Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): Guidelines for medical 3D printing and appropriateness for clinical scenarios

Este número da revista Cadernos de Estudos Sociais estava em organização quando fomos colhidos pela morte do sociólogo Ernesto Laclau. Seu falecimento em 13 de abril de 2014 surpreendeu a todos, e particularmente ao editor Joanildo Burity, que foi seu orientando de doutorado na University of Essex, Inglaterra, e que recentemente o trouxe à Fundação Joaquim Nabuco para uma palestra, permitindo que muitos pudessem dialogar com um dos grandes intelectuais latinoamericanos contemporâneos. Assim, buscamos fazer uma homenagem ao sociólogo argentino publicando uma entrevista inédita concedida durante a sua passagem pelo Recife, em 2013, encerrando essa revista com uma sessão especial sobre a sua trajetória

Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios

Abstract Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.https://deepblue.lib.umich.edu/bitstream/2027.42/146524/1/41205_2018_Article_30.pd

Advanced Applications of Rapid Prototyping Technology in Modern Engineering

Rapid prototyping (RP) technology has been widely known and appreciated due to its flexible and customized manufacturing capabilities. The widely studied RP techniques include stereolithography apparatus (SLA), selective laser sintering (SLS), three-dimensional printing (3DP), fused deposition modeling (FDM), 3D plotting, solid ground curing (SGC), multiphase jet solidification (MJS), laminated object manufacturing (LOM). Different techniques are associated with different materials and/or processing principles and thus are devoted to specific applications. RP technology has no longer been only for prototype building rather has been extended for real industrial manufacturing solutions. Today, the RP technology has contributed to almost all engineering areas that include mechanical, materials, industrial, aerospace, electrical and most recently biomedical engineering. This book aims to present the advanced development of RP technologies in various engineering areas as the solutions to the real world engineering problems

The of Application of 3D-Printing to Lumbar Spine Surgery

Rapid prototyping refers to the manufacturing process in which a three-dimensional (3D) digital model can be transformed into a physical model by layering material in the shape of successive cross sections atop of previously layers. Rapid prototyping has been increasing in popularity in the field of medicine and surgery due to the ability to personalize various aspects of patient care. The thesis will explore the use of rapid prototyping in lumbar spine surgery, aim to quantify the accuracy of medical imaging when relating to imaged structures and their corresponding models produced by rapid prototyping, and determine if complex patient-specific guides are accurate and safe

Chondrosarcoma of the spine: A case report in Sarawak General Hospital

Introduction: Chondrosarcoma represent a heterogenous group of tumors characterized by their ability of cartilage formation. Chondrosarcoma of spine is a rare condition with estimated incidence around 2% to 12% . Most frequently localized in thoracic spine followed by cervical and lumbar region. Discussion: We herein report a case of spinal chondrosarcoma over thoracic spine in 58 years old gentleman. He presented with progressive swelling over the back and incomplete neurological deficit for 3 months. MRI thoracic spine showed T6 to T18 posterior spinal soft tissues, neoplastic mass with lamina arches, spinous process, adjacent posterior ribs bony erosion and spinal cord compression. Core biopsy revealed Chondrosarcoma, Grade 1. Patient underwent excision of thoracic mass, posterior instrumentation and fusion T4 -T10 with removal of pedicle of T6, T7,T8. Intraoperatively, noted tumor measuring 20cm x 20cm extending from T6-T8, involving spinous process, lamina and pedicle. Laminectomy done and tumor was excised in 1 piece together with lamina and spinous process. Postoperatively, muscle power improves to 5 from L3 to S1. Patient was discharge home well with wheelchair ambulation on day 14 post operation. Conclusion: Chondrosarcoma is known to be resistance to both chemotherapy and radiotherapy. So, surgery is critically importance in managing spinal chondrosarcoma. En-block resection of chondrosarcoma with disease free margin reduce recurrence as low as 3-8%. Knowing the facts, the stability will be greatly affected due to extensive involvement to spinal column, we decided to proceed with posterior instrumentation. Surgery should aim at preserving or even improving functionality, relieving pain and controlling local tumor recurrence, promising a prolonged survival

A rare case of sacrococcygeal squamous cell carcinoma

Introduction: Sacrococcygeal neoplastic lesions are extremely rare. Primary benign or malignant lesion are lesser than 7% of all intraspinal lesions. Patients with sacral tumors present with non-specific symptoms, including pain, palpable mass, and neurologic deficits. Despite the advancement of imaging modalities, it is still a diagnostic and therapeutic challenge. Squamous cell carcinoma (SCC) of this area is very rare. A few case reported with acquired condition or underlying congenital or developmental remnants. A chronic sacrococcygeal pilonidal disease with SCC transformation is described by Michalopoulos et al. Demirel AH et al reported the incident of SCC with underlying tailgut cyst in 73 yearold female. CT-scan and MRI is done to define the anatomic origin, extent, and radiologic features of a given lesion. Biopsy is commonly performed to obtain histologic diagnosis. In this paper we report a primary squamous cell carcinoma in this region. Discussion: A 52 year-old lady who presented with five months history of painless right-sided sacral swelling associated with right radicular pain, urinary incontinence and constipation. No constitutional symptoms. The swelling is 8x8 cm in size, firm to hard consistency, non-mobile, smooth surface, illdefined border and not fixed to the overlying skin. Plain X-Ray of Pelvis revealed right sided sacrococcygeal expensile lytic lesion with ill-defined margin. CT-Scan of pelvis showed sacrococcygeal heterogenous mass associated with bony destruction and compression on bladder and rectum. MRI revealed aggressive sacrococcygeal mass with local bony invasion and sacral nerve root S2-S5 involvement. Biopsy was performed and HPE result was consistent with Squamous Cell Carcinoma (SCC). Systemic staging showed metastases to bilateral lungs. Palliative Care was planned with multidisciplinary team involvement. Conclusion: Sacrococcygeal Squamous Cell Carcinoma is very rare. Diagnosis remained challenging even with advancement of imaging modalities. Biopsy is required to confirm tissue diagnosis. Treatment requires multi-disciplinary team approach to ensure survival of the patien

