Biomedical subjects

M C Leeson

Publications and source records attributed to M C Leeson.

28 records · Page 2Linked to original sources

PubMed1986

Giant intraarticular loose bodies of the knee. Cases demonstrate spectrum of the lesion.

Synovial chondromatosis is a well-known, well-described clinical and histopathologic entity. Occasionally, loose bodies in the knee joint can continue to grow and become large enough to impinge on joint motion. Extremely large synovial chondromata are relatively rare in the knee joint and have only been described in singular case reports in the orthopaedic literature. We describe two cases representing the spectrum of this disease process occurring in the popliteal fossa, simulating bony and/or soft tissue neoplasm. Case 1 demonstrates a large ossified chondroma, while Case 2 demonstrates a large chondroma without much calcification and with no ossification present. Because of the rarity of these lesions, preoperative staging studies, including CT scan, bone scan, and angiography, are usually warranted to help in the preoperative planning. Open biopsy with adequate tissue sampling is necessary to make an accurate histopathologic diagnosis. Once diagnosis is made, local excision for removal of the mechanical block to motion results in "cure"; local recurrence has not been noted.

Aged↗

PubMed1986

Metastatic skeletal disease distal to the elbow and knee.

Metastatic disease of bone is the most common example of "bone cancer." The incidence of skeletal metastases varies from 6% to 85% depending on the primary tumor and the method of evaluation. Axial skeletal involvement is more common than appendicular involvement, and metastatic lesions below the elbow and knee are relatively uncommon. Fifty-seven autopsy subjects had had clinical evidence of metastatic involvement below the knee and elbow with an incidence of 7% (57/827). The lung was the most common primary site, and the tibia was the most common bone affected. Pain, local soft-tissue extension, and pathologic fractures were the most common presenting symptoms. Prior to 1960, most patients did not receive treatment. Until recent intervention, no treatment was offered to enhance the quantity or quality of patient survival.

Adolescent↗

PubMed1985

Primary amyloidoma of the spine. A case report and review of the literature.

Primary amyloidosis of bone is a rare disease process. When amyloid lesions do occur in bone, they are often associated with myeloma or other plasma cell dyscrasias. Because of its rarity and its protean clinical and radiographic picture adequate biopsy tissue for histopathologic studies is essential for accurate diagnosis. This case presents a 43-year-old man with nondescript back pain and an impressive radiographic lesion in his lower thoracic spine demonstrating the need for careful diagnostic evaluation and a high incidence of suspicion. When occurring primarily in a localized anatomic area, the prognosis for survival is excellent, and cure can be expected by local excision and reconstruction, as necessary.

Adult↗

PubMed1985

Osteochondrosis of the tarsal cuneiforms.

The osteochondroses are a conglomerate of bony lesions that share similar clinical, radiographic, and pathologic features. While almost any bone may demonstrate the features of this disease process, involvement of the tarsal bone is very rare. Some type of disorder of enchondral ossification is thought to be the common etiologic link in the development and manifestation of tarsal cuneiform osteochondrosis. The course of the disease process is benign and self-limited. The treatment is symptomatic.

Child↗

PubMed1983

Intraosseous lipoma.

Intraosseous lipoma is the rarest benign primary tumor of bone. The incidence is less than one per 1,000 bone tumors. Because of its rarity and non-specific clinicopathologic findings, large biopsy specimens are needed for an accurate diagnosis. Once diagnosis has been established, a conservative treatment protocol is mandatory. The prognosis is generally excellent, and recurrences have not been reported.

Aged↗

PubMedDate not supplied

Metastatic skeletal disease in the pediatric population.

We reviewed the autopsy, clinical, and radiographic records of 39 patients with metastatic skeletal disease (age range 18 months-20 years). There were 11 different primary tumors responsible for skeletal metastases, of which neuroblastoma was the most common (16 patients). Other commonly occurring tumors giving rise to secondary skeletal deposits were rhabdomyosarcoma (seven), teratoma-teratocarcinoma (four), and Wilms tumor (three). Overall patient survival ranged from 2 weeks to 72 months, with an average of 10.2 months. Those patients presenting without skeletal metastases at the time of diagnosis of the primary tumor had a survival time averaging 16.2 months (range 3-72 months), whereas those patients presenting initially with skeletal metastases at the time of diagnosis of the primary tumor had a survival time of 8.5 months (range 0.5-23 months).

Adolescent↗

PubMedDate not supplied

Primary epiphyseal transplants and bone overgrowth in childhood amputations.

Seventeen children aged newborn to 14 years underwent major through-bone amputations or revision at our two institutions. Ten patients (group 1) had primary autogenous epiphyseal transplants taken from the amputated limb and used to cap the open medullary canal of the residual limb. Seven patients (group 2) did not have epiphyseal transplants. Nine of 10 patients in group 1 (90%) had no problems related to bone overgrowth or delay in prosthetic fitting. In group 2, six of seven patients (86%) had clinically symptomatic bony overgrowth of 20 months after the index amputation on the average. Four patients had surgical revisions. Therefore, provided healthy autogenous donor epiphyses are available, we recommend primary epiphyseal transplants to avoid the complications of bone overgrowth in childhood through-bone amputations.

Adolescent↗

PubMedDate not supplied

Congenital duplication of the foot and toes.

Congenital duplication of the foot and toes is a commonly diagnosed condition in newborn nurseries across the United States. The foot involvement varies from simple fleshy tags to complex attempts at whole extremity duplication. We reviewed 59 patients (82 feet) with a variety of duplications (excluding skin tags). During our review, we devised a new descriptive system of classification of congenital duplications of the foot based primarily on the type and complexity of the skeletal duplication. Variables related to sex, bilaterality, age at surgery, family history, and follow-up results were documented, and an exact classification of each foot was accomplished. Results and prognosis vary with the class of duplication being treated and must be individualized case by case.

Animals↗

PubMedDate not supplied

Late-onset tibia vara: a histopathologic analysis. A comparative evaluation with infantile tibia vara and slipped capital femoral epiphysis.

Histopathologic and histochemical studies were performed on the entire physes and contiguous structures of five knees (three patients) with late-onset tibia vara (Blount's disease). A constellation of abnormalities of both medial and lateral physeal components resulted in disorganization and misalignment of the physeal zones. The changes were remarkably similar to those observed in both infantile tibia vara and slipped capital femoral epiphysis, suggesting a common etiology. Our evaluation indicates that asymmetric compressive and shear forces acting across the proximal tibial physis effect its disruption and causes suppression and deviation of normal endochondral ossification, thereby resulting in tibia vara.

Adolescent↗

PubMedDate not supplied

Eosinophilic granuloma of bone in the growing epiphysis.

Eosinophilic granuloma of bone is a rare skeletal manifestation of one of the spectrum of diseases known as histiocytosis X. These lesions often simulate other pathophysiologic processes (Ewing sarcoma, chronic osteomyelitis, Brodie abscess, and chondroblastoma) and may present significant diagnostic problems. Three additional cases of eosinophilic granuloma in an epiphysis are reviewed in this report. Transphyseal extension was present in all our cases and in five of 10 cases documented in the literature. Diagnosis demands accurate biopsy and histopathologic evaluation. Treatment and prognosis are individualized.

Biopsy↗