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

Tumors are rare causes of knee symptoms in children but must be considered in the differential diagnosis of pediatric knee pain in order to avoid errors in treatment that could result in loss of limb or even life. Experience with 199 bone and soft-tissue tumors about the knee in children are reviewed. The majority of lesions were benign bone tumors (n = 101), with osteocartilaginous exostoses, nonossifying fibromas, and chondroblastomas predominating. Malignant bone tumors (n = 59) were less frequent, and osteosarcoma (n = 48) was by far the most common sarcoma. Soft-tissue lesions (n = 31) were much less frequent and included rhabdomyosarcoma, synovial sarcoma, fibrosarcoma, and desmoid tumors. A careful history, physical examination, and review of roentgenograms are essential to avoid errors in diagnosis. Malignant tumors require roentgenograms and laboratory studies in sequence to stage the patient. A properly performed biopsy established the diagnosis in most instances. Popliteal cysts, stress fractures, infection, myositis ossificans, histiocytosis, and other lesions can mimic tumors and delay correct diagnosis.
 ...
PMID:Tumors about the knee in children. 218 35

Following total knee arthoplasty, seven patients developed significant wound necrosis and dehiscence, requiring wound coverage with soft tissue flaps. Three patients had rheumatoid arthritis, three had degenerative arthritis, and one had osteosarcoma of the distal femur. Five different prostheses were used and the wound problems were discovered on average 21 days after arthroplasty. The average wound size was 6.0 cm2. Five were infected, four with Staphylococcus epidermidis and one with Staphylococcus aureus. All patients were treated with antibiotics and local debridement for an average of 10 days prior to the flap procedure. Medical gastrocnemius muscle flaps were used in two patients, unipedicle flaps transposed from the lateral thigh in three, and bipedicle flaps shifted from the medial thigh in two. Flaps were done an average of 56 days after arthroplasty, and knee rehabilitation was delayed an average of 76 days after arthroplasty. Patients were followed an average of 48 months after the flap procedure. Six patients had mild or no knee pain and one who remained infected had moderate constant pain. Three of the patients had greater than 90 degrees of knee motion and one had 75 degrees of motion. The remaining three had only 35 degrees of motion, due in part to significant preoperative contractures, infection, local radiation, and chemotherapy. Late infection developed in two patients at 20 and 45 months following the flap procedure. There was one excellent, three good, two fair, and one poor result using the Hospital for Special Surgery knee rating system at final follow-up examination.
 ...
PMID:Treatment of major wound necrosis following total knee arthroplasty. 258 84

A 64-year-old man with right knee pain had uptake of Tc-99m MDP in the area as well as in the greater trochanter. Both sites were shown to contain osteogenic sarcoma. There was resection of the bone. Eight months later, radiogallium uptake was avid in the nearby soft tissue, indicating tumor spread.
 ...
PMID:Multifocal osteogenic sarcoma in the seventh decade. 345 63

We present a 14-year-old girl with multicentric osteosarcoma who has survived for over 9 years to date. The patient first noticed right knee pain in 1992. Radiographs showed a destructive and sclerotic lesion of the right distal femur. Similar small sclerotic lesions were seen in the proximal metaphysis of the right femur, proximal site of the right humerus, and mid-posterior of the left humerus. A diagnosis of multicentric osteosarcoma was made on a biopsy of the right distal femur. The sclerotic lesions of the bilateral humeri disappeared after systemic chemotherapy (T-20), and thus wide excisions of the right distal femur and proximal femur were performed in 1993. New lesions appeared in the left iliac bone and the first lumbar vertebra on bone scintigraphy 24 months after the first surgery. Chemotherapy and wide excisions of the left iliac bone and the first lumbar vertebra were performed. The patient was well at the latest follow-up in April 2003, with no evidence of local recurrence or distant metastasis, but recently renal dysfunction appeared.
 ...
PMID:Multicentric osteosarcoma with long-term survival. 1462 2

Mesenchymal chondrosarcoma is a rare but aggressive, high-grade malignancy of primitive cartilage-forming mesenchyme that arises most commonly from skeletal sites. Although there are radiological findings suggestive of the diagnosis, imaging features often overlap with those of other skeletal sarcomas. The definitive diagnosis relies on the histological finding of a typical bimorphic appearance, consisting of nests of small, round, poorly differentiated cells and more mature cartilaginous tissue. To highlight this, we present the case of a 21-year-old man who was referred to our institution with a history of right knee pain. Initial imaging and histological evaluation of a core biopsy of the lesion suggested osteosarcoma of the distal right femur; after review, however, the correct diagnosis of mesenchymal chondrosarcoma was made. Adequate tissue sampling and thorough histological evaluation of biopsy specimens is vital for the accurate diagnosis of primary bone malignancies, especially those of chondroid origin.
 ...
PMID:Femoral mesenchymal chondrosarcoma with secondary aneurysmal bone cysts mimicking a small-cell osteosarcoma. 1632 81

