Letter: Spontaneous regression in neuroblastoma.
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Abdominal Neoplasms↗
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Results for “FEMORAL NEOPLASMS”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Instability after major tumor resection: prevention and treatment.
Instability is a significant problem after resection of musculoskeletal tumors. In this article, the authors discuss the issue of instability after resections of the pelvis, the femur, and the proximal tibia. The options for reconstruction in each area are discussed along with a review of the literature and a description of the authors' preferred approach.
Bone Neoplasms↗
Intraosseous schwannoma: histologic features, ultrastructure, and review of the literature.
Intraosseous schwannoma, a rare benign neoplasm, has a characteristic radiographic appearance. The histologic features, although similar to those of soft tissue schwannomas, may be obscure when the lesions are highly cellular and the Antoni Types A and B patterns are subtle. Four additional cases of intraosseous schwannoma are presented, with ultrastructural studies from two tumors, one of which was highly cellular and presented a diagnostic problem. The ultrastructural features of intraosseous schwannomas have not been documented previously; however, the findings are essentially the same as those observed in soft tissue schwannomas. The radiographic, histologic, and ultrastructural findings in the cases reported are discussed in relation to published data for intraosseous and soft tissue schwannomas. The authors propose that the comparatively high frequency of mandibular involvement by intraosseous schwannoma may be related to the fact that schwannomas, in general, arise most frequently in the head and neck regions. Furthermore, since schwannomas arise mainly in association with sensory nerves, probably the dearth of such fibers within bone accounts for the rarity of intraosseous schwannoma.
Adolescent↗
Adolescent siblings with thigh pain at the same age.
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Adolescent↗
Multiple myeloma of an extremity: must the entire bone be treated?
PURPOSE/OBJECTIVE: Radiation of the entire shaft of a long bone affected by multiple myeloma (MM) is often advocated to prevent recurrent disease in the bone remote from the symptomatic site. Our standard of care has been to irradiate only the symptomatic area. We investigated the pattern of recurrence in patients treated in this manner. METHODS AND MATERIALS: 163 patient with MM were treated between 1971 and 1994. Twenty-seven patients received treatment to a long bone with 41 sites irradiated (17 humeri, 22 femurs, 1 radius, 1 ulna). The most common long bone treated was the femur. All patients were treated with megavoltage therapy. The symptomatic lesion, plus a margin of 1-2 cm was treated with no attempt to treat the entire shaft. Mean radiation dose was 27.82 Gy (range 6.00-44.80 Gy). The length of the field was measured in centimeters and expressed as both an absolute (AL) and relative (RL) length (i.e., percentage of total length of bone). RESULTS: The mean total AL and RL for femur fields was 18 cm and 42%, respectively. For the humerus, the AL and RL were 20 cm and 68%, respectively. Only four patients developed progressive disease in the same bone but outside the previously irradiated field. In three of the four patients the RL was between 20 and 30%. The dose of radiation given to these patients was 12.50, 21.00, 30.00, and 35.00 Gy. In all of these four cases, treatment of progressive disease in adjacent sites provided effective palliation of symptoms. CONCLUSION: Radiation therapy to the symptomatic portion of a long bone affected by MM is effective for palliation. Symptomatic recurrence out of the irradiated field is uncommon and can be effectively treated. Potential benefits of this approach include irradiation of less normal marrow and elimination of use of pairs of fields or extended distance treatment to cover the entire femur.
Adult↗
Radionuclide bone imaging.
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Anemia, Sickle Cell↗
Radiation-induced fibrosarcoma.
Six cases of fibrosarcoma arising in previously irradiated tissues are reported, out of a total of 220 cases of fibrosarcoma treated at Mount Vernon Hospital during the last 23 years.This rare occurrence may follow at any interval from 3 to 38 years after irradiation, usually after high dosage. Four of our six cases are known to have died of the disease.The literature regarding radiation-induced fibrosarcoma is reviewed and it is suggested that adequate excision or amputation may be curative, if undertaken early enough.
Adult↗
A functional analysis of massive knee replacement after extra-articular resections of primary bone tumors.
We performed a functional analysis of massive knee replacements after extra-articular resection of primary bone tumors. Patients did not score as highly on the Musculoskeletal Tumour Society Score and Knee Society Score (P < or = .01) as patients who had undergone intra-articular resection. Lower scores were achieved for emotional acceptance (P < or = .01), functional restriction (P < or = .05), walking distance (P < or = .05), and managing stairs (P < or = .05). These patients had a significantly greater extension lag (P < or = .01) and greater fixed flexion (P < or = .05). This functional deficit is primarily due to a compromised extensor mechanism inherent in the type of surgical resection necessary to achieve adequate removal of the tumor.
Adolescent↗
[The value of intra-osseous angiography for primary, malignant bone tumours (author's transl)].
By means of intra-osseous angiography, it is possible to demonstrate abnormal vascularisation, the vascular pattern of osteolytic sarcomas differing markedly from that of osteoplastictumours. Important information can be obtained regarding the close relationship between tumour vessels and the parosteal soft tissue vessels. The close relationship between these provides ample explanation for the early occurrence of haematogenous metastases. The extent of the intramedullary tumour component of chondrosarcomas can also be demonstrated.
