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)

We present the case of a large, painful pelvic bone tumor in a 53-year-old woman with severe Paget disease. Her presentation was complicated with bilateral total hip arthroplasty, history of spinal stenosis, and multiple lucent lesions in the spine and pelvis in severely affected pagetoid bone. This case features the rare but dreaded complication of osteosarcomatous transformation in Paget disease. A variety of imaging modalities including PET/CT were utilized in the evaluation of these lesions. The PET/CT findings were counter-intuitive with regard to the intense uptake of the underlying chronic disease process and the near-absence of uptake in the tumors. The histology of the pelvic mass is also intriguing, as it demonstrated a sarcoma with giant cell features. Conservative, non-operative management was chosen, due to the patient's poor medical condition, so we may never know the nature of the spinal lesion in this case, but will discuss the differential diagnosis for a lytic spinal lesion in a patient with severe Paget disease complicated by osteosarcoma with giant cell features.
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PMID:Falsely Negative F-18 FDG PET of Osteosarcoma Arising In Paget Disease. 2730 20

Study Design Resident's case problem. Background Although rare in the general population, bone and soft tissue tumors may be more frequently encountered in patients seeking physical therapy because of the propensity of their initial symptoms to mimic those of commonly treated musculoskeletal disorders. Screening for tumors requires the physical therapist to be attentive to unexpected findings. The purpose of this paper was to describe the clinical-reasoning and screening processes of physical therapists who facilitated the timely recognition of bone and soft tissue tumors in 3 patients referred through medical channels. Diagnosis The referral diagnoses were lumbar spinal stenosis, calcaneal bursitis, and postexcisional quadriceps weakness. When comprehensively examined, each of the patients had either atypical examination findings or failed to respond to physical therapy treatment. After the physical therapists alerted the appropriate medical providers of the examination findings, diagnoses of high-grade osteosarcoma of the pelvis, chondroma of the knee, and liposarcoma of the thigh followed. Discussion Tumors of the lower extremity can initially mimic common musculoskeletal pathology. Physical therapists must remain alert for red flags, atypical signs and symptoms, and poor responses to treatment, even when patients are referred through medical channels. Particular attention is necessary in the case of unusual symptoms in the lower extremity, where over half of primary malignant tumors occur. Level of Evidence Differential diagnosis, level 5. J Orthop Sports Phys Ther 2017;47(5):359-366. Epub 29 Mar 2017. doi:10.2519/jospt.2017.7037.
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PMID:Physical Therapist Clinical Reasoning and Action for Individuals With Undiagnosed Lower Extremity Tumors: A Report of 3 Cases. 2835 77