Exostosis múltiple hereditaria: revisión de los fundamentos moleculares, el diagnóstico y las posibles estrategias terapéuticas.(2021)

Artículo de revisión (Polonia)
Volumen 12 - 2021 |https://doi.org/10.3389/fgene.2021.759129
Exostosis múltiple hereditaria: revisión de los fundamentos moleculares, el diagnóstico y las posibles estrategias terapéuticas.
Ewelina Bukowska-Olech 1† ‡ * 10 de diciembre de 2021

El síndrome de exostosis múltiple hereditaria (EMH), también conocido como osteocondromas múltiples, representa un trastorno esquelético humano raro y grave. La enfermedad se caracteriza por múltiples crecimientos óseos benignos recubiertos de cartílago, denominados exostosis u osteocondromas, que se localizan con mayor frecuencia en las porciones yuxtaepifisarias de los huesos largos. 

Las personas afectadas suelen quejarse de dolor persistente causado por la presión sobre los tejidos vecinos, la alteración de la circulación sanguínea o, raramente, por la compresión de la médula espinal. 

Sin embargo, la complicación más grave de esta afección es la transformación maligna en condrosarcoma, que ocurre hasta en el 3,9 % de los pacientes con EMH. 

La enfermedad se debe principalmente a alteraciones heterocigotas con pérdida de función en los genes EXT1 o EXT2  que codifican las glicosiltransferasas asociadas al aparato de Golgi, responsables de la biosíntesis de heparán sulfato. 

Algunos pacientes con HME no presentan variantes patogénicas en esos genes, lo que sugiere la presencia de mutaciones somáticas, variantes intrónicas profundas u otros genes/loci. 

Esta revisión presenta un análisis sistemático de los conceptos celulares y moleculares actuales de las HME, junto con sus características clínicas, métodos de diagnóstico clínico y molecular, diagnóstico diferencial y posibles opciones de tratamiento. Continua AQUI el articulo.........

Nota: En la Biografia un caso español: 

¿Que son los Osteocondromas hereditarios múltiples?

Otros nombres:
HMO; Exostosis hereditarias múltiples; Exostosis hereditaria múltiple; rarediseases.info.nih.go, 4/9/2018 

Resumen
Los osteocondromas hereditarios múltiples (HMO), también llamados exostosis hereditarias múltiples, es un trastorno genético que causa el desarrollo de múltiples cartílagos cubiertos, tumores en las superficies externas de los huesos ( osteocondromas ). Los osteocondromas generalmente se hacen evidentes durante la infancia o la adolescencia, y el número, el tamaño y la ubicación de los osteocondromas varían de persona a persona. Los signos y síntomas pueden incluir dolor, disminución del rango de movimiento, choque nervioso, deformidad, diferencias en la longitud de las extremidades, baja estatura y fracturas. 

Los osteocondromas de las costillas pueden causar complicaciones como un colapso pulmonar ( neumotórax ), hemotórax o derrame pericárdico . [1] [2] [3]

Los osteocondromas generalmente crecen durante la infancia y dejan de crecer cuando se cierran las placas de crecimiento. [1] 

Sin embargo, se repiten más tarde en algunas personas. [1] 

Si bien la gran mayoría de los osteocondromas son benignos (no cancerosos), pueden volverse malignos (cancerosos) en la edad adulta en 2% a 5% de las personas con HMO. [1] [2]
La mayoría de los casos de HMO son causados ​​por una mutación en EXT1 o EXT2 gene con dominante autosómico-herencia. [1] [3] 

Alrededor del 96% de las mujeres con una mutación responsable de HMO desarrollarán osteocondromas (un fenómeno conocido como penetrancia reducida), y el 100% de los hombres desarrollarán osteocondromas. [1] [3]

El tratamiento depende de la ubicación y el tamaño de los osteocondromas y la gravedad de los síntomas que causan. Los ejemplos de opciones de tratamiento incluyen un enfoque de "observar y esperar" (cuando no hay síntomas presentes), extirpación quirúrgica del tumor, osteotomía correctiva y detención de la placa de crecimiento o procedimientos para alargar las extremidades. [1] [3] 

Si bien los osteocondromas benignos generalmente no afectan la esperanza de vida, aún pueden causar una variedad de problemas de salud y síntomas debilitantes que pueden afectar la calidad de vida. [2] [4]

Los osteocondromas que se vuelven malignos (convirtiéndose en condrosarcomas u osteosarcomas) pueden ser potencialmente mortales, pero el pronóstico en estos casos puede depender del grado del tumor . [2] [4]

¿Que son los Osteocondromas Multiples Congénitos?

Echando un vistazo a la RED, he encontrado estos 2 documentos sobre OMC, bastante actualizados.
1.- Presentación por parte de la Dr. Camila Azocar Sanhuez de la 

     University of Chile. Departamento de Traumatología (2014).
2.- Presentado por la Sociedad Europea de Radiología (ESR) en el 

     SERAM 2014
3.- Guia Metabólica sobre OMC/HME (2015), Hospital Infantil San Joan de Deu (Barcelona)

Bibliografia sobre OMC

http://www.portalesmedicos.com/publicaciones/articles/2089/3/Dolor-de-hombro-en-paciente-con-exostosis-multiple.-A-proposito-de-un-caso-clinico

Dolor de hombro en paciente con exostosis multiple. A proposito de un caso clinico
Autor: M. E. Mesa Rivero Publicado: 27/03/2010
Traumatologia , Imagenes de Radiodiagnostico y Radioterapia , Imagenes de Traumatologia , Casos Clinicos de Traumatologia

Bibliografía:
1. Gupta PP, Agarwal D. A middle-aged manwith persisting chest opacity and permanent bony swelling. CMAJ 2006 Nov 15 ; 31 (24): E920-4

2. Manish Chadha, MS; Arun Pal Singh, MS. Secondary chondrosarcoma of the cuboid bone in a patient with multiple exostosis. Can J Surg, 2008.Vol. 51 (1).

3. Judith VMG Bovée. Multiple osteochondromas. Orphanet Journal of Rare Diseases 2008, 3:3

4. Carolyn M. Sofka, MD& Gregory R. Saboeiro, MD& Robert Schneider, MD. Multiple Hereditary Exostoses. HSSJ (2005) 1:49–51.

5. J V M G Bovée, R J B Sakkers, M J A Geirnaerdt, A H M Taminiau, P C W Hogendoorn. Intermediate grade osteosarcoma and chondrosarcoma

6. Arising in an osteochondroma. A case report of a patient with hereditary multiple exostoses.J Clin Pathol 2002;55:226–229

Salupedia: Enciclopedia Medica Virtual

http://www.actasanitaria.com/actasanitaria/frontend/desarrollo_noticia.jsp?idCanal=3&idContenido=10990
MÉDICOS Y PACIENTES CONSTRUYEN LA PRIMERA ENCICLOPEDIA MÉDICA VIRTUAL EN INTERNET
Madrid 18/12/2008

A través de la colaboración entre profesionales de la Salud y ciudadanos ha nacido 'Salupedia', una enciclopedia médica en Internet, creada gracias a la subvención del Ministerio de Industria y el respaldo la Asociación Española de Pediatría, la Asociación Médica Argentina y la Universidad Politécnica de Valencia.

