Traumatic bone cyst: a retrospective study of 21 cases

Objective: To describe the clinical and radiological characteristics, and surgical findings of traumatic bone cysts. Study Design: A retrospective observational study was made of 21 traumatic bone cysts. The diagnosis was based on the anamnesis, clinical examination, and complementary tests. Panoramic and periapical X-rays were obtained in all cases, together with computed tomography as decided by the surgeon. A descriptive statistical analysis was made of the study variables using the SPSS v12.0 for Windows. Results: There was a clear female predominance (14:7). The mean age was 26.5 years (range 8-45 years). The cysts in all cases constituted casual findings during routine radiological exploration. In those cases where computed tomographic images were available, preservation of the vestibular and lingual cortical layers was observed. Five of the 21 patients (23.8%) reported a clear antecedent of traumatism in the affected zone. All the lesions were subjected to surgery, and the cavities were found to be vacant in 90.5% of the cases. In only two patients were vascular contents seen within the cavity. Two of the patients presented postoperative paresthesia of the inferior dental nerve that subsided within two weeks. The 19 patients in whom adequate postoperative follow-up proved possible all showed complete bone healing. Conclusions: Traumatic bone cysts were a casual finding. During the surgery, most cases showed to be vacant cavity without an ephitelial lining. Careful curettage of the lesion favors progressive bone regeneration, offering a good prognosis and an almost negligible relapse rate. Other treatment options only would be justified in cases of relapse.

Complex cytogenetic rearrangement in a case of unicameral bone cyst

Cytogenetic analysis of a unicameral bone cyst surgically resected in an 11-year-old boy revealed a highly complex clonal structural rearrangement involving chromosomes 4, 6, 8, 16, 21, and both 12. These findings reinforce the need for further studies on unicameral bone cysts to verify the frequency and to understand the significance of chromosome anomalies in this type of lesion.

Aneurysmal bone cyst of the tuberculum articulare of the temporomandibular joint: a case report

A case is presented of a 14-year-old boy with aneurysmal bone cyst of the tuberculum articulare of the temporomandibular joint (TMJ). This disease rarely involves the skull, and involvement of temporal bone is even more rare. To our knowledge, only 22 cases have been reported in the literature. This is the first case of aneurysmal bone cyst of the tuberculum articulare of the TMJ described in the literature.

Cisto ósseo simples: relatos de casos

Usually diagnosed in routine radiographs, the simple bone cyst occurs infrequently. Etiology is unknown and differential diagnosis has to be made with dentigerous cyst, keratocystic odontogenic tumor, adenomatoid odontogenic tumor, ameloblastoma and central giant cell granuloma. Treatment is surgical, by perforating the cortical bone. In most cases an empty cavity, without any capsule or epithelial covering, is encountered, but it may have a liquid content. Perforation of the mandibular cortical bone elicits a response that results in bone repair of the empty cavity. This article reviews the subject and presents two cases of this entity and discusses the possible factors that could interfere in healing course.

The use of a modular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation and analysis of 37 cases

We analyzed 37 patients who underwent segmental wide resection of bone tumors and reconstruction with a modular titanium endoprosthesis at the Orthopaedic Oncology Group, between 1992 and 1998. Twelve patients were male and 25 were female, with a mean age of 30 years (9 - 81). The mean follow-up was 14 months (2 - 48). The diagnoses were: osteosarcoma (14 cases), metastatic carcinoma (10), Ewing's sarcoma (4), giant cell tumor (4), malignant fibrous histiocytoma (3), chondrosarcoma (1), and aneurysmal bone cyst (1). Eleven articulated total knee, 8 partial proximal femur with bipolar acetabulum, 8 partial proximal humerus, 3 total femur, 2 partial proximal tibia, 2 diaphyseal femur, 2 diaphyseal humerus, and 1 total proximal femur with cementless acetabulum endoprosthesis implant procedures were done. The complications related to the procedure included: infection (5 cases), dislocation (3), module loosening (1), and ulnar nerve paresthesia (1). We used the following criteria for the clinical evaluation: presence of pain, range of motion, reconstruction stability, surgical and oncologic complications, and patient acceptance. The results were good in 56.8% of the cases, regular in 32.4% and poor in 10.8%.

