Acetabular avascular necrosis following high-dose steroid treatment and chemotherapy for leukemia

We present a case of a 20-year-old man with ALL who was diagnosed with debilitating AVN of both acetabula 2  years following initial diagnosis of ALL and treatment with a multi-agent chemotherapy regimen including high-dose corticosteroids. After unsuccessful treatment with bisphosphonate therapy, the acetabular AVN underwent bilateral curettage and impaction bone grafting to prevent collapse of subchond ral fractures with the hope of salvaging both hip joints. Computer tomography (CT) of the AVN affected areas, pre- and post-bone impaction grafting, demonstrated healing of the subchondral fractures and a doubling of bone density that was maintained at 2 years after surgery. The patient resumed ful l weight-bearing at 3 months after first surgery, continues to ambulate unrestricted, and remains pain free 3 years post-surgery.
Source: Skeletal Radiology - Category: Radiology Source Type: research

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The aim of this study was to identify early clinical and laboratory features that distinguish acute lymphoblastic leukemia (ALL) from juvenile idiopathic arthritis (JIA) in children presenting with persistent ...
Source: Pediatric Rheumatology - Category: Rheumatology Authors: Tags: Research article Source Type: research
A 14-year-old boy presented with bilateral knee pain. He had acute lymphoblastic leukemia, B precursor, and had received chemotherapy for 2  years. Following induction and consolidation therapy, maintenance therapy with methotrexate, mercaptopurine, dexamethasone, and vincristine was given. The patient complained of bilateral knee pain in week 103 of maintenance therapy. Physical examination yielded unremarkable findings, and an radiog raphs showed intact bony structures. Magnetic resonance imaging (MRI) showed bone infarction with a “map”-like appearance of bilateral femurs and tibias (Figures 1, 2, ...
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Rediscovering the Physical Exam Source Type: research
Conclusion: This case demonstrates the importance of a broad differential diagnosis for a child presenting with leg pain and fever. PMID: 31528139 [PubMed]
Source: Ochsner Journal - Category: General Medicine Tags: Ochsner J Source Type: research
AbstractIntroductionIntussusception, which is common in pediatric patients but rare in adults with leukemia, usually presents with an intralumenal lesion as a lead point in adults.Case reportWe herein report the case of a 38-year-old female who developed right lower quadrant abdominal pain and fever on day 16 of chemotherapy. Abdominal computed tomography showed ileocecal intussusception. The patient underwent surgery, and the definitive pathological diagnosis was typhlitis leading to intussusception. Albeit very rare in adults, typhlitis-induced intussusception should be suspected in those with leukemia presenting with abdominal pain.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Publication date: Available online 12 August 2019Source: Gynecologic Oncology ReportsAuthor(s): Jamil Kazma, Cynae Johnson, Nitin Jain, Vasantha Lakshmi Gali, Ken H. Young, Amir A. JazaeriAbstractThe involvement of the cervix as a site of relapse for hematologic malignancies is rare. We herein present a case of relapsed B-cell Acute Lymphoblastic Leukemia/Lymphoma (ALL) mimicking advanced cervical cancer. The patient is a 61-year-old female with history B-cell ALL and had multiple relapses confined to the bone marrow and had received several different chemotherapy regimens. She presented with lower abdominal pain after the...
Source: Gynecologic Oncology Reports - Category: OBGYN Source Type: research
ConclusionAsparaginase is a common cause of antineoplastic-induced liver injury with jaundice, typically with short latency, marked steatosis, and prolonged jaundice, which can lead to delays in antileukemic therapy. The cause of injury is likely direct inhibition of hepatic protein synthesis caused by asparagine depletion.
Source: Hepatology International - Category: Infectious Diseases Source Type: research
We present a 2-year-old boy with bilateral foot pain that worsened over 6 months. X-rays of the feet showed no obvious abnormalities. Magnetic resonance imaging revealed abnormal bone marrow consistent with an infiltrative process. The patient was found to have precursor B-cell acute lymphoblastic leukemia. Cases such as these highlight the possible future use of magnetic resonance imaging in the early diagnostic workup for bone and muscle pain. PMID: 31384202 [PubMed]
Source: Baylor University Medical Center Proceedings - Category: Universities & Medical Training Authors: Tags: Proc (Bayl Univ Med Cent) Source Type: research
Authors: Byrnes DM, Vargas F, Dermarkarian C, Kahn R, Kwon D, Hurley J, Schatz JH Abstract Acute lymphoblastic leukemia and other aggressive lymphoid malignancies like Burkitt leukemia/lymphoma have high incidence of central nervous system (CNS) involvement. Various solid tumors, most notably breast cancer, can also metastasize into the CNS as a late stage complication causing devastating effects. Intrathecal (IT) chemotherapy consisting of methotrexate, cytarabine, or the two in combination is frequently used for the prophylaxis and treatment of CNS metastasis. Because of the high toxicity of these chemotherapeuti...
Source: Journal of Oncology - Category: Cancer & Oncology Tags: J Oncol Source Type: research
Rationale: The differential diagnosis of conditions manifesting as bone and joint pain is complex. Although many individuals with acute leukemia experience bone pain, lumbosacral pain as an early feature of acute lymphoblastic leukemia (ALL) is rare. Patient concerns: Here we report a case of an adult who presented with a 7-month history of persistent lumbosacral pain which had become more severe during the previous month. Diagnoses: Prior to referral, his full blood count revealed no abnormalities, and a computerized tomography scan revealed mild bone hyperplasia of his lumbar vertebrae, with disc herniations of L...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Reena Goswami1, Gayatri Subramanian2, Liliya Silayeva1, Isabelle Newkirk1, Deborah Doctor1, Karan Chawla2, Saurabh Chattopadhyay2, Dhyan Chandra3, Nageswararao Chilukuri1 and Venkaiah Betapudi1,4* 1Neuroscience Branch, Research Division, United States Army Medical Research Institute of Chemical Defense, Aberdeen, MD, United States 2Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States 3Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States 4Department of Physiology and Biophysics, Case Western Reserve University, Clev...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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