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At least 307 records · Page 17Linked to original sources

Surface osteomas of the appendicular skeleton.

OBJECTIVE: This study describes the radiographic, CT, and MR imaging features of surface osteomas of the appendicular skeleton in four patients without Gardner's syndrome or tuberous sclerosis and reviews the incidence and management options of this uncommon tumor. CONCLUSION: On imaging (best seen on CT), the osteomas were homogeneously dense-as dense at the periphery as the base-and without an accompanying soft-tissue mass, cortical destruction, or intramedullary invasion. The margins of each osteoma were smooth or smoothly lobulated. When the correct diagnosis was considered in two patients, close clinical follow-up or marginal excision were the management options chosen. Histologic examination of the tumors revealed dense sclerotic lamellar bone with haversian systems that showed features similar to those of normal cortical bone. During a follow-up period of 6 months to 5 years, patients have had no local recurrences or metastases.

Adult↗

Dedifferentiated chondrosarcoma: an ultrastructural study of two cases, with immunocytochemical correlations.

The clinicopathologic features of two cases of dedifferentiated chondrosarcoma (DCS) are presented, in which anaplastic components showed the electron microscopic features of malignant fibrous histiocytoma, as well as immunoreactivity for alpha-1-antitrypsin and alpha-1-antichymotrypsin. Rare cells also displayed S100 protein in high-grade areas of the primary tumors, but a pulmonary metastasis lacked this determinant. These findings could be interpreted as reflecting a retained potential for primitive chondrogenesis in primary DCS, which may be lost in its metastases. In all other respects, this tumor appears to assume the morphological and immunocytochemical attributes of a fibrohistiocytic neoplasm.

Bone Neoplasms↗

Kotz modular femur and tibia replacement. 28 tumor cases followed for 3 (1-8) years.

In the period 1984-1991, 33 lower limb reconstructions were performed with an uncemented Kotz modular femur tibia reconstruction (KMFTR) prosthesis after resection of 32 malignant bone tumors and 1 benign giant cell tumors. Tumor localization was proximal femur in 12, distal femur in 17, and proximal tibia in 4. The mean age of the patients was 38 years. 28 patients with a minimum follow-up of 1 year were studied after 3 (1-8) years. 7 patients were reoperated because of complications. Good or excellent results were obtained in 6 of the 10 proximal and 13 of the 14 distal femur reconstructions. In 2 of the 4 patients undergoing combined distal femur and proximal tibia resection, a deep infection developed, and above-knee amputation was performed. One local recurrence occurred after proximal femur resection.

Adolescent↗

Expression of nm23 protein in human osteosarcoma in relationship with early metastasis.

Nm23 protein expression was analyzed by immunohistochemical staining using formalin-fixed, paraffin-embedded sections from 39 cases with osteosarcomas and compared with the histologic findings and early metastasis for the purpose of detecting nm23 expression in osteosarcoma and elucidating the clinical significance of its expression. Immunoreactivity of nm23 protein was detected in 48.7% of the total cases. There was no statistical difference between nm23 expression and early metastasis, but there was a trend for cases with nm23 expression to progress to early metastasis within 1 year after operation. The role of nm23 as a tumor metastasis suppressor in osteosarcomas appeared less prominent.

Adolescent↗

Preliminary observation on the correlation between nm23 expression and Ki-67 antigen with early metastasis of human osteosarcoma.

OBJECTIVES: To detect the nm23 expression in osteosarcoma, analyze the correlation between nm23 expression and early metastasis and to study the relation between nm23 expression with tumor differentiation and cell proliferation, as defined by Ki-67 labeling. METHODS: nm23 oncoprotein expression was measured by immunohistochemical staining using formalin fixed, paraffin embedded sections of 39 surgically resected osteosarcomas and was compared with Ki-67 expression, histological findings and early metastasis. In each sample, the grading of immunoreactivity was recorded as 0, 1+, 2+ according to the percentage of nm23 and Ki-67 labeling cells respectively. RESULTS: The cases with more than 25% positive immunoreactivity of nm23 protein were detected in 48.7% of the total cases. There was no statistical difference between nm23 expression and early metastasis, but the cases with nm23 expression appeared to have a trend to get early metastasis. nm23 expression was significantly correlated with Ki-67 expression, which was associated with differentiation of the tumor cells. CONCLUSION: The role of nm23 as a tumor metastasis suppressor in osteosarcoma is less prominent. Both nm23 and Ki-67 may help predict the possibility of early metastasis in human osteosarcomas.

