Correction to: A proposed “Radiological Evaluation Score for Bone Tumors” (REST): An objective system for assessment of a radiograph in patients with suspected bone tumor

This research is aimed to study the variations in the biomechanical behavior of bone and bone tissues with osteoporosis and bone tumors. Osteoporosis and bone tumors reduce the mechanical strength of bone, which creates a greater risk of fracture. In the United States alone, ten million individuals, eight million of whom are women, are estimated to already have osteoporosis, and almost 34 million more are estimated to have low bone mass (osteopenia) placing them at increased risk for osteoporosis. World Health Organization defines osteopenia, as a bone density between one and two and a half standard deviations (SD) below the bone density of a normal young adult. (Osteoporosis is defined as 2.5 SD or more below that reference point.). Together, osteoporosis and osteopenia are expected to affect an estimated 52 million women and men age 50 and older by 2010, and 61 million by 2020. The current medical cost of osteoporosis total is nearly about $18 billion in the U.S. each year. There is a dearth of literature that addresses the effects of osteoporosis on bone tissue properties. Furthermore, there are few studies published related to the effect of bone tumors such as Adamantinoma of long bones, Aneurysmal bone cyst, Hemangioma and others on overall behavior of bone. To understand the variations in bio-mechanical properties of internal tissues of bone with osteoporosis and bone tumor, a 2D finite element (FE) model of bone is developed using ANSYS 9.0 ® (ANSYS Inc., Canonsburg, PA). Trabecular bone is modeled using hexagonal and voronoi cellular structure. This finite element model is subjected to change in BVF (bone volume fraction) and bone architecture caused by osteoporosis. The bone tumor is modeled as finer multi-cellular structure and the effects of its size, location, and property variation of tumor on overall bone behavior are studied. Results from this analysis and comparative data are used to determine behavior of bone and its tissue over different stage of osteoporosis and bone tumor. Results indicate that both bone tumor and osteoporosis significantly change the mechanical properties of the bone. The results show that osteoporosis increases the bone tissue stiffness significantly as BVF reduces. Bone tissue stiffness is found to increase by 80 percent with nearly 55 percent reduction of BVF. The results and methods developed in this research can be implemented to monitor variation in bio-mechanical properties of bone up to tissue level during medication or to determine type and time for need of external support such as bracing.

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KPNA2 expression is a potential marker for differential diagnosis between osteosarcomas and other malignant bone tumor mimickers

10.21203/rs.3.rs-29911/v1 ◽

2020 ◽

Author(s):

Lucen Jiang ◽

Jianghuan Liu ◽

Qingzhu Wei ◽

Yiyang Wang

Keyword(s):

