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Toepfer A, Strässle M, Lenze U, Lenze F, Harrasser N. Allogenic Cancellous Bone versus Injectable Bone Substitute for Endoscopic Treatment of Simple Bone Cyst and Intraosseous Lipoma of the Calcaneus and Is Intraosseous Lipoma a Developmental Stage of a Simple Bone Cyst? J Clin Med 2023; 12:4272. [PMID: 37445307 DOI: 10.3390/jcm12134272] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/07/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Simple bone cysts (SBCs) and intraosseous lipoma (IOL) of the calcaneus are rare tumor entities that are primarily diagnosed due to unspecific heel pain, incidental findings, or rarely due to pathological fractures. Compared to traditional open tumor resections, endoscopic resection of these benign tumors aims to minimize surgical morbidity and maximize surgical efficiency without compromising safety. Grafting is regularly performed to reduce the risk of recurrence and stimulate osseous consolidation of the lytic lesion. As the incidence is low and treatment strategies are heterogeneous, there is no clear consensus for the treatment of simple cysts or intraosseous lipomas of the calcaneus. The objectives of this study are (a) to present medium to long-term results after endoscopic resection and grafting with allogenic cancellous bone or bioresorbable hydroxyapatite and calcium sulfate cement, and (b) to add further evidence to the discussion of whether calcaneal SBC and IOL are the same entity at different developmental stages. Between 2012 and 2019, a total of 25 benign bone tumors consisting of 17 SBCs and 8 IOLs were treated by A.T. with endoscopic resection and grafting, comprising the largest cohort to date. For grafting, 12 patients received allogenic cancellous bone (group A) and 13 patients received injectable bone substitute (group B). Pre- and postoperative imaging using plain X-rays and MRI was retrospectively analyzed with a mean follow-up time of 24.5 months to assess tumor size, osseous consolidation (modified Neer classification), and tumor recurrence. A retrospective chart analysis focusing on adverse intra- and perioperative events and other complications associated with the surgical procedure was performed using the modified Clavien-Dindo classification (CD1-3). A total of 12/13 cases with allogenic bone grafting showed a Neer Type 1 osseous healing of the tumorous lesion after endoscopic resection, whereas only 5/11 cases with injectable bone substitute showed sufficient healing (types 1 and 2). There were three recurrent cysts (Neer 4) and two persistent cysts (Neer 3) after using injectable bone substitute. Two CD1 complications were observed in group A (prolonged wound drainage, sural neuritis) and eight complications were observed in group B (6× CD1, 2× CD3). At least two IOLs diagnosed preoperatively using MRI were ultimately identified as SBCs upon histopathologic examination. Allogenic cancellous bone grafting after endoscopic resection of calcaneal SBC or IOL showed a very low rate of complications and no tumor recurrence in our series. On the other hand, depending on the material used, injectable bone substitute showed a high rate of "white-out" (excessive drainage), resulting in multiple complications such as prolonged wound healing, insufficient permanent defect filling, recurrence, and revision surgery. Over time, calcaneal SBC may transform into IOL, exhibiting distinct features of both entities simultaneously during ossoscopy and histopathological analysis.
