Clear Cell Chondrosarcoma of the Proximal Tibia. Case Reports

Introducción: El condrosarcoma de células claras es un subtipo de tumor poco frecuente del grupo de los condrosarcomas de bajo grado. A diferencia de los condrosarcomas convencionales, estos tumores se presentan principalmente en epífisis de huesos largos. Dadas sus características líticas de aspecto quístico, pueden confundirse con quistes óseos, por lo que su diagnóstico debe hacerse por histopatología e inmunohistoquímica mediante biopsia. Igualmente, la negatividad para citoqueratinas y anticuerpos antiendomisio es una herramienta para descartar el diagnóstico diferencial de metástasis. Su tratamiento es quirúrgico, bien sea con manejo intralesional o resección completa con márgenes libres. Presentación del caso: Mujer de 46 años quien consultó al servicio de ortopedia oncológica de una institución de IV nivel de atención por un cuadro clínico de 8 meses de evolución consistente en dolor en la cara medial de la rodilla izquierda a nivel de la tibia proximaluna. Se practicaron imágenes diagnósticas que mostraron una lesión quística en el platillo tibial lateral; se ordenó biopsia de la lesión, y mediante histopatología e inmunohistoquímica se diagnosticó condrosarcoma de células claras. Se realizó un manejo quirúrgico con resección de la lesión con márgenes libres y una reconstrucción del defecto óseo con un aloinjerto estructural de tibia proximal, con lo cual se obtuvo una evolución satisfactoria. Conclusiones: Se presenta el caso de una paciente con un subtipo de condrosarcoma de bajo grado infrecuente en su presentación y localización, quien fue diagnosticada mediante inmunohistoquímica y tratada quirúrgicamente para lograr un salvamento exitoso de su extremidad.Introduction: Clear cell chondrosarcomas are a rare type of low-grade chondrosarcoma. Unlike conventional chondrosarcomas, these tumors occur mainly in the epiphyses of long bones, especially in the proximal femur and proximal humerus. Given their lytic characteristics with a cystic appearance, they can be mistaken for bone cysts and diagnosed late. Diagnosis must be made based on histopathology and immunohistochemistry. Likewise, negativity for cytokeratins and anti-endomysial antibodies are tools to rule out the differential diagnosis of metastasis. The treatment of this low-grade chondral lesion is surgical, either with intralesional management or complete resection. Case presentation: This is the case of a 46-year-old woman who consulted the orthopedic oncology service of a quaternary care institution due to medial knee pain at the level of the proximal tibia for 8 months. Diagnostic imaging studies showed a cystic lesion in the lateral tibial plateau; a biopsy of the lesion was performed, and clear cell chondrosarcoma was diagnosed based on histopathology and immunohistochemistry. Surgical management included tumor-free resection margins and reconstruction of the bone defect with a structural allograft of the proximal tibia. The patient progressed satisfactorily. Conclusions: This was the case of a patient with a subtype of low-grade chondrosarcoma that is rare in incidence and location, who was diagnosed based on immunohistochemistry and treated surgically to achieve a successful limb salvage.https://orcid.org/0000-0001-6852-0350https://orcid.org/0000-0002-7894-3442https://orcid.org/0000-0001-7982-4552https://orcid.org/0000-0001-6637-0766https://orcid.org/0000-0003-2860-0713Revista Nacional - IndexadaN

Management of chondroblastoma of the femoral head by controlled hip dislocation technique and use of allograft : case report

Epiphyseal Chondroblastoma (EC) is known to be a very rare tumor with highly aggressive local capacity despite its benign nature. We report a case of a female patient treated for long lasting right hip pain diagnosed with EC of the femoral head. The lesion was treated with complete local resection by means of controlled surgical hip dislocation, “trap door” technique and use of allograft. Functional results in the short run where adequate with no local recurrence and no metastatic lung lesions. Nonetheless, during follow up, Avascular Necrosis (AVN), posterior dislocation of the femoral head and coxa magna took place, requiring multiple re interventions that allowed adequate functionality after 1 year of the initial surgery.https://orcid.org/0000-0002-6405-5030https://orcid.org/0000-0002-5643-0785https://orcid.org/0000-0003-2860-0713https://orcid.org/0000-0001-9209-8137https://orcid.org/0000-0001-7982-4552N/

Malignant Paraganglioma of the Carotid Body with Multiple Metastatic Involvement : A Rare Case

