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Adult-onset hypophosphatemic osteomalacia as a cause of widespread musculoskeletal pain: A retrospective case series of single center experience.

BACKGROUND: Osteomalacia (OM) is frequently confused with various musculoskeletal or other rheumatic diseases, especially in patients with adult-onset widespread musculoskeletal pain because of its low prevalence and non-specific manifestations. AIM: To facilitate the early diagnosis and etiology-specific treatment of adult-onset hypophosphatemic OM. METHODS: A retrospective review of medical records was performed to screen adult patients who visited a physiatry locomotive medicine clinic (spine and musculoskeletal pain clinic) primarily presenting with widespread musculoskeletal pain at a s

Интерпретация [18F]FDG-avid переломов после индуктивной терапии в множестве миеломы: выводы из подисследования PET/CT фазы 3 GMMG-HD7 суд.

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Better pain control with 8-gray single fraction palliative radiotherapy for skeletal metastases: a Bayesian network meta-analysis.

External Beam Radiotherapy (EBRT) allows remarkable pain control in patients with skeletal metastases. We performed a Bayesian network meta-analysis comparing the most commonly used radiotherapy regimens for palliative management in patients with skeletal metastases. The main online databases were accessed in October 2020. All randomized clinical trials evaluating the irradiation of painful bone metastases were considered. The following irradiation patterns were analysed and included in the present network meta-analysis: 8 Gy- and 10 Gy/single fraction, 20 Gy/5 fractions, 30 Gy/10 fractions. T

11C-choline vs. 18F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma.

BackgroundMultiple Myeloma (MM) is a B cell neoplasm causing lytic or osteopenic bone abnormalities. Whole body skeletal survey (WBSS), Magnetic resonance (MR) and 18F-FDG PET/CT are imaging techniques routinely used for the evaluation of bone involvement in MM patients.AimAs MM bone lesions may present low 18F-FDG uptake; the aim of this study was to assess the possible added value and limitations of 11C-Choline to that of 18F-FDG PET/CT in patients affected with MM.MethodsTen patients affected with MM underwent a standard 11C-Choline PET/CT and an 18F-FDG PET/CT within one week. The results

Long-term adoptive immunotherapy achieves complete response and bone lesion repair in an elderly patient with macrofocal multiple myeloma.

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Clinicopathologic characteristics, metastasis-free survival, and skeletal-related events in 628 patients with skeletal metastases in a tertiary orthopedic and trauma center.

BACKGROUND: Skeletal-related events (SREs) due to bone metastases (BM) significantly impact the morbidity and mortality of cancer patients. The present study sought to investigate clinicopathological characteristics, metastasis-free survival (MFS), and SREs in patients referred to a tertiary orthopedic and trauma center. METHODS: Data were retrieved from electronic health records (n=628). Survival curves were estimated utilizing the Kaplan-Meier method. The Cox regression model was used to determine factors influencing MFS based on estimated hazard ratios (HRs). RESULTS: Breast (55.8%) and l

Efficacy and safety of C-arm computed tomography-guided microwave ablation with percutaneous osteoplasty for flat bone metastases.

BACKGROUND: Flat bone metastases are common in patients with advanced cancers, often resulting in severe pain, limited mobility, and reduced quality of life (QOL). Traditional treatment options, such as radiotherapy or systemic therapies, often fail to provide sufficient pain relief or improve functional outcomes in these patients. Microwave ablation (MWA) offers advantages, such as shorter procedure times and larger ablation zones, while percutaneous osteoplasty (PO) enhances bone stability and prevents pathological fractures. Despite these benefits, the combination of these techniques for tr

Multifocal intraosseous hemangioma: A case report.

RationaleMultifocal intraosseous hemangioma, which affects multiple body parts, is rare. The selection of appropriate lesion sites for biopsy and effective treatment in multifocal intraosseous hemangioma is challenging. Here, we report a case of multifocal intraosseous hemangioma.Patient concernsA 49-year-old woman was admitted to our department with a chief complaint of aggravated lumber pain for 10 days.DiagnosesRadiographic imaging revealed lesions involving the bilateral ribs, lumbar vertebrae, ilium, pubis, and proximal femur. Open biopsy in the ilium established the pathological diagnosi

Challenges in the management of bone metastases: focus on differentiated thyroid cancer and neuroendocrine tumors.