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Affiliation(s)
- Andreas Toepfer
- Orthopaedics and Traumatology, Kantonsspital St.Gallen, Rorschacher Strasse 95, CH-9007 St.Gallen, Switzerland
| | - Michael Strässle
- Orthopaedics and Traumatology, Kantonsspital St.Gallen, Rorschacher Strasse 95, CH-9007 St.Gallen, Switzerland
| | - Ulrich Lenze
- Department of Orthopaedics and Sportorthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 München, Germany
| | - Florian Lenze
- Department of Orthopaedics and Sportorthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 München, Germany
| | - Norbert Harrasser
- Department of Orthopaedics and Sportorthopaedics, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 München, Germany
- ECOM Excellent Center of Medicine, 81925 München, Germany
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Gottlich C, Fisher JC, Campano D, Diab M. Management of Calcaneal Cysts in the Pediatric Population: A Review. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202303000-00007. [PMID: 36913318 PMCID: PMC10010847 DOI: 10.5435/jaaosglobal-d-22-00248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 03/14/2023]
Abstract
Cysts of the bone are a common pathology that, although benign, are frequently treated because of their tendency to compromise the integrity of affected bone. Two common entities are unicameral bone cysts and aneurysmal bone cysts. Although these are two distinct pathologies, they are treated similarly and thus will be discussed in tandem. The optimal treatment of calcaneal bone cysts in pediatric patients has long been debated among orthopaedic surgeons because of the relatively small number of cases and varied results within the literature. Currently, there are three lines of thought regarding treatment: observation, injection, and surgical intervention. When considering which course of treatment is best for an individual patient, the surgeon must consider the fracture risk without treatment, the risk of complications with treatment, and the recurrence rate with each treatment approach. There are limited data on pediatric calcaneal cysts specifically. Still, there are much data concerning simple bone cysts of long bones in the pediatric population and calcaneal cysts in the adult population. Because of the lack of literature on the subject, there is a need for a review of the available literature and a consensus on the approach to treating calcaneal cysts in the pediatric population.
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Endoscopic curettage and allografting of simple bone cysts of the calcaneus in young soccer players: Report of three cases. Foot (Edinb) 2022; 51:101868. [PMID: 35483303 DOI: 10.1016/j.foot.2021.101868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 07/21/2021] [Accepted: 09/22/2021] [Indexed: 02/04/2023]
Abstract
Open curettage with bone graft has been the traditionally suggested surgical treatment for the symptomatic simple (or unicameral as they used to be called) calcaneal bone cyst. Less invasive endoscopically assisted treatment with curettage and bone grafting with allograft have recently provided less postoperative morbidity. The aim of the present study is to present our experience with this method in young soccer athletes. Between April 2014 and May 2016 three consecutive young soccer players with symptomatic calcaneal bone cysts underwent endoscopic curettage, and percutaneous injection of demineralized bone matrix allograft. The mean age was 17.3 (16, 17 and 19 years old), and the mean follow-up was 32.1 (range 24-47) months. Both radiographic and functional follow-up, using the AOFAS score, showed good to excellent results. All lesions were radiographically healed. Preoperative AOFAS score (max. 100 pts) was 78.6 ± 4.7, improving to 98.0 ± 4.1. The patients returned to their initial level of sports activities within 18.3 (range 17-19) weeks after surgery. Evidence suggests an earlier return to sports using bone substitutes. However, the present study showed that endoscopic curettage and percutaneous injection of bone allograft is also an excellent treatment option for young athletes with a symptomatic calcaneal bone cyst. LEVEL OF CLINICAL EVIDENCE: 4.
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Ma H, Shi Y, Zhang W, Liu F, Han Y, Yang M. Open Curettage With Bone Augmentation for Symptomatic Tumors and Tumor-like Lesions of Calcaneus: A Comparison of Bioactive Glass Versus Allogeneic Bone. J Foot Ankle Surg 2021; 60:881-886. [PMID: 33781640 DOI: 10.1053/j.jfas.2021.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 06/06/2020] [Accepted: 02/24/2021] [Indexed: 02/03/2023]
Abstract
Few studies have characterized the clinical outcomes of 45S5 Bioglass® applied as a bone graft to that of allogeneic bone applied in calcaneal open curettage. Therefore, the purpose of the present investigation was to compare the outcomes of patients with calcaneal tumors and tumor-like lesions treated by open curettage with 45S5 Bioglass® or allogeneic bone. Of the 31 patients who underwent open curettage (18 cases of unicameral bone cysts, 7 cases of aneurysmal bone cysts, and 6 cases of intraosseous lipoma), 16 (52%) received grafts with 45S5 Bioglass® and 15 (48%) with allogeneic bone. All the feet achieved bone fusion according to the modified Neer radiographic classification system at the last follow-up examination. The mean bone ingrowth time for the grafts with 45S5 Bioglass® versus allogeneic bone was 3.71 ± 0.86 versus 4.46 ± 1.04 months (p = .038), the mean bone healing time was 4.86 ± 0.93 versus 5.73 ± 1.07 months (p = .021), and the mean incision drying time was 7.2 ± 1.8 versus 8.2 ± 1.5 days (p = .047), respectively. No differences were found in the postoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot scale scores between the 2 groups (p = .213). These results show that 45S5 Bioglass® can better facilitate the formation of new bone with a faster drying time of the incision than allogeneic bone. Although both materials can benefit the clinical outcomes of calcaneal tumors and tumor-like lesions, further studies are needed to observe the long-term complications and lesion recurrence rates.
