Background:Computed tomography(CT)and magnetic resonance imaging(MRI)data can be fused to identify the tumor boundaries.This enables surgeons to set close but tumor-free surgical margins and excise the tumor more prec...Background:Computed tomography(CT)and magnetic resonance imaging(MRI)data can be fused to identify the tumor boundaries.This enables surgeons to set close but tumor-free surgical margins and excise the tumor more precisely.This study aimed to report our experience in performing computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction to treat bone sarcoma in the diaphysis and metaphysis of the femur and tibia.Methods:Between September 2008 and December 2015,24 patients with bone sarcomas underwent surgical resection and joint-sparing reconstruction under image-guided computer navigation.The cohort comprised 16 males and eight females with a median age of 19.5 years(range:12-48 years).The tumor location was the femoral diaphysis in three patients,distal femur in 19,and proximal tibia in two.The tumors were osteosarcoma(n=15),chondrosarcoma(n=3),Ewing sarcoma(n=3),and other sarcomas(n=3).We created a pre-operative plan for each patient using navigation system software and performed navigation-aided resection before reconstructing the defect with a custom-made prosthesis with extracortical plate fixation.Results:Pathological examination verified that all resected specimens had appropriate surgical margins.The median distance from the tumor resection margin to the joint was 30 mm(range:13-80 mm).The median follow-up duration was 62.5 months(range:24-134 months).Of the 24 patients,21 remain disease free,one is alive with disease,and two died of the disease.One patient developed local recurrence.Complications requiring additional surgical procedures occurred in six patients,including one with wound hematoma,one with delayed wound healing,one with superficial infection,one with deep infection,and two with mechanical failure of the prosthesis.The mean Musculoskeletal Tumor Society score at the final follow-up was 91%(range:80%-100%).The 5-and 10-year implant survival rates were 91.3%and 79.9%,respectively.Conclusions:Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction with extracortical plate fixation is a reliable surgical treatment option for bone sarcoma in the diaphysis and metaphysis of the femur and tibia.展开更多
Objective To analyse comparatively the relevant data from bone tumor registries in China, Japan, and the United States Methods The data of 38?959 histologically confirmed primary bone tumors collected by the Chines...Objective To analyse comparatively the relevant data from bone tumor registries in China, Japan, and the United States Methods The data of 38?959 histologically confirmed primary bone tumors collected by the Chinese Bone Tumor Registry 1957 1988, 20?272 collected by the Japanese Bone Tumor Registry 1972 1990, and 11087 diagnosed and treated at Mayo Clinic, USA were used for comparative analysis by race, age, sex and skeletal distribution For reliability, we used ratios of different tumors to osteosarcoma for frequency analysis We also included some data from the SEER 1973 1987 as well as from Memorial Sloan Kettering Cancer Center, USA Results The relative frequency of osteosarcoma (OS) is higher in China and Japan than in the United States There were only limited number of OS patients aged over 50 years in Chinese and Japanese groups, which might be due to the lower incidence of OS subsequent to Paget's disease in Asians More osteosarcoma occurred in the flat bones in the Americans than in the Chinese and Japanese The relative frequency of chondrosarcoma (CS) was higher in the American group than in the Asian groups The average age of CS patient was younger in the Chinese than in the Japanese and the Americans The data confirmed the previous report that the incidence of Ewing sarcoma was higher in western people than in Asians The data showed that the comparative frequency of chordoma is higher in the Americans than in the Asians and that the incidence of giant cell tumor of bone is higher in the Chinese and Japanese than in the Americans Conclusion The findings from this analysis provide useful information for the epidemiologic study and the clinical diagnosis of bone tumors展开更多
Myxoinflammatory fibroblastic sarcoma(MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have ...Myxoinflammatory fibroblastic sarcoma(MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have rarely been reported. We report a case involving the distal left femur of a middle-aged man and tumoral invasion of the bone, which, to our knowledge, has been previously described only once. He was treated with distal femoral tumor resection and reconstruction with a modular prosthesis. Histopathologic diagnosis confirmed MIFS. We reviewed literature of the diagnostic imaging and bone invasion findings associated with this tumor type.展开更多
