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. 1995 Feb;48(2):177–178. doi: 10.1136/jcp.48.2.177

Heterotopic ossification induced by hypoxia in a retrosternal gastric tube following transhiatal oesophagectomy.

H C Buscher 1, J J van Lanschot 1, A H Mulder 1, H W Tilanus 1
PMCID: PMC502405  PMID: 7745119

Abstract

A 71 year old man underwent retrosternal gastric tube reconstruction following transhiatal oesophagectomy for squamous cell carcinoma. On the second post-operative day, the patient developed a cardiac arythmia with secondary hypotension followed by hypoxaemia necessitating artificial ventilation. Two weeks after surgery, endoscopy revealed massive necrosis of the proximal segment of the gastric tube extending from the anastomosis in the neck to the watershed area. Three weeks later, the patient died and a necropsy was performed. Macroscopic evaluation of the gastric tube revealed a sharply demarcated and fully ossificated proximal segment. Heterotopic ossification was present on histological examination. This condition has only been described in conjunction with primary or metastatic gastric adenocarcinoma. The location of the ossification and the presence of temporary systemic hypoxia suggest that the latter was the main factor responsible for the ossificative response.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ACKERMAN L. V. Extra-osseous localized non-neoplastic bone and cartilage formation (so-called myositis ossificans): clinical and pathological confusion with malignant neoplasms. J Bone Joint Surg Am. 1958 Apr;40-A(2):279–298. [PubMed] [Google Scholar]
  2. Ackerman N. B. Bone formation in the gastric mucosa following subtotal gastrectomy in rats. Exp Mol Pathol. 1968 Aug;9(1):125–130. doi: 10.1016/0014-4800(68)90056-7. [DOI] [PubMed] [Google Scholar]
  3. Akiyama H., Tsurumaru M., Kawamura T., Ono Y. Principles of surgical treatment for carcinoma of the esophagus: analysis of lymph node involvement. Ann Surg. 1981 Oct;194(4):438–446. doi: 10.1097/00000658-198110000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. An H. S., Ebraheim N., Kim K., Jackson W. T., Kane J. T. Heterotopic ossification and pseudoarthrosis in the shoulder following encephalitis. A case report and review of the literature. Clin Orthop Relat Res. 1987 Jun;(219):291–298. [PubMed] [Google Scholar]
  5. Moorehead R. J., Wong J. Gangrene in esophageal substitutes after resection and bypass procedures for carcinoma of the esophagus. Hepatogastroenterology. 1990 Aug;37(4):364–367. [PubMed] [Google Scholar]
  6. Pierie J. P., de Graaf P. W., Poen H., van der Tweel I., Obertop H. Incidence and management of benign anastomotic stricture after cervical oesophagogastrostomy. Br J Surg. 1993 Apr;80(4):471–474. doi: 10.1002/bjs.1800800422. [DOI] [PubMed] [Google Scholar]
  7. Rhone D. P., Horowitz R. N. Heterotopic ossification in the pulmonary metastases of gastric adenocarcinoma: report of a case and review of the literature. Cancer. 1976 Oct;38(4):1773–1780. doi: 10.1002/1097-0142(197610)38:4<1773::aid-cncr2820380453>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  8. Werner B., Dahm K., Breucker H. Ossification in cancer of the stomach: an experimental study. Z Krebsforsch Klin Onkol Cancer Res Clin Oncol. 1976 Jun 15;86(2):147–154. doi: 10.1007/BF00284002. [DOI] [PubMed] [Google Scholar]
  9. Yannopoulos K., Katz S., Flesher L., Geller A., Berroya R. Mesenteritis ossificans. Am J Gastroenterol. 1992 Feb;87(2):230–233. [PubMed] [Google Scholar]

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