Los paragangliomas son tumores neuroendocrinos raros derivados de las porciones simpáticas y parasimpáticas de los paraganglios y la presencia de metástasis, si bien es muy infrecuente es la que determina la malignidad. Se presenta el caso de un hombre de 34 años con un paraganglioma del cuerpo carotídeo con afectación metastásica múltiple: en hueso, ganglios, hígado y pulmón. Dado el estadio avanzado de la enfermedad no era candidato a cirugía y se le brindó tratamiento sintomático. Falleció dos semanas luego de su ingreso, por falla hepática secundaria al compromiso metastásico.Paragangliomas are rare neuroendocrine tumors derived from the sympathetic and parasympathetic portions of the paraganglia, the presence of metastasis although it is very infrequent, is what determines the malignancy. We present the case of a 34-year-old man with a carotid body paraganglioma with multiple metastatic involvement of bone, nodes, liver, and lung. Given the advanced stage of the disease, he was not a candidate for surgical management, symptomatic management. He died 2 weeks after admission due to liver failure secondary to metastatic involvement at this levelhttps://orcid.org/0000-0001-5505-9710https://orcid.org/0000-0002-7756-1805https://orcid.org/0000-0001-7982-4552https://orcid.org/0000-0002-5956-483

Diagnostic difficulties in congenital tumor with positive antibodies for skeletal muscle. Lipofibromatosis case report

Neonatos con Tumores congénitos de partes blandasIntroduction: Congenital soft tissue tumors are uncommon; proper diagnosis calls for histopathological experience and ancillary techniques based upon immunohistochemial, cytogenetic, and molecular biology. Following excision, intermediately aggressive soft tumors tend to local recurrence, which significantly impacts prognosis; some cases occur close to malignity; subsequently, diagnostic implications are enormous for the patient. Case report: A 26-day old neonate with a posterior left thigh mass entered hospital. Initial biopsy analysis could not rule out either striated muscle origin or malignancy; resection and classification of surgical piece followed. Pursuant to resection, using immunohistochemistry panel, tumor analysis and classification took place. Conclusion: Soft tumor diagnosis is a complex process, even more so for newborns. Infrequent occurrence requires that examiners have ample histopathological experience in the handling of ancillary techniques. Furthermore, as in lipofibromatosis, determining the presence of trapped vs. malignant tissue hinders proper classification, which, in turn, has profound implications for the patient. We include a standard diagnostic algorithm based on clinical and histological characteristics for this type of congenital lesions.https://orcid.org/0000-0003-3507-7596https://orcid.org/0000-0001-8932-4877https://orcid.org/0000-0002-7147-425Xhttps://orcid.org/0000-0001-7982-4552Revista Internacional - No indexadaN

Cutaneous collision tumor associated with porocarcinomatous and angiosarcomatous components : a potential diagnostic pitfall

Q4Q3Reporte de casoe128-e132Sarcomatoid eccrine porocarcinoma (SEP) is a very rare malignancy including epithelial and mesenchymal components exhibiting pleomorphic cells, nuclear hyperchromasia, and high mitotic activity in both elements. To date, only 6 cases of this uncommon neoplasm have been reported, corresponding to women over 70 years of age with ulcerated skin lesions. The authors describe the first sarcomatoid eccrine porocarcinoma in a 75-year-old male patient with a right hallux lesion, presenting a collision tumor with a mixed population of epithelial cells and a spindle cell angiosarcomatous mesenchymal component each expressing distinct and nonoverlapping morphologic and immunohistochemical features of epithelial and mesenchymal differentiation

Chondromyxoid fibroma in the iliac. Case report

Se trata de un paciente masculino de 31 años con diagnóstico de fibroma condromixoide del ilíaco derecho manejado en el Hospital Universitario San Ignacio en febrero del 2018. El paciente fue llevado inicialmente a biopsia abierta para confirmación histológica, posteriormente fue llevado a embolización preoperatoria, manejo intralesional con curetaje, fresado extendido, manejo adyuvante local y aplicación de cemento óseo. Se realiza seguimiento postoperatorio por 18 meses sin evidencia clínica ni radiográfica de recidiva tumoral. El objetivo de este trabajo es hacer una revisión de la literatura sobre el fibroma condromixoide con énfasis en su localización pélvica y su tratamiento. Nivel de Evidencia: IVPacientes con Fibroma condromixoide en el iliacoWe report a case of a 31-year-old male patient with diagnosis of chondromyxoid fibroma (CMF) of the iliac bone diagnosed at Hospital Universitario San Ignacio in february 2018; an open biopsy allowed recognizement and description of cytologic features, forward diagnosis and treatment with combination of pre-operative embolization, local and extended curettage, local adyuvance and bone cement as described. At 18 months follow-up have found the patient remains without clinical or radiologic recurrence of CMF. We made a review of literature on chondromixoid fibroma emphasizing on pelvic bones compromise regarding diagnosis and management options. Evidence Level: IVhttps://orcid.org/0000-0003-2186-0328https://orcid.org/0000-0001-7982-4552https://orcid.org/0000-0003-4913-7764https://orcid.org/0000-0002-8360-6192https://orcid.org/0000-0002-7640-7718Revista Nacional - IndexadaN

Inestabilidad microsatelital y cáncer gástrico

Microsatellite instability is caused by an alteration of the mismatch repair systems, which can affect microsatellites within the entire human genome, causing errors in their replication. Published studies, mainly in the English literature, have found thaRevista Nacional - IndexadaCN