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Alesawi AF, Abualross OH, Alesawi NF, Samargandi RS. Patellar osteoblastoma: A case report and literature review. Radiol Case Rep 2024; 19:2714-2718. [PMID: 38666146 PMCID: PMC11043779 DOI: 10.1016/j.radcr.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/28/2024] [Accepted: 03/12/2024] [Indexed: 04/28/2024] Open
Abstract
An osteoblastoma is a benign bone tumor characterized by osteoblast proliferation that is more commonly diagnosed in young men during adolescence and youth. The condition mainly occurs in the posterior regions of the spine and sacrum, but in rare cases, the patella as well. We present a case of patellar osteoblastoma successfully managed through intralesional curettage and grafting, highlighting the need for comprehensive imaging and pathological studies to ensure an accurate diagnosis. A 26-year-old male with a history of knee plica excision presented with persistent knee pain over 1 year. Radiographic and CT evaluations revealed an osteolytic lesion in the patella, further characterized by MRI. An incisional biopsy confirmed the diagnosis of osteoblastoma. Intralesional curettage and grafting were performed. Later, subsequent follow-up demonstrated complete pain relief, restoration of knee function, and optimal graft incorporation. As shown in this case, precise diagnosis and effective management are key to improving the quality of life of patients. Furthermore, it illustrates that intralesional curettage and grafting are effective treatments for patellar osteoblastomas. Given the rarity of this condition, further research and comprehensive case studies are imperative to establish standardized guidelines for improved healthcare and patient outcomes. In summary, while the clinical characteristics of patellar osteoblastoma resemble those of osteoblastomas in general, its unique presentation warrants specific attention. Individualized consideration of adjuvant measures, graft selection, and preventive fixation is vital to ensure optimal outcomes in patellar osteoblastoma management.
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Affiliation(s)
| | | | | | - Ramy S. Samargandi
- Department of Orthopedics, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
- Centre Hospitalier Régional Universitaire de Tours, Hôpital Trousseau, Chambray-lès-Tours, France
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Kuchhal M, Lamture Y. A Chondroblastic Osteosarcoma of the Patella: A Case Report. Cureus 2023; 15:e40777. [PMID: 37485194 PMCID: PMC10362475 DOI: 10.7759/cureus.40777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Osteosarcoma is a form of bone cancer that can originate in any bone throughout the body, although it is most commonly detected in the long bones of the arms and legs. Chondroblastic osteosarcoma, a rare variation of osteosarcoma, is associated with a greater likelihood of recurrence and metastasis. The term "chondroblastic" indicates that certain portions of the tumor have undergone changes, resembling a connective tissue called cartilage. In this report, we present an exceptional case of osteosarcoma affecting the patella. A 54-year-old patient sought consultation at our outpatient clinic, reporting a 10-year history of swelling in the left leg. Magnetic resonance imaging revealed the presence of a large, diverse mass lesion located near the proximal region of the left leg. A Tru-cut biopsy confirmed the presence of chondroblastic osteosarcoma.
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Affiliation(s)
- Mehak Kuchhal
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Yashwant Lamture
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Zhao Y, Zhang Q, Feng H, Zhu X. Oesophageal carcinoma with solitary patellar metastasis: a rare case report. J Int Med Res 2021; 49:3000605211009812. [PMID: 33906528 PMCID: PMC8108086 DOI: 10.1177/03000605211009812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The incidence of tumours found in the patella, including primary and metastatic tumours, is low. Solitary metastasis of oesophageal carcinoma (OC) in the patella is even rarer. A 50-year-old man presented to our clinic because of pain and limited range of motion in the right knee for 4 hours and after a fall. On the basis of the patient’s medical history, he was diagnosed with OC 2 months previously and underwent two cycles of paclitaxel liposome combined with tiggio chemotherapy (oral tiggio, 40 mg, two times/day, with a treatment cycle of 3 weeks). A 99mTc-methylene diphosphonate bone scintigraphy scan showed increased radioactivity in the right patella. A right knee biopsy showed the presence of patellar metastasis from OC. Unfortunately, the patient denied additional treatment and was discharged for personal reasons. At the 1-month follow-up, which was conducted by a telephone survey, we learned that the patient had died of acute pulmonary embolism. X-rays and computed tomography are useful for diagnosing patellar metastases, but 99mTc-methylene diphosphonate bone scintigraphy can help physicians diagnose patellar metastasis of OC more rapidly. Biopsy with pathology is the gold standard for diagnosing patellar metastases. Additionally, timely surgical treatment prolongs the survival time of these patients.
