Chondromyxoid fibroma of the calcaneus: two case reports and literature review

Chondromyxoid Fibroma of the Calcaneus: A Rare Case Report

Chondromyxoid fibroma (CMF) of the calcaneus is extremely rare. We report a case of CMF of the calcaneus in a 34-year-old female. She had foot pain for one year and had increased pain for the last two months. The patient complained of limping due to the pain she felt. CMF of the calcaneus was treated with curettage and bone grafting. The patient was allowed to mobilize the very next day of surgery with weight bearing as much as she could tolerate. No recurrence was encountered during the 18-month follow-up of the patient. The patient could perform activities in her daily life painlessly. Carefully performed curettage and bone grafting is an effective treatment method in the treatment of CMF of the calcaneus. CMF in the calcaneus may not be as rare as it is thought, and should be considered in the differential diagnosis.

Treatment of cryotherapy and orthotopic transplantation following chondromyxoid fibroma of zygomatic bone: A case report

INTRODUCTION

Chondromyxoid fibrotherma (CMF) is a rare benign cartilage tumor that occurs more frequently in young males at the age of 20 to 30. It occurs more frequently on long bones, but rarely involves craniofacial bones.

CASE PRESENTATION

This study mainly introduced a 30-year-old male with CMF of zygomatic bone. Single tumor excochleation was conducted initially. However, CMF reoccurred, and then the following steps were adopted: firstly, the tumor was extensively excised; secondly, in vitro tumor excochleation was conducted; thirdly, the excised tumor bone was placed in liquid nitrogen for 3 cycles of cryoablation; finally, the orthotopic transplantation was performed to reconstruct the zygomatic appearance, with satisfactory follow-up efficacy obtained.

CONCLUSIONS

Orthotopic transplantation after tumorectomy and cryopreservation of tumor bone in liquid nitrogen could lead to excellent therapeutic efficacy and deserves to be widely applied in clinical practice in the treatment of a male patient with CMF of zygomatic bone, because it not only radically eliminates the tumor and kills tumor cells, but also provides bony skeleton for the growth of new bone, thus greatly promoting postoperative aesthetic degree and reducing the occurrence rates of complications.

Primary tumours of the calcaneus

The calcaneus is a rare location for the occurrence and development of primary tumour types. Clinicians are unfamiliar with calcaneal tumour types, which may result in a delay in diagnosis or a missed diagnosis, resulting in unnecessary morbidity and amputation. Heel pain and localized swelling of the ankle are the most common symptoms. X-ray is the first choice for a tentative diagnosis of a calcaneal tumour. The final diagnosis depends on a histological examination. The treatment of calcaneal tumour types varies depending on the Enneking system. The majority of patients with benign tumours heal, except for a few with a palindromia. For malignant tumours, the prognosis is comparatively poor, resulting in disability and a high rate of metastasis. This review describes the spectrum of calcaneal tumour types and specifically illustrates the epidemiology, symptomatology, imagology, histopathology and treatment options that may facilitate diagnosis and improve prognosis.

An intracortical chondromyxoid fibroma in the diaphysis of the metatarsal

Chondromyxoid fibromas (CMFs) are rare, benign, primary tumors of bones, and occur in the metaphyses of the medullary canals of the long bones. The occurrence of intracortical CMFs is extremely rare. Very few cases of intracortical CMFs located in the long tubular bones have been reported to date. Moreover, even though the feet are the second most common site for CMF (after the knees), intracortical metatarsal CMF has not been reported previously, to our knowledge. We report an intracortical CMF occurring in the diaphysis of the metatarsal in a 17-year-old man. It showed the same imaging findings as usual intramedullary CMFs, except for its cortical location. The development and serial increase in this tumor over time are also demonstrated in this report. Additionally, we present a review of current literature on intracortical CMFs.