Este proyecto, dirigido por el Instituto ITACA-TSB y realizado por TSB Soluciones, contó con Ignacio Basagoiti como director del mismo.
"Salupedia' es el fruto del extraordinario esfuerzo de ciudadanos y profesionales de la salud, por conseguir un acceso seguro a la información sanitaria en Internet", apuntó Basagoiti.
En esta línea, "la creación de una comunidad de usuarios donde los profesionales recomienden contenidos, ya existentes pero dispersos en la red, a pacientes, familiares y ciudadanos en general, constituye una experiencia enriquecedora para ambos grupos", añadió el experto.

Información segura sobre salud.
De esta manera, el ciudadano encuentra un lugar donde acceder a información confiable sobre salud, recomendada por profesionales.
El profesional, a su vez, dispone de un lugar de confianza donde dirigir a sus pacientes cuando quiere prescribir información.

"Salupedia es muchas cosas, una enciclopedia, una Web social, una comunidad, una experiencia de Web 2.0, etc., pero es, sobre todo, una herramienta que permite recomendar y recibir información segura sobre salud. Es la primera vez que se pone en marcha un proyecto como éste y poder hacerlo en nuestro idioma da idea de la madurez que ha alcanzado el Español en Internet", señaló Basagoiti.

Una de las más importantes actividades de los profesionales de la salud es recomendar información y educar a la población.
Los ciudadanos incorporan más fácilmente actividades preventivas, siguen mejor su medicación y obtienen mayores beneficios clínicos cuando entienden lo que les ocurre y se implican en su proceso de curación.
Salupedia es, en este sentido, una enciclopedia médica familiar que recupera, clasifica y ordena, la mejor información sanitaria contenida en Internet, creada por una comunidad de profesionales y ciudadanos cuyos roles y actividades diferenciadas certifican y enriquecen dicha información.

Referencia Bibliografica Cancer de Hueso, Cuba

REFERENCIAS BIBLIOGRÁFICAS.
DeCS: BONE NEOPLASMS; DIAGNOSTIC TECHNIQUES, RADIOISOTOPE
Texto original en la página: www.amc.sld.cu/amc/2003/v7n2/542.htm

REFERENCIAS BIBLIOGRÁFICAS

Enneking WF, Conrad I I I EV. Common Bone Tumors. Summit CIBA. Geigy. 1989; 2. 45.
Enneking WF, Wolf RE. The staging and surgery of musculoskeletal neoplasm. Clin Orthop. 1996; 27: 433-81.
Enneking WF. A system of staging musculoskeletal neoplasms. Clin Oncol 1987; 1:97-109.
Gitelis S, Wilkins RA, Conrad I I I EU. Bening Bone Tumors. J Bone Joint Surg 1995; 77: 1756-81.
Coombs RR, Friedlaender GT. Bone Tumor Management. 1987. p 3-47.
Adler CP, Kozlowski KK. Primary Bone Tumors and Tumorous. Conditions in children. Berlin: Springer-Verlag; 1993. p. 9-119.
Carnesale PG. General Principles of Tumors. En: Crenshaw AH. Camprell's operative Orthopaedics. 8 ed. St Louis: Mosby; 1992. p. 641-94.
Turerk SL. Ortopedia. Principios y aplicaciones. La Habana: Editorial Científico Técnica; 1982. p. 641-94.
Springfield DS, Enneking WF, Neff JR, Makley JT. Principles of Tumor Management. AAOS. St Louis: Mosby; 1988. p. 1-26.
Unni KK. Dahlin's Bone Tumors. General aspects and data on 11,087 cases. 5 ed. Philadelphia: Lippincott-Raven; 1996. p.1-196.
Schajowicz FA. Tumors and Tumorlike Lesions of Bone and Joint. New York: Springer Verlag; 1981. p. 1-243, 417-518.
Fergunson AB. Orthopaedic Surgery in Infancy and childhood. 5 ed. Baltimore: William & Wilkins; 1982.p. 511-48.
Springfield OS. Musculoskeletal Tumors. En: Canale St, Beaty JH. Operative Pediatric Orthopaedics. St Louis: Mosby Year Book; 1991. p. 1073-1113.
Richards BS. OKU: Pediatrics. Rosemont. AAOS. 1996; p. 55-64.
Staheli LT. Fundamentals of pediatric Orthopaedics. New York: Raven Press; 1992. p. 13.1-13.10.
Wizggkowicz PZ, Lane JM, Eckardt JJ. Primary Tumors and Tumorous conditions. En: Callaghan JJ, Rosemberg AG, Rubash HE. The adult Hip. Philadelphia: Lippincott Raven; 1998. p. 527-46.
Pritchard DJ, Unni KK. Neoplasm of the Elbow. En: Morrey BF. The Elbow and its disorders 2 ed. Philadelphia: WB Saunders; 1993. p. 843-59.
Bradford DS, Bueff HU. Benign and Malignant Tumors of the spine. En: Lonstein JE, Bradford DS, Winter RB, Ogilvie JW. Text book of scoliosis and other spinal deformities. Philadelphia: WB Saunders; 1995. p. 483-501.
Craver RD. Laboratory evaluation of pediatric Bone and Soft tissue tumors. Clin Orthop. 1996; 27: 461-71.
Henry JM. Bone and Soft tissue tumors. En: CMC Evarts. Surgery of the musculoskeletal system 2 ed. New York: Churchill Livingstone; 1990. p. 4595-5053.
Staheli LT. Pediatric Orthopaedic secrets. Philadelphia: Hanley Belfuls; 1998. p. 317-32.
Tolo VT. Tumor management. J Pediatr Orthop 1997; 17: 421-23.
Eijken JW. Strategy in the treatment of Benign Bone Tumors. An overview. J Pediatr Orthop 1998; 7: 249-52.
Manking HJ, Gebhardt MC. Long term results of allograft replacement in the management of Bone tumors. Clin Orthop 1996; 24: 86-97.
Valls O, Marinello Z. Tumores y lesiones seudotumorales del esqueleto. La Habana: Editorial Científico Técnica; 1979. p.17, 215, 253, 265, 371-396.
Aboulafia AJ, Kennon RE, Jenilek JE. Benign Bone Tumors of Childhood. JAAOS 1999; 377-88.
Widhe BS,Widhe TS. Initial symptoms and clinical features in osteosarcoma and Ewing sarcoma. JBJS 2000;667-74.
Marco AW,Gitelis S. Cartilage Tumors. Evaluation and Treatment. JAAOS 2000; 292-304.
Takesita H, Kuzusaki K. Intrinsic Resistance to Chemotherapeutic Agents in Murine Osteosarcoma Cells. JBJS 2000; 963-69.
Winkelman WW. Type B III Rotationoplasty. An Alternative Operation for the Treatment of Malignant Tumors of the Femur in early Childhhod. JBJS 2000; 814-28.

