Skeletal radiology
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Case Reports
Case report 714. Postirradiation osteosarcoma after radiation of metastatic skeletal lesion.
Two cases of postirradiation osteosarcoma are presented--one in a 76-year-old woman with breast carcinoma and subsequent osteosarcoma after radiation therapy for a metastatic lesion in the right tibia, and the other in a 16-year-old girl with hepatocellular carcinoma metastatic to the left tibia and osteosarcoma after radiation therapy to that bone. Microscopically, both cases were high-grade spindle cell lesions with osteoid production. Both patients fared poorly. This is a rare complication of radiation therapy.
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We present a patient with parosteal osteosarcoma. The lesion arose at the surface of the femur without involvement of the marrow cavity. Some 24 months following resection of the involved bone, she developed distant metastases with no evidence of local recurrence. Neither the primary nor the metastatic lesions showed high-grade malignancy.
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Case Reports
Case report 752: Normal variant of the acromion simulating grade I acromioclavicular separation.
This case illustrates a developmental variant of the acromion resulting in apparent widening of the acromioclavicular joint space rather than discontinuity of the inferior cortices of the acromioclavicular joint. Had an axillary view not been obtained, an erroneous radiographic diagnosis of grade I acromioclavicular separation might have been suggested.
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A 50-year-old woman with juvenile rheumatoid arthritis presented with painful swelling of the right calf. Roentgenograms, sonograms, magnetic resonance images, and arthrograms were obtained. A diagnosis of hemorrhagic Baker's cyst was made, and surgical excision was performed. The etiology, clinical features, and radiological evaluation of simple and complicated Baker's cysts are discussed and the differential diagnosis considered.
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Fibrolipomatous hamartoma of a nerve represents an uncommon soft-tissue tumor which typically involves the median nerve distribution near the wrist. Macrodactyly may or may not be present. ⋯ These structures probably represent the neural elements and associated perineural fibrosis. Further experience may allow for an accurate preoperative diagnosis of this tumor.