Background: Eosinophilic fasciitis is a rare sclerosing syndrome with a poorly understood etiology. Objective: We report a case of eosinophilic fasciitis in a 40-year-old man undergoing treatment with natalizumab for multiple sclerosis. Natalizumab is a selective adhesion molecule inhibitor that prevents interaction of leukocytes with endothelial cells. Peripheral blood eosinophilia has been described under treatment with natalizumab, but we herein report the first case to our knowledge of eosinophilic fasciitis as a possible complication of this medication.Contexte: La fasciite à éosinophiles est un syndrome sclérosant rare, dont les causes sont mal connues. Objectif: Sera exposé ici un cas de fasciite à éosinophiles chez un homme de 40 ans, traité par le natalizumab, pour la sclérose en plaques. Le natalizumab est un inhibiteur sélectif des molécules d'adhésion, qui empêche les interactions entre les leucocytes et les cellules endothéliales. Il a déjà été fait mention d'éosinophilie sanguine périphérique en cours de traitement par le natalizumab, mais ¡I s'agit, à notre connaissance, du premier exposé de cas de fasciite à éosinophiles, décrit comme une complication possible de l'utilisation de ce médicament.
Inflammatory myofibroblastic tumor (IMT) of the nose and paranasal sinuses is a rare entity that exhibits a diverse histologic pattern that can mimic malignant tumors clinically and radiologically. We present a case of IMT in an 88-year-old man who presented with an aggressive tumor-like lesion in the nose and paranasal sinuses that had a malignant appearance on radiology. We discuss this tumor's clinicoradiologic resemblance to a malignancy, and we review the treatment options following careful histologic and immunohistochemical analysis.
Chordomas are rare primary, locally invasive tumour of the bone which derived from notochordal remnants. Currently, the mainstay of treatment of chordomas is surgical resection. Despite the clear advantages of adequate surgical margin, the locally advanced nature of chordomas makes wide resection of the tumour difficult as they are often in close proximity with the surrounding vital organs. The published literatures of sacral chordomas mainly focus on the approach of surgery, reconstruction post-resection, long-term survival and reports on successful surgical resection. We report a case which highlights the pitfall in the surgical management of a sacral chordoma. Our patient developed delayed bowel perforation which may be associated with the sacrum osteotomy.
Keywords: chordoma; sacrum; surgery; pitfall; outcome.
Introduction: Critical size defect (CSD) is defined as a defect that will not heal without intervention within the lifetime. The gold standard treatment for CSD is bone graft, although with some limitations. Substitute biomaterials were introduced to overcome the limitations. JectOS and MIIG® X3 are commercially available biomaterials in the market. Osteopaste is a local product produced by SIRIM. The objective of this study is to compare the radiological changes between Osteopaste, JectOS and MIIG® X3 in CSD in rabbit tibia bone. Methods: New Zealand White rabbits were divided into four groups: control group (Sham operation, n=3); Osteopaste treatment (n=12); JectOS treatment (n=12) and MIIG® X3 treatment (n=12). CSD was created at the right proximal tibia bone of the rabbits in each of the groups and the defects were filled with the biomaterial as assigned. Four animals from each group were sacrificed at 6 weeks, 12 weeks and 24 weeks respectively. The bones were harvested and x-ray imaging performed using SkyScan 1176 at 90kV, 281µA, resolution 4000x2672 with Aluminium 1.0mm. Results: The radiographic density at the CSD area was more prominent in the JectOS group throughout the 24 weeks. Meanwhile, in the MIIG® X3, full resorption occurred at 24 weeks. The Osteopaste group exhibited radiographic density in between that of JectOS and MIIG® X3. Conclusions: Different types of biomaterial exhibit different radiological changes over the period of bone healing.
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