Biomedical subjects
Publications and source records attributed to Martin Torriani.
Osteoid osteoma is a small osteogenic tumor usually found in the lower extremity of children and young adults. Although these lesions are benign and rarely progress, they present distinctive pain symptoms that frequently require medical intervention. This article reviews surgical, medical, and percutaneous techniques for treatment of osteoid osteoma, emphasizing the value of percutaneous radiofrequency treatment.
OBJECTIVE: To determine the value of sonographically guided core needle biopsies of musculoskeletal tumors as a reliable alternative to fluoroscopy and computed tomography. METHODS: A prospective study was performed in 74 patients referred for image-guided needle biopsy of primary or recurrent musculoskeletal neoplasms and suspected solitary metastasis. Imaging studies performed before biopsy established the feasibility of sonographic guidance in 65 lesions, of which 38 were soft tissue tumors and 27 were bone lesions with extraosseous masses. The lesions were located mainly in the appendicular skeleton. Tissue samples were obtained with a 14-gauge cutting needle coupled to an automated biopsy device under local anesthesia and sonographic guidance. Statistical analysis was based on 48 biopsies confirmed by successful clinical treatment (10 cases) or surgical resection (38 cases). RESULTS: An accurate diagnosis was obtained in 47 (97%) of 48 biopsies; sensitivity was 96%, and specificity was 100%. The method did not yield sufficient tissue to establish a diagnosis in 1 case. Considering all 65 biopsies, high-quality specimens were obtained in 96%. The procedure was carried out expeditiously, and there were no complications. CONCLUSIONS: Sonographically guided core needle biopsy is accurate and safe, obviating open biopsy in most soft tissue masses and bone tumors with extraosseous masses in the appendicular skeleton. In such patients, the sonographically guided procedure is the most prompt and effective method for obtaining tissue samples.
Adamantinoma is a rare malignant neoplasm arising most often in the tibia and is locally aggressive. Conservative surgical treatment frequently is followed by recurrence and magnetic resonance (MR) imaging plays an important role in preoperative planning. Magnetic resonance features of this tumor have not been described in detail. We report three cases of classic tibial adamantinoma examined at 2 Tesla. High-resolution images with findings that may influence management are discussed.
PURPOSE: To illustrate the radiological findings and review the current literature concerning a rare congenital abnormality of the posterior arch of the atlas. CASE REPORT: An adult female without neurological symptoms presented with an absent posterior arch of the atlas, examined with plain films and helical computerized tomography. Complete agenesis of the posterior arch of the atlas is a rare entity that can be easily identified by means of plain films. Although it is generally asymptomatic, atlantoaxial instability and neurological deficits may occur because of structural instability. Computerized tomography provides a means of assessing the extent of this abnormality and can help evaluate the integrity of neural structures. Although considered to be rare entities, defects of the posterior arch of the atlas may be discovered as incidental asymptomatic findings in routine cervical radiographs. Familiarity with this abnormality may aid medical professionals in the correct management of these cases.