Moradh El Yaacoubi

Squamous cell carcinoma arising from chronic osteomyelitis

OBJECTIVES Our aim was to present the results from a retrospective study of 7 cases of squamous cell carcinoma arising from chronic osteomyelitis. METHODS We treated seven cases of chronic osteomyelitis related squamous cell carcinoma between 1993 and 2005. The patients had an average age of 54.5 (range: 38-71) years, with a male predominance (6 men, 1 woman). We analyzed the time up to cancerization, the localization and histopathological type of the carcinoma, and the type and result of the treatment. RESULTS The mean time between the occurrence of the skin lesions and the diagnosis of malignant degeneration was 24.5 (range: 9 to 40) years. The carcinoma resulted from tibia osteomyelitis in 4 cases, femur osteomyelitis in 2 cases and humerus osteomyelitis in one. The pathological examination showed five cases of a well differentiated squamous cell carcinoma with bone invasion, and two cases of invasive squamous cell carcinoma. The treatment consisted of amputation in all but one patient, who refused the amputation. The six amputee patients did not show local recurrence or metastatic dissemination over a period of five years. CONCLUSION Amputation appears to be an effective treatment method in squamous carcinoma secondary to chronic osteomyelitis.

A rare cause of chronic sciatic pain: Schwannoma of the sciatic nerve

Schwannomas are common, benign tumors of the shelth of peripheral nerves. Sciatic schwannomas are rare. Their symptomatology usually mimics sciatic pain due to a herniated disc, which can delay the diagnosis. If there is no lumbar pain and lumbar MRI is normal, the sciatic nerve must be clinically and radiologically examined all along its course. We report a case of sciatic nerve schwannoma presenting with chronic sciatica which was diagnosed and monitored radiologically for several years before successful surgical resection.

Combined myoepithelial carcinoma and myoepithelioma in soft tissue: a case report and review of the literature

IntroductionSoft tissue myoepithelial carcinoma and myoepithelioma are rare entities, part of myoepithelial tumors. They were incorporated into the World Health Organization classification of soft tissue tumors in 2002. Here we present an exceptional case of myoepithelial carcinoma and myoepithelioma association. To the best of our knowledge, such an association has never been reported in the literature.Case presentationWe report a case of myoepithelial carcinoma combined with myoepithelioma occurring in the soft tissue of the right forearm of an 84-year-old Arabian man. We describe the clinical, radiological and pathological features dominated by histological polymorphism. We will also describe the proposed histological criteria of malignancy and the major role of immunohistochemistry in positive and differential diagnosis. We finally mention the therapeutic arsenal available.ConclusionThrough this work, we report that myoepithelioma of soft tissue can progress to malignant myoepithelioma.

Schwannoma of the Median Nerve: Diagnosis Sometimes Delayed

Schwannoma is a tumor that develops from nerve sheath. The authors report an unusual case of schwannoma of the median nerve (MN) that remained asymptomatic for four years. The diagnosis was based on MRI (magnetic resonance imaging) and histopathological examination. Surgical removal is usually curative. The asymptomatic character of the tumor and its slow evolution remain an essential factor in diagnosis delays. This tumor has a good prognosis with a low recurrence rate and potential for malignant transformation.

Non-traumatic myositis ossificans circumscripta: A diagnosis trap

Myositis ossificans circumscripta (MOC) is a benign condition of non-neoplastic heterotopic bone formation in the muscle or soft tissue. Trauma plays a role in the development of MOC, thus, non-traumatic MOC is very rare. Although MOC may occur anywhere in the body, the lesions are localized predominantly in the high-risk sites of injury, such as the thigh, buttock, and elbow. MOC can easily be mistaken for osteomyelitis or a malignant tumor, specifically osteosarcoma or soft-tissue sarcoma. We report a rare case of non-traumatic myositis ossificans circumscripta of thigh which appear clinically and radiologically as a malignant neoplasm. Despite its rarity, MOC should be contemplated in the differential diagnosis of malignant tumors.

Tuberculosis arthritis of the metatarsal phalangeal: a rare location

Tuberculosis TB is common in countries constituting endemic areas like Morocco, spinal sites represents half of osteo-articular locations, while peripheral locations in the limbs are rare. The authors relate in this observation the case of a particular location of tuberculosis arthritis. It is osteoarthritis of the metatarsophalangeal joint of the 2nd ray of the foot. Clinical signs were characterized by a moderately painful swelling of the dorsum of the foot with slow evolution. The definitive diagnosis was histologically obtained. Clinical cure was achieved after 09 months of medical treatment.

Creation of the bone bank of the Rabat and Casablanca region in Morocco

For a long time the use of bone grafting has demonstrated its interest in orthopedic surgery and traumatology. The autografts which are still very frequently used present various problems. On the one hand, it is necessary to find a correct mechanical quality and a sufficient quantity of bone. On the other hand, the graft removal lengthens the operative time and generally painful in postoperative. These disadvantages of autografts have led to the development of bone allografts. Indeed, the low immunogenic power of the bone, the good integration of the graft and the ease of bone preservation techniques make it possible to overcome the various problems posed by bone autografts. The increasing use of bone allografts has resulted in the need for a structure allowing the management of graft stocks. The purpose of this work is to demonstrate the mode of operation of a bone bank, whose conservation activity is limited to the femoral heads treated by cryopreservation and without secondary sterilization process. The bank collaborates with all orthopedic surgeons in the Rabat and Casablanca city at first and then with all orthopedic surgeons in Morocco. It provides allografts in quality and safety.

Cubitus varus: l'ostéotomie de soustraction externe a-t-elle toujours sa place? Etude rétrospective à propos de 25 cas

Cubitus varus or malunion is most often secondary to displaced supracondylar fractures of the lower end of the humerus in children. Various surgical techniques have been proposed with different success rates but also with different reported complication rates. Our retrospective study of 25 cases diagnosed at the University Hospital of Rabat evaluated the results of the technique of external subtraction which was used in our training to handle this deformation.

Osteoblastoma of the carpal navicular: a case report and review of the literature

Osteoblastoma of the scaphoid is an infrequent cause of hand and wrist pain. The few reported cases emphasize the rarity of osteoblastoma in hand and wrist localizations. Pathological examination is mandatory before treatment due to lack of distinctive clinical and radiological features. We report the case of a 17-year-old right-handed girl who presented with a more than 7-month history of progressive right-wrist pain. No history of trauma was reported. Conservative treatment with anti-inflammatory medications before referral was unsuccessful. The authors present the diagnostic difficulties and the treatment that was applied: proximal row carpectomy. Treatment options, according to the literature, also include scaphoidectomy and tumor curettage with bone grafting.