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Affiliation(s)
- Hongdong Ma
- Resident Doctor, Department of Orthopaedics, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yingxu Shi
- Resident Doctor, Department of Orthopaedics, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Weilin Zhang
- Doctor-in-Charge, Department of Orthopaedics, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Fei Liu
- Doctor-in-Charge, Department of Orthopaedics, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yaxin Han
- Associate Senior Doctor, Department of Orthopaedics, the First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Maowei Yang
- Chief Physician, Department of Orthopaedics, the First Hospital of China Medical University, Shenyang, Liaoning, China.
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Temple EW, Prusa RD. Calcaneal Bone Tumors. Clin Podiatr Med Surg 2021; 38:227-233. [PMID: 33745653 DOI: 10.1016/j.cpm.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bone tumors of the foot are an uncommon finding. Most tumors are found incidentally on imaging and are benign. Care must be taken although due to the aggressive nature of malignant bone tumors that can occur in the calcaneus. Malignant lesions will more commonly present with symptoms of pain and swelling. Often misdiagnosed as soft tissue injuries, it is critical to be able to diagnose and treat these lesions early. Imaging plays an important role with plain films and advanced imaging. Surgical treatments can range from curettage with grafting to amputation for more aggressive lesions.
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Affiliation(s)
- Eric W Temple
- The Iowa Clinic, 5950 University Avenue West, Des Moines, IA 50266, USA; Unitypoint Health - Iowa Methodist Medical Center, 1415 Woodland Avenue, Des Moines, IA 50309, USA.
| | - Ryan D Prusa
- The Iowa Clinic, 5950 University Avenue West, Des Moines, IA 50266, USA; Unitypoint Health - Iowa Methodist Medical Center, 1415 Woodland Avenue, Des Moines, IA 50309, USA
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Efficacy of Lesion Specific Portals in Endoscopic Treatment of Calcaneal Bone Cyst: A Case Report and Literature Review. ACTA ACUST UNITED AC 2021; 57:medicina57020111. [PMID: 33530595 PMCID: PMC7911473 DOI: 10.3390/medicina57020111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/23/2021] [Accepted: 01/24/2021] [Indexed: 11/17/2022]
Abstract
Background: Calcaneal bone cysts rarely occur and most of them are known to be benign. Among them, simple bone cysts (SBCs) third most commonly occur in the calcaneus and of the many surgical treatment options, endoscopic curettage is recently gaining popularity among surgeons due to its advantages of minimal invasiveness and optimal visualization. As for portal placement for endoscopy, two lateral portals are considered a standard technique, but no rationale has been established for SBCs with abnormal geometry. This case report suggests an SBC with secondary aneurysmal change located outside the Ward’s triangle, as well as an appropriate endoscopic approach. Case Presentation: An 18-year-old male high school student presented with a main complaint of pain at the hind foot level for the past one year, without significant improvement from conservative treatment. An endoscopic curettage through the lesion specific two posterior portals and bone graft using allogeneic cancellous bone were performed. SBC with a secondary aneurysmal bone cyst was diagnosed on pathology. At a one-year follow-up, the patient was painless and had returned to his regular activities. Physical and radiographic examinations revealed that the lesion was completely healed without any evidence of recurrence. Conclusion: For calcaneal bone cysts located at the posterior aspect of the calcaneus, eccentrically medial and abnormally long anterior-posteriorly, we suggest an endoscopic procedure using lesion specific portals such as two posterior portals.
