Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of epidermoid carcinoma of the femur that arose in an area affected with chronic osteomyelitis for over 40 years is reported. The incidence of this rare complication has been estimated at 0.23% to 1.6% of all cases of chronic osteomyelitis. Although cases of sarcoma, adenosarcoma, plasmocytoma, and malignant fibrous histiocytoma have been reported, epidermoid carcinoma is the most common cancer type. This tumor develops after 20 to 40 years of chronic infection with a discharging fistula. Epithelialization of the fistulous tract has been demonstrated. The cancer arises in the metaplastic epithelium and can secondarily spread to the bone. Despite the low grade of malignancy of many of these epidermoid carcinomas, pulmonary metastases are not rare. Amputation meeting criteria for oncologic surgery is the only means of ensuring a good prognosis.
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PMID:Epidermoid carcinoma complicating chronic osteomyelitis of the femur. 906 14

Although no specific radiographic appearance has emerged to date for the epithelioid subtype of hemangioma, these lesions most typically exhibit well-defined osteolysis. Other relatively common features include surrounding sclerosis, cortical expansion and cortical destruction. We present a case of epithelioid hemangioma of the spine with an unusual radiological appearance which to our knowledge has not previously been reported: diffuse sclerosis of the involved vertebral body. The diffuse sclerosis seen in this case resembles the osteosclerotic process seen not only in benign entities such as subacute and chronic osteomyelitis, but also in malignant lesions such as osteoblastic metastatic disease and lymphoma.
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PMID:Epithelioid hemangioma of bone. 1139 98

Lesions that involve the cortex of the tibia are fairly common in radiology practice. However, the number of diseases that involve the tibial cortex is great, and it can be difficult to arrive at a limited differential diagnosis from radiographic findings. Categorization of lesions of the tibia into those that cause cortical destruction and those that cause cortical proliferation can help narrow the broad differential diagnosis. Lesions that cause cortical destruction include nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, aneurysmal bone cyst, giant cell tumor, eosinophilic granuloma, Ewing sarcoma, neurofibromatosis, adamantinoma, osteoblastoma, chondromyxoid fibroma, hemangioendothelioma, renal cell metastatic disease, hemangioma, and hemangiopericytoma. Lesions that cause cortical proliferation include osteochondroma, stress fracture, osteoid osteoma, periosteal osteogenic sarcoma, diaphyseal dysplasia, venous stasis, cellulitis, chronic osteomyelitis, osteopathia striatum, and melorheostosis. Conventional radiography along with clinical and pathologic data can aid in diagnosis of the wide variety of disease processes that involve the tibial cortex.
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PMID:Cortical lesions of the tibia: characteristic appearances at conventional radiography. 1253 51

Fine-needle biopsy (FNB) has been reported as a rapid, minimally invasive technique for the diagnosis of metastatic melanoma. The diagnostic accuracy of FNB was assessed in a consecutive series of 2,204 FNBs of clinically suspicious lesions from patients with previous primary melanomas treated at the Sydney Melanoma Unit, Sydney, Australia, between January 1992 and December 2002. The sensitivity and specificity of FNB were 96.3% and 98.9%, respectively. There were 5 false-positive cases (0.6%), which were verified as metastatic adenocarcinoma (3 cases) or reactive processes (organizing hematoma and chronic osteomyelitis, 1 each). False-negative diagnoses (6.7% of cases) were associated with a variety of clinicopathologic factors, including difficult-to-access anatomic sites (eg, high axilla or deep inguinal), small lesions, and lesional characteristics such asfibrosis, necrosis, or cystic change. FNB is a highly accurate, rapid, and cost-effective procedure for the diagnosis of metastatic melanoma and should be considered as the initial diagnostic procedure of choice in patients with melanoma with clinically suspected metastases.
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PMID:Diagnosis of metastatic melanoma by fine-needle biopsy: analysis of 2,204 cases. 1727 48

Verrucous carcinoma is an uncommon complication of chronic osteomyelitis. The incidence of fistular carcinomas is reported to be between 0.21% and 3.36%. We present a case of verrucous carcinoma of the tibia arising after 58 years of chronic osteomyelitis. The primary presenting symptoms were acute pain, foul-smelling pus discharge and increasing lesion size. We used modern diagnostic investigations (biopsy, computed tomography, angiography, immunoscintigraphy, magnetic resonance tomography) to visualize the extent of the malignant lesion. No metastases were detected. Knee exarticulation was successful in treating the tumor and chronic infection in this case.
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PMID:Verrucous carcinoma of the tibia arising after chronic osteomyelitis: a case report. 1926 15

Primary bone lymphoma is an uncommon tumour accounting for approximately 4-5% of extra nodal lymphoma and less than 1% of all Non-Hodgkin's lymphoma. The radiographic appearance of primary bone lymphoma is variable. As lesions frequently resemble other disease processes namely chronic osteomyelitis and metastases, further imaging evaluation and histopathological examination allow early identification for appropriate treatment. The authors present a case of anaplastic large cell lymphoma of bone presenting with multifocal osseus involvement.
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PMID:Primary bone lymphoma: report of a case with multifocal skeletal involvement. 2161

Marjolin's ulcer is an aggressive cutaneous malignancy common in previously traumatized or chronically inflamed skin. It has high regional metastasis and fatality rates. Our patient presented with subcutaneous nodules and ulcerations on the right limb. He had a history of osteomyelitis of the fifth toe. Histopathological examination of the nodule and ulceration demonstrated squamous cell carcinoma. The nodules and ulcerations were in-transit metastases of Marjolin's ulcer. Here, we present a case of squamous cell carcinoma arising at a site of a chronic osteomyelitis with resultant in-transit metastases.
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PMID:Marjolin's Ulcer Presenting with In-Transit Metastases: A Case Report and Literature Review. 2627 63

Chronic nonbacterial osteomyelitis is a rare entity of unknown etiology and most likely an autoinflammatory disease. A 45-year-old man complained of a growing painful mass of the right chest wall. FDG PET/CT demonstrated a large destructive rib lesion with intense uptake and extensive FDG avid lymphadenopathy, which mimicked a malignant or metastatic disease. Both CT guided core-needle and excisional biopsies showed reactive/regenerative/granulomatous changes coupled with focal neutrophils and marrow atrophy, consistent with chronic osteomyelitis. Stains and cultures of surgical and wound specimens and multiple blood cultures were all negative for any kind of microorganism.
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PMID:Chronic Nonbacterial Osteomyelitis With FDG Avid Rib Destruction and Extensive Lymphadenopathy. 2740 29

Marjolin's ulcer, a form of squamous cell carcinoma, is a rare complication of a chronic wound infection. To date, there have not been any detailed reports of lymphatic spread of Marjolin's ulcer from an extremity. This report describes a 44-year old male with a history of an open tibia fracture at age 15, who presented with chronic osteomyelitis, increasing bloody wound drainage, and an enlarging vascular exophytic masses in the region of drainage. Biopsy of the mass showed squamous cell carcinoma. Initial staging with computed tomography (CT) was negative for metastatic disease. Six months after undergoing a below-knee amputation (BKA), the patient developed an enlarged lymph node in the left inguinal area. His re-staging CT and biopsy of inguinal node confirmed the presence of metastatic squamous cell carcinoma. The patient was subsequently treated with inguinal node dissection and adjuvant radiation therapy. At 2.5 years follow-up, the patient remains disease-free. Our case illustrates the importance suspecting squamous cell carcinoma in patients with chronic infections and diligent follow up for patients with Marjolin's ulcers.
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PMID:Marjolin's Ulcer of the Tibia With Pelvic Lymph Node Metastasis. 2885 47


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