Nevzat Dabak

Salter's innominate osteotomy in the treatment of congenital hip dislocation: a long-term review.

We reviewed 39 patients with 52 congenitally dislocated hips, all managed by open reduction and Salters innominate osteotomy. Mean follow-up period was 13 years (range, 8 to 25 years); 78.9% of the hips had a good or excellent clinical result, and 71.1% were good or excellent radiologically. The patients who underwent Salters innominate osteotomy before the age of 4 had better clinical and radiological results (88.4 and 81.4%, respectively). The radiographs of the unilateral normal hips were compared to the surgically treated hips according to their acetabular index angles, center-edge angles of Wiberg, and femoral neck-shaft angles. No statistical differences were found between these two groups. The Bucholz-Ogden classification was used for the diagnosis and classification of avascular necrosis. The late radiographic signs of types 2, 3, and 4 avascular necrosis were seen in 34.6% of this series. The results show that Salters innominate osteotomy provides good lateral coverage of the femoral head. The results are better if the operation is performed between the ages 18 months and 4 years.

Subungual glomus tumours of the hand: diagnosis and treatment of 14 cases.

A glomus tumour is a rare tumour of the hand, which presents with a classic triad of symptoms of temperature sensitivity, pain, and localised tenderness. We report a series of 14 patients with glomus tumours in the subungual region. There were four men and 10 women, whose mean age was 46 years (range 28-65). All patients complained of pain and localised tenderness and six of temperature sensitivity. The bony lesion was seen on radiographs in four patients. We used a transungual approach in all cases. A detailed history and clinical findings are the best way of making the diagnosis. The treatment of glomus tumour consists of complete excision and repair of the nailbed. Inadequate excision of the tumour usually causes local recurrence.

Extradigital glomus tumor of the triceps tendon as a cause of elbow pain: a case report

G lomus tumors are rare benign vascular tumors first described by Wood in 1812.5 Of all of the upper extremity tumors, they are the most interesting and worth investigating because of their clinical findings. Clinically, glomus tumors are characterized by a triad of temperature sensitivity, severe pain, and localized tenderness.2,3 Often these are unique positive diagnostic findings of a tumor, although several diagnostic methods have also been used. The lesion is usually located in the hand, especially the nail bed of the distal phalanx, but it may occur anywhere.1,2,4-7 We report a rare case of glomus tumor in the tendon of the triceps. It caused severe pain and limitation of the elbow joint.

MELANOTIC NEUROECTODERMAL TUMOR OF INFANCY OF THE FEMUR

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare neoplasm that often occurs during the first year of life. More than 90% of MNTIs occur in the head and neck region, with most on the anterior part of the maxillary ridge. MNTI has also been reported in the mediastinum, thigh, foot, shoulder, and gonads. Here the authors report a rare case of MNTI of the femur in a 3-month-old child.

Erdheim-Chester disease: 99mTc-MDP bone scan provides the diagnosis

1 Department of Nuclear Medicine, Ondokuz Mayıs University, Samsun, Turkey 2 Department of Trauma and Orthopaedics Surgery, Ondokuz Mayıs University, Samsun, Turkey 3 Department of Pathology, Ondokuz Mayıs University, Samsun, Turkey 4 Department of Radiology, Ondokuz Mayıs University, Samsun, Turkey 5 Kurupelit Kampus, Tip Fakultesi, Nukleer Tip ABD, Ondokuz Mayıs Universitesi, 55139 Samsun, Turkey

ACQUIRED VON WILLEBRAND SYNDROME IN A PATIENT WITH EWING SARCOMA

Acquired von Willebrand syndrome is a rare bleeding disorder with clinical and laboratory features closely resembling to hereditary von Willebrand disease. The syndrome may accompany various conditions, including malignant disorders, most often with Wilms tumor and adrenal cell carcinoma. In this report, the authors present a patient with AvWS in association with Ewing sarcoma for the first time in the literature. The abnormal bleeding tendency was successfully treated with fresh frozen plasma and did not recur after the first two courses of chemotherapy with clinical improvement.

Evaluation of primary bone lymphoma and the importance of positron emission tomography.

