Radiologic follow-up of untreated enchondroma and atypical cartilaginous tumors in the long bones

Management of atypical cartilaginous tumors (ACTs) in the long bones is shifting towards active surveillance to avoid unnecessary surgeries. The frequency and duration of active surveillance for these tumors is unclear as there is little knowledge of its biological behavior. In this retrospective study, we examined the natural course of enchondroma and ACTs through active surveillance. A total of 128 central cartilaginous tumors, located in the long bones, with a minimum interval of 24 months between baseline and last MRI were included. MRI characteristics (e.g., size, scalloping, fat entrapment) were scored and tumors were classified according to the changes between MRIs. Mean follow-up of this study was 50 months, range = 25–138 months. The majority of the cartilaginous tumors (87%) remained stable (n = 65) or showed regression (n = 46) on MRI. A total of 87% of the cases that developed tumor regression presented with entrapped fat at diagnosis. Only 13% (n = 17) showed some progression on MRI, although none of the tumors developed characteristics of high-grade chondrosarcoma. Based on our results, active surveillance is considered safe for enchondroma and ACTs of the long bones. We propose active surveillance for all asymptomatic enchondroma or ACTs in the long bones irrespective of tumor size, and follow-up schemes should be tailored on natural course.

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Diagnostic Value of CT- and MRI-Based Texture Analysis and Imaging Findings for Grading Cartilaginous Tumors in Long Bones

Frontiers in Oncology ◽

10.3389/fonc.2021.700204 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xue-Ying Deng ◽

Hai-Yan Chen ◽

Jie-Ni Yu ◽

Xiu-Liang Zhu ◽

Jie-Yu Chen ◽

...

Keyword(s):

Texture Analysis ◽

Feature Model ◽

Imaging Feature ◽

Low Grade ◽

Long Bones ◽

Imaging Features ◽

High Grade ◽

Accuracy Rate ◽

Predictive Values ◽

Cartilaginous Tumors

ObjectiveTo confirm the diagnostic performance of computed tomography (CT)-based texture analysis (CTTA) and magnetic resonance imaging (MRI)-based texture analysis for grading cartilaginous tumors in long bones and to compare these findings to radiological features.Materials and MethodsTwenty-nine patients with enchondromas, 20 with low-grade chondrosarcomas and 16 with high-grade chondrosarcomas were included retrospectively. Clinical and radiological information and 9 histogram features extracted from CT, T1WI, and T2WI were evaluated. Binary logistic regression analysis was performed to determine predictive factors for grading cartilaginous tumors and to establish diagnostic models. Another 26 patients were included to validate each model. Receiver operating characteristic (ROC) curves were generated, and accuracy rate, sensitivity, specificity and positive/negative predictive values (PPV/NPV) were calculated.ResultsOn imaging, endosteal scalloping, cortical destruction and calcification shape were predictive for grading cartilaginous tumors. For texture analysis, variance, mean, perc.01%, perc.10%, perc.99% and kurtosis were extracted after multivariate analysis. To differentiate benign cartilaginous tumors from low-grade chondrosarcomas, the imaging features model reached the highest accuracy rate (83.7%) and AUC (0.841), with a sensitivity of 75% and specificity of 93.1%. The CTTA feature model best distinguished low-grade and high-grade chondrosarcomas, with accuracies of 71.9%, and 80% in the training and validation groups, respectively; T1-TA and T2-TA could not distinguish them well. We found that the imaging feature model best differentiated benign and malignant cartilaginous tumors, with an accuracy rate of 89.2%, followed by the T1-TA feature model (80.4%).ConclusionsThe imaging feature model and CTTA- or MRI-based texture analysis have the potential to differentiate cartilaginous tumors in long bones by grade. MRI-based texture analysis failed to grade chondrosarcomas.

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Ewing's Sarcoma: An Approach to Radiological Diagnosis

Tumori Journal ◽

10.1177/030089167906500316 ◽

1979 ◽

Vol 65 (3) ◽

pp. 389-399 ◽

Cited By ~ 7

Author(s):

Fabrizio Lombardi ◽

Marco Gasparini ◽

Cristina Gianni ◽

Raffaele Petrillo ◽

John David Tesoro-Tess ◽

...

Keyword(s):

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Primary Site ◽

Long Bones ◽

Age Group ◽

Pediatric Age Group ◽

Localized Disease ◽

The Mean ◽

Small Bones

All the pertinent radiographs of 83 patients with histologically proven Ewing's sarcoma were reviewed. Forty-nine patients were in the pediatric age group, and 34 were adults. The mean age, the symptoms and time from symptoms to diagnosis were evaluated in the 2 groups. The site of primary involvement was in 54 % the long bones, 35 % the flat bones, 8 % the small bones and 3 % extraosseous. For the primary site we considered the diagnostic results of the standard radiographic investigations and in some cases the usefulness of angiography, xeroradiography and telethermography. At presentation we also evaluated the possible diffusion of the disease with standard radiographic surveys (chest and skeletal, including limbs) and with foot lymphography in selected cases. In this way, 57 patients (69 %) were considered to have localized disease. In this group, we also considered the value of the periodic radiographic follow-up, which enabled us to disclose the appearance of metastases (chest 64 %, bone 54 %, lymph nodes 11 %) in 28 cases (49 %). Finally, we made a comparison of the different radiologic and epidemiologic findings between children and adults.

