Tumor Lysis Syndrome due to Eribulin Administration for Metastatic Undifferentiated Pleomorphic Sarcoma of the Buttock

Tumor lysis syndrome (TLS) is a complication of cancer treatment that requires urgent intervention. It is extremely rare in the treatment of soft tissue sarcoma (STS) of the limbs or trunk, and there are currently no reports of TLS occurrence from eribulin therapy. We report the case of a 78-year-old woman with an undiffer-entiated pleomorphic sarcoma on the right buttock. We initiated chemotherapy with intravenous eribulin mesylate. Deterioration of renal function, mild hyperkalemia, hyperuricemia, hypocalcemia, and hyperphos-phatemia were confirmed on examination, suggesting the presence of TLS. We present an extremely rare case of TLS from eribulin for STS

Current Femoral Stem Fixation Selection in Hip-Fracture Bipolar Hemiarthroplasties, and Factors Affecting Surgeons’ Confidence in Their Ability to Teach about Cemented Stems: A Questionnaire in a Region of Japan with Super-Aged Patients

Japan’s hip fracture management guidelines now recommend the use of cemented stems in cases of bone fragility. However, the current stem selection practices in bipolar hemiarthroplasty (BHA) in a super-aging area in Japan remain unclear. This study aimed to examine the stem selection policies, the surgeons’ concerns about cemented stems, and factors affecting their confidence in their ability to coach others on cemented stem procedures. Ninety-four orthopedic surgeons (27 facilities) responded to our web-based questionnaire conducted in January/February 2022. Cementless stem was the first choice of 97.8% of the surgeons; <15% of the respondents expected to increase their use of cemented stems in the future. The cement technique was the greatest concern; almost half of the surgeons described having insufficient experience with cemented stems. The factor that most affected the surgeons’ expertise in using cemented stems is the number of surgeries they had conducted with a cemented stem (multivariable analysis odds ratio 8.42, p=0.001). Greater experience was associated with increased expertise of the surgeons in using cemented stems, with a threshold of 11 cases showing sensitivity of 41.7% and specificity of 98.3% for their confidence to instruct cemented stems

Prevalence, Spinal Alignment, and Mobility of Lumbar Spinal Stenosis with or without Chronic Low Back Pain: A Community-Dwelling Study

Although lumbar spinal stenosis (LSS) occurs almost universally with aging, little is known regarding its actual prevalence and relationships to chronic low back pain (CLBP) in the general population. The presence of CLBP in subjects with LSS may have negative impacts on spinal alignment and mobility. This study evaluated the prevalence of LSS using a self-administered, self-reported history questionnaire in 630 community-dwelling individuals ≥50 years old. Subjects with LSS were further divided into LSS+CLBP and LSS alone groups, and spinal alignment and mobility were compared using a computer-assisted device. Prevalence of LSS was 10.8% in this cohort. Subjects in the LSS+CLBP group (n = 46) showed a significantly more kyphotic lumbar spinal alignment with limited lumbar extension (P < .05), resulting in a stooped trunk compared to subjects in the LSS alone group (n = 22). However, no significant difference in spinal mobility was seen between groups

Deep Angiomyxoma of the Thigh That Is Difficult to Diagnose: A Case Report and Literature Review

We present an extremely rare case of deep angiomyxoma (DAM) in the thigh that was misdiagnosed as desmoid-type fibromatosis. A 40-year-old Japanese woman presented with a mass on the left thigh. The histological diagnosis by needle biopsy was desmoid-type fibromatosis; the tumor grew slowly and was resected 4 years later. The histological diagnosis from the resected tumor was DAM. As of 16 months post-surgery, the patient has not noticed any local recurrence. Although DAM in a lower extremity is extremely rare, clinicians must be aware of its possible occurrence in areas relatively close to the pelvis

A Case of Incomplete Atypical Femoral Fracture with Histomorphometrical Evidence of Osteomalacia

Roughly half of the femoral fracture patients diagnosed with AFF according to the criteria suggested by a task force of the American Society for Bone and Mineral Research (ASBMR) have not undergone bisphosphonate (BP) therapy. One suspected cause of such fractures is severe bone loss due to osteomalacia, but the pathogenesis remains unknown. We report a case of an 84-year-old woman with AFF not treated by BP therapy, in whom underlying osteomalacia was histologically diagnosed. The involvement of femoral curvature and spino-pelvic malaligment in the fracture in the present case was considered

Evaluation of bone mineral density and bone strength in autochthonous transgenic model mice for diabetes mellitus (Akita mice)

AbstractObjectivesDiabetes mellitus (DM) causes secondary osteoporosis, which reduces bone mineral density (BMD) and bone strength. Akita mice (AM) are DM model mice used to evaluate glucose metabolism. However, bone metabolism in AM remains unclear. The purpose of this study was to evaluate BMD, bone strength, and serum sclerostin levels in AM.MethodsFemale AM and control mice (C57/BL/6NCrSlc; CM) were divided into four groups: (1) a CM group sacrificed at 14 (CM-14w; n = 8) or (2) 18 weeks of age (CM-18w; n = 6); and (3) an AM group sacrificed at 14 (AM-14w; n = 9) or (4) 18 weeks of age (AM-18w; n = 6). Blood glucose level, serum sclerostin level, total tibial BMD, and femoral shaft bone strength were evaluated at each time point.ResultsBlood glucose levels were significantly higher in AM than in CM (p < 0.001). Serum sclerostin levels were significantly lower in AM-18w than in CM-18w (p < 0.001). BMD was significantly lower in AM-14w than in CM-14w (p = 0.004). Stiffness of the femoral shaft was significantly lower in AM-18w than in CM-14w (p = 0.04). Body weight (r = 0.608, p < 0.01) and maximum load (r = 0.438, p < 0.05) were significantly positively correlated with serum sclerostin levels, while blood glucose levels showed a significant negative correlation (r = −0.708, p < 0.01).ConclusionsAM showed decreased BMD and bone strength with lower levels of serum sclerostin than CM