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A Rare Recurrent Chondromyxoid Fibroma of the Proximal Tibia in an Adolescent Female

September 10, 2020

Original Article | Volume 6 | Issue 3 | JBST September – December 2020 | Page 16-19 | Ashish Kumar Goyal, Abhishek Vaish, Raju Vaishya, Pankaj Baweja DOI: 10.13107/jbst.2020.v06i03.34 Author: Ashish Kumar Goyal[1], Abhishek Vaish[1], Raju Vaishya[1], Pankaj Baweja[2] [1]Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India. [2]Department […]

Role of Intraoperative Nerve Stimulator? In a Case of Ulnar Nerve Schwannoma. A Case Report with Four-Year Follow-up and Review of Literature

September 10, 2020

Original Article | Volume 6 | Issue 3 | JBST September – December 2020 | Page 13-15 | Kalaivanan Kanniyan, Ying Lee Lam, Ho Wai Yip Kenneth, Yau Raymond DOI: 10.13107/jbst.2020.v06i03.33 Author: Kalaivanan Kanniyan[1],[2], Ying Lee Lam[1], Ho Wai Yip Kenneth[1], Yau Raymond[1] [1]Department of Orthopaedic Oncology, Queen Mary Hospital, University of Hong Kong, Hong […]

A Rare Recurrent Chondromyxoid Fibroma of the Proximal Tibia in an Adolescent Female

September 10, 2020

Role of Intraoperative Nerve Stimulator? In a Case of Ulnar Nerve Schwannoma. A Case Report with Four-Year Follow-up and Review of Literature

September 10, 2020

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A Rare Recurrent Chondromyxoid Fibroma of the Proximal Tibia in an Adolescent Female

September 10, 2020

Author: Ashish Kumar Goyal[1], Abhishek Vaish[1], Raju Vaishya[1], Pankaj Baweja[2]

[1]Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India.
[2]Department of Pathology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi, India.

Address of Correspondence
Dr. Ashish Kumar Goyal, Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi – 110 076, India.
E-mail: drgoyal41@gmail.com

Introduction: Lytic lesions of the bone are often seen in children and young adults. These are usually benign but sometimes are locally aggressive bone tumors. Lesser known causes of lytic lesions are chondromyxoid fibroma (CMF) and its recurrence is very rare. The accepted treatment for CMF is surgical curettage with bone grafting and the review of the literature shows that recurrence rate is 3–22%.
Case Report: We present a rare case of an adolescent girl of 14 years who presented with a recurrent bone tumor of the proximal tibia, after 4 years of the primary curettage. It turned out to be a CMF. She presented with swelling over the right upper leg for the past month. It was gradual in onset, progressive, and non-radiating in nature. There was no history of trauma. She had had a similar complaint 4 years back in 2016, for which she was operated elsewhere, where curettage and synthetic bone substitutes were used for filling the bone cavity. She was taken up for surgery for extended curettage and bone cementing. The histopathological examination was suggestive of CMF. Subsequent follow-up, she reported complete resolution of symptoms with a pain-free range of knee movements and no radiological signs of recurrence.
Conclusion: The accepted treatment for CMF is surgical curettage with bone grafting, but the recurrence rate is 3–22%.
Keywords: Chondromyxoid fibroma, benign lesions, tibia, recurrence.

Reference:
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3. Vargas B. Orthopedic Surgery for Fibrous Dysplasia. Background, Pathophysiology, Etiology. New York: Medscape; 2019. Available from: https://www.emedicine.medscape.com/article/1255262-overview. [Last accessed on 2020 Aug 22].
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5. Bhamra JS, Al-Khateeb H, Dhinsa BS, Gikas PD, Tirabosco R, Pollock RC, et al. Chondromyxoid fibroma management: A single institution experience of 22 cases. World J Surg Oncol 2014;12:283.
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8. Rui J, Guan W, Gu Y, Lao J. Treatment and functional result of desmoplastic fibroma with repeated recurrences in the forearm: A case report. Oncol Lett 2015;11:1506-8.
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How to Cite this article: Goyal AK, Vaish A, Vaishya R, Baweja P| A Rare Recurrent Chondromyxoid Fibroma of the Proximal Tibia in an Adolescent Female | Journal of Bone and Soft Tissue Tumors | September-December 2020; 6(3): 16-19.

