Soft Tissue Mass Research Articles

Myopericytoma of the hand.

Myopericytoma is a rare benign smooth-muscle cell neoplasm of the subcutaneous soft tissues that is primarily found in young adults with a male predominance. We present the clinical, radiologic, and histopathologic features of a longstanding myopericytoma of the hand. We emphasize the features that help the radiologist and pathologist to accurately characterize this entity. Radiologic evaluation, particularly MRI, plays a crucial role in differentiating myopericytoma from other soft tissue masses. Characteristic MR features include a well-demarcated lesion with intense post-contrast enhancement, isointensity to muscle on T1-weighted imaging, and hyperintensity on T2-weighted imaging, often with a central vascular pedicle. Histopathologic examination reveals a concentric perivascular growth pattern, which helps to distinguish myopericytoma from other soft tissue tumors. Immunohistochemically, these myoid cell neoplasms stain positive for alpha-smooth muscle actin and h-caldesmon, lack nuclear atypia, and are not highly proliferative (relatively low Ki-67 index and very low mitotic activity). The vast majority stain negative for desmin and CD34. Treatment typically involves complete surgical resection, with excellent prognosis and rare recurrence. Despite its rarity, awareness of this entity is important for clinicians who encounter soft tissue masses of the extremities.

The finger-ring test as an indicator of muscle mass estimated by dual-energy X-ray absorptiometry in an adult community-dwelling population.

The finger-ring test (FRT) offers a simple method to screen older adults at increased risk of sarcopenia. To investigate the association between the FRT and lean soft tissue mass estimated by dual-energy X-ray absorptiometry (DXA), and to further elucidate the FRT as an indicator of muscle mass, while accounting for potential confounders, in a community-dwelling population. Within this cross-sectional study 430 community-dwelling individuals aged 18 to 79 (286 women (66.5%) and 144 men (33.5%)) were enrolled. Data regarding FRT and anthropometric measurements were collected. Whole-body composition was estimated using DXA. Binary and ordinal logistic regressions were performed. The frequency of smaller calf, just fits, and bigger calf was 17.7%, 33.7%, and 48.6%, respectively. Regardless of sex, higher appendicular lean soft tissue mass adjusted for height squared was observed for higher FRT categories (p < 0.001). For the ordinal logistic regression model, each unity of increment in appendicular lean soft tissue mass adjusted for height squared (kg/m2) was associated with a higher probability of being allocated to higher finger-ring test categories, in both genders. A higher cumulative adjusted odds ratio was found for women (7.53; 95% confidence interval: 4.58-12.38) than for men (2.99; 2.00-4.48). By demonstrating an association between the appendicular lean soft tissue mass estimated by DXA and the FRT, these results strengthen the utility of this simple self-test as an indicator of muscle mass, which can be used in the primary prevention of muscle mass decline and its recovery.

TMJ synovial chondromatosis - an evaluation of 37 patients.

The authors evaluated a cohort of 37 patients with histologically verified synovial chondromatosis (SC) between 2013 and 2022. The cohort consisted of 37 patients (26 women, 11 men). 36 patients had unilateral involvement, while one patient had bilateral involvement. The average age of the patients was 54.77 years. The authors used the Milgram histopathological classification. They evaluated SC localisation, clinical symptoms, diagnostics and treatment (including recurrence incidence) in this cohort. In 31 patients (83.7%) SC affected only the upper joint space in one patient (2.7%) the lower space, and in five patients (13.6%) both spaces. 12 patients (32%) were Milgram Stage 1 (presence of synovial metaplasia without loose bodies), eight patients (22%) were Stage 2 (presence of synovial changes, loose bodies), and 17 patients (46%) were Stage 3 (presence of loose bodies, no synovial changes). Pain was the dominant clinical symptom (32 patients, 86.4%). Treatment consisted of arthroscopy and open surgery. Two patients underwent primary reconstruction and total TMJ replacement. Treatment was successful in 89.2% of cases (33 patients), with four (10.8%) patients suffering recurrence. As this patient cohort shows, pain was the dominant symptom in patients with SC. Magnetic resonance imaging is fundamental in the diagnosis of SC, demonstrating pathological findings even in patients for whom an initial X-ray was negative. These were mainly patients with Milgram Stages 1 and 2 without calcification, loose bodies or pathological changes of the bone structures. This is why the authors recommend MRI for any patient experiencing pain for more than three months, and if this reveals an effusion, joint distension or intraarticular soft tissue mass, they will always indicate arthroscopy. Thorough follow-up of patients is recommended, although SC recurrence is not very frequent. The authors recommend follow-up one, three and six months after surgery, and then annually for the first five years after surgery. They recommend follow-up MRI one, two and five years after surgery.

