Distal phalangeal bone cysts: differentiation of enchondromata and epidermal cysts

2009 ◽  
Vol 35 (2) ◽  
pp. 144-145 ◽  
Author(s):  
A. Momeni ◽  
N. Iblher ◽  
G. Herget ◽  
T. Bley ◽  
G. B. Stark ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Bone Grafting ◽  
Penetrating Trauma ◽  
Penetrating Injury ◽  
Epidermal Cyst ◽  
Bone Lesions ◽  
Bone Cysts ◽  
History Of ◽  
Phalangeal Bone

Enchondromas are common in the hand but less frequent in the distal phalanges. Epidermal cysts are rare in the hand but when they occur can be difficult to differentiate from enchondromas both clinically and radiologically. Our review of seven distal phalangeal bone lesions treated over 7 years included four enchondromas and three epidermal cysts. The patients with epidermal cysts all had a history of previous penetrating trauma 5–8 years earlier. One patient with an enchondroma had a history of a penetrating injury. Patients presenting with distal phalangeal lesions and a history of previous penetrating injury appear more likely to have an epidermal cyst than an enchondroma. This is important as there may be a higher recurrence rate following curettage and bone grafting.

Cystic Bone Lesions in Horses and Humans: A Comparative Review

1998 ◽  
Vol 11 (01) ◽  
pp. 08-18 ◽  
Author(s):  
C. W. McIlwraith ◽  
J. A. Auer ◽  
Brigitte von Rechenberg
Keyword(s):  
Recurrence Rate ◽  
Subchondral Bone ◽  
Fibrous Tissue ◽  
Clinical Signs ◽  
Bone Lesions ◽  
Anatomical Location ◽  
Cystic Lesions ◽  
Bone Cysts ◽  
Biological Behaviour ◽  
Comparative Review

SummaryCases of cystic bone lesions in horses and humans were reviewed in the literature. These lesions are radiolucent areas of bone, recognized as subchondral cystic lesions in the horse (SCL), intra-osseous ganglia (IOG), subchondral bone cysts secondary to osteoarthrosis (OAC), and unicameral bone cysts (UCB) in humans. Their morphology is quite similar, consisting of lesions with a distinct cyst wall, and a cavity filled with fibrous tissue and yellowish mucoid fluid. The lesions are surrounded by sclerotic bone and can be easily diagnosed radiographically. SCL, IOG and OAC occur in the subchondral bone close to the adjacent joint, whereas UCB occur in the metaphysis of long bones. Their aetiology and pathogenesis is still unknown, although primary damage to the subchondral bone, cartilage or local blood supply and growth disturbances are discussed. In this review 703 lesions of SCL in horses, 289 lesions of IOG and 1460 lesions of UCB in humans were compared in their anatomical location and clinical signs. SCL and OAC resembled each other with respect to anatomical location. A correlation of affected bones could not be found for all four groups. Clinical presentation concerning age was most similar for SCL and UCB with both lesions mainly occurring in young individuals. Gender predominance of males was present in SCL, IOG and UCB. Clinical diagnosis was either incidental, or connected with intermittent pain in all lesions except for OAC. Additionally, the lesions were also found in conjunction with degenerative joint disease (SCL, OAC) or pathological fractures (UCB). Cystic bone lesions were either treated conservatively, surgically with curettage alone, curettage in combination with grafting procedures, or intra-lesional application of corticosteroids. SCL and UCB were similar in their biological behaviour concerning their slow response to the therapy and relatively high recurrence rate. None of the cystic bone lesions were comparable, and a common aetiology and pathogenesis could not be found.In a literature review cases of cystic bone lesions in horses and humans were compared with the goal to find a common aetiology and pathogenesis. Cystic bone lesions occur in horses as subchondral cystic lesions (SCL), and in humans as either intra-osseous ganglia (IOG), subchondral cystic lesions secondary to osteoarthrosis (OAC) or unicameral bone cysts (UCB). IOG and OAC compare with SCL mainly in the anatomical location. IOG and SCL resemble each other in size, clinical signs and histology, whereas UCB and SCL show a similar biological behaviour regarding their therapeutic response and recurrence rate. None of the cystic bone lesions in humans were comparable to the SCL in horses in all aspects. A common aetiology and pathogenesis could not be established.

