1.Evaluation of clinical feature of some juxta-articular soft tissue diseases
Lan Thi Ngoc Nguyen ; Tinh Xuan Ha
Journal of Medical Research 2007;47(1):37-44
Background: In Vietnam the juxta-articular soft tissue diseasesare very popular, but they have not been studied yet. Objectives: (1) Describe clinical feature of some juxta-articular soft tissue diseases (tendinopathy) (except periarthritis of the shoulder). (2) Determine the risk factors of these diseases. Subjects and method:118 patients with juxta-articular soft tissue diseases. Diagnosed following the standard criteria and treated in Rheumatology Department Bach Mai hospital (Hanoi - Vietnam) in the period from December 2005 to August 2006 There was a prospective descriptive method of study.Results:(1) Clinical feature of some juxta-articular soft tissue diseases: average age: 50.2 \xb1 10.4 years, female/male ration: 4:1, the most frequent clinical forms: Tendinosis of the Elbow (Tennis Elbow) (25.4%), de Quervain\u2019s tenosynovitis (22.9%), trigger finger (17.8%), Pes Anserine Bursitis (23.7%). Clinical symtoms: pain intensity: average VAS score: 5,8 \xb1 1,3 mild and moderate limitation of movement, inflammatory signs were not evident: Mild swelling (55%), redness, increase of local temperature (4-5%), pain character: Tendinosis of the Elbow and Pes Anserine Bursitis: permanent mild pain (73.6% and 68%), de Quervain\u2019s tenosynovitis and trigger finger: pain with irrdiation along the tendon (100%). (2)The risk factors ofthese diseases: manual and repetitive work, care of children (74%), middle age (73%), female (80,5%), osteoarthritis (21.2%), diabetes associated with trigger finger (19%).Conclusion: (1) The juxta-articular soft tissue diseases were seen at middle age, with feminine preponderance, moderate pain, not evident inflammation. Clinical forms: the prevalence of each group odd diseases (Tendinosis of the Elbow, de Quervain\u2019s tenosynovitis, trigger finger, Pes Anserine Bursitis) are quite eqiuvalent. (2) The risk factors of these diseases: manual and repetitive work, care of children, middle age, female, osteoarthritis, diabetes.
Soft Tissue Neoplasms/epidemiology
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2.Analysis on recurrence factors associate with giant cell tumor of tendon sheath in upper extremity.
Yang-Bo LIU ; Ding-Sheng LIN ; Jian WANG ; Huai-Bao ZHANG ; Lei CHEN
China Journal of Orthopaedics and Traumatology 2011;24(12):988-991
OBJECTIVETo study the relation of the sex, age, location and chemotherapy with recurrence of the tumor.
METHODSFrom January 2000 to August 2010, 47 patients with giant cell tumor of tendon sheath in upper extremity were retrospectively analyzed. Statistical analysis of sex, age at presentation, lesion location, chemical inactivation, surgical complications, tumor recurrence and pathological findings were explored. There were 28 females and 19 males, ranging in age from 17 to 78 years, with an average of 38.15 years. All the patients underwent surgical excision. Fourteen patients received intraoperative chemically inactive treatment. All the patients had routine follow-up to observe the wound healing, pathological findings,tumor recurrence, and received necessary imaging examinations.
RESULTSAll the patients were followed up, and the duration ranged from 22 to 129 months, with a mean time of 53.89 months. Four patients who received intraoperative alcohol inactivation appeared wound complications such as wound swelling, discharge of necrotic tissue, delayed wound healing. Fifteen patients had active growth of tumor tissue, 1 patient had low-grade malignant giant cell tumor of tendon sheath. The recurrence rate was significantly higher in the group which preoperative X-ray was found to have bone destruction (P = 0.003); patients receiving chemically inactivation had lower risk of recurrence after surgery than patients not receiving chemically inactivation (P = 0.042).
CONCLUSIONThe recurrence rate of giant cell tumor of tendon sheath in upper limb was closely related to tumor growth site, bone destruction and chemical inactivation. Local excision of giant cell tumor of tendon sheath was the effective treatment. How to identify the patients at high risk of recurrence, how to reduce the recurrence rate and the functional restoration after wide resection are the priorities and difficulties of future researches.
Adult ; Female ; Giant Cell Tumors ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; epidemiology ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Soft Tissue Neoplasms ; pathology ; surgery ; Tendons ; pathology ; Upper Extremity
3.Analysis of soft tissue sarcomas in 1118 cases.
Zhi-wei FANG ; Jing CHEN ; Sheng TENG ; Yong CHEN ; Rui-feng XUE
Chinese Medical Journal 2009;122(1):51-53
BACKGROUNDIt is important to analyze and compare soft tissue sarcomas periodically so as to update the incidence, the clinical diagnosis, the treatment, and the ongoing research. The present study was conducted to determine the relative frequency of each type of soft tissue sarcoma.
METHODSA total of 1118 cases of primary soft tissue sarcomas treated between January 1993 and December 2006 were evaluated in a retrospective analysis.
