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Query: UMLS:C0029463 (osteosarcoma)
 16,637 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A surgical technique designed for safe and easy access to the popliteal vessels, resection of a large segment of the tibia and knee joint, and a method of patellar/extensor mechanism reconstruction and soft-tissue coverage that utilizes a transferred medial gastrocnemius muscle is reported. Eleven patients have been treated with this technique, including seven patients with a minimum follow-up evaluation of two years (average, 49.5 months; range, 24.6-84.4 months). There were five males and two females, with an average age of 28.7 years. The histologic diagnoses were osteosarcoma, four patients; malignant fibrous histiocytoma, one patient; chondrosarcoma, one patient; and poorly differentiated sarcoma, one patient. The surgical stages were Stage IIA, one patient, and IIB, six patients. Six intraarticular resections and one extraarticular resection were performed; all were classified as wide excisions. Four prosthetic replacements and three arthrodeses were performed. Pathological specimens showed meniscal and patellar tendon involvement in two patients and pericapsular tibiofibular joint involvement in six patients. Local complications were transient peroneal nerve palsy in four patients and superficial skin slough in one patient. All resections obtained negative margins, and there was no local recurrence or metastatic disease. Functional results (Musculoskeletal Tumor Society System classification) were excellent in one patient, good in four, fair in one, and poor in one. Limb-sparing surgery for high-grade tumors of the proximal tibia is recommended for carefully selected patients.
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PMID:Limb-sparing surgery for high-grade malignant tumors of the proximal tibia. Surgical technique and a method of extensor mechanism reconstruction. 253 5

The artificial materials in limb-saving surgery pose problems such as the age of patient, tolerance and stability. Thus, massive bone grafting should be reconsidered. In our clinic, out of 78 patients having malignant bone tumors, 29 received limb-saving surgery, and 10 of these cases received massive bone grafting using autografts and/or frozen allografts between 1968 and 1987. There were 7 cases with osteosarcoma, 1 case with mesenchymal chondrosarcoma, 1 case with leiomyosarcoma and 1 case with malignant fibrous histiocytoma. There were 5 males and 5 females ranging in age from 11 years to 44 years, and averaging 21 years. According to Enneking's staging system, these were all II-B cases. The median follow-up period was 71 mos, ranging from 13 to 239 mos. According to the modified Amago evaluation method, 80% of these cases had an excellent prognosis, one had a recurrence, but in all cases good bone union and stability were achieved without immunological reaction. Therefore we conclude that massive bone grafts in cases of malignant bone tumor surgery is a very beneficial method.
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PMID:[Limb-saving surgery of malignant bone tumors using massive bone grafts]. 254 23

The case records of and histopathologic findings in 57 dogs with nonangiogenic and nonlymphomatous splenic sarcomas were reviewed. Splenic neoplasms in these dogs included leiomyosarcoma, fibrosarcoma, undifferentiated sarcoma, liposarcoma, osteosarcoma, chondrosarcoma, myxosarcoma, rhabdomyosarcoma, and fibrous histiocytoma. The clinical signs associated with splenic sarcoma included anorexia or decreased appetite, abdominal distention, polydipsia, lethargy, vomiting, weight loss, and weakness. An abdominal mass was detected in 86% of the dogs by use of abdominal palpation (63%), and/or abdominal radiography (74%). The diagnosis was based on histopathologic findings in the spleen. Abdominal exploratory surgery was performed on 43 of the 57 dogs. Twenty-seven dogs were treated by splenectomy, and 16 were euthanatized at the time of surgery because of widespread metastatic lesions. Of the 14 dogs on which surgery was not performed, 11 were euthanatized on the basis of results of preoperative diagnostic tests, and the remaining 3 dogs had splenic neoplasms that were incidental findings at necropsy. Of the 27 surgically treated dogs, 5 died in the immediate postoperative period, 12 died or were euthanatized within 1 year after splenectomy, and only 5 dogs survived greater than or equal to 1 year. Three dogs were lost to follow-up evaluation, and 2 were still alive 6 and 7 months after surgery. The median survival time of the 22 dogs for which survival was known was 2.5 months. The median survival time for 11 dogs with no obvious metastasis at the time of splenectomy was 9 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nonangiogenic and nonlymphomatous sarcomas of the canine spleen: 57 cases (1975-1987). 255 65

Well documented examples of primary malignant giant cell tumor of bone (giant cell tumor and concurrent sarcoma arising de novo) are exceedingly rare in the literature. We report a case arising in the left ischium of a 44-yr-old man. He had no previous history of radiation therapy or multiple resections. Histologically, the tumor was a typical giant cell tumor of bone juxtaposed to a malignant fibrous histiocytoma (MFH). The juxtaposition of a high grade sarcoma (MFH) and a locally aggressive nonmalignant neoplasm such as giant cell tumor is analogous to several other tumors of bone and soft tissue in which a low grade malignant or locally aggressive tumor can be associated with MFH or fibrosarcoma de novo, namely chondrosarcoma, chordoma, liposarcoma, and well differentiated intraosseous and parosteal osteosarcoma. The presence of a high grade malignant component in each of the aforementioned neoplasms generally portends a more ominous prognosis, although this is not invariably true. Recognition of the phenomenon of "dedifferentiation" (or tumor progression) in some bone tumors and sarcomas is important to ensure appropriate treatment. Distinction from secondary malignant giant cell tumors which are usually radiation induced is also important, since the latter have a much worse prognosis than those with dedifferentiation occurring de novo.
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PMID:Primary malignant giant cell tumor of bone: "dedifferentiated" giant cell tumor. 255 83