scholarly journals Vocal Folds: An Unusual Hideout for Systemic Sarcoidosis

2019 ◽  
pp. 1-6
Author(s):  
Anis Hariz ◽  
Abir Derbel ◽  
Ines Kechaou ◽  
Imène Boukhris ◽  
Mohamed Salah Hamdi ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Folds ◽  
Unknown Etiology ◽  
Bone Lesions ◽  
Granulomatous Disease ◽  
Upper Respiratory Tract ◽  
History Of ◽  
Upper Respiratory ◽  
Systemic Sarcoidosis ◽  
Phalangeal Bone

Sarcoidosis is a chronic inflammatory granulomatous disease of unknown etiology. It can expand to all organs and tissues. Lungs and lymph nodes are the most commonly involved tissues. Laryngeal sarcoidosis is rare, accounting for no more than 1% of patients with systemic sarcoidosis. We herein report the case of a 51-year-old female presenting a two-year history of persistent voice hoarseness with direct laryngoscopy findings of epiglottis swelling and irregular swelled and bruised left vocal fold. Histological examination highlighted the presence of non-caseating granulomas. Further investigations revealed similar histological findings in the nasal cavity as well as lymphocytic alveolitis. It also showed the presence of phalangeal bone lesions of both hands. All these pointed to the diagnosis of sarcoidosis with upper respiratory tract (nasal and laryngeal), lung and bone involvement. The patient was started on 0.5 mg/kg daily of prednisone for 1 month followed by progressive tapering with lasting favorable outcome.

scholarly journals Surgically resected skull base meningiomas demonstrate a divergent postoperative recurrence pattern compared with non–skull base meningiomas

2016 ◽  
Vol 125 (2) ◽  
pp. 431-440 ◽  
Author(s):  
Alireza Mansouri ◽  
George Klironomos ◽  
Shervin Taslimi ◽  
Alex Kilian ◽  
Fred Gentili ◽  
...  
Keyword(s):  
Skull Base ◽  
Recurrence Rate ◽  
Postoperative Recurrence ◽  
Prior History ◽  
Skull Base Tumors ◽  
Who Grade ◽  
Predictors Of Recurrence ◽  
History Of ◽  
Skull Base Meningiomas

OBJECTIVE The objective of this study was to identify the natural history and clinical predictors of postoperative recurrence of skull base and non–skull base meningiomas. METHODS The authors performed a retrospective hospital-based study of all patients with meningioma referred to their institution from September 1993 to January 2014. The cohort constituted both patients with a first-time presentation and those with evidence of recurrence. Kaplan-Meier curves were constructed for analysis of recurrence and differences were assessed using the log-rank test. Cox proportional hazard regression was used to identify potential predictors of recurrence. RESULTS Overall, 398 intracranial meningiomas were reviewed, including 269 (68%) non–skull base and 129 (32%) skull base meningiomas (median follow-up 30.2 months, interquartile range [IQR] 8.5–76 months). The 10-year recurrence-free survival rates for patients with gross-total resection (GTR) and subtotal resection (STR) were 90% and 43%, respectively. Skull base tumors were associated with a lower proliferation index (0.041 vs 0.062, p = 0.001), higher likelihood of WHO Grade I (85.3% vs 69.1%, p = 0.003), and younger patient age (55.2 vs 58.3 years, p = 0.01). Meningiomas in all locations demonstrated an average recurrence rate of 30% at 100 months of follow-up. Subsequently, the recurrence of skull base meningiomas plateaued whereas non–skull base lesions had an 80% recurrence rate at 230 months follow-up (p = 0.02). On univariate analysis, a prior history of recurrence (p < 0.001), initial WHO grade following resection (p < 0.001), and the inability to obtain GTR (p < 0.001) were predictors of future recurrence. On multivariate analysis a prior history of recurrence (p = 0.02) and an STR (p < 0.01) were independent predictors of a recurrence. Assessing only patients with primary presentations, STR and WHO Grades II and III were independent predictors of recurrence (p < 0.001 for both). CONCLUSIONS Patients with skull base meningiomas present at a younger age and have less aggressive lesions overall. Extent of resection is a key predictor of recurrence and long-term follow-up of meningiomas is necessary, especially for non–skull base tumors. In skull base meningiomas, recurrence risk plateaus approximately 100 months after surgery, suggesting that for this specific cohort, follow-up after 100 months can be less frequent.

