A. Schreiber

Epithelioid sarcoma mimicking angiosarcoma: The value of immunohistochemistry in the differential diagnosis

Epithelioid sarcoma (ES) is a rare malignant tumour of young adults, usually presenting as a skin ulcer or subcutaneous nodule in the distal portion of the upper limb. Multiple recurrences and late metastases are typical, leading to fatality in a third to one-half of all cases. The slow evolution of the tumour is one reason for its delayed recognition. The other is its frequent histological misinterpretation, in particular, as a peculiar granulomatous reaction. In our case, the primary tumour presented a variant morphological pattern so closely mimicking a cavernous angiosarcoma as to mislead several reputable opinions. Later recurrences and metastases were typical of ES, while a focal angiomatoid pattern was maintained. The morphology and immunoreactivity to a wide spectrum of tumour markers is compared with that of six file cases of classical ES. Retrospectively, all neoplastic lesions in our patient were ES. In young adults, lesions of the upper extremity, even when angiomatoid or haemorrhagic, should raise a suspicion of ES. Once epithelioid sarcoma is suspected, the differential diagnosis can be elucidated on immunohistochemical grounds. Early diagnosis provides the best opportunity for radical surgery at a stage when the tumour has not spread locally or disseminated systemically.

Osseous lesions of the distal ulna: atypical location--unusual diagnosis. Report of three cases with similar imaging and different pathologic diagnoses.

Abstract Three cases with destructive bone lesions of the distal end of the ulna caused by different pathologic entities (Ewing’s sarcoma, osteosarcoma, rheumatoid pseudotumoral synovitis) are presented, all with similar clinical and comparable x-ray and magnetic resonance imaging features. Although the distal end of the ulna may be resected without significant functional impairment, careful evaluation of treatment strategies compatible with oncologic standards is warranted.

Muscle Reattachment — Especially the Gluteal Muscles — After Proximal Femoral Resection and Replacement by Tumor Prosthesis

The muscles inserting at the major trochanter (gluteal muscles, external rotators) are major abductors and extensors of the hip and have important functions for locomotion and stabilization against limping.

Reduced vitamin a tolerance in a hyperlipidaemia patient with rapid destructive and hyperostotic osteoarthritis of the hip

SummaryA 59-year-old patient suffering from hyperlipidaemia developed a chronic vitamin A intoxication syndrome after ingestion of 30000 IE retinol/daily over a period of six years. Functional disability of the right hip was caused by radiologically documented hyperostosis of the acetabular circumference. Finally, a prosthesis had to be implanted because of rapid destructive osteoarthritis of the right hip. Implications of vitamin A for rheumatological management are discussed.

Frozen Homologous Trabecular Bone Allografts: 12-Years’ Experience with Banking and Clinical Use

Frozen homologous trabecular bone (FHTB) is probably the most commonly used allogeneic material for biologic replacement of bone defects [1]. FHTB has been in use at the Klinik Balgrist since 1974. The results in cases of large defects are of interest in comparison with, for example, massive allografts.