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PubMedDate not supplied

[A surgical method in the complex treatment of metastatic bone tumors].

The article deals with the results of operations applied in the system of complex treatment of 83 patients (86 operations) with metastases of malignant tumours in the skeletal bones. Fourteen patient had carcinoma of the lung, 23--carcinoma of the breast, 28--carcinoma of the kidney, 8--carcinoma of the thyroid gland, and 10 patients had other malignant tumors. Operative interventions in the form of resection of the articular end or total removal of a tubular bone with endoprosthesis in affection of a long tubular bone and its pathological fracture or the threat of such fracture were substantiated. In the presence of special indications, osteosynthesis of the pathological fracture or amputation (exarticulation) of the limb may be undertaken. Laminectomy is indicated in metastatic lesion of the spine with the development of neurological disorders. Four (5%) patients died in the postoperative period. Average survival in the group of patients was 35 months, in the separate groups it was as follows: lung carcinoma metastases--9 months, kidney carcinoma metastases--31 months, thyroid carcinoma metastases--37 months, breast carcinoma metastases--40 months, metastases of other forms of malignant tumors--30 months. Longest survival--7.5 years. Average value of life quality according to Karnovsky was 30% before operation and 67% after it.

Amputation, Surgical↗
PubMed2004

[The clinical analysis of free patellar implantation in repairing the defect of the knee of giant cell tumors].

OBJECTIVE: To analysis the clinical effects of free patellar implantation in treating the defect of the knee joint after the excision of giant cell tumor in the distal femur and the proximal tibia. METHODS: If the giant cell tumor in the distal femur and the proximal tibia invaded the articular surface, we resected the condyle of femur or tibia including the tumor, dissociated the patella and placed it in the condyle horizontally to repair the articular surface. The cruciate ligament was reserved in all the patients. The condyle of femur or tibia was replaced by the anterior surface or the articular surface of the patella respectively. The implanted patella was fixed by the screw to the contralateral condyle, and the remaining defect was filled by autogenous cancellous illium. RESULTS: Nine patients were followed up 3 to 121 months, the average was 65 months. None of them recurred or metastated. The excellent and good rate of the functional evaluation of knee joints was 88.9%. CONCLUSION: After resecting the condyle of femur or tibia including the tumors which invade the articular surface, we find that free patellar implantation is a suitable way to repair the defect of the knee.

Adult↗
PubMed1992

[Surgical therapy of metastases of the proximal femur and acetabulum].

An analysis of indications and operative techniques was carried out in 166 patients with skeletal metastases of the proximal femur and acetabulum. Complications as well as functional and oncological results clearly show advantages and disadvantages of different methods such as osteosyntheses, standard hip prostheses and tumour prostheses referring to the tumour's localization and extent.

Acetabulum↗
PubMed2005

Non-monomelic synchronous primary multicentric chondrosarcoma: a case report.

We report a patient with simultaneous presentation of two histologically grade 2 conventional chondrosarcomas non-derived from pre-existing cartilaginous lesions, in the absence of pulmonary or visceral involvement. One tumour was located at the right proximal femur and the other one at the right scapula. There was no evidence of local recurrence or pulmonary or visceral involvement three years and a half after total scapulectomy and resection of the proximal third of the femur. To the best of our knowledge, this is the first report of a patient with two non-monomelic synchronous chondrosarcomas arising in two previously normal bones of the skeleton. Such cases are often difficult to differentiate from metastatic disease.

Bone Neoplasms↗
PubMed2005

[Clinicopathologic study of 10 cases of osteomalacia or rickets-associated mesenchymal tumors].