Bone Tumor ◽

Bone Tumors ◽

Diagnostic Value ◽

Benign Tumors ◽

Malignant Bone Tumor ◽

Malignant Bone Tumors ◽

Potential Marker ◽

Tumors Of Bone ◽

Bone Sarcomas ◽

Malignant And Benign Tumors

Abstract Background Karyopherin α 2 (KPNA2), a member of the Karyopherin α family, has been observed in several cancers but lack substantial investigation in malignant bone tumors. The purpose of the current study was to evaluate KPNA2 expression level and its utility as a novel diagnostic biomarker in osteosarcomas and their malignant bone tumor mimickers, such as chondrosarcomas and Ewing sarcomas.Method We investigated the expression of KPNA2 protein by immunohistochemistry on paraffin embedded surgical specimens from 217 patients with malignant and benign tumors of bone, including 81 osteosarcomas, 42 chondrosarcomas, 9 Ewing sarcomas, 28 osteoid osteoma, 20 osteochondroma and 37 Chondroblastoma. Immunoreactivity was scored semi quantitatively based on stain extent and intensity.Results Seventy one of 81 (87.7%) osteosarcomas, zero of 42 (0%) chondrosarcomas and one of 9 (11.1%) Ewing sarcomas showed immunoreactivity for KPNA2. Negative KPNA2 expression was observed in all of benign bone tumors. Much more positive expression of KPNA2 was found in osteosarcomas as compared with chondrosarcomas and Ewing sarcomas. The sensitivity and specificity of KPNA2 immuno-expression for osteosarcoma was 87.7% and 100%, respectively. In several subtypes of osteosarcomas, immunohistochemical expression of KNA2 was more frequent in osteoblastic (94.5%), with 39 (70.9%) showing strong-intensity staining. KPNA2 positivity was observed in eleven of 13 (84.6%) chondroblastic, three of 6 (50%) fibroblastic, three of 4 (75%) telangiectatic and two of 3 (66.7%) giant cell-rich osteosarcoma. Stronger-intensity staining was observed in osteoblastic osteosarcoma.Conclusion KPNA2 is most frequently expressed in osteosarcomas, particularly in osteoblastic and chondroblastic tumors, but is rarely positive in chondrosarcomas and Ewing sarcomas. This feature may have diagnostic value since it is very useful for distinguishing between osteosarcomas and other bone sarcomas mimickers. This report supports KPNA2 as a novel marker for the diagnosis of osteosarcoma.

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Association of The Cytotoxic T Lymphocyte Antigen-4 +49G/A Gene Polymorphism with Susceptibility to Malignant Bone Tumors

10.21203/rs.3.rs-54235/v1 ◽

2020 ◽

Author(s):

Ningfeng Guo ◽

Yaojun Wu ◽

Yueming Hu

Keyword(s):

T Lymphocyte ◽

Bone Tumor ◽

Bone Tumors ◽

Cytotoxic T Lymphocyte ◽

Meta Analysis ◽

Population Based ◽

Cochrane Library ◽

Malignant Bone Tumor ◽

Malignant Bone Tumors ◽

Lymphocyte Antigen

Abstract Background Earlier research works have studied the part that cytotoxic T-lymphocyte antigen-4 (CTLA-4) plays in the carcinogenesis of malignant bone tumors, nonetheless, findings had inconsistency. The current investigation aims at clarifying the association between CTLA-4 polymorphism and malignant bone tumor susceptibility through the meta-analysis.Methods We searched pertinent research works in not just PubMed, but also EMBASE, Cochrane library, and Chinese National Knowledge Infrastructure (CNKI) databases in humans published before October 2019. The use of the pooled odds ratio (OR) with its 95% confidence interval (95%CI) was made for estimating the strengths of the correlation existing between the CTLA-4 genetic polymorphism and malignant bone tumors susceptibility. An aggregate of six research works with 1191 malignant bone tumors patients and 1418 controls were selected eventually. The pooled results shed light on the fact that CTLA-4 +49G/A polymorphism had a significant correlation with an augmented vulnerability to the malignant bone tumors (A vs. G: OR=1.37, 95%CI=1.22-1.54; GA vs. GG: OR=1.20, 95%CI=1.01-1.42; AA vs. GG: OR=2.13, 95%CI=1.63-2.78; GA+AA vs. GG: OR=1.35, 95%CI=1.15-1.59; AA vs. GG+GA: OR=2.02, 95%CI=1.60-2.56). Subgroup analysis indicated that there exists a statistically significant correlation between CTLA-4 +49G/A polymorphism and augmented susceptibility to the malignant bone tumor in the population-based or hospital-based samples, and Ewing’s sarcoma or osteosarcoma. Moreover, there was also not observed any considerable heterogeneity across the research works. Results Our results suggest that the CTLA-4 +49G/A polymorphism may play a pivotal part in the carcinogenesis of malignant bone tumors. Conclusions More research works, on the basis of the large sample sizes as well as homogeneous specimens, are needed in order to verify these results.

