Soft Tissue and Bone Tumors

Background: The distal tibia is an unusual location for giant cell tumor. Less than 4% occurring in bone involve the foot and ankle region; the exact prevalence in the distal tibia is not known. Treatment remains unclear because of the rarity of the lesion in this location, the anatomy of the ankle, and difficulties associated with reconstruction.

Dermatofibrosarcoma protuberans (DFSP) has been described as a rare, locally invasive, malignant fibroblastic tumor with a high rate of recurrence that usually affects middle-aged patients. Herein, we describe a rare case of a pedunculated dermatofibrosarcoma protuberans of the right thumb in an 80-year-old woman treated with excision through the base of the pedicle. We also make a brief literature review concerning this tumor.

Solitary fibrous tumor (SFT) is characterized by the inv12(q13q13)-derived NAB2–STAT6 fusion, which exhibits variable breakpoints and drives STAT6 nuclear expression. The implications of NAB2–STAT6 fusion variants in pathological features and clinical behavior remain to be characterized in a large cohort of SFTs. We investigated the clinicopathological correlates of this genetic hallmark and analyzed STAT6 immunoexpression in 28 intrathoracic, 37 extrathoracic, and 23 meningeal SFTs. These 88 tumors were designated as histologically nonmalignant in 75 cases and malignant in 13, including 1 dedifferentiated SFT. Eighty cases had formalin-fixed and/or fresh samples to extract assessable RNAs for RT-PCR assay, which revealed NAB2–STAT6 fusion variants comprising 12 types of junction breakpoints in 73 fusion-positive cases, with 65 (89%) falling into 3 major types. The predominant NAB2ex4–STAT6ex2 (n = 33) showed constant breakpoints at the ends of involved exons, whereas the NAB2ex6–STAT6ex16 (n = 16) and NAB2ex6–STAT6ex17 (n = 16) might exhibit variable breakpoints and incorporate NAB2 or STAT6 intronic sequence. Including 73 fusion-positive and 7 CD34-negative SFTs, STAT6 distinctively labeled 87 (99%) SFTs in nuclei, exhibited diffuse reactivity in 73, but did not decorate 98 mimics tested. In seven fusion-negative cases, 6 were STAT6-positive, suggesting rare fusion variants not covered by RT-PCR assay. Regardless of histological subtypes, intrathoracic SFTs affected older patients (P = 0.035) and tended to be larger in size (P = 0.073). Compared with other variants, NAB2ex4–STAT6ex2/4 fusions were significantly predominant in the SFTs characterised by intrathoracic location (Po 0.001), older age (P = 0.005), decreased mitoses (P = 0.0028), and multifocal or diffuse STAT6 staining (P = 0.013), but not found to correlate with disease-free survival. Conclusively, STAT6 nuclear expression was distinctive in the vast majority of SFTs, including all fusion-positive tumors, and exploitable as a robust diagnostics of CD34-negative cases. Despite the associations of NAB2–STAT6 fusion variants with several clincopathological factors, their prognostic relevance should be further validated in large-scale prospective studies of SFTs. Solitary fibrous tumor is a relatively uncommon mesenchymal tumor of fibroblastic differentiation in adults, which was prototypically described as pleura-based 1 but is currently known to ubiquitously affect any anatomic site. 2,3 Most solitary fibrous tumors are clinically indolent, whereas the overall rate of local recurrences and/or metastases is

Gastrointestinal duplications are an uncommon congenital
abnormality that manifest before the age of two in 80% of
cases. Ileal duplication is the most common while colonic
duplication, either cystic or tubular, occurs in 10%-15%
of cases and remains asymptomatic and undiagnosed in
most cases. Mostly occurring in pediatric patients, colonic
duplication is encountered in adults in only a few cases.
The most common clinical manifestations are abdominal
pain and intestinal obstruction. Rarely, duplications
present with signs of acute abdomen or acute bleeding.
This study reports a case of colonic duplication in an
adult who presented with chronic constipation. Complete
diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Multislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.

Osteoid osteoma is a rare occurrence in the hand, especially in children. We report here a rare case of a 12-year-old boy complaining of growing painful swelling of the middle phalanx of the third finger that had started 3 months earlier and had not responded to anti-inflammatory medication. Based on the clinical findings and plain radiographs, osteomyelitis or Ewing’s sarcoma was suspected. However,
MRI revealed the typical characteristics of osteoid osteoma. The lesion was excised, and the histological examination confirmed the diagnosis. We make a brief review of the literature concerning this uncommon localization and discuss the differential diagnosis and treatment modalities.

The role of arthroscopic surgery for the treatment of various orthopedic pathologies has greatly improved during the last years. Recent publications showed that benign bone lesion may benefit from this minimally invasive surgical method, in order to minimize the invasiveness and the period of immobilization and to increase visualization. Unicameral bone cysts may be adequately treated by minimally invasive endoscopic surgery. The purpose of the current paper is to present the case report of a patient with a unicameral bone cyst of the calcaneus that underwent endoscopically assisted treatment with curettage and bone grafting with allograft from a bone bank, with emphasis on the surgical technique. Unicameral bone cyst is a benign bone lesion, which can be adequately treated by endoscopic curettage and percutaneous injection of morselized bone allograft in symptomatic patients.

Dans la littérature, les cas archéologiques de pathologie cancéreuse sont peu nombreux. Leur rareté s’explique par plusieurs facteurs. Seules les tumeurs osseuses primitives et les cancers à un stade avancé laissent des stigmates observables sur les restes humains squelettisés. De plus, les traces de ces maladies peuvent disparaître pour des raisons de taphonomie ou de conservation et, l’augmentation importante de l’incidence des cancers ces dernières décennies dans les pays industrialisés, laisse supposer une fréquence plus faible de ces pathologies dans l’Antiquité. Si nous ne disposons pas de données épidémiologiques pour cette période, cette dernière hypothèse reste plausible vue qu’elle se vérifie dans des populations actuelles qui ont un accès aux soins limité et/ou une plus faible exposition à des facteurs de risque carcinogènes. Enfin, de multiples contraintes matérielles ne permettent pas de réaliser un examen paléopathologique de l’ensemble des corps exhumés en archéologie. Pour toutes ces raisons, les cas paléopathologiques de lésions tumorales osseuses restent exceptionnels.
En 2014, l’équipe britannique de Michaela Binder de l’université de Durham et du British Museum publie les résultats de l’examen d’un adulte masculin dont l’âge au moment du décès est compris entre 25 et 35 ans. Sa tombe se situe dans l’actuel Soudan sur le site d’Amara ouest et date d’environ 1 200 avant J.C. Son squelette présente des lésions osseuses lytiques. L’analyse rigoureuse des auteurs et leur description très précise des zones pathologiques indiquent de manière certaine leur origine tumorale. La présence manifeste de zones de néo-ossification en périphérie des lésions, confirme le diagnostic de métastases osseuses multiples. Les chercheurs proposent l’hypothèse de localisations secondaires d’un carcinome. Cependant, en l'absence de preuve microscopique, le diagnostique de carcinome n'est pas certain et, il n'est pas possible d'éliminer l'hypothèse d'un mélanome ou d'une tumeur germinale.