Radiological and histological features of tumoral calcinosis of the dorsum of the foot

Primary Tumoral Calcinosis in a Pediatric Patient: A Rare Presentation

Tumoral calcinosis is a benign, progressive disorder characterized by massive periarticular deposition of calcium salts into subcutaneous and deeper tissue layers. While a majority of cases present secondary to underlying metabolic disorders, it can rarely present as a primary, idiopathic phenomenon. We present an atypical case of a pediatric patient with a large, ulcerated pedal soft tissue mass found to be consistent with primary tumoral calcinosis. This was confirmed by histopathologic analysis and comprehensive metabolic workup. The patient underwent surgical excision of the mass, with complete resolution of symptoms and no recurrence after a 1-year follow-up period.

Painful extraskeletal osteochondroma under the tarsal sesamoid: a case report and review of literature

Extraskeletal osteochondroma is a rare condition. To our knowledge, occurrence in the foot has been very rare. We present here a case wherein the patient developed a painful extraskeletal osteochondroma under the tarsal sesamoid. A fifty-one-year-old man presented at our department with a painful mass on the plantar part of the metatarsal joint of the right big toe. The mass had grown gradually in size for the past 7 months and was associated with pain while walking. Preoperative X-ray and a computed tomography showed that the tumor had no continuity with adjacent bone. Intraoperatively, a bony hard tumor was located in the subcutaneous tissue plantar to the tibial sesamoid. The mass was firmly attached to the sheath of the flexor hallucis brevis tendon. Macroscopically, the tumor was covered with glistering surface. The tumor was carefully dissected from the surrounding soft tissues and was removed. It was diagnosed as extraskeletal osteochondroma histologically. The patient had no recurrence at 1 year after operation.

Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel

PURPOSE

To determine the clinical utility of intrinsic molecular phenotype after breast-conserving therapy (BCT) with lumpectomy and whole-breast irradiation with or without a cavity boost.

PATIENTS AND METHODS

Four hundred ninety-eight patients with invasive breast cancer were enrolled into a randomized trial of BCT with or without a tumor bed radiation boost. Tumors were classified by intrinsic molecular phenotype as luminal A or B, HER-2, basal-like, or unclassified using a five-biomarker panel: estrogen receptor, progesterone receptor, HER-2, CK5/6, and epidermal growth factor receptor. Kaplan-Meier and Cox proportional hazards methodology were used to ascertain relationships to ipsilateral breast tumor recurrence (IBTR), locoregional recurrence (LRR), distant disease-free survival (DDFS), and death from breast cancer.

RESULTS

Median follow-up was 84 months. Three hundred ninety-four patients were classified as luminal A, 23 were luminal B, 52 were basal, 13 were HER-2, and 16 were unclassified. There were 24 IBTR (4.8%), 35 LRR (7%), 47 distant metastases (9.4%), and 37 breast cancer deaths (7.4%). The overall 5-year disease-free rates for the whole cohort were: IBTR 97.4%, LRR 95.6%, DDFS 92.9%, and breast cancer-specific death 96.3%. A significant difference was observed for survival between subtypes for LRR (P = .012), DDFS (P = .0035), and breast cancer-specific death (P = .0482), but not for IBTR (P = .346).

CONCLUSION

The 5-year and 10-year survival rates varied according to molecular subtype. Although this approach provides additional information to predict time to IBTR, LRR, DDFS, and death from breast cancer, its predictive power is less than that of traditional pathologic indices. This information may be useful in discussing outcomes and planning management with patients after BCT.