Biomedical subjects
Publications and source records attributed to F López-Barea.
Chondroblastoma is a rare benign bone tumor typically located in the epiphysis. We describe the first case of chondroblastoma arising in the diaphysis of a long bone. The patient was a 13-year-old girl who presented with pain over her right thigh. Radiographs showed a lytic lesion in the diaphysis of her right femur. A core biopsy and a subsequent surgical resection were performed.
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The factors contributing to renal osteodystrophy are still incompletely characterized. A variety of cytokines and growth factors appear to have ill-defined roles in this disease. Our aim is to compare osteoblastic cell growth and different osteoblastic markers in vitro with histomorphometric bone parameters and some serum bone-turnover markers in vivo in dialysis patients with either high- (HTBD) or low-turnover (LTBD) bone disease. Six patients were diagnosed to have LTBD, and another five patients, HTBD. Intact parathyroid hormone (PTH) and osteocalcin (OC) levels in serum were greater in patients with HTBD than in those with LTBD. Osteoblastic cells isolated from iliac crest biopsy specimens were grown in culture medium for different times up to 13 days. Osteoblastic cell growth (cell number and area under the cell growth curve) was greater in patients with HTBD than in those with LTBD. Static and dynamic bone formation parameters correlated with serum PTH levels. No correlation was found between PTH and osteoblastic cell proliferation. OC, C-terminal type I procollagen, and alkaline phosphatase osteoblastic secretion in vitro were similar in the HTBD and LTBD groups. However, interleukin-6 (IL-6) secretion was greater in cells isolated from patients with LTBD. Our results indicate that osteoblastic cell growth and osteoblastic IL-6 secretion are related to bone turnover in patients with osteodystrophy. Our findings support the hypothesis that factors other than PTH level might have an important role in affecting osteoblastic function in renal osteodystrophy.
Ewing's sarcoma is an uncommon malignancy that usually occurs in children. A case of Ewing's sarcoma of the mandible is presented, and the radiologic appearance is described, with special consideration given to the magnetic resonance imaging features.
The prevalence of low-turnover lesions in patients undergoing peritoneal dialysis (PD) is high. Our aims are to evaluate the prevalence of adynamic bone disease (ABD) in PD patients, analyze risk factors, and define the association of serum parathyroid hormone (PTH) levels measured under different plasma calcium concentrations with this lesion. Fifty-seven patients were studied by bone biopsy (BB). ABD was found in 63.2%, and 36.8% showed high-turnover bone disease (HTBD). Patients with HTBD had a lower prevalence of diabetes, younger age, lower accumulated oral calcium salt intake, and greater calcitriol doses, serum osteocalcin level, and ultrafiltration than patients with ABD. Both mean baseline PTH levels from the previous year and PTH level at time of BB were greater in patients with HTBD than those with ABD (357 +/- 267 pg/mL versus 89 +/- 67 pg/mL; 390 +/- 337 pg/mL versus 88 +/- 78 pg/mL, respectively; P < 0.05). However, the magnitude of the increase from baseline serum PTH levels in response to hypocalcemia was greater in patients with ABD than in those with HTBD (166.4% +/- 134% versus 83.5% +/- 73.6%; P < 0.05). We found that PTH levels less than 150 pg/mL in patients with ABD showed a sensitivity of 91. 6%, specificity of 95.2%, and positive predictive value (PPV) of 97%. In the HTBD group, PTH levels greater than 450 pg/mL had a specificity and PPV of 100%. Our data confirm that ABD is the most prevalent lesion in PD patients, and PTH secretion capacity is maintained in these patients. The definitive diagnosis and management strategies for many patients requires a BB, especially when HTBD is unlikely.
Osseous abnormalities produced by glomus tumors located in soft tissues of the periungual region have been described. More rare is the location of a glomus tumor within bone, which usually is located in the phalanx of the fingers. However, to the authors' knowledge, there is no previous description of a glomus tumor located in a periosteal location of a long bone. A 50-year-old man with a glomus tumor in a periosteal location of the lower metaphysis of the femur without neoplastic erosion of the cortical surface is reported. Magnetic resonance imaging and intraoperative ultrasonography were needed to locate the lesion.