Bone metastases represent an uncommon but clinically significant complication in endocrine malignancies including differentiated thyroid cancer and neuroendocrine tumors. Although these malignancies typically follow an indolent course, the development of bone metastases is associated with a worse prognosis and increased risk of skeletal-related events. The optimal strategies for the prevention and management of bone metastases in these patients remain unclear and are largely extrapolated from studies in other solid tumors. This presents a unique clinical challenge as treatment decisions need t

Clinical Efficacy of Microwave Ablation Combined with Percutaneous Osteoplasty in the Treatment of Flat Bone Metastases.

PurposeEvaluating the clinical efficacy and safety of microwave ablation combined with percutaneous osteoplasty (MWA + PO group) versus percutaneous osteoplasty (PO group) for the treatment of flat bone metastases.MethodsPatients with flat bone metastases and intractable pain who underwent PO and/or MWA from January 2016 to January 2023 in our hospital were included, with 36 cases in the MWA+PO group and 21 cases in the PO group. Changes in the visual analog scale (VAS), Oswestry Disability Index (ODI), and quality of life assessment scale(QOL) were evaluated regularly. Postoperative complicat

Expert consensus on resection of chest wall tumors and chest wall reconstruction.

Chest wall tumors are a relatively uncommon disease in clinical practice. Most of the published studies about chest wall tumors are usually single-center retrospective studies, involving few patients. Therefore, evidences regarding clinical conclusions about chest wall tumors are lacking, and some controversial issues have still to be agreed upon. In January 2019, 73 experts in thoracic surgery, plastic surgery, science, and engineering jointly released the Chinese Expert Consensus on Chest Wall Tumor Resection and Chest Wall Reconstruction (2018 edition). After that, numerous experts put forw

Case Report with Literature Review: Tumor-induced osteomalacia from a soft-tissue phosphaturic mesenchymal tumor of the trunk.

BACKGROUND: Tumor-induced osteomalacia (TIO), a type of acquired hypophosphatemic osteomalacia, is brought on by tumors producing excessive levels of fibroblast growth factor 23, which raises renal phosphorus excretion. METHODS: Through a review of the literature, we have outlined the clinical characteristics of 33 patients with soft-tissue TIO of the trunk and described a case of TIO brought on by a soft-tissue tumor on the back. RESULTS: A 63-year-old woman who had been experiencing generalized bone pain for approximately three years visited the hospital. Physical examination revealed a ro

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… She underwent lumbar internal fixation surgery for lumbar disc herniation at other hospitals more than a year earlier and was later admitted to our outpatient clinic in February with a diagnosis of bilateral rib fractures. She was managed conservatively at our hospital as an outpatient. … fractures, generalized bone pain, and muscle weakness | 3 | 1.6 mg/dL (2.5–4.9 mg/dL) | 68Ga-DOTATATE PET-CT | Left upper lobe of lung | 3.5 cm | Surgical resection | Complete resolution | 36 | HPT-PMT syndrome | NA Todesco et al. ( 31 ) | 2021 | 62 M | Weight loss and multiple fractures | NA | NA | …

Myeloma: Patient accounts of their pathways to diagnosis.

BackgroundPathways to myeloma diagnosis can be prolonged, and are often preceded by multiple GP consultations and emergency presentation. This is the first qualitative study to examine events leading to diagnosis by asking patients about their experiences during this time.MethodsSet within a UK population-based cohort, semi-structured interviews were conducted with 20 myeloma patients with varying characteristics and pathways, 12 of whom invited their relatives to take part. Interviews were audio-recorded and qualitative analysis undertaken.ResultsPre-diagnostic awareness of myeloma was minima

Diagnosis, treatment, and follow-up of patients with hypophosphatasia.

INTRODUCTION: Hypophosphatasia is a rare inherited systemic metabolic disorder, with an estimated prevalence in the severe forms of the disease of 1/100.000-1/300.000, that affects the typical architecture of bone, leading to defective mineralization during growth and remodeling. It is characterized by loss-of-function variants in the ALPL gene, resulting in low activity of tissue-nonspecific alkaline phosphatase. In severe cases, it can be fatal. OBJECTIVE: To generate recommendations on the diagnosis, treatment, and follow-up of patients with hypophosphatasia based on available evidence. M

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… Lethal HPP is named so because death occurs in utero or the first weeks of life due to the absence of skeletal mineralization, pulmonary hypoplasia, rib fractures, or pyridoxine-responsive seizures that are non-responsive to usual anticonvulsant treatment [ 23 , 25 ]. … Kidneys: nephrocalcinosis Calcium metabolism: hypercalcemia and hypercalciuria Thoracic deformity: knobs of bone at the costochondral joints, rib fractures Childhood Radiological findings | Fractures Limbs bones deformities/shortening Craniosynostosis cranial radiograph showing cooper-beaten pattern …

Explosive Disease Progression After Single-Agent B-cell Maturation Antigen-Targeted Treatment in Multiple Myeloma: A Report of Three Cases in Sheikh Shakhbout Medical City.