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Demographic, clinico-pathological features and management pattern of primary bone tumors in a tertiary care hospital of South India

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214962 ◽

2021 ◽

Vol 8 (1) ◽

pp. 60

Author(s):

Subbiah Shanmugam ◽

Sujay Susikar ◽

Bharanidharan T. ◽

Arun Victor Jebasingh

Keyword(s):

Bone Tumor ◽

Bone Tumors ◽

Tertiary Care ◽

Tumor Location ◽

Care Hospital ◽

Pathological Features ◽

Primary Bone Tumor ◽

Primary Bone Tumors ◽

True Incidence ◽

Primary Bone

Background: Primary bone tumors are very rare tumors. The true incidence of bone tumors is not well established and is under reported due to rarity and lack of accurate registries. Hence it is essential to study about the demographic, clinico-pathological features and the pattern of surgical management of bone tumors. The aim of this study is to analyze the demographic and clinico-pathological features of primary bone tumors that were managed by surgery.Methods: A retrospective analysis of all patients with primary bone tumor who were treated by surgery from 2012 to 2019 was done. The age, sex distribution, histopathology, location of the tumor and surgical procedure done were analyzed.Results: Among 103 patients analyzed, 66 (64%) were men and 37 (36%) were women. Primary bone tumors most commonly presented in 11 to 20 years of age with 35 (33.9%) patients occurring in this age group. Osteosarcoma was the most common primary bone tumor and it occurred in 49 (47.6%) patients, out of which 34 (69.3%) patients were below 20 years of age. Giant cell tumor was the most common benign bone tumor and it occurred in 22 patients, out of which nine (40.9%) patients were of age 21 to 30 years. Distal femur was the most common site with 39 (37.9%) patients. The limb preservation rate for malignant appendicular bone tumors was 69.0%.Conclusions: The diagnosis of bone tumor depends not only on histopathological features but also needs correlation with age, clinical features, tumor location and radiological features for confirmation of diagnosis.

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Pain Around Elbow: Not Always Tennis Elbow!

Journal of Experimental and Clinical Medicine ◽

10.52142/omujecm.38.2.12 ◽

2021 ◽

Vol 38 (2) ◽

pp. 121-124

Author(s):

Hüseyin Sina COŞKUN ◽

Nevzat DABAK ◽

Ferhat SAY ◽

Hasan GÖÇER

Keyword(s):

Soft Tissue ◽

Bone Tumor ◽

Bone Tumors ◽

Tennis Elbow ◽

Bone Cyst ◽

Body Part ◽

Soft Tissue Tumors ◽

Elbow Pain ◽

Solitary Bone Cyst ◽

Olecranon Bursitis

Elbow is a well-known body part of muscular strains and overuse syndromes. Patients presented to the orthopedic department with elbow pain or swelling often diagnosed with benign conditions such as tennis elbow, golfer’s elbow, or olecranon bursitis. It must be kept in mind that several tumoral conditions can be seen around the elbow and the patient must be carefully evaluated. In this study, we aimed to demonstrate rare cases of bone or soft tissue tumors around the elbow. Between 2004 and 2017, patients with a symptom of elbow pain or swelling are included in the study. Finally, the study consists of 53 patients. 20 patients were male and 33 were female. The mean age of the patients was 42.94 ± 15.3. There were 9 bone tumors, 16 soft tissue tumors, 9 non-classified benign cystic lesions, 3 metastasis, and 16 cases were non-tumoral conditions. 7 of 9 bone tumors were benign. The solitary bone cyst was the most common bone tumor seen around the elbow. 2 malignant bone tumor cases were diagnosed as Ewing Sarcoma and metastatic bone disease. Among the 16 soft tissue tumors, schwannomas are the most presented cases in the tumor council followed by lipoma (6 cases). Even in a multidisciplinary bone and soft tissue tumor council, almost one-third of the elbow pain patients were non-tumoral and the most commonly seen condition was myositis ossificans (6 cases), followed by infection or bursitis (5 cases). Elbow pain is commonly seen and evaluated by every orthopedic surgeon on outpatient’s clinic. It must be kept in mind that tumoral conditions around the elbow are rarely seen but deserve further examination in the presence of chronic pain.