RESULTSAccording to the pathologic grouping, the diseases with the highest proportion were malignant fibrous histiocytomas (35.24%), synovial sarcomas (17.08%), liposarcomas (16.28%), and rhabdomyosarcomas (12.61%). Soft tissue sarcomas were detected in every age group and occurred in all parts of the body. The number of cases increased gradually over the years.
CONCLUSIONSMalignant fibrous histiocytomas had the highest frequency among the soft tissue sarcomas. The number of cases increased gradually over the years.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Histiocytoma, Malignant Fibrous ; diagnosis ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Liposarcoma ; diagnosis ; epidemiology ; Male ; Middle Aged ; Rhabdomyosarcoma ; diagnosis ; epidemiology ; Sarcoma ; diagnosis ; epidemiology ; Sarcoma, Synovial ; diagnosis ; epidemiology ; Soft Tissue Neoplasms ; diagnosis ; epidemiology ; Young Adult
4.The natural history and prognosticative factors of adult extremity soft tissue sarcomas: an Asian perspective.
Annals of the Academy of Medicine, Singapore 2010;39(10):771-777
INTRODUCTIONWe describe the natural history of Asian adult soft tissue sarcomas (STSs) in the extremities and predict prognosticative factors for local recurrence, metastasis and tumour-related death.
MATERIALS AND METHODSBetween January 1999 and May 2009, 67 adult patients with first presentation STSs of extremity sites underwent surgical treatment at a single institution. The associations between patient demographics and pathological features with local recurrence, metastasis and mortality were studied using univariate and multivariate analysis.
RESULTSThe mean age of our patients was 52.4 years with most presentations occurring in the thigh. Majority of Asian STSs were high grade (61.3%) and large tumours with 81.0% being >5 cm. Stages Ia, Ib, IIa, IIb, IIc, III and IV accounted for 6.6%, 6.6%, 26.2%, 11.5%, 3.3%, 42.6% and 3.3% of presentations, respectively. Patients were followed-up for a mean period of 45.9 months. On univariate analysis, high tumour grade and advanced stage (IIc to IV) were predictive of local recurrence and metastasis. Deep lesions were more likely to recur but not metastasise or cause death. Age, sex, size, and margin positivity were not predictive for all end-points. On multivariate testing, only pathological high grade was associated adversely with local recurrence [odds ratio (OR) = 10.0, 95% CI, 1.2 to 84.9, P = 0.035], metastasis (OR = 12.7, 95% CI, 2.46 to 65.2, P = 0.002) and mortality (OR = 16.2, 95% CI, 1.95 to 135.0, P = 0.010).
CONCLUSIONSAsian adult extremity soft tissue sarcomas present late and are most commonly found in the thigh. High pathological grade is a consistent independent predictor for local failure, distant spread and tumour-related death. Our results reaffirm the current thinking that tumour biology is of primary importance in determining patient outcomes.
Adult ; Aged ; Aged, 80 and over ; Asia ; epidemiology ; Extremities ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Sarcoma ; classification ; ethnology ; mortality ; pathology ; surgery ; Soft Tissue Neoplasms ; classification ; ethnology ; mortality ; pathology ; surgery
5.Diagnostic Approach to a Soft Tissue Mass
Young Soo CHUN ; Seung Hyun SONG
The Journal of the Korean Orthopaedic Association 2019;54(4):293-301
Soft tissue masses of the extremities and torso are a common problem encountered by orthopaedic surgeons. Although these soft tissue masses are often benign, orthopaedic surgeons need to recognize the key features differentiating benign and malignant masses. An understanding of the epidemiology and clinical presentation of soft tissue masses is needed to develop a practical approach for evaluation and surgical management. Size and depth are the two most important factors on which triage decisions should be based. In a differential diagnosis of a tumor, it is important to know the characteristics of the soft tissue mass through detailed history taking and physical examinations before the diagnostic procedures. A variety of imaging studies, such as simple radiography, ultrasound, magnetic resonance imaging, positron emission tomography, computed tomography, bone scan, and angiography can be used to diagnose tumors. Know the ledge of advantages and disadvantages of each imaging study is essential for confirming the characteristics of the tumor that can be observed in the image. In particular, ultrasonography is convenient because it can be performed easily in an outpatient clinic and its cost is lower than other image studies. On the other hand, the accuracy of the test is affected by the skill of the examiner. A biopsy should be performed to confirm the tumor and be performed after all imaging studies have been done but before the final treatment of soft tissue tumors. When a biopsy is to be performed, careful attention to detail with respect to multidisciplinary coordination beforehand, cautious execution of the procedure to minimize complications, and expedient follow-up and referral to a musculoskeletal oncologist when appropriate, are essential.
Ambulatory Care Facilities
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Angiography
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Biopsy
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Diagnosis, Differential
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Epidemiology
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Extremities
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Follow-Up Studies
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Hand
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Magnetic Resonance Imaging
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Physical Examination
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Positron-Emission Tomography
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Radiography
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Referral and Consultation
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Soft Tissue Neoplasms
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Surgeons
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Torso
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Triage
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Ultrasonography