Sachio Masuda

Phalangeal microgeodic syndrome in childhood: Report of seven cases and review of the literature

Seven cases of phalangeal microgeodic syndrome in childhood are reported. Reviewing the literature, we have found a total of thirty Japanese cases, including the cases of our own. On the other hand, only ten cases have been reported outside Japan. The mean age of onset of the Japanese cases was six and a half years, which is older than that in the initial description. Of further interest is the fact that all the cases in Japan occurred sporadically and exclusively in winter, and regressed spontaneously and fairly rapidly within six months. Furthermore, most of the cases reported in Europe also occurred in the winter months. These facts imply an etiological relationship between the lowered temperature and the bone lesions.

Mixed tumor of deep soft tissue

Mixed tumors of the salivary gland and skin are relatively common but are quite rare in soft tissue. It is believed that, as in the salivary gland form, most of these lesions are benign, but that a small subset behave in an aggressive fashion. We report here a patient with recurrent mixed tumor of soft tissue with infiltrative growth. The primary tumor arose in deep subfascial soft tissue of the right lower leg and was adjacent to the surface of the fibula. An open biopsy and complete resection were performed. Upon histological examination of the resected specimen, neoplastic cell infiltration at the tumor/soft tissue interface was not obvious; local recurrence, however, was observed 1 year later. The patient was treated with wide resection. Histological examination confirmed that the recurrent tumor with an extensive chondroid area invaded the osseous tissue of the fibula. At present, 1 year after the second resection surgery, there is no evidence of disease.

Antitumor effect of human leukocyte interferon on human osteosarcoma transplanted into nude mice.

We studied the effect of human leukocyte interferon (HuIFN-alpha) on a human osteosarcoma (OS-OH) transplanted and passed serially in athymic mice. The growth of OS-OH was strikingly inhibited by HuIFN-alpha (50,000 IU/mouse), regardless of whether the interferon treatment was initiated 24 hr after tumor inoculation or 2 weeks later, when tumors had grown to an appreciable size (4-6 mm). The antitumor effect of HuIFN-alpha was found to be dose-dependent and a daily administration of HuIFN-alpha (50,000 IU/mouse) all but completely arrested the tumor growth.

Primary rhabdomyosarcoma of the iliac bone in an adult: A case mimicking fibrosarcoma

Primary rhabdomyosarcoma of bone is exceedingly rare. We present a case of rhabdomyosarcoma of the iliac bone in a 32-year-old male. Histologically, the tumour consisted mainly of a uniform proliferation of elongated spindle cells arranged in a herring bone pattern, simulating fibrosarcoma. Focally there was a conventional embryonal pattern with scattered rhabdomyoblasts possessing an eosinophilic cytoplasm. Immunohistochemical studies disclosed expression of muscle markers such as desmin and muscle-specific actin, in both the embryonal and spindle-cell areas and myoglobin only in the embryonal areas. Such histological features are unusual for classical embryonal rhabdomyosarcoma. The anatomical site and age of the patient are also atypical.

Degenerative Change in the Adjacent Segments to the Fusion Site after Posterolateral Lumbar Fusion with Pedicle Screw Instrumentation : A Minimum 4-Year Follow-up

BACKGROUND Controversy remains regarding the subsequent degeneration of adjacent segments, and little reliable information could be found in the literature regarding long-term clinical results and adjacent segment degeneration. The objective of this study is to investigate the degenerative change of adjacent segments to the fusion site and clinical outcome after posterolateral lumbar fusion with pedicle screw instrumentation and identify the risk factors in degenerative change at adjacent segments. METHODS Thirty-two patients who underwent posterolateral lumbar fusion and were able to be followed over four years were evaluated in this study. The intervertebral disc height, percent of slip, lumbosacral joint angle, lumbar lordosis and disc angle were all examined. The postoperative progression of degeneration at adjacent segments were defined as more than a 50 % narrowing in the adjacent disc height or more than a 5 % slip in adjacent segments in comparison to the preoperative neutral lateral radiographs. The clinical results were assessed using an evaluation scores for lumbar lesions proposed by the Japanese Orthopedic Association. RESULTS Fifteen (46.8%) of the 32 patients had adjacent segment degeneration including slip or narrowing. No significant correlation was found between the adjacent segment degeneration and the recovery rate at the final follow-up. In addition, no significant correlation was observed between the adjacent segment degeneration at the lastest follow-up and postoperative radiographic measurements. CONCLUSIONS The rate of radiographic degeneration at the adjacent segments was 46.8%. No significant correlation was found between degenerative change in the adjacent segments and the clinical results. We could not identify any preoperative radiographic factors which might have influenced the segments adjacent to the fusion.

Case report 877

A case of giant cell reparative granuloma in a 16-year-old girl has been reported. This is the first reported case of giant cell reparative granuloma associated with enchondromatosis. In addition to the clinical features, the pathologic findings and differential diagnosis were also discussed.

Case report 793

A case of periosteal osteosarcoma in an 18-year-old boy has been reported. This is the first reported case of periosteal osteosarcoma arising in the clavicle. The radiological features in this case were entirely similar to those in long bones such as the femur and tibia. In addition to the radiological features and pathologic findings, various clinical aspects and prognosis were also discussed.

Pseudomalignant myositis ossificans occurring in the hand

This is a case report of a patient with pseudomalignant myositis ossificans of the hand. This entity is usually related to trauma, but there was no history of injury in this patient. Radiographic follow-up, histologic zone phenomena and computerized tomography are helpful in obtaining the correct diagnosis.

Anorectal function after high sacrectomy with bilateral resection of S2–S5 nerves

A 19-year-old man underwent resection at the S1–S2 interspace with sacrifice of bilateral sacral nerves below S2 for a sacral tumor. The postoperative anorectal function was evaluated periodically for one year using manometry and subjective findings. The rectoanal inhibitory reflex was intact, whereas a disturbance of anorectal sensation, a loss of anal squeeze pressure, a decrease of anal canal resting pressure, urinary incontinence, and impotency were apparent. These findings suggest that sacrifice of bilateral sacral nerves below S2 leads to a feeble anal canal basal tone with the rectoanal inhibitory reflex, and that a significant impairment of anorectal function is inevitable.

Clear Cell Chondrosarcoma: A Case Report with Topographic Analysis

A case of clear cell chondrosarcoma located in the right proximal end of the femur is presented. Radiologically, the tumor appeared as a large osteolytic lesion with mottled calcification resembling chondroblastoma. Histologically, the greater portion was made up of tumor cells with abundant clear cytoplasm and usually distinct boundaries, associated with areas of conventional chondrosarcoma. The proportion of the clear cell areas was about 60%, and they were mainly distributed along the tumor periphery. Moreover, myxoid chondrosarcoma‐like areas, a feature not previously mentioned in clear cell chondrosarcoma, were observed, occupying about 10% of the tumor area. Acta Pathol. Jpn. 39: 533∼538, 1989.