scholarly journals Aneurysmal bone cyst of proximal fibula treated with en-bloc excision: a rare case report

2019 ◽  
Vol 5 (4) ◽  
pp. 736
Author(s):  
Piyush Wadhawan ◽  
Atul Agrawal ◽  
Ruchit Khera
Keyword(s):  
Bone Cyst ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Radiographic Findings ◽  
Proximal Fibula ◽  
Rare Case Report ◽  
Aneurysmal Bone Cysts ◽  
En Bloc Excision ◽  
Bloc Excision

Aneurysmal bone cysts (ABCs) are benign but locally destructive, blood filled reactive lesions of the bone. Although a wider age group may be affected, most commonly they are seen in patients younger than 20 years of age, with a slight female preponderance. Most common sites include metaphysis of femur followed by tibia and then humerus. Vertebral lesions involving the posterior elements are common.Aneurysmal bone cyst of proximal fibula is a rare and uncommon. Here, we report a case of 13 year old female with classic histologic, clinical, and radiographic findings that was treated by en bloc resection. <p class="Default"> </p>

Two-Stage En Bloc Resection of Multilevel Cervical Chordomas With Vertebral Artery Preservation: Operative Technique

2017 ◽  
Vol 14 (5) ◽  
pp. 538-545 ◽  
Author(s):  
Xingwen Wang ◽  
Eldan Eichbaum ◽  
Fengzeng Jian ◽  
Dean Chou
Keyword(s):  
Vertebral Artery ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Nerve Roots ◽  
Cervical Nerve ◽  
En Bloc ◽  
Bloc Spondylectomy ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Cervical Chordoma

Abstract BACKGROUND En bloc excision of cervical chordoma is a technically complex procedure, due to the involvement and closeness of the tumor to the spinal cord, cervical nerve roots, and vertebral arteries. Studies have previously shown that en bloc excision of chordomas with negative margins improves local control and prolongs disease-free survival compared with intralesional excision. True en bloc spondylectomy in the cervical spine is not feasible since bilateral vertebral artery sacrifice is not possible. However, for lateralized tumors, en bloc excision of chordoma can be performed with unilateral vertebral artery preservation by parasagittal osteotomy. OBJECTIVE To describe the operative technique of performing en bloc excision of cervical chordoma via parasagittal osteotomy. METHODS Four patients underwent en bloc excision of multilevel cervical chordomas via parasagittal osteotomy between 2008 and 2016. These 4 cases of chordoma were at the upper-cervical, mid-cervical, and cervicothoracic regions. We analyzed the tumor location, oncological staging, surgical technique, and perioperative complications. RESULTS All 4 patients underwent en bloc excision of chordoma with expandable cage reconstruction and posterior instrumentation. Cervical nerve roots were sacrificed in 2 patients, and vertebral artery ligation was performed in 3 patients. Complications include new neurologic deficit, implant failure, and pharyngeal erosion after radiation. No tumor recurrence was seen. CONCLUSION Parasagittal osteotomy is a useful alternative to en bloc spondylectomy in the treatment of lateralized multilevel cervical chordoma, preserving one vertebral artery while still achieving an en bloc resection.

scholarly journals Combined posterior hemiosteotomies and stabilization with lateral thoracotomy for en bloc resection of thoracic paraspinal primary bone tumors: technical note

2016 ◽  
Vol 24 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Mauricio J. Avila ◽  
Jesse Skoch ◽  
Vernard S. Fennell ◽  
Sheri K. Palejwala ◽  
Christina M. Walter ◽  
...  
Keyword(s):  
Bone Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Technical Note ◽  
En Bloc ◽  
Primary Bone Tumors ◽  
Primary Bone ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Lateral Thoracotomy

Primary bone tumors of the spine are rare entities with a poor prognosis if left untreated. En bloc excision is the preferred surgical approach to minimize the rate of recurrence. Paraspinal primary bone tumors are even less common. In this technical note the authors present an approach to the en bloc resection of primary bone tumors of the paraspinal thoracic region with posterior vertebral body hemiosteotomies and lateral thoracotomy. They also describe 2 illustrative cases.

