A Giant Sacrococcygeal Chordoma: Case Report and Literature Review

Introduction: Chordomas are rare low-grade malignant lesions that are mostly seen in the spine. They constitute about 1% of intracranial tumors and 3-4% of all primary bone tumors. The principal spinal location is usually the sacrococcygeal and infrequently the sphenooccipital and cervical areas. Case Presentation: We present a 74-year-old man with a huge sacrococcygeal mass extending to both buttocks. Computerized tomography (CT-scan) and magnetic resonance imaging (MRI) as well as computerized tomographic angiography (CTA) evaluations were suggestive to chordoma. Immunohistochemical analysis confirmed the diagnosis after the patient was successfully operated on. All aggravating symptoms resolved after the operation. Conclusion: The management of giant sacrococcygeal chordomas can be very challenging but with all-inclusive treatment, complete cure is achievable although recurrence can occur. In our case, surgery alone was curative. Preoperative CTA aided us in achieving total tumor resection.

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Intraosseous Schwannoma of the Calcaneus: A Rare Tumor of the Bone

Case Reports in Orthopedics ◽

10.1155/2018/9824025 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Bahtiyar Haberal ◽

Duygu Turkbey Simsek ◽

Ekin Kaya Simsek

Keyword(s):

Cystic Lesion ◽

Plain Radiograph ◽

Posterior Part ◽

Heel Pain ◽

Primary Bone Tumors ◽

Intraosseous Schwannoma ◽

Long Time ◽

Primary Bone ◽

Magnetic Resonance Imaging Mri ◽

Extended Curettage

Schwannomas (also called neurilemmomas) are slow-growing nerve sheath tumors derived from Schwann cells. However, intraosseous schwannoma is a rare entity with an incidence of only 0.2% in overall primary bone tumors. The purpose of this case report is to present a case of an intraosseous schwannoma of the calcaneus. A 35-year-old woman was admitted to our outpatients’ clinics with a complaint of long-time right heel pain (for approximately eight months). After a suspicious cystic lesion was observed on the patient’s plain radiograph examination, a magnetic resonance imaging (MRI) was performed. The MRI showed a 22 × 20 mm intraosseous cystic lesion at the posterior part of the calcaneus. Extended curettage and iliac bone grafting were performed. In the presence of postoperative histopathologic and immunohistochemical examination, histopathologic diagnosis of the patient was reported as intraosseous schwannoma. After 4 weeks of nonweight-bearing, she completely recovered with no pain. In conclusion, intraosseous schwannoma of the calcaneus must be kept in mind for patients who have chronic heel pain.

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Radioimaging Evaluation of Primary Bone Tumors and Tumor like Lesions

Asian Journal of Medical Radiological Research ◽

10.47009/ajmrr.2020.8.1.14 ◽

2020 ◽

Vol 8 (1) ◽

pp. 69-82

Author(s):

Sunil K Vatukiya ◽

Bhautik Kapadia

Keyword(s):

Imaging Techniques ◽

Bone Tumour ◽

Pathologic Fracture ◽

Malignant Tumour ◽

Final Diagnosis ◽

Matrix Mineralization ◽

Primary Bone Tumors ◽

Primary Bone ◽

Malignant Lesions ◽

Mri Characteristics

Background: Bone tumour is relatively rarely encountered by radiologist, so sometimes it creates diagnostic difficulty. Aim over study was to determine the X-ray CT and MRI characteristics of different primary bone tumours and tumour like lesion and correlation of radiologic diagnosis with histopathologic diagnosis whenever possible. To understand the advantages and limitations of different radio-imaging techniques. Subjects and Methods: We have studied total 45 cases of primary bone tumour and tumour like lesions during study of 15 months duration in department of Radiodiagnosis, Baroda Medical College, Vadodara, Gujarat, India. First radiological diagnosis and differential diagnosis was given than histopathologic examination was done in all malignant and indeterminate lesions for final diagnosis. Results: Out of 45 patients 21 (46.6%) were female and 24 (53.3%) were male. Benign and malignant lesions were 69% and 31% respectively. Multiple lesions were common with osteochondroma, hemangioma and multiple myeloma. Most common malignant tumour was osteosarcoma and benign tumour was osteochondroma. Pathologic fracture was seen in 6 patients but out of them 2 fractures were missed on radiograph. Skip lesions were seen in two malignant lesions which was missed on radiograph and CT but it was easily detected on MRI. Conclusion: Radiography is baseline investigation for evaluation of bone tumor and tumour like lesions. Pathological fracture and matrix mineralization can be better seen on CT. MR is superior in detection skip lesion, soft tissue and marrow extension.

