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At least 307 records · Page 17Linked to original sources
PubMed2005

[A case of primary and solitary bone metastasis of testicular seminoma after orchiectomy].

A 40-year-old man with stage I left testicular seminoma who had been followed for 18 months after orchiectomy, complained of pain in his left upper extremity and dysbasia. Magnetic resonance imaging (MRI) and bone scintigraphy suggested multiple bone lesions in the thoracic vertebrae and right ischium, and bone biopsy revealed metastasis of seminoma. There was no evidence of other metastatic lesions. After he was treated with 2 courses of first-line chemotherapy consisting of peplomycin, etoposide, and cisplatin, which were followed by 2 courses of high-dose chemotherapy with carboplatin, etoposide, and ifosfamide, the metastatic lesions were nearly in complete response on MRI and bone scintigraphy and the result of fluorodeoxyglucose-positron emission tomography was negative, but the hCG-beta level remained slightly elevated. In most advanced testicular tumors, bone metastasis usually coexists with other metastatic lesions and appears as a secondary lesion. Herein, we report this rare case of primary and solitary bone metastasis from testicular seminoma after orchiectomy.

Adult↗
PubMed2006

Bone metastasis as a presenting feature of endometrial adenocarcinoma: case report and literature review.

A rare case of endometrial adenocarcinoma that presented with symptoms of bone metastasis in the right ischium is described. The patient had no signs or symptoms of gynecological malignancy and the diagnostic work up did not reveal the primary disease. The bone metastasis was treated successfully by radiotherapy, but three years later the patient noted vaginal bleeding, which led to the diagnosis and treatment of the primary endometrial cancer. Another 20 cases of endometrial carcinoma with bone metastasis have been found in literature, but only five of them presented with the feature of bone metastasis. Bone metastasis should be considered in patients with endometrial adenocarcinoma.

Adenocarcinoma↗
PubMed2006

[Plasmacytoma with multiple hypervascular lesions revealed by angiography in a patient with multiple myeloma].

A 68-year-old woman suffering from a left iliac tumor and severe back pain was admitted to another hospital in May 1999. The bone X-ray, CT scan and MRI demonstrated a 7 cm x 5 cm left iliac tumor with osteolysis and she was transferred to our hospital. Angiography demonstrated multiple hypervascular lesions in the left ilium, lumbar vertebrae, left ischium, left pubis and left rib. The tumor was resected and diagnosed as a plasmacytoma. Immunoelectrophoresis did not show any M-protein in the serum and urine, but the patient was diagnosed as having a non-secretory or low producing multiple myeloma because of the presence of 42.8% of abnormal plasma cells in the bone marrow aspirate. Her symptoms improved following 3 courses of MCNU-VMP therapy and the bone marrow plasma cells decreased to less than 5%. She was discharged and treated as an outpatient but relapsed and died of chemotherapy-resistant myeloma. We report this case because macro-angiogenesis in a multiple myeloma demonstrated by angiography is rare and interesting.

Aged↗
PubMed2006

[Resection and reconstruction for tumors of iliac bone].

OBJECTIVE: To discuss the resection of tumors, reconstruction of defects. METHODS: Sixty-one patients with tumors in ileum were treated surgically in People's Hospital from July 1998 to July 2004. The series comprised 38 males and 23 females with an average age of 43 years old (range from 12 to 78 years old). According to Enneking staging system, 36 cases had lesions in region I, 17 cases in region I and II, and 8 cases in region I and IV. After tumor resected, posterior fixation system of spine was applied to reconstruct the integrality of pelvic ring in series of region I cases. The four pedicle screws were implanted in the lumbar and sacrum superiorly, pubis and ischium inferiorly. For children patients, bone graft or bone cement and Steinmann's pins internal fixation was applied to reconstruct the pelvis. RESULTS: Among all the 61 cases, 48 cases followed up from 16 months to 6 years. Thirty-three cases were survived and had no local recurrence or metastasis. Fifteen cases were dead. Oncology result: local recurrence were found in 19.4% patients with region I resection (7/36), the resection level was close to acetabulum (in order to reserve the acetabulum), and it might be the reason of recurrence. 35.3% of patients (6/17) with region I and II resection had local recurrence, the recurrence maybe related to residual tumor after curettage. 50.0% of the patients (4/8) with region I and IV resection had local recurrence, the tumor residual in sacrum might be the reason of recurrence. Functional result: all of the 36 cases received region I resection regained normal walking function. The hip joint function was normal in 17 cases received tumor curettage, bone cement or hip joint replacement. CONCLUSIONS: The posterior fixation system of spine can be used to reconstruct the integrality of pelvic ring after resection of iliac tumors. Simple reconstruction is more favorable for child patients. Allograft or self-ileum can be implanted in the space of sacral wing and residual ileum, and the bone graft is fixed with compressional screw.

