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)

Thirty cases of osteosarcoma of the jaws were reviewed (20 men and 10 women, mean age 34 years). Seventeen lesions occurred in the mandible and 13 in the maxilla. Swelling without pain was the most common presenting symptom. Thirteen lesions were initially misdiagnosed as odontogenic infections. Numbness as a presenting symptom was statistically associated with poor prognosis. Treatment included all combinations of surgery, chemotherapy and radiotherapy. Patients receiving chemotherapy with four or more agents showed a trend toward better survival with 71% alive and disease-free at the time of review. Patients' increasing age was statistically associated with decreased survival. The average age of survivors was 27 years and nonsurvivors, 40 years. Older patients suffered more local recurrences which, in all but one case, resulted in mortality. Expectedly, clear surgical margins correlated statistically with improved survival. With margins of less than 5 mm, 27% of patients were alive and disease-free as compared to 62% with surgical margins greater than 5 mm. The importance of early diagnosis, definitive surgical treatment and aggressive adjuvant chemotherapy is demonstrated. The Proportional Hazards Regression model was employed to evaluate the statistical significance of a variety of factors on disease-free and overall survival.
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PMID:Osteogenic sarcoma of the jaws: factors influencing prognosis. 918 Feb 30

This report discusses a rare case of giant cell-rich osteosarcoma. The patient, a 19-year-old male, was diagnosed with a metadiaphyseal osteolytic lesion when he consulted a local doctor complaining of motion pain without swelling. Radiography revealed a geographic osteolytic lesion, cortical thinning and ballooning without obvious cortical destruction. However, a fine onion skin-like periosteal reaction was observed on the lateral side of the femur. The transitional none was narrow and endosteal scalloping was also noted. Needle biopsied material clearly showed nuclear atypism of the stromal tumor cells with numerous osteoclast-like giant cells. Using a combination of pathological examination, radiography, computed tomography (CT) and magnetic resonance imaging (MRI), a diagnosis of giant cell-rich osteosarcoma was reached. After chemotherapy, resection and limb salvage surgery with an autogeneous autoclaved bone graft, a vascularized fibular graft were performed, and the patient has shown excellent limb function without local recurrence or distant metastasis during the past 72 months.
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PMID:Giant cell-rich osteosarcoma: a case report. 921 41

Osteosarcoma, either primary or metastatic, rarely involves the jaws. Though only a few cases of mandibular metastasis of osteosarcoma have been reported, only one case of et al maxillary involvement (Singh, 1978) has been reported. A case of 21 year old boy with metastasis of osteosarcoma to the right maxilla from primary osteosarcoma of the left femur is presented. The patient complained of pain and swelling in the left maxillary region which was earlier diagnosed as maxillary sinusitis on the basis of Water's sinus radiograph in a medical hospital. Further radiographic examination with the panoramic and intraoral periapical radiographs done by us and later by fine needle aspiration cytology led us to diagnose a secondary deposits of osteosarcoma.
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PMID:Maxillary metastasis of osteosarcoma. 949 57

Excision of the distal ulna to treat degenerative disease or instability has fallen into disfavor following reports of radioulnar impingement, carpal instability, and distal ulnar instability. Alternative procedures for reconstruction of the painful distal ulna have been developed to address these problems; the results have been generally favorable. When faced with distal ulnar reconstruction that has failed after multiple surgical procedures, or a distal ulnar neoplasm, the surgeon is left with few treatment options. Creation of a one-bone forearm, free fibular transfer, and allograft replacement have been attempted, with mixed outcomes. We report the results of 5 men and 7 women who underwent wide excision of the distal ulna, defined as surgical excision of 25% to 50% of the ulnar length. The diagnosis was failed distal radioulnar reconstruction or excision in 8 patients, osteomyelitis in 1, congenital pseudoarthrosis of the radius in 1, and neoplasm in 2. No soft tissue reconstruction was performed. Patients were examined at an average of 22 months after surgery for radiocarpal and radioulnar instability, functional outcome, pain relief, grip strength, and range of motion. Nine of the 12 procedures resulted in good or excellent results; 1 patient had a fair result after resection for osteosarcoma, and the procedure in 2 patients failed, requiring conversion to a one-bone forearm. Grip strength was restored to 75% of the normal side and range of motion was restored to 86% of the normal side. Wide excision of the distal ulna without soft tissue reconstruction is a simple and durable treatment of neoplasms of the distal ulna or salvage of the failed reconstruction of the distal radioulnar joint. We do not recommend its use in patients with incompetency or disruption of the interosseous membrane.
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PMID:Wide excision of the distal ulna: a multicenter case study. 955 59

We surveyed 65 patients age 13 years or older who had been treated for malignant bone tumors and were in remission at least 1 year after limb-sparing surgery (LS) or amputation (AMP) to assess general satisfaction with the surgical outcome and its impact on various areas of functioning. Of 130 eligible patients, 65 responded (61 treated for osteosarcoma, 3 for Ewing's sarcoma, and 1 for mesenchymoma). The median current age of the cohort was 25.8 years (range, 14.2 to 47.5 years). The median time from surgery was 14.2 years (range, 4.0 to 30.4 years) for the AMP group, and 5.5 years (range, 2.0 to 13.8 years) for the LS patients. Questionnaire responses of patients treated with AMP compared to those who had LS surgery showed no significant differences in the impact of the surgical procedure on educational and occupational status, functional limitations, pain intensity and degree of pain interference, emotional distress, interpersonal/social interactions and self-image, rehabilitation experience, and overall satisfaction with the surgical procedure. Functional limitation was significantly related to pain interference, as well as emotional distress, self-image, and interpersonal difficulties for the entire cohort. Our findings highlight procedure-related advantages and difficulties that may potentially enhance decision making regarding the selection of the surgical procedure for individual patients with malignant bone tumors of an extremity.
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PMID:Patient satisfaction after limb-sparing surgery and amputation for pediatric malignant bone tumors. 959 15

