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Biomedical subjects

M M Lewis

Publications and source records attributed to M M Lewis.

At least 19 recordsLinked to original sources
PubMed1992

Case report 754: Xanthoma of the Achilles tendon.

The MRI features of bilateral xanthoma of the achilles tendon in type II hyperlipoproteinemia are reported. MRI has proved to be the best imaging modality available in assessing enlargement of the Achilles tendon. It demonstrates the heterogeneous signal on both T1- and T2-weighted images where the xanthomatous deposits are relatively higher in signal intensity than the tendon itself. MRI also has a potential value in the clinical assessment and therapeutic response of the xanthoma after operative intervention.

Achilles Tendon↗
PubMed1992

Case report 711: Parosteal osteosarcoma of left femur.

We present a patient with parosteal osteosarcoma. The lesion arose at the surface of the femur without involvement of the marrow cavity. Some 24 months following resection of the involved bone, she developed distant metastases with no evidence of local recurrence. Neither the primary nor the metastatic lesions showed high-grade malignancy.

Adult↗
PubMed1992

Case report: angiosarcoma occurring in a bone infarct.

An unusual case of an angiosarcoma that occurred in a bone infarct is presented. A bone infarct may occasionally dedifferentiate to an osteogenic sarcoma or a malignant fibrous histocytoma. However, the association of angiosarcoma with a bone infarct is extremely rare. To the best of our knowledge, there is only one other report of this association in the English literature.

Bone Neoplasms↗
PubMed1992

Tumour and tumour-like conditions of the soft tissue: magnetic resonance imaging features differentiating benign from malignant masses.

49 primary soft-tissue masses were studied by magnetic resonance imaging (MRI) in an effort to differentiate benign from malignant lesions. There were 24 benign and 25 malignant tumours. Images were evaluated for the presence of low-signal septation, changes in pattern of homogeneity, signal intensity, and margin definition and shape. 20 of the 25 malignant tumours (80%) demonstrated low-signal septation, and two of the 24 benign tumours (8%) also demonstrated this feature. Malignant tumours tended to change pattern from being homogeneous on T1-weighted images to being heterogeneous on T2-weighted images (72%). Benign tumours maintained their pattern on both sequences (67%). Only three of the 24 benign tumours (12.5%) changed from being homogeneous to heterogeneous. Our findings suggest that tumours which change pattern, from homogeneous on T1-weighted images to heterogeneous on T2-weighted images, and tumours which have low-signal septations are likely to be malignant. Moreover benign lesions tend to have well defined margins, and some benign masses have characteristic appearances that aid in their differentiation from malignant processes.

Adolescent↗
PubMed1992

Intramuscular myxoma: magnetic resonance features.

Magnetic resonance imaging (MRI) was performed in six cases of intramuscular myxoma of the extremities and revealed the following characteristics. All tumours were confined to muscle and had a sharply defined border. All had a signal intensity lower than skeletal muscles on T1-weighted images and brighter than fat on T2-weighted images. The signals were homogeneous on both T1- and T2-weighted images. This study did not include contrast enhancement. The diagnosis was confirmed by an open biopsy. All tumours were resected with no recurrence. Diagnosis based on these MRI characteristics was incorrect in two cases of intramuscular ganglia and in a case of intramuscular cysticercus cellulose. MRI features of intramuscular myxoma are typical in the majority of cases. Benign intramuscular lesions that contain mainly fluid can mimic intramuscular myxomas.

Adult↗
PubMed1992

Hemangiomas of the long tubular bone.

The overall spectrum of hemangiomas involving long tubular bones is exemplified by three cases, the first being medullary, the second periosteal, and the third intracortical. The clinical presentation was progressive pain at the site of the lesion in all cases. The medullary hemangioma involved the distal shaft of the humerus and was entirely radiolucent. The periosteal tumor was exceptional in that it affected the proximal shaft of the tibia in contrast to the seven previously reported cases that involved the midshaft of the bone. The intracortical hemangioma was in the tibia, the site of all three previously reported cases. Hemangioma of bone may show variable roentgenographic patterns related to the anatomic location and the type of involved bone. The final diagnosis is dependent on histologic evaluation.

Adult↗
PubMed1991

Fibromyxoma of bone.

We report two cases of fibromyxoma, one affecting the iliac crest and the second involving the proximal shaft of the tibia. Fibromyxoma is a rare neoplasm related to benign fibrous tumors and is characterized by exuberant, extracellular, ground substance production. Its histologic appearance is benign and distinctive and can be readily distinguished from that of myxoid chondrosarcoma or chondromyxoid fibroma. The radiographic picture is, however, difficult to interpret, and the entity can be easily mistaken for other tumors.

