specialized tumour centres. It is therefore important to recognise that any suspicious mass in the foot and ankle must be considered a possible malignancy until proven otherwise.
PubMed: 38256484
DOI: 10.3390/jcm13020350 -
International Journal of Surgery Case... Feb 2024Osteochondromas are the most common benign bone tumours in children. They typically manifest near the knee, proximal humerus, or distal femur. While often asymptomatic,...
INTRODUCTION
Osteochondromas are the most common benign bone tumours in children. They typically manifest near the knee, proximal humerus, or distal femur. While often asymptomatic, they can lead to pain, functional impairments, deformities, and pathologic fractures. Involvement of the growth plates can result in severe deformities during childhood growth.
CASE PRESENTATION
A 15-year-old Ugandan female with no prior medical conditions presented to a mobile clinic with a mass on the left elbow. This mass showed a histopathologically confirmed case of osteochondroma. The distinctive aspect of this case is the location of the mass and the delay in patient care due to surgical inaccessibility and financial constraints, allowing a 13-year growth period for the mass.
DISCUSSION
While osteochondromas are benign, this mass's location and early onset warranted early biopsy and surgical excision to prevent future complications. The delay in care resulted in emotional distress, eliciting the patient's withdrawal from school and hindering her ability to fulfil culturally significant household duties in Uganda. Proximity to surgical care and cost are the most significant barriers in rural Uganda.
CONCLUSION
Following complete excision, the persistence of postoperative pain under heavy loads underscores the critical importance of early diagnosis and treatment in mitigating psychological trauma, anxiety, and discomfort associated with large masses.
PubMed: 38244375
DOI: 10.1016/j.ijscr.2024.109223 -
Romanian Journal of Ophthalmology 2023To describe the ophthalmological management of a girl diagnosed with Stuve Wiedemann syndrome (SWS). Clinical and in vivo confocal microscopy (IVCM) are described....
To describe the ophthalmological management of a girl diagnosed with Stuve Wiedemann syndrome (SWS). Clinical and in vivo confocal microscopy (IVCM) are described. Case report of a 6-year-old girl, who presented with neurotrophic keratitis and was treated with intense lubrication including heterologous serum and tear plugs. In the following months, the evolution of the neurotrophic keratitis was good, but a hypertrophic corneal leukoma persisted with mild neovascularization in the left eye. Close ophthalmological follow-up in patients with SWS is needed, given that most of the time they do not present symptoms due to the characteristic neuropathy of their lesions. SWS = Stuve-Wiedemann syndrome, IVCM = in vivo confocal microscopy, CNTF = ciliary neurotrophic factor, BCVA = best corrected visual acuity, LIFR = Leukemia Inhibitory Factor Receptor, IGF1 = Insulin-like growth factor-1.
Topics: Female; Humans; Child; Exostoses, Multiple Hereditary; Cornea; Osteochondrodysplasias; Keratitis; Microscopy, Confocal
PubMed: 38239413
DOI: 10.22336/rjo.2023.66 -
Cureus Dec 2023This case report presents a rare occurrence of exostosis of the ulna associated with a developmental deformity of the left forearm in a 15-year-old female. The patient...
This case report presents a rare occurrence of exostosis of the ulna associated with a developmental deformity of the left forearm in a 15-year-old female. The patient reported a history of trauma resulting in a supracondylar humerus fracture managed conservatively eight years prior. The patient presented with a two-year history of pain and swelling over the left forearm. Clinical examination revealed a firm, non-tender, immobile swelling closely associated with the ulna, accompanied by a 20-degree cubitus varus deformity and forearm shortening. Radiographs and computed tomography scans confirmed the presence of a solitary external bony protuberance over the ulna shaft, communicating with the medullary cavity. A preliminary diagnosis of osteochondroma was established based on clinical and imaging findings. The patient underwent extraperiosteal en bloc resection of the lesion under supraclavicular nerve block anesthesia. A histopathological examination confirmed the diagnosis. Postoperative physiotherapy was initiated, and at the one-month follow-up, the patient reported being pain-free. This case highlights the rarity of exostosis of the ulna with associated developmental deformity, emphasizing the importance of a comprehensive diagnostic approach. Early surgical intervention resulted in a successful outcome, underscoring the significance of timely management in improving patient outcomes and quality of life.
