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10 downloadsThis model is the left foot and ankle skin rendering of a 65-year-old male with left thigh myxoid fibrosarcoma. At the time of diagnosis, the patient had metastases to his lungs. The patient therefore underwent neoadjuvant radiotherapy, surgery, and adjuvant chemotherapy and was found to have an intermediate grade lesion at the time of diagnosis. The patient unfortunately died 9.5 months after diagnosis. This is an STL file created from DICOM images of his CT scan which may be used for 3D printing. Topographical landmarks of the foot and ankle consist of muscular, tendinous, and bony structures. Proximally, the superficial muscles of the anterior (tibialis anterior), lateral (peroneals) and posterior (gastrocnemius) compartments may be palpated. Anteriorly, the tibialis anterior tendon crosses the ankle joint and is used as a landmark for ankle joint injections and aspirations, where the practitioner will place the needle just lateral to the tendon. Posteriorly, the gastrocnemius and soleus converge to form the Achilles tendon. Ruptures of the tendon as well as tendinous changes due to Achilles tendinopathy may be palpated. At the level of the ankle joint, the joint line, medial malleolus (distal tibia) and lateral malleolus (distal fibula) may be palpated. The extensor hallucis longus and extensor digitorum longus tendons are visible at the surface of the dorsal foot. The extensor digitorum brevis muscle belly is seen on the dorsum of the lateral foot. On the plantar foot, the plantar fascia may be palpated. Nodules associated with plantar fascial fibromatosis may be palpated here. Plantar fasciitis is also diagnosed when pain is associated with palpation of the insertion of the plantar fascia on the medial heel. Other common pathologies on the plantar foot are ulcerations associated with diabetic neuropathy and other neuropathic conditions. This model was created from the file STS_023.
2 downloadsThis model is the left lower extremity skin rendering of a 65-year-old male with left thigh myxoid fibrosarcoma. At the time of diagnosis, the patient had metastases to his lungs. The patient therefore underwent neoadjuvant radiotherapy, surgery, and adjuvant chemotherapy and was found to have an intermediate grade lesion at the time of diagnosis. The patient is still living with the metastatic disease at 2.5 years since diagnosis. This is an STL file created from DICOM images of his CT scan which may be used for 3D printing. Myxoid fibrosarcoma (or myxoid MFH) is the most common subtype of MFH, at about 10%-20% of cases. Clinically, the tumor presents as a deep, slow-growing, painless mass. It is located more commonly in the lower extremities and retroperitoneum. Imaging on MRI demonstrates a mass with low signal intensity on T1-weighting imaging, and high signal intensity on T2-weighted imaging. On histology, a myxoid background is present with a storiform (or cartwheel) pattern seen on low-power imaging, seen in fibrosarcomas. A “myxoid background” is composed of a clear, mucoid substance. Treatment includes radiation, wide surgical resection, and chemotherapy in selected cases. However, the 5-year survival is 50%-60% depending on size, grade, depth and presence of metastasis. The term “malignant fibrous histiocytoma” was coined in the 1960s by Margaret R. Murray when histology a sarcoma demonstrated an appearance like histiocytes, with characteristics of phagocytosis and a pleomorphic pattern. With further research, this entity was identified to have a wider range of appearances with a fibrous characteristic. Today, these sarcomas are known as “pleomorphic sarcomas.” Recently, a change in the understanding of soft tissue tumors has purported that MFH is not a specific type of cancer, but a common morphologic pattern shared by unrelated tumors. One school of thought states that this morphologic pattern is shared by tumors as a common final pathway in cancer progression whereas another school of thought believes that true pleomorphic sarcomas are the result of a transformation from mesenchymal stem cells. Future research into understanding the pathway of these sarcomas and progression will help to target specific therapies and, hopefully, eventual cures. This model was created from the file STS_022.