[Pseudosarcomatous traumatic myositis ossificans].
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The case of a 19-year-old female patient with myositis ossificans progressiva is reported. This disease is a rare hereditary disorder with a dominant autosomal genotype. The patient had typical ossifications of the humeral and dorsal muscles, as well as of those of the left thigh and upper arm, and also an ankylosis of the left hip. There were typical deformations of the cervical vertebrae and of the skeleton of the hands and feet. Laboratory tests showed alkaline phosphatase to be greatly increased. ECG revealed a bifascicular bundle-branch block, and a high-grade restrictive ventilation disorder was shown up by pulmonary function test. When the stability of the genetic material was investigated, DNA synthesis was found to be normal, DNA repair was slightly accelerated, and the sister chromatid exchange rate following stimulation with mitomycin C was higher than in controls.
A 53-year-old woman had extraskeletal osteosarcoma that developed from a soft tissue bony mass present on the volar aspect of the left wrist for 4 years. Initially, the bony mass was soft and movable, but during the first year it became hard and fixed. The patient had no history of trauma. Because the lesion did not grow or cause any symptoms, the patient did not come to the hospital until 4 years after she first noticed the lesion. Radiologically, the bony mass had features characteristic of mature myositis ossificans, showing "eggshell" ossification. A nonmineralized soft tissue mass occurred between the surface of the radius and the bony shell. Histologically, a high-grade osteosarcoma was present between the surface of the radius and the well-differentiated bone tissue, which included fatty and hematopoietic marrow. All the findings indicated that our patient had an extremely rare case of malignant transformation of myositis ossificans.
This report describes the cytological findings of a case of myositis ossificans in a 16-yr-old girl. Clinically and radiologically she was suspected to have a malignant soft tissue tumor. This was not confirmed by fine-needle aspiration cytology and a diagnosis of benign lesion, probably myositis, was given. This diagnosis was confirmed by histological examination.
The clinical and laboratory features of a case of myositis ossificans progressiva are described, and the recent literature concerning the pathogenesis and treatment of the condition is briefly reviewed.
We are showing a case of the myositis ossificans, appearing after the dissection of axilla simulating a metastasis of a malignant melanoma. In these circumstances this is a very rare case. It can, however, lead to an unnecessary operation. For this reason it should be useful to bera this possibility in mind.
We report a case of myositis ossificans circumscripta with an initial periosteal reaction and subsequent development of a cyst in the underlying cortex. All the roentgenographic abnormalities resolved spontaneously and permanently. The unusual course may have been due to formation of a subperiosteal hematoma at the time of development of the soft tissue ossification.
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Localized areas of active myositis ossificans, occurring without a clear history of antecedent trauma, have been referred to as a "pseudo-malignant osseous tumor of soft tissue." This lesion may be mistaken both roentgenographically and pathologically for a malignancy. The roentgenographic signs which favor a diagnosis of non-neoplastic heterotopic bone formation include a lucent zone between the lesion and the adjacent bone, an intact underlying cortex, diaphyseal location, dense calcification in the periphery, and loss of volume on serial films.
From 1981 to 1997, 26 cases of myositis ossificans circumscripta (MOC) were diagnosed and treated in our hospital, 22 of whom, occupying 84.6%, were confirmed by pathological examination. All the clinic data are reported as follows.
Myositis ossificans traumatica (MOT) is a rare musculoskeletal disorder in young children. Clinical and imaging presentation in the early stage of disease makes it difficult to differentiate between infection and musculoskeletal neoplasms, particularly in the absence of a history of trauma. Three cases of MOT in children under the age of 10 years, two with inferential trauma, are presented and the findings on different imaging modalities are discussed with reference to the existing literature. While findings based on a single imaging technique, including MRI, may be rather non-specific and even misleading, the combination of different modalities can assist in the consideration of MOT as a possible diagnosis. For example, the demonstration of soft-tissue haematoma on US would suggest the traumatic origin. A rational imaging approach is proposed.
This is a case report of a patient with pseudomalignant myositis ossificans of the hand. This entity is usually related to trauma, but there was no history of injury in this patient. Radiographic follow-up, histologic zone phenomena and computerized tomography are helpful in obtaining the correct diagnosis.
We have described the pre- and postgadolinium MR appearance in one case of acute myositis ossificans. The unenhanced sequences can be helpful in excluding malignancy, particularly when viewed serially. While use of gadolinium allowed primary sarcoma to be ruled out in this case, it was not useful in the exclusion of early abscess formation or necrotic metastasis.
Functionally disabling myositis ossificans of the posterior aspect of the elbow occurred in a 66-year-old man as a sequela of tetanus. Serial quantitative bone scans were done to determine the optimal time for excision, which produced an excellent functional result without recurrence at 4 years.
The case reported here demonstrates the need to consider myositis ossificans after acute injury to the CNS, irrespective of the nature of the trauma. This latter by no means needs to be direct trauma--as the present case shows. When the condition does occur, the time needed for rehabilitation may be significantly lengthened.
A case of heterotopic ossification (myositis ossificans) secondary to the central nervous system complications of acquired immune deficiency syndrome (AIDS) is reported. Because of the overwhelming suspicion of infection in this patient, this diagnosis was not considered until a gallium scan revealed the typical findings of heterotopic ossification. Because of the increasing utilization of gallium imaging in the AIDS population, every imaging specialist should be aware of this potential disorder.