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Tumor-Induced Osteomalacia: Increased Level of FGF-23 in a Patient with a Phosphaturic Mesenchymal Tumor at the Tibia Expressing Periostin

Case Reports in Endocrinology ◽

10.1155/2014/729387 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Anke H. Hautmann ◽

Josef Schroeder ◽

Peter Wild ◽

Matthias G. Hautmann ◽

Elisabeth Huber ◽

...

Keyword(s):

Postoperative Radiotherapy ◽

Somatostatin Receptor ◽

Tumor Resection ◽

Distal Tibia ◽

Immunohistochemical Analysis ◽

Mesenchymal Tumor ◽

Phosphaturic Mesenchymal Tumor ◽

Multiple Fractures ◽

Magnetic Resonance Imaging Mri ◽

Fgf 23

In our case, a 45-year-old male patient had multiple fractures accompanied by hypophosphatemia. FGF-23 levels were significantly increased, and total body magnetic resonance imaging (MRI) revealed a tumor mass located at the distal tibia leading to the diagnosis of tumor-induced osteomalacia (TIO). After resection of the tumor, hypophosphatemia and the increased levels of FGF-23 normalized within a few days. Subsequent microscopic examination and immunohistochemical analysis revealed a phosphaturic mesenchymal tumor mixed connective tissue variant (PMTMCT) showing a positive expression of somatostatin receptor 2A (SSTR2A), CD68, and Periostin. Electron microscopy demonstrated a poorly differentiated mesenchymal tumor with a multifocal giant cell component and evidence of neurosecretory-granules. However, the resected margins showed no tumor-free tissue, and therefore a subsequent postoperative radiotherapy was performed. The patient is still in complete remission after 34 months. Tumor resection of PMTMCTs is the therapy of choice. Subsequent radiotherapy in case of incompletely resected tumors can be an important option to avoid recurrence or metastasis even though this occurs rarely. The prognostic value of expression of Periostin has to be evaluated more precisely in a larger series of patients with TIO.

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Solitary Plasmacytoma of The Sternal Stalk: A Case Report and Literature Review

International Journal of Orthopaedics Research ◽

10.33140/ijor.04.03.11 ◽

2021 ◽

Vol 4 (3) ◽

Keyword(s):

Preoperative Diagnosis ◽

Radical Surgery ◽

Costal Cartilage ◽

Tumor Resection ◽

Bone Neoplasms ◽

Anterior Chest Wall ◽

Postoperative Recovery ◽

Solitary Plasmacytoma ◽

Case Presentation ◽

Primary Bone

Background: It has been reported that sternal neoplasms are a rare disease, accounting for about 1% of primary bone neoplasms, of which about 60% are malignancy, mostly occurring in the manubrium sternum. Case presentation: We reviewed a 77-year-old man with a solitary plasmacytoma of the sternal stalk presenting with pain in the anterior chest wall by examining a preoperative diagnosis of sternal manubrium malignant bone tumor. We performed extensive sternal manubrium tumor resection + bilateral partial costal cartilage resection + bilateral clavicular head resection + cervical lymph node dissection + thoracic reconstruction, and the postoperative recovery was perfect. Conclusion: We report a rare case of solitary plasmacytoma of the manubrium sternum successfully treated by extensive radical surgery for the manubrium tumor. Although rare, the disease should be identified, examined, and treated early to avoid serious complications.

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Failure to Thrive Revealing a Pilomyxoid Astrocytoma: An Uncommon Case Report with Literature Review

Case Reports in Pediatrics ◽

10.1155/2021/6670585 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Salma Benyakhlef ◽

Abir Tahri ◽

Asmaa Khlifi ◽

Hajar Abdelouahab ◽

Kamaoui Imane ◽

...

Keyword(s):

Subcutaneous Fat ◽

Tumor Resection ◽

Failure To Thrive ◽

Progression Free Survival ◽

World Health ◽

Low Grade ◽

Pilomyxoid Astrocytoma ◽

Suprasellar Region ◽

Magnetic Resonance Imaging Mri ◽

Health Organization

Pilomyxoid astrocytoma (PMA) is a freshly described figure of low-grade neoplasms encountered in early childhood. Nevertheless, its precise classification by the World Health Organization (WHO) is still debatable. Making an exact diagnosis relies on histological and immunohistochemical pathognomonic features with specific radiological findings. PMA behaves aggressively with a shorter progression-free survival, and its management is unfortunately still arguable. We describe a rare case of PMA involving the suprasellar region who displays symptoms consistent with diencephalic syndrome. The diagnosis was made by magnetic resonance imaging (MRI) focused on the hypothalamic-pituitary axis, and the patient underwent a subtotal tumor resection combined with chemotherapy. Diagnosis of brain tumors should be kept in mind in young children with generalized and severe unexplained loss of subcutaneous fat with failure to thrive after ruling out classical causes.