Chondrosarcoma of the Flat Bones: Differential Survival Between High-Grade Lesions of the Pelvis and Scapula.

Flat bone chondrosarcomas have worse outcomes than extremity tumors, but there is no data directly comparing the different flat bones. The aim of this study was to examine differences in recurrence and survival between pelvic and scapular chondrosarcoma. One hundred and sixty-nine (42 scapula, 127 pelvic) patients with chondrosarcoma who underwent surgical resection were reviewed. High-grade tumors were defined as lesions that were Grade 3 or dedifferentiated on surgical pathology. Patients with low-intermediate grade lesions of the scapula were more likely to have positive margins during definitive surgical management (14% vs. 3%, OR 5, 95% CI [1.15, 22.6], p = 0.02), however, this did not translate to differences in recurrence or survival (p > 0.05). The presence of an associated soft tissue mass in low-intermediate grade lesions was not associated with increased recurrence. Among high-grade tumors, patients with scapular lesions had worse DSS (HR 2.99, 95% CI [1.05, 8.51], p = 0.04). One- and 2-year DSS for high-grade pelvic tumors was 75% and 57%, respectively, and 50% and 33% for scapular tumors. Survival for high-grade chondrosarcoma of the flat bones is poor, particularly for those of the scapula. Despite a higher rate of positive margins for low-intermediate grade lesions of the scapula, there was no significant difference in survival compared to low-intermediate grade lesions of the pelvis. Additional studies with larger sample sizes are needed to further elucidate differences between these locations.

Misdiagnosis of Clival Lesion as Macroadenoma and Subsequent Identification as Clival Chordoma: Emphasizing the Role of MRI

ABSTRACT Clival chordomas are rare, malignant tumors arising from remnants of the notochord, comprising less than 1% of all bone tumors. Due to their insidious growth and location at the skull base, they are frequently misdiagnosed as pituitary macroadenomas, which present with similar clinical symptoms, including headaches and visual disturbances. This case study highlights the diagnostic challenges encountered in a 65-year-old male, initially diagnosed with pituitary macroadenoma based on clinical presentation and early imaging findings. Despite the proximity of the lesion to the sellar region, initial CT imaging failed to differentiate the clival chordoma from a pituitary macroadenoma due to overlapping features such as bone destruction and soft-tissue mass appearance. However, subsequent magnetic resonance imaging (MRI) provided crucial details that led to the correct diagnosis. T2-weighted MRI revealed heterogeneous hyperintensity, necrotic and cystic components, and low-signal-intensity septations—features not typically seen in macroadenomas. Post-contrast enhancement patterns and evidence of local invasion into surrounding structures further supported the diagnosis of clival chordoma. This case underscores the importance of MRI in the differential diagnosis of skull base tumors, especially when clinical and initial imaging findings are inconclusive. Early and precise use of MRI can prevent misdiagnosis and guide appropriate treatment planning, particularly in rare pathologies like clival chordomas.

Are Imaging Evaluations of Soft-Tissue Masses Before Referral to a Specialized Center Being Performed Properly? A Systematic Review