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Potocnik P, Hochreiter B, Harrasser N, Meester J, Toepfer ADA. [Differential diagnosis of heel pain]. DER ORTHOPADE 2019; 48:261-280. [PMID: 30747270 DOI: 10.1007/s00132-019-03690-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
"Heel pain" describes a very common reason for foot orthopedic consultation and the further differential diagnostic investigation is crucial for the choice of correct treatment. In the treatment of frequent underlying diseases, such as plantar fasciitis or insertional tendinopathy of the Achilles tendon, a variety of modern strategies are available. Rarer diseases, such as tumors or nerve entrapment syndromes must be delineated and correctly classified. This article provides the current state of the diagnostics and treatment of the most common entities of heel pathologies.
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Affiliation(s)
- Primoz Potocnik
- Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparats, Sektion Fuß- und Sprunggelenkchirurgie, Kantonspital St. Gallen, Rorschacher Str. 95, 9007, St. Gallen, Schweiz
| | - Bettina Hochreiter
- Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparats, Sektion Fuß- und Sprunggelenkchirurgie, Kantonspital St. Gallen, Rorschacher Str. 95, 9007, St. Gallen, Schweiz
| | - Norbert Harrasser
- Zentrum für Fuß- und Sprunggelenkchirurgie, Schön Klinik München Harlaching, Harlachinger Str. 51, 81547, München, Deutschland
| | - Jan Meester
- Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparats, Sektion Fuß- und Sprunggelenkchirurgie, Kantonspital St. Gallen, Rorschacher Str. 95, 9007, St. Gallen, Schweiz
| | - An Dre As Toepfer
- Klinik für Orthopädische Chirurgie und Traumatologie des Bewegungsapparats, Sektion Fuß- und Sprunggelenkchirurgie, Kantonspital St. Gallen, Rorschacher Str. 95, 9007, St. Gallen, Schweiz.
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Toepfer A, Harrasser N, Recker M, Lenze U, Pohlig F, Gerdesmeyer L, von Eisenhart-Rothe R. Distribution patterns of foot and ankle tumors: a university tumor institute experience. BMC Cancer 2018; 18:735. [PMID: 30001718 PMCID: PMC6043962 DOI: 10.1186/s12885-018-4648-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 06/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Bone and soft tissue masses of the foot and ankle are not particularly rare but true neoplasia has to be strictly differentiated from pseudotumorous lesions. Diagnosis is often delayed as diagnostic errors are more common than in other regions. Awareness for this localization of musculoskeletal tumors is not very high and neoplasia is often not considered. The purpose of this study is to provide detailed information on the incidence and distribution patterns of foot and ankle tumors of a university tumor institute and propose a simple definition to facilitate comparison of future investigations. METHODS As part of a retrospective, single-centre study, the data of patients that were treated for foot and ankle tumors between June 1997 and December 2015 in a musculoskeletal tumor centre were analyzed regarding epidemiologic information, entity and localization. Included were all cases with a true tumor of the foot and ankle. Exclusion criteria were incomplete information on the patient or entity (e.g. histopathological diagnosis) and all pseudotumoral lesions. RESULTS Out of 7487 musculoskeletal tumors, 413 cases (5,52%) of tumors of the foot and ankle in 409 patients were included (215 male and 198 female patients). The average age of the affected patients was 36 ± 18y (min.3y, max.92y). Two hundred sixty-six tumors involved the bone (64%), among them 231 (87%) benign and 35 (13%) malignant. There were 147 soft tissue tumors (36%), 104 (71%) were benign, 43 (29%) malignant. The most common benign osseous tumor lesions included simple bone cysts, enchondroma and osteochondroma. By far the most common malignant bone tumor was chondrosarcoma. Common benign soft tissue tumors included pigmented villo-nodular synovitis, superifcial fibromatosis and schwannoma whereas the most common malignant members were synovial sarcoma and myxofibrosarcoma. Regarding anatomical localization, the hindfoot was affected most often. CONCLUSIONS Knowledge of incidence and distribution patterns of foot and ankle tumors will help to correctly assess unclear masses and initiate the right steps in further diagnostics and treatment. Unawareness can lead to delayed diagnosis and inadequate treatment with serious consequences for the affected patient.
