Pseudogout attack of the lumbar facet joint is rare, but this clinical entity should be added to the differential diagnosis of acute low back pain.

A solitary fibrous tumor is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that solitary fibrous tumors also affect extrathoracic regions. The current study presents a literature review with four additional patients with solitary fibrous tumor arising from the extremities to clarify clinicopathologic features. The current four patients were two males and two females, ranging from 17 to 60 years of age. Magnetic resonance imaging scans of the current patients showed inhomogeneous low to intermediate intensity signal on T1-weighted images and inhomogeneous intermediate to high intensity signal on T2-weighted images. Histologically, the tumors were composed of a haphazard proliferation of spindle cells, although cellularity was variable in each case. Two of the four tumors showed hypercellularity of spindle cells with focally myxomatous or hyaline changes, whereas myxomatous patterns with scattered spindle cells throughout the specimens were observed in the other two tumors. Immunohistochemically, all four patients showed positive immunoreactivity for CD34, and two tumors showed focally positive immunoreactivity for bcl-2 protein. During the followup of 12 to 54 months, neither local recurrence nor distant metastasis was detected after wide resection. Examination of the literature and the current patients suggests that solitary fibrous tumors in the extremities are likely to have a malignant potential, although most patients have a benign clinical course. Local wide resection and careful long-term followup are necessary for patients with solitary fibrous tumor in the extremities.

Osteoblastomas located on the surface of the cortical bone, so-called periosteal osteoblastomas, are extremely rare. We report on a case of periosteal osteoblastoma arising from the posterior surface of the right distal femur in a 17-year-old man. Roentgenographic, computed tomographic, magnetic resonance imaging, and histologic features of the case are presented. Periosteal osteoblastoma should be radiologically and histologically differentiated from myositis ossificans, avulsive cortical irregularity syndrome, osteoid osteoma, parosteal osteosarcoma, periosteal osteosarcoma, and high-grade surface osteosarcoma. Although periosteal osteoblastoma is rare, this tumor should be included in the differential diagnosis of surface-type bone tumors.

Background/Aim: This study aimed to evaluate the association of clinical characteristics with treatment outcomes to ascertain the appropriate treatment options for soft tissue sarcomas (STS) patients with brain metastasis (BM). Patients and Methods: Medical records of STS patients with BM who were treated in our institutions were retrospectively reviewed, and analyzed to identify the factors associated with post-BM survival. Results: Among the 509 STS patients, BM occurred in five patients (0.98%). The median survival after BM was 1.5 months. Histological subtypes of the primary lesions in the five BM patients were: two synovial sarcomas, one myxoid liposarcoma, one alveolar soft part sarcoma, and one rhabdomyosarcoma. Among the five BM patients, the post-BM survival of two patients, who underwent surgery and postoperative radiotherapy, was longer than that of the other patients (p<0.01). Conclusion: Combined surgery and postoperative radiotherapy effectively managed symptoms and prolonged survival in STS patients with BM.Soft tissue sarcomas (STS) are uncommon and heterogeneous cancers of mesenchymal origin, representing approximately 1% of cancers in the adult population (1). Although adequate wide resection is the dominant curative therapy for primary STS (2), a multidisciplinary approach using chemotherapy and/or radiotherapy should be considered as pre-or post-operative adjuvant therapies (3). Half of patients with high-grade STS have been reported to die from metastatic disease, which may present as microscopic foci at the time of primary diagnosis (4). This is especially true in the lung, which is the most common site of distant metastasis (5). Brain metastasis (BM) in STS is rarely encountered, with a reported incidence of 1-8% (6-14). However, its incidence has been increasing due to advances in chemotherapeutic agents and diagnostic imaging technology (15). BM significantly affects the quality of life (QOL) and the prognosis of the patients. The mean overall survival after BM has been reported to be 1.8 to 11.8 months (6,7,9,(11)(12)(13)(15)(16)(17)(18). Therefore, early diagnosis and effective treatment are crucial for BM patients. Valid treatment options for BM are surgery, radiotherapy, chemotherapy, and their combination. Previous reports have demonstrated that surgery and postoperative radiotherapy prolonged survival after BM, and it may be widely accepted as a standard treatment approach for BM from STS (19,20). However, the appropriate treatment for each patient is still controversial due to the limited information available.In the present study, we retrospectively reviewed BM in STS patients to clarify the prognostic factors that may affect post-BM survival in patients. We focused on the appropriate treatment for each patient. Patients and MethodsEthical considerations. This study was approved by the Ethics Review Board of our institutions (#B190213). Informed consent was obtained in the form of an opt-out system. Those who rejected were excluded.

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