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)

In a retrospective radiologic and histologic study of 286 osteosarcomas in files of a metropolitan hospital, four patients (three men and one woman) with osteosarcomas confined to the epiphysis were identified. In this series, there were also 16 metaphyseal osteosarcomas that extended to the epiphysis with penetration through the cartilaginous growth plate, a structure that ordinarily resists tumor growth. All tumors occurred in the femoral condyle. Characteristically, all four patients had histories of knee joint pain, and three reported antecedent trauma. Radiologically, the tumors showed predominantly lytic features. Histologically, three of the tumors were osteoblastic in type, and one was mostly chondroblastic. Purely epiphyseal osteosarcoma has overlapping radiologic features with clear cell chondrosarcoma, epiphyseal chondroblastoma, and epiphyseal enchondroma. The epiphyseal osteosarcomas of the distal femur reported here were characterized by a history of symptoms localized to the knee joint itself as a consequence of their epiphyseal location and joint involvement. This is in contrast to the usual metaphyseal osteosarcomas, which present with lower thigh pain and swelling. Because osteosarcomas may present as lytic tumors confined to the epiphysis, they should be included in the differential diagnosis of such lesions.
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PMID:Epiphyseal osteosarcoma: distinguishing features from clear cell chondrosarcoma, chondroblastoma, and epiphyseal enchondroma. 347 6

The authors report 17 cases of primary tumors of the knee treated by wide resection, removing "en bloc" the entire epiphysis in 14 cases and in the remaining 3 most of the epiphysis. The series consisted of 8 giant cell tumors of which 6 were followed for between three and fifteen years, and for 9 tumors of moderate malignancy amongst which 1 fibrosarcoma, 1 parosteal osteosarcoma and 3 cartilaginous tumors which were followed between five and fourteen years. All were free of metastatic spread except 1 fibrosarcoma whose resection was debatable. Arthrodesis was carried out on all but 2 patients received prosthesis. The arthrodeses were made by autogenous grafts protected in 11 cases by intramedullary rod, in 1 case by a plate, and in 3 cases by both. The series contains one amputation and three fractures necessitated secondary grafting with replacement of rod in two cases. The results are analysed in carcinological and technical shemes. The value of resection and the importance of grafting over the arthrodesis are emphasised. In the long term, resection-arthrodesis means the conservation of a stable and functional limb, permitting an active life one year postoperatively. Massive prosthesis are only exceptionally indicated.
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PMID:[Resection-reconstruction of the knee for bone tumor (author's transl)]. 645 11

Although the physeal cartilage is considered resistant to invasion by metaphyseal osteosarcoma, no objective clinical proof exists to support this view. Fourteen cases of osteosarcoma of long bones in patients ranging in age from ten to 19 years with open physes were reviewed to determine the incidence of transphyseal spread. The physeal cartilage was not crossed in only two cases. In the remaining 12 cases the tumor crossed the cartilaginous plate partially or completely, remaining in the epiphysis in seven and crossing the articular cartilage and involving the joint in five. Histologic sections showed that increased vascularity occurs initially, followed by osteoclastic and chondroclastic activity at the physeal plate with subsequent tumor tissue invasion. The incidence of transphyseal spread in the three published series (total of 64 cases, including the present 14 cases) is 81.2%. This is contrary to the often published unsupported statements of others. Transphyseal spread of osteosarcoma is the rule rather than the exception.
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PMID:The incidence and mechanism of transphyseal spread of osteosarcoma of long bones. 657 30

In a restrospective macroscopic and microscopic study of twenty-six macrosections of skeletally immature individuals with metaphyseal osteosarcoma, we determined the incidence, extent, and mode of tumor extension into the epiphysis. The physis appeared to have a tendency to act as a barrier to tumor spread, but did not restrain the tumor tissue in most cases. Epiphyseal extension of the tumor tissue was massive in more than half of the cases, with tumor tissue abutting against the articular cartilage, and in one instance perforating it. Some tumors had a sizable extra-osseous component that extended around the physis beneath the perichondral ring and capsular structures into the ossific nucleus. These findings have important implications when limited surgery is performed for appendicular osteosarcoma.
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PMID:Epiphyseal extension of metaphyseal osteosarcoma in skeletally immature individuals. 692 14