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Affiliation(s)
- Andreas Toepfer
- Klinik für Orthopädie und Sportorthopädie Klinikum rechts der Isar der Technischen, Universität München, Ismaningerstr.22, 81675, München, Germany. .,Wilhelm Sander-Therapieeinheit für Knochen- und Weichteilsarkome am Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Germany. .,Kantonspital St. Gallen, Klinik für Orthopädische Chirurgie und Traumatologie, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland.
| | - Norbert Harrasser
- Klinik für Orthopädie und Sportorthopädie Klinikum rechts der Isar der Technischen, Universität München, Ismaningerstr.22, 81675, München, Germany.,Wilhelm Sander-Therapieeinheit für Knochen- und Weichteilsarkome am Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Germany
| | - Maximiliane Recker
- Klinik für Orthopädie und Sportorthopädie Klinikum rechts der Isar der Technischen, Universität München, Ismaningerstr.22, 81675, München, Germany
| | - Ulrich Lenze
- Klinik für Orthopädie und Sportorthopädie Klinikum rechts der Isar der Technischen, Universität München, Ismaningerstr.22, 81675, München, Germany.,Wilhelm Sander-Therapieeinheit für Knochen- und Weichteilsarkome am Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Germany
| | - Florian Pohlig
- Klinik für Orthopädie und Sportorthopädie Klinikum rechts der Isar der Technischen, Universität München, Ismaningerstr.22, 81675, München, Germany.,Wilhelm Sander-Therapieeinheit für Knochen- und Weichteilsarkome am Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Germany
| | - Ludger Gerdesmeyer
- Universitätsklinikum Schleswig Holstein, Campus Kiel, Sektion für Onkologische und Rheumatologische Orthopädie in der Klinik für Unfallchirurgie, Arnold Heller Strasse, D-24105, Kiel, Germany
| | - Rüdiger von Eisenhart-Rothe
- Klinik für Orthopädie und Sportorthopädie Klinikum rechts der Isar der Technischen, Universität München, Ismaningerstr.22, 81675, München, Germany.,Wilhelm Sander-Therapieeinheit für Knochen- und Weichteilsarkome am Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Germany
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Toepfer A. Ossoskopie gutartiger osteolytischer Läsionen des Kalkaneus. ARTHROSKOPIE 2018. [DOI: 10.1007/s00142-017-0172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yan L, Zong J, Chu J, Wang W, Li M, Wang X, Song M, Wang S. Primary tumours of the calcaneus. Oncol Lett 2018; 15:8901-8914. [PMID: 29928329 PMCID: PMC6004727 DOI: 10.3892/ol.2018.8487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 03/02/2018] [Indexed: 12/14/2022] Open
Abstract
The calcaneus is a rare location for the occurrence and development of primary tumour types. Clinicians are unfamiliar with calcaneal tumour types, which may result in a delay in diagnosis or a missed diagnosis, resulting in unnecessary morbidity and amputation. Heel pain and localized swelling of the ankle are the most common symptoms. X-ray is the first choice for a tentative diagnosis of a calcaneal tumour. The final diagnosis depends on a histological examination. The treatment of calcaneal tumour types varies depending on the Enneking system. The majority of patients with benign tumours heal, except for a few with a palindromia. For malignant tumours, the prognosis is comparatively poor, resulting in disability and a high rate of metastasis. This review describes the spectrum of calcaneal tumour types and specifically illustrates the epidemiology, symptomatology, imagology, histopathology and treatment options that may facilitate diagnosis and improve prognosis.