Primary lymphoma of the bone is an extremely rare tumor in the form of non-Hodgkin lymphoma or Hodgkin lymphoma. The majority of primary bone lymphomas are non-Hodgkin lymphoma, of which the most common subtype is diffuse large cell lymphoma. Patients can present with pain, swelling or pathologic fracture. Definitive diagnosis is made after biopsy examination. Treatment consists of chemotherapy, radiotherapy and surgery. We report 3 male patients who presented with pain and swelling. Involvement was in the distal femur, proximal fibula and iliac crest in all patients. Patients were diagnosed with non-Hodgkin lymphoma in biopsy examination and underwent chemotherapy. The patient with distal femoral involvement underwent distal femoral resection prosthesis. Another patient with involvement of the fibular head experienced foot drop and delayed wound healing. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography revealed complete response to the treatment. Patients are in remission and continue schooling.

Pilomatrixoma localized in the arm and forearm

Pilomatrixoma is a rare benign skin tumor arising from hair follicle stem cells which is also known as calcifying epithelioma of Malharbe. It occurs with a rate of 0.1% among skin tumors. The definite diagnosis is made histopathologically. In treatment, it is recommended that the lesion be excised surgically. In this study, we wished to present two patients who presented with swelling and underwent excisional biopsy as a result of magnetic resonance imaging and whose pathological result was reported to be pilomatrixoma in accompaniment with the literature.

Distribution and evaluation of bone and soft tissue tumors in the middle Black Sea Region

OBJECTIVE The aim of this study was to evaluate the characteristics of bone and soft tissue tumors operated on at the Department of Orthopedics and Traumatology at Ondokuz Mayıs University Faculty of Medicine Hospital between January 1987 and January 2012. METHODS This descriptive study retrospectively evaluated 1,925 patients hospitalized with a preliminary diagnosis of tumor. Patients were analyzed for age, gender, tumor incidence and localization. Three hundred and forty-nine patients found to have non-tumor causes. The 94 patients discharged at their own request or deceased during follow-up were not included in the tumor group. RESULTS Of the 1,482 (76.9%) patients diagnosed with tumor, 687 (46.4%) were bone tumors, 586 (39.5%) soft tissue tumors and 209 (14.1%) metastatic tumors. The most common benign bone tumor was osteochondroma (118; 25%), followed by enchondroma (68; 14.4%) and giant cell tumor (59; 12.5%), and the most common malignant bone tumor was osteosarcoma (58; 27%), followed by chondrosarcoma (36; 16.7%) and Ewings sarcoma (33; 15.3%). The most common benign soft tissue tumor was cystic hygroma (96; 22%), followed by lipoma (75; 17.2%) and hemangioma (52; 11.9%), and the most common malignant soft tissue tumors were pleomorphic cell tumor (29; 19.3%) and liposarcoma (29; 19.3%), followed by pleomorphic undifferentiated sarcoma (21; 14%). Seventy (33.5%) of the metastatic tumors were of pulmonary origin, 36 (17.2%) were of breast origin and the primary site of the tumor was not clearly determined in 58 (27.8%) patients. CONCLUSION The distribution of bone and soft tissue tumors appear to have certain characteristics but can show regional differences. We believe that the establishment of a larger series through the collection of these types of studies from centers in which bone and soft tissue tumor surgery is performed will provide important information on the epidemiological features of bone and soft tissue tumors.

Interesting image. Rapid verification of unusual tracer uptake patterns by means of SPECT/CT: a case of unexpected 111indium pentetreotide accumulation in a splenic variant.

Abstract: A 45-year-old woman with gluteal mass and a histopathological diagnosis of malign small round cell sarcoma was investigated for metastatic spread. The patient was referred to nuclear medicine for further evaluation by means of somatostatin analogues. 111Indium- pentetreotide whole body imaging revealed an intense and inverted arrow-shaped uptake in the left upper quadrant resembling cardiac activity. Although the location and posterior appearance of the tracer uptake was indicating somehow splenic activity, a SPECT/CT scan was performed for anatomic verification. The reconstructed SPECT/CT fusion images depicted clearly that the totality of the atypical activity originated from the spleen, which was defined as an anatomic variant. In this case, SPECT/CT easily clarified the unusual appearance of the spleen, suggesting a pathologic finding on conventional whole body imaging.