Background/Objectives: Since the initial approach towards the clinical presentation of soft-tissue masses is challenging for frontline physicians, some countries use clinical practice guidelines. Proper imaging work-up is crucial to differentiate between soft-tissue tumors. Recently, ultrasonography and magnetic resonance imaging (MRI) have been widely used. But there is some controversy about whether pre-referral evaluations are being conducted properly. Thus, this study aims to assess whether the ultrasonography investigation of soft-tissue masses prior to referral to the musculoskeletal tumor center is being performed adequately in terms of indications, diagnostic accuracy, and referral interval, and to evaluate whether the pre-referral MRI for soft-tissue masses is being conducted reasonably concerning indications, imaging protocol, reporting, diagnostic accuracy, and cost-effectiveness. Methods: The study protocol was registered. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. We performed a database search of the MEDLINE, Embase, and Cochrane Library. Then, two authors reviewed the studies, and the third author resolved any disagreement between them. A total of nine studies were included. The Risk Of Bias In Non-Randomized Studies-of Interventions was applied. Relevant data were extracted by two authors. Results: This review showed that the way that the imaging investigations are performed in non-specialized centers before referral was generally considered inappropriate. Conclusions: Frontline physicians should regard the alarm symptom as an indication for advanced imaging evaluation. Education and certification may be required for ultrasonography. MRI should be performed and interpreted in a specialized center or by a specialist with relevant expertise. Guidance may help reduce inappropriate imaging.

Diagnosis and Treatment of Schwannoma of the Nasal Tip: A Case Report

Introduction: Schwannomas are typically benign tumors with a low likelihood of becoming malignant. Approximately 4% of schwannomas occur in the nasal passages, leading to gradual enlargement, cosmetic issues, and sensory disturbances. Common symptoms include nasal congestion and headaches. Nasal tip schwannomas are particularly rare, with only a few cases documented. This report presents a case of nasal tip schwannoma, detailing the symptoms, diagnostic process, and treatment provided. Case Presentation: A 14-year-old girl was referred for evaluation of a nasal lump that altered the appearance of her nose. She reported mild pain and numbness in the nasal area. Upon examination, a mobile lump was identified beneath the skin and inside the nasal cavity, with no other abnormalities noted. Preoperative imaging revealed a well-defined soft tissue mass without infiltration into surrounding structures. During an open rhinoplasty procedure, 17 nodules were excised to correct nasal deviation. Pathology confirmed a benign schwannoma. The surgery was successful, and after nine months, the patient maintained a stable nasal appearance and reported symptom relief. No complications or recurrences were observed, preserving the aesthetic outcome. Conclusions: Nasal tip schwannoma is an uncommon condition that is diagnosed through imaging studies and confirmed by histopathology. Accurate diagnosis requires careful review of the patient’s medical history, a thorough physical examination, and relevant diagnostic tests. This comprehensive approach is essential for timely and precise diagnosis of rare nasal conditions, including differential diagnoses such as hemangioma.

A Case Report on Ellis–van Creveld Syndrome: Clinical, Embryological, Anesthetic, and Surgical Implications

AbstractPostaxial polydactyly (PAP) in the form of rudimentary soft tissue masses is quite common. Management involves ligation or surgical excision. Rarely do literature discussions cover complex variants in which the extra finger is fully developed. Ellis–van Creveld syndrome (EVC) or chondroectodermal dysplasia is a rare disorder characterized by PAP. When chondral dysplasia encompasses PAP, dwarfism, and genu valgum, ectodermal dysplasia involves nails and teeth. We describe two EVC cases. When one had cardiac malformations, the other had dental anomalies. One of them underwent genu valgum correction and removal of the additional finger. The hand surgery proved complex due to fusion of its metacarpal with the fifth metacarpal. Pediatric Outcomes Data Collection Instrument (PODCI) scores at 1.5 and 2.5 years after hand and knee surgeries were excellent. A multidisciplinary approach is essential to achieve comprehensive care. Additional embryological research is necessary to elucidate the clinical manifestations described in this report.

Mesocolic schwannoma mimicking gastrointestinal stromal tumor: A case report and review of literature.

Schwannomas are common peripheral nerve tumors originating from Schwann cells, primarily occurring in the head and neck, limbs, and trunk. Schwannomas occurring in the mesocolon are rare and often have no specific manifestations. Abdominal schwannomas need to be differentiated from common abdominal tumors such as gastrointestinal stromal tumors. We report a case of a mesocolic schwannoma in a 59-year-old female presenting with gastrointestinal symptoms of acid reflux. At an outside hospital, gastroscopy, colonoscopy, and abdominal computed tomography scans revealed a soft tissue mass adjacent to the greater curvature of the stomach, leading to a suspicion of a gastric mesenchymal tumor. Mesocolic schwannoma. Laparoscopy was performed at our hospital. Intraoperatively, the tumor was found to be closely related to the transverse colon and was initially diagnosed as a mass originating from the transverse colon. Consequently, a resection of the mass along with the adherent portion of the transverse colon was performed. Postoperative pathology and immunohistochemistry confirmed that the tumor was a schwannoma of the mesentery and did not originate from the transverse colon. Schwannomas can be distinguished from gastrointestinal stromal tumors by immunohistochemical staining, and surgical treatment is effective for benign schwannomas.

