Clear cell chondrosarcoma of proximal femur: a rare entity with diagnostic dilemma

2020 ◽  
Vol 13 (10) ◽  
pp. e236389
Author(s):  
Manish Pruthi ◽  
Jagandeep Singh Virk ◽  
Anila Sharma ◽  
Vivek Mahawar
Keyword(s):  
Femoral Head ◽  
Clear Cell ◽  
Correct Diagnosis ◽  
Malignant Neoplasm ◽  
Diagnostic Dilemma ◽  
Clear Cell Chondrosarcoma ◽  
High Local Recurrence Rate ◽  
Appropriate Treatment ◽  
Slow Growing

Clear cell chondrosarcoma is an extremely rare malignant neoplasm. The rarity and slow-growing nature of this tumour often lead to prolonged symptoms and also initial misdiagnosis with benign lesions such as chondroblastoma. It can also be confused with avascular necrosis of the femoral head when the lesion is located in the femoral head, as was in the case we report. The patient was kept on observation and conservative treatment for almost 9 years before the correct diagnosis and appropriate treatment. Wide local resection with negative margins forms the mainstay of treatment since intralesional procedures predispose to high local recurrence rate. A prolonged follow-up is recommended since late local recurrences and metastases are common.

Bifocal clear cell chondrosarcoma of femoral head.

1998 ◽  
Vol 170 (3) ◽  
pp. 802-803 ◽  
Author(s):  
G de Pinieux ◽  
P Anract ◽  
E Pessis
Keyword(s):  
Femoral Head ◽  
Clear Cell ◽  
Clear Cell Chondrosarcoma

scholarly journals Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14-17
Author(s):  
Md Saiful Islam ◽  
Md Masudar Rahman ◽  
M Fardil Hossain Faisal ◽  
Md Alamgir Jalil Pramanik ◽  
Muhammad Abdur Rouf
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Dilemma ◽  
Peritoneal Tissue ◽  
Appropriate Treatment ◽  
Liver Surface ◽  
Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

scholarly journals Clear Cell Chondrosarcoma: Clinical Characteristics and Outcomes in 15 Patients

Sarcoma ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
James H. Flint ◽  
Anthony P. Conley ◽  
M. Laura Rubin ◽  
Lei Feng ◽  
Patrick P. Lin ◽  
...  
Keyword(s):  
Median Time ◽  
Clinical Characteristics ◽  
Clear Cell ◽  
Primary Treatment ◽  
Wide Resection ◽  
Rare Entity ◽  
Clear Cell Chondrosarcoma ◽  
Time To Death ◽  
Time To Recurrence

Background. Clear cell chondrosarcoma (CCC) represents less than 6% of all chondrosarcomas, and thus, our understanding of this rare entity is limited. Analyzing clinical characteristics and treatment patterns, thus increasing our knowledge, may improve treatment strategy. We review our institutional experience with 15 patients, including one case with dedifferentiation. Methods. A retrospective review was conducted in CCC patients treated at our institution from 1996 to 2015, with at least 2-year follow-up. Descriptive statistics and Kaplan–Meier survival analyses were performed. Results. Of 19 patients identified, 15 patients had at least 2-year follow-up and were included. The median age at diagnosis was 43 years. 80% were male. The most common presenting signs were pain (12 patients; 80%) and fracture (2 patients; 13.3%). The most common site was proximal femur (8 patients; 53%). All patients had MSTS Stage I disease. Primary treatment included wide resection in 10 patients (67%) and intralesional or marginal resection in 5 patients (33%). Three patients died of disease during the study period, 1 with dedifferentiation of recurrent CCC. The median time to death from disease was 15.3 years (95% CI: (14.2; NA)). The median time to either recurrence or death was 7.73 years for patients who had intralesional/marginal resection and 16.44 years for patients with wide resection (HR (wide vs. intralesional/marginal) = 0.21, 95% CI: (0.04; 1.18), p = 0.053 ). The median time to recurrence or death was significantly shorter for patients not initially treated at a sarcoma center ( p = 0.01 ). Conclusions. CCC is a rare entity, and our understanding of it is still evolving. We observed a higher recurrence rate for intralesional or marginal resection, and wide resection alone remains the mainstay of treatment. Better outcomes were observed in patients initially treated by trained musculoskeletal oncologists. Due to the propensity of CCC to recur decades after initial resection, lifelong surveillance is recommended.

