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Role of MRI and Plain Radiograph to Diagnose Fibrous Dysplasia Mimicking Metastasis on PET/CT in a Patient with Breast Cancer.

Song Mee CHO ; Won Hee JEE ; Ie Ryung YOO ; Ahwon LEE ; Yang Guk CHUNG

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):47-50. doi:10.5292/jkbjts.2010.16.1.47

Fibrous dysplasia is a common benign disorder of bone in which normal bone marrow is replaced with fibro-osseous tissue. As PET/CT is increasingly used for the staging of different malignant disease, incidentally found fibrous dysplasia with increased FDG uptake may mimic metastasis. We report on a 46-year-old woman with fibrous dysplasia who underwent PET/CT because of suspected recurrence of breast cancer and was misdiagnosed as a bony metastasis with a focal FDG uptake on left proximal femur. This lesion was interpreted as fibrous dysplasia based on MRI in addition to the plain radiographs. We conclude that MRI in addition to radiography may help to differentiate fibrous dysplasia mimicking metastasis on PET/CT in the patients with malignancy.
Bone Marrow ; Breast ; Breast Neoplasms ; Female ; Femur ; Humans ; Hydrazines ; Middle Aged ; Neoplasm Metastasis ; Recurrence

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Deep Submuscular Parosteal Angiomyxolipoma in a Child.

Hong Kyun KIM ; Jeong Han YOO ; Yong Wook PARK ; Jin Soo PARK ; Kyu Cheol ROWE ; Kuk Jin CHUNG ; Keun Jong CHANG ; Ji Hyo HWANG

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):42-46. doi:10.5292/jkbjts.2010.16.1.42

Angiomyxolipoma is a rare variant of lipoma, which is described by Mai, 1996, at first. The nine cases of which have been reported to date. Microscopically, the lesion consists of adipose tissue with the paucicellular myxoid areas and fat tissue with numerous thin, dilated, and congestive blood vessels. The reported cases mostly located to the superficial layer on the scalp, subungual, extremities in adults. We report one case of angiomyxolipoma located in the submuscular and parosteal area in the distal femur around knee joint in a child.
Adipose Tissue ; Adult ; Blood Vessels ; Child ; Estrogens, Conjugated (USP) ; Extremities ; Femur ; Humans ; Knee Joint ; Lipoma ; Scalp

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Juvenile Hemangioma Occurred in Distal Femoral Epiphysis.

Tai Seung KIM ; Chang Hoon LEE ; Chan Keum PARK

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):37-41. doi:10.5292/jkbjts.2010.16.1.37

A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.
Biopsy ; Congenital Abnormalities ; Contracture ; Epiphyses ; Femur ; Follow-Up Studies ; Hemangioma ; Knee ; Leg ; Preschool Child ; Tibia

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Outcomes of Diffuse-Type Pigmented Villonodular Synovitis (PVNS) after Open Total Synovectomy.

Moses LEE ; Soo Hyun LEE ; Jin Suck SUH ; Woo Ik YANG ; Kyoo Ho SHIN

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):27-36. doi:10.5292/jkbjts.2010.16.1.27

PURPOSE: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. MATERIALS AND METHODS: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. RESULTS: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. CONCLUSION: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.
Animals ; Ankle ; Elbow ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Synovitis ; Synovitis, Pigmented Villonodular

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Secondary Chondrosarcoma Arising from Osteochondroma(tosis).

Hyun min CHO ; Seung Koo RHEE ; Yong Koo KANG ; Yang Guk CHUNG ; An Hi LEE ; Jung Mi PARK ; Won Jong BAHK

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):21-26. doi:10.5292/jkbjts.2010.16.1.21

PURPOSE: To analyze clinical, radiological and pathological features as well as clinical outcome after surgical treatment of patients with secondary chondrosarcoma arising from osteochondroma(tosis). MATERIALS AND METHODS: We retrospectively reviewed clinical records, radiographs, pathologic slides of 14 patients. Nine patients were male and five were female. The mean age was 34 years. The mean follow-up period was 54 months. RESULTS: All patients had a history of previous mass since childhood or puberty. Preexisted osteochondroma was single in 3 patients and multiple in 10. Remaining 1 patient had multiple osteochondromatosis with enchondromatosis. MRI clearly provided thickness of cartilage cap, which was over 2 cm except in 2 cases. Chondrosarcoma was grade 1 in all except 1 case, which was grade 2. Wide excision was performed in 10 patients, marginal excision in 3 and amputation in 1. Twelve patients were doing very well without evidence of disease. Among 3 patients with marginal excision, 1 patient had local recurrence and 1 patient died of disease. CONCLUSION: Comprehensive understanding of clinical, radiological and pathological features of secondary chondrosarcoma is warranted for accurate diagnosis. The best result can be expected with early recognition of malignant change of osteohcondroma(tosis) and wide excision.
Amputation ; Cartilage ; Chondrosarcoma ; Enchondromatosis ; Female ; Follow-Up Studies ; Humans ; Male ; Osteochondroma ; Osteochondromatosis ; Puberty ; Recurrence ; Retrospective Studies

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Prognostic Factors in Liposarcomas: A Retrospective Study of 52 Patients.