Management of brachial plexus region tumours and tumour-like conditions: relevant diagnostic and surgical features in a consecutive series of eighteen patients

Tumours of the brachial plexus region are rare and most publications are case reports or studies with a small series of patients. The aim of this study is to present our experience in managing these lesions. We review 18 patients with tumours in the brachial plexus region submitted to surgical treatment in a 6 year period, including their clinical presentation, neuro-imaging data, surgical findings and outcome. The tumours comprised a heterogeneous group of lesions, including schwannomas, neurofibromas, malignant peripheral nerve sheath tumour (MPNST), sarcomas, metastases, desmoids and an aneurysmal bone cyst. The most common presentation was an expanding lump (83.33%). Eleven tumours were benign and 7 were malignant. Neurofibromatosis was present in only 2 patients (11.11%). Gross total resection was achieved in 14 patients and sub-total resection in the others. Only 3 patients presented with new post-operative motor deficits. The incidence of complications was low (16.5 %). The majority of tumours were benign and most of them could be excised with a low incidence of additional deficits. Some of the malignant tumours could be controlled by surgery plus adjuvant therapy, but this category is still associated with high morbidity and mortality rates.

Cutaneous Leiomyomatosis in a Mother and Daughter

A 34-year-old woman with no known medical history was evaluated for multiple painful brown nodules and papules on the anterior aspect of the trunk. She mentioned a history of similar cutaneous findings on her mother. Biopsies of three lesions revealed piloleiomyomata. Renal and adrenal ultrasound revealed an isolated simple cortical cyst, and pelvic and endovaginal ultrasound revealed two uterine myomata. The clinical diagnosis of hereditary leiomyomatosis and renal cell cancer was corroborated by the identification of a heterozygous variant on exon 5 of the fumarate hydratase gene (c.578C>T p.T193I). Identification of the tumor piloleiomyoma should alert the dermatologist to this rare genodermatosis, which is associated with an increased risk of renal cell tumors, demanding multidisciplinary follow-up, and personal and family counseling.

Unusually rapid growth of brown tumour in the mandible after parathyroidectomy associated with the presence of a supernumerary parathyroid gland

The aim of this study is to report the case of a quick growing brown tumour in the jaw after a parathyroidectomy due to the presence of a rare fifth parathyroid gland. The patient had chronic renal disease and the diagnosis was tertiary hyperparathyroidism. Thirty days after the parathyroidectomy, the patient returned with a significant increase in the tumour size. The suspicion of a supernumerary gland was confirmed by parathyroid scintigraphy. The treatment of brown tumour is dependent on the treatment of the hyperparathyroidism. However, curettage should be considered if a large lesion is disturbing mastication. In conclusion, this case should attract the attention of general practitioner dentists, since they may be the first professionals who have contact with the patient with a brown tumour in the jaws. Likewise, this case emphasises the importance of knowing the type of hyperparathyroidism involved to allow for effective treatment planning. © 2011 European Association for Cranio-Maxillo-Facial Surgery.