PubMed: 38226087
DOI: 10.7759/cureus.50528 -
Molecular and Clinical Oncology Feb 2024Multiple osteochondromas (MOs) are inherited in an autosomal-dominant manner, with a penetrance of ~96 and 100% in female and male patients, respectively....
Multiple osteochondromas (MOs) are inherited in an autosomal-dominant manner, with a penetrance of ~96 and 100% in female and male patients, respectively. Osteochondromas primarily involve the metaphyses and diaphyses of long bones, including the ribs. Osteoid osteomas account for ~3 and 11% of all bone tumors and benign bone tumors, respectively. Furthermore,1 the male-to-female ratio is 2-3:1, and they generally occur in the long bones of the lower extremities, with the femoral neck being the most frequent site. The present study describes the case of a 16-year-old male patient with a bony mass around the left knee joint and pain in the left calf. Radiography revealed MOs in the upper and lower extremities, while computed tomography showed a nidus in the cortex of the tibial shaft. The patient's family history included the presence of MOs, and the patient was diagnosed with MOs and a solitary osteoid osteoma. Surgical excision of the osteochondroma and curettage of the osteoid osteoma in the proximal tibia and tibial shaft, respectively, were performed simultaneously. Postoperative pathological examination revealed osteochondroma and osteoid osteoma. Furthermore, the pain resolved, and no recurrence was observed 7 months post-operation. To the best of our knowledge, no reports exist on coexisting MOs and osteoid osteoma; therefore, the present study describes the first case of such a condition. Marginal excision for osteochondroma and curettage for osteoid osteoma effectively improved the symptoms.
PubMed: 38213658
DOI: 10.3892/mco.2023.2711 -
Cureus Dec 2023Osteochondromas (OCs) are benign bone tumors characterized by their growth with a cartilage cap and typically occurring at the ends of long bones. Their occurrence in...
Osteochondromas (OCs) are benign bone tumors characterized by their growth with a cartilage cap and typically occurring at the ends of long bones. Their occurrence in the head and neck region is infrequent, accounting for only around 1% of head and neck tumors. Notably, the mandibular coronoid process and the mandibular condyle are the primary sites where an OC is reported. Patients often exhibit facial asymmetry, limited mouth opening, and malocclusion. Possible treatment options depending on the condition include partial or total condylectomy, vertical ramus osteotomy, and supplementary orthognathic surgery. The recurrence rate of under 1%- 2% is reported after local resection. In this case report, we present a unique case of an OC in a 27-year-old woman. It involved the mandibular condyle, resulting in a left-sided mouth deviation while opening and closing her mouth. The purpose of this article is to detail the clinical and radiographic features, histopathological aspects, and treatment strategies and differentiate potential diagnoses, for such OCs.
PubMed: 38213345
DOI: 10.7759/cureus.50355 -
Orthopaedic Surgery Mar 2024Fibrodysplasia ossificans progressiva (FOP) is an extremely rare disease characterized by malformation of the bilateral great toes and progressive heterotopic...
BACKGROUND
Fibrodysplasia ossificans progressiva (FOP) is an extremely rare disease characterized by malformation of the bilateral great toes and progressive heterotopic ossification. The clinical features of FOP occur due to dysfunction of the bone morphogenetic protein (BMP) signaling pathway induced by the mutant activin A type I receptor/activin-like kinase-2 (ACVR1/ALK2) which contributes to the clinical features in FOP. Dysregulation of the BMP signaling pathway causes the development of osteochondroma. Poor awareness of the association between FOP and osteochondromas always results in misdiagnosis and unnecessary invasive operation.