Approximately 45 percent of malignant bone tumors are seen under the age of 16 and one of the important results of growth plate sacrification in patients with immature skeletons is limb inequality.Until the early 1990...Approximately 45 percent of malignant bone tumors are seen under the age of 16 and one of the important results of growth plate sacrification in patients with immature skeletons is limb inequality.Until the early 1990s,the treatment options for these patients were rotationplasty or amputation.Multimodal approaches that combine imaging,chemotherapy,and surgical techniques have enabled the development of limb-preserving methods with satisfactory results.In order to overcome inequality problems,expandable prostheses have been developed in the 1980s.Extendable endoprosthesis replacements have been improved over the years and are now an established and safe alternative.Noninvasive prostheses appear to be advantageous compared to minimally invasive expandable prostheses that require multiple surgical procedures,but the complication rate remains high.Therefore,although expandable prostheses are not the definitive answer to the treatment of bone sarcomas in skeletally immature children,they are still a suitable interim choice until full adulthood is achieved.Due to reported high complication rates,the procedures require significant experience and are recommended for use only in specialized cancer centers.展开更多
骨与软组织肉瘤是一组异质性肿瘤,起源于骨骼或软组织中的不同细胞类型,根据国际肿瘤分类学委员会(International Classification of Disease for Oncology Third Edition, ICD-O3)的分类,骨与软组织肉瘤可以分为50余种亚型,其中骨肉瘤...骨与软组织肉瘤是一组异质性肿瘤,起源于骨骼或软组织中的不同细胞类型,根据国际肿瘤分类学委员会(International Classification of Disease for Oncology Third Edition, ICD-O3)的分类,骨与软组织肉瘤可以分为50余种亚型,其中骨肉瘤、软骨肉瘤和尤文肉瘤是最常见的3种原发性恶性骨肿瘤。由于骨与软组织肉瘤具有侵袭性、易转移和发展快的特点,传统治疗手段虽然可以控制疾病进展,但对于晚期或复发性患者的生存率提升仍然有限。免疫治疗以激活患者自身免疫系统为核心,通过调节免疫反应,实现对肿瘤的有针对性攻击,从而在最大程度上减少对正常组织的损害,这一治疗策略的独特性和高效性使其成为当前癌症治疗领域备受瞩目的研究热点。基于此,本综述将系统性地回顾并总结骨与软组织肉瘤免疫治疗的最新研究进展,重点关注已经在临床试验中取得成功的免疫治疗手段,并探讨其在改善患者预后、减轻治疗不良反应以及提高生存质量方面的潜在作用,以期为进一步探索免疫治疗在骨与软组织肉瘤中的应用提供参考和启示。展开更多
Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the osteogenic sarcoma (osteosarcoma), a non-destructive neutron activation analysis with high resolution spectrometry of long-...Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the osteogenic sarcoma (osteosarcoma), a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides was performed. Methods: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn) mass fraction, Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fraction multiplications were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 27 patients with osteosarcoma (9 females and 18 males, 6 to 71 years old). The reliability of difference in the results between intact bone and osteosarcoma tissues was evaluated by Student’s t-test. Results: In the osteosarcoma tissue the mass fractions of Co, Cr, Fe, Sb, Se, and Zn are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, we found significantly lower values of Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as significant higher mean values of Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fractions multiplications in the osteosarcoma tissue compared to intact bone. In the osteosarcoma tissue many correlations between trace elements found in the control group were no longer evident. Conclusion: In osteosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.展开更多
Metastatic peritoneal sarcomatosis most commonly occurs from primary soft tissue sarcomas arising either within the abdomen or extremities. Metastatic peritoneal sarcomatosis from an osteosarcoma is extremely rare;onl...Metastatic peritoneal sarcomatosis most commonly occurs from primary soft tissue sarcomas arising either within the abdomen or extremities. Metastatic peritoneal sarcomatosis from an osteosarcoma is extremely rare;only six cases have previously been reported. We report the first case of metastatic peritoneal sarcomatosis originating from radiation-induced osteoblastic osteosarcoma in a 22-year-old woman who had previously been treated for pelvic Ewing’s sarcoma. Abdominal computed tomography, bone scintigraphy and FDG PET/CT demonstrated extensive finely nodular disseminated peritoneal lesions. Histopathologic examination of these peritoneal lesions revealed osteosarcomatosis. In summary, we describe an unusual case of metastatic peritoneal sar comatosis from secondary osteosarcoma arising in a previously irradiated pelvicEwing’s sarcoma.展开更多
BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the di...BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the diagnosis and treatment of a case of this rare disease and provide a review of the literature.CASE SUMMARY In this article,we discuss the case of a 40-year-old Hispanic female who presented with progressive thrombocytopenia and multiple hypoechoic lesions in the spleen without splenomegaly.Positron emission tomography-computed tomography showed increased activity in cervical lymph nodes,as well as multiple bone and splenic lesions with positive uptake.Two bone marrow biopsies and fine-needle aspiration of the cervical lymph node were inconclusive.Laparoscopic splenectomy was performed,and gross examination showed a 110.1 g spleen with multiple rubbery,nodular lesions within the subcapsular sinus and splenic parenchyma.The microscopic findings showed multinodular histiocyte proliferation with atypia and multilobulated nuclei,which were positive for CD163,CD4,and CD68 by immunohistochemical analysis.The final pathologic diagnosis was difficult and was found to be low-grade HS of the spleen,after consultations with two renowned hematopathology institutions.At the patient’s five-month follow-up visit,her bone marrow metastasis had progressed.She is waiting to be enrolled in a clinical trial.CONCLUSION Pathologic diagnosis of splenic HS can be challenging.Low-grade differentiation may be associated with a slow progressive disease.展开更多