A retrospective review was performed of the results of all allograft reconstructions that had been done after the resection of an osteosarcoma or an Ewing sarcoma in a skeletally immature patient between 1982 and 1989 at The Hospital for Sick Children in Toronto. There were twenty-six patients. Six reconstructions were intercalary, sixteen were resection arthrodeses, three followed resection of a bone segment including the epiphysis (osteoarticular reconstruction), and one was a replacement of the entire humerus. Resection arthrodesis about the knee was performed with a smooth intramedullary rod and with one growth plate left intact. Six procedures were performed in the upper extremity. Excluding the patients who died, the average duration of follow-up was five years and three months. Twenty-one of the twenty-six patients had reached skeletal maturity at the time of follow-up. Eighteen (69 per cent) of the patients had a good or excellent result, four (15 per cent) had a fair result, and four had a failure. Twenty patients (77 per cent) had at least one complication (other than a limb-length discrepancy), and fourteen (54 per cent) sustained at least one fracture of the allograft. Fifteen patients who had had a reconstruction in the lower extremity had survived with survival of the allograft at the time of the latest follow-up. A limb-length discrepancy of at least two centimeters developed in nine of the fifteen patients. Five were managed with a contralateral epiphyseodesis, and one of them had an unsuccessful attempt at limb-lengthening as well. The patients who had a limb-length discrepancy of more than three centimeters at the time of follow-up had been significantly younger (p < 0.05) at the time of the reconstruction than those who had a smaller discrepancy. Three allografts (12 per cent), two of which were implanted early in the series, became infected. Soft-tissue coverage is of paramount importance for the prevention of infection, and we now routinely perform primary muscle (gastrocnemius or latissimus dorsi) transfers when dealing with an inadequate muscle envelope. Twelve patients were followed for more than four years (average, six years and seven months); they had no complications other than increased limb-length discrepancy and one subluxation of the shoulder after the first four years following the reconstruction. Although the rate of complications is higher than in adults, allograft reconstruction remains a useful option for the management of skeletally immature individuals.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Massive allografts in the treatment of osteosarcoma and Ewing sarcoma in children and adolescents. 782 56

Giant cell tumor of the bone is usually located within the epiphysis of a long bone, the majority of the lesions occurring in the third and fourth decades of life. We report an unusual case of giant cell tumor (GCT) arising in the parietal skull bone of a 9-year-old girl. The tumor exhibited histologic findings typical for GCT, with conspicuous intravascular giant cells. Based on microscopic features, not only conditions like aneurysmal bone cyst or bone changes associated with hyperparathyroidism but also tumors such as chondroblastoma or osteosarcoma had to be considered. Immunohistochemistry revealed strong reactivity of the tumor giant cells and normal bone osteoclasts with CD68 but not Mac-387; tumor stromal cells were uniformly negative for both. The stromal cells exhibited two immunohistochemically distinct phenotypes. One, involving 50-80% of the tumor cells, exhibited negative lysozyme staining with positivity of proliferating cell nuclear antigen (PCNA) in about 30% of the nuclei. The other showed reactivity with lysozyme but negative PCNA staining. Immunohistochemistry thus helped to distinguish chondroblastoma and osteosarcoma, in which lysozyme positivity would reside in macrophages but not within stromal cells. Instead, chondroblastoma would exhibit protein S-100 positivity in the tumor cells. The biological behavior of GCT is difficult to predict based on morphology alone, although the malignant potential seems to rest in the stromal cells rather than the giant cells. Specifically, in reported cases, the intravascular occurrence of giant cells in GCT is not associated with an increased incidence of metastasis.
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PMID:Giant cell tumor in the skull of a 9-year-old child: immunohistochemistry to confirm a diagnosis rare for age and site. 859 62

