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Biomedical subjects

M M Lewis

Publications and source records attributed to M M Lewis.

At least 37 records · Page 2Linked to original sources

Case report 835: Parosteal osteosarcoma involving the left radius.

A case of parosteal osteosarcoma arising in the radius was presented. The site is uncommon, being represented in about 1% of all reported cases of parosteal osteosarcoma. The clinical and radiographic characteristics of this lesion were described and the histological as well as the differential diagnosis discussed.

Bone Neoplasms↗

Subperiosteal giant-cell reparative granuloma.

We present a case of subperiosteal giant-cell reparative granuloma followed over six years showing the complete evolution from the early phase of subperiosteal haematoma to the end stage of an ossified haematoma. Such lesions, although they are histologically similar to true giant-cell tumours, can be distinguished by the patients' age, their location on the diaphysis, and by their radiological and histological features.

Adult↗

Case report 785: Radiation-induced osteochondroma of the ilium.

A case of osteochondroma of the pelvis secondary to radiation therapy after radical nephrectomy for a Wilm's tumor is reported. The occurrence of such a complication has been discussed. Proof was obtained by open biopsy. The indications for surgical resection of such a tumor were considered. The differential diagnosis, though limited, was discussed.

Adult↗

Case report 773. Radiation-induced osteochondroma of the ilium.

A case of osteochondroma of the pelvis secondary to radiation therapy after radical nephrectomy for a Wilm's tumor is reported. The occurrence of such a complication is discussed. Proof was obtained by open biopsy. The indications for surgical resection of such a tumor were considered. The differential diagnosis, although limited in scope, was discussed.

Adult↗

Lesions of juxtacortical origin (surface lesions of bone).

A large variety of tumor and tumor-like conditions have been shown to originate from the surface of bone (Table 1). Most surface lesions are associated with periosteal reaction. The periosteum is a multipotential membrane. Its cellular composition may give rise to a variety of both neoplasms and tumor-like conditions. To avoid misinterpretation, the orthopedist, radiologist, and pathologist should be familiar with the entire spectrum of surface lesions. A better understanding of the natural history and biological behavior at different lesional maturity stages and correlation of the history with the radiographic and pathological findings is essential to establish the correct diagnosis. A history of injury or blunt trauma is very important. A stress fracture may produce a periosteal reaction acd callus that can be difficult to distinguish from osteosarcoma. In this review article, the authors wish to describe and define each term by its anatomy and radiographic features while discussing the entire spectrum of surface lesions. All the illustrative cases in this review article have been proven histologically.

Bone Diseases↗

Case report 794. Primary leiomyosarcoma of the right femur (fig. 4).

A rare case of primary leiomyosarcoma of the proximal end of the shaft of the right femur in a 52-year-old man has been reported. Proof was obtained by an open biopsy. The origin, pathological features, and clinical presentation have been discussed. The radiographic appearance, the differential diagnosis, and the poor prognosis of this tumor have also been indicated.

Femoral Neoplasms↗

Case report 796. Alveolar soft part sarcoma.

We have presented a young adult with alveolar soft part sarcoma. The lesion occurred in the ankle region and caused extensive bony erosion that mimicked metastasis. At the time of presentation, gingival and subcutaneous metastases were present. Within a short period, however, the patient developed disseminated lung and skeletal metastases as well.

Adult↗

Case report 810: Giant cell tumor of the first metatarsal.

And unusual case of giant cell tumor in a 3-year-old girl has been presented. The topic of giant cell tumors has been discussed at length. The pathology and the differential diagnosis have been considered. The incidence of giant cell tumors in children and adolescents has also been reviewed and proved to be extremely rare.

Bone Neoplasms↗

The role of microvascular surgery in limb-sparing procedures for malignant tumors of the knee.

Limb-sparing surgery has proven to be a feasible alternative to amputation for treatment of malignant tumors about the knee. Microvascular surgery and the possibility of providing healthy, stable soft-tissue coverage to the affected limb have expanded the possible role of limb-sparing techniques. Microvascular free flaps were utilized in 26 patients undergoing resection for large malignant tumors of the knee or adjacent to the knee. Patients were then followed for a minimum of 3 years to a maximum of 7 years and evaluated for tumor recurrence and limb function. Survival and disease-free interval were 68 and 77 percent, respectively, in stage II patients and only 50 and 0 percent, respectively, in stage III patients. Function, as determined by the MSTS functional evaluation system, was found to be fair to good in all patients. Microvascular free-tissue transfer has proven to be a valuable adjunct in limb-sparing surgery.

Adolescent↗

Periosteal ganglia: CT and MR imaging features.

The imaging features of four cases of periosteal ganglia were studied. Three lesions were located over the proximal shaft of the tibia, in proximity to the pes anserinus. The fourth lesion involved the distal shaft of the ulna. Three lesions had different degrees of external cortical erosion, scalloping, and thick spicules of periosteal bone on plain radiographs. The bone adjacent to the fourth lesion was not involved. Computed tomography (CT) showed these lesions to be sharply defined soft-tissue masses abutting the periosteum. All of the lesions had the same attenuation as fluid. Magnetic resonance (MR) imaging revealed the ganglia to be sharply defined masses that were isointense compared with neighboring muscles on T1-weighted images. There was markedly increased signal intensity compared with that of fat on T2-weighted images. The signal intensity on both types of images was homogeneous. The MR imaging features were consistent with the fluid nature of the lesions. Under the appropriate clinical circumstances, the MR imaging and CT features of periosteal ganglia are diagnostic.

Adult↗

Intramuscular myxoma of the left forearm.

Intramuscular myxoma is a distinct benign tumor confined to muscles. This tumor usually favors the thigh and shoulder. We are reporting a case of intramuscular myxoma of the forearm in an elderly female, a very rare site for this tumor. The magnetic resonance features of intramuscular myxoma are described. The differential diagnosis that included acute hematoma, acute abscess, intramuscular synovial cyst, schwannoma and malignant soft tissue tumors with myxomatous degeneration is discussed. The association between intramuscular myxomas and fibrous dysplasia has been emphasized.

Aged↗

Case report 795. High-grade surface osteosarcoma of the radius.

We described a case of high-grade surface sarcoma of the radius in a 14-year-old boy. The lesion appeared radiologically benign and was confined to the surface. The tumor was resected. At the time of biopsy both lungs showed diffuse metastases. Following surgery the patient underwent chemotherapy and the lung metastases improved. The pertinent literature was briefly discussed.

Adolescent↗