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Surgical Strategy of Pediatric Benign Sacral Tumors.

BACKGROUND: Primary benign osseous tumors and tumor-like lesions at the sacrum are rare in the pediatric population and exact surgical strat … osteoblastomas, 5 neurogenic tumors, 3 hemangiomas, 3 teratomas, 2 Langerhans cell histiocytosis, 1 chondroblastoma, 1 fibrous dysplasia, and 1 GCT of tendon sheath. We proposed our surgical plan and surgical classification for pediatric patients with sacral benign tumors or tumor-like lesions. RESULTS: The mean follow-up duration was 6.2 years (range, 1.0 to 18 …

Aneurysmal bone cyst: concept, controversy, clinical presentation, and imaging.

The aneurysmal bone cyst is the result of a specific pathophysiologic change, which is probably the result of trauma or a tumor-induced anomalous vascular process. In approximately one third of cases, the preexisting lesion can be clearly identified. The most common of these is the giant cell tumor, which accounts for 19-39% of cases in which the preceding lesion is found. Other common precursor lesions include osteoblastoma, angioma, and chondroblastoma. Less common lesions include fibrous dysplasia, fibroxanthoma (nonossifying fibroma), chondromyxoid fibroma, solitary bone cyst, fibrous hist…

Quantitative analysis of solitary lesions of bone.

RATIONALE AND OBJECTIVES: To quantitate the radiographic features of common solitary lesions of bone using vector analysis to optimize their radiographic description. METHODS: Plain radiographs of 709 solitary bone lesions were reviewed. Relevant demographic, anatomic, and structural data were cataloged. These data were used to approximate the vector space defined by all possible solitary lesions of bone. Vector space analysis on the entire set of lesions was performed to determine similarities among and between lesion types. RESULTS: The 709 lesions generated 614 separate vectors within the

Cyst and cystlike lesions of the foot.

A variety of cyst and cystlike lesions may present in the osseous structures of the foot. Such lesions are infrequent in their occurrence, and often cannot be diagnosed on the basis of radiographic appearance. In addition to the morphologic data that can be derived from evaluation of standard radiographs, other diagnostic radiographic studies such as tomography, CT scanning, radionuclide bone imaging, angiography, or other studies may be required to ascertain the nature and extent of cystlike lesions of the foot. This is dependent on histopathologic information derived from biopsy. A variety o

H3F3A G34 mutation DNA sequencing and G34W immunohistochemistry analysis in 366 cases of giant cell tumors of bone and other bone tumors.

H3F3A mutations and the expression of glycine 34 to tryptophan (G34W) mutants in giant cell tumors of bone (GCTBs) and other bone tumors wer … GCTB (n=19), GCTB with lung metastasis (n=5), pediatric GCTB (n=15), primary malignant GCTB (n=5), chondroblastoma (CB, n=61), chondrosarcoma grade II (n=15), dedifferentiated chondrosarcoma (n=17), chondromyxoid fibroma (n=9), aneurysmal bone cyst (n=9), nonossifying fibroma (n=9), osteosarcoma (n=16), and undifferentiated sarcoma (n=6). Sanger DNA sequencing a …

[Treatment concepts of benign bone tumors and tumor-like bone lesions].

The indications for surgical treatment of benign bone tumors and tumor-like lesions depend on the biological activity, clinical symptoms and anatomic location of the the lesion. Clinically silent lesions ("leave me alone Lesions") lacking any scintigraphic enhancement and without danger of pathologic fracture or malign transformation only need surveillance and do not require surgery.However, tumors becoming symptomatic, displaying progression after termination of skeletal growth or radiographic signs of malignancy should be scheduled for surgical intervention. For most benign tumors intralesio

[EFFICACY OF BIOACTIVE GLASS AND ALLOGENIC BONE IN REPAIR OF BONE DEFECT AFTER BENIGN BONE TUMOR CURETTAGE].

OBJECTIVE: To compare the healing process and clinical results of bioactive glass and allogenic bone in the repair of bone defects after benign bone tumor curettage. METHODS: Between November 2011 and December 2012, 20 patients with benign bone tumor received bioactive glass and allogenic bone for repair of bone defects after benign bone tumor curettage. There were 17 males and 3 females, aged 9-68 years (median, 18.5 years). The mean course of disease was 3.3 months (range, 1-9 months). Pathological examination revealed that there were 7 cases of chondroblastoma, 5 cases of bone cyst, 2 case…

Staged sacrectomy--an adaptive approach.

Object Sacral tumors are commonly diagnosed late and therefore present at an advanced stage. The late presentation makes curative surgery te … subtotal, and 4 were total sacrectomy. Histological diagnosis included giant cell tumor, chordoma, chondroblastoma, adenocarcinoma of rectum, and retroperitoneal sarcoma. The giant cell tumor was the most common tumor in this series, followed by chordoma. The patients' mean age at diagnosis was 32 years. There were 10 male and 9 female patients. Fortyseven perce …

Unusual tumours of the skull and skull base: a pictorial essay.

