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Biomedical subjects

S Kenan

Publications and source records attributed to S Kenan.

At least 19 recordsLinked to original sources

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

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

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

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

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

Experimental transplantation of the Swarm rat chondrosarcoma into bone: radiological and pathological studies.

The Swarm rat chondrosarcoma has been the subject of extensive biochemical studies. However, to our knowledge, there are no previous reports in the literature on transplantation of this tumor into bone. This article describes the natural history of the tumor when implanted into the bone of the rat, and correlates its histological growth pattern with its radiological appearance. Our results showed that the tumor grows slowly in the bone. The rate of intramedullary growth, however, was variable and was not the same in all the animals. Its growth pattern resembles human chondrosarcoma, with extensive invasion of the marrow and cortex. In the first few weeks after implantation, the only radiological changes noted were mild medullary radiopacities. At a later stage, 12-14 weeks postimplantation, as the tumor infiltrated the bone, significant radiological abnormalities were observed in the medullary cavity and cortex. Periosteal reaction was seen after the tumor invaded the cortex with the production of a soft-tissue mass. Distant dissemination was rare; only 1 of 24 rats developed pulmonary metastases. The Swarm rat chondrosarcoma is a well-differentiated malignant tumor that histologically resembles well-differentiated human chondrosarcoma. Transplanted into bone, it may be useful as an experimental model for comparative studies with human chondrosarcoma.

Animals

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

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

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

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

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

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

CO2 laser cauterization of giant-cell tumor margins.

The CO2 laser was evaluated to determine its effectiveness for marginal cauterization of giant-cell tumors after resectional curettage. Average power densities of 11-53 W/cm2 for corresponding application times of 120 and 60 seconds were found to produce 30 degrees temperature rises in fresh human femoral heads. This temperature was adequate to achieve thermal necrosis of the tumor margins to a depth of 5 mm. CO2 laser resection was found to be accurate and reproducible. No damage to underlying hyaline cartilage and soft tissues was evident histologically at one and four weeks after experimental local laser cauterization of distal femoral condyles in rabbits.

Animals