Bibliografia sobre el Caso Peruano, 1995

Revista Peruana de Reumatología : Volumen 1 Nº 3, Año 1995 LIMA-PERU
sisbib.unmsm.edu.pe/.../v01_n3/espondilitis.htm
Documento original en: sisbib.unmsm.edu.pe/.../v01_n3/espondilitis.htm

Bibliografía
1. Van Der Linden S, Valkenburg H, Cats A.: Evaluation of diagnostic criteria for Ankylosing Spondylitis. Arth Rheum 1984; 27(4): 361-68.
2. Resnick D, Niwayama G: Parathiroid disorders and renal osteodistrophy. En Diagnosis of bone and joint disorders. Resnick & Niwayama. W.B. Saunders Company 1981; vol 2: pp 1850-55.
3. Resnick D,: Additional congenital or heritable anomalies and syndromes. En Diagnosis of bone and joint disorders. Resnick & Niwayama. W.B. Saunders Company 1981; vol 3: pp 2618-29.
4. Alfaro J, Rodríguez Z, Torres C, Acevedo E: Prevalencia del HLA-B27 en pacientes con diagnóstico definitivo de espondilitis anquilosante y en controles sanos en población mestiza peruana. Boletín Asoc Per Reumatol 1994; 13(3): A-27.

Bibliografia sobre HME/OMC en los Perros (v.o. Inglés)

http://images.google.es/imgres?imgurl=http://cal.vet.upenn.edu/saortho/chapter_75/75f8.jpg&imgrefurl=http://cal.vet.upenn.edu/saortho/chapter_75/75mast.htm&h=475&w=521&sz=113&hl=es&start=14&tbnid=uzyUS0UJWrYzyM:&tbnh=119&tbnw=131&prev=/images%3Fq%3DEXOSTOSIS%2BMULTIPLE%26gbv%3D2%26svnum%3D10%26hl%3Des%26sa%3DG
Benign Bone Tumors in the Dog
Michael H. Goldschmidt and Donald E. Thrall

References
1. Banks WC, Bridges CH: Multiple cartilaginous exostoses in a dog. J Am Vet Med Assoc 129: 131, 1956
2. Diamond S S. Raflo C P. Anderson M P : Multilobular osteosarcoma in the dog. vet Pathol 17:759, 1980
3. Foley RH: Osteoma in two young dogs. J Am Anim Hosp Assoc 14:253, 1978
4. Gambardella PC, Osborne CA, Stevens JB: Multiple cartilaginous exostoses in the dog. J Am Vet Med Assoc 166:761, 1975
5. Gee BR, Doige CE: Multiple cartilaginous exostoses in a litter of dogs. J Am Vet Med Assoc 156:53, 1970
6. Hamilton JM, Knight D: Cartilaginous tumours in dogs. A description of two cases with a review of the literature. Vet Rec 92:41, 1973
7. Jacobson SA: The Comparative Pathology of Tumors of Bone. Springfield, IL, Charles C. Thomas, 1971
8. Lange AL, Stogdale L: Chondroma rodens in a dog. J S Afr Vet Med Assoc 49:60, 1978
9. Ling GV, Morgan JP, Pool RR: Primary bone tumors in the dog: A combined clinical, radiographic and histologic approach to early diagnosis. J Am Vet Med Assoc 165:55, 1974
10. Liu SK, Dorfman HD: The cartilage analogue of fibromatosis (juvenile aponeurotic fibroma) in dogs. Vet Pathol 11 :60, 1974
11. Liu SK, Dorfman HD, Hurvitz AI et al: Primary and secondary bone tumours in the dog. J Small Anim Pract 18:313, 1977
12. Owen LN, Bostock DE: Multiple cartilaginous exostoses with development of metastasizing osteosarcoma in a Shetland sheepdog. J Small Anim Pract 12:507, 1971
13. Owen LN, Nielsen SW: Multiple cartilaginous exostoses (diaphyseal aclasis) in a Yorkshire terrier. J Small Anim Pract 9:519, 1968
14. Pool RR: Tumors of bone and cartilage. In Moulton J (ed): Tumors in Domestic Animals, 2nd ed, pp 89-149. Berkeley, University of California Press, 1978
15. Prata RG, Stoll SG, Zaki FA: Spinal cord compression caused by osteocartilaginous exostoses of the spine in two dogs. J Am Vet Med Assoc 166:371, 1975
16. Spjut HL, Dorfman HD, Fechner RF et al: Tumors of bone and cartilage. In Atlas of Tumor Pathology, second series, fascicle 5. Washington, DC, Armed Forces Institute of Pathology, 1976
17. Weller RE, Breznock EM: Cartilaginous bone tumor in a dog. Mod Vet Pract 59:193, 1978
18. Zaki FA, Liu SK, Kay WJ: Calcifying aponeurotic fibroma in a dog. J Am Vet Med Assoc 166:384, 1975

Un Libro: Principios de Medicina Interna. Por Harrison Med.

Harrison Principios de Medicina Interna 16a edición
http://www.harrisonmedicina.com/content.aspx?aID=102072&searchStr=osteocondromatosis

Parte XIV. Endocrinología y metabolismo
Sección 2. Trastornos del metabolismo óseo y mineral: Otras displasias de hueso y cartílago
Sections: Otras displasias de hueso y cartílago, Paquidermoperiostosis , Osteocondrodisplasias , Acondrodisplasia , Encondromatosis , Exostosis múltiples .
Temas tratados: acondroplasia; encondromatosis; osteoartropatía hipertrófica; osteocondromatosis; síndrome de maffucci; síndrome de osteocondrodisplasia.

Extracto: "La paquidermoperiostosis u osteoartropatía hipertrófica (primaria o idiopática) es un trastorno autosómico dominante caracterizado por la formación de hueso nuevo perióstico que afecta las partes más distales de las extremidades.

Las lesiones se manifiestan por hipocratismo digital e hiperhidrosis y engrosamiento de la piel, principalmente de la cara y la frente. Los cambios suelen aparecer durante la adolescencia, avanzan en el siguiente decenio y luego se vuelven quiescentes.
Durante la fase activa, el crecimiento progresivo de las manos y los pies produce un aspecto semejante al de una garra que puede confundirse con acromegalia. También se presentan artralgias, seudogota y limitación de la movilidad.

El trastorno debe distinguirse de la osteopatía hipertrófica secundaria que se desarrolla durante la evolución de los trastornos pulmonares graves.
Los dos trastornos pueden diferenciarse con las radiografías estándar de los dedos de las manos, en las cuales la paquidermoperiostosis secundaria produce una abundante formación de hueso nuevo perióstico y una superficie lisa y ondulante.
En cambio, la osteopatía hipertrófica primaria se caracteriza..."

