Wide excision, a recommended treatment for osteoid osteoma, creates needless resection of surrounding bone and causes difficult intraoperative nidus identification. It was in the form of granules 2 to 3 mm , sticks 20 x 5 x 5 or 10 x 5 x 5 mm or custom made blocks. General anesthesia was employed in two cases and conscious sedation in one. We compared our operative technique with 247 cases in which the percutaneous technique of removal or coagulation of the nidus had been performed. A well-informed orthopaedic surgeon may manage most of these tumours but any doubt must be verified by a consultation in a specialized orthopaedic department. There were no perioperative anesthetic, neurologic, hardware, or healing complications. A central secondary chondrosarcoma is defined as one that shows the combination of both the enchondromatous and chondrosarcomatous patterns.
The judicious use of computed tomography, magnetic resonance imaging, and nuclear medicine in conjunction with appropriate clinical data allows the radiologist to establish the correct diagnosis of benign or malignant medullary chondroid lesion in the majority of cases. Will we ever reliably predict prognosis in a patient with myxoid and round cell liposarcoma? A different diagnosis was made in six patients: mucoid cyst, subchondral arthritic geode, fibrous dysplastic lesion, focal osteochondritis, or focal chronic osteomyelitis. The participants were observed for changes in N-telopeptide, pain score, and radiographic changes. Données récentes dans le diagnostic des liposarcomes. Pueden plantearse tratamientos simples que van desde la vigilancia hasta la destrucción bajo control radiológico.
In 14 cases, the bone defect was due to conservative treatment of a benign tumor, in 3 cases due to aseptic post-traumatic non union, in 3 cases due to wide resection for malignant tumors of the pelvis and in 3 cases following osteotomy. We tried to find factors predictive of recurrence. No stress fractures occurred in the substitute. The burr-down technique was successfully used in 15 cases, and four were treated with wide excision. He was treated by curettage and packing with bone substitute. The possibility of immediate fixation and stabilization of large defects is the most valuable point of this method.
Cure was obtained in 32 patients 84% , whatever the cause. All patients underwent curettage and cryosurgery through a cortical window; we replaced the window and plated the region with at least three screws beyond the curetted area. This burr-down technique requires precise preoperative anatomic localization by thin section 1-1. Pathological features close to those noted in aneurismal bone cysts were often encountered. Local recurrence seems to be easily detectable by magnetic resonance imaging. All except one patient were mobilised two to four days after surgery.
Computed tomography-guided imaging was used to introduce a trephine for placement of the electrode tip in the nidus. In Conduite à tenir devant une image osseuse ou des parties molles d'allure tumorale. After 2 recurrences with soft tissue and intra-articular extension, we performed a wide resection with reconstruction using a vascularized fibular graft. Fifteen patients had operative treatment twelve immediate and three delayed ; all fifteen had complete relief of pain. The data confirm the appropriateness of conservative surgery for central low-grade chondrosarcomas of the proximal humerus and distal femur based on a combination of intralesional curettage and cryogenic parietal sterilization.
La benignidad de estos tumores no exime de la meticulosidad en todos los pasos del proceso. The short- and medium-term clinical course and histologic features of the resection specimens were analyzed. The low aggressiveness of Grade I chondrosarcomas is compatible with conservative surgical treatment. Normal physical activity without restrictions was restored immediately after discharge. The one metastasizing benign chondroblastoma that was documented is a pathologic rarity. The ultra-structure of these tumours was also studied.
The average operative time was 30 min, with negligible blood loss and a minimum hospital stay and rehabilitation. Fibrous dysplasia is proliferation of fibrous tissue within the bone marrow causing osteolytic lesions and pathologic fractures. Hyperthermic treatment was carried out at temperature of 60 degrees for 10 min and in other conditions. Major complications occurred in 15% and included infection, refracture, coxa vara, extremity shortening, and physeal damage. No complications were associated with this simplified cryotherapy technique. The most severe complications were two femoral fractures and one focal chronic osteomyelitis due to Staphylococcus aureus infection.
The crucial enchondroma patterns consist of multiple nodules of hyalin cartilage separated by normal marrow in conjunction with partial to complete encompassing plates of lamellar bone that conform to the irregular shapes of the cartilage nodules. Le patient a été stadifié comme métastatique. In Conduite à tenir devant une image osseuse ou des parties molles d'allure tumorale. A randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. The diagnosis was confirmed histologically in all specimens.
Conversely, local aggressiveness may need rapid excision, mostly by intralesional excision and rarely by wide excision with reconstruction. A retrospective review of clinical records and radiographic studies radiographs, magnetic resonance images, and bone scans was done for all patients presenting to an orthopaedic oncology unit with solitary enchondroma of the proximal humerus. This study evaluates the clinical and histological efficiency of an intraoperative localization of the nidus by the tetracycline fluorescence test which is based on histomorphometric bone labeling techniques. Radiographic healing of defects with normal appearing bone was complete in four patients by 12 months, in an additional eight patients by 24 months, and in all except four patients by 48 months. Twenty-four patients were evaluated and diagnosed, between August 1975 and July 1989, as having probable osteoid-osteoma. All 18 of the pure enchondromas diagnosed by the methods proposed in this article behaved with strict benignity i.
Less bone resection is required by successively burring through the reactive bone to identify the nidus, which is then removed with curettes and burrs. Chondroblastoma is a benign bone tumor, but prognosis depends on the rapidity and severity of recurrence. The radiologic signs necessary to establish rates are described and illustrated. Although Grade 2 and 3 chondrosarcomas could be diagnosed on the basis of cytologic features alone, low-grade chondrosarcoma could not be adequately differentiated from pure, benign enchondroma s by cytology alone. Ils sont de bons amis avec des serpents et des coqs, mais totalement à la fin avec des chèvres.