DAVID R. LUCAS
University of Michigan
Ann Arbor, MI
A 21-year-old man with hereditary multiple exostosis (HME) presented with new-onset pain and swelling
in his left leg. Radiographs disclosed a large osteochondroma that formed a synostosis between the
proximal fibula and tibia. The gross resection specimen contained a 10 cm ostechondroma with a
lobulated cartilage cap, which varied from 0.2 to 2.0 cm in thickness. Destructive involvement of the
stalk was not present, and there was no gross evidence of peripheral soft tissue invasion.
GENE P. SIEGAL
University of Alabama
Birmingham, AL
The patient is a 55 year old Caucasian woman who presented with headache and neck pain 3 months
earlier. She was otherwise in excellent health without known major medical illnesses or surgeries. A
course of antibiotic therapy did not relieve her pain. A subsequent trial with steroids was similarly
unsuccessful in alleviating her symptoms.
Three weeks prior to admission to our institution she
developed blurred vision and "double vision" with drooping of her left eyelid.
On physical
examination she appeared healthy but with ptosis of her left eyelid with inhibition of both lateral
and medial gaze. An MRI and CT examination were performed which favored the diagnosis of meningioma
filling the spheroid sinus & pituitary fossa.
Nasal endoscopy demonstrated a mass in the superior
portion of the nasopharynx which was smooth & mucosally-covered. The neck was free of adenopathy and
no lesions were appreciated in the oral cavity.
Following endoscopic evaluation she underwent
biopsy of the mass.
ANDREW HUVOS
Memorial Hospital for Cancer
New York, NY
This is a destructive lytic intramedullary lesion of the right proximal femur in a 7 year old girl.
Imaging workup showed a 9cm intramedullary metadiaphyseal tumor with cortical penetration and adjacent
soft tissue extension. There were no skip lesions nor were any other bones affected. No pulmonary
metastases were demonstrable.
An open biopsy was performed with appropriate immunohistochemical
panel, electron microscopic analysis as well as RT-PCR study.
ANDREW G. ROSENBERG
Massachusetts General Hospital
Boston, MA
A 64 year old woman presented to her physician complaining of a 1 year history of headaches and
diplopia. The symptoms had become progressively more severe during this time period. Radiographic
imaging studies revealed a focally calcified, well circumscribed mass in the region of the clivus that
impinged upon the brain stem. A biopsy was performed.
K. KRISHNAN UNNI
Mayo Clinic
Rochester, MN
22-year-old man presented with pain in the lower back and constipation. Roentgenograms revealed a
mineralizing mass involving the coccyx.