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TMPRSS2-ERG fusions confer efficacy of enzalutamide in an in vivo bone tumor growth model

BMC Cancer ◽

10.1186/s12885-019-6185-0 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Louie Semaan ◽

Navneet Mander ◽

Michael L. Cher ◽

Sreenivasa R. Chinni

Keyword(s):

Prostate Cancer ◽

Tumor Growth ◽

Bone Tumor ◽

Bone Tumors ◽

Growth Analysis ◽

Biosynthetic Enzyme ◽

Enzyme Expression ◽

Oncogenic Signaling ◽

Androgen Synthesis

Abstract Background Castrate Resistant Prostate Cancer (CRPC) is an advanced disease resistant to systemic traditional medical or surgical castration, and resistance is primarily attributed to reactivation of AR through multiple mechanisms. TMPRSS2-ERG fusions have been shown to regulate AR signaling, interfere with pro-differentiation functions, and mediate oncogenic signaling. We have recently shown that ERG regulates intra-tumoral androgen synthesis and thereby facilitates AR function in prostate cancer cells. We hypothesize that enzalutamide treatment will be more effective in cells/tumors with TMPRSS2-ERG translocations because these tumors have increased AR signaling. Methods ERG knockdown was performed with VCaP cells using lentiviral infections to generate VCaP ERGshRNA cells and control VCaP scr cells with scrambled shRNA. Cell-growth analysis was performed to determine the effect of enzalutamide. Reverse transcription, quantitative real-time PCR (RT-qPCR) was used to determine the expression of AR responsive genes. Luciferase tagged VCaP scr and shRNA infected cells were used in an intra-tibial animal model for bone tumor growth analysis and enzalutamide treatment used to inhibit AR signaling in bone tumors. Western blotting analyzed VCaP bone tumor samples for ERG, AR, AKR1C3 and HSD3B1 and HSD3B2 expression. Results Enzalutamide inhibited the growth of VCaP scr cells more effectively than shERG cells. Analysis of AR responsive genes shows that Enzalutamide treatment at 5 micromolar concentration inhibited by 85–90% in VCaP Scr cells whereas these genes were inhibited to a lesser extent in VCaP shERG cells. Enzalutamide treatment resulted in severe growth inhibition in VCaP scr shRNA cells compared to VCaP shERG cells. In bone tumor growth experiment, VCaP ERG shRNA cells grew at slower than VCaP scr shRNA cells. Androgen biosynthetic enzyme expression is lower VCaP shERG bone tumors compared to VCaP scr shRNA bone tumors and enzalutamide inhibited the enzyme expression in both types of tumors. Conclusions These data suggest that ERG transcription factor regulates androgen biosynthetic enzyme expression that enzalutamide treatment is more effective against VCaP bone tumors with an intact ERG expression, and that knocking down ERG in VCaP cells leads to a lesser response to enzalutamide therapy. Thus, ERG expression status in tumors could help stratify patients for enzalutamide therapy.

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KPNA2 expression is a potential marker for differential diagnosis between osteosarcomas and other malignant bone tumor mimics

Diagnostic Pathology ◽

10.1186/s13000-020-01051-6 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Lucen Jiang ◽

Jianghuan Liu ◽

Qingzhu Wei ◽

Yiyang Wang

Keyword(s):