Rare posterior mediastinal hemangiomas invading the spinal cord through the intervertebral foramen and causing acute symptoms: illustrative case.

Hemangioma is a rare vascular tumor characterized by endothelial cell proliferation that primarily occurs in soft tissues. While most cases in the paraspinal posterior mediastinum are clinically indolent, they can also exhibit aggressive growth, leading to severe clinical outcomes and necessitating urgent treatment. A 61-year-old right-handed female presented with reduced lower-extremity mobility that had begun 4 days earlier. An examination revealed that both lower limbs had grade 4 muscle strength. Computed tomography and magnetic resonance imaging revealed a right T1-3 paravertebral dumbbell-shaped soft tissue mass invading the spinal canal, destroying the T2 vertebra, and compressing the spinal cord and nerve roots. Elective surgery was planned, but a rapid muscle strength decline prompted emergency surgery. Postoperative muscle strength improved to grade 4, and at the 3-month follow-up, muscle strength had fully recovered. Postoperative pathological examination revealed that the mediastinal dumbbell-shaped lesion was a hemangioma. While most hemangiomas progress slowly, acute symptoms of spinal cord compression are exceedingly rare. This case demonstrates the aggressive behavior of hemangioma, which invaded through the intervertebral foramen and compressed the spinal cord, resulting in acute symptoms. This case also shows that surgical removal of the tumor and restoration of spine stability via a posterior approach has proven beneficial. https://thejns.org/doi/10.3171/CASE24485.

A Novel Endoscopic Approach to Fibroadipose Vascular Anomaly

BackgroundOpen surgery is the standard treatment for fibroadipose vascular anomalies (FAVA). This study evaluated an endoscopic approach for FAVA, assessing its safety and feasibility. MethodsData from October 1, 2019, and May 1, 2024, were analyzed from the Vascular Anomalies Center database at our institution. Patients with FAVA Stage I (pain stage) or II (contracture stage) were included and divided into the endoscopic surgery group (ESG) and open surgery group (OSG). ResultsIn total, 101 patients underwent 110 procedures. In ESG, 42 patients (16 males and 26 females; 31 with Stage I and 11 with Stage II) underwent radical excision (with tendon lengthening in 2 patients). Ten patients underwent an open surgery. In OSG, 63 patients (18 males and 45 females; 30 with Stage I and 33 with Stage II) underwent radical excision (with tendon lengthening in 12 patients). The OSG had significantly shorter operative time than the ESG (p = 0.009). Furthermore, The OSG had longer hospitalization time (p = 0.022) than the ESG. The blood loss in the OSG was greater than that in the ESG, but without statistical difference (p = 0.069). During follow-up, the incidence of wound complications (p = 0.121) and residual symptoms (p = 0.179) were slightly higher in the OSG. ConclusionsEndoscopic surgery is a safe and effective treatment for FAVA, promoting faster habilitation and improved patient satisfaction. This method may also serve as a reference for the excision of other benign muscle and soft tissue masses.

Epidermal Inclusion Cyst Presenting as Prepatellar Bursitis

An epidermal inclusion cyst is one of the rare benign lesions that can occur around the knee and can mimic prepatellar bursitis. They can occur anywhere in the body, but more prevalent sites are the face, neck, trunk, behind the ears, and palmoplantar region. In the present case, a 52-year-old man with epidermal inclusion cyst presented to the surgery outpatient department (OPD) with symptoms clinically mimicking as prepatellar bursitis, occurring at a rather unusual site, ie; the anterior aspect of the left knee. The possibility of an epidermal inclusion cyst should always be considered in an atypical soft tissue mass when presenting around the knee. Histopathological examination confirms the diagnosis.

