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

An osteosarcoma with neurologic manifestations complicated Paget's disease of the lumbar spine in a 63-year-old man. Initially without demonstrable metastasis, the patient was treated by decompressive laminectomy followed by radiation and adjuvant chemotherapy (COMPADRI-1 regimen). While such treatment may not be curative, there are significant palliative benefits.
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PMID:Osteosarcoma complicating Paget's disease of the spine with neurologic complications. 8 24

Eleven cases of sarcoma in Paget's disease of bone are presented, together with an extensive review of the literature. These neoplasms are rare but not exceptional, and mostly affect male subjects in the seventh decade of life. The sites most frequently affected are the pelvis, femur and humerus. In 30 per cent of cases these neoplasms are multifocal. Radiographically the lesions are nearly always osteolytic. The radiographic diagnosis may, however, be quite difficult, especially in the presence of the severe (but benign) osteolyic lesions that sometimes occur in Paget's disease. Morphologically these tumours are mostly highly polymorphic sarcomas. The cases in this series were diagnosed histologically as osteosarcoma, grade 3 fibrosarcoma, and malignant fibrous histiocytoma; but there are no prognostic differences between the various histological types. The prognosis is very serious, only about 3 per cent of patients surviving for five years from the time of diagnosis. Therapy, unfortunately nearly always palliative, is based on amputation or disarticulation after sections biopsy in cases where the disease is localised to the limbs, and on radiotherapy in cases not amenable to surgery.
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PMID:Sarcoma in Paget's disease (11 cases). 23 74

Six cases of osteosarcoma of the maxilla are reported, including one case that was radiation-associated and one case that arose in Paget's disease. The literature on this entity is reviewed and the clinicopathologic features of this lesion in this unusual location are discussed.
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PMID:Osteogenic sarcoma of the maxilla. 26 50

A study is presented of all cases of primary sarcoma of bone registered during the period 1946 to 1974 for a specified population resident in south-western England. Ninety-six per cent of the 365 cases were histologically and radiologically verified and are separated into 8 categories of sarcoma. The number of tumours presenting during each hemi-decade did not markedly diverge from the 5-year mean for the period, nor was any significant change found in tumour incidence during the last 20 years of the survey. The age, sex and site distributions correspond with those reported elsewhere. Age-specific incidence rates are compared with those published for Sweden. For osteosarcoma and Ewing's tumour, both commoner in young people, the two series agree closely up to age 55 years, after which the Swedish incidence rates rise and are not exceeded when, for the present cases, Paget's osteosarcomas are included. Whilst Paget's disease may change the age incidence of some types of bone sarcoma, it is uncertain whether it increases the total number which occur. Differences in tumour incidence between males and females, whether for a specific type or for all bone sarcomas, are seldom statistically significant, but the patterns appear to be consistent.
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PMID:Incidence of bone sarcoma in SW England, 1946-74, in relation to age, sex, tumour site and histology. 27 Oct 10

A multifactorial analysis was performed on all 153 unequivocal cases of genuine osteosarcoma recorded in the Swedish Cancer Registry for the years 1958 through 1968. Cases of so-called parosteal osteosarcoma, soft-tissue osteosarcoma and osteosarcoma secondary to Paget's disease of bone were not included. The osteosarcomas were subclassified as follows: osteoblastic (69 per cent), chondroblastic (19 per cent) and fibroblastic (12 per cent). The overall 5-year survival rate was 22 per cent; 55 per cent for those who had undergone amputation above the joint proximal to the involved skeletal part, 22 per cent for those amputated on the involved skeletal part, 11 per cent for those treated with local extirpation of the tumor, and 1 per cent in cases in which the lesion was not radically removed. Tumors of the femur, humerus and scapula were as malignant as axial tumors. The former carried a 5-year survival rate of 13 per cent, regardless of whether the patients had been treated with exarticulation or amputation on the involved skeletal part. Patients with axial tumors showed a 5-year survival rate of 15 per cent. These survival data suggest that proximal amputation alone might suffice for lesions situated distally to the knee and elbow joints, while tumors in the humerus and femur should be treated with amputation combined with multicytostatic treatment or immunotherapy and axial tumors with local resection and multicytostatic or immunologic treatment.
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PMID:Osteosarcoma. A multifactorial clinical and histopathological study with special regard to therapy and survival. 28 71

