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Nonangiogenic and nonlymphomatous sarcomas of the canine spleen: 57 cases (1975-1987).

The case records of and histopathologic findings in 57 dogs with nonangiogenic and nonlymphomatous splenic sarcomas were reviewed. Splenic neoplasms in these dogs included leiomyosarcoma, fibrosarcoma, undifferentiated sarcoma, liposarcoma, osteosarcoma, chondrosarcoma, myxosarcoma, rhabdomyosarcoma, and fibrous histiocytoma. The clinical signs associated with splenic sarcoma included anorexia or decreased appetite, abdominal distention, polydipsia, lethargy, vomiting, weight loss, and weakness. An abdominal mass was detected in 86% of the dogs by use of abdominal palpation (63%), and/or abdominal radiography (74%). The diagnosis was based on histopathologic findings in the spleen. Abdominal exploratory surgery was performed on 43 of the 57 dogs. Twenty-seven dogs were treated by splenectomy, and 16 were euthanatized at the time of surgery because of widespread metastatic lesions. Of the 14 dogs on which surgery was not performed, 11 were euthanatized on the basis of results of preoperative diagnostic tests, and the remaining 3 dogs had splenic neoplasms that were incidental findings at necropsy. Of the 27 surgically treated dogs, 5 died in the immediate postoperative period, 12 died or were euthanatized within 1 year after splenectomy, and only 5 dogs survived greater than or equal to 1 year. Three dogs were lost to follow-up evaluation, and 2 were still alive 6 and 7 months after surgery. The median survival time of the 22 dogs for which survival was known was 2.5 months. The median survival time for 11 dogs with no obvious metastasis at the time of splenectomy was 9 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Reconstruction of bone defects with autograft after resection of upper extremity bone].

OBJECTIVE: To discuss the reconstructive method of the bone defect after resection of the upper extremity bone tumor and to assess the outcome of the autograft to reconstruct the bone defect after the bone tumor resection. METHODS: From August 1998 to March 2004, 16 patients aged 7-45 years suffering from bone tumor of the upper extremity were treated with the wide resection of the bone tumor and the reconstruction of the bone defect by the autograft. The following diagnoses were confirmed by pathological examination: Ewing's sarcoma and osteosarcoma of the proximal humerus in 1 patient each; Ewing's sarcoma of the distal humerus in 2 patients; giant cell tumor in 8 patients, high-grade chondrosarcoma in 2, malignant fibrohistiocytoma in 1; and osteosarcoma in 1 of the distal radius. Substitution of the proximal humerus with the clavicle was performed in 2 patients, and the distal humerus with the fibula in other 2 patients. Of the 12 patients with tumor in the distal radius, 1 was reconstructed with autograft of the iliac bone and 11 with autograft with the fibula. The functional outcome was evaluated by the MSTS score. RESULTS: The follow-up for 36 and 12 months respectively revealed that in the 2 patients undergoing the autograft with the clavicle in the proximal humerus, good shoulder functions of flexion and extension were obtained although the function of abduction was poor, with the MSTS scores of 23 and 22 respectively. In the 2 patients undergoing the autograft with the fibular in the distal humerus, good elbow function and bone union were observed according to the follow-up for 3 and 4 months respectively, with the MSTS scores of 24 and 19 respectively. Of the 12 patients undergoing the autograft in the distal radius, 11 had an excellent or good function with no complication, with the average MSTS score of 22.6 (ranging from 18 to 27), according to the follow-up for 6-75 months; only 1 had no bone union 10 months after operation and lost the follow-up afterwards. CONCLUSION: Reconstruction of the bone defect with the autograft after the wide resection of the upper extremity bone tumor is an ideal and reliable method for some suitable patients, especially for some children.

Adolescent↗

Comparison of technetium 99m-phytate and technetium 99m-sulphur colloid in primary bone tumours.

Eleven patients with proven primary bone tumour (five Ewing sarcomas, six osteosarcomas) and two cases of metastatic bone involvement (primary other than bone) were investigated with 99mTc-phytate and 99mTc-sulphur colloid to compare the behaviour of the two radiopharmaceuticals at the tumour site. After intravenous administration of the respective radiopharmaceutical, imaging of the tumour site and its contralateral part was carried out at 15 min and 1 h intervals. The data were stored in our computer. Bone scanning was also carried out in all patients. 99mTc-phytate uptake was observed at the tumour site in ten cases. The 99mTc-sulphur colloid study revealed sparse or no significant uptake in eight cases. In two patients, with osteosarcoma 99mTc-sulphur colloid investigation showed uptake at the primary tumour site. However, the distribution pattern is different from that of 99mTc-phytate. No significant uptake of either 99mTc-phytate or 99mTc-sulphur colloid was observed in the two patients with metastatic skeletal disease. It may be concluded that the unusual accumulation of 99mTc-phytate at the tumour site is not due to any generalized reticuloendothelial phenomenon and that the radiopharmaceutical itself is responsible for this.

Adolescent↗

Pelvic limb-salvage surgery for malignant tumors.

Thirteen patients with primary malignant tumors of the pelvis underwent internal hemipelvectomy. The diagnoses were: Ewing's sarcoma 7, osteosarcoma 4, chondrosarcoma 1, and malignant fibrous histiocytoma 1. No megaprostheses or massive allografts were used for reconstruction. Six patients underwent resection only with no reconstruction, 5 had strut grafts inserted to restore the pelvic ring, 1 had an autoclaved autograft of the acetabulum and 1 had an ilio-femoral arthrodesis. No patients were lost to follow-up. Nine patients died from their disease after an average of 23 months (range 2 to 72 months). The 4 survivors (3 free of disease) have an average follow-up of 84 months (range 60 to 120 months).