Accuracy of clinical diagnosis, imaging methods, and biopsy in tumours and pseudo-tumours of the hand.

The appropriate use of imaging methods in bone and soft tissue tumours of the hand is well established in the radiological literature. However, since most of the tumoral conditions of the hand are benign, the use of imaging methods may be based on clinician preferences and technical availability. The aim of this work is to present the experience in our institution in the management of tumours and pseudo-tumours of the hand and to review the utility of different imaging methods in their diagnosis. We present a retrospective and consecutive case series of patients referred to Hospital Universitario Virgen de las Nieves due to clinical suspicion of hand tumour in the last 10 years. We assessed the accuracy of clinical and imaging diagnoses, matching the final pathological or surgical results, considering a diagnosis as "correct" if it was included in the differential diagnosis suggested in the clinical (including all provided diagnoses) or radiological report (only the first 2 diagnoses), respectively. Biopsy accuracy was contrasted with surgical findings. We included 175 patients with a pathological or microbiological diagnosis of hand tumors, obtained through surgery (n=124) and/or core needle biopsy (n=62), or puncture-drainage (n=30). Among these, 21 cases were identified as infectious, metabolic, or inflammatory processes, while 154 were classified as hand tumours or pseudotumours (101 in soft tissues and 53 in bone). The overall diagnostic accuracy (95% confidence interval) for each approach was as follows: clinical diagnosis, 26.3% (19.8-32.8%); ultrasound, 72.6% (64.3-80.8%); magnetic resonance imaging (MRI), 80.6% (73.8-87.4%); computed tomography (CT), 84.6% (74.8-94.4%); and radiography, 46.8% (38.6-55.0%). The overall accuracy of imaging was 81.1% (75.3-86.9%). For soft tissue masses, the diagnostic accuracy was: clinical, 30.7% (25.5-42.1%); ultrasound, 69.8% (62.9-80.1%); MRI, 73.9% (65.5-83.4%); CT, 75.0% (30-92%); and radiography, 20.3% (14-33%), with an overall imaging accuracy of 75.2% (69.2-84.1%). For bone tumours, the accuracy was: clinical, 10.9% (5.2-21.8%); ultrasound, 75.0% (46.8-91.1%); MRI, 90.7% (78.4-96.3%); CT, 92.3% (79.7-97.3%); and radiography, 83.3% (71.3-91%), with an overall imaging accuracy of 89.1% (78.2-94.9%). Biopsy accuracy was 90.7% (83-98.5%) overall, 86.4% (74-98%) for soft tissue masses, and 100% (81.5-100%) for bone tumours. Imaging outperforms clinical diagnosis in terms of accuracy and should be mandatory before any interventional procedure. Imaging-guided biopsy is an efficient complementary technique when doubts persist about the nature or potential malignancy of a hand tumour.

Nasal Respiratory Epithelial Adenomatoid Hamartoma: Three Case Reports and Review of the Literature.

Hamartomas, as non-true tumors, are commonly found in the lungs, digestive tract, and kidneys, and there are few clinical reports on nasal cases. Nasal histiocytosis accompanied by lymphatic lesions is a common feature of nasal hamartoma. Three patients with nasal cavity hamartoma were treated in our department, including 1 male and 2 females, with nasal obstruction or epistaxis. The imaging (computed tomography, magnetic resonance imaging) of 2 patients showed a soft tissue mass in the nasal cavity and no erosion of bone, while in 1 patient, the imaging was inconclusive. The excised material in all patients was found to be a soft mass. The 3 cases showed the same pattern under histological examination, and all 3 patients were diagnosed with nasal cavity respiratory epithelial adenomatoid hamartoma (REAH). Nasal hamartoma is a rare disease with nonspecific clinical manifestations and imaging features and is often misdiagnosed. Only by a better understanding of this disease can the rate of correct clinical diagnosis be improved.

