HighlightsLymph node metastasis of osteosarcoma, which is a rare entity.Metastatic patterns could not be clearly explained.The effects of lymph node metastasis on prognosis are also not clearly defined and further studies are needed.
INTRODUCTIONThe fibular nerve is the most frequent site of neural entrapment in the lower extremity and the third most common site in the body, following the median and ulnar nerves. The peroneal nerve is commonly injured upon trauma. Additionally, a dropped foot might be a symptom related to the central nervous system or spinal pathologies in pediatric patients. Entrapment of the peripheral nerve as an etiologic cause should be kept in mind and further analyzed in orthopedic surgery clinics.PRESENTATION OF CASEIn this study, the evaluation and treatment results of five patients with no history of trauma, who underwent diagnostic procedures and treatment in various clinics (physical therapy and rehabilitation and neurosurgery), are reported. The patients underwent several treatments without diagnosis of the primary etiology. Upon initial consultation at our department, osteochondroma at the proximal fibula was detected after physical examination and radiologic assessment. During surgery, the peroneal nerve was dissected, starting from a level above the knee joint. Following nerve release, the osteochondroma was removed, including its cartilage cap. Consequently, recovery was observed in all five cases after surgery.DISCUSSIONMany factors may cause non-traumatic neuropathies. However, due to their rare occurrence, lesions such as osteochondromas may be overlooked at non-orthopedic clinics. Nerve entrapment due to proximal fibular osteochondroma is rare. Surgical treatment planning plays a critical role in nerve entrapment cases.CONCLUSIONDespite its frequent occurrence, a drop foot associated with peroneal nerve entrapment by an osteochondroma is not easily remembered and diagnosed. Especially in pediatric cases, inadequate clinical consultation and a lack of appropriate radiologic studies may result in a delay in diagnosing peroneal nerve lesions.
The management of atrophic type humeral nonunions is difficult. The method that we practice in such patients is a reliable treatment option with its stabile fixation and high union rates.
We present a 46-year-old female patient who is diagnosed with synchronous postirradiation sarcoma, cutaneous relapse of a previous soft tissue sarcoma, and lung adenocarcinoma. More than one malignant tumor at the same time with an accompanying relapse of a previous malignant tumor is a rare entity. A relatively young patient diagnosed with adenocarcinoma of the urethra before age 40, which is an unusual tumor for that age, later three more different malignant tumors being diagnosed, two of which are synchronous, causes the suspicion of Li-Fraumeni syndrome.
Objective: Compression of nerves by benign bone and soft tissue tumors comprise an uncommon cause of peripheral neuropathies. We aim to present cases of peripheral nerve compression due to benign bone and soft tissue tumors treated in our clinic. Methods: We report a case series with a total of 16 patients who were treated in our clinic between 2010 and 2015. Mean age of the patients was 28 (2,5-55). Six of the patients had osteochondroma of the fibular head. The remaining 10 patients had various soft tissue tumors localized at different locations. Patients presented with pure sensory, pure motor, or mixed sensory and motor deficits. Mean duration of follow-up was 38 (11-120) months. Results: All patients underwent surgical excision and were treated additionally with vitamin supplements. All patients regained function within 1 month post-operatively. There was no recurrence at the end of the follow-up. Conclusions: Compression by tumors should be included in the differential diagnosis and work-up of peripheral neuropathies. Results are excellent with prompt diagnosis and surgical intervention.
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