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Neurothekeoma of petrous apex: A rare entity

Indian Journal of Neurosurgery ◽

10.4103/2277-9167.118135 ◽

2013 ◽

Vol 02 (02) ◽

pp. 210-212

Author(s):

Sunitha Kumaran ◽

Nandita Ghosal ◽

Saikiran Narayanam ◽

Sanjaya Viswamitra ◽

Zarina Assis

Keyword(s):

Internal Auditory Canal ◽

Petrous Apex ◽

Primary Bone Tumors ◽

Nerve Sheath Tumors ◽

Time In Literature ◽

Bony Lesion ◽

Primary Bone ◽

Magnetic Resonance Imaging Mri ◽

Extradural Approach ◽

First Time

Abstract Intraosseous nerve sheath tumors are very rare tumors accounting for lesser than 0.2% of primary bone tumors. We present an 18-year-old female who presented with left facial paresis for the last 1 year. Magnetic resonance imaging (MRI) demonstrated expansile, multiseptated, enhancing bony lesion in the left petrous apex. There was also abnormal enhancement of the 7-8th nerve complex within the internal auditory canal. Tumor was excised by subtemporal extradural approach. The lesion was diagnosed as intraosseous neurothekeoma on histopathology. This is an extremely rare tumor and its MRI appearance in this location is being described for the first time in literature.

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Role of diffusion-weighted MRI in differentiating benign from malignant bone tumors

BJR|Open ◽

10.1259/bjro.20180048 ◽

2019 ◽

Vol 1 (1) ◽

pp. 20180048

Author(s):

Anuradha Rao ◽

Chandni Sharma ◽

Raghuram Parampalli

Keyword(s):

Bone Tumors ◽

Response To Treatment ◽

Diffusion Weighted Mri ◽

Benign Lesions ◽

Primary Bone Tumors ◽

Diffusion Weighted ◽

Adc Values ◽

Primary Bone ◽

Malignant Lesions ◽

Tumor Like Lesions

Objective: To evaluate the role of diffusion-weighted MRI in differentiating benign from malignant primary bone tumors. To know the sensitivity and specificity of diffusion weighted MRI and calculating apparent diffusion coefficient (ADC) cutoff in differentiating benign from malignant primary bone tumors. Methods and materials : This is a prospective observational study of 50 patients, who were clinically or radiologically suspected with primary bone tumor and referred to the Department of Radiodiagnosis, for radiography or for MRI. These patients underwent routine MRI sequences including diffusion-weighted MRI with b-values of 0, 500 and 1000, followed by pathological examination supplemented by immunohistochemistry (wherever necessary). Hematological malignancies, recently biopsied cases and recurrent cases were excluded from the study. Results: Out of 50 patients with suspected bone tumors, 15 were benign (and tumor like lesions) and 35 were malignant primary bone tumors. The most common age group involved for both benign and malignant primary bone tumors was 11–20 years (23 cases—46%). In our study, total number of affected males were 27 (54%) and total number of affected females were 23 (46%) with M:F ratio of 1.17:1. In this study 72% lesions had appendicular bone involvement and 28% had axial bone involvement. 94.3% of malignant lesions showed restriction on diffusion-weighted imaging (DWI) and in 80 % of benign lesions restriction was absent on DWI which was statistically significant. Mean ADC levels in malignant lesions was 1.092 ± 0.497 and in benign lesions was 1.62 ± 0.596 which was statistically significant. Chondrosarcoma had highest ADC and Ewing’s sarcoma had lowest ADC values in malignant lesions. Chondroblastoma had highest ADC and Osteomyelitis had lowest ADC values in benign lesions. ADC value of 1.31 had highest sensitivity and specificity to differentiate between benign and malignant lesions. Conclusion: DWI is helpful in differentiating malignant from benign bone tumors and tumor like lesions with diffusion restriction favoring malignancy. Inspite of some overlap, ADC values of benign and malignant bone tumors are different and measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Calculation of ADC may also be used as baseline reference to assess response to treatment in future or for follow up. Advances in knowledge: DWI imaging (and ADC values) has been extensively used in neuroimaging. Extension of this application to musculoskeletal–oncologic imaging is not so well studied. Apart from differentiating benign from malignant lesions which is the main focus of this study, assessment of response to treatment by ADC values may be possible in near future.

