Most investigators believe that fibrous cortical defects and nonossifying fibromas are simply different radiographic manifestations of the same disease process. Fibrous cortical defects are small, asymptomatic, and intracortical lesions, while a nonossifying fibroma is a large, tumorous lesion involving spongy bone and the medullary cavity of bone, and leads to clinical symptoms.A fibrous cortical defect does not require either biopsy or curettage. Asymptomatic nonossifying fibromas require no treatment, but rare symptomatic forms of the disease, and those which are great enough in size to constitute a danger of fracture, should be submitted for curettage and bone grafting.
We report a case of angiosarcoma in a 46-year-old man with cerebral palsy. He had difficulty walking caused by the rapid growth of a tumor mass in his left posterior thigh. The tumor was 24×13cm in size, and was an elastic soft mass giving off local heat. Magnetic resonance imaging and computed tomography showed multivacuoles in the semitendinous muscle and semimembranous muscle with signs of compression of muscle and blood vessels. After biopsy granulation was seen, with bleeding from the wound continuling leading to enucleation of the tumor mass. The pathological diagnosis after surgery was angiosarcoma. Local recurrence occurred post-operatively Note to Anther one-half what (days, months). After wide resection of local tumor, the patient was treated with chemotherapy, radiotherapy and immunotherapy. Multiple metastases to bone occurred eight months later and the patient died thirteen months from onset.
This article describes a right forearm osteosarcoma reconstructed using a free vascularized fibular graft. A 16-year-old girl was admitted to the Fukuoka University Hospital in March 1993 with an 8-week history of pain and swelling of the right forearm. Roentgenography of the right forearm revealed sclerotic change with spiculation and an extended soft tissue mass in the distal region of the radius. The patient received combination chemotherapy with cyclophosphamide, adriamycin, parapulatin, and caffein. Because chemotherapy was clinically effecitive, the neoplasm was removed with a limb salvage operation and reconstruction carried out using a free vascularized fibular gragt. Five months after the operation, the grafted fibular bone fused with the remaining radius, and the function of the right elbow, foream, and wrist joint are excellent. Vascularized bone grafting may be useful for reconstruction of large bone defects in malignant tumors as well as in this case.
An osteoid osteoma in a 19-year-old female was diagnosed with Magnetic Resonance Imaging (MRI). She had an obstinate pain at day-break for 1 year. On physical examination her Lasègue's sign was positive. MRI was performed to discover any lumbar disc herniation, and demonstrated a tumor in the left vertebral arch of the third lumbar spine. The tumor had high signal intensity with a very low signal in the center on the T2-weighted image. The MRI findicgs showed the nidus of the osteoid osteoma.
We report a case of coracoid process fracture with clavicle fracture. A 32-year-old-male was injured and suffered open clavicle fracture by a direct blow. He also suffered a coracoid process fracture. Initially a correct diagnosis could not be made. When contusions around the shoulder are seen, the possibility of a coracoid process fracture should always be kept in mind.
A case of suppurative arthritis by Serratia Marcescen was reported.The patient was a sixty-seven years old male who complained of pain and swelling in his right hip.Roentgenographically in this case, destructive changes in the femoral head and acetabulum had been obsered within short duration. Especially disappearance of the femoral head had been observed within about three weeks.Serratia Marcescens was verified in bacteria culture from joint fluid and synovial tissue.Focal curettage and medication of Astromycin 400mg/day and Flomoxef sodium 2g/day for about a month post-operation, were administered, and thereafter his symptom and laboratory data, including C-reactive Protein and erythrocyte sedimentation rate, were improved.He was satisfied with the result of our treatment though using the hip brace.
Heterotransplantation of a human liposarcoma in nude mice was used to evaluate the efficiency of Menogaril as a new antitumor agent. The in vivo model was successfully produced by tranplantation of cloning cells from a human liposarcoma cultured cell line. The cultured layer was established from a myxoid liposarcoma. The drug was administered orally to the models by 3 different methods. The administration group demonstrated marked growth inhibition of the tumors. In conclusion, administration of Menogaril was effective in the in vivo model.
Three patient with chronic osteomyelitis of the calcaneus have been treated surgically (curettage and bone graft in two, curettage only in one) and intra-arterial antibiotics. The results in all patients were satisfactory in that the infection was eradicated and the patients were able to walk again without any support.
To elucidate the precise origin and characteristics of the proliferating cells in malignant fibrous histiocytoma (MFH), the authors analyzed 33 MFH tumors, using immunohistochemical techniques with a panel of 12 antibodies. All three types of MFH cells (spindle cells, polygonal cells, and bizarre giant cells) stained positively for mesenchymal antigens (FU3 and vimentin) but did not stain for macrophage/histiocyte markers (HAM 56 and CD68). Therefore, the MFH cells may not represent true histiocytes, although they may be mesenchymal-derived cells behaving as "facultative histiocytes" with superficial resemblance to actual histiocytes. Normal histiocytes in the stroma tested positive for macrophage/histiocyte antigens; the most common cells were HAM 56-positive cells constituting 30-80% of nonneoplastic stromal cells, followed by those positive for CD68 (10-50%), Mac 387 (less than 2%), and S-100 protein (less than 1%). Our results indicate the presence of heterogeneity of "histiocytic" cells in MFH. Proliferating-cell nuclear antigen (PCNA) was expressed not only in the spindle and polygonal MFH cells but also in the bizarre giant cells. These findings suggest that all three types of MFH cells participate in the proliferative compartment of MFH. Uneven PCNA staining of the irregular nuclear segments of the bizarre giant cells may result in abnormal DNA synthesis, possibly contributing to the marked diversity of nuclear morphology in MFH. Touton-type and osteoclast-like giant cells did not stain for PCNA but stained positively for histiocytic markers. Therefore, these giant cells may lack proliferative activity and probably result from normal histiocytes fusing together.
