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At least 199 records · Page 11Linked to original sources
PubMed1982

The total thigh and rectus abdominis myocutaneous flap for closure of extensive hemipelvectomy defects.

Hemipelvectomy is a lifesaving procedure when used appropriately and yields a 35%, five-year survival in the cancer patient. However, the standard posterior flap for closure is not always available. Two flaps, the thigh flap and the rectus abdominis myocutaneous flap, are described in which any soft tissue defect resulting from hemipelvectomy can be safely closed primarily when the posterior flap is not available. The total rectus abdominis flap is previously undescribed and unique in its application. These techniques significantly contribute to the surgeon's armamentarium for decreasing morbidity and mortality and resectability of unusual pelvic and thigh tumors.

Abdominal Muscles↗
PubMed1985

Periosteal osteosarcoma.

An analysis of 6 patients with periosteal osteosarcoma treated by the authors along with a review of 55 patients reported in the literature demonstrates that periosteal osteosarcoma is distinctly different from conventional osteosarcoma or periosteal chondrosarcoma. Periosteal osteosarcoma is a less aggressive tumor than conventional osteosarcoma. It is a relatively well-differentiated chondroblastic osteosarcoma occurring on the surface of the long bones of the extremities. Three patients demonstrated frank medullary invasion of tumor, two grossly and one microsurgically. Patients treated with marginal resection had a 70% local recurrence rate. Patients receiving wide resection or primary amputation have survived longer with less recurrence of disease. Overall, 10 of 61 patients are dead with metastatic disease with a mean reported follow-up of 6 years and 7 months. Adjunctive therapy has been of no demonstrable aid in terms of prolonging survival. Medullary extension of this tumor should not be used to exclude this diagnosis. The authors believe that the treatment of choice is wide resection without adjunctive chemotherapy.

Adolescent↗
PubMed1989

Dedifferentiated parosteal osteosarcoma of the femur with aneuploidy and lung metastases.

In this report, the pathologic findings and the results of cellular DNA measurements of a tumor that on first presentation seemed to be a classical parosteal osteosarcoma are described. After resection 8 months later, part of the tumor appeared to display highly malignant features. DNA flow cytometry of this part of the tumor showed an aneuploid cell population. The aggressive nature of the tumor was confirmed by the development of lung metastases approximately 1 year after resection of the primary tumor.

Adult↗
PubMed1993

Surgical management of pelvic and extremity osteosarcoma.

Between 60-80% of all patients with osteosarcomas of the pelvis and the extremities can now be safely treated with limb-sparing surgery. Results (as defined by rates of local recurrence, overall survival, and function) are equal to or better than those associated with amputation. Successful use of limb-sparing procedures, however, depends on a well-developed surgical plan. An understanding of the biologic behavior and growth patterns of these lesions is fundamental. Staging of the primary tumor must involve a full complement of imaging modalities, including plain radiography, bone scintigraphy, computerized axial tomography (CAT), magnetic resonance imaging (MRI), and angiography. The biopsy must be well placed to reduce the possibility of tissue contamination, which is a common reason for amputation. Restaging is necessary before surgery for patients who have undergone neoadjuvant therapy; there is recent evidence that preoperative therapy may make limb-sparing surgery possible in more than 50% of patients who otherwise would have required amputation. Relative contraindications to limb-sparing surgery include major involvement of the neurovascular bundle, pathologic fracture, inappropriate biopsy site, infection, immature skeletal age, and extensive muscle involvement. Each of these factors is relative, and patient selection decisions must be made on an individual basis. Limb-sparing surgery consists of the following three phases: tumor resection, skeletal reconstruction, and soft tissue and muscle transfers. The range of reconstruction techniques has been broadened by developments in bioengineering. Among the more commonly used techniques are custom endoprostheses and allograft replacements. Future progress in induction regimens and reconstructive techniques will undoubtedly enable limb-sparing surgery to be a satisfactory alternative to amputation in even more patients.