Cisto ósseo traumático da mandíbula: revisão de 26 casos

O cisto ósseo traumático é uma entidade patológica caracterizada pela presença de uma cavidade óssea assintomática desprovida de revestimento epitelial, sendo raramente encontrado nos maxilares. OBJETIVO: Descrever as características clínico-cirúrgicas e radiográficas dos cistos ósseos traumáticos. MATERIAL E MÉTODO: Estudo de caráter retrospectivo dos pacientes diagnosticados com cisto ósseo traumático em um serviço de patologia oral no período de 1992 a 2007. Informações referentes às características clínicas, radiográficas e cirúrgicas foram coletadas. RESULTADOS: Vinte e seis casos de cisto ósseo traumático foram diagnosticados no período de 15 anos, 17 pertencentes ao sexo masculino e 09 ao sexo feminino. A maioria dos pacientes afetados pertencia às duas primeiras décadas de vida, não relatava sintomatologia dolorosa, bem como história de trauma na região da lesão. O padrão multilocular foi observado em apenas sete casos, dando às lesões uma aparência radiográfica tumoral. A presença de ar no interior da cavidade patológica foi relatada em aproximadamente 70% dos casos, sendo rara a presença de conteúdo serossanguíneo e seroso. CONCLUSÃO: A maior prevalência de casos em pacientes jovens, a infrequente história de trauma e o pequeno número de lesões com conteúdo serossanguíneo refletem a necessidade de se discutir a real patogênese do cisto ósseo traumático.

Dor abdominal em adolescente

Doente do sexo feminino de 16 anos de idade, recorreu ao serviço de urgência por dor abdominal com duas semanas de evolução localizada à fossa ilíaca esquerda (FIE) associada a obstipação. Negava atividade sexual, referindo último cataménio três semanas antes. Apresentava palpação abdominal dolo- rosa na FIE, sem defesa ou sinais de irritação peritoneal. Estudo analítico inicial e exame sumário de urina normais. Ecografia abdomino-pélvica revelou quisto complexo na região anexial esquerda e ascite de médio volume. Foi doseada a hormona gonadotrofina coriónica sérica que foi positiva (2608 mUI/mL). A ecografia transvaginal revelou quisto simples com área adjacente de aspeto reticular, não evidenciando qualquer imagem de saco gestacional intrauterino. Foi submetida a laparotomia exploradora, constatando-se hemoperitoneu e gravidez ectópica tubar esquerda e efetuada salpingectomia esquerda. Os autores pretendem alertar para uma causa rara de dor abdominal na adolescência, que deverá ser considerada de for- ma a evitar um desfecho potencialmente fatal.

É simples o que faço com os quistos simples do ovário

É cada vez mais frequente o diagnóstico de quisto do ovário pelo uso crescente de exames radiológicos. É essencial a distinção entre quisto simples e quisto complexo, pois a sua abordagem é diferente, sendo o algoritmo de abordagem adaptado à mulher pré- ou pós-menopáusica [1]. A recomendação inicial a seguir varia em função do tamanho da lesão e do valor do CA 125.

Outcome of Multi-Cystic Dysplastic Kidneys in Children

Background: Renal cystic diseases are important causes of chronic kidney disease (CKD). Objectives: We report the pattern of renal cystic disease in children and evaluate the outcome of children with multicystic dysplastic kidney (MCDK). Patients and Methods: Retrospective study of all children with cystic kidney diseases at King Abdulaziz University hospital from 2006 to 2014. Results: Total of 55 children (30 males); 25 MCDK, 22 polycystic kidney diseases (PKD), 4 nephronophthises and 4 renal cysts. Consanguinity was positive in 96.2%. MCDK and simple renal cyst patients had good renal function while PKD and nephronophthisis developed renal impairment. Most MCKD were diagnosed ante-natally, 16 of them were followed up for 3.4 (1.97) year. Their last creatinine was 33.9 (13.5) umol/L. MCDK was spontaneously involuted at mean age of 2.6 (1.3) years in 56%. Conclusions: MCDK is the commonest cystic renal disease and diagnosed ante-natally in the majority of cases. It has a good prognosis.

Population balance model of in vivo neutrophil formation following bone marrow rescue therapy

In this paper, we develop a simple four parameter population balance model of in vivo neutrophil formation following bone marrow rescue therapy. The model is used to predict the number and type of neutrophil progenitors required to abrogate the period of severe neutropenia that normally follows a bone marrow transplant. The estimated total number of 5 billion neutrophil progenitors is consistent with the value extrapolated from a human trial. The model provides a basis for designing ex vivo expansion protocols.