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Affiliation(s)
- Yi Zhao
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Qianqian Zhang
- Department of Gynecology, Hebei Medical University Second Affiliated Hospital, Shijiazhuang, Hebei, P. R. China
| | - Helin Feng
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China
| | - Xiyan Zhu
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P. R. China
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Lang Y, Yu Q, Liu Y, Yang L. Chondroblastoma of the patella with pathological fracture in an adolescent: a case report. World J Surg Oncol 2019; 17:218. [PMID: 31831014 PMCID: PMC6909653 DOI: 10.1186/s12957-019-1760-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chondroblastoma is a rare primary bone tumor of young people that generally occurs in the epiphyseal plate of long bones. To date, only 13 cases of patella with pathological fracture in chondroblastoma have been previously published. CASE PRESENTATION A 15-year-old male patient presented with acute pain in the left knee after an injury occurred while playing basketball. Plain radiographs and computed tomography showed a pathological fracture of the left patella with an osteolytic lesion (1.5 × 2 × 3 cm). Magnetic resonance imaging revealed an expansile lesion within the patella with a slightly high signal on the T1-weighted image, a high signal on the T2-weighted image and soft tissue swelling in front of the patella. A m99Tc bone scintigraphy revealed moderate uptake. The preoperative diagnosis was chondroblastoma. This patient underwent intralesional meticulous extended curettage, adjuvant high-speed burr, 95% alcohol and electrotome treatment, autogenous iliac crest bone grafting, and internal fixation. A postoperative pathological diagnosis was chondroblastoma. The patient's function was satisfactory, and there was no sign of tumor recurrence. The internal fixator was good, with no loosening or migration observed at the last follow-up at 20 months after surgery. CONCLUSIONS Rarely, chondroblastoma of the patella can present with acute pain due to pathological fracture. We present the 14th such case in the literature to associate patellar chondroblastoma with pathological fracture. The patient was treated with curettage, inactivation, autogenous bone grafting, and internal fixation. A satisfactory therapeutic effect was obtained. This case may be beneficial to the diagnosis and treatment of chondroblastoma patella.
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Affiliation(s)
- Yun Lang
- Department of Orthopedics, People's Hospital of Deyang City, Taishan North Road 173#, Deyang, 618000, Sichuan Province, People's Republic of China
| | - Qing Yu
- Department of Pathology, People's Hospital of Deyang City, Taishan North Road 173#, Deyang, 618000, Sichuan Province, People's Republic of China
| | - Yuehong Liu
- Department of Orthopedics, People's Hospital of Deyang City, Taishan North Road 173#, Deyang, 618000, Sichuan Province, People's Republic of China
| | - Lejin Yang
- Department of Orthopedics, People's Hospital of Deyang City, Taishan North Road 173#, Deyang, 618000, Sichuan Province, People's Republic of China.
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Bavaneh MK, Kiyak G, Balikci T. A review of literature: Mosaicoplasty as an alternative treatment for resection of patellar osteoid osteoma and cartilage reconstruction. J Orthop 2018; 15:768-771. [PMID: 29946202 DOI: 10.1016/j.jor.2018.05.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/06/2018] [Indexed: 11/28/2022] Open
Abstract
Osteoid osteoma is an uncommon benign tumor and causes severe pain, being worse at night, that responds dramatically to nonsteroidal anti-inflammatory medications. An osteoid osteoma of the patella is very rare and if it arise close to chondral surface differential diagnosis may be challenging. In three patients the osteoid osteoma was completely excised by nidus removal by mosaicoplasty set with open surgical technique. The patients were followed up in average for 31 (16-48 months) months with annual clinical and radiographic evaluations. There were no relapse of the pain and no residual recurrent tumor. The aim of the treatment for osteoid osteoma is to remove entire nidus by open surgical excision or by percutaneous procedures such as percutaneous radiofrequency and laser ablation. Mosaicoplasty is a good alternative for treatment of osteoid osteoma of the patella in the subchondral bone.
