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A multiple myeloma in an unusually young Cairn terrier (13 months, female) is described. Radiographically, pelvic tumor masses and characteristic systemic osteolysis were found at the end of the 4 week disease course. Therapeutic attempts were hopeless at this stage of the disease, but a form of chemotherapy is recommended.
OBJECTIVE: To investigate the curative effect of the treatment of reserving limb for patients with malignant bone tumor. METHODS: Forty patients with bone neoplasms underwent the operation of reserving limbs. The neoadjuvant chemotherapy was given to all the patients before the operation. After the ablation of the tumor we used the artificial prosthetic replacement,tumor tissue deactivation and reimplant, variant bone and joint transplantation to reserve the limb. RESULTS: All the patients were followed up. The average follow-up time was 34.8 months. Eight patients got complications. And the fineness rate was 72.5% according to functional evaluation standard of Enneking after surgical treatment of bone tumor. CONCLUSION: The operation of reserving limb was an ideal method to cure the malignant bone tumor. The proper operative treatment with neoadjuvant chemo-therapy is helpful to extend the life of the patients and increase the quality of life.
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Clear cell chondrosarcoma, a subtype and separate entity from the conventional chondrosarcoma, is characterized by its special histologic features, site of predilection, slow growth and better prognosis. Three cases are presented with elucidation of clinicopathologic correlation and detection by ABC immunohistochemical method using several antibodies. The observation of positive reaction to S-100 protein, vimentin, anti-alpha-chymotrypsin and Lysozyme by the tumor cells of clear cell chondrosarcoma, similar to chondrosarcoma and chondroblastoma, proves that this tumor has its origin from the cartilaginous tissue. It was found for the first time that the clear cell chondrosarcoma was positive for wheat germ agglutinin and concanavalin A. The authors believe that clear cell chondrosarcoma may result from the anaplastic change of chondroblastoma cells into another subtype of that tumor. The osteoblastlike multinucleated giant cells, retaining the antigens of phagocytes, are not considered to be neoplastic.
Three patients with foregut (bronchial), hindgut (rectal) or (ovarian) carcinoid tumors had symptomatic bone metastasis with abnormal 99m Tc pyrophosphate bone scans and bone roentgenograms. Six patients with midgut (small intestine or caecal) carcinoid) carcinoid tumors who had no symptoms of bone metastasis had no evidence of bone metastasis on bone scan or bone roentgenographic examination. This study supports the clinical impression that patients with midget carcinoid tumors have a low incidence of bone metastasis.
Materials, methods, and techniques of pelvic resections are discussed. Results, including the complications of nerve damage, infection, and vascular, visceral, and reconstructive complications are tabulated.
Clear cell chondrosarcoma is a form of chondrosarcoma that was first described by Unni in 1976. It is essentially a low-grade chondrosarcoma with many similar clinical, radiological and histological features as the more common chondrosarcomas. However, the distinguishing feature of this variant is in the presence of the characteristic clear cells histologically. We relate two such cases of clear cell chondrosarcoma in Singapore. A short discussion covering the incidence/prevalence of this tumour, its common presenting clinical, radiological and histological features follows. We also review the available world literature, highlight the salient and differentiating aspects of this particular tumour, and touch on its management and eventual prognosis.
The interim results of the use of high-dose methotrexate with leucovorin rescue for the treatment of 26 patients with osteogenic sarcoma are discussed. Preoperative chemotherapy was followed by marked regression of primary tumor in one out of seven patients with localized disease. In that group, metastasis-free period lasted 2, 3, 10+, 12, 17+ and 24+ months. Response was observed in two out of 19 (10.6%) cases of metastases. Toxic side-effects were moderate and were mainly nausea (38.5% of patients), vomiting (26.9%), elevation of serum transaminase levels (38.5%) and fever (30.7% of cases).
The article discusses problems dealing with the diagnosis of a benign tumor of the skeleton, "non-ossifying++ tumor of bone", encountered quite often in children. Observations over 68 patients of 7 to 15 years of age show that the tumor develops from foci of fibrous osteodysplasia (Lichtenstein-Braitsev disease) and its solitary from--fibrous metaphyseal defect. The latter usually ossifies spontaneously by the end of the child's growth and follows an asymptomatic course, but cases with growth of the focus occur. Magnified radiographs (the reisgraphy method) make it possible to detect the transformation of a dysplastic process into a true tumor. All of the 68 patients were operated on by means of ultrasonic bone resection and repair of the defect with a cortico-demineralized allograft by the "faggot" method suggested by the author.