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We report a case of primary aneurysmal cyst of soft tissues in a 57-year-old woman presenting with a painful mass in her left arm. Conventional radiography showed a radiolucent soft tissue mass surrounded by a ring of bone. MRI displayed an unusual, ill-defined soft tissue lesion that was not connected to the nearby humerus and appeared to be an aggressive tumour. Microscopically, the mass consisted of multiple anastomosing cavernous channels surrounded by a peripheral band of mature trabecular bone. These bloody channels were separated by fibrous septa containing fibroblasts, histiocytes and multinucleated giant cells, as well as fibromyxochondroid material. Some of these giant cells lined the septa and partially occupied the lumen of the channels. Ultrastructurally, the features observed in this tumour were similar to those described in aneurysmal bone cyst; the giant cells lining the septa were an additional observation. Whereas most bone tumours have a well-known extraosseous counterpart, this unique lesion is not well recognized by surgical pathologists and the few published cases have been reported under different names. Gross, microscopic, radiological and ultrastructural findings are presented to familiarize pathologists with this underdiagnosed condition.
This report illustrates a calcified leiomyoma of deep soft tissue in the left leg of a 6-year-old boy. The tumour was composed of spindle cells arranged in interlacing bundles, between which were multiple small and large areas of calcification. Tumour cells were positive for vimentin, desmin and smooth muscle actin. Ultrastructurally, the cells showed numerous pinocytotic vesicles and bundles of intracytoplasmic filaments with smooth muscle dense bodies. Only four calcified leiomyomas have been previously reported in the deep soft tissues of limbs. Here we report a new case and suggest a new pathogenetic scheme involving alkaline phosphatase in the origin of these calcifications.
In this report we describe a soft-tissue aneurysmal cyst located in the left shoulder of a 20-year-old woman. Although the tumor initially was clinically considered a myositis ossificans, the microscopic features were identical to those found in classic aneurysmal bone cyst (ABC). Light microscopy showed a lesion composed of a peripheral band of mature trabecular bone surrounding a multicystic central area made up of anastomosing cavernous blood channels separated by fibrous septa that contained osteoid, mineralized myxochondroid material and osteoclastic giant cells. Whereas most bone tumors have an extraosseous counterpart, ABC has been found outside the bone only once, in an artery, but never in soft tissues. Moreover, major reviews state that aneurysmal bone cyst occurs exclusively within bones. This unique case is a very rare occurrence of one of these lesions in the soft tissues.
The case is reported of a patient with giant cell arteritis affecting several organs. The triggering cause of death was a brainstem infarction due to basilar artery thrombosis. The necropsy showed the systemic character of the disease affecting the coronary, bronchial, and ovarian arteries.
Benign metastasizing giant-cell tumor of the hands is an extremely infrequent neoplasm. A 37-year-old man with one of these neoplasms in the second phalanx of his fifth left finger was examined. Microscopically, the tumor was a conventional Grade 1 giant-cell tumor that metastasized to the lung. Although this tumor is most infrequent, its metastatic potential indicates inclusion of benign metastasizing giant-cell tumor in the differential diagnosis with other giant-cell neoplasms of the hands.
Malignant fibrous histiocytoma of bone is a rare skeletal neoplasm, reported in the patella on only a few occasions. We describe an additional case in this bone in an 84-year-old woman. We believe this neoplasm should be considered in the differential diagnosis of malignant tumors of the patella.
Intracortical osteosarcoma (IO) is the rarest form of osteosarcoma. A 19-year-old man had one of these lesions in the upper diaphysis of the femur. Microscopically, IO was a well-differentiated osteosarcoma with an osteoblastic histologic pattern. The typical location in the diaphysis and the peculiar histologic and roentgenographic findings with intracortical origin clearly separate this entity from conventional osteosarcomas as well as periosteal and parosteal osteosarcomas. IO are lytic neoplasms confined to the cortex of the diaphysis with a benign roentgenographic appearance, but are included in the differential diagnosis of benign tumors.
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Osteogenic sarcoma of the maxilla and mandible is a peculiar entity within the context of the malignant bone tumors of other sites. In our series of nine cases the mean age at appearance was 34.1 years; 44.5% of the tumors affected the maxilla, and 55.5% affected the mandible. Most of the tumors were principally rapidly growing and painless or minimally painful masses. Histopathologically, the fibroblastic type was the most frequent, with prevalence of Broders' Grades III and IV. Radical surgery was the only therapeutic procedure in 87.5% of the series, producing a survival of 85%. Overall survival for all the therapeutic categories was 75%, with a mean disease-free interval of 8 years. In the remaining cases, local recurrence and intracranial invasion were the main causes of death.
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