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Affiliation(s)
- Motasım K Bavaneh
- Dept. of Orthopaedic Surgery, Atasehir Avicenna Hospital, kayısdagı cad. No. 47, Atasehir, Istanbul, Turkey
| | - Gorkem Kiyak
- Dept. of Orthopaedic Surgery, Academic Hospital, Nuhkuyusu cad. No: 94 34664, Üsküdar, Istanbul, Turkey
| | - Tevfik Balikci
- Dept. of Orthopaedic Surgery Medistate Hospital, Kavacık, Istanbul, Turkey
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BAPTISTA ANDRÉMATHIAS, SARGENTINI SYLVIOCESAR, ZUMÁRRAGA JUANPABLO, CAMARGO ANDRÉFERRARIDEFRANÇA, CAMARGO OLAVOPIRESDE. TUMORS OF THE PATELLA: THE EXPERIENCE OF INSTITUTE OF ORTHOPEDICS AND TRAUMATOLOGY AT UNIVERSITY OF SÃO PAULO, BRAZIL. ACTA ORTOPEDICA BRASILEIRA 2016; 24:151-4. [PMID: 27217817 PMCID: PMC4863864 DOI: 10.1590/1413-785220162403159158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To obtain epidemiological data from the tumors of the patella diagnosed and treated at the Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Universidade de São Paulo (IOT-HC-FMUSP) between 1998 and 2015. Methods: Series of cases with retrospective evaluation of patients diagnosed with tumors located in the patella. The data was obtained from the records and patients' charts at the Department of Pathology of IOT-HC-FMUSP. Results: A total of 2220 medical records from patients with anatomopathological reports were included in the study. Only eight (0.3%) patients had patellar tumors. We found that six (75%) of these were benign, one (12.5%) was a pseudotumoral lesions and one (12.5%) was reported as malignant. Among benign tumors, the giant cell tumor (GCT) was the most frequently reported corresponding to 50% of the cases. Hemagioendothelioma was the only case of malignant tumor in this series. As for the pseudotumoral lesions, we found a brown tumor. Conclusion: From the data obtained retrospectively in a 17 year time frame, in a service that treats benign, malignant and pseudotumoral bone lesions, we conclude that our casuistry in patellar tumors is similar to that reported in scientific literature, where benign tumors are predominant in a 7:1 ratio over malignant tumors, being a rare location of appearance, with the GCT as the most common diagnosis . Level of Evidence IV, Case Series.
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7
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Valsalan RM, Zacharia B. Ewings sarcoma of patella: A rare entity treated with a novel technique of extensor mechanism reconstruction using tendoachilles auto graft. World J Orthop 2015; 6:744-749. [PMID: 26495252 PMCID: PMC4610917 DOI: 10.5312/wjo.v6.i9.744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 05/14/2015] [Accepted: 07/23/2015] [Indexed: 02/06/2023] Open
Abstract
We report a case of Ewings sarcoma (ES) involving the patella in a young female. ES of patella is a rare entity. The patient was presented with anterior knee pain and swelling arising from the patella. She was treated with neoadjuvant chemotherapy followed by wide excision of the patella and reconstruction of the extensor mechanism using split tendoachilles auto graft. The patella is an uncommon site for primary or metastatic tumors of the bone. ES, though rare, should be included in the differential diagnosis of swellings arising from the patella. Auto graft from the tendoachilles is a good alternative for reconstructing the extensor mechanism of the knee.