Imaging manifestations and misdiagnosis of liposclerosing myxofibroma fumor

To focus on the imaging features of liposclerosing myxofibrous tumor (LSMFT) and diagnostic challenges to enhance clinical recognition and differential diagnosis accuracy. Retrospective analysis was conducted on the imaging and pathological data from 21 cases diagnosed with LSMFT between January 2014 and November 2022, including 14 males and 7 females (aged from 21 to 73 years; the course of disease ranged from 4 to 48 months). Patient demographics, clinical presentations, and imaging modalities including X-ray, CT, and MRI were reviewed. Pathological findings were correlated with imaging features to delineate diagnostic criteria and identify causes of misdiagnosis. All 21 patients represented primary lesions, located in 14 bilateral femurs [9 on the right and 5 on the left; 12 proximal femurs (intertrochanteric and peripheral) and 2 distal femurs], 2 proximal tibia, 2 proximal humerus, 1 proximal radius, and 1 ilium and 1 calcaneus. On X-ray and CT, all lesions showed cartographical or quasi-circular osteolytic destruction with distinct and sclerotic margins, continuous bone cortex, absence of periosteal reaction and surrounding soft tissue mass. Calcification, bone ridge and varying degrees of fat components were observed in 16 lesions, displaying mixed density;5 lesions showed ground-glass density with minimal bone ridge. On MRI, the signal intensity of the lesion was heterogeneous. T1-weighted imaging showed iso-to slightly high signal intensity, while T2-weighted imaging demonstrated unevenly high signal intensity. Fat-suppressed sequences depicted significantly elevated signal intensity within lesions, with post-contrast enhancement showing uneven patterns. 5 Cases were initially misdiagnosed as fibrous dysplasia. LSMFT is an uncommon benign bone tumor, typically localized in the proximal femur but occasionally found in other skeletal sites. Understanding its distinct imaging characteristics is crucial for accurate diagnosis. Typical cases exhibit identifiable imaging patterns, whereas atypical presentations may lead to misdiagnosis as fibrous dysplasia.

Costs of induced defenses dissipate by maturity for diploid and triploid oysters

Oyster reef restoration efforts and on-bottom aquaculture are frequently plagued with high predation rates. Oysters are phenotypically plastic, and rearing juvenile oysters, Crassostrea virginica, with predator cues causes them to grow stronger shells that increases survivorship in the field. However, induced defenses (e.g., shell hardening in oysters) are often associated with cost-benefit trade-offs, and the extent the increased shell strength persists into adulthood and alters the growth of somatic and reproductive tissues remains unknown. We raised diploid oysters (used in reef restoration) and triploid oysters (used in aquaculture) with and without predator cues for one month before placing individuals on an oyster farm to grow to market size. Oyster shell characteristics, soft tissue mass, and reproductive investment were measured periodically over one year of culture and compared across treatments. Both diploid and triploid oysters had significantly stronger and smaller shells than controls at the end of their nursery period. However, while diploid shells became 15 % stronger and 17 % smaller than controls, triploid shells became 28 % stronger and 23 % smaller. Additionally, triploid oysters exposed to predator cues returned to the size of controls faster and maintained their shell strength differences longer than diploids. Differences in soft tissue mass between treatments mirrored the patterns exhibited in shell size and weight with greater initial physiological costs and faster recovery for triploid individuals. There was no significant difference in somatic or reproductive tissue mass between induced and control oysters of the same ploidy after seven months in the field. Triploid oysters were 15–110 % larger than diploids depending on the characteristic measured at maturity. Additionally, there was a significant interaction between treatment and ploidy because induced triploids had marginally greater growth than their control counterparts while induced diploids had marginally less growth than controls. These findings demonstrate that physiological costs of oysters reacting to predators in early life stages are minimal by the time individuals reach maturity. Early exposure to predator cues is a promising tool for improving oyster survivorship in restoration and aquaculture operations, especially in regions with high predation pressure.