Expansile aneurysmal bone cyst in the tubular bones of the hand treated with en bloc excision and autograft reconstruction: a report of 12 cases

2011 ◽  
Vol 36 (8) ◽  
pp. 648-655 ◽  
Author(s):  
D. Jafari ◽  
K. Jamshidi ◽  
F. Najdmazhar ◽  
H. Shariatzade ◽  
O. Liaghat
Keyword(s):  
Tumor Recurrence ◽  
Bone Cyst ◽  
Joint Motion ◽  
En Bloc ◽  
Aneurysmal Bone Cysts ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Partial Resorption ◽  
Tubular Bones ◽  
Low Rate

Primary aneurysmal bone cysts (ABCs) in the small tubular bones of the hands are rare and optimal treatment is not yet established. Between August 1997 and June 2009, 12 patients with biopsy-proven expansile primary ABCs of the small tubular bones of the hand were treated with en bloc tumor excision and strut autograft reconstruction. The adjacent joint was preserved if feasible, otherwise it was fused. Patients were followed for at least 2 years (mean = 7 years). All grafts were incorporated except for partial resorption in one. There was only one tumor recurrence about 1 year after the operation. Other complications included premature physeal arrest in one case and limitation of adjacent joint motion in three. A relatively low rate of recurrence and other complications indicates that this technique would serve as a good strategy for patients with expansile ABCs in the hand in terms of safety, simplicity and reduced number of re-operations.

Giant Cell Tumours of the Hand

1996 ◽  
Vol 21 (5) ◽  
pp. 683-687 ◽  
Author(s):  
B. K. S. SANJAY ◽  
G. A. RAJ ◽  
D. A. YOUNGE
Keyword(s):  
Giant Cell ◽  
Giant Cell Tumour ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cell Tumour ◽  
Fibular Graft ◽  
En Bloc ◽  
Giant Cell Tumours ◽  
En Bloc Excision ◽  
Bloc Excision

A study of seven cases of giant cell tumours of the hand is reported. All tumours were treated by an en bloc excision of the tumour or by whole ray resection. En bloc resection of the tumour and reconstruction with a fibular graft where necessary should be considered as the treatment of choice in giant cell tumour of the hand.

Parosteal Osteogenic Sarcoma of the Mastoid Bone

1997 ◽  
Vol 106 (9) ◽  
pp. 729-732 ◽  
Author(s):  
Daniel R. Seely ◽  
George A. Gates
Keyword(s):  
Surgical Treatment ◽  
Osteogenic Sarcoma ◽  
Signs And Symptoms ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Long Bones ◽  
En Bloc ◽  
Radiographic Findings ◽  
Surrounding Soft Tissue ◽  
Mastoid Bone

Parosteal osteogenic sarcoma (POS) is an uncommon surface bone tumor, most often arising from the metaphyseal end of long bones. Involvement of the cranial bones is rare, with only 1 case of mastoid bone POS previously reported in the literature. Two patients with POS of the mastoid are presented, 1 followed up for 25 years after surgical treatment. The presenting signs and symptoms, as well as distinctive radiographic findings, are discussed. Histologic features are also described. Typically, cranial POS appears as a sessile, densely ossified surface growth with radiating bone spicules that blend with surrounding soft tissue. Treatment is en bloc resection, which is curative in most cases.

scholarly journals Appendiceal Adenocarcinoma Presenting as a Rectal Polyp

2016 ◽  
Vol 10 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Erin Fitzgerald ◽  
Lilian Chen ◽  
Moises Guelrud ◽  
Harmony Allison ◽  
Tao Zuo ◽  
...  
Keyword(s):  
Rectal Wall ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Rectal Polyp ◽  
Preoperative Imaging ◽  
En Bloc ◽  
Lower Quadrant ◽  
Operative Strategy ◽  
Radiographic Findings ◽  
Appendiceal Adenocarcinoma

