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Journal of Neurosurgery. Case Lessons Aug 2022Solitary fibrous tumor (SFT) is a rare mesenchymal tumor known for its propensity for recurrence and metastasis. Furthermore, aneurysmal bone cyst (ABC) is a benign...
BACKGROUND
Solitary fibrous tumor (SFT) is a rare mesenchymal tumor known for its propensity for recurrence and metastasis. Furthermore, aneurysmal bone cyst (ABC) is a benign osteolytic lesion. ABC-like areas can be seen in bone tumors that have undergone hemorrhagic cystic change. They are formed by disruptions in the osseous circulation caused by the associated lesion. The most common associated lesions are giant cell tumor, chondroblastoma, osteoblastoma, osteosarcoma, chondromyxoid fibroma, and fibrous dysplasia. There has been no reported case of SFT being the associated lesion.
OBSERVATIONS
A 42-year-old woman presented with a 6-month history of headache and impaired memory. Radiological examinations revealed a 50-mm cystic lesion with multiple fluid levels arising from the left temporal bone. Total resection of the tumor was conducted, and postoperative course was uneventful. Histopathological examination was consistent with SFT with ABC-like change.
LESSONS
This is the first documented case of SFT with ABC-like change in the cranial fossa. This should be considered a differential diagnosis when treating a lesion in the cranial fossa, such as in this case, to achieve complete resection of the tumor and have close follow-up postoperatively.
PubMed: 36051777
DOI: 10.3171/CASE22271 -
Disease Markers 2022This study is aimed at exploring the clinical manifestations and prognostic factors of osteosarcoma.
OBJECTIVE
This study is aimed at exploring the clinical manifestations and prognostic factors of osteosarcoma.
METHODS
The clinical data of patients with osteosarcoma who were treated in our hospital from January 2018 to March 2020 were selected for retrospective analysis. The general information of the patients, including age, gender, tumor diameter, tumor location, tumor type, surgical method, and Enneking stage, distant disease metastasis, KPS score, and the number of postoperative adjuvant chemotherapy, were grouped by prognosis for statistical analysis. The clinical characteristics, morbidity and mortality, and prognostic factors of patients were statistically analyzed.
RESULTS
Among the 83 patients in this group, there were 52 males and 31 females, 59 tumors > 10 cm in diameter and 24 tumors < 10 cm in diameter, 16 tumors in the upper limbs and 67 tumors in the lower limbs, 25 tumors in osteoblastoma, 16 tumors in chondroblastoma, 42 tumors in fibroblastoma, 62 tumors in stage II, and 21 tumors in stage III of Enneking stage, 10 tumors in distant metastasis, and 10 tumors in distant metastasis. The death rate of this group was 19.28% (16/83). Multifactor regression analysis confirmed that the Enneking stage III, distant metastasis, KPS score < 70, and the number of postoperative adjuvant chemotherapy < 6 were important factors influencing the death of osteosarcoma ( < 0.05).
CONCLUSION
Enneking stage III, distant metastasis, KPS score < 70, and the number of postoperative adjuvant chemotherapy < 6 are important influencing factors of osteosarcoma death. Clinical practice can take corresponding preventive and control measures according to the existence of these factors to ensure a good prognosis.
Topics: Bone Neoplasms; Chemotherapy, Adjuvant; Female; Humans; Male; Osteosarcoma; Prognosis; Retrospective Studies
PubMed: 35968499
DOI: 10.1155/2022/1599112 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Aug 2022In this article we reported 13 cases of the substantial nasal mass in children. Among 13 these patients, 3 cases were septal hemangioma, 2 cases were maxillary... (Review)
Review
In this article we reported 13 cases of the substantial nasal mass in children. Among 13 these patients, 3 cases were septal hemangioma, 2 cases were maxillary hemangioma, 1 case was nasal infantile fibromatosis, 1 case was osteoblastoma of the nasal cavity and sinuses, 2 cases were lymphoma of nasopharynx, 1 case was maxillary lymphoma, 1 case was rhabdomyosarcoma of nasopharynx, 1 case was maxillary squamous-cell carcinoma, 1 case was squamous-cell carcinoma of nasopharynx.All 13 cases were treated with surgery, 1 case with nasal infantile fibromatosis, 2 cases with lymphoma of nasopharynx, 1 case with rhabdomyosarcoma of nasopharynx, 1 case with nasopharyngeal carcinoma and 1 case with maxillary carcinoma were taken postoperative radiotherapy and chemotherapy. The most common substantial nasal mass in children was hemangioma. This study included 2 cases with nasal invasive benign tumors, 1 case with nasal infantile fibromatosis and 1 case with osteoblastoma of the nasal cavity and sinuses. The functional nasal endoscopic surgery of mass resection was the main method for the treatment of mass in this area and had achieved satisfied effect. Lymphoma and rhabdomyosarcoma were the most common nasal malignant tumor in children. Nasopharyngeal carcinoma and maxillary carcinoma were not uncommon.