Sarcomatous changes in Paget's disease are known to occur, but cranial localization with invasion of cerebral parenchyma is rarely seen. A case is reported of osteogenic sarcoma occurring during Paget's disease, which was diagnosed from neurological signs, and on which a complete anatomical study was made.
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PMID:[Osteogenic cranial sarcoma in Paget's disease (author's transl)]. 28 36

A retrospective review of all recorded cases of osteosarcoma diagnosed and treated in Manitoba from 1930 to 1977 was carried out. There were 95 patients (64 males, 31 females). The peak age was 10 to 19 years. The most common sites of osteosarcoma were the femur (38 patients), tibia (14 patients), humerus (13 patients) and pelvis (9 patients). The survival rate (excluding parosteal and periosteal types) was 28% at 2 years and 16% at 5 years. Patients who were operated upon had a somewhat better prognosis than those who had radiotherapy. Initial results of chemotherapy are encouraging. Patients with distal limb tumours had a better prognosis than those with more proximal neoplasms. Patients with tumour secondary to Paget's disease and to irradiation did poorly, those with parosteal and periosteal osteosarcoma did better. Thirteen patients had 31 thoracotomies for pulmonary metastases; their average duration of survival after this procedure was 9.3 months.
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PMID:Osteosarcoma in Manitoba: review of 95 patients. 29 64

An accurate pathological diagnosis must be made prior to treatment of a primary malignant bone tumour. Consideration must be given to the clinical and radiologic aspects as well as the histology. Both benign and malignant tumours occur more frequently in certain decades. A search should be made for precursor lesions such as Paget's disease. The presenting manifestations of pain, a mass and dysfunction are not specific for tumours. Laboratory tests may be helpful, especially in distinguishing tumours from infections and metabolic diseases. Metastasis is usually via the blood stream to the lungs and bones. The low survival rate following amputation for osteosarcoma and radiation therapy for Ewing's sarcoma has been improved by chemotherapy. The lower-grade tumours such as aggressive giant cell tumour and low-grade chondrosarcoma can often by treated successfully by resection and insertion of an autograft, an allograft or a metallic implant.
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PMID:Malignant tumours of bone: clinical aspects and natural course. 33 30

Histological and biochemical changes during calcitonin treatment have been studied in 15 patients with Paget's disease of bone. For each patient, osteoclast counts were made by the same observer on serial needle biopsies of diseased bone from the posterosuperior iliac spine. Serial estimations were also made of the serum alkaline phosphatase and urinary hydroxyproline excretion. A total of 66 biopsies was examined (ranging from two to seven per patient). Osteoclast populations and the biochemical measurements were log normally distributed. During calcitonin treatment there was a statistically significant decrease in: (1) the total osteoclast count per square millimetre; (2) the number per square millimetre of osteoclasts in resorption cavities on the trabecular surface; (3) the relative proportion of osteoclasts sited in resorption cavities compared with total osteoclasts; (4) the serum alkaline phosphatase level; (5) 24-hour urinary hydroxyproline excretion. On stopping treatment there was a statistically significant increase in all of these histological and biochemical values except that the proportion of osteoclasts in resorption cavities remained low. The trabecular cement line pattern remained abnormal during and after treatment in all biopsies examined, and complete suppression of osteoclast activity was not observed. One of the patients developed a Paget's osteosarcoma while on calcitonin therapy.
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PMID:Effect of calcitonin treatment on osteoclast counts in Paget's disease of bone. 74 91

Two complications of Paget's disease are presented : they include an osteogenic sarcoma and a giant-cell tumour (GCT) of the lumbar spine with a radiculo-medullary compression syndrome. The rarity of sarcomatous degeneration of the spine affected by Paget's disease is emphasized and also the unusual character of the spinal GCT which develop in the presence of Paget's disease. As in the present case, it is often difficult to confirm the benign or malignant character of a GCT and the principal criteria of this classification are discussed.
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PMID:[Radiculomedullary compressions by osteosarcoma and by giant cell tumor of the spine occurring in Paget's disease]. 110 64


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