BACKGROUND Dedifferentiated chondrosarcoma(DDCS)accounts for 10%of all chondrosarcomas and has the poorest outcome,with a 5-year survival rate of 7%-25%.DDCS commonly occurs in the femur and pelvis,whereas DDCS of the...BACKGROUND Dedifferentiated chondrosarcoma(DDCS)accounts for 10%of all chondrosarcomas and has the poorest outcome,with a 5-year survival rate of 7%-25%.DDCS commonly occurs in the femur and pelvis,whereas DDCS of the finger is extremely rare.Furthermore,the histological findings of preexisting solitary enchondroma samples are important and valuable for diagnosing malignant transformations.CASE SUMMARY We report our experience with DDCS in the proximal phalanx of the left middle finger of an 87-year-old woman.She had undergone surgery for enchondroma,with curettage and artificial bone grafting,11 years ago,in the same location.Several years after the primary surgery,the left middle finger gradually started to enlarge,and the growth speed increased in the past year.Plain radiographs showed an expansive osteolytic lesion with calcifications and residual grafting material.Owing to the suspicion of malignancy,we performed ray amputation.Histological findings revealed an abrupt transition between the low-grade chondrosarcoma and dedifferentiated sarcoma components.The dedifferentiated components showed the features of a high-grade undifferentiated pleomorphic sarcoma.The patient was diagnosed with DDCS arising from a preexisting enchondroma.She had no local recurrence or distant metastasis and died of pneumonia 6 years and 10 months after the second surgery.CONCLUSION The histological findings of a precursor lesion showed a typical enchondroma,suggesting that DDCS can arise from enchondroma.展开更多
BACKGROUND Hutchinson-Gilford progeria syndrome(HGPS)is an extremely rare disease characterized by the rapid appearance of aging with an onset in childhood.Serious cardiovascular complications can be life-threatening ...BACKGROUND Hutchinson-Gilford progeria syndrome(HGPS)is an extremely rare disease characterized by the rapid appearance of aging with an onset in childhood.Serious cardiovascular complications can be life-threatening events for affected patients and the cause of early death.Herein we report a HGPS patient with osteosarcoma hat was successfully managed and is alive 13 years after the diagnosis.This is the first report describing the detailed surgical procedure and long-term follow-up of osteosarcoma in a patient with HGPS.CASE SUMMARY The patient was diagnosed with HGPS at 5 years of age with typical features and was referred to our department with a suspected bone tumor of the left proximal tibia at the age of 18.Open biopsy of the tibial bone tumor revealed a conventional fibroblastic osteosarcoma.We have developed and performed a freezing technique using liquid nitrogen for tumor reconstruction.This technique overcame the small size of the tibia for megaprosthesis and avoided amputation and limb salvage was achieved 13 years post-operatively.Although the patient had a number of surgical site complications,such as wound dehiscence,and superficial and deep infections due to vulnerable skin in HGPS,no recurrence or metastases were detected for 13 years,and she walks assisted by crutches.Her general health was good at the latest follow-up at 31 years of age.CONCLUSION A HGPS patient with osteosarcoma was successfully managed and she was alive 13 years after the diagnosis.展开更多
Recently we have been performing biological reconstruction for malignant bone tumors of the extremities using frozen autografts. Here we present a case treated with free vascularized fibular graft (FVFG) after this me...Recently we have been performing biological reconstruction for malignant bone tumors of the extremities using frozen autografts. Here we present a case treated with free vascularized fibular graft (FVFG) after this method. A 23-year-old man developed osteosarcoma in his left distal tibia. There was nonunion after frozen autograft reconstruction, which we treated with FVFG. Twenty-four months later, bridging between the host bone and the frozen autograft was achieved. Our department has achieved bone union in almost all cases, but we sometimes encounter cases of nonunion after this method because of delayed blood supply. In these instances, reconstruction using FVFG may represent an attractive choice for salvage treatment.展开更多
文摘BACKGROUND Dedifferentiated chondrosarcoma(DDCS)accounts for 10%of all chondrosarcomas and has the poorest outcome,with a 5-year survival rate of 7%-25%.DDCS commonly occurs in the femur and pelvis,whereas DDCS of the finger is extremely rare.Furthermore,the histological findings of preexisting solitary enchondroma samples are important and valuable for diagnosing malignant transformations.CASE SUMMARY We report our experience with DDCS in the proximal phalanx of the left middle finger of an 87-year-old woman.She had undergone surgery for enchondroma,with curettage and artificial bone grafting,11 years ago,in the same location.Several years after the primary surgery,the left middle finger gradually started to enlarge,and the growth speed increased in the past year.Plain radiographs showed an expansive osteolytic lesion with calcifications and residual grafting material.Owing to the suspicion of malignancy,we performed ray amputation.Histological findings revealed an abrupt transition between the low-grade chondrosarcoma and dedifferentiated sarcoma components.The dedifferentiated components showed the features of a high-grade undifferentiated pleomorphic sarcoma.The patient was diagnosed with DDCS arising from a preexisting enchondroma.She had no local recurrence or distant metastasis and died of pneumonia 6 years and 10 months after the second surgery.CONCLUSION The histological findings of a precursor lesion showed a typical enchondroma,suggesting that DDCS can arise from enchondroma.
文摘BACKGROUND Hutchinson-Gilford progeria syndrome(HGPS)is an extremely rare disease characterized by the rapid appearance of aging with an onset in childhood.Serious cardiovascular complications can be life-threatening events for affected patients and the cause of early death.Herein we report a HGPS patient with osteosarcoma hat was successfully managed and is alive 13 years after the diagnosis.This is the first report describing the detailed surgical procedure and long-term follow-up of osteosarcoma in a patient with HGPS.CASE SUMMARY The patient was diagnosed with HGPS at 5 years of age with typical features and was referred to our department with a suspected bone tumor of the left proximal tibia at the age of 18.Open biopsy of the tibial bone tumor revealed a conventional fibroblastic osteosarcoma.We have developed and performed a freezing technique using liquid nitrogen for tumor reconstruction.This technique overcame the small size of the tibia for megaprosthesis and avoided amputation and limb salvage was achieved 13 years post-operatively.Although the patient had a number of surgical site complications,such as wound dehiscence,and superficial and deep infections due to vulnerable skin in HGPS,no recurrence or metastases were detected for 13 years,and she walks assisted by crutches.Her general health was good at the latest follow-up at 31 years of age.CONCLUSION A HGPS patient with osteosarcoma was successfully managed and she was alive 13 years after the diagnosis.
文摘Recently we have been performing biological reconstruction for malignant bone tumors of the extremities using frozen autografts. Here we present a case treated with free vascularized fibular graft (FVFG) after this method. A 23-year-old man developed osteosarcoma in his left distal tibia. There was nonunion after frozen autograft reconstruction, which we treated with FVFG. Twenty-four months later, bridging between the host bone and the frozen autograft was achieved. Our department has achieved bone union in almost all cases, but we sometimes encounter cases of nonunion after this method because of delayed blood supply. In these instances, reconstruction using FVFG may represent an attractive choice for salvage treatment.