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Affiliation(s)
- Litao Yan
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Junwei Zong
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Jin Chu
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Wendong Wang
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Mingshu Li
- Department of Ophthalmology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Xianfeng Wang
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
| | - Mingzhi Song
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
- Department of Orthopaedics, The Third Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116200, P.R. China
| | - Shouyu Wang
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P.R. China
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Rosario MS, Yamamoto N, Hayashi K, Takeuchi A, Kimura H, Miwa S, Higuchi T, Inatani H, Abe K, Taniguchi Y, Aiba H, Tsuchiya H. An unusual case of proximal humeral simple bone cyst in an adult from secondary cystic change. World J Surg Oncol 2017; 15:102. [PMID: 28506249 PMCID: PMC5433014 DOI: 10.1186/s12957-017-1166-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 04/23/2017] [Indexed: 01/30/2023] Open
Abstract
Background Simple bone cysts (SBC) have been documented to occur in adults with closed physeal plates, most commonly affecting the calcaneus in this patient subset. Although most authors theorize an association to trauma, etiology of simple bone cysts remains an enigma up to now. Case presentation A 26-year-old kickboxing coach sought consult for a painful right shoulder which on radiographs and magnetic resonance (MR) imaging showed a proximal humeral lesion with signs of ossification. The patient was lost to follow-up but again sought consult after 3 years for the recurring complaint. On repeat radiographs, computed tomography (CT) scan, and MR images, tumor enlargement with cystic findings typical of simple bone cyst were documented. Diagnostic aspiration of the lesion was firstly done, revealing straw-colored fluid. The patient then underwent intralesional curettage with alpha-tricalcium phosphate cement reconstruction of the lytic defect. No perioperative complications were incurred, and on latest follow-up at 3 years postoperatively, Musculoskeletal Tumor Society (MSTS) and visual analog scale (VAS) pain scores were 30/30 and 0/10, respectively. Conclusions The authors believe their report provides support to a possible association to trauma of simple bone cysts occurring in the adult population with closed physes and suggest this subset of patients may require a different treatment approach from that for juvenile simple bone cysts.
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Affiliation(s)
- Mamer S Rosario
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan.,Department of Orthopaedics, East Avenue Medical Center, East Avenue, Diliman, 1101, Quezon City, Metro Manila, Philippines
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan.
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Akihiko Takeuchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Takashi Higuchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hiroyuki Inatani
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Kensaku Abe
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Yuta Taniguchi
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hisaki Aiba
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Ishikawa, Japan
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Toepfer A. [Foot and ankle tumors: a closure look at indistinct masses of the foot and ankle]. MMW Fortschr Med 2016; 158:67-70. [PMID: 27966125 DOI: 10.1007/s15006-016-9107-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Andreas Toepfer
- Zentrum für Fuß und Sprunggelenkchirurgie, Schön Klinik München Harlaching, FIFA Medical Centre, Harlachinger Straße 51, D-81547, München, Deutschland.
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Lui TH. Endoscopically and Fluoroscopically Assisted Curettage and Bone Grafting of the Navicular Bone Cyst. Arthrosc Tech 2016; 5:e1221-e1227. [PMID: 28149717 PMCID: PMC5263100 DOI: 10.1016/j.eats.2016.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/20/2016] [Indexed: 02/03/2023] Open
Abstract
Simple bone cyst is a common tumorlike lesion of the bone and can involve the bones of the foot. It is usually asymptomatic but can also present with pain or pathologic fracture. The purpose of this technical note is to describe the uni-osseous portal approach of endoscopic curettage and bone grafting of simple bone cyst of the navicular bone. The single-portal approach reduces the risk of iatrogenic fracture of the navicular bone. This is indicated for painful bone cyst of the navicular bone resistant to conservative treatment. It is contraindicated in multiple septated cysts, the presence of pathologic fracture, or the presence of aggressive cystic lesions.
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Affiliation(s)
- Tun Hing Lui
- Address correspondence to Tun Hing Lui, M.B.B.S.(HK), F.R.C.S.(Edin), F.H.K.A.M., F.H.K.C.O.S., Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong SAR, China.Department of Orthopaedics and TraumatologyNorth District Hospital9 Po Kin RoadSheung Shui, NTHong Kong SARChina
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