Acetabulum↗
PubMed1991

[Statistical analysis of the prostatic cancer patients detected from 1985 to 1989 in and around Gunma prefecture].

Prostatic cancer is one of the most common malignant tumors in the field of urology. The number of patients is increasing rapidly and its importance as a mortal disease is gathering attention. In 1985, we organized a registration system for prostatic cancer patients found in and around Gunma prefecture. In this study, we analyzed the clinical characteristics of the 730 patients registered from 1985 to 1989. The results were as follows. Mean age was 74.0 years old and the number of the patients was the greatest in the eighth decade. Voiding disturbance was the most common chief complaint, followed by pollakisuria, gross hematuria and miction pain. Stage and grade distribution were as follows. Stage A 16.2%, B 21.1%, C 17.0%, D 45.7%, well differentiated 27.4%, moderately differentiated 48.2% and poorly differentiated 24.5%, respectively. A statistically significant relationship between stage and grade was observed. Bone was the most common metastatic site. The highest incidence of bone metastasis was in lumbar vertebra, followed by ribs, ilium, thoracic vertebra and ischium. The value of PAP, ALP and ESR tended to be higher in high stage patients, and that of Hb was lower. Fifty two patients were detected by mass screening. Most of these patients were in an early stage. Most of the patients were treated by hormonal therapy. LH-RH agonists constituted 39.2% of the cases given hormonal therapy.

Adenocarcinoma↗
PubMed1991

[Magnetic resonance in the diagnosis of aneurysmal bone cyst].

A patient of 12 suffering from aneurysmal cyst of the ischium was studied with traditional radiology, computed tomography (CT) and magnetic resonance imaging (MRI). The advantages of MRI in the study of this pathology compared to traditional radiography and CT are assessed. It was shown that the CT and MRI techniques are superior to standard X-ray examinations in anatomic definition and in evaluating the lesions's relationships with neighbouring structures and, in particular, that MRI is superior to CT in extension.

Bone Cysts↗
PubMedDate not supplied

[A case of sirenomelia].

The case of a 37-year-old woman, dressmaker, with congenital lower limb amelia is presented. The specific and complementary investigations revealed the absence of the left half of sacrum, coccyx, together with the left iliac bone, ischium and pubis. Urography demonstrated the absence of left kidney. Ultrasonography revealed the presence of the spleen. The data in the literature are reviewed and some comments are made.

Adult↗
PubMed1978

Pelvic osteomyelitis in children.

Six children (7 to 16 years of age) with pelvic osteomyelitis are described. Sites of involvement included the pubis in three patients, the ilium in two patients, and the ischium in one patient. All were right-sided. Each patient presented with a history of fever and an abnormal gait. In four, the point tenderness indicated the site of bony involvement. All patients had pain on abduction but free passive range of motion of the hip. Soft tissue swelling was present on admission pelvic roentgenograms in five patients. Intravenous pyelogram revealed deviation of the bladder toward the midline in each of four patients studied. Roentgenographic changes typical of osteomyelitis developed in four patients ten days to ten weeks after onset of symptoms. In four patients in whom an organism was identified, Staphylococcus aureus was isolated from blood and/or bone. All isolates were methicillin-sensitive and two were penicillin-sensitive. Purulent material was drained from three of the five patients who underwent surgical exploration of the pelvis. All patients received parenteral antistaphylococcal therapy for 3 to 5 1/2 weeks (mean, 4 weeks). Oral antibiotics were given to five patients for an additional 3 to 14 weeks. All patients recovered completely.

Adolescent↗
PubMed1990

Triple osteotomy of the pelvis. A review of 51 cases.