Topics: Bone Neoplasms; Carcinoma, Squamous Cell; Child; Fibroma; Hemangioma; Humans; Lymphoma; Nasal Cavity; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose Neoplasms; Osteoblastoma; Rhabdomyosarcoma
PubMed: 35959585
DOI: 10.13201/j.issn.2096-7993.2022.08.014 -
Surgical Neurology International 2022Gross-total excision of spinal osteoblastomas remains challenging as they are typically found in close proximity to major neural and/or vascular structures. Here, we...
BACKGROUND
Gross-total excision of spinal osteoblastomas remains challenging as they are typically found in close proximity to major neural and/or vascular structures. Here, we found that O-arm navigation allowed for safe/effective excision of a spinal osteoblastoma in a 29-year-old male.
CASE DESCRIPTION
A 29-year-old male presented neurologically intact with mid back pain of 8 months' duration and 2 months of the left-sided chest wall discomfort. X-rays showed a sclerotic left D12 pedicle, while the MRI revealed an extradural lesion in extending into the left D11-12 neural foramen (i.e., hypointense on both T1- and T2-weighted images). The CT scan suggested a "floating" foraminal radiolucent lesion with surrounding vertebral body/posterior elements sclerosis and dense peripheral rim enhancement. These findings were diagnostic for an osteoblastoma. Utilizing O-arm navigation, the nidus and full extent of the lesion were excised (i.e., utilizing intralesional curettage). Two year's postoperatively, there was no MR evidence of tumor recurrence.
CONCLUSION
O-arm navigation provided accurate intraoperative localization to safely and fully excise a left D11- D12 spinal osteoblastoma.
PubMed: 35855177
DOI: 10.25259/SNI_467_2022 -
Frontiers in Surgery 2022Spinal osteoblastomas are primary benign bone tumors most commonly presenting as diffuse back pain in young adults. Rarely, spinal osteoblastoma is associated with...
INTRODUCTION
Spinal osteoblastomas are primary benign bone tumors most commonly presenting as diffuse back pain in young adults. Rarely, spinal osteoblastoma is associated with ossification of the ligamentum flavum (OLF), a form of ectopic bone formation, which can present with myelopathy. This report highlights a unique case of a patient with spinal osteoblastoma, associated OLF, and thoracic myelopathy.
CASE DESCRIPTION
The patient presented with subtle myelopathy consisting of mid-thoracic back pain, paresthesias, and gait instability. Imaging findings were suggestive of spinal osteoblastoma with multifocal OLF. The patient was consented for thoracic decompression and stabilization at the T6-10 levels. Histopathology confirmed osteoblastoma with associated OLF. At follow up, the patient's neurological symptoms had completely resolved.
CONCLUSION
This case describes management for a rare presentation of osteoblastoma with associated OLF and myelopathy. Surgeons should be wary of disproportionate neurological compromise when spinal osteoblastoma is associated with OLF. Further study is required to elucidate the pathogenesis of this condition.
PubMed: 35846967
DOI: 10.3389/fsurg.2022.890965 -
Cureus Jun 2022Benign osteoblastoma is an uncommon, solitary, osteoid, bone-producing tumor containing a rich vascularized delicate fibrous stroma and active osteoblasts. Benign...
Benign osteoblastoma is an uncommon, solitary, osteoid, bone-producing tumor containing a rich vascularized delicate fibrous stroma and active osteoblasts. Benign osteoblastoma is a unique benign bone neoplasm that mostly affects the vertebrae and long tubular bones and rarely affects the maxillofacial skeleton. Many bone-producing lesions have clinical, radiological, and histological features that are similar to osteoblastoma. Benign osteoblastoma manifests clinically as localized swelling of the jaw, presenting as an asymptomatic or a symptomatic lesion, and proper investigations are necessary for accurate diagnosis. It usually manifests in the second and third decades of life predominantly in males. In this report, we present a case of benign osteoblastoma of the mandible in a 39-year-old male patient. The lesion was treated by complete surgical excision, and uneventful wound healing was observed during the one-year postoperative follow-up period.
PubMed: 35822148
DOI: 10.7759/cureus.25799 -
Dentistry Journal Jun 2022Mineralized lesions of the jaws are often found incidentally on radiographs and computed tomography. Most of them are benign, and only a few rare cases are associated... (Review)
Review
BACKGROUND
Mineralized lesions of the jaws are often found incidentally on radiographs and computed tomography. Most of them are benign, and only a few rare cases are associated with malignant transformation. However, there is little clinical data on successful rehabilitation with implants in patients with mineralized lesions. This narrative review aimed to study the efficiency and safety of dental implantation in the area of hyperdense lesions.
MATERIALS AND METHODS
A PubMed, Google Scholar, and Science Direct database search was carried out with keywords and manually.