Patients with "penta-refractory" multiple myeloma (MM) are challenging to treat given the limited treatment options available to them. Belantamab mafodotin is the first B-cell maturation antigen (BCMA)-targeting antibody-drug conjugate approved for the treatment of relapsed/refractory MM (RRMM). In this case report, we reviewed in detail three female patients who were diagnosed with MM international scoring system (ISS)-3 and were heavily pretreated, and refractory to CD38 monoclonal antibodies, two proteasome inhibitors, and two immunomodulatory agents. These patients were started on belantam

Imatinib-based therapy in adult Philadelphia chromosome-positive acute lymphoblastic leukemia: A case report and literature review.

Acute lymphoblastic leukemia (ALL) has a rapid onset and rarely occurs with exclusive prodrome of general osteoporosis and vertebral compression fractures. However, Philadelphia chromosome-positive (Ph+) ALL has a poor prognosis, even when patients are treated with intensive chemotherapy, and the first-line effective treatment requires further elucidation. The present study focused on a 56-year-old Chinese male patient who initially presented with spontaneous bone fractures and was ultimately diagnosed as Ph+ ALL after 6 months, which required to preliminarily exclude a working diagnosis of my

Romosuzumab used to treat a 29-year-old patient with anorexia nervosa related osteoporosis - A case report.

Osteoporosis and decreased bone density is a frequent complication of anorexia nervosa (AN). As of yet, there have been no studies of accomplished treatment of AN-related osteoporosis with romosuzumab, a monoclonal antibody to sclerostin. We report the first case of a premenopausal, 29-year old patient in Switzerland with decreased bone density and osteoporotic fractures due to anorexia nervosa, who completed the treatment with romosuzumab. There was a significant increase in bone mineral density (BMD) after 12 months of therapy. No serious side effects were reported. To date, only bisphosphon

Apical lung mass-A rare presentation of multiple myeloma.

Multiple myeloma is a neoplastic proliferation of immunoglobulin-producing plasma cells with clinical features resulting from infiltration of plasma cells into bones and other organs. Multiple myeloma manifesting as an apical lung mass is less common and very few cases have been reported. We report the case of a 50-year-old female who presented with an apical lung mass which happened to be multiple myeloma arising from the upper ribs into the lung. At the time of diagnosis, patient had axillary lymph node metastasis with extensive bony involvement. This case report and literature review provid

Несекретарша с несколькими миеломами с плохими реакциями на химиотерапию на основе Даратумумаба.

Несекретарская миелома (NSMM) — вариант множественных миелом, определяемый без обнаруживаемого секреции белка М в сыворотке или моче электрофорезе. Из-за отсутствия обнаруживаемого " пика М " диагноз часто является сложным и опирается на исследования костного мозга. В связи с отсутствием исследований, конкретно посвященных НУМР, нынешние руководящие принципы лечения основаны на исследованиях по скрытию множественной миеломы. В данном случае мы описываем следующее: 77-year-old пациентка с типичным представлением NSMM, которая не отреагировала на химиотерапию на основе daratumumab.

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… Past medical history included chronic back and pelvic pain and a history of hairline rib fractures thought secondary to osteoporosis. Home medications were alendronate, calcium citrate, and cholecalciferol. …

Fractures and survival in multiple myeloma: results from a population-based study.

Multiple myeloma causes lytic bone lesions and fractures. The impact of fractures on multiple myeloma (MM) survival is unclear. The aim of this study was to evaluate the effect of fractures on survival in MM using data from MM patients diagnosed in Sweden in the years 1990-2013, identified from the Swedish Cancer Registry. Information on date of birth, MM diagnosis, fractures, and death was collected from central registries. A Cox regression model was used to compare survival in patients with and without a fracture at MM diagnosis and another Cox model was used with fracture as a time-dependen