Adolescent↗

Pathological fracture complicating epidural local anaesthetic opioid infusion for cancer pain.

Two cases of severe bone pains from metastatic cancer, without clinical or radiological evidence of fractures on admission, are presented. Pain control and mobilization were achieved initially with local anaesthetic-opioid epidural infusion. Subsequent loss of analgesia prompted a re-examination, which revealed pathological fractures of the femur. Internal fixation of the fractures resulted in good control such that strong opioids were no longer required.

Aged↗

Coexisting chondroblastoma and osteochondroma: a case report.

The coexistence of two different types of benign cartilaginous tumours of bone in the same patient has not been reported in literature. We report a case in which a sixteen-year-old male had a benign chondroblastoma of the proximal left humerus and an osteochondroma of the distal left femur. Both originated at the same time and had a progressive increase in size with growth.

Adolescent↗

[Therapy of bone metastases of the lower extremity with the KMFTR modular tumor endoprosthesis system].

During the years 1975 through 1989, 189 patients have been operated because of metastases within bones of the lower extremity. Thereof, 34 patients received an endoprosthesis of the KMFTR (Kotz Modular Femur-Tibia reconstruction system) type. In detail, the following reconstruction elements had been used: proximal femur (n = 20), distal femur (n = 7), complete femur (n = 2), proximal tibia (n = 5). At the time of follow-up examination 30 patients had died. Mean survival time after resection of metastases was 18.6 months (range 8-44 months). According to histologic judgement, in 23 cases wide or marginal resections had been performed whereas 11 patients had been operated intralesionally. In no case local recurrence as relevant to therapy was observed. At the same time-point, survival periods after detection of secondary manifestations of the malignant diseases within the remaining 4 patients were 29, 61, 73 and 125 months, respectively. The following complications were observed: luxation of the prosthesis (n = 6), transient paresis of the peroneus (n = 3), deep vein thrombosis (n = 2), pulmonary infarction (n = 1), wound healing disturbances (n = 2) and hematoma (n = 3).

Acetabulum↗

[Complications caused by artificial hinge knee joint].

Artificial hinge knee joint was used in 25 patients with bone tumors around the knee joint. 23 patients were followed on the average for 3 years and 3 months. Complication was noted in 10 patients including infection in 7 (5 short-term, 2 long-term), broken joint in 1 patient and loosening in 2. The causes for complication and counter-measures were discussed.

Adolescent↗

[Experience with modular system tumor prostheses].

Authors elaborated a modular tumor prosthesis by the use of which the bone segment lost after the resection of hip, femur, knee and proximal tibial tumors can be supplemented in the desired measure. The components of the prosthesis set and the field of its use are described. In the last one and half year modular tumor prostheses were inserted in 10 patients: in 6 primary bone tumors and 4 solitary metastases. One shoulder, 5 hip, 3 stiff knee and 1 tibia diaphysis supplementing modular prostheses were inserted. In spite of 2 complications the initial experiences are encouraging, and in adequate indication the possibility of retaining limb and articular function beside good functional results is given.

Bone Neoplasms↗

[Results of using bone cement and phenol lavage in the surgical management of giant cell bone tumors].

Authors report on experiences gained with phenol lavage used as adjuvant and filling with bone cement in the surgical treatment of giant cell tumors of the bone. The effect of the adjuvant therapy was a considerable decrease in the rate of relapses: in 11 patients 1 relapse was found only in contrary to the 15 relapses in the control material (41 per cent) after 36 excochleations. They think that with adequate indications both the phenol lavage and filling with bone cement are useful supplements to the surgical therapy.

Adolescent↗