T4 basal cell carcinoma of the forearm

Basal cell carcinoma represents the most common cutaneous malignancy. Most of these tumors are small, easily treated skin lesions that occur on sun-exposed skin. Giant basal cell carcinoma is a rare variant of this tumor that is most often observed on the trunk. Neglect appears to be the main causative factor for such an exceptional presentation. A patient with a T4 (17×14 cm) giant basal cell carcinoma of the left forearm treated by excisional surgery with free margins is reported.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Osteosarcoma of the Proximal Fibula: Report of 3 Cases

Osteosarcoma of the proximal fibula represents about 2% of all osteosarcomas. The complexity of anatomical structures in this region led in the past to low transfemoral amputation in order to achieve local control. Three patients aged 14, 13 and 14 were treated in our institution and surgical margins were free of tumour after a wide en bloc resection. To achieve that, the lateral wall of the tibia and the anterior tibial artery were taken out with the proximal fibula. All three patients are alive without evidence of disease. The functional results are evaluated according to Enneking system recommended and adopted by the Musculo-Skeletal-Tumor Society (M.S.T.S). Overall functional results were 80, 100 and 100%.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Tumeurs desmoïdes.

Desmoid tumor can be defined as a pseudoencapsulated infiltrative growth of well-differentiated collagenous fibroblasts and fibrocytes arising either in fascia or musculoaponeurotic structures. The etiology of desmoid tumors is poorly defined. The most commonly implicated etiologic factors are trauma, hormonal disturbances, and genetic or hereditary factors. Desmoid tumors of the anterior abdominal wall are much less common than extra-abdominal desmoids; they may occur at any age but are most common in the third and fourth decades. Although both sexes may be affected, abdominal desmoids predominate in females, particularly in females of childbearing age. Extra-abdominal desmoids, which most commonly occur on the back, chest wall, head and neck, or lower extremity, have a male predominance. Most patients complain of a painless mass of several months or years' duration. The primary consideration in surgical treatment of desmoid tumors should be the prevention of local recurrence. In most instances, this can be achieved by wide local excision or muscle group resection. There is no clear evidence that irradiation or chemotherapy are effective in controlling desmoid tumors.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Complete fibular regeneration following removal of the fibula for bone grafting

Major bone defects may be reconstructed by either vascularized or not vascularized fibula grafts. No much attention is done so far to the donor site. This article emphasizes on an interesting observation, where almost total regeneration of a subperiosteally harvested fibula graft occurred within the first three postoperative months.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

PEComa of the talus: a unique case of a soft tissue tumor within bone

Introduction: Perivascular epithelioid cell tumor (PEComa) is a family of rare mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelioid cells (PECs). These tumors have been described at multiple anatomic sites. PEComas presenting in bone are especially rare and they have been reported to be either primary or metastatic lesions. None of them is located at the level of the foot. Patient: We report on a case of primary bone PEComa of the talus, the first one to be published to the best of our knowledge. Treatment and result: Limb sparing surgical treatment has been done using intralesional tumor removal, burring and application of argon beam at the tumor walls and primary filling of the tumor cavity by bone cement with so far absence of any tumor recurrence documented by multiple histological sections at second look operation nine months after primary surgery, where cement has been replaced by autologous bone graft, and by subsequent follow-up. Conclusions: PEComa is a very rare tumor, and its presence in bone is especially rare. The here reported case of PEComa presenting at the level of the talus is, to the best of our knowledge, the first case to be reported in the literature.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Chondrosarcoma of the spine :A report of three cases and literature review

Chondrosarcomas of the spine are rare and are difficult to treat. Three cases of chondrosarcoma are presented, and a series compiling similar cases reported in the literature was established. This study shows that chondrosarcomas of the spine are generally smaller, more difficult to excise, and followed by higher local recurrence compared with chondrosarcomas in the peripheral skeleton. The most important prognostic factor for local control is wide or marginal tumour resection. © 2008, Acta Orthopædica Belgica.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Contribution to the vascular origin of the unicameral bone cyst

Vascular occlusion between bone cyst and intramedullary venous system seems to be the primum movens in the genesis of a unicameral bone cyst. High speed injection of saline and alternative aspiration injection of the cyst fluid and reaming of the medullary cavity clearly open vascular channels connecting the bone cyst to the intramedullary venous system. This was monitored by pre- and postmanipulative radiographs. This technique was employed in 12 patients with a unicameral bone cyst. All but one went on to healing with increasing diameter of the cortical bone and filling of the cystic cavity.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Management of periprosthetic fractures in patients treated with a megaprosthesis for malignant bone tumours around the knee.

Early and late infection as well as loosening and mechanical failure are among the postoperative complications most often reported following reconstruction with a tumour prosthesis in patients with a sarcoma around the knee. Scarce instances of periprosthetic fractures have been reported. The literature includes the description of two patients with such a complication, however no treatment recommendation was detailed in those articles. We recorded in our experience two patients with a traumatic fracture following a massive prosthetic bone and joint replacement after major resection for a bone sarcoma. The surgical treatment was open reduction and internal fixation using a cable and plate system, allowing preservation of the prosthesis and providing stable fracture fixation and excellent fracture healing.Journal Articleinfo:eu-repo/semantics/publishe

Treatment of humeral pathological fractures by internal fixation and methylmetacrylate injection

Between 1986 and 1993, 18 patients with complete or impending fractures of the humerus were treated using Hacketall rods in association with semi-liquid methylmetacrylate after excision of the metastatic lesion. Methylmetacrylate was always injected proximally and distally to the curetted bone through drill holes. Fourteen patients had a pathological fracture and four presented with an impending lesion. The mean age at time of surgery was 62 years (range: 42-83). The primary tumour was a breast carcinoma in 10 cases, bronchogenic squamous cell carcinoma in three cases and hypernephroma, multiple myeloma, malignant melanoma, rectal adenocarcinoma and unknown primary tumour in one case each. The left arm was involved in seven cases and the right in 11. All patients experienced immediate relief from the pre-operative pain, although three patients complained of a residual discomfort during motion. In these three cases the residual pain can easily be managed with use of oral non-morphinic drugs. The functional aspect was not evaluated in two patients who died in the early post-operative period as a result of their general condition. In 15 patients, the postoperative range of motion was at least 80% of a normal humerus mobility. One patient encountered motion limitation because of an important lymph oedema. There was no infection, one patient had a temporary radial palsy with a complete restoration after a period of 5 days. No migration of the material was observed during an average follow-up of 9 months (range: 1-24).SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Ewing Sarcoma of the Cubitus Reconstructed by a Non Vascularized Autologous Fibular Graft

A 19-year-old white man presented with an Ewing sarcoma of the left cubitus. A preoperative chemotherapy was administered according to the T9 ROSEN protocol. A wide excision was performed with a 19 cm bone defect, reconstructed in the same operating time by a non vascularized autologous fibular transfer. The postoperative chemotherapy was administered without any major problem. Both surgical and functional evolution are here presented and the osteointegration is evaluated. A discussion of this type of reconstruction is presented evaluating donor site morbidity and possible complications.SCOPUS: ar.jinfo:eu-repo/semantics/publishe