Skeletal metastases in advanced pancreatic ductal adenocarcinoma (PDAC): A retrospective analysis.

245 Background: Skeletal metastasis (SM) in advanced PDAC is an infrequent occurrence and has been previously reported to be < 2.5%. However; pathological fractures in these patients can result in intractable pain, immobilization and a significant deterioration in quality of life. Methods: A retrospective analysis was conducted of patients (pts) with advanced PDAC receiving palliative chemotherapy. Data collection included age, gender, ECOG, sites of disease, and overall survival (OS). Statistical analysis included Kaplan Meier survival analysis. Results: The 135 pts included had a median age of 65.8 years (range: 53.7–91.3); 5 (31.2%) were women and 11 (68.7%) had an ECOG performance status of 0 or 1. A majority of patients received combination therapy that was either gemcitabine or 5-flurouracil based. Sixteen pts (11.8%) had skeletal metastasis with the primary tumor located in the pancreatic body/tail (11 pts - 68.7%).The sites of SM included thoracic vertebrae (8), lumbar vertebrae (5), pelvis (5), ribs (4), sacrum (4), scapula (3), acetabulum (2), cervical vertebrae (2), femoral head (2), sternum (1) and humerus head (1). A majority of the lesions were osteolytic (62.5%) with a median time of diagnosis of SM from initial diagnosis being 1.25 months (range 0-33). Bone pain was observed as the initial symptom in 5 pts (32%), 1 pt (6.2%) had a pathological fracture. The mOS for patients with SM was 6.5 months (range 0-38) when compared to 8 months (range 0-147) without SM.The mOS for pts treated with gemcitabine based regimen was 5.75 months (range 2.5-14), and patients who received multiple lines of therapy including gemcitabine and 5-FU based regimens was 15 months (range 5-38). Survival from onset of skeletal metastases ranged from 0-14 months (mOS: 4 months). Conclusions: More effective systemic therapies which improve mOS are likely to result in increased incidence of SM. The most common sites observed were the thoracic and lumbar vertebrae and pathological fractures in these sites can be catastrophic. Therefore careful evaluation of skeletal signs and symptoms, early detection and intervention will be important to prevent morbidity and mortality from pathological fractures.

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The locomotor system

Anatomy for Dental Students ◽

10.1093/oso/9780199234462.003.0008 ◽

2013 ◽

Author(s):

Martin E. Atkinson

Keyword(s):

Vertebral Column ◽

Cervical Vertebrae ◽

Lumbar Vertebrae ◽

Posterior Wall ◽

Axial Skeleton ◽

Intervertebral Discs ◽

Central Canal ◽

The Body ◽

Thoracic Vertebrae ◽

Locomotor System

The locomotor system comprises the skeleton, composed principally of bone and cartilage, the joints between them, and the muscles which move bones at joints. The skeleton forms a supporting framework for the body and provides the levers to which the muscles are attached to produce movement of parts of the body in relation to each other or movement of the body as a whole in relation to its environment. The skeleton also plays a crucial role in the protection of internal organs. The skeleton is shown in outline in Figure 2.1A. The skull, vertebral column, and ribs together constitute the axial skeleton. This forms, as its name implies, the axis of the body. The skull houses and protects the brain and the eyes and ears; the anatomy of the skull is absolutely fundamental to the understanding of the structure of the head and is covered in detail in Section 4. The vertebral column surrounds and protects the spinal cord which is enclosed in the spinal canal formed by a large central canal in each vertebra. The vertebral column is formed from 33 individual bones although some of these become fused together. The vertebral column and its component bones are shown from the side in Figure 2.1B. There are seven cervical vertebrae in the neck, twelve thoracic vertebrae in the posterior wall of the thorax, five lumbar vertebrae in the small of the back, five fused sacral vertebrae in the pelvis, and four coccygeal vertebrae—the vestigial remnants of a tail. Intervertebral discs separate individual vertebrae from each other and act as a cushion between the adjacent bones; the discs are absent from the fused sacral vertebrae. The cervical vertebrae are small and very mobile, allowing an extensive range of neck movements and hence changes in head position. The first two cervical vertebrae, the atlas and axis, have unusual shapes and specialized joints that allow nodding and shaking movements of the head on the neck. The thoracic vertebrae are relatively immobile. combination of thoracic vertebral column, ribs, and sternum form the thoracic cage that protects the thoracic organs, the heart, and lungs and is intimately involved in ventilation (breathing).

