Epigenetic heterogeneity in primary bone cancers

Whole-body scintigraphy with both 99mTc-phosphonate and 67Ga was performed on 92 patients suspected of primary bone tumors. In 46 patients with primary malignant bone tumors, scintigraphy with 99mTc-phosphonate disclosed the primary tumor in 44 cases and skeletal metastases in 11, and 67Ga scintigraphy detected the primary tumor in 43 cases, skeletal metastases in 6 cases and soft-tissue metastases in 8 cases. In 25 patients with secondary malignant bone tumors, bone scintigraphy visualized a single lesion in 10 cases and several lesions in 15 cases, and 67Ga scintigraphy detected the primary tumor in 17 cases, skeletal metastases in 17 cases and soft-tissue metastases in 9 cases. In 21 patients with benign bone disease positive uptake of 99mTc-phosphonate was recognized in 19 cases and uptake of 67Ga in 17 cases. It is concluded that bone scintigraphy should be used in patients suspected of primary bone tumors. If malignancy is suspected, 67Ga scintigraphy should be performed in addition.

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Computed tomography analysis of primary bone tumors : the significance in the evaluation of destructive lesionsof pelvic bone

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1988.24.4.648 ◽

1988 ◽

Vol 24 (4) ◽

pp. 648

Author(s):

J S Suh ◽

E J Lee ◽

C Y Park

Keyword(s):

Computed Tomography ◽

Bone Tumors ◽

Pelvic Bone ◽

Primary Bone Tumors ◽

Primary Bone ◽

Tomography Analysis

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CRYOSURGERY IN THE TREATMENT OF PATIENTS WITH BONE TUMORS

Problems in oncology ◽

10.37469/0507-3758-2019-65-2-165-171 ◽

2019 ◽

Vol 65 (2) ◽

pp. 165-171

Author(s):

Aleksey Belyaev ◽

Georgiy Prokhorov ◽

Anna Arkhitskaya

Keyword(s):

Liquid Nitrogen ◽

Bone Tumors ◽

Cryogenic Treatment ◽

Long Term Results ◽

Bone Lesions ◽

Giant Cell Tumors ◽

Primary Bone Tumors ◽

Circulation Circuit ◽

Recent Emergence ◽

Primary Bone

A review of the literature shows that surgical procedures will remain the standard treatment for primary bone tumors. Analysis of studies on the assessment of long-term results shows that additional double cryogenic treatment of the curettage cavity can improve the treatment outcomes of patients with giant cell tumors, dysplastic diseases and some forms of malignant lesions. The traditional execution of the procedure is associated with the open installation of liquid nitrogen in the bone cavity, which requires special skills in handling aggressive refrigerant from the staff and does not exclude complications. In case of multiple metastatic bone lesions, surgical treatment is not indicated. The recent emergence in clinical practice of new equipment with a closed liquid nitrogen circulation circuit inside cryoprobes resumes interest in cryoabla-tion of bone tumor lesions using modern minimally invasive puncture cryotechnology and expanding indications for its use in patients with severe comorbidities.

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Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors

Healthcare ◽

10.3390/healthcare9050566 ◽

2021 ◽

Vol 9 (5) ◽

pp. 566

Author(s):

Masato Ise ◽

Eiji Nakata ◽

Yoshimi Katayama ◽

Masanori Hamada ◽

Toshiyuki Kunisada ◽

...

Keyword(s):

Risk Factors ◽

Psychological Distress ◽

Soft Tissue ◽

Rating Scale ◽

Numeric Rating Scale ◽

Soft Tissue Tumors ◽

Number Of Patients ◽

Primary Bone ◽

Associated Risk Factors ◽

Numeric Rating

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient’s distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.

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Parosteal Osteosarcoma with Pancreatic Metastasis and Multiple Relapses: A Case Report and Review of the Literature

Case Reports in Oncology ◽

10.1159/000516033 ◽

2021 ◽

pp. 983-988

Author(s):

Daniel Cirotski ◽

Jyoti Panicker

Keyword(s):

Age Groups ◽

Bone Cancer ◽

Pancreatic Metastasis ◽

Low Grade ◽

Parosteal Osteosarcoma ◽

Disease Course ◽

Review Of The Literature ◽

Histologic Subtype ◽

Primary Bone ◽

Multiple Relapses

Osteosarcoma is the most common primary bone cancer in all age groups. Metastasis mostly occurs with high-grade tumors disseminating to the lungs and other bones. Spread to the pancreas is rare and undocumented in the low-grade subtypes. Additionally, it is uncommon for the disease course of low-grade subtypes to involve multiple relapses. We present a 35-year-old woman with parosteal osteosarcoma who has experienced an atypical metastasis to the pancreas as well as multiple local and pulmonary relapses. The lesion was identified incidentally on routine imaging, and the patient underwent resection. We compare our case to the other reports of pancreatic metastasis in the literature. Despite being especially rare, clinicians ought to be aware of pancreatic metastasis of osteosarcoma. Furthermore, despite parosteal osteosarcoma’s less aggressive disease course, it can uncommonly lead to multiple relapses. We present a rare case exemplifying these phenomena in the prognostically favorable histologic subtype of parosteal osteosarcoma.