scholarly journals Primary Occipital Ewing’s Sarcoma with Subsequent Spinal Seeding

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Ali Alqahtani ◽  
Roaa Amer ◽  
Eman Bakhsh
Keyword(s):  
Posterior Fossa ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Bone Cancer ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Bone Lesions ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine

Ewing’s sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing’s sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT) imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) seeding from the L5 to the S4 vertebrae. Primary cranial Ewing’s sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing’s sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing’s sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.

scholarly journals Autoinfarction of Giant Parathyroid Adenoma after Preoperative Withdrawal of Anticoagulants

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Raoul Verzijl ◽  
Pim J. Bongers ◽  
Geetha Mukerji ◽  
Ozgur Mete ◽  
Karen M. Devon ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Elective Surgery ◽  
Histopathological Examination ◽  
Neck Mass ◽  
Bone Lesions ◽  
Imaging Studies ◽  
Cystic Change ◽  
Parathyroid Adenomas ◽  
History Of ◽  
Brown Tumors

A 71-year-old man with known history of atrial fibrillation (treated with routine rivaroxaban therapy) was found to have incidental biochemical elevated calcium and parathyroid hormone (PTH) levels. His physical examination demonstrated the presence of a palpable right neck mass. Subsequent imaging studies revealed a large parathyroid mass as well as multiple bone lesions, raising the suspicion of parathyroid carcinoma. The anticoagulant therapy was stopped 5 days prior to his elective surgery. The night before his elective surgery, he presented to the emergency room with profound hypocalcemia. The surgery was postponed and rescheduled after calcium correction. Intraoperative findings and detailed histopathological examination revealed an infarcted 4.0 cm parathyroid adenoma with cystic change. His bony changes were related to brown tumors associated with long-standing hyperparathyroidism. Autoinfarction of a large parathyroid adenoma causing severe hypocalcemia is a rare phenomenon and may be considered in patients with large parathyroid adenomas after withdrawal of anticoagulants.

scholarly journals Clinical and laboratory differences between extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative bacteria in febrile urinary tract infection in pediatrics

2021 ◽  
Vol 11 (1) ◽  
pp. e2-e2
Author(s):  
Manijeh Kahbazi ◽  
Parsa Yousefichaijan ◽  
Danial Habibi ◽  
Somaie Nejabat ◽  
Amirreza Najmi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Recurrence Rate ◽  
Urine Analysis ◽  
Third Generation ◽  
Extended Spectrum ◽  
First Choice ◽  
Febrile Uti ◽  
History Of ◽  
Tract Infections ◽  
Third Generation Cephalosporins

Introduction: The prevalence of urinary tract infections (UTIs) due to extended-spectrum beta-lactamase (ESBL)-producing bacteria is rising, which needs more potent antibiotics, such as carbapenems. Objectives: To evaluate the clinical and laboratory differences between ESBL-positive and ESBL-negative bacteria in febrile UTI in children between one month to seven years to indicate prognostic parameters for ESBL+ UTI and to suggest appropriate antibiotic treatment. Patients and Methods: This cross-sectional study investigated 282 patients diagnosed with the first febrile UTI. The participants were assigned to ESBL-positive and ESBL-negative UTI groups. The groups were compared based on their clinical and laboratory characteristics and outcomes; the infant group was assessed separately (with the onset age of <3 months). Results: The ESBL UTI was detected in 10.2% of the cases with a history of more frequent hospitalization (P=0.002), longer hospitalization (P=0.04), higher recurrence rate (P=0.003), and more red blood cell count in urine analysis findings (P=0.02). In the antimicrobial susceptibility assay, the ESBL-positive UTI group indicated resistance to third-generation cephalosporins; nevertheless, 93.1% of the cases responded clinically. The infant group showed 13% of the patients with ESBL-positive UTI that was correlated with a history of longer preonset hospital stay (P=0.001), elevated C-reactive protein (CRP) concentration (P=0.002), and elevated recurrence rate (P=0.03), compared to the older group. Conclusion: The ESBL UTI should be further considered due to the resulted recurrence rate. The antimicrobial sensitivity assay indicated resistance to third-generation cephalosporins; however, these drugs are applied as the first choice due to the high response rate. Aminoglycosides are applicable as second choice drugs prior to initiating the use of carbapenems, if third-generation cephalosporins did not indicate bactericidal impacts on ESBL UTI.