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Anatomo-radiographic description of the axial skeleton of the crab-eating fox (Cerdocyon thous)

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2012001300001 ◽

2012 ◽

Vol 32 (suppl 1) ◽

pp. 01-03 ◽

Cited By ~ 1

Author(s):

Janaína D. Barisson ◽

Cristiane H. Louro ◽

Sheila J.T. Dias ◽

Flávio S. Jojima ◽

Murilo S. Ferreira ◽

...

Keyword(s):

Cervical Vertebrae ◽

Spinous Process ◽

Lumbar Vertebrae ◽

Axial Skeleton ◽

The Other ◽

Domestic Dog ◽

Thoracic Vertebrae ◽

The Third ◽

Caudal Vertebrae ◽

Cerdocyon Thous

The aim of this study was to describe the axial skeleton of a wild Brazilian carnivorous, the crab-eating fox (Cerdocyon thous). Five specimens of crab-eating fox were previously unfrozen for radiographic exams and their bones went through dissection and chemical maceration. This animal presents seven cervical vertebrae, and from the third on, they become shorter and wider than the other ones e the spinous process was makeable from the fifth cervical vertebrae on. There are thirteen thoracic vertebrae and the spinous process of the lumbar vertebrae, which are seven, decreases from the fifth on. The sacrum is formed by two vertebrae and there are twenty or twenty one caudal vertebrae. It can be concluded that the crab-eating fox axial skeleton is similar to that of the domestic dog.

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Gross Morphological Studies on the Vertebral Column of Indian Eagle Owl (Bubo bengalensis)

Indian Journal of Animal Research ◽

10.18805/ijar.b-4132 ◽

2020 ◽

Author(s):

P. Sridevi ◽

K. Rajalakshmi ◽

M. Sivakumar ◽

A. Karthikeyan

Keyword(s):

Vertebral Column ◽

Cervical Vertebrae ◽

Lumbar Vertebrae ◽

Cervical Vertebra ◽

Neural Spine ◽

Thoracic Vertebrae ◽

Post Mortem ◽

Post Mortem Examination ◽

Morphological Studies ◽

Eagle Owl

Background: Indian eagle owl known to rotate their necks up to 270 degrees in either direction without injuring their vessels running below the head thereby without cutting off blood supply to their brains. The vertebral column in birds carry peculiar features like higher number of cervical vertebrae due to long mobile neck, lumbar and sacral vertebrae fused together giving rigidity which aid in flight. The extensive fusion of vertebral column posterior to the neck provides the required rigidity in the trunk region, this inflexibility feature might reduce weight, as it avoids the need for extensive musculature to maintain a streamlined and rigid body posture during flight. The current study aimed to study the vertebral column of Indian eagle owl in order to understand the anatomical adaptations related to this species. Methods: The specimens were procured from three Indian eagle owl brought for post mortem examination during the year 2019 to the Department of Veterinary Pathology, Rajiv Gandhi Institute of Veterinary Education and Research, Puducherry. After completion of the post-mortem examination the carcass was collected and macerated as per the standard technique and various measurements on vertebral column bones were measured using vernier calliper. Result: The study revealed that vertebral column of Indian eagle owl consisted of 14 cervical vertebrae, 7 thoracic vertebrae, 13 to 14 lumbar vertebrae fused with sacral vertebrae forming synsacrum and 7 coccygeal vertebrae. The hypapophyses of the 14th cervical vertebra and first two thoracic vertebrae were trifid in nature specific feature seen in Indian eagle owl. The vertebral column had characteristics features of hypapophyses, transverse process, pneumatic foramen and neural spine which enable the owl to adapt for head rotation and various task involving vertebrae.

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The Skeleton of Giraffes

10.1093/oso/9780197571194.003.0015 ◽

2021 ◽

pp. 342-381

Author(s):

Graham Mitchell

Keyword(s):