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OC27.05: Long-term follow-up on fetuses with isolated sonographic finding of short long bones

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.19388 ◽

2018 ◽

Vol 52 ◽

pp. 64-64

Author(s):

A. Mohr Sasson ◽

S. Toussia-Cohen ◽

M. Shapira ◽

R. Achiron ◽

Y. Gilboa

Keyword(s):

Sonographic Finding ◽

Long Bones ◽

Long Term Follow Up

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Feline Chondrosarcoma: A Retrospective Study of 67 Cats (1987–2005)

Journal of the American Animal Hospital Association ◽

10.5326/0440124 ◽

2008 ◽

Vol 44 (3) ◽

pp. 124-130 ◽

Cited By ~ 13

Author(s):

Amy C. Durham ◽

Catherine A. Popovitch ◽

Michael H. Goldschmidt

Keyword(s):

Retrospective Study ◽

Nasal Cavity ◽

Axial Skeleton ◽

Long Bones ◽

Facial Bones ◽

Definitive Evidence ◽

The Mean

The histories of 67 cats diagnosed with chondrosarcoma (CSA) from 1987 to 2005 were reviewed. The mean age was 9.6 years, and males were 1.9 times more likely to be affected than females. Chondrosarcomas were diagnosed in the following sites: appendicular and axial skeleton, nasal cavity, facial bones, and extraskeletal sites. Of the 46 (70%) CSA associated with bone, 63% arose in long bones and 37% arose in flat bones. The remaining (30%) CSA arose in the subcutis. In cases available for follow-up (n=24), no definitive evidence of metastases was found. Cats that underwent radical surgical therapies were more likely to achieve long-term control or cure.

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Long-Term Follow-Up of Cartilaginous Tumors of the Larynx

Otolaryngology ◽

10.1177/019459980112400607 ◽

2001 ◽

Vol 124 (6) ◽

pp. 634-640 ◽

Cited By ~ 3

Author(s):

Robert Thomé ◽

Daniela Curti Thomé ◽

Rodrigo A. C. De La Cortina

Keyword(s):

Long Term Follow Up ◽

Cartilaginous Tumors

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Prognosis of Adamantinoma of Long Bones: A Long-Term Follow-Up Study

Shafa Orthopedic Journal ◽

10.17795/soj-4461 ◽

2016 ◽

Vol In Press (In Press) ◽

Author(s):

Khodamorad Jamshidi ◽

Sam Hajialilo Sami ◽

Farshad Abolghasemzadeh Ahangar ◽

Nariman Latifi

Keyword(s):

Long Bones ◽

Follow Up Study ◽

Long Term Follow Up

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Results of bridging LCP along with corticocancellous autogenous bone graft and calcium hydroxyapatite blocks in gap nonunion of long bones

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20183010 ◽

2018 ◽

Vol 4 (5) ◽

pp. 702

Author(s):

Ankur Agarwal

Keyword(s):

Bone Graft ◽

Calcium Hydroxyapatite ◽

High Energy ◽

Drop Out ◽

Autogenous Bone ◽

Long Bones ◽

Gap Size ◽

Non Union ◽

Radiological Union

Background: High-energy trauma is an important cause of compound fractures of long bones that in turn results into bone gap due to bone loss or high communition with resultant displacement of minute fracture fragments and hence non-union. Bone resorption or surgical excision for infection or tumour also leads to gap non-unions.Methods: Forty-one patients having fracture of long bones of extremities with a bone gap of upto 2 inches were enrolled and were treated with autogenous bone grafting and calcium hydroxyapatite (CHA) blocks along with fixation by a locked compression plate (LCP) and plaster slab. The average follow-up period was ten months. One patient was excluded from the study due to drop out from follow up.Results: In 23 (57.5%) patient’s radiological union occurred by 24-26 weeks. In 16 (40%) patients, radiological union was seen between 26-28 weeks, while in one (2.5%) patient union was seen at 30 weeks. Also, it was seen that smaller the length of gap, the faster was the union. Excellent results were seen in the majority of 25 patients (62.5%), good results in 11 patients (27.5%), fair results in 3 patients (7.5%) and poor outcome in 1 patient (2.5%). Also, it was seen that smaller the gap size, better was the outcome.Conclusions: The technique of bridge plating using internal fixator i.e. LCP along with autogenous corticocancellous bone graft and CHA blocks is a fairly good technique to treat gap non unions. It has its own advantages of avoiding complications associated with large external frame constructs. However, larger gap size limits the usefulness of this technique.

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Intraosseous schwannoma of the glenoid: case report and literature review

SICOT-J ◽

10.1051/sicotj/2020048 ◽

2021 ◽

Vol 7 ◽

pp. 2

Author(s):

Pieter Reyniers ◽

Hazem Wafa ◽

Friedl Sinnaeve ◽

Philippe Debeer ◽

Raf Sciot

Keyword(s):

Bone Tumors ◽

Long Bones ◽

Rare Presentation ◽

Correct Treatment ◽

Primary Bone Tumors ◽

Intraosseous Schwannoma ◽

Spindle Cells ◽

Orthopaedic Oncologist ◽

Primary Bone

Intraosseous schwannomas represent an extremely rare subgroup of schwannomas, accounting for <1% of all primary bone tumors. They mostly occur in the mandible, the maxilla, the sacrum, and they are also seen in long bones. We herein report a rare presentation of an intraosseous schwannoma in the glenoid of a 49-year-old patient. She complained of shoulder pain and was referred to the orthopaedic oncologist after detection of a suspicious lesion on imaging. Biopsy revealed benign spindle cells and immunohistochemistry was positive for S100. Because of the rarity of these intraosseous schwannomas it is important to recognize their radiological and histological features and make a differential diagnosis with other lytic tumors. Only if these characteristics are recognized, correct treatment can be given with definite curettage and bone grafting and correct follow-up with avoidance of unnecessary adjuvant therapy.

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