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Malignant Giant-cell Tumor of the Parietal Bone: Case Report and Review of the Literature

Neurosurgery ◽

10.1097/00006123-200102000-00039 ◽

2001 ◽

Vol 48 (2) ◽

pp. 424-429 ◽

Cited By ~ 3

Author(s):

Jeffrey Leonard ◽

Murat Gökden ◽

Michael Kyriakos ◽

Colin P. Derdeyn ◽

Keith M. Rich

Keyword(s):

Giant Cell ◽

Clinical Presentation ◽

Paget’S Disease ◽

Paget's Disease ◽

Parietal Bone ◽

Low Grade ◽

Giant Cell Tumors ◽

Primary Bone Tumors ◽

Malignant Giant Cell Tumor ◽

Primary Bone

Abstract OBJECTIVE AND IMPORTANCE Giant-cell tumors (GCTs) are primary bone tumors that involve long bones in 75 to 90% of patients. They seldom develop in the cranium and are very rare in patients older than 60 years of age. A GCT rarely occurs with Paget's disease; when it does, however, it is most commonly associated with the polyostotic form and tends to involve the craniofacial bones. Pagetic GCTs are less aggressive than GCTs that are not associated with Paget's disease. CLINICAL PRESENTATION We report the case of an 81-year-old woman with a painless left parietal mass and asymptomatic monostotic parietal Paget's disease. INTERVENTION Surgical resection was performed, and histological examination of the lesion demonstrated Paget's disease with a malignant GCT. An incidental, low-grade, small-cell lymphocytic lymphoma also was noted. The patient experienced local recurrence of the malignant GCT and eventually died after developing pulmonary metastases of the malignant GCT. CONCLUSION This case is the first reported example of a patient with a malignant GCT of the cranium associated with monostotic Paget's disease. It provides evidence that not all pagetic GCTs in the cranium are benign, as has been reported.

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3D-Printed Titanium Custom-Made Prostheses in Reconstruction after Pelvic Tumor Resection: Indications and Results in a Series of 14 Patients at 42 Months of Average Follow-Up

Journal of Clinical Medicine ◽

10.3390/jcm10163539 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3539

Author(s):

Carmine Zoccali ◽

Jacopo Baldi ◽

Dario Attala ◽

Alessandra Scotto di Uccio ◽

Luca Cannavò ◽

...

Keyword(s):

Tumor Resection ◽

Long Term Results ◽

Wide Resection ◽

Primary Bone Tumors ◽

Spine Stabilization ◽

Custom Made ◽

Prosthesis Removal ◽

3D Printed ◽

Primary Bone ◽

Custom Made Prostheses

Wide resection is currently considered the mainstay treatment for primary bone tumors. When the tumor is located in anatomically complex segments, 3D-Printed Titanium Custom-Made Prostheses (3DPTCMP) are possible reconstructive solutions. The aim of the present paper is to analyze indications, results and complications of a series of 14 patients who underwent pelvis reconstruction with 3DPTCMP after tumor removal from January 2015 to December 2019. Chondrosarcoma was the main histology; indications were tumors located in the acetabular area without enough residual bone to support a cup with an iliac stem, and tumors located near the sacrum-iliac joint. The margins were wide in 12 cases, and marginal and intralesional in one case each. In three cases, resection also included the sacrum-iliac joint, so a spine stabilization was performed and linked to the pelvic prosthesis; The average MSTS score was 46.3%; the 5-year local recurrence-free survival was 85.7%. Wound dehiscences were the main complication, resolved with multiple debridements; nevertheless, prosthesis removal was necessary in one case. Currently, the 3DPTCMP is an effective resource for reconstruction after resection of tumors located in the pelvis. Further studies are necessary to value long-term results; more strategies are necessary to try to reduce the infection rate and improve osteointegration.

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Solitary Plasmacytoma of the Sternal Stalk: A Case Report and Literature Review.

10.21203/rs.3.rs-635302/v1 ◽

2021 ◽

Author(s):

qiang you zhang ◽

guang yu shen ◽

jiang run wang ◽

you lun zhang ◽

Ling Yan

Keyword(s):

Preoperative Diagnosis ◽

Radical Surgery ◽

Costal Cartilage ◽

Tumor Resection ◽

Bone Neoplasms ◽

Anterior Chest Wall ◽

Postoperative Recovery ◽

Solitary Plasmacytoma ◽

Case Presentation ◽

Primary Bone

Abstract Background: It has been reported that sternal neoplasms are a rare disease, accounting for about 1% of primary bone neoplasms, of which about 60% are malignancy, mostly occurring in the manubrium sternum.Case presentation: We reviewed a 77-year-old man with a solitary plasmacytoma of the sternal stalk presenting with pain in the anterior chest wall by examining a preoperative diagnosis of sternal manubrium malignant bone tumor. We performed extensive sternal manubrium tumor resection + bilateral partial costal cartilage resection + bilateral clavicular head resection + cervical lymph node dissection + thoracic reconstruction, and the postoperative recovery was perfect.Conclusion: We report a rare case of solitary plasmacytoma of the manubrium sternum successfully treated by extensive radical surgery for the manubrium tumor. Although rare, the disease should be identified, examined, and treated early to avoid serious complications.

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