A case of laryngeal osteosarcoma in a 75-year-old man is described. The osteosarcoma probably arose by dedifferentiation of a chondrosarcoma of the cricoid cartilage. Laryngeal osteosarcoma is rare: the literature is reviewed and management discussed.
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PMID:Osteosarcoma of the larynx. 258 67

We retrospectively studied all bone tumors diagnosed in Ramathibodi hospital from 1977-1986 regarding frequency, age and skeletal distribution. Six hundred and fifty-two cases were collected. Among these, primary bone tumors accounted for 75 per cent, the remainder were metastatic lesions. Among benign bone tumors, the two most common tumors are osteochondroma (47%), and chondroma (15%). Osteochondroma is frequently found in younger patients with a mean age of 20.12 years and is usually located about the knee. Chondroma, found in this series, usually affected ribs (32%) with a mean age of 27.47 years. Among primary malignant bone tumors, the three most common tumors are osteosarcoma (39.9%), giant cell tumor (22.7%), and chondrosarcoma (14.1%). Osteosarcoma affects younger patients more often than giant cell tumors and chondrosarcomas do, with a mean age of 17.27 years. The common primary malignant bone tumors usually affect weight-bearing bones.
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PMID:Analysis of bone tumors in Ramathibodi Hospital, Thailand during 1977-1986: study of 652 cases. 263 5

Oral rhabdomyosarcoma (RMS) was studied by analysis of eight such cases which presented over a 25-year period. Rhabdomyosarcoma was the fourth most common oral sarcoma (7.5%) from this period after osteosarcoma (32%), fibrosarcoma (19%), and chondrosarcoma (9%). In patients younger than 20 years, RMS was the second most common sarcoma (six cases) after osteosarcoma (ten cases). Combined analysis with 113 further cases documented in the literature showed the majority of cases (71.2%) were embryonal. The alveolar subtype was considered a distant second in frequency (12.3%) even though the pleomorphic subtype was apparently more common (16.4%). However, the pleomorphic cases were diagnosed before histologic criteria were established to discern this entity from other pleomorphic sarcomas and this data is probably unreliable. Site predilections were found for the soft palate, maxillary sinus and alveolus, posterior mandibular region, cheek and lip and possibly tongue. The gingiva and floor of mouth were uncommon sites. There was a predilection for occurrence in the first two decades with a decline in the third decade. Documentation of recent cases treated with a multidisciplinary approach indicated that lesions in the oral soft tissues have a good prognosis; 17 of 21 such cases showed no evidence of disease after a mean follow-up period of 7.2 years (SD = 4.4). In contrast, four of five cases in the posterior mandible resulted in death after a mean period of 1.1 years (SD = 0.3).
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PMID:Rhabdomyosarcoma of the oral and paraoral region. 264 20

The outcomes of 31 cases of limb salvage procedures for malignant bone tumors performed between 1974 and August 1988 were investigated. The age at operation ranged from 7 to 76. Thirteen cases were growing children under 15. The site of lesions were humerus in 6 cases, femur in 20, tibia in 3 and fibula in 2. Pathological diagnoses were osteosarcoma in 19, chondrosarcoma in 5 and others in 7. Reconstructive procedures were performed in 28 cases, consisting of endoprosthetic replacements in 18, vascularized fibula grafts in 6 and free autogenous bone grafts in 4. Two cases of osteosarcoma recurred, and amputations were performed. Six cases died of pulmonary metastases, while 22 cases (71%) are alive and free of disease. Functional results depended mainly on the size and site of resection rather than on the reconstructive procedures, and were generally good in the proximal femur and fibula, and poor in the distal femur and proximal tibia. Discrepancy in the length of lower limbs occurred in 8 cases of growing children; 5 of 6 vascularized fibula grafts showed thickening of the grafted bones, and one of them grew by 2.5 cm in length. Endoprosthetic replacements are adequate for hip and shoulder regions, and for low grade sarcoma which does not require chemotherapy or irradiation. Free autogenous bone grafts are good for narrow defect of bone, and cases of arthrodesis of joint. Vascularized fibula grafts are adequate for the upper limb, and lower limb of growing child.
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PMID:[Limb salvage procedures in malignant bone tumors of the extremities, with special reference to the various reconstructive procedures of bone defects]. 265 32

How radiation therapy works, determination of an individual's sensitivity to it, delivery systems, and side effects are summarized briefly. More specific discussions include treatments for osteogenic sarcoma, chondrosarcoma, Ewing's sarcoma, and soft tissue sarcomas.
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PMID:Radiation therapy in the treatment of bone and soft tissue sarcomas. 266 19

Chest-wall resection can be performed with low morbidity and mortality rates and remains the primary treatment for most chest-wall tumors. However, some lesions are best treated with a multimodality approach including preoperative chemotherapy. Therefore, pretreatment tissue diagnosis is essential in planning. The biopsy should be done at the medical center where the definitive treatment will be undertaken, and frequently, a needle biopsy will be sufficient. Osteosarcoma, rhabdomyosarcoma, Ewing's sarcoma, and other small-cell sarcomas are sensitive to chemotherapy, which should be given preoperatively, continued postoperatively, and modified according to the tumor response. Chondrosarcomas and most adult soft-tissue sarcomas are well controlled by primary excision and selective use of adjuvant irradiation. Better systemic and local therapy is needed for the recurrent soft-tissue sarcomas and the aggressive unclassified sarcomas. Chest-wall resection continues to play a primary role in the management of locally and regionally recurrent breast cancer but is best combined with systemic chemotherapy. Chest-wall resection can provide a long disease-free survival in patients with isolated metastases from sarcomas or carcinomas. In addition, significant palliation can be afforded patients with symptomatic chest-wall metastases and a shortened life expectancy.
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PMID:Current management of chest-wall tumors. 267 48


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