Cervical Vertebrae ◽

Lumbar Vertebrae ◽

Average Density ◽

Cross Sectional Area ◽

Thoracic Vertebrae ◽

Sectional Area ◽

Average Chemical Composition ◽

Cross Sectional ◽

Limb Bones ◽

The Difference

The giraffe skeleton consists of ~170 bones. The dry mass of the skeleton is 70 g.kg-1 body mass. The average chemical composition of their bones is 33% minerals (mainly calcium and phosphorus in a ratio of 2:1), 34% collagen, and 33% water. The skull contributes ~10%, the vertebrae ~25% and the limb bones ~65% to skeleton mass. The average density of all bones is 1.6 g cm-3, ranging from 0.8 g cm-3 (cervical vertebrae) to 2.0 g cm-3 (limb bones). Resistance to fracture by vertebrae depends on their cross-sectional area, and is greatest in cervical and the first few thoracic vertebrae. Resistance to fracture by limb bones depends on wall thickness (the difference between inner and outer diameter), which is uniquely thick. The growth of all limb bones except the humerus follows a geometric pattern (length and diameter increase at the same rate) which confers resistance to compression stress. The humerus follows an elastic pattern (diameter increases faster than length) a pattern that resists bending stress. Giraffes bones are exceptionally straight which further reduces bending stresses. The torque generated by the mass of the head and neck is resisted by the ligamentum nuchae which is exceptionally well-developed in giraffes, extends from the lumbar vertebrae to the occipital crest, can have a diameter of ~10 cm, and can support loads of ~1.8 tonnes before rupturing. As a giraffe grows muscle cross-sectional area (and contraction strength) declines and the duty factor reduces, both of which reduce the risk of fracture.

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Evaluation of skeletal metastatic pattern by 99m Tc- Methylene diphosphonate in prostatic carcinoma patients

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v17i2.28198 ◽

2016 ◽

Vol 17 (2) ◽

pp. 130-133

Author(s):

Nasreen Sultana ◽

Zeenat Jabin ◽

Rahima Parveen ◽

Shamim MF Begum ◽

Rokeya Begum

Keyword(s):

Nuclear Medicine ◽

Retrospective Study ◽

Prostatic Carcinoma ◽

Cervical Vertebrae ◽

Lumbar Vertebrae ◽

Skeletal Metastasis ◽

Whole Body ◽

Methylene Diphosphonate ◽

Group B ◽

Age Range

Objective: The objective of this study was to find out the pattern of skeletal metastasis in-patient with prostatic carcinoma by using 99mTechnetium-Methylene diphosphonate (99mTc MDP).Methods: This retrospective study was carried out at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS) from January 2014 to December 2014. The study included 65 histologically proven prostatic carcinoma patients. They were divided into three groups according to their age. Whole body bone scintigraphy was performed with 99mTc MDP and was interpreted by expert nuclear medicine physicians as negative or positive for skeletal metastases.Results: Bone scan was done on 65 prostate cancer patients. They were divided into three groups according to their age. In this series, the lowest age of patients were 50 years and highest 85 years with a mean ± SD was 65.80 ± 10.11 years. Group A comprised of 14 subjects age ranged 50 to 59 years. Out of them 8 (57%) were positive for skeletal metastasis. Group B comprised of 25 subjects and age range from 60 to 69 years. Out of them 18(72%) were positive for skeletal metastasis. Third group C comprised of 26 subjects and age ranged from 70-80+ years of age. Out of 26 subjects 22(84%) were positive for skeletal metastasis. The most common site involved was dorsal vertebrae in which 60% secondaries were isolated. Sacroiliac joint 39% and ribs 33% were the second and third most common affected areas respectively. Other involved sites were skull, sacrum, lumbar vertebrae, ileum, mandible, femur, sternum, cervical vertebrae, iliac crest, scapula, hip joint, tibia and pelvis.Conclusion: This retrospective study focused on the pattern of skeletal metastasis in various bony sites due to prostate carcinoma, which might be helpful for the oncologist and clinician in further treatment planning.Bangladesh J. Nuclear Med. 17(2): 130-133, July 2014

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Frequency Distribution of Bone metastasis in Breast cancer: A retrospective study in Khartoum Oncology Hospital 2019

International Journal of Orthopaedics Research ◽

10.33140/ijor.03.03.07 ◽

2020 ◽

Vol 3 (3) ◽

Keyword(s):

Breast Cancer ◽

Retrospective Study ◽

Bone Metastasis ◽

Bone Metastases ◽

Cervical Vertebrae ◽

Lumbar Vertebrae ◽

Clinical Information ◽

Thoracic Vertebrae ◽

Common Site ◽

Duration Of Treatment

Background: Breast cancer (BC) is a common cancer in women worldwide and leading cause of bone metastasis (BM). This study reveals the incidence of bone metastases and the most frequent BM sites secondary to BC in Khartoum Oncology Hospital. Materials and method: Retrospective study in Khartoum oncology hospital of medical record from January 2019 to September 2019. Demographic and clinical information extracted from the medical records of eligible patients in the last 5 years 2015-2019 included age, sex, social habits, duration of breast cancer, duration of treatment and location of bone metastasis. Statistical analyses were performed using SPSS, Version 22.0. (IBM, USA). Results: From all patients diagnosed with BC, 3.03% had developed BM out of whom 50% of patients developed bone metastases in 2-5 years of diagnosis of BC and 39.7% in less than 2 year of diagnosis. The median age was 54 years (range 28-78). The most common site is lumbar vertebrae (48.8%), followed by thoracic vertebrae (32.9%), pelvis 34 (32.9%), sternum (27.1%), ribs (25.7%), femur (15.7%), skull (15.7%), clavicle (14.3%), sacral vertebrae (14.3%), cervical vertebrae (12.8%), hummers (11.4%), and tibia (4.3%). Right side BC contribute to 57.1% of BM whereas left side BC to 40%. The duration of BC significantly correlates to number of distant bone metastases (P = 0.006). Conclusion: The most common site of BM in BC patients is lumbar vertebrae, the duration of BC affects development of BM, Exploring the knowledge of patient populations prone to develop bone metastasis helps in further intervention and management.

