Sarcoma arising in irradiated bone: report of eleven cases. 1948.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to N L Higinbotham.
Explore the source record for details and available documents.
Sixty-six patients with well-documented osteogenic sarcomas arising in bones and soft tissues after exposure to x-rays, which represent approximately 5.5 percent of all osteogenic sarcomas registered since 1921 at this institution, were studied. These secondary sarcomas occurred in equal proportion in both sexes, with the sixth decade of life being the most common age. In 42 patients, the bone had been normal at the time of irradiation, whereas in 24, the radiation was directed against an osseous tumor or tumor-like lesion. The median latent period was 10.5 years in both groups, ranging from 3.5 to 33 years. The radiation varied from diagnostic quality to 1 MeV x-rays. The dose was variable, but none was less than 2000 rads. Postradiation osteogenic sarcomas most commonly arose in the bones of the pelvic and shoulder regions. Histologically, the sarcomas were mostly of the fibrous type (46%) and radiographically showed a destructive bone lesion with or without signs of radiation osteitis. The cumulative disease-free survival rate at 5 years was 17%, with a median survival estimate of 1 year.
One hundred thirty patients with histologically verified primary fibrosarcoma of bone, unassociated with any pre-existent benign bone condition, were treated at Memorial Sloan-Kettering Cancer Center between 1918 and 1973. This series of cases represents approximately 5% of primary malignant bone tumors treated in our institution. Eighty-nine of the lesions were medullary or central in location, and 41 were periosteal or peripheral. There was a nearly equal sex distribution, and a mean age of 38 years ranging from 4 to 83 years. This lesion exhibited a strong predilection for long bones, with the most common location being the femur (43 cases), humerus (16 cases), and tibia (12 cases). In 19 instances, bones of the head and neck area were the primary sites. The roentgenographic differential diagnoses included osteolytic osteogenic sarcoma, malignant giant cell tumor, metastatic carcinoma, or solitary plasma cell myeloma. Major ablative surgery was the primary method of therapy. Amputation was performed, yielding the best curative results in high-grade tumors, while radical local excision sufficed for most low-grade periosteal fibrosarcomas. Thirty-four percent of the patients survived 5 years (27% medullary and 52% periosteal), while 28% were alive after 10 years (20% medullary and 48% periosteal). These survival rates provide further evidence that fibrosarcoma of bone is a distinct clinicopathologic entity and not a variant of osteosarcoma, which carries a much poorer 5-year survival rate of approximately 17%.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.