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Diagnostic and Interventional Imaging Apr 2024
Topics: Humans; Sarcoma; Soft Tissue Neoplasms; Hemangioma; Hemangioendothelioma; Biomarkers, Tumor
PubMed: 38388250
DOI: 10.1016/j.diii.2024.02.008 -
Skeletal Radiology Feb 2024Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive, incisionless, radiation-free technology used to ablate tissue deep within the body. This... (Review)
Review
Magnetic resonance-guided focused ultrasound (MRgFUS) is a noninvasive, incisionless, radiation-free technology used to ablate tissue deep within the body. This technique has gained increased popularity following FDA approval for treatment of pain related to bone metastases and limited approval for treatment of osteoid osteoma. MRgFUS delivers superior visualization of soft tissue targets in unlimited imaging planes and precision in targeting and delivery of thermal dose which is all provided during real-time monitoring using MR thermometry. This paper provides an overview of the common musculoskeletal applications of MRgFUS along with updates on clinical outcomes and discussion of future applications.
PubMed: 38363419
DOI: 10.1007/s00256-024-04620-8 -
Journal of Medical Case Reports Feb 2024Osteomas are asymptomatic, benign tumors and are diagnosed accidentally by radiological investigations conducted for other reasons. In some cases, they may cause...
BACKGROUND
Osteomas are asymptomatic, benign tumors and are diagnosed accidentally by radiological investigations conducted for other reasons. In some cases, they may cause aesthetic or functional symptoms by affecting nearby organs. The cause of osteoma is still dialectical. Many theories suggest that inflammation, trauma, or congenital causes are behind its formation. In our case, the patient presented with a symptomatic and huge osteoma in the frontoparietal bone caused by trauma from 18 years ago.
CASE PRESENTATION
A 24-year-old Syrian woman came to our hospital complaining of headaches, syncope episodes, blurred vision, and tumor formation in the frontoparietal region. The medical and surgical histories of the patient revealed appendectomy and head trauma when she was 6 years old in a traffic accident. Radiological investigations showed thickness in the space between the two bone plates in the left frontoparietal region, which reached the orbital roof without cortical destruction or periosteum reaction; the tumor size was 5 cm × 5 cm. A surgical excision was indicated. Under general anesthesia, the surgery was done for the tumor excision. The histopathology examination emphasized the diagnosis of osteoma. The follow-up for 7 months was uneventful.
CONCLUSION
This paper highlights the importance of focusing on the medical history of patients with osteoma in an attempt to explain the reasons for its occurrence. It stresses the need to put osteoma within the differential diagnoses of skull tumors.
Topics: Female; Humans; Young Adult; Bone and Bones; Craniocerebral Trauma; Diagnosis, Differential; Osteoma
PubMed: 38331951
DOI: 10.1186/s13256-024-04373-x -
The Journal of Craniofacial Surgery Feb 2024Traditionally forehead bony lesion is approached directly through the forehead skin or invasive coronal incision resulting prominent scar. An endoscopic approach through...
Traditionally forehead bony lesion is approached directly through the forehead skin or invasive coronal incision resulting prominent scar. An endoscopic approach through mini hairline incisions may provide a unique way to achieve the best esthetic results, but often time the authors encounter potential soft tissue injury from the high-speed burr. The authors present a case with multiple frontal bone osteoma lesions which were successfully removed through 2 small hairline incisions with the help of an otorhinolaryngological system and an innovative mini-trocar. Significant improvement in forehead shape with minimal scars was observed at an 18-month follow-up. This innovative and easily manipulating technique may help surgeons achieve better outcomes when treating frontal bone osteoma endoscopically.
PubMed: 38330386
DOI: 10.1097/SCS.0000000000009921 -
Journal of Neurosurgery. Case Lessons Feb 2024Osteoid osteoma is a common benign bone tumor frequently seen in the frontoethmoid region. However, involvement of the skull base is rare, with few cases previously...
BACKGROUND
Osteoid osteoma is a common benign bone tumor frequently seen in the frontoethmoid region. However, involvement of the skull base is rare, with few cases previously reported.
OBSERVATIONS
The authors report two cases of spontaneous, symptomatic frontoethmoidal osteoma: one presented with neurological deficit secondary to tension pneumocephalus and the other with cerebrospinal fluid leakage. The first case was managed with a transfrontal sinus craniotomy and pneumocephalus decompression with osteoma resection and skull base reconstruction. The second case was managed with a uninaral endoscopic endonasal approach to the anterior skull base with osteoma resection and reconstruction.
LESSONS
Given the paucity of cases with associated tension pneumocephalus described in the literature, it was relevant to describe the authors' experience with surgical decision-making and the expected outcomes among patients with this pathology when using minimally invasive techniques.
PubMed: 38315987
DOI: 10.3171/CASE23699 -
Medicine Feb 2024Osteoid osteoma (OO) is a benign lesion characterized by an increased fibrous component in the bone marrow, presence of bone-like structures within the medullary cavity,... (Review)
Review
BACKGROUND
Osteoid osteoma (OO) is a benign lesion characterized by an increased fibrous component in the bone marrow, presence of bone-like structures within the medullary cavity, and a surrounding sclerotic bone rim. Reports on OO located in the posterior proximal tibia are rare.