Six unusual tumours of the skull and skull base are illustrated in this pictorial essay; for three of the tumours, both magnetic resonance imaging and computed tomography were performed preoperatively. These two imaging modalities can provide complementary information in the preoperative evaluation of unusual tumours of the skull and skull base.

Is Core Needle Biopsy Reliable in Differentiating Between Aggressive Benign and Malignant Radiolucent Bone Tumors?

BACKGROUND: Although there is widespread acceptance of core needle biopsy (CNB) for diagnosing solid tumors, there is reluctance by some clinicians to use CNB for aneurysmal bone cysts (ABCs) as a result of concerns of safety (bleeding, nerve injury, fracture, readmission, or infection) and reliability, particularly to rule out malignant diagnoses like telangiectatic osteosarcoma. This is especially true when CNB tissue is sent from an outside hospital, where the technique used to obtain the tissue may be spurious. QUESTIONS/PURPOSES: (1) Is CNB effective (provided adequate information to ind

Maxillary functional reconstruction using a reverse facial artery-submental artery mandibular osteomuscular flap with dental implants.

PURPOSE: This clinical study assessed the reverse facial artery-submental artery mandibular osteomuscular flap with titanium dental implants for the functional reconstruction of maxillary defects. PATIENTS AND METHODS: Class 2a defects in 5 patients were repaired with a reverse facial artery-submental artery mandibular osteomuscular flap with titanium dental implants (n = 21). All patients received a fixed partial denture after a 3- to 6-month healing period. RESULTS: All lesions were widely excised in an area extending to the maxilla. Of the implants, 20 (95.2%) were loaded and 1 was lost b

What Proportion of Patients Treated With Calcium Phosphate and Calcium Sulfate Bone Substitutes for Benign Pediatric Bone Tumors Develop Recurrent Lesions?

BACKGROUND: Synthetic composites of calcium phosphate and calcium sulfate have been used for grafting after intralesional curettage of benig … . Of those that recurred, there were three aneurysmal bone cysts, one unicameral bone cyst, and one chondroblastoma. CONCLUSION: The bone substitute was associated with gradual resorption, low recurrence rates, and no fractures in this cohort. With the right indications, patients can start weightbearing at 6 weeks without hardware augmentation. Close monitoring …

What Are the MSTS Scores and Complications Associated With the Use of Three-dimensional Printed, Custom-made Prostheses in Patients Who Had Resection of Tumors of the Hand and Foot?

BACKGROUND: There are a few good options for restoring bone defects in the hand and foot. 3D-printed implants have been used in the pelvis a … were five hand tumors and six tumors of the feet. Tumor types were giant cell tumor of bone (five), chondroblastoma (two), osteosarcoma (two), neuroendocrine tumor (one), and squamous cell carcinoma (one). Margin status after resection was ≥ 1 mm. All patients were followed for a minimum of 24 months. The median follow-up time was 47 months (range 25 to 67 months …

Primary tumours of the calcaneus.

The calcaneus is a rare location for the occurrence and development of primary tumour types. Clinicians are unfamiliar with calcaneal tumour types, which may result in a delay in diagnosis or a missed diagnosis, resulting in unnecessary morbidity and amputation. Heel pain and localized swelling of the ankle are the most common symptoms. X-ray is the first choice for a tentative diagnosis of a calcaneal tumour. The final diagnosis depends on a histological examination. The treatment of calcaneal tumour types varies depending on the Enneking system. The majority of patients with benign tumours h

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… Chondroblastoma Chondroblastoma is a rare chondroid tumour, accounting for 4.5% of all bone tumour types and 2.8% of all calcaneal tumour types ( 46 ). There is a clear male predominance with an incidence ratio of 5:1 ( 46 ). … Chondroblastoma of the hands and feet. Skeletal Radiol. 2004;33:582–587. doi: 10.1007/s00256-004-0762-1. 47. Guedes A, Barreto B, Barreto Soares LG, Athanazio DA, Athanazio PR. Calcaneal chondroblastoma with secondary aneurysmal bone cyst: A case report. …

Tumors of the Acromion Process-A Pictorial Review.

Introduction Acromion is essential for stabilizing the shoulder complex. Tumors of the acromion are rare. We report the largest series of acromion tumor and tumor-like lesion. Materials and Methods A retrospective review of the oncology and radiology database within our tertiary center for orthopaedic oncology was performed to identify all tumors of the acromion over the past 30 years and imaging was reviewed. Results We identified a total of 31 lesions arising in the acromion and chondrosarcoma was the commonest. Conclusion One needs to be aware of tumor and tumor-like lesions of acromion.

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… Chondroblastoma Chondroblastoma is a rare benign but aggressive cartilaginous neoplasm formed of chondroblasts. 25 Chondroblastomas are rare and represent less than 1 to 2% of all primary bone tumors. It usually affects adolescents and young adults, with a slight male predominance. … Treatment and prognosis of chondroblastoma. Clin Orthop Relat Res. 2005;438(438):103–109. doi: 10.1097/01.blo.0000179591.72844.c3. 26. Arıkan M, Toğral G, Yıldırım A, Irkkan Ç. A rare case of chondroblastoma of the acromion. …

Диагностика генетической и иммуноистотохимической полезности H3-3A Анализ мутации в гигантском клеточном ощущении кости.