Uncommon Presentation of Multiple Myeloma: Pleural Effusion and Extensive Extramedullary Involvement

A 60-year-old female presented with abdominal pain, weight loss, and fatigue. Imaging revealed a pancreatic mass, bilateral pleural effusion, ascites, and lytic bony lesions. Investigations confirmed multiple myeloma with lambda light chain disease. Positron emission tomography-computed tomography (PET-CT) scan demonstrated extensive metabolically active soft tissue masses involving the pancreatic region, retroperitoneum, mediastinum, paravertebral regions, and multiple skeletal lesions with extraosseous soft tissue involvement, along with bilateral pleural effusions with metabolically active pleural and extrapleural deposits. The patient was initiated on a bortezomib, cyclophosphamide, and dexamethasone chemotherapy regimen with therapeutic thoracentesis for pleural effusion management. After two cycles, the patient showed remarkable clinical improvement. A repeat PET-CT scan revealed significant interval regression of soft tissue masses, metabolic activity resolution, and regression of pleural and extrapleural deposits. The extensive skeletal lytic lesions showed morphological stability but regression of associated metabolic activity and extraosseous soft tissue. This case highlights the potential of novel agent-based regimens in achieving exceptional responses in multiple myeloma patients with extensive extramedullary disease (EMD), including uncommon manifestations like pleural effusion. Early recognition and prompt initiation of appropriate therapy are crucial for improving outcomes in such cases.

3D-printed custom ankle braces for people with Charcot-Marie-Tooth disease: A pilot study.

Charcot-Marie-Tooth disease (CMT) is a neurodegenerative condition resulting in footdrop, ankle instability and impaired balance and gait. This study aimed to determine (1) whether 3D-printed custom ankle braces improve function and balance in people with CMT and (2) whether this is an acceptable device for use in this population. A within-subject comparison pragmatic/pilot study was undertaken. Ten people with CMT (mean [SD] age 48 [14] years, 60% male) were fitted with 3D-printed ankle braces. Following a 4-week wear-in period, walking and balance tests and patient-reported outcomes were assessed in two experimental conditions: (i) usual shoes and (ii) usual shoes with 3D-printed custom ankle braces. Differences in outcome measures between experimental conditions were analysed using linear mixed models. Comfort, aesthetics and overall satisfaction of the brace were assessed via 100-mm visual analogue scale (VAS). Adverse events and tripping/falls associated with the brace during the wear-in period were also recorded by participants using daily diaries. A significant improvement was seen during single-leg balance with eyes open (p=0.026, Cohen's d=0.55) and a significant reduction in foot pain (p=0.045, Cohen's d=0.82), with use of the ankle brace. Mean (SD) 100mm VAS scores were 62.7mm (17.9) for overall comfort and 73.9mm (21.2) for overall satisfaction. Subjective data from the daily dairies showed that one participant found the brace too firm around the ankle due to loss of soft tissue mass and two participants found it challenging to don and doff the brace due to loss of hand dexterity. This pilot study suggests that a 3D-printed custom ankle brace may improve balance and reduce foot pain in people with CMT; however, larger-scale trials are needed to further explore the impact of this brace on function and balance. Further customisation of the brace may also be required to improve acceptability for some people.

Breast Metastasis From Sigmoid Adenocarcinoma Revealed by FDG PET/CT.

Breast metastasis from sigmoid carcinoma is rare. A 32-year-old woman, who had a history of sigmoid carcinoma, was found a hypermetabolic soft tissue mass in the left breast and a lymph node with moderate uptake on FDG PET/CT. Final pathology supported that the breast mass and lymph node were both metastases from the sigmoid carcinoma.

Hyperphosphatemic Familial Tumoral Calcinosis (HFTC) in a One-Year-Old Child: A Case Report and Literature Review

Introduction: Hyperphosphatemic Familial Tumoral Calcinosis (HFTC) is a rare autosomal recessive metabolic disorder characterized by abnormal phosphate regulation and soft tissue calcifications. Early diagnosis is crucial for optimal management to prevent complications. Case Presentation: A one-year-old child presented with intermittent fevers and a gluteal mass. Ultrasound revealed a calcified abscess, and biopsy confirmed a pseudocyst. Further workup identified elevated blood calcium, phosphorus, and neutropenia. The patient was ultimately diagnosed with HFTC. Discussion: Early diagnosis of HFTC is challenging due to the rarity of the disease and the potential for non-specific initial symptoms. This case highlights the importance of considering HFTC in the differential diagnosis for a young child with unexplained soft tissue masses or skeletal abnormalities, even outside the usual age range. Conclusions: This case report emphasizes the need for a high index of suspicion for HFTC in pediatric patients with suggestive clinical features, regardless of age. Early diagnosis and prompt intervention are essential to improve long-term outcomes and prevent complications.