文摘Background:Computed tomography(CT)and magnetic resonance imaging(MRI)data can be fused to identify the tumor boundaries.This enables surgeons to set close but tumor-free surgical margins and excise the tumor more precisely.This study aimed to report our experience in performing computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction to treat bone sarcoma in the diaphysis and metaphysis of the femur and tibia.Methods:Between September 2008 and December 2015,24 patients with bone sarcomas underwent surgical resection and joint-sparing reconstruction under image-guided computer navigation.The cohort comprised 16 males and eight females with a median age of 19.5 years(range:12-48 years).The tumor location was the femoral diaphysis in three patients,distal femur in 19,and proximal tibia in two.The tumors were osteosarcoma(n=15),chondrosarcoma(n=3),Ewing sarcoma(n=3),and other sarcomas(n=3).We created a pre-operative plan for each patient using navigation system software and performed navigation-aided resection before reconstructing the defect with a custom-made prosthesis with extracortical plate fixation.Results:Pathological examination verified that all resected specimens had appropriate surgical margins.The median distance from the tumor resection margin to the joint was 30 mm(range:13-80 mm).The median follow-up duration was 62.5 months(range:24-134 months).Of the 24 patients,21 remain disease free,one is alive with disease,and two died of the disease.One patient developed local recurrence.Complications requiring additional surgical procedures occurred in six patients,including one with wound hematoma,one with delayed wound healing,one with superficial infection,one with deep infection,and two with mechanical failure of the prosthesis.The mean Musculoskeletal Tumor Society score at the final follow-up was 91%(range:80%-100%).The 5-and 10-year implant survival rates were 91.3%and 79.9%,respectively.Conclusions:Computer navigation-aided joint-preserving resection and custom-made endoprosthesis reconstruction with extracortical plate fixation is a reliable surgical treatment option for bone sarcoma in the diaphysis and metaphysis of the femur and tibia.
文摘Objective To analyse comparatively the relevant data from bone tumor registries in China, Japan, and the United States Methods The data of 38?959 histologically confirmed primary bone tumors collected by the Chinese Bone Tumor Registry 1957 1988, 20?272 collected by the Japanese Bone Tumor Registry 1972 1990, and 11087 diagnosed and treated at Mayo Clinic, USA were used for comparative analysis by race, age, sex and skeletal distribution For reliability, we used ratios of different tumors to osteosarcoma for frequency analysis We also included some data from the SEER 1973 1987 as well as from Memorial Sloan Kettering Cancer Center, USA Results The relative frequency of osteosarcoma (OS) is higher in China and Japan than in the United States There were only limited number of OS patients aged over 50 years in Chinese and Japanese groups, which might be due to the lower incidence of OS subsequent to Paget's disease in Asians More osteosarcoma occurred in the flat bones in the Americans than in the Chinese and Japanese The relative frequency of chondrosarcoma (CS) was higher in the American group than in the Asian groups The average age of CS patient was younger in the Chinese than in the Japanese and the Americans The data confirmed the previous report that the incidence of Ewing sarcoma was higher in western people than in Asians The data showed that the comparative frequency of chordoma is higher in the Americans than in the Asians and that the incidence of giant cell tumor of bone is higher in the Chinese and Japanese than in the Americans Conclusion The findings from this analysis provide useful information for the epidemiologic study and the clinical diagnosis of bone tumors
文摘Myxoinflammatory fibroblastic sarcoma(MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have rarely been reported. We report a case involving the distal left femur of a middle-aged man and tumoral invasion of the bone, which, to our knowledge, has been previously described only once. He was treated with distal femoral tumor resection and reconstruction with a modular prosthesis. Histopathologic diagnosis confirmed MIFS. We reviewed literature of the diagnostic imaging and bone invasion findings associated with this tumor type.