Проверка надежности и внедрение объективного диагностического метода для гигантской опухоли клеток кости (ГТБ). H3-3A Проведен анализ генов на мутации с использованием two - различные методы, последовательность действий Sanger и анализ иммунохимического (ICC). Всего 214 пациентов, в том числе 120 с ГТБ и 94 В исследовании приняли участие и другие гигантские повреждения костей, богатые клетками. Последовательность сангеров и IHC с антихистоун H3.3 G34W и G34V антитела были выполнены на формализованных тканях с парафинами, которые в случае необходимости ранее были отделены от ЭДТА. Чувствительно

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… Distinct H3F3A and H3F3B driver mutations define chondroblastoma and giant cell tumor of bone. Nat. Genet. 2013;45:1479–1482. doi: 10.1038/ng.2814. 11. Presneau N., Baumhoer D., Behjati S., Pillay N., Tarpey P., Campbell P.J., Jundt G., Hamoudi R., Wedge D.C., Van Loo P., et al. … H3F3 mutation status of giant cell tumors of the bone, chondroblastomas and their mimics: A combined high resolution melting and pyrosequencing approach. Mod. Pathol. 2017;30:393–406. doi: 10.1038/modpathol.2016.212. 29. Gong L., Bui M.M., Zhang W., Sun X., Zhang M., Yi D. …

Knee bone tumors: findings on conventional radiology.

The knee is a common site for bone tumors, whether clinically painful or not. Conventional radiology has been established as the first line of investigation in patients with knee pain and can reveal lesions that often generate questions not only for the generalist physician but also for the radiologist or general orthopedist. History, image examination, and histopathological analysis compose the essential tripod of the diagnosis of bone tumors, and conventional radiology is an essential diagnostic tool in patients with knee pain. This pictorial essay proposes to depict the main conventional ra

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… Chondroblastoma Also known as Codman's tumor, chondroblastoma is a benign yet aggressive cartilage-forming bone tumor that affects the epiphysis in immature skeletons. The clinical presentation includes joint pain and localized swelling in young patients with an open growth plate. … Radiography of a chondroblastoma ( Figure 7 ) shows well-defined osteolytic epiphyseal lesions, with a narrow zone of transition, a reactive sclerotic rim which generally does not break through the cortex, and foci of calcification within the lesion, characteristic of the cartilaginous origin of this …

Vertebral Primary Bone Lesions: Review of Management Options.

The assessment and treatment of vertebral primary bone lesions continue to pose a unique yet significant challenge. Indeed, there exists little in the literature in the way of compiling and overviewing the various types of vertebral lesions, which can often have complicated intervention strategies. Given the severe consequences of mismanaged vertebral bone tumors-including the extreme loss of motor function-it is clear that such an overview of spinal lesion care is needed. Thus, in the following paper, we aim to address the assessment of various vertebral primary bone lesions, outlining the re

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… Deventer et al. report the overall recurrence rate of chondroblastoma with intralesional curettage as surgical treatment to be 39.5% [ 46 ]. … Functional and Oncological Outcome After Treatment of Chondroblastoma With Intralesional Curettage. J. Pediatr. Orthop. 2019;39:e312–e317. doi: 10.1097/BPO.0000000000001293. 44. Veth R., Schreuder B., van Beem H., Pruszczynski M., de Rooy J. …

How long do endoprosthetic reconstructions for proximal femoral tumors last?

BackgroundAs the life expectancy of patients with musculoskeletal tumors improves, long-term studies of endoprosthetic reconstructions are necessary to establish realistic expectations for the implants and compare them to other reconstruction approaches.Questions/purposes(1) What is the long-term survival of cemented bipolar proximal femoral replacements? (2) How does prosthesis survival compare to patient survival among patients with Stage I, II, and III disease? (3) Do modular implants outperform custom-built prostheses? (4) Do some proximal femoral replacements require conversion to THA?Pat

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… grade | Stage III primary or metastatic | Total Chondrosarcoma | 9 | 12 | | 21 Osteosarcoma | 17 | 1 | | 18 Ewing’s sarcoma | 10 | | 1 | 11 Giant cell tumor | | 4 | | 4 Malignant fibrous histiocytoma | 3 | | | 3 Fibrosarcoma | 2 | | | 2 Lymphoma | | | 2 | 2 Multiple myeloma | | | 1 | 1 Chondroblastoma … Table 2 Patients requiring revision of femoral component (n = 5) Patient | Age (years) | Index diagnosis | Stage | Cause of revision | Time to revision (months) 1 | 42 | Chondrosarcoma | IA | Aseptic loosening | 63 2 | 19 | Chondroblastoma | IA | Osteolysis of prosthesis-stem junction | 200 3 | 22 | …