Todo sobre Exostosis Multiples u Osteocondromas

Información básica sobre el estado de Investigación sobre HME/OMC.
Nos referimos a NCBI- PubMed, donde estan todos los Informes medicos sobre Exostosis Múltiples u Osteocondromas y sus efectos:
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pubmed&LinkReadableName=Related%20Articles&IdsFromResult=4547842&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Otra Direccion: http://www.upmc.com/HealthManagement/ManagingYourHealth/HealthReference/Diseases/?chunkiid=127516

Más Información: http://wimp.nsm.uh.edu/ext-ref.html

Desde Japón: Radiological Study of the Pattern of Multiple Cartilaginous Exostosis Lesions in Children and Classification According to Severity
Journal of Saitama Medical School & Taniguchi Kazhuhiko (Department of Orthopaedics, Saitama Medical Center, Saitama Medical School )
http://ci.nii.ac.jp/naid/110000450750/en/

Bibliografia sobre Tumores Oseos.

http://www.arturomahiques.com/bibliografia.htm

General
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* American Academy of Orthopaedic Surgeons: Actualizaciones en Cirugia Ortopédica y Traumatología. Volumen 4. Garsi. Madrid 1993.
* American Academy of Orthopaedic Surgeons: Actualizaciones en Cirugia Ortopédica y Traumatología. Volumen 5. Masson. Barcelona 1997.
* American Academy of Orthopaedic Surgeons: Actualizaciones en Cirugia Ortopédica y Traumatología. Volumen 5. Masson. Barcelona 1997.
* Baron, M. G.; de la Gandara, I.; Espinosa, E.; de Paredes, M.L. G.;Zamora, P.; and Mondejar, J. L.: Bone metastases as the first manifestationof a tumour. Internat. Orthop., 15: 373-376, 1991.
* Belliveau, R. E., and Spencer, R. P.: Incidence and sites of bonelesions detected by Tecnecio-99m-polyphosphate scans in patientswith tumors. Cancer, 36: 359-363, 1975.
* Berger, P. E., and Kuhn, J. P.: Computed tomografía of tumors of the musculosqueletyc system in children. Radiology, 127: 171-175, 1978.
* Bernardino, M. E.; Jing, B.-S.; Thomas, J. L.; Lindell, M. M., Jr.;and Zornoza, Jesus: The extremity soft-tissue lesion: acomparativestudy of ultrasonido, computed tomografía, and xeroradiography.Radiology, 139: 53-59, 1981.
* Berquist, T. H.: Magnetic resonance imagen of musculoesqueléticos neoplasms. Clin.Orthop.,244: 101-118, 1989.
* Bowers, T. A.; Murray, J. A.; Charnsangavej, Chusilp; Soo, C.-S.;Chuang, V. P.; and Wallace, Sidney: Bone metastases from renal carcinoma.The preoperative use of transcatheter arterial occlusion. J. Boneand Joint Surg., 64-A: 749-754, June 1982.
* CAMPANACCI M. et RUGGIERI P. - Tumeurs osseuses: Classification, diagnostic et principes thérapeutiques. - Encycl. Méd.-Chir. (Elsevier, Paris-France), Appareil locomoteur, 14-030-A-10, 1992, 12 p.
* Chang, A. E.; Schaner, E. G.; Conkle, D. M.; Flye, M. W.; Doppman,J. L.; and Rosenberg, S. A.: Evaluation of computed tomografíain the detection of pulmonary metastases. A prospective study.Cancer, 43: 913-916, 1979.
* Collin, C.; Godbold, J.; Hajdu, S.; and Brennan, M.: Localizedextremity soft tissue sarcoma: an analysis of factors affectingsurvival. J. Clin. Oncol., 5: 601-612, 1987.
* de Santos, L. A.; Goldstein, H. M.; Murray, J. A.; and Wallace,Sidney: Computed tomografía in the evaluation of musculoesqueléticos neoplasms. Radiology, 128: 89-94,1978.
* Didolkar, M. S.; Fanous, N.; Elias, E. G.; and Moore, R. H.: Metástasiscarcinomas from occult primary tumors. A study of 254 patients.Ann. Surg., 186: 625-630, 1977.
* Enneking, W. F.; Chew, F. S.; Springfield, D. S.; Hudson, T. M.; andSpanier, S. S.: The role of radionuclide bone-scanning in determiningthe resectability of soft-tissue sarcomas. J. Bone and JointSurg., 63-A: 249-257, Feb. 1981.
* Finn, H. A.; Simon, M. A.; Martin, W. B.; and Darakjian, Hrair:Gammagrafía with galio-67 citrate in staging of soft-tissue sarcomasof the extremity. J. Bone and Joint Surg., 69-A: 886-891, July 1987.
* Greenspan A., Remagen W. - Differential diagnosis of tumors and tumor-like lesions of bone and joints. Philadelphia: Lippincott-Raven Pub.
* Holmes, F. F., and Fouts, T. L.: Metástasis cancer of unknownprimary site. Cancer, 26: 816-820, 1970.
* Hudson, T. M.; Haas, George; Enneking, W. F.; and Hawkins, I. F.,Jr.: Angiography in the management of musculoesqueléticos tumors. Surg.,Gynec. and Obstet., 141: 11-21, 1975.
* Jaffe, Norman; Robertson, Resa; Ayala, Alberto; Wallace, Sidney;Chuang, Vincent; Anzai, Takashi; Cangir, Ayten; Wang, Y.-M.; andChen, Timothy: Comparison of intra-articular cis-diamminedichloroplatinumII with high-dose methotrexate and citrovorumfactor rescue in the treatment of primary osteosarcoma. J. Clin.Oncol., 3: 1101-1104, 1985.
* Jeon DG et al. Algorithm for the surgical treatment of malignant lesions of the proximal tibia. CORR No 358 1999. p 15.
* Kirchner, P. T., and Simon, M. A.: Current concepts review. Radioisotopicevaluation of skeletal disease. J. Bone and Joint Surg.,63-A: 673-681, April 1981.
* Kirchner, P. T., and Simon, M. A.: The clinical value of bone andgalio gammagrafía for soft-tissue sarcomas of the extremities.J. Bone and Joint Surg., 66-A: 319-327, March 1984.
* Kransdorf, M. J.; Jelinek, J. S.; Moser, R. P., Jr.; Utz, J. A.;Brower, A. C.; Hudson, T. M.; and Berrey, B. H.: Soft-tissue masses:diagnosis using MR imagen. AJR: Am. J. Roentgenol., 153: 541-547,1989.
* Lange, T. A.; Austin, C. W.; Seibert, J. J.; Angtuaco, T. L.; andYandow, D. R.: Ultrasonido imagen as a screening study for malignantsoft-tissue tumors. J. Bone and Joint Surg., 69-A: 100-105, Jan.1987.
* Levin, D. C.; Watson, R. C.; and Baltaxe, H. A.: Arteriographyin diagnosis and management of acquired peripheral soft-tissuemasses. Radiology, 104: 53-58, 1972.
* Lleander, V. C.; Goldstein, G.; and Horsley, J. S., III: Chemotherapyin the management of metástasis cancer of unknown primarysite. Oncology, 26: 265-270, 1972.
* Lodwick, G. S.: A systematic approach to the roentgen diagnosisof bone tumors. In Tumors of Bone and Soft Tissues, pp. 49-68.Chicago, Year Book Medical, 1965.
* Mankin, H. J.; Lange, T. A.; and Spanier, S. S.: The hazards ofbiopsy in patients with malignant primary bone and soft-tissue tumors.J. Bone and Joint Surg., 64-A: 1121-1127, Oct. 1982.