scholarly journals Pantaloon Hernia in a Female: A Rare Finding

2021 ◽  
Vol 3 (2) ◽  
pp. 1-2
Author(s):  
Onyeyirichi Otuu ◽  
Uche Emmanuel Eni ◽  
Callistus Ugochukwu Ndunaka ◽  
Nwanneka Louisa Kwentoh
Keyword(s):  
Inguinal Hernia ◽  
Correct Diagnosis ◽  
Posterior Wall ◽  
Uneventful Recovery ◽  
Indirect Inguinal Hernia ◽  
Left Groin ◽  
Epigastric Artery ◽  
Appropriate Treatment ◽  
Groin Swelling

The incidence of inguinal hernia in females is less compared to the males. Pantaloon hernia in females is even rarer and may be first diagnosed during surgery. We report a rare case of pantaloon hernia in a 60 year old female patient. She presented with reducible left groin swelling of 3 years duration and a clinical diagnosis of an indirect inguinal hernia made. A direct sac and an indirect sac were discovered at operation on both sides of the inferior epigastric artery. The posterior wall was repaired by Lichtenstein method. Patient made an uneventful recovery and there was no recurrence after 12 months of follow up. Though pantaloon hernia is rare in females, proper dissection, and identification of structure in the inguinal canal is necessary to make the correct diagnosis and to offer the appropriate treatment.

scholarly journals Successful en Bloc Resection for Femoral Head Clear Cell Chondrosarcoma Without Biopsy: A Case Report

2021 ◽  
Author(s):  
Manabu Hoshi ◽  
Naoto Oebisu ◽  
Yoichi Ohta ◽  
Ayaka Tomimoto ◽  
Hiroaki Nakamura
Keyword(s):  
Femoral Head ◽  
Clear Cell ◽  
Surgical Margin ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Wide Resection ◽  
Low Grade ◽  
En Bloc ◽  
Postoperative Function ◽  
Clear Cell Chondrosarcoma

Abstract Background: Clear cell chondrosarcoma (CCCS) is a rare, low-grade, malignant chondrogenic bone tumour. This tumour commonly occurs at the epiphysis of long bones, particularly in the proximal femur. Case presentation: This report describes a 58-year-old man with right hip pain since 5 months. Plain radiography, magnetic resonance imaging (MRI), and computed tomography (CT) revealed the characteristic appearance of chondroid mineralisation in the right femoral head, suggesting typical CCCS. Although a biopsy is the gold standard for definite diagnosis before treatment, wide resection with removal of the biopsy tract is thought to affect negatively affect surgical margin and postoperative hip function. En bloc resection without a biopsy and a hip hemiarthroplasty were performed instead. The pathological diagnosis was CCCS, and an adequate surgical margin was obtained. No local recurrence or distant metastases were found, and postoperative function was excellent at the final follow-up. Conclusion: The femoral head is a typical location of CCCS. Wide resection with adequate margins is the main treatment strategy for CCCS. When radiological features are typical, performing an en bloc resection without performing a biopsy is an acceptable treatment that may improve patient outcomes.

scholarly journals Reactive Lesions of Oro-Maxillofacial Region

2021 ◽  
pp. 599-614
Author(s):  
Raja Sekhar Gali
Keyword(s):  
Soft Tissues ◽  
Correct Diagnosis ◽  
Low Grade ◽  
Maxillofacial Region ◽  
Diagnostic Dilemma ◽  
Hormonal Influence ◽  
Facial Region ◽  
Appropriate Treatment ◽  
The Common ◽  
Low Grade Inflammation

AbstractA plethora of pathologies occurs in the skeletal and soft tissues of the oro-facial region that are reactive. These arise as a result of chronic low-grade inflammation, trauma, hormonal influence and other causes. Varied types of clinical, radiological and histological presentations are often associated with these lesions that pose a diagnostic dilemma to the clinician. This chapter describes in detail the common reactive lesions of the maxillofacial region with an emphasis on correlating the clinical and investigational findings to arrive at the correct diagnosis and provide appropriate treatment.