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Role of Whole-Body Tc 99m MDP Bone Scintigraphy for Evaluating Skeletal Metastasis in Patients with Lung Cancer

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v42i3.32214 ◽

2017 ◽

Vol 42 (3) ◽

pp. 132-136

Author(s):

Rawnak Afrin ◽

Fatema Sultana Haque ◽

Shankar Kumar Biswas ◽

Sanowar Hossain ◽

Mahmood Uz Jahan

Keyword(s):

Lung Cancer ◽

Cell Carcinoma ◽

Bone Scintigraphy ◽

Bone Scan ◽

Metastatic Cancer ◽

Lumbar Vertebrae ◽

Cost Effective ◽

Skeletal Metastasis ◽

Whole Body ◽

Thoracic Vertebrae

Lung cancer is the third most common site of origin of metastatic cancer deposits in bone, after breast and prostate. Its metastasis to bone is one of the most aggressive tumors and has a very unfavorable prognosis. This retrospective descriptive study was designed to detect the skeletal metastasis of carcinoma (Ca) lung patient by Tc 99m MDP bone scan. The medical records of all patients attended between January 2015 and July 2015 with a diagnosis of lung cancer were reviewed. Lung cancer in all patients was confirmed pathologically, and patients underwent whole-body bone scan for evaluating skeletal metastasis. Patient with clinical and laboratory evidence of infection, trauma, metabolic disease or arthropathy were not included in the study. Bone scan was done after three hours of intravenous administration of 20mci Tc 99m MDP (methylene diphosphonate) and images were obtained on a gamma camera. The mean age of the patients was Mean ± SD was 55.5 ± 12.5 with range from 31 to 90 years. Out of 47 cases, 36 (76.59%) were diagnosed as positive for skeletal metastasis by bone scan and 11 (23.41%) were negative for bony metastasis. Among 36 positive patients, 28 patients (77.86%) were histopathologically diagnosed as adenocarcinoma, 7 patients (19.44%) had squamous cell carcinoma and only one patient (2,7%) had small cell carcinoma. Bone scan findings were compared by either conventional X-ray/CT scan/MRI /pathologically. In present study, the distribution of lesions in bone scan had recorded. Maximum 47.22 % lesions were found in ribs, 27.77% lesions were in lumbar vertebrae, 19.44% in thoracic vertebrae, 19.44% in joints, 16.66% in long bones (femur and humerus), 11.11% in skull bones, 22.22% in pelvic bones, 5.55% in clavicle and 2.77% in scapula. Tc 99m MDP bone scan plays a pivotal role for detection of skeletal metastasis which is very essential to manage Ca lung patient. As bone scintigraphy is very cost effective in govt. nuclear medicine centre in comparison to other imaging modalities, so it can play a major role in detecting skeletal metastasis in ca lung patients in a developing country like Bangladesh.

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Femoral Metastasis from Penile Carcinoma: Report of 2 Cases

Case Reports in Urology ◽

10.1155/2015/583851 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Laura Braumann ◽

Panagiotis Tsagozis ◽

Rikard Wedin ◽

Otte Brosjö

Keyword(s):

Pain Relief ◽

Bone Metastases ◽

Penile Cancer ◽

Pathological Fracture ◽

Squamous Carcinoma ◽

Skeletal Metastasis ◽

Skeletal Metastases ◽

Endoprosthetic Reconstruction ◽

Pathological Fractures ◽

Femoral Metastasis

Purpose. Penile cancer rarely gives symptomatic skeletal metastases.Methods. We present 2 patients with squamous carcinoma of the penis who were surgically treated for metastases in the femur.Results. Both patients had pathological fractures and were operated on. In one case, the skeletal metastasis preceded any lymphatic spread of the disease, suggesting early haematogenous dissemination.Conclusions. Endoprosthetic reconstruction resulted in pain relief and restored the ambulatory capacity. Clinicians should be aware of the possibility for symptomatic bone metastases with a risk for pathological fracture in patients with penile cancer.