CASE SUMMARY
Herein, we report the case of an 18-year-old male, admitted for the evaluation of right knee pain. The right knee pain had started 6 months prior without any apparent cause, which was notably severe at night, affecting sleep, and was exacerbated while climbing stairs or bearing weight. The patient also experienced pain on flexion. Three-dimensional computed tomography and magnetic resonance imaging revealed a nodular lesion beneath the cortical bone of the posterior medial plateau of the right tibia and an abnormal signal focus on the posterior lateral aspect of the right tibial plateau associated with extensive bone marrow edema. A small amount of fluid was present in the right knee joint capsule. The patient subsequently underwent arthroscopic excision of the OO. Postoperatively, there was significant relief of pain, and the knee range of motion returned to normal.
CONCLUSION
Although OO in the posterior proximal tibia is a rare occurrence, it can be effectively excised through minimally invasive arthroscopic visualization.
Topics: Male; Humans; Adolescent; Tibia; Osteoma, Osteoid; Bone Neoplasms; Pain; Knee
PubMed: 38306554
DOI: 10.1097/MD.0000000000037076 -
European Journal of Medical Genetics Apr 2024Familial Adenomatous Polyposis (FAP) is a colorectal cancer (CRC) predisposition syndrome caused by germline APC mutations and characterised by an increased risk of CRC...
BACKGROUND
Familial Adenomatous Polyposis (FAP) is a colorectal cancer (CRC) predisposition syndrome caused by germline APC mutations and characterised by an increased risk of CRC and colonic polyps and, in certain forms, of specific prominent extraintestinal manifestations, namely osteomas, soft tissue tumours and dental anomalies. Pachydysostosis of the fibula is a rare clinical entity defined by unilateral bowing of the distal portion of the fibula and elongation of the entire bone, without affectation of the tibia.
CLINICAL REPORT
We report a 17-year-old male, who presented with a non-progressive bowing of the right leg detected at 18 months of age caused by a fibula malformation (later characterized as pachydysostosis) and a large exophytic osteoma of the left radius, noticed at the age of 15 years, without gastrointestinal symptoms. There was no relevant family history. Detailed characterisation revealed multiple osteomas, skin lesions and dental abnormalities, raising the hypothesis of FAP. This diagnosis was confirmed by genetic testing [c.4406_4409dup p.(Ala1471Serfs*17) de novo mutation in the APC gene] and endoscopic investigation (multiple adenomas throughout the colon, ileum and stomach).
DISCUSSION
This case report draws attention to the phenotypic spectrum of skeletal manifestations of FAP: this patient has a congenital fibula malformation, not previously associated with this syndrome, but which is likely to have been its first manifestation in this patient. This clinical case also illustrates the challenges in the early diagnosis of FAP, especially without family history, and highlights the importance of a multidisciplinary approach and the adequate study of rare skeletal abnormalities.
Topics: Male; Humans; Adolescent; Adenomatous Polyposis Coli Protein; Fibula; Adenomatous Polyposis Coli; Genes, APC; Germ-Line Mutation; Osteoma
PubMed: 38286305
DOI: 10.1016/j.ejmg.2024.104913 -
Cureus Jan 2024[This retracts the article DOI: 10.7759/cureus.21488.].
[This retracts the article DOI: 10.7759/cureus.21488.].
PubMed: 38274604
DOI: 10.7759/cureus.r133 -
World Journal of Surgical Oncology Jan 2024A malignant myoepithelioma is a rare tumor, mostly arising from the salivary glands. Myoepitheliomas of the ear have rarely been reported. The manuscript reports... (Review)
Review
BACKGROUND
A malignant myoepithelioma is a rare tumor, mostly arising from the salivary glands. Myoepitheliomas of the ear have rarely been reported. The manuscript reports myoepithelial carcinoma of the external auditory canal (EAC) spreading to the infratemporal fossa. A clinician must be aware of anatomical variation of the bony EAC wall, such as the foramen of Huschke. This rare defect may be a pathway for spreading pathologies between these two anatomical regions.
CASE REPORT
We present a case of osteoma-like stenosis of the EAC, which turned out to be an extremely rare malignant tumor. The preoperative MRI and PET/CT revealed that two parts of the tumor communicated through a defect in the antero-inferior portion of the bony ear canal. No distant metastases were detected. Subsequently, the tumor was resected from the ear canal and the infratemporal fossa en bloc. Perioperatively the defect in the EAC wall was suspected of the foramen of Huschke. After the surgery, the older scans of the patient from the past showed no presence of a congenital EAC wall defect. Therefore, the authors concluded that the tumor aggressively grew through the bone due to its biological nature.
CONCLUSION
Malignant myoepithelioma of the external auditory canal is an extremely rare condition and could be misdiagnosed as other benign lesions. In cases of suspicious lesions, it is advisable to do a probatory biopsy from the EAC. Surgery is the treatment of choice in malignant myoepitheliomas, and regular follow-ups are essential to monitor for recurrence or metastatic disease. Any mass located at the antero-inferior portion of the EAC wall warrants close evaluation due to its potential for expansion from the EAC.
Topics: Humans; Ear Canal; Myoepithelioma; Clinical Relevance; Positron Emission Tomography Computed Tomography; Carcinoma
PubMed: 38268020
DOI: 10.1186/s12957-024-03317-5