OBJECTIVE: To study the clinicopathologic features of osteomalacia or rickets-associated mesenchymal tumors. METHODS: The clinical and pathologic findings of 10 cases of osteomalacia or rickets-associated mesenchymal tumors were evaluated. Hematoxylin and eosin stain, immunohistochemistry and histochemistry were performed on the archival paraffin sections. RESULTS: Amongst the 10 patients studied, 6 were males and 4 were females. Their age at the time of operation ranged from 28 to 69 years ( mean = 45.6 years). A history of long-standing bone pain, arthralgia, limitation in movement, hypophosphatemia and hyperphosphaturia was present in all cases. The duration of symptoms ranged from 2 to 27 years (mean = 9.6 years). The tumor size ranged from 1 to 7 cm (mean size = 3.52 cm). Microscopically, the tumors were composed of various mesenchymal cells, including spindled fibroblast-like cells, adipocytes, chondroid cells and mucinous cells. The background was rich in blood vessels. In 8 of the 10 cases, there was also dystrophic calcification in an unusual flocculent or "grungy" pattern. Peripheral woven bone shell formation was noted in 2 cases and non-urate crystal deposition in 2 cases. Mitotic figures were rare in 9 cases. In 1 of the 10 cases however, mitotic figures and bizarre cells were commonly encountered. On immunohistochemical study, the tumor cells were all positive for vimentin. There was focal positivity for smooth muscle actin and CD34 in 5 and 3 cases respectively. The staining for desmin, S-100 and AE1/AE3 was negative. Ki-67 proliferation index was less than 4% in 8 cases and 30% in 1 case. Alcian blue-positive mucinous matrix and mucinous degeneration around vessels were noted in 8 cases. CONCLUSIONS: Most of the osteomalacia or rickets-associated tumors are either benign or low-grade malignant mesenchymal tumors. They can be mistaken as other neoplasms due to the morphologic heterogeneity present. Thorough understanding of the associated clinical features and laboratory investigation results is helpful in arriving at the correct diagnosis.

Actins↗
PubMed1992

Evaluation of the lymph flow with lymphoscintigraphy after rotationplasty for the treatment of bone tumors.

We studied the cases of eleven patients in whom a rotationplasty had been done after wide resection of the distal part of the femur. All patients had had a malignant tumor of bone, but none had the complication of edema or leakage of lymph after the rotationplasty. We made lymphoscintiscans soon after the operation in four patients and weeks or months later in all eleven patients. There was a delay in the flow of lymph in three of the four patients who were examined lymphoscintigraphically soon after the operation and there was obstruction of flow in the fourth patient, but there was evidence of a decreased rate of flow in only two of the eleven patients at the time of the later examination.

Adolescent↗
PubMed1992

Soft-tissue management with prosthetic replacement for sarcomas around the knee.

The soft-tissue management was reviewed in 46 consecutive primary and nine revision segmental knee resections with prosthetic reconstruction performed for sarcomas around the knee. From January 1983 until August 1986, before the extensive use of free-tissue transfer in these patients, 20 primary segmental knee reconstructions were performed with five patients receiving gastrocnemius rotation flaps, and one patient receiving a late free flap (Group I). In this group, three patients were converted to an above-knee amputation because of wound problems. From August 1986 to August 1988, free-tissue transfer was available and extensively used in addition to rotation flaps to manage 26 primary (Group II) and nine revision (Group III) segmental knee reconstructions. In contrast to Group I, none of the patients in Groups II or III required amputation or conversion to a nonlimb-sparing procedure for soft-tissue management. None of the patients in this study received radiation therapy to their extremities. Chemotherapy protocols were similar in Groups I and II with 22 of 26 patients in Group I and 19 of 20 in Group II receiving treatment. The availability and expertise to perform free and rotational flaps at the time of initial excision provides greater selection and improved outcome for those patients whose wounds are closed primarily. The capability to perform free and rotation flaps at initial resection and for postoperative wound management is a major determinant of ultimate success in patients having reconstruction after excision of sarcomas about the knee.

Bone Neoplasms↗
PubMed1991

[The role of transmission electron microscopy played in diagnosis of knotty tumors].

Eight cases were reported in order to elucidate the important role of electron microscopy (EM) played in diagnosis of knotty tumors. The diagnosis of tumors made by light microscopy (LM) could be confirmed, corrected or eliminated with EM, and the types and histogenesis of tumors could be decided more accurately with EM than with LM. But EM has its inherent limitations, so it is emphasized that diagnosis made by EM must rest on solid basis of LM, and sometimes EM should be combined with other methods, such as histochemistry and immunohistochemistry.

