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Asian Journal of Surgery Jun 2024
Topics: Humans; Chordoma; Sacrococcygeal Region; Spinal Neoplasms; Male; Female; Treatment Outcome; Middle Aged
PubMed: 38519318
DOI: 10.1016/j.asjsur.2024.03.018 -
Cureus Feb 2024We presented an unusual case of a teratoma in a 76-year-old female who began four years ago with paresthesias and hypoesthesias in the sacral and gluteal regions. She...
We presented an unusual case of a teratoma in a 76-year-old female who began four years ago with paresthesias and hypoesthesias in the sacral and gluteal regions. She denied weakness or gait instability. The magnetic resonance imaging showed an intradural lesion within the cauda equina at levels L2-L3. We decided to perform a posterior midline approach to the lumbar region to expose L2-L3 levels. After doing the L2-L3 laminectomy and the durotomy, we found a solid lesion surrounded by nerve roots with heterogeneous content. Through the meticulous separation of the nerve roots surrounding the lesion, we punctioned it, observing the exit of melanocytic material. Histopathological findings showed germinal neoplasia without immature neuroepithelium or malignant component; therefore, the diagnosis of mature teratoma was made. The patient was discharged without any aggregate neurological deficit. At the six-month follow-up visit, the patient continued with paresthesia in the gluteal region without motor weakness and reported minimal gait improvement.
PubMed: 38465043
DOI: 10.7759/cureus.53785 -
International Journal of Surgery Case... Mar 2024Pilonidal sinus is a condition that causes inflammation and abscesses in the sacral region and affects adolescents and young adults. The etiology of this condition...
INTRODUCTION
Pilonidal sinus is a condition that causes inflammation and abscesses in the sacral region and affects adolescents and young adults. The etiology of this condition remains controversial.
CASE PRESENTATION
A six year old boy was observed to have an orifice in the frontonasal region which contained hair. He had two previous infections which were treated with antibiotics. Magnetic Resonance Imaging showed no cranial malformations. Surgery was performed under general anesthesia and the pilonidal sinus was completely excised. At follow-up the child was in good health.
CLINICAL DISCUSSION
This case in a child with a frontonasal skin anomaly highlights that skin anomalies may be a cause of pilonidal sinus.
CONCLUSION
Skin malformations can be the underlying cause of pilonidal sinus in some cases.
PubMed: 38430899
DOI: 10.1016/j.ijscr.2024.109444 -
Physics and Imaging in Radiation... Jan 2024Nuclear interaction correction (NIC) and trichrome fragment spectra modelling improve relative biological effectiveness-weighted dose (D) and dose-averaged linear energy...
BACKGROUND AND PURPOSE
Nuclear interaction correction (NIC) and trichrome fragment spectra modelling improve relative biological effectiveness-weighted dose (D) and dose-averaged linear energy transfer (LET) calculation for carbon ions. The effect of those novel approaches on the clinical dose and LET distributions was investigated.
MATERIALS AND METHODS
The effect of the NIC and trichrome algorithm was assessed, creating single beam plans for a virtual water phantom with standard settings and NIC + trichrome corrections. Reference D and LET distributions were simulated using FLUKA version 2021.2.9. Thirty clinically applied scanned carbon ion treatment plans were recalculated applying NIC, trichrome and NIC + trichrome corrections, using the LEM low dose approximation and compared to clinical plans (). Four treatment sites were analysed: six prostate adenocarcinoma, ten head and neck, nine locally advanced pancreatic adenocarcinoma and five sacral chordoma. The FLUKA and clinical plans were compared in terms of D deviations for D, D, D for the clinical target volume (CTV) and D in ring-like dose regions retrieved from isodose curves in plans. Additionally, region-based median LET deviations and global gamma parameters were evaluated.
RESULTS
Dose deviations comparing and evaluation plans were within ± 1% supported by γ-pass rates over 97% for all cases. No significant LET deviations were reported in the CTV, but significant median LET deviations were up to 80% for very low dose regions.
CONCLUSION
Our results showed improved accuracy of the predicted D and LET. Considering clinically relevant constraints, no significant modifications of clinical protocols are expected with the introduction of NIC + trichrome.
PubMed: 38419802
DOI: 10.1016/j.phro.2024.100553 -
Journal of Indian Association of... 2024This case report describes a 4-year-old girl with an isolated neurofibroma in the sacrococcygeal region. Although initially resembling sacrococcygeal teratoma,...
This case report describes a 4-year-old girl with an isolated neurofibroma in the sacrococcygeal region. Although initially resembling sacrococcygeal teratoma, histopathology revealed a benign nerve sheath tumor. Wide local excision was performed, and the final diagnosis was plexiform neurofibroma. Diagnostic challenges in rare childhood tumors require stepwise evaluation and multidisciplinary team discussions.
PubMed: 38405243
DOI: 10.4103/jiaps.jiaps_136_23 -
Orthopaedic Journal of Sports Medicine Feb 2024Differences in the physical characteristics of bilateral and unilateral lumbar bone stress injuries (BSIs) are unknown.
BACKGROUND
Differences in the physical characteristics of bilateral and unilateral lumbar bone stress injuries (BSIs) are unknown.
PURPOSE
To compare bilateral and unilateral lumbar BSIs in adolescent male soccer players, with a focus on lumbopelvic alignment.
STUDY DESIGN
Cross-sectional study; Level of evidence, 3.
METHODS
A total of 78 players (age range, 12-15 years) from a local soccer club who had magnetic resonance imaging (MRI) evaluations were included in the study. Lumbopelvic alignment and lumbar BSI were evaluated using short-tau inversion recovery and 3-dimensional LAVA on 3-T MRI; lumbar BSI was defined as the presence of bone marrow edema and/or the complete and incomplete fracture in the pars region on the MRI. Pelvic tilt (PT) and pelvic outflare angles were assessed on the kicking and pivoting sides, and asymmetry for each parameter was calculated by subtracting the kicking side from the pivoting side. In addition, the lumbar lordosis (LL), sacral slope (SS), and SS relative to LL (calculated by subtracting LL from the SS) were assessed. One-way analysis of variance was performed to compare lumbopelvic alignment in players with bilateral BSI, unilateral BSI, or no abnormal findings (controls).
RESULTS
No significant differences were found regarding lumbopelvic alignment between the players with bilateral versus unilateral lumbar BSI. PT asymmetry was significantly greater in both players with bilateral lumbar BSI and unilateral lumbar BSI compared with controls ( = .018 and = .016, respectively). In addition, SS relative to LL was significantly greater in players with bilateral lumbar BSI compared with controls ( < .001).
CONCLUSION
Although there were no significant lumbopelvic alignment differences between bilateral and unilateral BSI, players with bilateral BSI exhibited increased sacral anterior tilt relative to the LL, and the pelvis was more posterior on the pivoting side than on the kicking side in both players with bilateral BSI and unilateral BSI. Our results suggest that lumbopelvic alignment assessment may contribute to the management strategy for players with lumbar BSI and to the identification of players at high risk of lumbar BSI.
PubMed: 38405007
DOI: 10.1177/23259671241229692