A rare probable chondroblastoma of the calcaneus in a pre-Columbian subadult from Illinois

Discrete cystic or tumorous intraosseous lesions can arise from a variety of benign and malignant conditions as well as trauma and infection. They are clinically rarely observed in the calcaneus. A fourteen-to-seventeen-year-old subadult recovered from a Late Woodland (∼AD 800-1100) period mortuary context in the Mississippi River Valley of central Illinois presents with a single lytic intraosseous lesion on the posterior right calcaneus that bilaterally perforates the cortex. The lesion, although primarily anterior to the epiphyseal plate, does breach it. There is also a small perforation of the outer cortex of the epiphysis above the insertion of the Achilles' tendon. The lesion is well-defined with a primarily spongy cancellous interior margin. On the body of the calcaneus, there is periostosis and a slightly expansive endosteal reaction. Comparative radiographic assessments undertaken to differentially diagnose the lesion indicate that it was likely not malignant. Based on the posterior location, the radiographic signature, the bilateral cortical perforation and the breach of the epiphysis, the lesion is best interpreted as a chondroblastoma.

Safety and efficacy of angiographic occlusion of duodenal varices as an alternative to TIPS: review of 32 cases

BACKGROUND/RATIONALE OF STUDY: Analyze safety and efficacy of angiographic-occlusion-with-sclerotherapy/embolotherapy-without-transjugular-intrahepatic-portosystemic-shunt (TIPS) for duodenal varices. Although TIPS is considered the best intermediate-to-long term therapy after failed endoscopic therapy for bleeding varices, the options are not well-defined when TIPS is relatively contraindicated, with scant data on alternative therapies due to relative rarity of duodenal varices. Prior cases were identified by computerized literature search, supplemented by one illustrative case. Favorable clinical outcome after angiography defined as no rebleeding during follow-up, without major procedural complications.

RESULTS

Thirty-two cases of duodenal varices treated by angiographic-occlusion-with-sclerotherapy/embolotherapy- without-TIPS were analyzed. Patients averaged 59.5 ± 12.2 years old (female = 59%). Patients presented with melena-16, hematemesis & melena-5, large varices-5, growing varices-2, ruptured varices-1, and other- 3. Twenty-nine patients had cirrhosis; etiologies included: alcoholism-11, hepatitis C-11, primary biliary cirrhosis- 3, hepatitis B-2, Budd-Chiari-1, and idiopathic-1. Three patients did not have cirrhosis, including hepatic metastases from rectal cancer-1, Wilson's disease-1, and chronic liver dysfunction-1. Thirty-one patients underwent esophagogastroduodenoscopy before therapeutic angiography, including fifteen undergoing endoscopic variceal therapy. Therapeutic angiographic techniques included balloon-occluded retrograde-transvenous-obliteration (BRTO) with sclerotherapy and/or embolization-21, DBOE (double-balloon-occluded-embolotherapy)-5, and other-6. Twenty-eight patients (87.5%; 95%-confidence interval: 69-100%) had favorable clinical outcomes after therapeutic angiography. Three patients were therapeutic failures: rebleeding at 0, 5, or 10 days after therapy. One major complication (Enterobacter sepsis) and one minor complication occurred.

CONCLUSIONS

This work suggests that angiographic-occlusion-with sclerotherapy/ embolotherapy-without-TIPS is relatively effective (~90% hemostasis-rate), and relatively safe (3% major-complication-rate). This therapy may be a useful treatment option for duodenal varices when endoscopic therapy fails and TIPS is relatively contraindicated.

Atypical Localization of Enchondroma in the Calcaneus

A 53-year-old man presented to the orthopedic outpatient clinic with pain and swelling in the right heel without any trauma. On physical examination and radiologic assessment, a lesion with calcification and peripheral sclerosis was detected in the medullary cavity of the calcaneus, and computed tomographic images revealed cortical thinning adjacent to the lesion. Magnetic resonance images showed a 23 × 19-mm lesion. Tru-Cut biopsy, performed to clarify the diagnosis, revealed an enchondroma. As a definitive treatment, curettage of the lesion and grafting of the cavity was performed. Although enchondromas are common pathologic abnormalities of the skeleton and are usually asymptomatic, atypical localization, such as the calcaneus, and atypical clinical manifestations, such as heel pain, should also be kept in mind.