Yang Guk CHUNG ; Yong Koo KANG ; Won Jong BAHK ; Seung Koo RHEE ; An Hi LEE ; Jung Mee PARK ; Min Woo KIM

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):14-20. doi:10.5292/jkbjts.2010.16.1.14

PURPOSE: To investigate prognostic factors influencing on local recurrence, distant metastasis and event-free survival of liposarcomas. MATERIALS AND METHODS: Fifty-two patients managed for liposarcomas since 1993 were analyzed respectively in the view of prognostic influence of patient age, tumor size, location, histologic type, histologic grade, resection type, surgical margin, chemotherapy and radiation therapy on local recurrence, distant metastasis and event-free survival. The mean follow up period was 39 months. The univariate and multivariate regression analysis were performed for statistical evaluation. RESULTS: The local recurrences occurred in 11 patients (21.2%) and distant metastasis in 4 patients (8%), Event-free survival rate at 4 year follow up was 67%. In univariate analysis, histologic grade, surgical margin, chemotherapy and radiation therapy were significant prognostic factors on local recurrence (p<0.05). However, histologic grade lost its significance in muitivariate analysis. Trunk location revealed higher rate of distant metastasis than extremity location. In univariate analysis on event-free survival. histologic grade and chemotherapy were significant factors (p<0.05). No factor remained significant in multivariate analysis. CONCLUSION: Considering selection bias, positive surgical margin was negative prognostic factor on local recurrence. Liposarcomas arisen in trunk revealed higher rate of distant metastasis. There was no independent prognostic factor on event-free survival of patients with liposarcomas.
Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Liposarcoma ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Selection Bias

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The Effect of Platelet-Rich Plasma on Allograft Transplantation after Curettage in Benign Bone Tumor.

Jae Do KIM ; Ji Youn KIM ; Su Jin JANG ; So Hak CHUNG ; Gu Hee JUNG

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):8-13. doi:10.5292/jkbjts.2010.16.1.8

PURPOSE: This study was performed to evaluate the efficiency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. MATERIALS AND METHODS: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. RESULTS: The mean size of lesion was 33.5 cm3 (range, 2.3-181.9 cm3) (29.4 cm3 in PRP group and 40.2 cm3 in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. CONCLUSION: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.
Acceleration ; Anti-Bacterial Agents ; Bone Cysts ; Bone Resorption ; Chondroma ; Curettage ; Follow-Up Studies ; Fractures, Spontaneous ; Giant Cell Tumors ; Humans ; Platelet-Rich Plasma ; Recurrence ; Transplantation, Homologous ; Transplants

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The Reconstruction with Extracorporeal Irradiated Autograft for Osteosarcoma of Extremities.

Jae Do KIM ; Gun Woo LEE ; So Hak CHUNG

The Journal of the Korean Bone and Joint Tumor Society.2010;16(1):1-7. doi:10.5292/jkbjts.2010.16.1.1

PURPOSE: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. MATERIALS AND METHODS: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. RESULTS: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. CONCLUSION: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.
Amputation ; Disease-Free Survival ; Extremities ; Female ; Femur ; Fibula ; Follow-Up Studies ; Humans ; Humerus ; Joint Instability ; Limb Salvage ; Male ; Neoplasm Metastasis ; Osteosarcoma ; Periprosthetic Fractures ; Recurrence ; Replantation ; Retrospective Studies ; Survival Rate ; Tibia ; Ursidae

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FDG-PET/CT Complements Bone Scan with Respect to the Detection of Skip Metastasis of Osteosarcoma: A Case Report.

Gi Jeong CHEON ; Jae Gol CHOE ; In Jung CHAE ; Dae Hee LEE ; Sang Heon SONG ; Myo Jong KIM ; Jong Hoon PARK

The Journal of the Korean Bone and Joint Tumor Society.2012;18(1):45-49. doi:10.5292/jkbjts.2012.18.1.45

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.
Complement System Proteins ; Femur ; Neoplasm Metastasis ; Osteosarcoma ; Prognosis

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Giant Synovial Chondromatosis of the Knee Mimicking a Parosteal Osteosarcoma: A Case Report.

Chang Ho KANG ; Jong Hoon PARK ; Dae Hee LEE ; Chul Hwan KIM ; Jeong Mi PARK ; Won Seok LEE

The Journal of the Korean Bone and Joint Tumor Society.2010;16(2):95-98. doi:10.5292/jkbjts.2010.16.2.95

Synovial chondromatosis is a benign nodular cartilaginous proliferation arising in the synovium of joints. The radiolographic features of this condition are variable. Rarely, it would be confused with malignancy such as chondrosarcoma, osteosarcoma or synovial sarcoma. We report a case of primary synovial chondromatosis of the posterior aspect of the proximal tibia mimicking a parosteal osteoarcoma on the radiography, which showed a homogeneously radiopaque juxtacortical mass. However, subsequent computed tomography (CT) showed multiple intra-articular masses containing chondroid mineralization, suggesting synovial chondromatosis.
Chondromatosis, Synovial ; Chondrosarcoma ; Diagnostic Imaging ; Joints ; Knee ; Osteosarcoma ; Sarcoma, Synovial ; Synovial Membrane ; Tibia

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