CASE PRESENTATION
In this study, we present a case of classical FOP involving osteochondroma. An 18-year-old male adolescent, born with deformity of bilateral big toes, complained multiple masses on his back for 1 year. The mass initially emerged with a tough texture and did not cause pain. It was misdiagnosed as an osteochondroma. After two surgeries, the masses became hard and spread around the entire back region. Meanwhile, extensive heterotopic ossification was observed around the back, neck, hip, knee, ribs, and mandible during follow-up. Osteochondromas were observed around the bilateral knees. No abnormalities were observed in the laboratory blood test results. Whole exome sequencing revealed missense mutation of ACVR1/ALK2 (c.617G > A; p.R206H) in the patient and confirmed the diagnosis of FOP.
CONCLUSION
In summary, classical FOP always behaves as a bilateral deformity of the big toes, as well as progressive ectopic ossification and osteochondromas in the distal femur and proximal tibia. An understanding of the association between osteochondromas and FOP aids in diagnosis and avoids unnecessary invasive management in patients.
Topics: Male; Adolescent; Humans; Myositis Ossificans; Mutation; Ossification, Heterotopic; Signal Transduction; Osteochondroma
PubMed: 38185793
DOI: 10.1111/os.13956 -
Clinical Case Reports Jan 2024In managing a child with a solitary osteochondroma, the most advisable course of action involves vigilant observation and regular follow-up, given the potential for...
KEY CLINICAL MESSAGE
In managing a child with a solitary osteochondroma, the most advisable course of action involves vigilant observation and regular follow-up, given the potential for spontaneous resolution.
ABSTRACT
The most frequent benign cartilage tumors in children are osteochondromas, which develop when the growth plate herniates during bone development. Treatment depends on the symptoms, with asymptomatic cases requiring monitoring and symptomatic patients requiring surgical intervention. Rarely, an asymptomatic osteochondroma may spontaneously disappear. We report the case of a 3-year-old male who presented with left arm swelling and pain due to trauma while playing football. X-rays revealed a proximal humerus posterolateral sessile osteochondroma. After 6 months of observation, the boy tolerated activity and had no pain. Five years later, the osteochondroma was resolved spontaneously both clinically and radiologically. Our study suggests that annual observation of child patients with osteochondroma is more effective than surgical intervention due to the possibility of spontaneous resolution.
PubMed: 38161641
DOI: 10.1002/ccr3.8372 -
Cureus Nov 2023Osteochondromas (OCs) are bone lesions composed of cartilaginous and medullary bone capped with hyaline cartilage. OCs result from the separation of epiphyseal growth...
Osteochondromas (OCs) are bone lesions composed of cartilaginous and medullary bone capped with hyaline cartilage. OCs result from the separation of epiphyseal growth plate cartilage, pushing through the periosteal bone cuff. They commonly appear as pedunculated or sessile masses in the metaphysis of long bones and are the most common benign bone tumors. While rare in the scapula, OCs can occur there. Symptoms may arise from fractures, osseous abnormalities, or potential malignant transformation, especially in the presence of hereditary multiple exostoses (HME). The estimated rate of malignant transformation in solitary lesions is 1%, whereas in hereditary multiple OCs, it can reach up to 3-5%. We report a case of a 10-year-old female who presented with a gradually progressive swelling on the back of her right scapula. This progressive growth has been observed over the course of the past two years accompanied by mild pain. The pain was intermittent and did not affect her daily activities. On examination, a hard, tender, non-mobile swelling of approximately 2 × 2 cm was found over the right scapula. The patient had a normal range of motion in the shoulder and scapulothoracic regions. In conclusion, since solitary scapular OCs are extremely rare, they are quite common when associated with HME. This study aimed to increase awareness of the unusual site of OCs. Furthermore, we have included a full account of the surgical therapy we administered to this patient in order to assist future surgeons who may come across similar conditions.
PubMed: 38156180
DOI: 10.7759/cureus.49582