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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Treatment of carcinomatous degeneration in patients with chronic osteomyelitis requires differentiation between benign, penetrating epithelioma and invading, low-grade squamous-cell carcinoma. Although most lesions are low grade, analysis of the case histories of twenty-three patients treated at the Mayo Clinic indicates that these tumors do metastasize. When malignant-appearing epithelium invading bone is identified, ablative surgery is indicated. Inadequate surgical treatment resulted in the deaths of two patients in our series. Routine regional lymphadenectomy at the time of amputation seems unnecessary. Regional lymphadenopathy persisting for six to twelve weeks after amputation warrants surgical intervention. With prompt, aggressive surgical treatment, the prognosis for patients with squamous-cell carcinoma in an osteomyelitic cavity is good.
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PMID:Squamous-cell carcinoma complicating chronic osteomyelitis. 100 59

We report the case of a young boy referred to our Department of Nuclear Medicine under the suspicion of a malignant tumor. The leading clinical symptoms were pain in the joints and loss of weight and vitality. Radiographic findings were suggestive of osteogenic sarcoma, but bone scans showed multiple increased tracer depositions along the cortex of femur and tibia, and in the lower and upper jaw. The enrichment pattern was not typical for metastases, but more probably demonstrated the multiple foci of osteomyelitis. This assumption was confirmed by the histological findings, which were diagnosed as primary chronic osteomyelitis. This rare pediatric bone disorder has been described by Giedion et al. The etiology of the disease is unknown, and therapy is discussed controversely in literature.
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PMID:Case report 756: Chronic multifocal osteomyelitis. 143 3

Lymphoma can involve any part of the musculoskeletal system. Primary musculoskeletal lymphoma is rare but can occur in bone (reticulum cell sarcoma) or in the skin and subcutaneous tissues (mycosis fungoides). Secondary involvement in the musculoskeletal system is more common and can have a variety of radiologic findings. The definitive diagnosis of musculoskeletal lymphoma, however, is difficult to make by using imaging criteria alone. Any part of the musculoskeletal system can be involved and, therefore, a wide variety of primary and secondary neoplasms or inflammatory processes may have similar radiologic findings. The main differential diagnostic considerations, depending on the age of the patient and the clinical presentation, include osteosarcoma, Ewing's tumor, metastatic disease (from breast, lung, thyroid, or renal primary lesions), as well as chronic osteomyelitis or myositis. Primary and secondary bone lymphoma can be indistinguishable radiologically and histologically, but modern imaging techniques allow more accurate differentiation of primary from secondary bone involvement. This pictorial essay illustrates the CT findings of primary and secondary lymphoma involving bone, muscle, and skin and subcutaneous tissues.
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PMID:Lymphoma of bone, muscle, and skin: CT findings. 837 91

Malignant fibrous histiocytoma (MFH) was found in the femur of a 28-year-old man who had suffered from chronic osteomyelitis. The patient had undergone surgery for a valgus knee deformity and the procedure was complicated by chronic osteomyelitis which lasted for 12 years. Four months after the onset of painful symptoms related to the occurrence of MFH, gross bone destruction with pathologic fracture and pulmonary metastases were present. The patient died 4 months later. Histopathological and immunohistochemical examinations indicated the diagnosis of MFH.
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PMID:Malignant fibrous histiocytoma in the course of chronic osteomyelitis. 166 83

Squamous cell carcinoma (SCC) arising in a focus of chronic osteomyelitis is a rare but potentially fatal disease. Because of the possibility of metastases, amputation proximal to the site of the tumor is the current standard of therapy. We report the first case of SCC arising in chronic osteomyelitis treated by Mohs micrographic surgery as an alternative method of treatment.
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PMID:Squamous cell carcinoma arising in a site of chronic osteomyelitis. Treatment with Mohs micrographic surgery. 191 84

Malignant change following chronic osteomyelitis with draining sinuses is rare (0.38-2.7%). The time from onset of osteomyelitis until malignant changes differs but needs 30 years in an average. Most patients are men between 50 and 60 years of age. If there is any doubt about malignancy (bleeding, tumor growth) biopsy should be performed and repeated if histological findings give no clear diagnosis. Metastases should be excluded by x-ray of the chest, scintigram and CT of the regional lymphnodes. Correct surgical therapy can only be done by amputation or exarticulation of the extremity. Patients who were operated upon malignant carcinoma of a sinus after osteomyelitis ought to be controlled in a regular follow-up including blood test (tumor marker).
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PMID:[Chronic osteomyelitis and cancer of the fistula]. 292 35

Malignant change at the site of a chronic osteomyelitis, a rare condition, is reported in a 45-year-old man, along with a review of the literature. This patient with a 30-year history of chronic osteomyelitis of the right femur and an intermittently discharging sinus had a large abscess in the lower thigh. The abscess was drained, and an ulcer developed at the mouth of the sinus tract. Soon afterward, he sustained a pathologic fracture through the lower femur. Biopsy specimens of the ulcer showed a well-differentiated squamous carcinoma. An amputation was performed at the level of the proximal 10 cm of the femur. The patient remains well 18 months later with no clinical or radiologic evidence of metastases. Changes in character of a previously innocuous osteomyelitis sinus tract should arouse suspicion of neoplastic transformation. Biopsy of various depths of the sinus tract, including the bone marrow, is essential. Early amputation for squamous cell carcinoma is indicated and offers a good prognosis.
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PMID:Squamous cell carcinoma in chronic osteomyelitis. Report of a case and review of the literature. 402 59

A new nuclear scanning technique was found more specific for bone, joint, and soft tissue infections than any previously described scanning technique. The leukocyte scan, whereby a patient's own cells are labeled with a radioactive tagging agent (111In oxine), can distinguish an active infectious process from other pain-inducing conditions. Ninety-seven 111In labeled autologous leukocyte scans were performed in 88 patients. The findings in 17 of 40 patients scanned for possible acute osteomyelitis, six of nine for suspected septic arthritis, and six for possible soft tissue infections, were positive. Subsequent clinical courses verified the infectious nature of these processes in all patients. Patients who had chronic osteomyelitis (14), bony metastases (four patients), heterotopic ossification (three), and degenerative arthritis (two) demonstrated negative findings. Of the seven patients scanned for acute long-bone fractures, one demonstrated positive findings. Nine scans demonstrated positive findings without determined causes. The leukocyte scan is a useful addition to the diagnostic tools of the orthopedic surgeon.
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PMID:The white blood cell scan in orthopedics. 680 87

We report on two patients with painful hyperostosis of the mandible and the thoracic skeleton. Other symptoms were arthralgia, arthritis, osteitis, and palmoplantar pustulosis. Radiographic analysis revealed regions of circumscribed hyperostosis which showed in increased uptake in scintiscan. Metastasis, chronic osteomyelitis, Ewing's sarcoma, or Paget's disease were excluded and the diagnosis Sapho syndrome was made. This recently introduced acronym describes a disease with Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis. Because of the possible axial skeleton involvement, an association to the spondylathropathy group is still being discussed. The etiopathogenesis of this rheumatologic disease is not known.
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PMID:[Sapho syndrome: 2 case reports]. 788 32

Two cases of carcinoma which had developed in chronic fistulating osteomyelitis are presented. In one case the patient was cured by an above-the-knee-amputation. In the other case the patient was also treated by amputation, but died of metastases. The need for active surgical treatment of chronic osteomyelitis is emphasized.
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PMID:[Squamous cell carcinoma developing in chronic fistulating osteomyelitis]. 832


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