RESUMEN
A primary hemangiopericytoma (HP) of the bone is rare, because the vast majority of these tumors arise in soft tissue. This report presents a case of a hemangiopericytoma in the sacrum (S1-S2) with extension to the retrorectal space. Only a few cases of osseous hemangiopericytomas in the sacrum and involving the retrorectal space have so far been reported. The difficult diagnosis of HP and the surgical strategy was chosen according to the location of the lesion in the sacrum and retrorectal space. A local excision was indicated. A sacral resection should be considered for tumors below S4. This report demonstrated the safety of this strategy. Adjuvant radiotherapy is useful in HP. The value of chemotherapy is still doubtful, although patients with high-grade tumors or metastatic spread seem to gain substantial benefit. Due to the often unpredictable behavior of this neoplasm, extended follow-up is strongly recommended.
Asunto(s)
Hemangiopericitoma/cirugía , Sacro/patología , Sacro/cirugía , Neoplasias de la Columna Vertebral/cirugía , Adulto , Biopsia , Diagnóstico Diferencial , Femenino , Hemangiopericitoma/diagnóstico , Humanos , Imagen por Resonancia Magnética , Radioterapia Adyuvante , Neoplasias de la Columna Vertebral/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
The authors report a case of concomitant plantar Lisfranc dislocation and plantar metatarsophalangeal dislocation of the hallux. This is the second case of floating metatarsal described in the literature. When examining patients with Lisfranc joint injuries, one should explore carefully the metatarsophalangeal joints. It is also imperative to adapt the order of reductions to the presumed tension on the plantar fascia. Open reduction on the proximal side and closed reduction on the distal side, in addition to internal fixation proximally and distally, gave good results in this case.