Adolescent↗
[Xeroradiography in the diagnosis of skeletal diseases (author's transl)].
The value of xeroradiography in the diagnosis of peripheral skeletal lesions is illustrated by some typical examples and compared with standard radiographic procedures. The advantages of xeroradiography depend on its convenient format, easy appreciation of structural changes and easy viewing. On the other hand, density gradations are flattened. Compared with a technically satisfactory film examination, there is no increase in diagnostic information. Xeroradiography can therefore only be regarded as complementary to conventional radiography for the diagnosis of skeletal conditions.
Bone Diseases↗
[Retinoblastoma gene analysis in a patient with osteosarcoma following previous bilateral retinoblastoma].
In a native osteosarcoma specimen of a patient cured of a bilateral retinoblastoma eight years before we found a homozygous deletion of a 7.5 kb Hind III-fragment within the retinoblastoma gene and a hemizygous deletion of the same fragment in its constitutional cells. In a native osteosarcoma tissue of a lung metastasis of a patient with sporadic osteosarcoma the Rb-gene-analysis did not reveal any deletion within the gene. This might be due to the fact that the used c-DNA-probe did not detect point mutations. Nevertheless, the possibility of additional or alternative transforming events should be kept in mind.
Brain Neoplasms↗
[Internal osteosynthesis of pathological fractures caused by breast cancer].
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Bone Neoplasms↗
[Diagnosis of recurrence and therapy of recurrence with in situ bone cement filling in the treatment of giant cell tumor].
Bone-cement plugging allows immediate weight bearing and early detection in case of recurrence of giant cell tumor. A recurrence might be treated by either total or partial removal of the old plug and new curettage followed by a second cement plug. The method allows to plan the final surgery for a time which is likely free of risk of recurrence and which appears appropriate in terms of private time scheduling. In addition it saves the valuable autogenous graft.
Adolescent↗
[The deliberate intralesional tumor resection].
Two exemplary cases (giant cell tumor, osteochondroma) are described in order to show the problems associated with intralesional tumor excision. Quite frequently, the size and location of the tumor will permit an intralesional procedure only, with high risk of regrowth or further growth of the tumor. Patients should be informed of possible consequences.
Adult↗
[Partial replacement of the pelvis with the hip joint and proximal femur. A possibility in tumor treatment].
In cases of extensive destructive osteolytic processes in the pelvis and hip region, alloplastic replacement of a part of the pelvis with a total hip replacement and, if necessary, partial replacement of the femur, can represent a therapeutic alternative to hemipelvectomy for preserving the limb in the presence of malignancies; it offers the same degree of radicality in removing the affected bone and soft tissue while preserving the bone. This applies with regard both to primary malignant growths as well as extensive isolated metastases and aseptic osteolysis following multiple total replacement procedures. The partial pelvic prostheses, produced individually on the basis of roentgenograms, are adapted to a great degree intraoperatively and fixed with screws, locknuts, and Palacos, and if possible lined with autogenous bone. Where the defects are extensive the pubic bone of the unaffected side is incorporated in the stabilization. Experience gathered so far and follow-up examinations show that all patients regain full mobility and weight-bearing ability, with almost complete lack of complaints and adequate to good motility. This is demonstrated by examples.
Adult↗
Bone metastases from thyroid carcinoma: clinical characteristics and prognostic variables in one hundred forty-six patients.
To describe the clinical characteristics and define the indicators that best predict survival in patients with bone metastases from thyroid carcinomas. We collected data from medical records of 146 patients with documented bone metastases from thyroid carcinoma seen at our medical center over a 38-year period. Univariate and multivariate analyses of prognostic indicators for survival were performed. Bone metastases were present at the initial diagnosis in 47% of patients. Vertebrae (29%), pelvis (22%), ribs (17%), and femur (11%) were the most common sites of metastases. Multiple lesions were present in 53% of the cases. The overall 10-year survival rate from the time of diagnosis of thyroid cancer was 35%, and from diagnosis of initial bone metastasis was 13%. By univariate analysis from the time of the initial bone metastasis, radioiodine uptake by skeletal metastases, the absence of nonosseous metastases and treatment with radioiodine were significant prognostic factors. By multivariate analysis, radioiodine uptake by skeletal metastases and the absence of nonosseous metastases were independent favorable prognostic variables for survival. In a subgroup of patients in which histologic specimens were available and were reviewed, Hurthle cell carcinoma was the most favorable histologic subtype for survival with the undifferentiated subtype being the worst. The spread of thyroid carcinoma to bone is more common in patients over 45 years of age, is usually symptomatic, and is often multicentric. Overall survival is best in those whose lesions concentrate radioactive iodine and those who have no nonosseous metastases.
Adult↗
Sliding shape-designed latissimus dorsi flap.
The latissimus dorsi musculocutaneous flap can provide a large, reliable flap for reconstruction of various areas of the body. This flap can also be extended quite some way over the anterior and upper border of the muscle, although its width is limited to between 10 cm and 12 cm if direct closure of the donor site defect is required. This paper presents a sliding-shaped modification of the latissimus dorsi flap that enables the flap to be used efficiently in covering a wide defect as well as in correcting the donor site defect.
Adolescent↗