* Martel, William, and Abell, M. R.: Radiologic evaluation of softtissue tumors. A retrospective study. Cancer, 32: 352-366, 1973.
* McLeod, R. A., and Stephens, D. H.: Computed tomografía of pelvic musculoesqueléticos neoplasm.Contemp.Orthop., 1: 36-41, Oct. 1979.
* McMillan, J. H.; Levine, Errol; and Stephens, R. H.: Computedtomografía in the evaluation of metástasis adenocarcinoma from anunknown primary site. A retrospective study. Radiology, 143: 143-146,1982.
* McNeil, B. J.: Rationale for the use of bone scans in selectedmetástasis and primary bone tumors. Sem. Nucl. Med., 8: 336-345,1978.
* Mercuri M., Casadei M.: Patellar Tumors. CORR 2001;2001:35-46
* Miller, W. E.; Crowe, J. K.; and Muhm, J. R.: The evaluation ofpulmonary parenchymal abnormalities by tomografía. Radiol. Clin. NorthAmerica, 14: 85-93, 1976.
* Mosende, Crisanta; Gutierrez, Manuel;Caparros, Brenda; and Rosen,Gerald: Combination chemotherapy with bleomycin, cyclophosphamideand dactinomycin for the treatment of osteogenic sarcoma.Cancer, 40: 2779-2786, 1977.
* Muhm, J. R.; Brown, L. R.; and Crowe, J. K.: Detection of pulmonarynodules by computed tomografía. AJR: Am. J. Roentgenol., 128:267-270, 1977.
* Muhm, J. R.; Brown, L. R.; and Crowe, J. K.: Use of computed tomografíain the detection of pulmonary nodules.Mayo Clin. Proc., 52:345-348, 1977.
* Myhre-Jensen, Olaf: A consecutive 7-year series of 1331 benignsoft tissue tumours. Clinicopathologic data. Comparison with sarcomas. Acta Orthop.Scandinavica, 52: 287-293, 1981.
* Norman, A.: The value of tomografía in the diagnosis of skeletaldisorders. Radiol. Clin. North America, 14: 251-258, 1976.
* Nottebaert, M.; Exner, G. U.; von Hochstetter, A. R.; and Schreiber,A.: Metástasis bone disease from occult carcinoma: a profile.Internat. Orthop., 13: 119-123, 1989.
* Nystrom, J. S.; Weiner, J. M.; Heffelfinger-Juttner, Joan; Irwin,L. E.; Bateman, J. R.; and Wolf, R. M.: Metástasis and histologicpresentation in unknown primary cancer.Sem. Oncol., 4:53-58, 1977.
* Nystrom, J. S.; Weiner, J. M.; Wolf, R. M.; Bateman, J. R.; andViola, M. V.: Identifying the primary site in metástasis cancer ofunknown origin. Inadequacy of roentgenographic procedures. J. Am. Med.Assn., 241: 381-383, 1979.
* Panza, Nicola; Lombardi, Gaetano; De Rosa,Michelle; Pacilio,Giovanni; Lapenta, Liliana; and Salvatore, Marco: High serum thyroglobulinlevels. Diagnostic indicators in patients with metastasesfrom unknown primary sites. Cancer, 60: 2233-2236, 1987.
* Petasnick, J. P.; Turner, D. A.; Charters, J. R.; Gitelis, Steven;and Zacharias, C. E.: Soft-tissue masses of the locomotor system:comparison of MR imagen with CT. Radiology, 160: 125-133, 1986.
* Quinn, S. F.; Erickson, S. J.; Dee, P. M.; Walling, A.; Hackbarth,D. A.; Knudson, G. J.; and Moseley, H. S.: MR imagen in fibromatosis:results in 26 patients with pathologic correlation. AJR: Am.J. Roentgenol., 156: 539-542, 1991.
* Rosenthal, D. I.: Computed tomografía in bone and soft tissueneoplasm: application and pathologic correlation. CRC Crit. Rev.Diag. Imag., 18: 243-278, 1982.
* Rougraff, B. T.; Kneisl, J. S.; and Simon, M. A.: Skeletal metastasesof unknown origin: prospective evaluation of a diagnostic strategy.Unpublished data.
* Rydholm, Anders, and Berg, N. O.: Size, site and clinical incidenceof lipoma. Factors in the differential diagnosis of lipoma andsarcoma. Acta Orthop. Scandinavica, 54: 929-934, 1983.
* Rydholm, Anders; Gustafson, Pelle; Rooser, Bo; Willen, Helena;and Berg, N. O.: Subcutaneous sarcoma. A population-based study of129 patients. J. Bone and Joint Surg., 73-B(4): 662-667, 1991.
* Schajoviwich F.: Tumores y Lesiones pseudotumorales de huesos y articulaciones. editorial panamericana. Buenos Aires, 1982.
* Schajoviwich F.:Tumors and tumor like lesions of bone and joints. Springer-Verlag. New York - Beidelberg - Berlin
* Schaner, E. G.; Chang, A. E.; Doppman, J. L.; Conkle, D. M.; Flye, M.W.; and Rosenberg, S. A.: Comparison of computed and conventionalwhole lung tomografía in detecting pulmonary nodules: a prospectiveradiologic-pathologic study. AJR: Am. J. Roentgenol., 131:51-54, 1978.
* Schreiman, J. S.; Crass, J. R.; Wick, M. R.; Maile, C. W.; andThompson, R. C., Jr.: Osteosarcoma: role of CT in limb-sparing treatment.Radiology, 161: 485-488, 1986.
* Simon, M. A., and Bartucci, E. J.: The search for the primarytumor in patients with skeletal metastases of unknown origin. Cancer,58: 1088-1095, 1986.
* Simon, M. A., and Kirchner, P. T.: Scintigraphic evaluation ofprimary bone tumors. Comparison of tecnecio-99m phosphonate and galio citrate imagen.J. Bone and Joint Surg., 62-A: 758-764, July 1980.
* Simon, M. A., Finn, H. A.: INSTRUCTIONAL COURSE LECTURES, THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS. DIAGNOSTIC STRATEGY FOR BONE AND SOFT-TISSUE TUMORS. Journal of Bone and Joint Surgery, Vol. 75-A, NO. 4, APRIL 1993, pp. 622-631
* Simon, M. A.: Current concepts review.Biopsy of musculoesqueléticos tumors.J.Bone and Joint Surg., 64-A: 1253-1257, Oct.1982.
* Simon, M. A.; Schaaf, H. W.; and Metz, C. E.: Clinical utilityof the erythrocyte sedimentation rate in preoperative evaluationof solitary skeletal lesions. J. Orthop. Res., 2: 262-268, 1984.
Stewart, J. F.; Tattersall, M. H. N.; Woods, R. L.; and Fox, R. M.:Unknown primary adenocarcinoma: incidence of overinvestigation andnatural history. British Med. J., 1: 1530-1533, 1979.
* Thorpe, W. P.; Reilly, J. J.; and Rosenberg, S. A.: Pronósticosignificance of alkaline phosphatase measurements in patientswith osteogenic sarcoma receiving chemotherapy. Cancer, 43: 2178-2181,1979.
* Totty, W. G.; Murphy, W. A.; and Lee, J. K. T.: Soft-tissue tumors:MR imagen. Radiology, 160: 135-141, 1986.
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* Wheeless' Textbook of Orthopaedics: www.medmedia.com/o6/136.htmWoods, R. L.; Fox, R. M.; Tattersall, M. H. N.; Levi, J. A.; andBrodie, G. N.: Metástasis adenocarcinomas of unknown primary site. Arandomized study of two combination-chemotherapy regimens. NewEngland J. Med., 303: 87-89, 1980.
* Zimmer, W. D.; Berquist, T. H.; McLeod, R. A.; Sim, F. H.; Pritchard,D. J.; Shives, T. C.; Wold, L. E.; and May, G. R.: Bone tumors:magnetic resonance imagen versus computed tomografía. Radiology,155: 709-718, 1985.