Osteosarcoma (OS) is a highly malignant tumour and is the most common primary neoplasm of bone; although rare, especially in the maxillofacial skeleton. This article presents 14 Kenyan cases of OS of the maxillofacial bones seen between January 1991 and July 1997: 11 in the mandible, two in the maxilla and one in the right zygomatic arch. Patients ranged in age from one week to 50 years (Mean = 29.7), with an equal gender distribution. While pain and rapid swelling were the commonest clinical features, the radiographic and histopathological characteristics were as varied as has been described elsewhere. Generally, effective management of most of the cases was poor due to late presentation for treatment.
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PMID:Osteosarcoma of the maxillofacial bones in Kenyans. 961 73

Thoracic surgical oncology involves surgical treatment of lesions of the thoracic wall, pulmonary parenchyma, or mediastinum (also including heart, esophagus, or trachea). The most common neoplasms of the thoracic wall are osteosarcoma and chondrosarcoma. Histopathologic type, the use of chemotherapy for osteosarcoma, and completeness of surgical margins are prognostic for survival. Relative to solitary pulmonary masses, carcinomas are most common, with histopathologic type, tumor size, tumor grade, and lymph node status prognostic for survival. Of the aforementioned variables, lymph node status is the most significant. Extensive preoperative workup, including bronchoscopy and transthoracic fine needle aspiration of solitary lung masses, is usually not recommended. Thymomas are the most common surgical mediastinal mass. Patients are frequently affected with paraneoplastic syndromes including myasthenia gravis, polymyositis, and nonthymic neoplasia. Patients without megaesophagus with surgically resectable masses have an excellent prognosis for survival. Provision of analgesia after surgery in thoracotomy patients is extremely important. Carefully selected analgesic agents in thoracotomy patients are far less damaging to cardiovascular status than is tachycardia from excessive pain. Given these and other guidelines, perioperative mortality in thoracotomy patients is minimal, and long-term survival in selected patients is excellent.
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PMID:Thoracic surgical oncology. 963 48

Nine dogs with primary bone tumours were treated with Samarium-153-EDTMP (Sm-153-EDTMP). Conventional treatment protocols were precluded by the size of the dogs and the owners' refusal of limb amputation. All the tumours were of the appendicular skeleton; 4 were confirmed osteosarcomas. The other 5 tumours were radiologically suspect for osteosarcoma. Bone scans were performed on all dogs using Technetium-99m-methylene diphosphonate (Tc-99m-MDP) before administration of Sm-153-EDTMP. Regions of interest were identified over the contralateral limb at the same site as the tumour and counts per pixel were recorded for the tumour and contralateral limb and expressed as a ratio. The dogs were given 1 injection of 37 MBq/kg (1 mCi/kg) of Sm-153-EDTMP intravenously. Thoracic and primary tumour site radiographs were taken at monthly or 2-monthly intervals to monitor progression of the primary tumour and search for evidence of metastasis. Two dogs showed no response to treatment, with an increase in bone pain, and were euthanased within 1 month. In 1 dog, a tumour of the scapula underwent complete involution and the dog is considered free of disease at 20 months post Sm-153-EDTMP treatment. The overall tumourcidal effect of a single dose of Sm-153-EDTMP on primary bone tumours was difficult to evaluate in this group of dogs, as, with one exception, all the primary tumours progressed over time and the dogs were euthanased. Pain control, for which Sm-155-EDTMP is used in man, was not evident, except in the dog that responded completely to treatment.
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PMID:Targeted radiotherapy with Sm-153-EDTMP in nine cases of canine primary bone tumours. 964 55

The case of a 66-year-old woman with a primary cardiac osteosarcoma is described. These distinctly rare malignant tumors arise preferentially in the left atrium. Clinically, they often present symptoms of both, intramural and intracavitary neoplasm in addition to general weakness, recurrent breast pain, and dyspnea. As shown in the present case, with growing intracavitary tumor masses the risk for peripheral arterial including cerebral embolism increases. Consequently, in most patients with symptoms of systemic arterial embolism of unknown origin performance of transesophageal echocardiography seems advisible, which is presently the most convenient noninvasive imaging method to exclude or to identify intracardiac sources of emboli, irrespective of their type.
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PMID:A primary osteosarcoma of the heart as a cause of recurrent peripheral arterial emboli. 973 45

A 20-year-old female with right femoral osteosarcoma noted severe pain and swelling of the right thigh, and was transferred to the authors' hospital after suffering a pathologic fracture of the right femur. Plain x-ray disclosed a tumor shadow extending from the pathologic fracture of the distal portion of the femur to the center of the diaphysis. MRIs showed a broad lesion and hematoma, and invasion to the femoral vascular bundle was suspected. Angiograms revealed vascularization coincidental to the tumor, and an irregular vascular wall of the femoral artery, which was shifted posteriorly. After consultation with the patient and her family, rotation plasty was performed. The sciatic nerve was isolated and preserved; major vessels were sectioned proximally and distally because of tumor tissue invasion to the femoral artery and vein. After wide excision of the tumor, the leg was rotated outward 180 degrees, and osteosynthesis was performed between the remaining femur and the tibia, followed by microsurgical anastomosis of vessels. Five years postoperatively, no local recurrence or metastasis has been observed. The patient has excellent functional recovery without pain, and no other complications.
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PMID:Rotation plasty for osteosarcoma of the femur. 985 44


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