1,721,049 research outputs found

    Aneurysmal bone cyst of the acromion treated by selective arterial embolization

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    Aneurysmal bone cysts are rarely located in the scapula and are especially rare in the acromion. We present an 8-year-old boy with a large aneurysmal bone cyst of the acromion that achieved curative treatment with one selective transcatheter arterial embolization. Five years after the procedure, healing of the lesion and remodeling of the acromion was observed without any evidence of recurrenc

    Successful treatment of aneurysmal bone cyst of the proximal fibula with embolization

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    We present an 8-year-old girl with evolution of an aneurysmal bone cyst of the proximal fibula after intralesional surgery, treated successfully with one selective transfemoral embolization with N-2-butyl-cyanoacrylate. By the first 5 days, the patient experienced complete pain relief. Post-embolization imaging follow-up showed progressive homogenous trabecular bone formation and gradual reduction of the size of the lesion. These findings canceled our initial consideration for surgical treatment. Three years after the embolization, healing of the lesion and remodeling of the proximal fibula were observed without evidence of recurrence. Our successful results with excellent response seen 3 years after embolization are in favor and should increase the awareness of surgeons regarding embolization for aneurysmal bone cysts in difficult anatomic locations such as the proximal fibula. © 2012 Springer-Verlag

    Palliative treatments: electrochemotherapy and thermoablation.

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    Metastatic disease is a major cause of pain and decreased quality of life in patients with cancer. Autopsy studies have shown that up to 85% of patients who die from breast, prostate or lung cancer have histological evidence of bone metastases at the time of death. In Europe, the number of new cases of bone metastases per year is approximately 1 in 100,000. Worsening of patients’ quality of life is due to associated symptoms such as intractable pain, pathological fractures, spinal cord compression, hypercalcemia and reduction of movement and performance status

    Successful treatment of aggressive aneurysmal bone cyst of the pelvis with serial embolization

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    Intralesional surgery is most commonly used for aneurysmal bone cysts. Rarely is en bloc resection used for active, aggressive, recurrent lesions and those located in expendable bones. However, persistence or recurrence of aneurysmal bone cysts is common. The clinical behavior of aneurysmal bone cysts is more aggressive in younger patients. Selective embolization is used as the primary treatment for aneurysmal bone cysts in surgically difficult anatomical locations and as an adjuvant to surgical treatment to reduce intraoperative blood loss and facilitate curettage. This article describes a 3-year-old boy with an aggressive aneurysmal bone cyst of the pelvis involving the right ischiopubic rami that achieved curative treatment with 3 embolizations with N-2-butyl-cyanoacrylate. Biopsy was diagnostic; however, the clinical course was misleading. Twenty days after the first embolization, despite complete occlusion of the feeding vessels, the patient experienced severe pain, increased size of the lesion, and lateral subluxation of the right hip. Based on the imaging and histological diagnosis, intralesional hemorrhage was assumed, and repeat embolization was performed. After the second embolization, the patient experienced perineal skin necrosis from normal vessel embolization; it was treated with wound dressing changes and healed uneventfully. A third embolization was performed because of a persistent lesion. Six years after treatment, the patient was symptom free, and imaging showed complete ossification of the cyst. Selective catheterization and occlusion of the feeding arteries with the appropriate embolic agent provide tumor devascularization, size reduction, pain relief, and induction of new bone formation. Multiple procedures are often necessary, and complications may occur

    Successful Treatment of a Bifocal Eosinophilic Granuloma of the Spine with CT-Guided Corticosteroid Injection

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    Observation and immobilization is adequate for most patients with spinal eosinophilic granuloma; however, in patients with symptomatic lesions, treatment other than simple observation or biopsy alone is recommended. In view of the benign clinical course of eosinophilic granuloma, a simple, minimally invasive, outpatient treatment with a low complication rate such as computed tomography (CT)-guided intralesional corticosteroid injection may be considered the treatment of choice. This article presents a case of a 21-year-old man with a symptomatic bifocal eosinophilic granuloma at the vertebral body of the L3 vertebra and the left T5 costovertebral joint treated effectively by CT-guided intralesional methylprednisolone injection. To the best of our knowledge, this is the first case of successful treatment of a bifocal eosinophilic granuloma with CT-guided corticosteroid injection.Under general anesthesia and CT guidance, the lesion was located through the right transpedicular approach for the L3 lesion and the left posterolateral approach for the T5 lesion using a biopsy trocar. Tissue sample was retrieved and frozen section biopsy showed eosinophilic granuloma. One intralesional CT-guided injection of 80 mg (2 mL) of methylprednisolone acetate was performed in each lesion. Complications related to the procedure were not observed. The patient was admitted postprocedural for overnight medical evaluation and was discharged from the hospital the next day. Complete resolution of pain was observed 72 hours after the procedure. At 5 years after diagnosis and treatment, the patient is asymptomatic; imaging showed healing of both lesions

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Difficult diagnosis of angiomatoid fibrous histiocytoma of the leg mimicking a benign condition

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    Angiomatoid fibrous histiocytoma is a rarely metastasizing soft-tissue tumor of low-grade malignancy. Here we report a case of angiomatoid fibrous histiocytoma located in the leg of a 15-year-old female. This case is of particular interest due to its radiological features that led to raise two questions concerning the nature of the disease (is it reactive or tumoral?) and its site of origin (within soft tissues or the tibial periosteum?). Here we describe ultrasound, magnetic resonance imaging, computed tomography scan and positron emission tomography findings that helped answer these questions, understand the real nature of the disease and its appropriate treatment. This case shows that a single type of imaging technique may not be sufficient to understand the real nature of a musculoskeletal lesion and that it is necessary to combine all information derived from various imaging techniques in order to correctly diagnose and treat the disease
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