RESULTS
The literature exploration identified 323 articles; only 19 of them matched the search criteria and reported cases about dental implantation in the lesion area. It has been shown that in 84.2% of described cases, dental implantation was successful: in the osteoid osteoma, odontoma, cementoblastoma, idiopathic osteosclerosis, and condensing osteitis areas dental implantation was performed without any complications. The possibility of lesion recurrence and implant failure limited the use of dental implants in the area of osteoblastoma and cemento-osseous dysplasia. Although most cases of dental implantation in hyperdense jaw lesions were successful and were not accompanied by complications, further research is needed.
PubMed: 35735649
DOI: 10.3390/dj10060107 -
Frontiers in Surgery 2022Osteoblastoma (OB) is a benign bone tumor with aggressive behavior and a tendency for local recurrence. The appropriate surgical strategy for spinal OB remains unclear....
Osteoblastoma (OB) is a benign bone tumor with aggressive behavior and a tendency for local recurrence. The appropriate surgical strategy for spinal OB remains unclear. This retrospective study aimed to verify the clinical efficacy and safety of intralesional marginal resection of OB in the mobile spine. We enrolled 50 consecutive patients with spinal OB between January 2009 and December 2019. The tumors were staged based on the Enneking system, with 21 and 29 lesions being determined as stage 2 (St.2) and stage 3 (St.3), respectively. Among them, 42 patients underwent intralesional marginal resection, five underwent extensive curettage, and three underwent en bloc resection successfully since their lesions were limited to the posterior element in a single vertebra. We analyzed clinical characteristics, perioperative and follow-up images, surgical details, and follow-up data. Within a median follow-up duration of 50 (range: 24-160) months, six (12.0%) patients had local recurrence. The recurrence rates among patients who underwent intralesional marginal resection, curettage, en bloc resection were 7.1%(3/42), 60.0%(3/5), and 0%(0/3), respectively. The recurrence rate of intralesional marginal resection of St.3 lesions was slightly higher than that of St.2 lesions (7.7%[2/26] vs. 6.3%[1/16]). There were 16(38.1%), 3(60.0%), and 0 patients with surgical complications among those who underwent intralesional marginal resection, curettage, and en bloc resection, respectively. Local recurrence was observed in five (5/14, 35.7%) patients who had vertebral artery extension and in none who did not have vertebral artery extension (= 0.02). Our findings suggest that intralesional marginal resection could be an appropriate treatment choice for patients with spinal OB, both St.2 and St.3 lesions, with an acceptable local recurrence rate and a low risk of complications. Vertebral artery extension could be a strong risk factor for local recurrence in patients with spinal OB.
PubMed: 35733437
DOI: 10.3389/fsurg.2022.838235 -
Journal of Clinical Imaging Science 2022The performance of preoperative embolization on a spinal tumor can be a useful adjunctive procedure that minimizes blood loss and complications, particularly for both...
The performance of preoperative embolization on a spinal tumor can be a useful adjunctive procedure that minimizes blood loss and complications, particularly for both metastatic and non-metastatic hypervascular tumors. We discuss two cases of hypervascular spinal tumors that were successfully treated with preoperative embolization and surgery. The first patient was an 18-year-old man who presented with cervical and shoulder pain for two months without paralysis or weakness. Magnetic resonance imaging revealed a tumor located in the D2 posterior vertebral arch that extended into the spinal canal and compressed the spinal cord. The second patient was a 68-year-old man with back pain that radiated to the legs for ten days. Magnetic resonance imaging revealed a mass in the L4 vertebral body. Both patients received tumor embolization and surgery. After surgery, neither patient experienced any major complications. Histological examination revealed osteoblastoma in the first patient and plasmacytoma in the second patient.
PubMed: 35673594
DOI: 10.25259/JCIS_20_2022 -
Cureus May 2022Background/Aim Oral epithelia demonstrate a broad spectrum of pre-cancerous, cancerous, and benign lesions. The aim of this study was to record and analyze the...
Background/Aim Oral epithelia demonstrate a broad spectrum of pre-cancerous, cancerous, and benign lesions. The aim of this study was to record and analyze the prevalence of various oral and intraosseous lesions, highlighting malignancies that are hard to clinically identify as such too. Materials and methods A series of 536 oral lesions were collected covering a period of 8.5 years. Epidemiological and clinico-histopathological data were stratified and analyzed retrospectively. Results According to extensive differential analysis, the male to female ratio for oral squamous cell carcinoma was estimated at 1:1, for pre-cancerous lesions at 1:2, and for lichen planus at 1:5. The prevalent diagnostic category were cysts (n = 223, 41.6%). The biological behavior of lesions differed among anatomic sites (P<0.001). Concordance between clinical suspicion of pre-cancerous or malignant lesions and histological verification was 96.4% (P<0.001). Conclusions Primary intraosseous squamous cell carcinoma, acinic cell carcinoma, clear cell myoepithelial carcinoma, aggressive osteoblastoma/parosteal osteosarcoma, and undifferentiated carcinoma raised no clinical suspicion of malignancy reflecting the importance of training in oral biopsy taking.
PubMed: 35572462
DOI: 10.7759/cureus.24956