Giant cell tumor of the bone (GCT) is a relatively uncommon tumor. It is characterized by the presence of multinucleated giant cells. GCT is a primary benign tumor but may evolve into a malignant tumor, usually after irradiation. We report a rare case of osteosarcoma arising ten years after the primary surgery for GCT without radiation. A 45-year-old woman presented with severe right knee pain after suffering contusion. Roentgenogram revealed a bone tumor in the lateral femoral condyle of the right knee. Histopathological examination demonstrated the features of GCT, and treatment consisted of curettage and bone grafting. Four months after the operation, multiple lung metastases of GCT occurred, which were treated by partial lobectomy. Ten years after the primary treatment, severe knee pain recurred. Roentgenogram and magnetic resonance imaging (MRI) demonstrated a destructive lesion in the lateral condyle of the right knee. Histopathological examination demonstrated a lacy pattern of osteoids and abnormal mitoses in the aggregated atypical mononuclear cells, indicating osteosarcoma. Despite above-knee amputation and chemotherapy, scapular and lung metastases developed and the patient died five months after above knee amputation. One may question whether the primary GCT contained some malignant cells. However, given the aggressiveness of the malignant tumor, this is unlikely. The recurrence of pain and aggravation of bone destruction many years after the primary treatment suggest malignant transformation of GCT.
 ...
PMID:Osteosarcoma arising from giant cell tumor of bone ten years after primary surgery: a case report and review of the literature. 1643 39

Desmoplastic small round cell tumor (DSRCT) is a rare malignant neoplasm typically involving the abdominal cavity of a young male. Extra-abdominal occurrence of this tumor is very rare. We report a 10-year-old girl with primary DSRCT arising within the left femur. The patient presented with knee pain, and radiological findings were strongly suggestive of osteogenic sarcoma. In addition to the typical microscopic appearance and immunophenotype, RT-PCR demonstrated the chimeric transcript of EWS-WT1, which is diagnostic of DSRCT. Pulmonary metastases were present at initial staging studies, but no abdominal or pelvic lesion was present. Despite chemotherapy and complete tumor excision, the patient developed progressive lung and bone metastases and died 3 years after initial presentation. This is the second reported case of primary DSRCT of bone with genetic confirmation.
 ...
PMID:Primary desmoplastic small round cell tumor of the femur. 1847 May 11

Although osteosarcoma is the most common primary malignancy of bone, it has only been reported to arise from the patella in a handful of cases. Telangiectatic osteosarcoma accounts for <5% of all osteosarcomas, and it is distinguished histologically by spaces, often blood filled, separated by septa containing highly malignant cells and radiographically by a predominately lytic and/or expansile component. Telangiectatic osteosarcoma can be radiologically confused with aneurysmal bone cyst or giant cell tumor. A 22-year-old otherwise healthy man presented with increasing pain, swelling, and limited flexion of the right knee after failing physical therapy for anterior knee pain. Standard anteroposterior and lateral radiographs demonstrated a diffuse destructive process involving the majority of the patella (including loss of the inferior patellar cortex) and a lytic lesion of the proximal tibia. Apparent osteoid matrix was visible in the soft tissue extension along the inferior pole of the patella. A computed tomography scan of the chest showed 2 pulmonary nodules consistent with metastatic disease. Evaluation of core needle biopsy showed osteosarcoma with telangiectatic features. Given that the majority of the tumor involved the patella/extensor mechanism, it was clear that the tumor originated in the patella. This case presents the first published report of a telangiectatic osteosarcoma arising from the patella.
 ...
PMID:Telangiectatic osteosarcoma of the patella. 1929 11

Osteosarcoma is the most common primary malignant osseous neoplasm, constituting approximately 35% of skeletal malignancies. The different subtypes of osteosarcoma are differentiated based on clinical, histologic, and radiographic data, as well as the variable amount of osteoid produced by malignant cells. The epithelioid osteosarcoma subtype accounts for only 5.7% of all osteosarcomas and portends an extremely poor prognosis. The 5-year survival rate for patients with epithelioid osteosarcoma treated with surgery (with or without chemotherapy) is 13.5%. This is in direct contrast to the >70% ten-year survival rate of conventional osteosarcoma treated with surgery and chemotherapy. This article presents a fatal case of epithelioid osteosarcoma in an 11-year-old girl with right knee pain of 6 months' duration. Biopsy demonstrated morphologic findings consistent with high-grade osteosarcoma with epithelioid features. The epithelioid component was positive for vimentin and CD99; however, fluorescent in situ hybridization for the (11;22) translocation was negative. In this case, the epithelioid cells failed to respond to conventional or subsequent experimental chemotherapy for osteosarcoma and eventual metastasized to the lymph nodes and lungs despite multiple ablative surgeries. This case report supports the concept of carcinosarcoma with malignant cells lines arising from 2 different cellular lineages or a common cellular precursor. The epithelial component was more aggressive than the cells of mesenchymal origin, highlighting the need for continued research and a more favorable outcome for this rare subset of osteosarcoma.
 ...
PMID:Progression of aggressive metastatic carcinosarcoma after treatment of epithelioid osteosarcoma. 2080 64

We present a rare case of osteosarcoma involving the patella. A 30-year-old Japanese woman first consulted our out-patient clinic with a 2-year history of knee pain. Radiographs showed an enlargement of the patella with irregular distribution of both osteolytic and sclerotic lesions. Computed tomography and magnetic resonance imaging demonstrated soft tissue extension at the anterior part of the patella. Incisional biopsy showed abundant osteoid formation by spindle-shaped malignant cells, and the histological diagnosis was conventional osteosarcoma. The patient underwent preoperative chemotherapy, but there was no response. Furthermore, she developed a pathological fracture during chemotherapy. She underwent above-the-knee amputation with postoperative chemotherapy. She developed multiple metastases in the thoracic vertebrae 20 months after the surgery. At the most recent examination, she remains alive with multiple spinal metastases without paralysis 4 years after the surgery.
 ...
PMID:Osteosarcoma of the patella: a case report. 2220 Jan 1


1 2 Next >>