Adolescent↗

Sarcoma in Iran.

PURPOSE: To review the clinical characteristics of 1470 sarcoma cases and to define the factors in patients that predict out come, relapse and survival. METHODS: Retrospective analysis of the database for the period 1991-2002, focusing on demographic, tumor related and treatment related variables, relapse free survival (RFS) and overall survival (OS) using the Kaplan- Meier method. Statistical significance was evaluated using the chi square and t- tests for univariate influence and a Cox regression model for multivariate influence. RESULTS: Mean age was 30 years. The male to female ratio was 3/2 and 23% of the cases were under 16 years of age. Median tumor diameter was 10.5 centimeters. The bone to soft tissue sarcoma ratio was 3/1 in children and 1/3 in adults. Osteosarcoma, Ewing's tumours and rhabdomyosarcomas accounted for 83% of childhood tumors. In adults osteosarcomas, synovial sarcomas and malignant fibrous histocytomas (MFHs) were the most common subtypes. Mean follow up time was 56 months. Of the total, 25% had initial metastasis, 86% received chemotherapy and 41 % underwent radiotherapy. The main prognostic factors for survival were tumor size, margin of surgery, neurovascular involvement in the pathological report, initial metastasis and no complete response to first therapy. Adjuvant radiotherapy, small tumor size, curative surgery with chemotherapy and free surgical margins were significantly associated with reduced recurrence. CONCLUSION: Our patients are characterised by diagnosis with a large tumor size, advanced stage of disease and short survival. A complete response to primary therapy is the main independent variable for overall survival. Earlier diagnosis and an experienced team including surgical, medical and radiotherapy oncologists are needed for a better response and longer survival of patients.

Adolescent↗

Differential susceptibility of pediatric sarcoma cells to oncolysis by conditionally replication-competent herpes simplex viruses.

PURPOSE: Attenuated viruses derived from herpes simplex virus (HSV) type 1 that kill tumor cells (oncolysis) are currently in clinical trials for selected cancers, primarily carcinomas and gliomas. The authors sought to determine if pediatric sarcoma cells are also sensitive to HSV-mediated oncolysis. MATERIALS AND METHODS: The authors tested a panel of ten cell lines derived from rhabdomyosarcoma, osteosarcoma, Ewing sarcoma, and a secondary malignant fibrous histiocytoma for survival after exposure to attenuated HSV vectors. The viruses used included NV1020, haploid for the neurovirulence gene, and G207, deleted for both and ribonucleotide reductase but expressing the beta-galactosidase reporter gene. G207 transduction was determined by measuring beta-galactosidase expression. RESULTS: Sarcoma cells differed in their sensitivity to viral oncolysis but were relatively consistent by histologic type. Rhabdomyosarcoma and malignant fibrous histiocytoma cells were most sensitive while osteosarcoma cells were intermediately sensitive to oncolysis by both HSV recombinants. Although Ewing sarcoma cells showed efficient viral entry and gene transfer, these cells were the least susceptible to oncolysis by HSV. CONCLUSIONS: Conditionally replication-competent HSV-derived vectors may be useful for the treatment of rhabdomyosarcoma and osteosarcoma, but may not be as efficacious for treating Ewing sarcoma until the mechanism of resistance is defined and circumvented.

Cell Survival↗

[Adjuvant chemotherapy in the treatment of sarcomas].

For many types of cancers, adjuvant chemotherapy showed a moderate but significant benefit in terms of survival improvement. In sarcomas, the situation is contrasted and depends on the histological, molecular sub-types, as well as the topography of the tumor. Soft tissue sarcomas are in general poorly chemosensitive tumors and while adjuvant chemotherapy was found effective to delay relapses or to decrease the local relapses, it failed to yield a significant benefit with regard to overall survival. Sub-groups analysis indicate a significant lengthening of survival for the soft tissues sarcomas of the extremities. Neoadjuvant chemotherapy of the soft tissues sarcomas starts should be reserved to rhabdomyosarcomas and the bone sarcomas like the osteosarcomas and the Ewing's sarcomas of bones are more susceptible to chemotherapy, which is an integral part of the treatment with a preoperative chemotherapy and, following surgery of the primary tumor, an adjuvant chemotherapy adapted to the histological response to the neoadjuvant treatment.

Antineoplastic Combined Chemotherapy Protocols↗

[Roentgen diagnosis of structural changes in the pubic area in children and adolescents. Personal case reports, differential diagnosis and literature review].

Structural changes in the pubic bone often are difficult to interpret. The radiologic appearance is very different. The differentiation between inflammatory and malignant processes is hardly to distinguish. We are reporting ten patients with osseous changes in the os pubic (4 Ewing's sarcoma, 1 osteosarcoma, 1 Morbus Hodgkin, 1 osteochondronecrosis, 2 osteochondritis, 1 subchronic osteomyelitis). Two patients with Ewing's sarcoma who were initially treated for osteomyelitis are described in detail. Differential diagnosis and previous literature are reviewed.

Adolescent↗

Osteosarcoma with small cells simulating Ewing's tumor.

Twenty-four patients who had osseous lesions with histological features of both Ewing's sarcoma and osteosarcoma were studied. Because of their appearance, these lesions have been labeled small-cell osteosarcomas. They appear to represent a definite histological entity and the prognosis may be worse for these lesions than for conventional osteosarcomas. It is most important not to misdiagnose this tumor as Ewing's sarcoma because it appears not to be radiosensitive. Radical surgery and modern adjuvant chemotherapy seem to offer the best chance of cure.

Adolescent↗