Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0029463 (osteosarcoma)
 16,637 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The intraarticular infiltration of sarcomas around the shoulder was analyzed. Of 58 sarcomas located around the shoulder, which were treated between 1993 and 1998, 15 osteosarcomas, 12 chondrosarcomas, and one Ewing's sarcoma that abutted the shoulder were selected. Radiologic images of 28 tumors were analyzed and compared with pathologic examinations. In 17 of 28 sarcomas (15 in the proximal humerus and two in the scapula), joint infiltration was suspected radiologically because of the existence of a tumor mass probably inside the joint or disruption of the joint surface and protrusion of the tumor. Seven of 17 tumors with radiologically positive and zero of 11 tumors with radiologically negative findings showed histologically positive findings for tumor inside the joint. Four of 11 osteosarcomas and three of four chondrosarcomas of the proximal humerus showed histologic findings of joint infiltration. Pericapsular extension was seen in two patients, direct articular spread with a pathologic fracture was seen in two patients, direct articular spread was seen in one patient, direct articular spread with pericapsular extension was seen in one patient, and pericapsular extension with a pathologic fracture was seen in one patient. The current study showed that pericapsular or direct articular infiltration into the glenohumeral joint is a phenomenon in sarcoma around the shoulder. Exact assessment of tumor existence inside the joint can be difficult in osteosarcoma and chondrosarcoma, so abnormal radiologic findings should be regarded as proof of existence of tumor, and extraarticular wide resection should be planned.
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PMID:Incidence and mechanisms of infiltration of sarcomas in the shoulder. 1193 83

The aim of the current study was to determine the prognostic factors of primary osteosarcoma in adults. This is a review of 47 patients older than 40 years (27 men and 20 women) who were treated between 1977 and 1998 at the authors' institution. Tumors involved the lower limbs in 26 patients and the axial skeleton in 18 patients (38.3%). Eight patients (17%) had synchronous pulmonary metastasis and seven had a pathologic fracture before the definitive surgery. At review, 33 patients had died and 13 were alive. Twenty-one patients (44.7%) did not receive any form of systemic treatment. Tumors were treated surgically in 42 patients (89%). Local recurrence was documented in seven patients (17%). Metastasis after diagnosis appeared in 29 patients (61.7%). The 5-year disease-free survival and overall survival rates were 32.54% and 41.64%, respectively. Adult patients (> 19 years) with primary osteosarcoma had a poor clinical outcome. Metastatic disease at presentation or later, a pathologic fracture, large tumor volumes, and inadequate margins at the time of surgery were associated with significantly lower survival. The high number of adults presenting with advanced stage lesions and more tumors in the axial location might explain the high rate of recurrences. Aggressive multiagent regimens are needed to improve survival.
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PMID:Primary osteosarcoma in adults older than 40 years. 1195 95

Benign and malignant tumors of bone often have common musculoskeletal manifestations mimicking rheumatic disorders. The detection and resolution of mimicking symptoms require knowledge, skills, and a problem-solving attitude for musculoskeletal disorders. Before engaging in an extensive investigation, a careful history and full physical examination must be done. This review addresses the recent literature from June 2001 to May 2002 on musculoskeletal manifestations of benign and malignant tumors of bone using "red flag" rubrics: nonspecific pain pattern, atypical soft-tissue or bony swellings, pathologic fracture, spinal paresis, osteolytic x-ray findings, and unexpected results of laboratory tests. Early diagnosis (appropriate use of imaging techniques) and multidisciplinary management have improved considerably the survival of patients with primary malignant bone disease (eg, osteosarcoma). For some benign bone tumors (eg, osteoid osteoma), interstitial laser photocoagulation is now the treatment of choice with a success rate comparable with that of other treatments.
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PMID:Musculoskeletal manifestations of benign and malignant tumors of bone. 1249 13