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Reconstructive Approaches in Surgical Management of Congenital Pseudarthrosis of the Tibia

Journal of Clinical Medicine ◽

10.3390/jcm9124132 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4132

Author(s):

Andrea Laufer ◽

Adrien Frommer ◽

Georg Gosheger ◽

Robert Roedl ◽

Frank Schiedel ◽

...

Keyword(s):

External Fixation ◽

Bone Transport ◽

Bone Union ◽

Complication Rates ◽

Union Rate ◽

Bone Fusion ◽

Group A ◽

Primary Bone ◽

Group B

Treatment of congenital pseudarthrosis of the tibia remains a major challenge in pediatric orthopedics. Ideal timing and preference of surgical procedures are discussed controversially. A variety of reconstructive treatment strategies have been described in literature, but so far none has proven its superiority. The aim of treatment is to obtain long-term bone union, to prevent refracture, and to correct angular deformities and leg length discrepancies. This study retrospectively evaluates the outcome of different reconstructive strategies. Sixty-nine patients were identified who presented to our outpatient department between 1997 and 2019. Twenty-six of these patients underwent reconstructive surgical treatment and were included in this study. The study cohort was divided into three groups. Excision of the pseudarthrosis was performed in all patients in Group A and B, and in two patients of Group C. Group A (six/26 patients) received subsequent bone transport through external fixation maintaining original length. In Group B (15/26 patients), patients underwent either previous, simultaneous, or subsequent extrafocal lengthening through external fixation to reconstitute length. In Group C (five/26 patients), internal fixation with intramedullary nails was applied. Radiological and clinical evaluation was performed to assess bone union and complication rates. Results varied considerably between the study groups. Overall, the primary bone fusion rate was 69.2%. There were four refractures, all occurring in Group B. The long-term bone union rate without refracture was 53.8%. The overall complication rate was 53.8% and 23.1% showed persistent pseudarthrosis. Two secondary amputations were performed due to failed bone fusion. In conclusion, excision of the pseudarthrosis and extrafocal lengthening achieves a satisfying bone union rate and limb reconstruction, while bone transport does not offer significant advantages but shows higher complication rates. Intramedullary stabilization should be applied to maintain bone union, but shows lower bone union rates when used as a stand-alone treatment regimen. Regardless of the primary bone fusion rates, the probability of long-term bone union remains unpredictable.

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Porous tantalum acetabular cups for reconstructions after peri-acetabular resections of primary bone tumours

Hip International ◽

10.1177/11207000211001552 ◽

2021 ◽

pp. 112070002110015

Author(s):

Riccardo Zucchini ◽

Andrea Sambri ◽

Claudio Giannini ◽

Michele Fiore ◽

Carlotta Calamelli ◽

...

Keyword(s):

Bone Tumour ◽

Hip Dislocation ◽

Functional Results ◽

Bone Tumours ◽

Harris Hip Score ◽

Porous Tantalum ◽

Term Survival ◽

Primary Bone ◽

Primary Bone Tumours

Introduction: Periacetabular reconstruction after resection of primary bone tumour is a very demanding procedure. They are frequently associated with scarce functional results and a high rate of complications. We report a series of patients with periacetabular resections for primary bone tumours and reconstruction with a porous tantalum (PT) acetabular cup (AC). Materials and methods: 27 patients (median age 30 years) were included, being affected by primary bone tumours of the pelvis and treated with peri-acetabular resection and reconstruction with a PT AC. The diagnoses were 13 osteosarcomas, 7 chondrosarcomas and 7 Ewing sarcomas. Function was assessed with the Harris Hip Score and complications were classified according to Zeifang. Results: The median follow-up was 70 months. 1 patient required removal of the PT AC because of implant associated infection 55 months after surgery. There was 1 hip dislocation and no case of aseptic loosening. At final follow-up, the median HHS was 81 points (range 48–92). Conclusions: The used PT AC had good medium-term survival rates and good functional results. This technique is a viable reconstructive option after resections of periacetabular primary bone sarcomas.