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Role of Intraoperative Nerve Stimulator? In a Case of Ulnar Nerve Schwannoma. A Case Report with Four-Year Follow-up and Review of Literature

September 10, 2020

Author: Kalaivanan Kanniyan[1],[2], Ying Lee Lam[1], Ho Wai Yip Kenneth[1], Yau Raymond[1]

[1]Department of Orthopaedic Oncology, Queen Mary Hospital, University of Hong Kong, Hong Kong,
[2]Department of Arthroplasty and Oncology, Asian Joint Reconstruction Institute – AJRI at SIMS Hospitals, Chennai, Tamil Nadu, India.

Address of Correspondence
Dr. Kalaivanan Kanniyan,
Division of General Orthopaedics and Oncology, Queen Mary Hospital, University of Hong Kong, Hong Kong.
E-mail: drkkbriyan@gmail.com

Introduction: Schwannoma (neurolimmea) is an uncommon benign nerve sheath tumor arising from the peripheral nerve system with an incidence of 5%. They are slow growing tumors affecting all age group and occur in isolation. They are common in upper extremity followed by the lower extremity.
Case report: She presented with complaint of pain and swelling over her right wrist disturbing her daily activities such as eating and holding her walker. The swelling was sudden on onset slowly progressive in nature over many years. She was on treatment for diabetes mellitus, hypertension, and Parkinson. She had left leg weakness due to polio and hence walker bound. She underwent occipitocervical fusion for cervical vertebrae C1 and C2 subluxation and cervical myelopathy. The swelling was 2.5 cm × 2.5 cm, soft-tissue mass over the volar aspect of right wrist mobile only in the longitudinal direction. Hand grip was fair with sensory loss along the ulnar nerve distribution. There was no hypothenar muscle wasting. Magnetic resonance imaging suggested of neurogenic tumor of ulnar nerve origin. Patient was planned for enucleation (excision biopsy). The anesthesia nerve block device was used as nerve stimulator to identify the motor nerve and preserved it. Enucleation was not possible and hence the tumor was removed with a segment of sensory fibers. Histology finding was consistent with schwannoma. Postoperatively, the patient was pain free and able to hold the walker and carry on her daily activities. At 4 year follow-up the patient had no recurrence of such tumor or any other complication in the operated side.
Conclusion: Enucleation is the treatment of choice. Patient age, complaints, comorbidities, functional demand, tumor location, and intraoperative findings with nerve stimulator help in deciding the choice of nerve grafting along with enucleation.
Keywords: Schwannoma, ulnar nerve, enucleation, sural nerve graft, intraoperative nerve stimulator.

Reference:
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2. Trãistaru R, Enãchescu V, Manu CD, Gruia C, Ghiluşi M. Multiple right schwannoma. Rom J Morphol Embryol 2008;49:235-9.
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4. Chris YK, Fung B, Fok M, Zhu J. Schwannoma in the upper limbs. BioMed Res Int 2013;2013:167196.
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8. Hems TE, Burge PD, Wilson DJ. Role of magnetic resonance imaging in the management of peripheral nerve tumours. J Hand Surg 1997;22:57-60.
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10. Van Herendael B, Heyman S, Schepper A, Gielen J, Parizel PM. Schwannoma of left ulnar nerve. JBR BTR 2006;89:156-7.

How to Cite this article: Kanniyan K, Lam YL, Kenneth HWY, Raymond Y | Role of Intraoperative Nerve Stimulator? In a Case of Ulnar Nerve Schwannoma. A Case Report with Four-Year Follow-up and Review of Literature | Journal of Bone and Soft Tissue Tumors | Sep-Dec 2020; 6(3): 13-15.

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A Rare Recurrent Chondromyxoid Fibroma of the Proximal Tibia in an Adolescent Female

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Role of Intraoperative Nerve Stimulator? In a Case of Ulnar Nerve Schwannoma. A Case Report with Four-Year Follow-up and Review of Literature

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A Rare Recurrent Chondromyxoid Fibroma of the Proximal Tibia in an Adolescent Female

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Role of Intraoperative Nerve Stimulator? In a Case of Ulnar Nerve Schwannoma. A Case Report with Four-Year Follow-up and Review of Literature

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A Rare Recurrent Chondromyxoid Fibroma of the Proximal Tibia in an Adolescent Female

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Role of Intraoperative Nerve Stimulator? In a Case of Ulnar Nerve Schwannoma. A Case Report with Four-Year Follow-up and Review of Literature

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