Malignant Neoplasm of Perivascular Epithelioid Cells of the Liver

2006 ◽  
Vol 130 (8) ◽  
pp. 1219-1222 ◽  
Author(s):  
Jeremy R. Parfitt ◽  
Anthony J. Bella ◽  
Jonathan I. Izawa ◽  
Bret M. Wehrli
Keyword(s):  
Clinical Features ◽  
Clear Cell ◽  
Malignant Neoplasm ◽  
Epithelioid Cells ◽  
Immunohistochemical Markers ◽  
Sugar Tumor ◽  
Long Term Follow Up ◽  
Malignant Pecoma

Abstract Neoplasms of perivascular epithelioid cells (PEComas) have in common the coexpression of muscle and melanocytic immunohistochemical markers. Although this group includes entities with distinct clinical features, such as angiomyolipoma, clear cell sugar tumor of the lung, and lymphangioleiomyomatosis, similar tumors have been documented in an increasing diversity of locations. The term PEComa is now generally used in reference to these lesions that are not angiomyolipomas, clear cell sugar tumors, or lymphangioleiomyomatoses. While most reported PEComas have behaved in a benign fashion, malignant PEComas have occasionally been documented. We present a case of hepatic PEComa with benign histologic features, which nonetheless presented with metastases to multiple sites nearly 9 years later. This case represents the second documented malignant PEComa of the liver, as well as the longest follow-up of a surviving patient with a malignant PEComa, emphasizing both the need for criteria that more accurately predict the behavior of PEComas and the necessity of long-term follow-up of patients with PEComas.

Clear cell chondrosarcoma of bone: long time follow-up of 18 cases

2007 ◽  
Vol 128 (2) ◽  
pp. 137-142 ◽  
Author(s):  
Davide Donati ◽  
Jun-qiang Yin ◽  
Marco Colangeli ◽  
Simone Colangeli ◽  
Claudia Di Bella ◽  
...  
Keyword(s):  
Clear Cell ◽  
Clear Cell Chondrosarcoma ◽  
Long Time

scholarly journals Acute Pisiform Dislocation in Association with Terrible Triad Injury of the Elbow

2019 ◽  
Author(s):  
Pedro Martins Branco ◽  
João Sousa ◽  
Carlos Maia Dias ◽  
Manuel Oliveira ◽  
António Júlio Silva ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Kirschner Wire ◽  
Ground Level ◽  
Collateral Ligaments ◽  
Terrible Triad ◽  
Range Of Movement ◽  
Rare Injury ◽  
Radial Head Arthroplasty ◽  
Appropriate Treatment

Dislocation of the pisiform is a rare injury, with only few cases reported in the literature. This condition, in association with terrible triad injury of the elbow, is an even more rare occurrence. We report a case of a 51-years-old right-handed female patient who suffered from a dislocation of the left pisiform in association with terrible triad injury of the elbow, after a ground level fall. It was performed a reinsertion of the coronoid process and radial collateral ligaments with anchors, radial head arthroplasty, and closed reduction and internal fixation of the pisiform with Kirschner wire. At the end of follow-up, the patient had satisfactory range of movement of the wrist and elbow, and no residual pain. This rare injury to the wrist is demanding in diagnostics and treatment. However, with a correct diagnosis and appropriate treatment, an excellent clinical outcome can be achieved.

scholarly journals A Comparison of the Effectiveness of Surgical and Nonsurgical Treatment of Legg-Calve-Perthes Disease: A Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Mohammad Taghi Karimi ◽  
Tony McGarry
Keyword(s):  
Femoral Head ◽  
Hip Joint ◽  
Relevant Literature ◽  
Disease Onset ◽  
Treatment Method ◽  
Perthes Disease ◽  
Joint Range Of Motion ◽  
Appropriate Treatment ◽  
Joint Range

Legg-Calve-Perthes disease (LCPD) is a degenerative condition of the hip joint characterised by idiopathic avascular necrosis of the femoral head. Loss of bone mass causes a degree of collapse of the joint and may result in deformity of the ball of the femur and the surface of the hip socket. A reduction in hip joint range of motion, alternation in growth of femoral head, and associated pain are most important problems associated with this disease. Various treatment methods are currently in use and aim to increase containment of the femoral head within the acetabulum, redistribute loading patterns applied to the femoral head, and to decrease the final deformities associated with this condition. These treatments depend on a variety of underlying factors and the aim of this paper was to determine appropriate pathways for treatment and the evidence of treatment method success. A review of the relevant literature was carried out in a variety of data bases including PubMed and ISI Web of Knowledge, and Gale between 1950 and 2011. Research results were categorised depending on the identified treatment method. The success of each treatment pathway was assessed and reasons for the pathway selected were grouped by the age of disease onset, follow-up period, and the final outcome. Evidence relating to the effectiveness of the treatment method used was conflicting. Different methods of screening and follow-up periods were employed in each study which used subjects of varying ages. Minimal evidence of sufficient quality exists in the literature to determine the most appropriate treatment of Legg-Calve-Perthes disease. Research provides some evidence to suggest that nontreatment may be as effective as orthotic or surgical intervention. More research is required to determine the effectiveness of orthotic and surgical treatment.

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