Appendiceal adenocarcinoma typically presents as an incidentally noted appendiceal mass, or with symptoms of right lower quadrant pain that can mimic appendicitis, but local involvement of adjacent organs is uncommon, particularly as the presenting sign. We report on a case of a primary appendiceal cancer initially diagnosed as a rectal polyp based on its appearance in the rectal lumen. The management of the patient was in keeping with standard practice for a rectal polyp, and the diagnosis of appendiceal adenocarcinoma was made intraoperatively. The operative strategy had to be adjusted due to this unexpected finding. Although there are published cases of appendiceal adenocarcinoma inducing intussusception and thus mimicking a cecal polyp, there are no reports in the literature describing invasion of the appendix through the rectal wall and thus mimicking a rectal polyp. The patient is a 75-year-old female who presented with spontaneous hematochezia and, on colonoscopy, was noted to have a rectal polyp that appeared to be located within a diverticulum. When endoscopic mucosal resection was not successful, she was referred to colorectal surgery for a low anterior resection. Preoperative imaging was notable for an enlarged appendix adjacent to the rectum. Intraoperatively, the appendix was found to be densely adherent to the right lateral rectal wall. An en bloc resection of the distal sigmoid colon, proximal rectum and appendix was performed, with pathology demonstrating appendiceal adenocarcinoma that invaded through the rectal wall. The prognosis in this type of malignancy weighs heavily on whether or not perforation and spread throughout the peritoneal cavity have occurred. In this unusual presentation, an en bloc resection is required for a complete resection and to minimize the risk of peritoneal spread. Unusual appearing polyps do not always originate from the bowel wall. Abnormal radiographic findings adjacent to an area of gastrointestinal pathology may signify locally advanced disease from a surrounding organ that secondarily involves the gastrointestinal tract. These findings warrant further investigation prior to any intervention to ensure appropriate treatment.

scholarly journals Primary Aneurysmal Bone Cyst and Its Recent Treatment Options: A Comparative Review of 74 Cases

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2362
Author(s):  
Nils Deventer ◽  
Martin Schulze ◽  
Georg Gosheger ◽  
Marieke de Vaal ◽  
Niklas Deventer
Keyword(s):  
Aneurysmal Bone Cyst ◽  
Bone Cyst ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Treatment Modalities ◽  
En Bloc ◽  
Intralesional Curettage ◽  
Cyst Volume ◽  
Comparative Review ◽  
The Mean

(1) Background: An aneurysmal bone cyst (ABC) is a benign, locally aggressive tumor. Different treatment modalities are described in the literature i.e., en bloc resection, intralesional curettage and percutaneous sclerotherapy. (2) Methods: This single-center study is a review of 74 patients with primary ABCs who underwent a surgical treatment or polidocanol instillation. Cyst volume measurements using MRI and conventional radiographs are compared. (3) Results: The mean pre-interventional MRI-based cyst volume was 44.07 cm3 and the mean radiographic volume was 27.27 cm3. The recurrence rate after intralesional curettage with the need for further treatment was 38.2% (13/34). The instillation of polidocanol showed a significant reduction of the initial cyst volume (p < 0.001) but a persistent disease occurred in 29/32 cases (90.6%). In 10 of these 29 cases (34.5%) further treatment was necessary. After en bloc resection (eight cases) a local recurrence occurred in two cases (25%), in one case with the need for further treatment. (4) Conclusions: MRI scans are superior to biplanar radiographs in the examination of ABCs. Sequential percutaneous instillations of polidocanol are equally effective in the therapy of primary ABCs compared to intralesional curettage. However, several instillations have to be expected. In a considerable number of cases, a conversion to intralesional curettage or en bloc resection may be necessary.

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