Faculty Bibliography

We present the case of a patient with malignant transformation of a liposclerosing myxofibrous tumor. The patient had a histologically confirmed liposclerosing myxofibrous tumor that, during a course of 22 months, spontaneously transformed into a lesion appearing like a benign giant cell reactive lesion and subsequently into a high-grade bone sarcoma. Few such cases of spontaneous malignant transformation of liposclerosing myxofibrous tumor have been reported. We report what we believe to be the first case documenting spontaneous transformation of a liposclerosing myxofibrous tumor into an intermediate lesion with benign-appearing histologic features and then into a high-grade malignant tumor.

BACKGROUND: Strain injury to the adductor longus muscle is a common cause of groin pain in athletes and generally occurs in the proximal portion of the muscle, near its origin from the anterior aspect of the pubis. The composition and cross-sectional anatomy of this muscle's origin has not been previously described. HYPOTHESIS: We hypothesize that the adductor longus muscle origin is composed mainly of muscle fibers and that the tendon composes only a small part of the cross section at the origin of the muscle. STUDY DESIGN: Descriptive laboratory study. METHODS: We harvested 42 adductor longus muscles from 28 cadavers and measured the cross-sectional dimensions of the tendon with microcalipers. Next, we determined the relative contributions of the tendon and muscle fibers to the cross-sectional anatomy of the muscle using optical scanning. These 2 sets of measurements were obtained at 3 locations: at the muscle origin and 1.0 and 2.0 cm distal to the origin. RESULTS: The average length and width of the tendon was 11.6 and 3.7 mm, respectively, at the origin. The average cross-sectional areas of the tendon were 49.3, 27.9, and 25.7 mm(2) at points 0.0, 1.0, and 2.0 cm from its origin, respectively. The origin of the adductor longus muscle was composed of 37.9% tendon and 62.1% muscle tissue. At 1.0 cm from the origin, the percentage of tendon decreased to 34%. At 2.0 cm from the origin, the tendon composed 26.7% of the cross section. CONCLUSION: The cross-sectional area of the tendon of the adductor longus muscle is relatively small. The muscle origin is composed predominantly of direct attachment of muscle fibers. CLINICAL RELEVANCE: Knowledge of the cross-sectional anatomy of the adductor longus muscle at its origin may help clinicians better understand the complex nature of injuries in this area