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At least 19 recordsLinked to original sources

[Surgical treatment of pelvic and femoral bones neoplasms].

The author has reported 42 operations on the pelvic girdle and femoral bones. Two new variants of surgical intervention are suggested: 1) interiliac-pubic-sciatic amputation of a lower extremity, and 2) extended exarticulation of the femur. Des keletization of pelvic bones in both operative procedures renders them more ablastic and radical as compared with routine operations. Interiliac-abdominal resection is felt to be more rational from the rehabilitation viewpoint, moreover it is the author's opinion that resection of the femoral proximal segment should be avoided whenever possible.

Bone Neoplasms

Lymph node metastases from osteoblastic osteogenic sarcoma visible on plain films.

The radiologic features of lymph node metastases from osteogenic sarcoma visible on plain films in two patients are described. In one patient the lymph node ossification was visible on presentation and in the other patient it was demonstrated six months after the initial diagnosis. The radiologic pattern in both cases was similar. Deposition of metastatic osteoid tissue in lymph nodes, to such a degree that it can be recognized on plain films, appears to be a distinctly uncommon complication of this malignant neoplasm. It is considered probable that this complication occurs with the osteoblastic type of osteogenic sarcoma. It is suggested that lymphography might be of value in the detection of such metastases at an earlier stage, thus influencing the plan of treatment.

Adolescent

Bone scintigraphy of osteoid osteoma: a clinical review.

Osteoid osteoma is a painful osteoblastic process. The pre-operative diagnosis is usually made by roentgenogram. Four surgically confirmed cases are examined where the preoperative diagnosis was clarified by bone scintigraphy. The clinical indications, the diseases process, the literature are reviewed.

Adolescent

Synovial hyperemia in giant cell tumor of bone: angiographic pitfall.

Arteriography has been found useful in the clinical staging of giant cell tumors of bone in its capacity to demonstrate the presence and extent of soft tissue, extraosseous extension of the tumor. A potential source of error is the presence of hyperemic synovial tissue that may closely resemble tumor vascularity, and therefore be confused with tumor extraosseous extension. Of the 48 giant cell tumors in this series, 21 demonstrated extraosseous vascularity representing synovial hyperemia. Two patients were considered to have extraosseous tumor extent but only hypertrophic synovial tissue was found at surgery. The angiographic features of synovial hyperemia are outlined.

Angiography

Sarcoma in Paget's disease (11 cases).

Eleven cases of sarcoma in Paget's disease of bone are presented, together with an extensive review of the literature. These neoplasms are rare but not exceptional, and mostly affect male subjects in the seventh decade of life. The sites most frequently affected are the pelvis, femur and humerus. In 30 per cent of cases these neoplasms are multifocal. Radiographically the lesions are nearly always osteolytic. The radiographic diagnosis may, however, be quite difficult, especially in the presence of the severe (but benign) osteolyic lesions that sometimes occur in Paget's disease. Morphologically these tumours are mostly highly polymorphic sarcomas. The cases in this series were diagnosed histologically as osteosarcoma, grade 3 fibrosarcoma, and malignant fibrous histiocytoma; but there are no prognostic differences between the various histological types. The prognosis is very serious, only about 3 per cent of patients surviving for five years from the time of diagnosis. Therapy, unfortunately nearly always palliative, is based on amputation or disarticulation after sections biopsy in cases where the disease is localised to the limbs, and on radiotherapy in cases not amenable to surgery.

Adult

Total joint arthroplasty. Applications in the management of bone tumors.

Limb-saving resection has become a valid alternative to amputation in carefully selected patients with bone tumors. As interest grows in this technique, efforts continue to improve our methods of bone and joint reconstruction to restore a functional extremity. Previously there was little interest in this form of treatment despite a limb-saving potential, because of inadequate methods of skeletal reconstruction. The purpose of this paper is to review these previous methods and to outline our present approach to the problem.

Adolescent

Sclerotic medullary spread in diaphyseal osteosarcoma.

Dense medullary sclerosis is reported in the shafts of long bones accompanying diaphyseal osteosarcoma. Histological evidence suggests that this indicates more extensive medullary spread of tumour than is readily apparent on standard radiographic examination. It would appear that these sclerotic lesions show active radio-isotopes retention following skeletal scintigraphy. The clinical and radiological features and prognostic implications of these findings are discussed.

Adolescent

[The malignant fibrous histiocytoma of bone (author's transl)].

The primary malignant fibrous histiocytoma of bone (Stout) is a rare and autonomous sarcoma of the bone which has to be separated from the osseous sarcoma and the osseous fibrosarcoma. The malignant histiocytoma is morphologically characterized by the storiform pattern of interlacing spindle cell bundles and functionally by the phagocytosis of lipids, glycogen, hemosiderin and hematoidin. Contrary to the osteosarcomas, the main age of osseous histiocytomas are the fifth and sixth decade. Location of predilection are the metaphyses of the long tubular bones. The X-rays show moth-eaten spongiolysis, endosteal erosion and perforation of the cortex. Early metastases in the lungs are frequent. The primary treatment is a surgical one. Case record of a typical malignant osseous histiocytoma from the proximal metaphysis of the left femur with metastases in the lung of a female child, aged 14 years.

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

Surgical treatment of myelomatosis--a review of 18 cases.

The authors review 18 patients with multiple myeloma who had bone destruction of a kind that indicated surgical therapy. Eight patients had paralegic myelopathy and one had compression of the cauda equina. Four of them displayed partial to complete regression. One patient lived for 77 months after the operation, most of the time in excellent condition. The operative technique is discussed, with laminectomy, exeresis, filling of bone with cement and, in some instances, mechanical support from metal plates. Early diagnosis and operation is imperative, postoperative irradiation obligatory in severe cases. Radiation alone may be the method of choice in early stages. The other 9 patients were operated upon for bone destruction in the limbs. A Moore operation on the destroyed hip was performed in one patient, who lived in excellent condition for about four years. Active surgical therapy combined with radiation and cytostatics seems to be of value in many patients with multiple myeloma.

Aged