From 1980 to 1987, 43 patients (51 hips) were treated by triple pelvic (ischium, ilium, and pubis) osteotomy for moderate to severe symptomatic acetabular dysplasia. They were followed postoperatively for an average of 48 months (range, 18 to 84 months). In 41 patients (43 hips; 96%) there was dramatic relief of pain. The mean center-edge angle improved from 13.4 degrees to 36.1 degrees. The coverage of the femoral head was improved by an average of 25%. The authors conclude that triple osteotomy of the pelvis gives consistently good and predictable results with regard to pain relief and adequate femoral head coverage.

Acetabulum↗
PubMed1990

Avascular necrosis in patients treated with the Pavlik harness for congenital dislocation of the hip.

Two hundred and seventy hips of 220 patients were treated with the Pavlik harness for congenital dislocation. Two hundred and thirty-three hips were dislocated, and thirty-seven hips had acetabular dysplasia. Of the 233 dislocated hips, thirteen (6 per cent) were not reduced. In one hundred and eighty-four hips that were successfully reduced, avascular necrosis did not develop. Avascular necrosis was observed in thirty-six (16 per cent) of the 220 reduced hips. Of these, twenty-seven hips were followed for five to twenty years (average, nine years). The result was excellent or good in eighteen hips (67 per cent), fair in three (11 per cent), and a failure in six (22 per cent). Avascular necrosis was seen in one of the thirty-seven hips that had acetabular dysplasia, and it was found even in the normal hip of a patient who had unilateral dislocation. In this study, the amount of displacement was represented by distances a and b, as defined by Yamamuro and Chene. Distance a is the length from the middle point of the proximal metaphyseal border of the femur to the Y-line, and distance b is the distance from the same point to the lateral margin of the ischium. When distance a was more than four millimeters, the over-all rate of reduction was 97 per cent (209 of 215 hips), ranging from 96 per cent (eighty-two of eighty-five hips) when distance a was eight to ten millimeters to 100 per cent (twenty-nine hips) when distance a was more than ten millimeters.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMedDate not supplied

Popliteal pterygium syndrome: an orthopaedic perspective.

Popliteal pterygium syndrome (PPS) is a rare autosomal dominant disorder consisting of popliteal webs and craniofacial, genitourinary, and extremity anomalies. The popliteal webs make this syndrome particularly important to the orthopaedic surgeon. The resultant fixed flexion deformity can be severe, at times approximating the ischium to the calcaneus. The neurovascular bundle is contained in the web's posterior subcutaneous (S.C.) margin, which makes surgery precarious and difficult. We reviewed four patients between 1964 and 1986, three of whom were severely affected with fixed flexion deformities at the knee. Distal femoral shortening and extension osteotomies provided good results, and this procedure should be considered earlier rather than later in treatment of this problem.

Adolescent↗
PubMed1989

Primary malignant giant cell tumor of bone: "dedifferentiated" giant cell tumor.

Well documented examples of primary malignant giant cell tumor of bone (giant cell tumor and concurrent sarcoma arising de novo) are exceedingly rare in the literature. We report a case arising in the left ischium of a 44-yr-old man. He had no previous history of radiation therapy or multiple resections. Histologically, the tumor was a typical giant cell tumor of bone juxtaposed to a malignant fibrous histiocytoma (MFH). The juxtaposition of a high grade sarcoma (MFH) and a locally aggressive nonmalignant neoplasm such as giant cell tumor is analogous to several other tumors of bone and soft tissue in which a low grade malignant or locally aggressive tumor can be associated with MFH or fibrosarcoma de novo, namely chondrosarcoma, chordoma, liposarcoma, and well differentiated intraosseous and parosteal osteosarcoma. The presence of a high grade malignant component in each of the aforementioned neoplasms generally portends a more ominous prognosis, although this is not invariably true. Recognition of the phenomenon of "dedifferentiation" (or tumor progression) in some bone tumors and sarcomas is important to ensure appropriate treatment. Distinction from secondary malignant giant cell tumors which are usually radiation induced is also important, since the latter have a much worse prognosis than those with dedifferentiation occurring de novo.

Adult↗
PubMed1989

[Perineal neuralgia and Alcock's canal syndrome].

