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Radiographic Findings Of Intra-Osse-Ous Neurofibroma Of Calcaneus

Mahidol University Annual Research Abstracts           128 Faculty of Medicine Siriraj Hospital   cal studies, the areas of conventional chordoma were marked with epithelia makers (cytokeratin, epithelia membrane antigen) and S-100 protein.

The dedifferentiated component exhibited features of fibrosarcoma and osteosarcoma. (From Proceedings of the Twelfth National Congress of Pathology, Chonburi, Thailand, 2000, P. 54)     RADIOGRAPHIC FINDINGS OF INTRA-OSSE-OUS NEUROFIBROMA OF   CALCANEUS WITH NO NEUROFIBROMATOSIS MANIFESTATION (NO. 339)   Saowapak Subchareon1, Pipat Chiewvit1, Suchart Benjaras-sameeroj2, Apichat Assavmongkolkul3 1Department of Radiology, 2Department of Pathology, 3Department of Orthopedics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 Key words: Neurofibroma, bone, calcaneus                     Neurofibroma is neurogenic tumor which presence of peripheral nerve and connective tissue.

This tumor rarely occurred in bone. Incidence is less than 0.2% of pathological-analysis of primary bone tumor. Patients between 20-40 years are usually affected.

Majority of neurofibroma are associated with neurofibromatosis then the incidence of solitary intra-osseous neurofibroma is extremely rare. Most common site of solitary intra-osseous neurofibroma is mandible. Only one report found neurofibroma at iliac crest.                     We will present case of 72-year-old female who had no family history or clinical evidence of neurofibromatosis presenting at Siriraj Hospital with painless mass at posterior aspect of right foot for 2 years.

Plain radiograph and magnetic resonance imaging of right ankle were performed and followed by intralesional curettage with allograft. Pathological report is intra-osseous neurofibroma. This is the one of 115 benign bone tumor cases at orthopedics Department, Siriraj Hospital between Jan 1994 to Jan 2000. (From Proceedings of the Tenth Congress of Asean Association of Radiology and Thirty-seventh Annual Scientific Meeting of Royal College of Radiologists, Bangkok, Thailand, 2000, P.

8)     BONE SURFACE LESIONS IN ORTHOPAEDIC TUMOR CLINIC; 5 YEARS   RECORD (NO. 340)   Teerachai Leelametakul, Pipat Chiewvit, Apichat Asavamong-kolkul, Kullatorn Tepmongkol Key words : Bone surface lesions, imaging                     Purpose : For evaluation of the incidences of various bone surface tumor and tumor-like lesions additional with assessment of the definite characteristics and complications in some of the disease entities in 46 patients registered in orthopedic tumor clinic, Siriraj Hospital.                     Materials and methods : Conventional radiographs, computed tomographic scans, magnetic resonance imagings including with pertinent clinical informations and pathologic diagnoses of 46 patients between Jan 1995 and Dec 1999 were reviewed by musculoskeletal radiologists and oncologic orthopedic surgeon. In addition, these available images and data were evaluated the radiologic characteristics, clinical correlations and statistical records.

                    Results: 46 patients were included in the study. The disease entities comprised of 7 benign and 3 malignant lesions. Benign lesion were composed of 21 osteochondromas, 12 multiple exostoses, 5 osteoid osteomas, 1 osteofibrous dysplasia, 1 periosteal hemangioma and 1 myositis ossificans. Malignancies were 2 parosteal OGS, 1 periosteal OGS and 1 periosteal Ewing sarcoma.

The most causative presenting symptom was palpable mass (85%). In the more sufficient data for statistical analysis of osteochondromas, we found some results had not corresponded theoretically with existing knowledges. Good clinical outcomes were achieved from surgical treatment in benign lesions. Whereas in the rather limited malignant series, the one of periosteal OGS was expired in 3 years after treatment but possibly due to the coincidental carcinoma of breast.

However, 2 parosteal OGS still live in disease free after 5 years and 6 months follow up.                     Conclusion: Osteochondroma is the most frequent bone surface lesion. Multiple exotoses is the second most common. Bone surface malignancies have limited data; nonetheless, they show rather fair treatment outcome like conventional studies.

(From Proceedings of the Tenth Congress of Asean Association of Radiology and Thirty-seventh Annual Scientific Meeting of Royal College of Radiologists, Bangkok, Thailand, 2000, P. 9)     IMAGING OF EXTRASPINAL TUBERCULOUS OSTEOMYELITIS (NO. 341)   Thirasak J1, Churojana A1, Benajarassamerote S2,and Asava-mongkolkul A3 1Department of Radiology, 2Department of Pathology, 3Department of Orthopaedic Surgery, Faculty of Medicine Sirriaj Hospital Mahidol University, Bangkok 10700. Key words: Extraspinal tuberculosis, imaging                     Purpose: To describe the radiographic patterns of tuberculous osteomyelitis whereas extraspinal location were uncommon.

                    Materials and methods: Five of twenty-two patients with pathological diagnosis of skeletal tuberculosis who had extraspinal lesions were retrospectively reviewed. All imaging techniques including routine plain radiographs, CT scan or MR imaging were evaluated.                     Results: Four patients had solitary lesion with different sites in phalanx, metacarpal bone, capitulum and ileum respectively. The other one had two lesions in bony pelvis.

All had similar patterns of osteolysis with irregular borders and cortical violations. None had sclerosis or periosteal reaction. CT and MRI exhibited one sequestrum and one abscess extension into soft tissue.                     Conclusion: On the basis of radiologic appearance, the extraspinal tuberculous osteomyelitis is difficult to differentiate from tumor and tumor-like conditions.

CT or MRI can provide more information of sequestrum and abscess that is helpful for diagnosis and evaluation of extent of lesion. (From Proceedings of the Tenth Congress of Asean Association of Radiology and Thirty-seventh Annual Scientific Meeting of Royal College of Radiologists, Bangkok, Thailand, 2000, P. 75)    
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