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Relationship between body size traits and carcass traits with primal cuts yields in Hanwoo steers

Animal Bioscience ◽

10.5713/ajas.19.0809 ◽

2021 ◽

Vol 34 (1) ◽

pp. 127-133

Author(s):

Hyun-Woo Seo ◽

Hoa Van Ba ◽

Pil-Nam Seong ◽

Yun-Seok Kim ◽

Sun-Moon Kang ◽

...

Keyword(s):

Body Size ◽

Cervical Vertebrae ◽

Carcass Traits ◽

Lumbar Vertebrae ◽

Live Weight ◽

Significant Negative Correlation ◽

Carcass Weight ◽

Thoracic Vertebrae ◽

Muscle Area ◽

Positive Correlations

Objective: This study was conducted to evaluate the correlation between body size traits, carcass traits, and primal cuts in Hanwoo steers.Methods: Sixty-one beef carcasses were classified for conformation and primal cut weight. Additionally, carcass weight, fat thickness, carcass dimensions, and <i>longissimus</i> muscle area were determined to complement the grading.Results: The average live weight and cold carcass weight were 759 and 469 kg, respectively. The mean carcass meat, fat, and bone proportions were 551, 298, and 151 g/kg, respectively. Primal cuts weights showed significant positive correlations (p<0.001) of 0.42 to 0.82 with live weight, carcass weight, and longissimus muscle area and a significant negative correlation with carcass fat (without shank, –0.38 to –0.10). Primal cut weights were positively correlated (p<0.01) with carcass length (0.41 to 0.77), forequarter length (0.33 to 0.57), 6th lumbar vertebrae–heel length (0.33 to 0.59), 7th cervical vertebrae carcass breadth (0.35 to 0.58), 5th to 6th thoracic vertebrae breadth (0.36 to 0.65), 7th to 8th thoracic vertebrae girth (0.38 to 0.63), and coxae girth (0.34 to 0.56) and non-significantly related to cervical vertebrae length and coxae thickness.Conclusion: There was a high correlation among live weight, carcass weight, <i>longissimus</i> muscle area, carcass length, 7th cervical vertebrae carcass breadth, 5th to 6th thoracic vertebrae breadth, and 7th to 8th thoracic vertebrae girth of the primal cuts yield. The correlation between fat and primal cut yields was highly significant and negative. Carcass length and 7th to 8th thoracic vertebrae girth, appear to be the most important traits affecting primal cut yields.

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An Anatomical and Radiographic Study on the Vertebral Column of the Two-Toed Sloth (Choloepus hoffmanni)

Revista Ciencias Veterinarias ◽

10.15359/rcv.39-2.2 ◽

2021 ◽

Vol 39 (2) ◽

pp. 1-18

Author(s):

Maripaz Chinchilla-Barboza ◽

Siam Chiquillo-Vergara ◽

Valeria Delgado-Álvarez ◽

Susan Gutiérrez-Gutiérrez ◽

Johnny Steven Mora-Aleman ◽

...

Keyword(s):

Vertebral Column ◽

Cervical Vertebrae ◽

Lumbar Vertebrae ◽

Axial Skeleton ◽

Variable Number ◽

Medical Attention ◽

Thoracic Vertebrae ◽

Radiographic Study ◽

Proper Understanding ◽

Caudal Vertebrae

The Choloepus Hoffmani is a mammal belonging to the Xenarthra superorder; xenarthrans are distributed from North to South America. It is common for these animals to require medical attention at wildlife rescue centers after being attacked by domestic animals or run over by cars. A proper understanding of this species’ anatomy is vital in order to be able to offer them a proper level of clinical attention. This publication aims to describe the spine’s anatomical and radiographic characteristics of the Choloepus Hoffmani. Four individuals were used in this research; the spine bones were cleaned by boiling and maceration. In the results, it was possible to observe how the postcranial axial skeleton in the sloths is made up by five of distinctive vertebra types. In the spine were found: six cervical vertebrae, a variable number of thoracic vertebrae, xenarthrous lumbar vertebrae, and a fusion between the sacrum and coxal bone. Finally, four underdeveloped caudal vertebrae were also identified in a small stump-like tail. Radiographically, no pathologies were observed in the alignment or structure of the spine. In conclusion, the present study described both the osteology alongside the anatomical radiography of the vertebral column of the Choloepus hoffmani, highlighting the particularities that are not found in domestic mammals and other members of the Xenarthra superorder. Information of this kind is relevant for forensic wildlife analysis, alongside aiding the treatment of animals in this species who suffered lesions in their spine.

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