We present the clinical, radiographical and pathological features of low-grade fibrosarcoma of the left proximal humerus in a 23-year-old man in whom it was necessary to distinguish the tumor from desmoplastic fibroma, malignant fibrous histiocytoma and intramedullary well-differentiated osteosarcoma. The patient presented with a 10-day history of pain in his left upper arm sustained when trying to break his fall with his left hand when slipping in the street. Plain radiography revealed an expanding multilobular osteolytic lesion from the proximal metaphysis to the diaphysis of his left humerus, accompanied by a pathological fracture at the distal portion of the lesion. Open biopsy of the lesion was performed twice; however, a conclusive diagnosis could not be obtained. The patient underwent wide excision and prosthetic replacement of the left proximal humerus. Histologically, the resected tumor was composed of both cellular areas and hypocellular areas. Cellular areas revealed a proliferation of bundles of uniform fibroblastic spindle-shaped cells with minimal cellular atypia, mixed with abundant intercellular collagenization. Mitotic figures were occasionally seen. Hypocellular areas showed myxoid features with loose bundles of collagen fibers. The patient demonstrates no evidence of disease 42 months after surgery. It is important to detect the scant atypical cells for the differential diagnosis of low-grade fibrosarcoma and desmoplastic fibroma of bone.
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PMID:Low-grade fibrosarcoma of the proximal humerus. 1258 41

To determine whether a pathologic fracture in osteosarcoma of long bones has prognostic importance, and limb salvage can be safely performed in such cases, we reviewed the surgical treatment and oncologic results in 46 patients with nonmetastatic osteosarcoma of the extremity and pathologic fracture at presentation who had been treated in our Institution with neoadjuvant chemotherapy, between 1983 and 1999. Neoadjuvant chemotherapy was given according to 6 consecutive protocols. Surgery consisted of limb salvage (34 patients), amputation (11 patients) and rotationplasty (1 patient). The average follow-up was 11 (3-20) years. 28 patients remained continuously disease-free, 17 patients relapsed and 1 died of chemotherapy-related toxicity. Despite the high rate of limb salvage, only 2 local failures occurred, 1 after amputation and 1 after limb salvage. The 5-year disease-free survival and overall survival rates were 59% and 65%, respectively, with no differences between amputated and resected patients. These results are similar to those obtained in 689 contemporary patients having an osteosarcoma without a pathologic fracture treated in our Institution, and using the same protocols for chemotherapy. We conclude that with neoadjuvant chemotherapy, osteosarcoma patients presenting with a pathologic fracture can be surgically treated like those with no fracture, and that limb salvage procedures do not increase the risk of local recurrence or death of these patients.
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PMID:Nonmetastatic osteosarcoma of the extremity with pathologic fracture at presentation: local and systemic control by amputation or limb salvage after preoperative chemotherapy. 1452 Dec 97

The presenting signs of osteogenic osteosarcoma are commonly pain, local swelling, local warmth, pathologic fracture, and metastatic disease. Deep venous metastasis of osteoblastic osteosarcoma is most often a postmortem diagnosis. This paper describes the case of a previously healthy 18-year-old woman who presented with dyspnea and lower extremity edema. This is a rare, and to our knowledge, a previously unreported case of right atrial and ventricular tumor thrombus infiltrated with osteoblastic osteosarcoma.
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PMID:Right atrial and ventricular thrombus infiltrated with osteoblastic osteosarcoma. 1474 80

Treatment of osteosarcoma (OSA) of the proximal humerus poses many difficulties and challenges to the treating team. Between 1993 and 2000, we treated 11 patients (three women, eight men; age range, 17-74 years) suffering from OSA of the proximal humerus by 'composite': massive allografts and long humeral prosthesis. At presentation, 10 patients were at stage 2-B and one at stage 3-B of OSA. One patient presented with a pathologic fracture. All patients except patient No. 6, received preoperative chemotherapy followed by limb salvage surgery and postoperative chemotherapy.Surgical margins were graded as wide in all patients. Postoperative complications included non-union at the allograft/host junction (which united after auto grafting) and superficial wound infections that resolved after antibiotic therapy. All surgical procedures were performed by a team headed by an orthopedic oncologist and shoulder surgeon. At latest follow-up (December 2001) all patients, with the exception of one (who was at stage 3-B at presentation) were alive, and had good function of the upper limb. It is our opinion that the team approach comprising an orthopedic oncologist and shoulder surgeon greatly contributed to the good surgical outcome, and hence the good survival and functional results of the patients. Bone allograft offers a modular malleable durable solution to the resected bone segment.
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PMID:Composite grafts in the treatment of osteosarcoma of the proximal humerus. 1525 68