Estadios quirúrgicos
* Cheng EY and Thompson R.: New Developments in the staging and imaging of soft tissue sarcomas. JBJS. Vol 81-A. No 6. June 1999. p 882.
* Finn HA; Simon MA; Martin WB; Darakjian H.: Scintigraphy with gallium-67 citrate in staging of soft-tissue sarcomas of the extremity. J-Bone-Joint-Surg-Am. 1987 Jul; 69(6): 886-91. We performed a retrospective study of sixty patients who had a activity of the gallium was present in forty-one of forty-eight sites in citrate should be employed routinely for staging of soft-tissue sarcomas.
* Enneking WF.: Current concepts review: The surgical staging of musculoskeletal staging of musculoskeletal sarcoma. JBJS Vol 62-A. 1980. p 1027-1030.
Enneking WF et al.: A system for the surgical staging of musculoskeletal sarcoma. CORR. Vol 153. 1980. p 106-120.
* Mankin HJ; Connor JF; Schiller AL; Perlmutter N; Alho A; McGuire M; Grading of bone tumors by analysis of nuclear DNA content using flow cytometry. J-Bone-Joint-Surg-Am. 1985

* Mar; 67(3): 404-13. We studied 217 consecutive tumors of bone by flow cytometric analysis of nuclear DNA concentration after staining with propidium iodide. A diagnosis and histological grade (benign, low-grade, or high-grade sarcoma) were assigned to each tumor on the basis of staging data (with the exception of the forty-six giant-cell tumors, which, although indistinguishable histologically, were divided according to the flow cytometric pattern into two distinct groups), and we quantitatively studied the flow cytometry data to assess the percentages of cells in diploidy, tetraploidy, or aneuploidy. When compared, the mean values for the flow cytometric data for the three grades showed significant differences. Criteria were established for the three classes of tumors: for benign tumors, less than 11 per cent tetraploidy and no aneuploidy;

* PeabodyaT.D. Simon M. A.: Principles of staging of soft-tissue sarcomas. University of Chicago Medical Center, Section of Orthopaedic Surgery Clin-Orthop. 1993 Apr. (289). P 19-31. * The TNM staging system is a modus for diagnosis and treatment in which T is the extent of the tumor involvement, N is lymph node involvement, and M is the metastases; this system is supplemented with a histologic malignancy grade. Staging systems identify specific prognostic factors with which to predict clinical outcome. Staging systems are useful for assigning treatment priorities, determining the role of adjuvant therapies, and evaluating clinical investigations. Unfortunately, no universally accepted staging system for soft-tissue sarcomas exists. This is related to the relatively low incidence of sarcomas, the unique and unpredictable behavior of sarcomas, significant disagreement regarding histogenesis and grading, and lack of consensus regarding the value of various prognostic factors. In adults, the two most commonly used staging systems are those developed by the American Joint Committee on Cancer and by Enneking. In children, the Intergroup Rhabdomyosarcoma Study and the International Union Against Cancer have described the systems most commonly used. These systems for soft-tissue sarcomas rely on an ability to accurately determine both the local and distant extent of disease. Advances in the field of computed tomography and magnetic resonance imaging have made this possible. It is likely that a staging system based upon a more sophisticated understanding of the basic biology of sarcomas will become available. Author-abstract.

* Saddegh M-K. Lindholm J. Lundberg A. Nilsonne U. Kreicbergs A.: Staging of soft-tissue sarcomas. Prognostic analysis of clinical and pathological features. Dept of Orthopaedics, Karolinska Hospital, Stockholm, Sweden. J-Bone-Joint-Surg-[Br]. 1992 Jul. 74(4). P 495-500. In a retrospective study of all 137 patients with soft-tissue sarcoma treated by surgery between 1972 and 1984, the clinical course was related to several host and tumour features, including the Surgical Staging System of Enneking, Spanier and Goodman (1980). Only patients free from metastasis with untreated primary lesions on admission were included. According to the Surgical Staging System, nine tumours were IA, 18 IB, 38 IIA and 72 IIB. Only 12 patients underwent amputation; 125 were treated by local surgery. The mean follow-up time was ten years (minimum five). For the whole series the probability of seven-year survival was 0.65; 42 patients (31%) died from tumour disease. All these had metastases and 24 also had local recurrence. The local recurrence rate was 36%. Multivariate analysis identified large tumour size and high histological grade as significant risk factors for metastatic disease and tumour-related death. Sex, age, tumour site, surgical margin and local recurrence showed no correlation with survival. The prognostic contribution of compartmentality was virtually nil. Histological grade combined with tumour size was found to give better prognostic information than that obtained by the Surgical Staging System. Author-abstract.

Estudios de imagen
* Moser R. Personal communication 1992.
* Edeiken J. Roentgen diagnosis of diseases of bone. (4th ed.) Baltimore: Williams & Wilkins, 1989 (Harris JJ, ed. Golden's diagnostic radiology).
* Helms, CA. Personal communication, 1983.
* Madewell JE, Ragsdale BD, Sweet DE. Radiologic and pathologic analysis of solitary bone lesions. Part I: Internal margins. Radiol Clin N Am 1981;19:715-748.
* Panuel M, Gentet JC, Scheiner C, Jouve JL, Bollini G, Petit P, Bourliere-Najean B, Devred P. Physeal and epiphyseal extent of primary malignant bone tumors in childhood. Correlation of preoperative MRI and the pathologic examination. Pediatr Radiol 1993;23:421-424.
* Norton KI, Hermann G, Abdelwahab IF, Klein MJ, Granowetter LF, Rabinowitz JG. Epiphyseal involvement in osteosarcoma. Radiology 1991;180:813-816.
* Ragsdale BD, Madewell JE, Sweet DE. Radiologic and pathologic analysis of solitary bone lesions. Part II: Periosteal reactions. Radiol Clin N Am 1981;19:749-783.