“Not what it seems to be” : A rare case of left ulna brodie’s abscess in children

Introduction: Brodie abscess is a subacute hematogenous osteomyelitis characterized by intraosseous abscess formation. It is typically localized in the metaphysis of tubular bones, particularly in the lower limbs. The diagnosis in upper extremities is challenging and can mimics bone tumor because there is no characteristic finding on an X-ray and no obvious inflammatory response. There's very few study reporting Brodie Abscess in upper extremities especially Ulna Bone. The treatment is drainage and curettage that leaves large cavity requiring bone grafting. This a case of Brodie's abscess in the left ulna healed with spontaneous rupture and antibiotic. Discussion: A 7 year-old girl presented with a month history of left distal forearm painless swelling. There was no history of trauma, constitutional symptom or febrile illness prior to presentation. At first presentation, the examination revealed a well defined swelling 4x3 cm, firm to hard consistency, fixed to the underlying structures but not to the overlying skin. The plain X-ray of left radius ulna showed radiolucent expansile lytic lesion of the diaphysis of ulna bone with nidus formation with distal ulna cortical destruction. Blood tests showed normal white count and inflammatory markers. While waiting for scheduled MRI, she had a painless sinus discharging pus of the left distal forearm and a reduction in the size of the swelling. She was otherwise well. The second left ulna plain radio-graph shows less lucency with improved distal ulnar cortex appearance. Diagnosis of brodie's abscess is obtained following radiographic nidus formation with self-drained abscess. She was treated with cefuroxime for eight weeks. Conclusion: Brodie's abscess of the ulna is rare and never been reported before in the literature. The Xray may mimic bone tumor presentations. MRI and tissue biopsy is required to confirm diagnosis. In our case, she had a spontaneous ruptured swelling while waiting for MRI and treated non operatively

Metastatic erector spinae tumor underlying primary lung adenocarcinoma with paraneoplastic secreting beta-human chorionic gonadotropin hormone: A rare case report

Introduction: Beta-human chorionic gonadotropin (β-HCG) hormone is physiologically produced by syncytiotrophoblast cells in the placenta during pregnancy. It is also a specific marker for trophoblastic tumors of placenta and gestational tumors. In rare case, a rise in serum β-HCG may be due to ectopic secretion especially in epithelial carcinoma namely lung CA and other tumors. Here, we report a case of a middle-age woman presenting with rapid growing back swelling with amenorrhea and high serum β-HCG with underlying primary lung cancer. Discussion: 48 year-old single lady, ex-smoker and nulliparous presented with painful rapid growing back swelling for 3 months associated with marked loss of weight and appetite for 9 months. She was amenorrheic for 3 months. A firm mass located at left paraspinal area with 6x6cm in size, fixed to the underlying muscle and skin, irregular surface and border. Other systemic examinations was unremarkable. Serum β-HCG was high 1142mIU/ml. Transvaginal Ultrasonography was normal. Chest X-Ray showed consolidation over left middle zone of the lung. CT-TAP had left lung mass measuring 5.6x4.6x2.8cm with left hilar lymphadenopathy. MRI of whole spine revealed left erector spinae intramuscular lesion with adjacent inflammatory changes with no intraspinal extension. Tissue HPE showed fragments of fibrocollagenous tissue with malignant cell infiltration arranged in cords and glandular pattern. The malignant cells displayed mild pleomorphism with hyperchromatic nuclei and eosinophilic cytoplasm. Immunohistochemical study has positive CK7 and GATA3 with negative CK20 and TTF-1. These features are consistent with metastatic adenocarcinoma likely primary lung adenocarcinoma. Bronchoscopy-guided biopsy was performed and confirmed the diagnosis. She was then referred to oncology for further management. Conclusion: Ectopic secretion of β-HCG in lung carcinoma is not well understood and has not been well reported in literature. Therefore, such presentation may mimic various condition and this may result in delay of diagnosis. More studies are required for better understanding

Extraskeletal soft tissue chondroma of right thumb : A rare case

Introduction: Extraskeletal soft tissue chondroma (ESSC) is a rare benign cartilaginous soft tissue tumour. It represents around 1.5% of all benign soft tissue tumours. ESSC is slow growing tumour arising from extra-osseous and extra-synovial location. Predominantly occurs in hands and feet especially in the fingers. We report a rare case of ESSC of right thumb treated with marginal excision. Discussion: A 31 years-old gentleman presented with progressively increasing painless swelling over his right thumb past 7 months. The swelling is 3x3cm in size, volar aspect of right thumb interphalangeal joint. Swelling was lobulated, firm in consistency, mobile and non-tender. No neurological involvement. Plain radiograph of the right thumb demonstrated well demarcated soft tissue swelling palmar side of right thumb with internal calcification and no underlying bony erosion. Marginal excision was performed. Intra operatively found that tumour is arising from flexor tendon sheath. Macroscopically tumour is greyish, firm, lobulated measuring 2.5x2x1.5cm. Histopathological examination revealed cartilaginous matrix with occasional binucleation of chondrocytes. There is presence of myxoid change areas, calcification and ossification. Conclusion: Clinical diagnosis might be challenging given the rarity of the disease. Combination of clinical, radiological and histopathology examination are necessary to diagnose ESSC. Marginal en-bloc excision is the first line of treatment to prevent local recurrenc