scholarly journals Radiotherapy for Recurrent Keloid: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 89-91
Author(s):  
Christina Hari Nawangsih Prihharsanti ◽  
Muhamad Rizqi Setyarto ◽  
Dion Firli Bramantyo
Keyword(s):  
Connective Tissue ◽  
Recurrence Rate ◽  
Corticosteroid Injection ◽  
Inflammatory Cells ◽  
Early Postoperative Period ◽  
High Recurrence Rate ◽  
Surrounding Soft Tissue ◽  
History Of

Background: Keloid is a benign growth of connective tissue. There are several risk factors that play a role in keloid growth. Excision surgery is one of the modalities in the treatment of keloids. However, excision surgery alone has a recurrence rate of 45-100%.Case: Male, 37 years old, with complaints arising from a keloid lesions in the left earlobe since three years ago with a history of previous injuries. The lesions is then operated on but always grows back postoperatively. The number of surgeries that have been carried out three times with further treatment in the form of corticosteroid injection. However, keloid still recurrence. Finally it was decided to undergo treatment with surgery followed by radiotherapy within a period of no more than 24 hours postoperatively. Follow-up after six months gave good results without recurrence.Discussion: Keloid has a high recurrence rate after excision surgery. Surgery followed by radiotherapy has a low recurrence rate compared to surgery or surgery followed by administration of corticosteroid injections. Radiotherapy as adjuvant therapy for postoperative keloid excision has the role of sterilizing the connective tissue stem cell active fibroblasts and acute inflammatory cells that grow in the early postoperative period. A study states that administration of postoperative radiation with electrons in keloids in the earlobe at a dose of 15 Gy in three fractions gives a low recurrence rate and a low risk of side effects in the surrounding soft tissue. 

scholarly journals  Early surgical intervention is indicated for recurrent spontaneous pneumothorax in children and adolescents

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Cody Tragesser ◽  
Brian W. Gray, MD ◽  
Matthew P. Landman, MD, MPH
Keyword(s):  
Recurrence Rate ◽  
Chest Tube ◽  
Spontaneous Pneumothorax ◽  
Surgical Intervention ◽  
Univariate Analysis ◽  
X Rays ◽  
Radiographic Findings ◽  
Radiographic Measurements ◽  
Ipsilateral Recurrence ◽  
History Of

Background: Primary spontaneous pneumothorax (PSP) occurs most often in adolescent patients. There is consensus that surgical intervention plays an important role in preventing recurrence, however, the optimum timing of surgery is debated. We hypothesize that clinical and radiographic factors are associated with eventual need for surgery.  Experimental Design: We searched the medical record for PSP patients between ages 9 and 21 treated from 1/1/08 to 12/31/17 and collected data on chest tube management, radiographic measurements, operative management, and recurrence. We performed univariate analysis on relationships between admission events and eventual surgery or other management strategies.  Results: We identified 68 PSP admissions from 31 patients. Considering only first-time admissions, there was no association between eventual surgery and clinical factors and radiographic findings.  The single factor associated with eventual surgery was history of pneumothorax in any lung (p=0.015). For patients with prior pneumothorax who underwent surgery, operation the day after admission would have reduced hospital stay by an average of 1.5 days (min=0, max=9) and an average of 2.2 days (min=0, max=10) if performed on the day of admission, with a mean 1.85 fewer chest x-rays (min=0, max=7). Considering only first admissions, ipsilateral recurrence rate was 16.7% after surgery, 46.7% after chest tube alone, and 100% after observation alone.  Conclusion: This analysis suggests that though eventual surgery is difficult to predict, ipsilateral recurrence rate is reduced following surgery. Furthermore, earlier operation in recurrent patients could reduce resource utilization. Thus, expedited surgical treatment may merit consideration in patients with a history of pneumothorax. 

scholarly journals A patient with a history of breast cancer and multiple bone lesions: a case report

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Marie-Angela Schnyder ◽  
Paul Stolzmann ◽  
Gerhard Frank Huber ◽  
Christoph Schmid
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Bone Lesions ◽  
History Of
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