Amputation, Surgical↗
PubMed1985

Breast carcinoma metastatic to eyelids: case report and review of the literature.

Violaceous, indurated plaques around both eyes were found to be cutaneous metastases and the initial clinical presentation of a lobular carcinoma of the breast in an 80-year-old woman. Available literature indicates that breast carcinoma is the most common metastatic tumor of the eyelid and the onset of a palpebral mass may precede the diagnosis of the primary tumor in the breast.

Aged↗
PubMed1992

Surgical treatment of metastatic tumors of long bones and the spine.

We have operated on 42 patients with bone metastasis from various primary tumors over the past fourteen years. The number of operated cases of metastasis secondary to thyroid and breast carcinoma was especially high, since patients with such types of cancer have prolonged life expectancies in general. The sites of these operation were as follows: 27 in the spine, 12 in the femur, 2 in the tibia, and 1 in the humerus.

Aged↗
PubMed1992

Computed tomography appearance of bone metastases of leiomyosarcoma.

Bone lesions in leiomyosarcoma are uncommon. When encountered, they are usually a late manifestation of disease seen in the setting of widespread systemic metastases. We present five cases of metastatic leiomyosarcoma, including one in which a bone lesion predated detection of a primary gastric leiomyosarcoma and one in which bone metastases signaled disease recurrence. Computed tomography in 14 of 16 osseous leiomyosarcomas demonstrated a lytic, non-expansile pattern.

Adult↗
PubMed1990

Malignant transformation in bone lipomas.

This report presents four cases of presumed malignant transformation within intraosseous lipomas, one occurring in a stage I lesion and three in stage III lesions, according to my classification. These lesions demonstrated radiologic and histologic features of benign lipomas together with histologic fields of either malignant fibrous histiocytoma or liposarcoma. In two of the three patients who were followed up, the tumors were fatal despite amputation. Malignant transformation of a lipoma should be suspected when rapid bone destruction is seen in a stage I radiolucent lipoma. Malignant transformation of stage III lipomas could be mistaken for malignant transformation within bone infarcts.

Adult↗
PubMed1990

Case report 618. Metastatic angioblastic meningioma.

A patient with a history of angioblastic meningioma 7 years previously developed lytic metastatic disease to the femur at two separate sites. The controversy in terminology of angioblastic meningioma and hemangiopericytoma and the similarity in radiological and pathological appearance of primary and metastatic hemangiopericytoma of bone illustrate the need for an accurate clinical history to arrive at a correct diagnosis.

Adult↗
PubMed1995

Multicentric giant cell tumor of skeleton.

A case of multicentric metachronous GCT was presented. The clinical and radiographic features of multicentric GCT as reported in the literature and in the present case were discussed. The multiple bone involvement made therapeutic assessment difficult. The surgical stage as well as the location of each lesion were important in planning surgery.

Adult↗
PubMed1992

Case report 722. Osteosarcomatosis in a skeletally immature girl.

We report a case of a clinically and radiographically dominant osteosarcoma of the proximal end of the tibia, in which the second skeletal focus of osteosarcoma was apparent on MRI, after having escaped detection on routine radiographs and scintigraphy. Detection of the second lesion significantly altered the subsequent treatment and prognosis. The improved sensitivity of MRI may increase the accuracy of the diagnosis of osteosarcomatosis. Although further study is needed, MRI study of long bones, especially T1-weighted images in the coronal plane, may be considered as a screening procedure to exclude occult skeletal involvement in patients with osteosarcoma and negative standard metastatic evaluation.

Adolescent↗
PubMed1985

[Twenty-year record of osteosynthesis of bone metastases. Analyses of 300 cases].

The authors have analysed the results of 300 operations for metastases in bone carried out in the last 20 years. The best results were obtained where prosthetic replacement was possible, and where deposits in long bones were treated by closed intramedullary fixation. This type of surgery gives satisfactory, comfortable function and should be part of a multidisciplinary approach in the management of patients with cancer.

Adult↗