Adult↗
PubMed1991

Case report 696: Chondroblastoma of the right acetabulum and superior pubic ramus.

A case of chondroblastoma involving the right acetabulum and superior pubic ramus in a 60-year-old man has been presented. Tissue was obtained by open biopsy. The clinical and radiographic characteristics of chondroblastoma in general, and this tumor in particular, were discussed. The histopathology and differential diagnosis were also considered. The relatively uncommon site of the tumor and its occurrence in an older patient made the radiographic diagnosis difficult, and other possibilities were discussed.

Acetabulum↗
PubMed1991

Transarticular invasion of joints by bone tumors: hypothesis.

Eight bone tumors with associated transarticular invasion of the sacroiliac joints are described. All invaded the true synovial joint and spread to the opposing bone. One tumor was benign, and the other seven were malignant. Five of the seven were primary and two were metastatic cancer. One, a myeloma, invaded the disc spaces between the fourth and fifth lumbar vertebrae and the fifth lumbar vertebra and sacrum as well as the sacroiliac joint. The right facet joints of the two vertebrae were also invaded. After a thorough search of the literature, we find that the sacroiliac joint is the most common joint to be invaded by tumors. This is followed by the vertebral disc spaces and, last, the facet joints. Apart from these joints, we were unable to find any radiographic documentation of other joints being transarticularly invaded by tumors. We noted that there is a direct relation between transarticular tumor spread and joints that lack mobility and that certain tumors, benign and malignant, tend to invade these joints.

Adult↗
PubMed1991

Role of angiography in limb-tumor surgery.

Routine preoperative angiograms obtained in 97 consecutive patients with bone and soft-tissue tumors of the extremities were retrospectively reviewed to determine the role of angiography in surgical planning. Some degree of major vessel displacement was demonstrated in 51 patients. Encasement of major vessels, which precluded limb-salvage surgery, was seen in five of 76 bone tumors and in three of 21 soft-tissue tumors. All five patients with osteochondromas had associated vessel occlusion or compromise. For surgical planning, the demonstration of adequate anastomoses in the arches of the hands and feet is important, as branches of brachial and popliteal arteries may have to be sacrificed during limb-tumor surgery. Angiographic findings indicated or supported the need for a vascular surgeon in five cases in this series. Preoperative angiography provides important information with regard to the status of the vasculature and therefore is essential in the management of bone and soft-tissue tumors of the extremities.

Adolescent↗
PubMed1991

Limb-sparing surgery in skeletally immature patients with osteosarcoma. The use of an expandable prosthesis.

Limb-sparing surgery has a definite role in the treatment of osteosarcoma in children. Increased survival, however, raises problems of limb-length discrepancy and prosthetic longevity. The concept of an expandable adjustable prosthesis addresses the problem of leg-length discrepancy. The problem of prosthesis longevity will require further long-term evaluation of current designs and methods of fixation, as well as the development of a permanent prosthesis or biologic replacement. At skeletal maturity, the expandable prosthesis may either be maintained or substituted with another implant or biological alternative if warranted by the clinical situation.

Adolescent↗
PubMed1991

Limb salvage in pediatric surgery. The use of the expandable prosthesis.

Limb sparing in growing children has proved to be very effective from an oncologic perspective, with good, long-term acceptance by the patients. As in the adult, when performed by experienced surgeons, limb sparing neither compromises the survival rate nor significantly increases the local recurrence rate, compared with cross-bone amputation. Discussions include patient evaluation, surgical options, materials and methods, and results.

Bone Neoplasms↗
PubMed1990

Case report 623. Osteitis condensans of the left clavicle (OCC).

A case of OCC in a 35-year-old woman is presented. Proof was obtained by open biopsy. This rare entity is benign and its etiology is still obscure. No definite association with osteitis pubis or osteitis condensans ilii has been reported. The involvement of the clavicle is invariably unilateral. The clinical and radiographic characteristics of this benign condition have been discussed and the differential diagnosis has been considered. Consideration should be given to the concept that if the imaging features are characteristic, as in this case, biopsy may not be necessary.

Adult↗
PubMed1990

Case report 588: Intracortical chondroma of the left femur.

A case of intracortical chondroma in the left femur in a 22-year-old man is presented. Proof was obtained by open biopsy. The issue of periosteal vs intracortical chondroma was discussed in depth, with emphasis on the radiographic appearances. The differential diagnosis of this benign intracortical lesion was also included. The histopathologic characteristics of this intracortical chondroma were described and a possible explanation for the unusual location of the cartilage lesion within the cortex was considered.

Adult↗