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Irie T, Mawatari T, Ikemura S, Matsui G, Iguchi T, Mitsuyasu H. Brown tumor of the patella caused by primary hyperparathyroidism: a case report. Korean J Radiol 2015; 16:613-6. [PMID: 25995691 PMCID: PMC4435992 DOI: 10.3348/kjr.2015.16.3.613] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 02/16/2015] [Indexed: 12/04/2022] Open
Abstract
It has been reported that the common sites of brown tumors are the jaw, pelvis, ribs, femurs and clavicles. We report our experience in a case of brown tumor of the patella caused by primary hyperparathyroidism. An initial radiograph and CT showed an osteolytic lesion and MR images showed a mixed solid and multiloculated cystic tumor in the right patella. One month after the parathyroidectomy, rapid bone formation was observed on both radiographs and CT images.
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Affiliation(s)
- Tomoko Irie
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka 810-8539, Japan
| | - Taro Mawatari
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka 810-8539, Japan
| | - Satoshi Ikemura
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka 810-8539, Japan
| | - Gen Matsui
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka 810-8539, Japan
| | - Takahiro Iguchi
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka 810-8539, Japan
| | - Hiroaki Mitsuyasu
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka 810-8539, Japan
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9
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Song M, Zhang Z, Wu Y, Ma K, Lu M. Primary tumors of the patella. World J Surg Oncol 2015; 13:163. [PMID: 25906772 PMCID: PMC4435649 DOI: 10.1186/s12957-015-0573-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 04/04/2015] [Indexed: 11/10/2022] Open
Abstract
The patella is an uncommon location for cancerous occurrence and development. The majority of tumors of the patella are benign, with a significant incidence of giant cell tumors and chondroblastoma. With the development of modern diagnostic technologies, there appear however many other histological types which raise challenges of diagnosis and treatment. In this article, we review the reported histological types of primary patellar tumors. Specifically, epidemiology, symptomatology, imageology, histopathology, and treatment options for these histological lesions will be discussed, respectively. As there is an increasing focus on the diagnosis and the treatment of these lesions, the availability of the integrated information about primary patellar tumors becomes more significant.
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Affiliation(s)
- Mingzhi Song
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116011, People's Republic of China. .,Department of Orthopaedics, The Third Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116200, People's Republic of China.
| | - Zhen Zhang
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116011, People's Republic of China.
| | - Yuxuan Wu
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116011, People's Republic of China. .,Department of Orthopaedics, The Third Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116200, People's Republic of China.
| | - Kai Ma
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116011, People's Republic of China.
| | - Ming Lu
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116011, People's Republic of China.
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Abstract
Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting.
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11
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Gorelik N, Dickson BC, Wunder JS, Bleakney R. Ewing's sarcoma of the patella. Skeletal Radiol 2013; 42:729-33. [PMID: 23381466 DOI: 10.1007/s00256-013-1580-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 01/02/2013] [Accepted: 01/13/2013] [Indexed: 02/02/2023]
Abstract
Ewing's sarcoma is a relatively rare malignancy, occurring mainly between 4 and 25 years of age. It usually arises from the pelvis, followed by the femur, tibia, and remainder of both the long bones of the extremities and flat bones of the axial skeleton. To the best of our knowledge, Ewing's sarcoma of the patella has never been reported previously. Patellar tumors occur infrequently and represent an uncommon etiology of anterior knee pain. We describe the rare case of a 41-year-old man who presented with a 3-4 month history of escalating right anterior knee pain and swelling. Imaging demonstrated an aggressive patellar tumor with an adjacent soft tissue mass. The diagnosis of Ewing's sarcoma was confirmed by pathology. Physicians should be aware of atypical locations for Ewing's sarcoma and, conversely, of rare tumors arising in the patella and accounting for anterior knee pain. Early recognition of such malignancies allows prompt initiation of treatment, hence improving prognosis.
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Affiliation(s)
- Natalia Gorelik
- Faculty of Medicine, McGill University, Montreal, QC, Canada.