Perineal neuralgia is characterised clinically by pain (burning type of perineal pain) exacerbated in the sitting position. It is secondary to impairment of the internal pudendal nerve in its musculo-osteo-aponeurotic tunnel composed by the ischium and the obturator internus muscle (ischiorectal fossa or pudendal canal). As in any nerve tunnel syndrome, pre-existing neuropathy constitutes a predisposing factor and should therefore be identified. The diagnosis of pudendal tunnel syndrome is confirmed by perineal electrophysiological investigations (detection of neurogenic muscles of the perineal floor, increased sacral latency). Treatment consists of infiltration, possible repeated, of the pudendal tunnel with a sustained-release corticosteroid under CT guidance.

Aged↗
PubMed1989

[Design of partial pelvic replacement with calculation of stresses on the pelvic bone using the finite element method].

Although tumors of the pelvic region are relatively rare, with regard to the provision of an individual prosthesis, they make great demands both on the engineer and on the surgeon. In the case of partial pelvic replacement, the main problem is that of fixation. The direction of the preload by the screw and counternut in the anchorage should make possible the introduction of forces into the bone that closely mimic the natural pre-operative situation, in order to keep bone remodeling and stressing to a minimum. A three-dimensional finite element (FE) analysis of the stresses at work in the pelvic bone was performed using an FE model of the pelvis constructed on the basis of computed tomographic data, since with the FE method it is possible to obtain information about deformations, internal stresses and local forces acting on the bone. The results show that the main stressing of the bony pelvis occurs in the region of the acetabulum and the iliosacral joints, and that further points of loading are located in the lower region of the ischium-and this while standing on one leg, on the side of the supporting leg.

Biomechanical Phenomena↗
PubMed1989

[Triple osteotomy of the pelvis in children].

The innominate osteotomy described by Salter was used to redirect the acetabulum in the course of the treatment of a number of hip diseases in children. This resulted in an immediate improvement of coverage of the femoral head. One can also expect a more congruent growth of the two constituents of the hip joint in the forthcoming years. In older children in whom rigidity of the pubic symphysis did not permit a sufficient amount of acetabular tilt the acetabulum had to be isolated from the rest of the pelvis by a triple osteotomy which consisted of, in addition to the osteotomy of the ilium, osteotomies of the superior pubic ramus and the ischium or the inferior pubic ramus.

Acetabulum↗
PubMedDate not supplied

Megakaryocytes and ganglion cells mimicking cancer in fine needle aspiration of the prostate.

In six cases, fine needle aspiration (FNA) directed at prostatic lesions produced specimens containing megakaryocytes or ganglion cells, which are sources of potential diagnostic error in the interpretation of aspirates of the prostate gland. In three cases, apparent accidental penetration of the tip of the transrectal FNA biopsy needle into the ischium instead of the prostate resulted in the aspiration of megakaryocytes and other bone marrow elements; the megakaryocytes mimicked anaplastic cancer. Three additional FNAs of the prostate produced specimens containing a small number of ganglion cells mimicking well-differentiated adenocarcinoma; the accompanying strands of wavy neural tissue served as a clue to the ganglionic origin of these potentially misleading cells. The paucity of "atypical" cells and the sparsity or absence of prostatic epithelium in the aspirates were additional clues to the cytologist that the findings represented an anatomic misplacement of the FNA biopsy needle tip, rather than a prostatic cancer.

Adenocarcinoma↗
PubMed1987

Surgical treatment of giant cell tumors of the pelvis.

There are many problems concerning management of giant cell tumors in the pelvis: diagnosis, surgical approach, adequacy of treatment, reconstruction, and prognosis. Of 58 cases of giant cell tumor of bone from 1962 to 1985, five cases arose in the pelvis, two in the ilium, two in the ischium, and one in the pubis. Surgical procedures included en bloc excision in four cases and intralesional excision in one. Reconstruction included sacroiliac fusion in one, iliofemoral fusion in one, and pelvic prosthetic replacement in another. Recurrence and metastasis did not occur in any of the cases. All patients were able to walk without crutches. A good surgical approach isolates major vessels and nerves, and permits excision to prevent recurrence and control bleeding. Reconstructive surgery may be required for treatment of a pelvic giant cell tumor.

Adult↗