Child↗
PubMed1991

[Osteoid osteoma of the limbs: the clinical aspects and diagnostic problems].

The authors report their experience in the treatment of "osteoid osteoma", drawing attention to the great clinical polymorphism of this affection. They also demonstrate the reliability of a preliminary systematic study with bone scan and CT, which are indispensable to early diagnosis and correct surgical procedure.

Adult↗
PubMed1991

Modified Van Nes rotationplasty in the treatment of malignant neoplasms in the lower extremities of children.

A technique of modified Van Nes rotationplasty has been used since 1981 for limb salvage surgery in children and adolescents with malignant sarcoma of the lower extremity. The original procedure for lesions of the distal femur was further modified and adopted for selected lesions of the proximal femur and tibia. Sixteen skeletally immature children form the base of this report. The tumors were located in the distal femur in ten children, the proximal tibia in five and the proximal femur in one. There were no intraoperative complications and postoperative complications included one infection requiring debridement and three minor healing delays. There were no local recurrences, neurovascular compromises, late derotations, or psychologic decompensations. One patient died of metastatic disease and another died of a second malignancy (leukemia). The remaining patients are good, functional, below-knee prosthesis users who participate in a number of sporting and athletic activities. The procedure is safe, has a relatively low complication rate, allows for the functional demands of an active, growing child, and accommodates for the future growth of extremities.

Adolescent↗
PubMed1978

Malignant fibrous histiocytoma with skeletal involvement.

Malignant fibrous histiocytoma of soft part is rather common but malignant fibrous histiocytoma of the bone is rarely encountered clinically. Authors present five cases of malignant fibrous histiocytoma with skeletal involvement and discuss their clinical course, x-ray findings and histological features. This tumor has marked tendency for local recurrence and metastasis. Other bone tumors such as giant cell tumor, aneurysmal bone cyst, non ossifying fibroma, osteosarcoma, fibrosarcoma of bone and metastatic cancer can be excluded by several characteristic findings observed in x-rays as well as histopathological features. All information on the patient should be carefully analysed, because it is difficult to decide whether bone involvement is primary or secondary. Four out of five cases definitely originated within the bone.

Bone Neoplasms↗
PubMedDate not supplied

Regression of multiple osseous metastatic renal cell carcinoma.

A 65-year-old man with 6 osseous metastatic lesions was successfully treated by nephrectomy. Five of 6 metastatic tumors, 2 of which were histologically proved, dramatically regressed and disappeared roentgenographically. The other metastasis was removed by amputation 4 years prior to the nephrectomy. No apparent complication was found after the nephrectomy and the patient is in very good health. The factors responsible for regression of osseous metastatic renal cell carcinoma cannot be fully explained. The only common treatment given to 4 patients whose osseous renal cell cancer regressed, was nephrectomy. Since every therapy for metastatic renal cell cancer is unreliable, palliative nephrectomy seems to be justified as a treatment of choice even when osseous metastases are noted and there is a possibility of regression of metastatic lesions. Regression of osseous metastasis from renal cell carcinoma is extremely rare and only 3 cases have been reported.

Adenocarcinoma↗
PubMed1990

[The selection of treatment for giant-cell tumor of bone].

Eighty-two patients with giant-cell tumor of the bone were operated with 4 different methods depending on the site of tumor, extent of local invasion and degree of malignancy. Curettage plus filling operation was performed for Grade I tumors and localized lesions. Resection of the tumor segment and replacement of the joint with allograft or artificial joint were done for Grade II tumors involving the joint but with clear borders. The indications of amputation were Grade III tumors, frequent recurrence and malignant change. Local curettage plus radiotherapy was undertaken in tumors that could hardly be completely curetted, such as tumors in the sacrum and spine. The results showed that the first method gave a high recurrence rate; the second method was the best; the third was worse due to conservativeness of amputation; the fourth method had the poorest prognosis owing to incomplete removal of the tumor.

Adolescent↗