Metástasis óseas
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I X. Peabody TD. Evaluation and management of carcinoma metastatic to bone. Curr Opin Orthop 1996;7:75-79
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Bibliografia HME/OMC Escapular, Cuba 2003

http://bvs.sld.cu/revistas/ort/vol17_1-2_03/ort191-203.htm
COMPLEJO CIENTÍFICO ORTOPÉDICO INTERNACIONAL "FRANK PAÍS".
CIUDAD DE LA HABANA, CUBA

Referencias bibliográficas
1.- Galate JF, Blue JM, Gaines RW. Osteochondroma of the scapula. Mo Med 1995;92(2):95-7.
2.- Blacksin MF, Benevenia J. Neoplasms of the scapula. Am J Roentgenol 2000;174:1729-35.
3.- Calafiore G, Bertone C, Urgelli S, Rivera F, Maniscalco P. Osteochondrom: report of a case with atypical localization and symptomatology. Acta Biomed Ateneo Parmense 2001;72(5-6):91-6.
4.- López Martína N, Calvo Crespo E, Álvarez Galovicha L. Tumores de escápula de estirpe cartilaginosa. Rev Ortop Traum 2002;46:259-62.
5.- Campanacci M, Ruggieri P. Tumeurs osseuses á histogenése cartlagineuse. En: Dorfmann H, ed. Encyclopédie médico chirurgicale: aparato locomotor. París: Elsevier Science; 1992 p. 660-92.
6.- Shackcloth MJ, Page RD. Scapular osteochondroma with reactive bursitis presenting as a chest wall tumour. Eur J Cardiothorac Surg 2000;18(4):495-6.
7.- Okada K, Terada K, Sashi R, Hoshi N. Large bursa formation associate with osteochondroma of the scapula: a case report and review of the literature. J Clin Oncol 1999; 29(7):356-60.
8.- Ben Hamouda M, Allegue M, Bergaoui N, Dahmene J, Korbi S, Moula T, et al. Scapular exostosis complicated by bursitis: apropos of a case. J Radiol 1993;74(3):143-6.
9.- Bloch AM, Nevo Y, Ben-Sira L, Harel S, Shahar E. Winging of the scapula in a child with hereditary multiple exostoses. Pediatric Neurol 2002;26(1):74-9.
10.- Vande Lune DW. Osteochondroma of the scapula. Mo Med 1995;92(6):296-301.
11.- Craig EV. Subacromial impigment symdrome in hereditary multiple exostoses. Clin Orthop 1986;(209):182-4.
12.- Griffiths HJ, Thompson RC Jr, Galloway HR, Everson LI, Suh JS. Bursitis in association with solitary osteochondromas presenting as mass lesions. Skeletal Radiol 1991;20(7):513-6.
13.- Than P, Balint L, Kustos T. The Scapula: rare localization of osteochondroma. Orv Hetil 1995;136(38):2047-9.

Recibido: 16 de diciembre de 2002. Aprobado: 4 de marzo de 2003.
Dr. Juan Entenza Surí.
Complejo Científico Ortopédico Internacional “Frank País”.
Ave. 51 No. 9603 entre 196 y 202.
La Lisa. Ciudad de La Habana.
Cuba.

Bibliografia HME/OMC en Español

Correspondencia:
Alberto Giménez Bascuñana.
Servicio de Anatomía Patológica
Hospital Morales Meseguer.
Murcia, España.
mailto:watson1@teleline.es

BIBLIOGRAFIA
1. Brien EW, Mirra JM, Kerr R. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. Skeletal Radiol, 1997; 26: 325-53.

2. Willms R, Hartwig CH, Bohm P, Sell S. Malignant transformation of a multiple cartilaginous exostosis: a case report. Int Orthop, 1997; 21: 133-6.

3. Mehta M et al. MR imaging of symptomatic osteochondromas with pathological correlation. Skeletal Radiol, 1998; 27: 427-33.

4. Claikens B, Brugman E, Oosterlinck D. Synovial osteochondromatosis. JBR-BTR, 2000; 83: 10.

Bibliografia sobre HME/OMC: Español e Inglés

BIBLIOGRAFÍA
1. Beitins IZ. Opportunities and challenges in pediatric clinical research. J Clin Endocrinol Metab 1999; 84: 4302-4306.
2. Argente J, Pérez-Jurado LA, Sotos JF. Bases moleculares de la patología del crecimiento. Rev Esp Ped 2000 (en prensa).
3. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa,K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature 1999; 402: 656-660.
4. Le Roith D, Butler AA. Insulin-like growth factors in pediatric health and disease. J Clin Endocrinol Metab 1999; 84: 4355-4361.

5. Parks JS, Brown MR, Hurley DL, Phelps CJ, Wajnrajch MP. Heritable disorders of pituitary development. J Clin Endocrinol Metab 1999; 84: 4362-4370.
6. López-Bermejo A, Buckway CK, Rosenfeld RG. Genetic defects of the growth hormone-insulin-like growth factor axis. TEM 2000; 11: 39-49.
7. Rao E, Weiss B, Takami M, y cols. Pseudoautosomal deletions encompassing a novel homeobox gene cause growth failure in idiopathic short stature and Turner syndrome. Nauture Genet 1997; 16: 54-62.

8. Binder G, Schwarze CP, Ranke MB. Identification of short stature caused by SHOX defects and therapeutic effect of recombinant human growth hormone. J Clin Endocrinol Metab 2000; 85: 245-249.
9. Conley ME, Burks AW, Herrog HG, Puck JM. Molecular analysis of X-linked agammaglobulinemia with growth hormone deficiency. J Pediatr 1992; 119: 392-397.
10. Ogata T, Tomita K, Hida A, Matsuo N, Nakahori Y, Nakagome Y. Chromosomal localization of a Y specific growth gene(s). J Med Genet 1995; 32 (7): 572-575.
11. Joyce CA, Sharp A, Walker JM, Bullman H, Temple IK. Duplication of 7p12.1-p13, including GRB10 and IGFBP1, in a mother and daughter with features of Silver-Russell syndrome. Hum Genet 1999; 105: 273-280.

12. Monk D, Wakeling EL, Proud V, Hitchins M, Abu-Amero SN, Stanier P, Preece MA, Moore GE. Duplication of 7p11.2-p13, including GRB10, in Silver-Russell syndrome. Am J Hum Genet 2000; 66: 36-46.
13. Sotos JF. Overgrowth, section II. Clin Pediatr 1996; 35: 579-590. 14. Eugster EA, Pescovitz OH. Gigantism. J Clin Endocrinol Metab 1999; 84: 4379-4384.
15. Juul A. Skakkebaek NE. Prediction of the outcome of growth hormone provocative testing in short children by measurement of serum levels of IGF-I and IGFBP-3. J Pediatr 1997; 130: 197-204.
16. Nagel BHP, Palmbach M, Ranke MB. Magnetic resonance imaging in growth hormone deficiency. En: Ranke Mb, Wilton P, eds.. Growth hormone therapy in KIGS-10 years’experience. Heidelberg, Leippzig: Barth; 1999; 65-71.

17. Guyda HJ. Four decades of growth hormone therapy for short children: Whay have we achieved? J Clin Endocrinol Metab 1999; 84: 4307-4316.
18. Laron Z. The essential role of IGF-I lessons from the long-term study and treatment of children and adults with Laron syndrome. J Clin Endocrinol Metab 1999; 84: 4397-4404.
19. Laron Z. Clinical use of insulin-like growth factor-I. Yes or no? Pediatr Drugs 1999; 1: 155-159.
20. Caplan AL, Wilson JM. The ethical challenges of in utero gene therapy. Nat Genet 2000; 24: 107.

