Background and Objectives: Tenosynovial giant cell tumors (TSGCTs) are benign soft tissue tumors that are divided into localized- and diffuse-type tumors, according to the World Health Organization classification of soft tissue tumours. The diffuse-type TSGCT sometimes behave aggressively and poses treatment challenges especially in patients with neurovascular involvement. Symptomatic patients who are not good candidates for surgery due to high morbidity risk may benefit from medical therapy. Objectives: Drugs that target programmed death ligand 1 (PD-L1) are among a new generation of medical therapy options, which, recently, have been explored and have displayed promising results in various cancer types; therefore, we aimed to investigate the PD-L1 status of TSGCTs as a possible therapeutic target. Materials and Methods: We assessed the PD-L1 status of 20 patients (15 men and 5 women, median age = 39 years) that had been diagnosed with TSGCTs in a single institution, between 2018 and 2020. The patients had localized- (n = 7) and diffuse-type (n = 13) TSGCTs. Formalin-fixed paraffin-embedded (FFPE) blocks were retrospectively retrieved from the pathology department. An immunohistochemical analysis was performed in sections of 3 micron thickness from these blocks. Results: Seventy-five percent of our patients with TSGCTs were immunopositive to PD-L1 staining. Conclusions: Taking into consideration the high positivity rate of PD-L1 staining in TSGCTs, PD-L1 blockage may be used as a valuable medical treatment for TSGCTs; however, further studies are needed.
Introduction/Objectives. Bone and soft tissue infections might mimic bone and soft tissue tumors. Therefore, differential diagnosis is important to prevent errors in treatment. This report aims to present the data of patients with indistinct clinical and radiological findings mimicking benign and malignant bone and soft tissue tumors, which were later diagnosed as inflammatory infections. Methods. A retrospective chart review of the clinical, microbiological, radiologic, and pathologic findings of patients presented with a presumed diagnosis of a possible malignant lesion was performed. Results. The study included 21 patients with a median age (IQR) of 37 (1 month ? 72 years) years, and 13 (61%) patients were men. In total, 16 (76%) patients were admitted to the hospital with complaints of pain. The diagnoses were hydatid cyst, tuberculous osteomyelitis, cat-scratch disease, chronic osteomyelitis, subacute osteomyelitis, and soft tissue abscess. All patients were treated depending on the diagnosis of the lesion. Conclusion. There are chances of misdiagnosis due to shared common characteristics of tumoral and infectious lesions which might be mildly increased inflammatory markers with deeply seated non-mobile soft tissue masses and aggressive periosteal reactions and/or bone destruction patterns. So, each pseudotumoral lesion due to possible infectious causes should be histopathologically examined and correlated with other clinical and laboratory data in order to achieve a final diagnosis
Aim: The aim of this study is to evaluate the causative agents, diagnosis, treatment, and outcomes of acute septic arthritis cases. Material and Methods: In this retrospective, single-center study, patients over 18 years of age diagnosed with acute septic arthritis were searched from the hospital database between January 2015 and April 2021. Demographic characteristics, diagnostic procedures, therapeutic management, and outcomes were recorded. Results: A total of 59 patients and 60 septic joints were included in the study. The causative microorganisms were isolated in 52.54% of the cases. Staphylococcus aureus grew in 70.96% of the cases and among these, 31.82% were methicillin-resistant. The most frequently affected body part was the knee (73.33%). The cases were found to have fever at a rate of 42.37%. Diabetes was the most common comorbidity (30.51%), and immunosuppression was found in 39% of the cases. Arthrotomy was the most commonly used surgical method for the management of septic arthritis (43.55%). The mortality rate was 6.78%. The cases were categorized as groups with and without microorganisms isolated in culture. When these two groups were compared, no statistically significant difference was found except for the duration of hospitalization (p=0.001). Conclusion: Septic arthritis should be considered in the differential diagnoses of a warm and swollen single joint, especially in the presence of risk factors, until it is excluded. Knowledge of regional epidemiological data is essential in planning treatment approaches.
Objective/Aim. Pathologic fractures are devastating complications in metastatic bone disease. Treatment of these condition varies, including systemic therapies and surgical interventions. Lack of evidence still exists for standardized care. The aim of this study is to analyze radiological healing response and clinical outcomes after intramedullary nailing and adjuvant radiotherapy in complete pathologic fractures of femur or humerus Methods. A total of 19 patients who presented with pathological fracture were retrospectively reviewed. Data regarding demographic characteristics, clinical outcomes and radiologic images were obtained from hospital records. All patients in this cohort were treated with closed, unreamed intramedullary nailing (IMN) and adjuvant radiation treatment. Results. Pain relief and full range of motion was obtained in all patients. The mean postoperative Musculoskeletal Tumor Society (MSTS) scores at last follow-up were 69% (range 50-85). All patients demonstrated complete radiographic healing between 2 and 6 months. Only one patient required reoperation for refracture at the tip of the nail which was revised with a longer nail. Conclusion. Our study demonstrated that pathologic fractures managed with closed unreamed IMN and adjuvant multifractional 20 Gy dose radiotherapy yielded good clinical outcomes with complete radiologic response regardless of patient?s life expectancy, adjuvant treatments and overall condition. Closed unreamed IMN was also associated with decreased surgical time in these high-risk patients.
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