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12
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Casadei R, Kreshak J, Rinaldi R, Rimondi E, Bianchi G, Alberghini M, Ruggieri P, Vanel D. Imaging tumors of the patella. Eur J Radiol 2012; 82:2140-8. [PMID: 22951298 DOI: 10.1016/j.ejrad.2011.11.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patellar tumors are rare; only a few series have been described in the literature and radiographic diagnosis can be challenging. We reviewed all patellar tumors at one institution and reviewed the literature. MATERIALS AND METHODS In an evaluation of the database at one institution from 1916 to 2009, 23,000 bone tumors were found. Of these, 41 involved the patella. All had imaging studies and microscopic diagnostic confirmation. All medical records, imaging studies, and pathology were reviewed. RESULTS There were 15 females and 26 males, ranging from 8 to 68 years old (average 30). There were 30 benign tumors; eight giant cell tumors, eight chondroblastomas, seven osteoid osteomas, two aneurysmal bone cysts, two ganglions, one each of chondroma, exostosis, and hemangioma. There were 11 malignant tumors: five hemangioendotheliomas, three metastases, one lymphoma, one plasmacytoma, and one angiosarcoma. CONCLUSION Patellar tumors are rare and usually benign. As the patella is an apophysis, the most frequent lesions are giant cell tumor in the adult and chondroblastoma in children. Osteoid osteomas were frequent in our series and easily diagnosed. Metastases are the most frequent malignant diagnoses in the literature; in our series malignant vascular tumors were more common. These lesions are often easily analyzed on radiographs. CT and MR define better the cortex, soft tissue extension, and fluid levels. This study presents the imaging patterns of the more common patellar tumors in order to help the radiologist when confronted with a lesion in this location.
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Affiliation(s)
- R Casadei
- Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna, Italy.
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Altschuler EL, Yoon RS, Dentico R, Liporace FA. Spontaneous patella fracture presenting as osteomyelitis in focal dermal hypoplasia. Knee 2012; 19:500-3. [PMID: 22000280 DOI: 10.1016/j.knee.2011.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 08/24/2011] [Accepted: 09/12/2011] [Indexed: 02/02/2023]
Abstract
We report the first case of the assessment and treatment of a spontaneous patellar fracture in a patient with Goltz syndrome-a rare dermal hypoplasia. This case illustrates the non-straightforward presentation of a spontaneous patellar fracture in seemingly osteoporotic bone stock further complicated by the inability to rule out osteomyelitis. In this confusing presentation, a high index of suspicion for patella fracture should be maintained for patients with knee pain and osteoporosis on x-ray with a dysplastic syndrome.
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Affiliation(s)
- Eric L Altschuler
- Clinical Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation UMDNJ - New Jersey Medical School Newark, NJ 07103, USA.
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14
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Abstract
We present a rare case of osteosarcoma involving the patella. A 30-year-old Japanese woman first consulted our out-patient clinic with a 2-year history of knee pain. Radiographs showed an enlargement of the patella with irregular distribution of both osteolytic and sclerotic lesions. Computed tomography and magnetic resonance imaging demonstrated soft tissue extension at the anterior part of the patella. Incisional biopsy showed abundant osteoid formation by spindle-shaped malignant cells, and the histological diagnosis was conventional osteosarcoma. The patient underwent preoperative chemotherapy, but there was no response. Furthermore, she developed a pathological fracture during chemotherapy. She underwent above-the-knee amputation with postoperative chemotherapy. She developed multiple metastases in the thoracic vertebrae 20 months after the surgery. At the most recent examination, she remains alive with multiple spinal metastases without paralysis 4 years after the surgery.
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Affiliation(s)
- Shuichi Chida
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
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Gozzetti A, Coviello G, Fabbri A, Della Corte R, Bocchia M, Defina M, Lauria F. Unusual localizations of plasmacytoma. Leuk Res 2011; 35:e104-5. [PMID: 21397945 DOI: 10.1016/j.leukres.2011.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 01/26/2011] [Accepted: 02/14/2011] [Indexed: 11/29/2022]
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Abstract
Focal lesions of the patella may be identified during the investigation of anterior knee pain or as an incidental finding on radiological images. This pictorial review describes the radiographic appearances of a wide range of conditions that have been seen in this sesamoid bone. Where appropriate, computed tomography and magnetic resonance features have been included.
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