Bibliografia en MedLine:1998-2000

Referencias Bibliográficas:
1. Wong KT, Chu WC, Griffith JF, Chan YL, Kumta SM, Leung PC. Pseudoaneurysm complicating osteochondromas: Sympton relief with embolization. Clin Orthop. 2002;1:339-42. 2. Murphey MD, Choi JJ, Kransdorf MJ, Flemming DJ, Gannon FH. Imaging of osteochondroma: Variants and complications with radiologic-pathologic correlation. Radiographics. 2000;20:1407-34. [Medline]
3. Vasseur MA, Fabre O. Vascular complications of osteochondromas. J Vasc Surg. 2000;31:532-8. [Medline]
4. Pérez-Burkhardt JL, Gómez JC. Postraumatic popliteal pseudoaneurysm from femoral osteochondroma: Case report and review of the literature. J Vasc Surg. 2003;37:669-71. [Medline]
5. Wiater JM, Farley FA. Popliteal pseudoaneurysm caused by an adjacent osteochondroma: A case report and review of the literature. Am J Orthop. 1999;28:412-6. [Medline]
6. Smits AB, Moll FL. Unusual arterial complications caused by an osteochondroma of the femur or tibia in young patients. Ann Vasc Surg. 1998;12:370-2. [Medline]
7. Matsushita M, Nishikimi N, Sakurai T, Nimura Y. Pseudoaneurism of the popliteal astery caused exostosis of the fémur: Case report and review of the literature. J Vasc Surg Surg. 2000;32:201-4.

Bibliografia Caso Cubano

Recibido: 16 de diciembre de 2002. Aprobado: 4 de marzo de 2003.
Dr. Juan Entenza Surí.
Complejo Científico Ortopédico Internacional “Frank País”.
Ave. 51 No. 9603 entre 196 y 202.
La Lisa. Ciudad de La Habana.
Cuba.
1 Profesor Titular de Ortopedia y Traumatología del ISCM-H. Especialista de II Grado en Ortopedia y Traumatología.
2 Especialista de I Grado en Ortopedia y Traumatología.
3 Residente de IV año de Ortopedia y Traumatología.
4 Especialista de I grado en Imagenología. Jefa del departamento de Radiología.
5 Especialista de II Grado en Ortopedia y Traumatología. Instructor.


Referencias bibliográficas
1.-Galate JF, Blue JM, Gaines RW. Osteochondroma of the scapula. Mo Med 1995;92(2):95-7.
2.-Blacksin MF, Benevenia J. Neoplasms of the scapula. Am J Roentgenol 2000;174:1729-35.
3.-Calafiore G, Bertone C, Urgelli S, Rivera F, Maniscalco P. Osteochondrom: report of a case with atypical localization and symptomatology. Acta Biomed Ateneo Parmense 2001;72(5-6):91-6.

4.- López Martína N, Calvo Crespo E, Álvarez Galovicha L. Tumores de escápula de estirpe cartilaginosa. Rev Ortop Traum 2002;46:259-62.
5.- Campanacci M, Ruggieri P. Tumeurs osseuses á histogenése cartlagineuse. En: Dorfmann H, ed. Encyclopédie médico chirurgicale: aparato locomotor. París: Elsevier Science; 1992 p. 660-92.

6.- Shackcloth MJ, Page RD. Scapular osteochondroma with reactive bursitis presenting as a chest wall tumour. Eur J Cardiothorac Surg 2000;18(4):495-6.
7.- Okada K, Terada K, Sashi R, Hoshi N. Large bursa formation associate with osteochondroma of the scapula: a case report and review of the literature. J Clin Oncol 1999; 29(7):356-60.
8.- Ben Hamouda M, Allegue M, Bergaoui N, Dahmene J, Korbi S, Moula T, et al. Scapular exostosis complicated by bursitis: apropos of a case. J Radiol 1993;74(3):143-6.
9.- Bloch AM, Nevo Y, Ben-Sira L, Harel S, Shahar E. Winging of the scapula in a child with hereditary multiple exostoses. Pediatric Neurol 2002;26(1):74-9.

10.-Vande Lune DW. Osteochondroma of the scapula. Mo Med 1995;92(6):296-301.
11.-Craig EV. Subacromial impigment symdrome in hereditary multiple exostoses. Clin Orthop 1986;(209):182-4.
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Bibliografia Caso Colombia

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Bibliografia sobre HME/OMC I

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Bibliografia 1 en Web sobre HME/OMC

PAG. WEB sobre Exostosis:

contexto original en la página: secure.netterimages.com/image/list.htm?page=8...

contexto original en la página: www.wheelessonline.com/ortho/osteochondroma_o...

contexto original en la página: www.wheelessonline.com/ortho/multiple_cartila...

contexto original en la página: www.flash.net/~drrad/tf/102599.htm

contexto original en la página: www.usc.edu/hsc/dental/opfs/BT/17big.html

contexto original en la página: www.sepeap.es/casos_clinicos/caso1_metab.htm

contexto original en la página: www.accessexcellence.org/.../1knee/exosl.html

http://en.wikibooks.org/wiki/Diagnostic_Radiology/Musculoskeletal_Imaging/Tumors_Basic/Osteochondroma

contexto original en la página: escuela.med.puc.cl/.../12osea2.html

www.rad.washington.edu/mskbook/dysplasia.html

www.osteoporosis-center.com/.../c005-3.htm

www.bachur.com.ar/t_cirugia.htm

www.shoulderdoc.co.uk/patient_info/article.as...

www.amershamhealth.com/.../EXOSTOSIS.ASP

DrAbdulhalimBadr@groups.msn.com

groups.msn.com/.../bonetumorsamptumorlike.msnw

DrAbdulhalimBadr@groups.msn.comDrAbdulhalimBadr

BIBLIOGRAFIA BASICA SOBRE HME/OMC

Referencias Bibliográficas:

1. Pierz KA, Stieber JR, Kusumi K, Dormans JP.“ Hereditary multiple exostoses: One center's experience and review of etiology “.Clin Orthop Relat Res. 2002;(401):49-59.

2. Schmale GA, Conrad EU 3rd, Raskind WH. “ The natural history of hereditary multiple exostoses “. J Bone Joint Surg (Am). 1994;76:986-92. [Medline]

3. http://iier.isciii.es/er/prg/er_bus2.asp?cod_enf = 957

4. Legeai-Mallet L, Munnich A, Maroteaux P, Le Merrer M. “ Incomplete penetrance and expressivity skewing in hereditary multiple exostoses”. Clin Genet. 1997;52:12-6. [Medline]

5. http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id = 133700

6. Porter DE, Emerton ME, Villanueva-López F, Simpson AH. “ Clinical and radiographic analysis of Osteochondromas and growth disturbance in hereditary multiple exostoses “.J Pediatr Orthop. 2000;20:246-50. [Medline]

7. Noonan KJ, Feinberg JR, Levenda A, Snead J, Wurtz LD. “ Natural history of multiple hereditary Osteochondromatosis of the lower extremity and ankle”. J. Pediatr Orthop. 2002;22:120-4. [Medline]

8. Silber JS, Mathur S, Ecker M. “A solitary Osteochondroma of the pediatric thoracic spine: a case report and review of the literature”. Am J Orthop. 2000;29:711-4. [Medline]