An osteosarcoma developed in a boy, 16 years of age, 9 years after staples had been inserted in the region of the lower femoral epiphysis. The possible association between the implant and the tumour is discussed.
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PMID:Osteosarcoma associated with a metal implant. 893 Jul 30

The epiphyses of bone have a different physiologic development and pathophysiology compared to the other skeleton. Hereby the very low incidence of primary bone tumors has to be noted. The analysis of our tumor register, including 2758 cases, and of the literature confirms the chondroblastoma as the most frequent bone tumor especially in the second decade of life. Besides this we find chondromas of the epiphysis in infancy. Osteoid osteomas and osteoblastomas as well as tumor-like lesions and osteomyelitis occur extremely rare. We had no case of a primary malignant bone tumor in our register. Moreover less than 10 cases of osteosarcoma of the epiphysis have been reported in the literature. The border between metaphysis and epiphysis can not be distinguished any more after closure of the epiphyseal growth plate so that primary and secondary bone tumors can develop in this region now. An isolated occurrence of tumor in the epiphysis is even rare in adolescence.
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PMID:[Epiphyseal tumors]. 896 39

We have compared the cell and tissue selective estrogenic and antiestrogenic activities of tamoxifen, raloxifene, ICI 164,384 and a permanently ionized derivative of tamoxifen--tamoxifen methiodide (TMI). This non-steroidal antiestrogen has limited ability to cross the blood brain barrier and is therefore less likely to cause the central nervous system disturbances caused by tamoxifen. We have used the stimulation of the specific activity of the "estrogen induced protein", creatine kinase BB, as a response marker in bone, cartilage, uterine and adipose cells and in rat skeletal tissues, uterus and mesometrial adipose tissue. In vitro, TMI, tamoxifen and raloxifene mimicked the agonistic action of 17beta-estradiol in ROS 17/2.8 rat osteogenic osteosarcoma, female calvaria, and SaOS2 human osteoblast cells. In Ishikawa endometrial cancer cells, tamoxifen showed reduced agonistic effects and raloxifene showed no stimulation. However, as antagonists, tamoxifen and raloxifene were equally effective in Ishikawa or SaOS2 cells. In immature rats, all four of the antiestrogens inhibited estrogen action in diaphysis, epiphysis, uterus and mesometrial adipose tissue; when administered alone, tamoxifen stimulated creatine kinase (CK) specific activity in all these tissues. Raloxifene and TMI, however, stimulated only the skeletal tissues and had no stimulatory effect in the uterus or mesometrial fat, and the pure antiestrogen ICI 164,384 showed no stimulatory effect in any of the tissues. The simultaneous injection of estrogen, plus an antiestrogen which acted as an agonist, resulted in lower CK activity than after injection of either agent alone. These differential effects, in vivo and in vitro, may point the way to a wider therapeutic choice of an appropriate antiestrogen which, although antagonizing E2 action in mammary cancer, can still protect against osteoporosis and cardiovascular disease and not stimulate the uterus with its attendant undesirable changes, or interfere with the beneficial action of E2 in the brain.
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PMID:Tissue selective action of tamoxifen methiodide, raloxifene and tamoxifen on creatine kinase B activity in vitro and in vivo. 901 Mar 44

The authors present a case of bone infarction in the proximal epiphysis of the right tibia, which was caused by preoperative intraarterial chemotherapy for osteosarcoma. MR imaging revealed that suspected metastases had inhomogeneous signal intensity similar to that of the primary tumor, which made a metastatic lesion difficult to exclude. On TI-201 SPECT, no accumulation was found in the lesions, confirming that they were not osseous metastases. Consequently, this enabled limb salvage surgery to be performed with joint preservation. Intraoperative biopsy revealed no viable tumor cells in the lesion, and bone infarction was suspected. TI-201 SPECT was very useful, not only in differentiating bone infarction from tumor progression, including metastatic lesions, but also in the determination of the operative technique.
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PMID:Thallium-201 SPECT in differentiating bone infarction from metastatic lesions in osteosarcoma. 936 82


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