BACKGROUND Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporad...BACKGROUND Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporadic. While most of the glomus tumors are benign, atypical glomus tumors with unusual features can be occasionally found, leading to distinctive malignant potential required different therapeutic approaches. Glomus tumor of uncertain malignant potential is one type of atypical glomus tumor with limited criteria for malignancy and without metastasis. CASE SUMMARY Herein, we report a case of a 48-year-old Thai male with a large painful mass in his axilla for one year without apparent neurological deficit. Magnetic resonance imaging showed a large heterogeneous mass encasing entire posterior cord of left brachial plexus and axillary artery. The tumor tissue from core needle biopsy histologically demonstrated the sheets and cords of relatively uniform tumor cells with foamy cytoplasm and round to oval hyperchromatic nuclei without atypia. The mitotic count was 0 per 50 high power field. A final diagnosis of glomus tumor of uncertain malignant potential was rendered. Complete surgical resection was performed, followed by adjuvant radiation due to positive margin. Neither local recurrence nor distant metastasis was observed at 2-year follow up. Unfortunately, postoperative incomplete brachial plexopathy without signs of reinnervation by electromyography was persisted. Later nerve grafting reconstruction was performed, followed by ongoing neurological rehabilitation. CONCLUSION Glomus tumor of uncertain malignant potential is exceedingly rare, especially around brachial plexus. Although the prognosis is good, careful histological diagnosis and treatment are needed to achieve an optimal outcome with lower morbidity.展开更多
Three-dimensional printed Ti-6Al-4V hemipelvic prosthesis has become a current popular method for pelvic defect reconstruction.This paper presents a novel biomimetic hemipelvic prosthesis design that utilises patient-...Three-dimensional printed Ti-6Al-4V hemipelvic prosthesis has become a current popular method for pelvic defect reconstruction.This paper presents a novel biomimetic hemipelvic prosthesis design that utilises patient-specific anatomical data in conjunction with the Voronoi diagram algorithm.Unlike traditional design methods that rely on fixed,homogeneous unit cell,the Voronoi diagram enables to create imitation of trabecular structure(ITS).The proposed approach was conducted for six patients.The entire contour of the customised prosthesis matched well with the residual bone.The porosity and pore size of the ITS were evaluated.The distribution of the pore size ranged from 500 to 1400μm.Porosity calculations indicated the average porosity was 63.13±0.30%.Cubic ITS samples were fabricated for micrograph and mechanical analysis.Scanning electron microscopy images of the ITS samples exhibited rough surface morphology without obvious defects.The Young’s modulus and compressive strength were 1.68±0.05 GPa and 174±8 MPa,respectively.Post-operative X-rays confirmed proper matching of the customised prostheses with the bone defect.Tomosynthesis-Shimadzu metal artifact reduction technology images indicated close contact between the implant and host bone,alongside favourable bone density and absence of resorption or osteolysis around the implant.At the last follow-up,the average Musculoskeletal Tumour Society score was 23.2(range,21-26).By leveraging additive manufacturing and Voronoi diagram algorithm,customised implants tailored to individual patient anatomy can be fabricated,offering wide distribution of the pore size,reasonable mechanical properties,favourable osseointegration,and satisfactory function.展开更多
文摘BACKGROUND Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporadic. While most of the glomus tumors are benign, atypical glomus tumors with unusual features can be occasionally found, leading to distinctive malignant potential required different therapeutic approaches. Glomus tumor of uncertain malignant potential is one type of atypical glomus tumor with limited criteria for malignancy and without metastasis. CASE SUMMARY Herein, we report a case of a 48-year-old Thai male with a large painful mass in his axilla for one year without apparent neurological deficit. Magnetic resonance imaging showed a large heterogeneous mass encasing entire posterior cord of left brachial plexus and axillary artery. The tumor tissue from core needle biopsy histologically demonstrated the sheets and cords of relatively uniform tumor cells with foamy cytoplasm and round to oval hyperchromatic nuclei without atypia. The mitotic count was 0 per 50 high power field. A final diagnosis of glomus tumor of uncertain malignant potential was rendered. Complete surgical resection was performed, followed by adjuvant radiation due to positive margin. Neither local recurrence nor distant metastasis was observed at 2-year follow up. Unfortunately, postoperative incomplete brachial plexopathy without signs of reinnervation by electromyography was persisted. Later nerve grafting reconstruction was performed, followed by ongoing neurological rehabilitation. CONCLUSION Glomus tumor of uncertain malignant potential is exceedingly rare, especially around brachial plexus. Although the prognosis is good, careful histological diagnosis and treatment are needed to achieve an optimal outcome with lower morbidity.
基金supported by Qingdao Research Institutes of Sichuan University,Research of Biomedical Materials and 3D Printing Related Products(No.20GZ30301).
文摘Three-dimensional printed Ti-6Al-4V hemipelvic prosthesis has become a current popular method for pelvic defect reconstruction.This paper presents a novel biomimetic hemipelvic prosthesis design that utilises patient-specific anatomical data in conjunction with the Voronoi diagram algorithm.Unlike traditional design methods that rely on fixed,homogeneous unit cell,the Voronoi diagram enables to create imitation of trabecular structure(ITS).The proposed approach was conducted for six patients.The entire contour of the customised prosthesis matched well with the residual bone.The porosity and pore size of the ITS were evaluated.The distribution of the pore size ranged from 500 to 1400μm.Porosity calculations indicated the average porosity was 63.13±0.30%.Cubic ITS samples were fabricated for micrograph and mechanical analysis.Scanning electron microscopy images of the ITS samples exhibited rough surface morphology without obvious defects.The Young’s modulus and compressive strength were 1.68±0.05 GPa and 174±8 MPa,respectively.Post-operative X-rays confirmed proper matching of the customised prostheses with the bone defect.Tomosynthesis-Shimadzu metal artifact reduction technology images indicated close contact between the implant and host bone,alongside favourable bone density and absence of resorption or osteolysis around the implant.At the last follow-up,the average Musculoskeletal Tumour Society score was 23.2(range,21-26).By leveraging additive manufacturing and Voronoi diagram algorithm,customised implants tailored to individual patient anatomy can be fabricated,offering wide distribution of the pore size,reasonable mechanical properties,favourable osseointegration,and satisfactory function.