Differential Diagnosis ◽

Bone Tumor ◽

Bone Tumors ◽

Bone Sarcoma ◽

Malignant Bone Tumor ◽

Diagnostic Biomarker ◽

Malignant Bone Tumors ◽

Benign Bone Tumors ◽

Potential Marker ◽

Osteoblastic Osteosarcoma

Abstract Background Karyopherin α2 (KPNA2), a member of the karyopherin α family, has been studied in several cancers but has not yet been substantially investigated in malignant bone tumors. The purpose of the current study was to evaluate the KPNA2 expression level and its utility as a novel diagnostic biomarker in osteosarcomas and malignant bone tumor mimics, such as chondrosarcomas and Ewing sarcomas (ESs). Method We investigated the expression of KPNA2 protein by immunohistochemistry on paraffin-embedded surgical specimens from 223 patients with malignant and benign bone tumors, including 81 osteosarcomas, 42 chondrosarcomas, 15 ESs, 28 osteoid osteomas, 20 osteochondromas and 37 chondroblastomas. Immunoreactivity was scored semiquantitatively based on staining extent and intensity. Results Sixty-seven of 81 (82.7%) osteosarcoma, zero of 42 (0%) chondrosarcoma and one of 15 (6.7%) ES samples showed immunoreactivity for KPNA2. Negative KPNA2 expression was observed in all benign bone tumors. The expression of KPNA2 in osteosarcoma samples was much higher than that in chondrosarcoma and ES samples (P < 0.001). The sensitivity and specificity of KPNA2 immunoexpression for detecting osteosarcoma were 82.7 and 100%, respectively. Several subtypes of osteosarcoma were analyzed, and immunostaining of KPNA2 was frequent in osteoblastic samples (90.9%), with 39 samples (70.9%) showing strong-intensity staining. KPNA2 positivity was observed in ten of 13 (76.9%) chondroblastic, two of 6 (33.3%) fibroblastic, three of 4 (75%) telangiectatic and two of 3 (66.7%) giant cell-rich osteosarcoma samples. The strongest intensity staining was observed in osteoblastic osteosarcoma. Conclusion KPNA2 is frequently expressed in osteosarcomas, particularly in osteoblastic and chondroblastic tumors, but is rarely positive in chondrosarcomas and ESs. This feature may aid in distinguishing between osteosarcoma and other bone sarcoma mimics. This report supports KPNA2 as a novel marker for the diagnosis of osteosarcoma.

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Osteoblastoma

Archives of Pathology & Laboratory Medicine ◽

10.5858/2010-0201-cr.1 ◽

2010 ◽

Vol 134 (10) ◽

pp. 1460-1466 ◽

Cited By ~ 12

Author(s):

David R. Lucas

Keyword(s):

Case Report ◽

Bone Tumor ◽

Bone Tumors ◽

Differential Diagnoses ◽

Benign Bone Tumor ◽

Benign Bone Tumors ◽

Pathologic Features ◽

Clinicopathologic Findings

Abstract Osteoblastoma is a rare benign bone tumor. Although the histologic features in most cases are distinctive, there are various permutations that make the diagnosis challenging. It can mimic a variety of other benign bone tumors, but more importantly, distinguishing it from osteoblastoma-like osteosarcoma can be difficult. In this case report, I describe the clinicopathologic findings for a 13-year-old adolescent boy with T7 spinal osteoblastoma and review salient clinical, radiographic, and pathologic features of osteoblastoma, as well as the differential diagnoses.

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Femoral Expandable Prosthesis In Bone Tumor of an Adult: A Case Report

Folia Medica ◽

10.2478/folmed-2018-0019 ◽

2018 ◽

Vol 60 (3) ◽

pp. 483-489

Author(s):

Domenico Fenga ◽

Michele A. Rosa

Keyword(s):

Bone Tumor ◽

Bone Tumors ◽

New Technologies ◽

Adult Population ◽

Lower Limbs ◽

Review Of Literature ◽

Leg Length ◽

Endoprosthetic Replacement ◽

Malignant Bone Tumors ◽

Point Of Interest

Abstract Management of bone tumors of the limbs is still a field to be explored. The problems to be faced are diff erent, especially when the lower limbs are the point of interest, due to the diff erent leg length residual. A possible solution, provided by new technologies, is the use of electromagnetic expandable prosthesis. This device is successfully used in the management of paediatric malignant bone tumors. The strength of this prosthesis is the possibility to assist the musculoskeletal growth in children. To our acknowledge review of literature points out only few cases in which this mechanism is used in adult population. The authors present their results with expandable endoprosthetic replacement in an adult patient with severe lower limb discrepancy which occurred after a malignant bone tumor of the knee, obtaining a recovery of approximately 6 cm.

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