Neoplastic cells were isolated from 2 sibling Great Dane/Labrador Retriever mixed-breed dogs in which telangiectatic type osteosarcomas arose concurrently. Cells from various sites in the same osteosarcoma appeared similar in culture, but there were differences between the 2 osteosarcomas in growth characteristics and appearance of cells. Cells from 1 osteosarcoma had a small, but significant (P less than 0.05), cyclic adenosine monophosphate response to parathyroid hormone stimulation, indicating a low order of osteoblastic differentiation. Cells from the other osteosarcoma had no response to parathyroid hormone stimulation. Cells from both osteosarcomas and a concentrated cell-free filtrate from the osteosarcoma with osteoblastic differentiation were injected into nude mice, but osteosarcomas were not induced. Results of ultrastructural examination of osteosarcoma samples for viral particles were negative and supernatant fluids from cultured cells were considered negative for viral reverse transcriptase activity.
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Of 62 cases of histologically confirmed osteosarcomas, 50 long bone cases aged under 30 years were grouped as "typical" osteosarcoma, and the other 4 long bone cases and 8 short and flat bone cases were grouped as "atypical" osteosarcoma. Gross and microscopic findings of the lesions, postmortem findings, and survival of the patients were compared between the two groups. Small round cell-type tumor cells and relatively well-differentiated foci resembling osteoblastoma were more often found in the atypical than in the typical osteosarcomas. Although patterns of metastasis were not very different between the two groups, 2 of 6 autopsied short and flat bone cases showed no metastasis. Five-year survival rates of both groups were similar, each about 25%. Six patients of the typical and only one of the atypical osteosarcomas are alive without recurrence more than 6 years after amputation.
Between 1974 and 1982, twelve patients with malignant fibrous histiocytoma of the femur and tibia were treated by excision and adjuvant chemotherapy. During the same time-period, eighteen patients were treated by excision alone. The disease-free survival rate among the former was 59 per cent (seven of twelve). There was only one survival in the latter group.
Skeletal involvement in childhood nonosseous tumors can be due to primary involvement, arrosion or metastasis, secondary due to therapy induced alterations or osteomyelitis following diminished immunity. The occurence of bone changes differs widely from those in adults. Neuroblastoma, rhabdomyosarcoma and malignant lymphoma are discussed in detail. Rare tumors are listed for synopsis. As diagnostic screening method skeletal scintigraphy is recommended, whereas in localized disease X-rays should be performed. Beside roentgenmorphology-particularly in primary disease-localisation, frequency and age dependency may give essential diagnostic hints. Prognosis depends on primary tumor.
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The authors report their experience in the treatment of metastases in long bones. Between 1980 and 1985, 51 cases were submitted to surgical treatment. They comprised osteolytic lesions in the femur (44), tibia (2), and humerus (5). The most frequent primary tumours were: carcinoma of the breast (37%), lung (25%), kidney (16%), rectum (9%). The remaining 13% were from the prostate gland, bladder, ovaries, uterus, chronic lymphatic leukemia, and haemangiopericytoma. Surgical treatment was supplemented by medication and physiotherapy. The choice of instrumentation (prosthesis, total prosthesis, plates, endomedullary nailing) was based on the site of the metastasis and the general condition of the patient. Palliative surgery in these cases was fully justified by the results in that it achieved the aim we set ourselves, namely to restore these unfortunate patients to as normal a lifestyle as possible.
Six cases of children diagnosed as having osteoid osteoma with different localization are reviewed. They constitute 0.04% of all those admitted to the paediatrics department. The average age is 8 1/12 years and three exists a male predominance over the female in the proportion of 2/1. The clinic has shown it self through characteristic pain, with nocturnal paroxysms, which disappears with aspirin, in addition to functional impotence and muscular atrophy. In the case of vertebral localization, scoliosis was detected. Both, the radiography and the computerized axial tomography showed to be efficient for the diagnosis, which was confirmed anatomo-pathologically in the case operated on. The evolution was satisfactory in all of them.