RESUMEN

Presentamos el caso de un osteoma osteoide recurrente en forma de un osteoblastoma agresivo en columna lumbar. Un varón de 15 años acudió a nuestro servicio con una escoliosis dolorosa. El TC y la RM mostraron una tumoración formadora de hueso esclerótico de 7 mm compatible con un osteoma osteoide. Se realizó una ablación percutánea guiada por radiofrecuencia con remisión completa de la sintomatología. Seis meses después, dicha sintomatología recurrió. Se realizaron TC y RM que mostraron un crecimiento del nidus en la lámina L4 derecha, con un diámetro de 15 mm. Se realizó una resección marginal. La histología mostró un osteoblastoma epiteloide. Un años después, se realizaron nuevos estudios de imagen que mostraron una nueva recurrencia del tumor con rasgos agresivos e invasión del canal espinal. Se le realizó una cirugía de resección en bloque con estabilización de la columna lumbar. La histología confirmó el diagnóstico de osteoblastoma epiteloide

We report an uncommon case of osteoid osteoma recurring as an aggressive osteoblastoma of the spine. A 15-years-old male consulted in our department with long-term painful scoliosis. The CT-scans and MRI revealed a sclerotic bone forming tumor of 7 mm diameter consistent with a osteoid osteoma. A percutaneous radiofrequency ablation was performed with complete resolution of the symptoms. After 6 months, the symptoms recurred. A new CT and a MRI showed a growth of the nidus on the right L4 lamina, with a size of 15 mm. Therefore, a marginal resection by laminectomy of L4 was performed. Pathology confirmed an epithelioid osteoblastoma. A year later, subsequent imaging studies showed a new recurrence with aggressive features and invasion of the spinal canal. The patient then underwent an "in block surgery" needing concurrent stabilization of the spine. Histopathology confirmed the diagnosis of epithelioid osteblastoma

Asunto(s)

RESUMEN

OBJETIVO DEL TRABAJO: El objetivo principal del estudio es la revisión de la casuística de modelos impresos en 3D para planificación quirúrgica en el Servicio de Cirugía Ortopédica y Traumatología del Hospital Universitario Virgen del Rocío (Sevilla).MATERIALES Y MÉTODOS: Se realizó un estudio epidemiológico, retrospectivo, descriptivo y analítico a partir de una base de datos encriptada sobre pacientes diagnosticados y tratados quirúrgicamente de lesión traumática junto con el uso de un biomodelo 3D. RESULTADOS: Se analizaron 173 biomodelos 3D y se clasificaron según tipo de lesión, localización anatómica de la misma y unidad solicitante. El tipo de lesión implicada con mayor frecuencia fue la fractura compleja o secuelas de ésta. La meseta tibial y la pelvis son las localizaciones en las que se utilizó con mayor frecuencia los biomodelos 3D. CONCLUSIONES: La impresión 3D en el campo de la Cirugía Ortopédica y Traumatología es una tecnología actual, en rápida evolución y permite a los cirujanos ortopédicos y traumatólogos comprender mejor los casos complejos, ayudando a la planificación quirúrgica de los mismos. Por tanto, podemos considerarla como un complemento para mejorar la atención al paciente por los beneficios que conlleva su uso

PURPOSE: The main aim of this study is the collection and review of information about the application of 3D printed models for surgical planning of complex injuries in the Orthopedic Surgery and Traumatology service of "Virgen del Rocío" University Hospital (Sevilla). MATERIALS AND METHODS: An epidemiological, retrospective, descriptive and analytical study is carried out from an encrypted database of patients diagnosed and treated surgically with complex traumatic injury together with the use of a 3D anatomical biomodel. RESULTS: The results of 173 patients classified by type of injury, anatomical location of the injury and requesting unit are obtained. The results suggest that the type of injury most frequently involved is complex fracture or its sequelae. The tibial plateau and the pelvis are the locations where 3D printing is most widely used due to its complexity. CONCLUSIONS: 3D printing is a rapidly evolving field which allows surgeons to better understand complex cases, aiding in their surgical planning. Therefore, we should consider it as a complement to improve patient care due to the benefits of its use

Asunto(s)

RESUMEN

Endometrial stromal cells (EnSCs) and decidual stromal cells (DSCs) originate from fibroblastic precursors located around the vessels of the human nonpregnant endometrium and the pregnant endometrium (decidua), respectively. Under the effect of ovarian or pregnancy hormones, these precursors differentiate (decidualize), changing their morphology and secreting factors that appear to be essential for the normal development of pregnancy. However, the different physiological context - that is, non-pregnancy vs pregnancy - of those precursors (preEnSCs, preDSCs) might affect their phenotype and functions. In the present study, we established preEnSC and preDSC lines and compared the antigen phenotype and responses to decidualization factors in these two types of stromal cell line. Analyses with flow cytometry showed that preEnSCs and preDSCs exhibited a similar antigen phenotype compatible with that of bone marrow mesenchymal stem/stromal cells. The response to decidualization in cultures with progesterone and cAMP was evaluated by analyzing changes in cell morphology by microscopy, prolactin and IL-15 secretion by enzyme immunoassay and the induction of apoptosis by flow cytometry. In all four analyses, preDSCs showed a significantly higher response than preEnSCs. The expression of progesterone receptor (PR), protein kinase A (PKA) and FOXO1 was studied with Western blotting. Both types of cells showed similar levels of PR and PKA, but the increase in PKA RI subunit expression in response to decidualization was again significantly greater in preDSCs. We conclude that preEnSCs and preDSCs are equivalent cells but differ in their ability to decidualize. Functional differences between them probably derive from factors in their different milieus.

Asunto(s)

RESUMEN

We report an uncommon case of osteoid osteoma recurring as an aggressive osteoblastoma of the spine. A 15-years-old male consulted in our department with long-term painful scoliosis. The CT-scans and MRI revealed a sclerotic bone forming tumor of 7mm diameter consistent with a osteoid osteoma. A percutaneous radiofrequency ablation was performed with complete resolution of the symptoms. After 6 months, the symptoms recurred. A new CT and a MRI showed a growth of the nidus on the right L4 lamina, with a size of 15mm. Therefore, a marginal resection by laminectomy of L4 was performed. Pathology confirmed an epithelioid osteoblastoma. A year later, subsequent imaging studies showed a new recurrence with aggressive features and invasion of the spinal canal. The patient then underwent an "in block surgery" needing concurrent stabilization of the spine. Histopathology confirmed the diagnosis of epithelioid osteblastoma.

Asunto(s)