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First-ever intraosseous ancient schwannoma of the proximal ulna successfully treated using the cement technique

Journal of International Medical Research ◽

10.1177/0300060520987732 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052098773

Author(s):

Kai Xuan Lim ◽

Karl Wu

Keyword(s):

Rare Case ◽

Pathological Fracture ◽

Soft Tissue Neoplasm ◽

Proximal Ulna ◽

Intraosseous Schwannoma ◽

First Case ◽

Primary Bone ◽

Primary Bone Tumours ◽

Current Report ◽

Neural Sheath

Schwannoma or neurilemmoma is a common soft tissue neoplasm arising from the neural sheath of Schwann cells. However, intraosseous schwannoma is rare, accounting for less than 0.2% of primary bone tumours. Several variants of schwannoma have been reported; among them, intraosseous schwannoma with ancient change is extremely rare. This current report presents an extremely rare case of ancient intraosseous neurilemmoma. The patient presented with right elbow pain and disability. A radiolucent, well-defined, lobulated lesion with a thin sclerotic rim in the proximal ulnar metaphysis that had caused a pathological fracture was noted. The mass was surgically excised using marginal resection and bone curettage was undertaken. The bone deficit was grafted with hydroxyapatite and β-tricalcium phosphate and augmented with bone cement. There were no signs of any recurrence after 3 years. This is the first case of an ancient intraosseous schwannoma of the proximal ulna. Although rare, intraosseous schwannoma should be considered in the differential diagnosis of radiographically benign-appearing osseous tumours in the bone. The cement technique is recommended for the treatment of intraosseous schwannoma.

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Systematic Review of Recurrent Osteosarcoma Systemic Therapy

Cancers ◽

10.3390/cancers13081757 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1757

Author(s):

Ioanna Gazouli ◽

Anastasios Kyriazoglou ◽

Ioannis Kotsantis ◽

Maria Anastasiou ◽

Anastasios Pantazopoulos ◽

...

Keyword(s):

Clinical Evidence ◽

Treatment Effectiveness ◽

Treatment Strategies ◽

Bone Cancer ◽

Predictive Biomarkers ◽

Mtor Inhibitors ◽

Cytotoxic Chemotherapy ◽

Driver Mutations ◽

Preclinical Research ◽

Primary Bone

Osteosarcoma is the most frequent primary bone cancer, mainly affecting those of young ages. Although surgery combined with cytotoxic chemotherapy has significantly increased the chances of cure, recurrent and refractory disease still impose a tough therapeutic challenge. We performed a systematic literature review of the available clinical evidence, regarding treatment of recurrent and/or refractory osteosarcoma over the last two decades. Among the 72 eligible studies, there were 56 prospective clinical trials, primarily multicentric, single arm, phase I or II and non-randomized. Evaluated treatment strategies included cytotoxic chemotherapy, tyrosine kinase and mTOR inhibitors and other targeted agents, as well as immunotherapy and combinatorial approaches. Unfortunately, most treatments have failed to induce objective responses, albeit some of them may sustain disease control. No driver mutations have been recognized, to serve as effective treatment targets, and predictive biomarkers of potential treatment effectiveness are lacking. Hopefully, ongoing and future clinical and preclinical research will unlock the underlying biologic mechanisms of recurrent and refractory osteosarcoma, expanding the therapeutic choices available to pre-treated osteosarcoma patients.

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Osteosarcoma and Metastasis Associated Bone Degradation—A Tale of Osteoclast and Malignant Cell Cooperativity

International Journal of Molecular Sciences ◽

10.3390/ijms22136865 ◽

2021 ◽

Vol 22 (13) ◽

pp. 6865

Author(s):

Kirstine Sandal Nørregaard ◽

Henrik Jessen Jürgensen ◽

Henrik Gårdsvoll ◽

Lars Henning Engelholm ◽

Niels Behrendt ◽

...

Keyword(s):

Bone Metastasis ◽

Cancer Cells ◽

Bone Cancer ◽

Degradation Process ◽

Cell Types ◽

Malignant Cell ◽

Pathological Process ◽

Course Of Disease ◽

Bone Degradation ◽

Primary Bone

Cancer-induced bone degradation is part of the pathological process associated with both primary bone cancers, such as osteosarcoma, and bone metastases originating from, e.g., breast, prostate, and colon carcinomas. Typically, this includes a cancer-dependent hijacking of processes also occurring during physiological bone remodeling, including osteoclast-mediated disruption of the inorganic bone component and collagenolysis. Extensive research has revealed the significance of osteoclast-mediated bone resorption throughout the course of disease for both primary and secondary bone cancer. Nevertheless, cancer cells representing both primary bone cancer and bone metastasis have also been implicated directly in bone degradation. We will present and discuss observations on the contribution of osteoclasts and cancer cells in cancer-associated bone degradation and reciprocal modulatory actions between these cells. The focus of this review is osteosarcoma, but we will also include relevant observations from studies of bone metastasis. Additionally, we propose a model for cancer-associated bone degradation that involves a collaboration between osteoclasts and cancer cells and in which both cell types may directly participate in the degradation process.

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