[Multiple chondromas--healing following a pathological fracture].
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Biomedical subjects
Publications and source records attributed to J R Döhler.
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Benign by nature, aggressive fibromatoses (desmoid fibromas) may represent as difficult therapeutic problems as malignant tumours. When subtotally resected they tend to recur. But spontaneous regression is possible. Expense and limits of their surgical treatment are discussed with reference to seven patients. In five cases primary affliction of bone was evident. There are three reports given in detail: In the first, malignant transformation may be due to radiation therapy and hemipelvectomy could not prevent recurrence. In the second, spontaneous regression of untreated pelvic affection may have occurred. In the third, several resections and amputation of the leg failed to cure congenital infantile fibromatosis.
Although nodular fasciitis is one of the most common of the fibroproliferative conditions, it has not been widely reported. As it is a reactive and selflimiting process, it can be dealt with effectively by surgical excision and recurrences are rare. Histological differentiation from sarcomas is still proved to be difficult and hence there is the risk that inappropriate treatment may be recommended. This case report deals with the onset and natural history of nodular fasciitis in the upper arm of a keen marksman. When instructing children in the use of a shotgun, he was in the habit of placing the shorter shaft of these weapons against the upper third of his arm instead of the shoulder. Here he developed a tender swelling which showed increased up-take in a scintigram. One year after exstirpation the patient reported pain relief, a recurrence has not been observed so far.