文摘Approximately 45 percent of malignant bone tumors are seen under the age of 16 and one of the important results of growth plate sacrification in patients with immature skeletons is limb inequality.Until the early 1990s,the treatment options for these patients were rotationplasty or amputation.Multimodal approaches that combine imaging,chemotherapy,and surgical techniques have enabled the development of limb-preserving methods with satisfactory results.In order to overcome inequality problems,expandable prostheses have been developed in the 1980s.Extendable endoprosthesis replacements have been improved over the years and are now an established and safe alternative.Noninvasive prostheses appear to be advantageous compared to minimally invasive expandable prostheses that require multiple surgical procedures,but the complication rate remains high.Therefore,although expandable prostheses are not the definitive answer to the treatment of bone sarcomas in skeletally immature children,they are still a suitable interim choice until full adulthood is achieved.Due to reported high complication rates,the procedures require significant experience and are recommended for use only in specialized cancer centers.
文摘骨与软组织肉瘤是一组异质性肿瘤,起源于骨骼或软组织中的不同细胞类型,根据国际肿瘤分类学委员会(International Classification of Disease for Oncology Third Edition, ICD-O3)的分类,骨与软组织肉瘤可以分为50余种亚型,其中骨肉瘤、软骨肉瘤和尤文肉瘤是最常见的3种原发性恶性骨肿瘤。由于骨与软组织肉瘤具有侵袭性、易转移和发展快的特点,传统治疗手段虽然可以控制疾病进展,但对于晚期或复发性患者的生存率提升仍然有限。免疫治疗以激活患者自身免疫系统为核心,通过调节免疫反应,实现对肿瘤的有针对性攻击,从而在最大程度上减少对正常组织的损害,这一治疗策略的独特性和高效性使其成为当前癌症治疗领域备受瞩目的研究热点。基于此,本综述将系统性地回顾并总结骨与软组织肉瘤免疫治疗的最新研究进展,重点关注已经在临床试验中取得成功的免疫治疗手段,并探讨其在改善患者预后、减轻治疗不良反应以及提高生存质量方面的潜在作用,以期为进一步探索免疫治疗在骨与软组织肉瘤中的应用提供参考和启示。
文摘Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the osteogenic sarcoma (osteosarcoma), a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides was performed. Methods: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn) mass fraction, Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fraction multiplications were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 27 patients with osteosarcoma (9 females and 18 males, 6 to 71 years old). The reliability of difference in the results between intact bone and osteosarcoma tissues was evaluated by Student’s t-test. Results: In the osteosarcoma tissue the mass fractions of Co, Cr, Fe, Sb, Se, and Zn are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, we found significantly lower values of Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as significant higher mean values of Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fractions multiplications in the osteosarcoma tissue compared to intact bone. In the osteosarcoma tissue many correlations between trace elements found in the control group were no longer evident. Conclusion: In osteosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.
文摘Metastatic peritoneal sarcomatosis most commonly occurs from primary soft tissue sarcomas arising either within the abdomen or extremities. Metastatic peritoneal sarcomatosis from an osteosarcoma is extremely rare;only six cases have previously been reported. We report the first case of metastatic peritoneal sarcomatosis originating from radiation-induced osteoblastic osteosarcoma in a 22-year-old woman who had previously been treated for pelvic Ewing’s sarcoma. Abdominal computed tomography, bone scintigraphy and FDG PET/CT demonstrated extensive finely nodular disseminated peritoneal lesions. Histopathologic examination of these peritoneal lesions revealed osteosarcomatosis. In summary, we describe an unusual case of metastatic peritoneal sar comatosis from secondary osteosarcoma arising in a previously irradiated pelvicEwing’s sarcoma.
基金supported (in whole or part) by HCA Healthcare and/or an HCA Healthcare affiliated entity
文摘BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the diagnosis and treatment of a case of this rare disease and provide a review of the literature.CASE SUMMARY In this article,we discuss the case of a 40-year-old Hispanic female who presented with progressive thrombocytopenia and multiple hypoechoic lesions in the spleen without splenomegaly.Positron emission tomography-computed tomography showed increased activity in cervical lymph nodes,as well as multiple bone and splenic lesions with positive uptake.Two bone marrow biopsies and fine-needle aspiration of the cervical lymph node were inconclusive.Laparoscopic splenectomy was performed,and gross examination showed a 110.1 g spleen with multiple rubbery,nodular lesions within the subcapsular sinus and splenic parenchyma.The microscopic findings showed multinodular histiocyte proliferation with atypia and multilobulated nuclei,which were positive for CD163,CD4,and CD68 by immunohistochemical analysis.The final pathologic diagnosis was difficult and was found to be low-grade HS of the spleen,after consultations with two renowned hematopathology institutions.At the patient’s five-month follow-up visit,her bone marrow metastasis had progressed.She is waiting to be enrolled in a clinical trial.CONCLUSION Pathologic diagnosis of splenic HS can be challenging.Low-grade differentiation may be associated with a slow progressive disease.