Fractures through bone tumors are often difficult to treat. We reviewed our combined experience with this problem in children, as well as the existing literature, to formulate management guidelines. For this study, prospective databases (1987 to 2002) from three referral centers were screened for pathologic fractures occurring under the age of 14 years. One hundred five patients presented with fracture through unicameral bone cyst, nonossifying fibroma, fibrous dysplasia, aneurysmal bone cyst and osteosarcoma. Seventeen patients were excluded. The most common primary locations were the proximal humerus and proximal femur. Pathologic fracture through nonossifying fibroma had the best outcome; union occurred with nonsurgical treatment in all cases. Unicameral bone cyst required surgical treatment to avoid persistence of the cyst and refracture. However fracture healing was predictable without surgical treatment. Proximal femoral lesions tended to heal in malunion if not fixed surgically. Aneurysmal bone cyst required surgical treatment for the lesion to heal and to allow the fracture to heal as well. Percutaneous sclerotherapy may be the treatment of choice for many of these lesions. Fibrous dysplasia allows fracture healing with nonoperative therapy. Progressive deformity requires followup and surgical correction. Malignant lesions presenting a pathologic fracture are best managed by initial nonoperative therapy during investigation and neoadjuvant therapy when possible, followed by definitive treatment.
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PMID:Pathologic fractures in children. 1573 11

This study aimed to analyse the clinical, radiological and histological features of 16 scapulo-humeral Paget's sarcoma cases accrued from Scottish Bone Tumour Registry between January 1950 and December 2000. The mean age was 61.5 (range, 44-77) years with 12 men and 4 women. There were three scapular cases and 13 humeral (1 whole length, 5 upper humeral, 5 lower humeral and 2 mid-humeral). These patients presented with progressively increasing pain in the shoulder, arm or elbow (n = 5), a painful mass associated with a pathological fracture (n = 4), a pathological fracture with progressively worsening pain (n = 3), a painful mass (n = 3) and a painless mass associated with wrist drop (n = 1). Histology showed predominantly osteosarcoma (n = 12), followed by pleomorphic sarcoma (n = 2), malignant fibrous histiocytoma (n = 1) and fibrosarcoma (n = 1). Overall, the median survival period was 4.5 months. In summary, Paget's sarcoma of the scapulo-humeral area presents with progressively worsening pain, a painful mass with or without a pathological fracture, predominantly lytic in humeral and purely sclerotic in scapular lesions, osteosarcoma-dominant histology, primarily treated with an early limb ablative surgery and associated with a poor 1-year survival (12.5%) and 5-year survival (6.2%) rate.
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PMID:Scapulo-humeral Paget's sarcoma: Scottish Bone Tumour Registry experience. 1609 22

Between 1995 and 2004, 142 malignant bone tumours comprising 76 primary and 66 secondary tumours were identified in the Pathology Department of Al-Sabah Hospital, Kuwait. Pathological fracture was the presenting sign in 35% of the cases. The mean incidence of primary tumours/year was 3.3 cases/million inhabitants. The primary tumours showed a male predilection and 42% occurred below the age of 20 years. The most frequent in the descending order of frequency were Ewing's sarcoma, multiple myeloma, osteosarcoma, chondrosarcoma and non-Hodgkin's lymphoma. The femur was the most common site for secondary tumours; more than half of the tumours with metastases at this site originated in the breast. The high frequency of Ewing's sarcoma is noteworthy and requires further investigation.
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PMID:Malignant bone tumors in Kuwait: a 10-year clinicopathological study. 1620 Apr 21


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