scholarly journals Osteoblastomas of the spine: a comprehensive review

2016 ◽  
Vol 41 (2) ◽  
pp. E4 ◽  
Author(s):  
Michael A. Galgano ◽  
Carlos R. Goulart ◽  
Hans Iwenofu ◽  
Lawrence S. Chin ◽  
William Lavelle ◽  
...  
Keyword(s):  
Bone Destruction ◽  
Residual Tumor ◽  
Mass Effect ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Radiographic Examination ◽  
En Bloc ◽  
Comprehensive Overview ◽  
Primary Bone Tumors ◽  
Timely Fashion

Osteoblastomas are primary bone tumors with an affinity for the spine. They typically involve the posterior elements, although extension through the pedicles into the vertebral body is not uncommon. Histologically, they are usually indistinguishable from osteoid osteomas. However, there are different variants of osteoblastomas, with the more aggressive type causing more pronounced bone destruction, soft-tissue infiltration, and epidural extension. A bone scan is the most sensitive radiographic examination used to evaluate osteoblastomas. These osseous neoplasms usually present in the 2nd decade of life with dull aching pain, which is difficult to localize. At times, they can present with a painful scoliosis, which usually resolves if the osteoblastoma is resected in a timely fashion. Neurological manifestations such as radiculopathy or myelopathy do occur as well, most commonly when there is mass effect on nerve roots or the spinal cord itself. The mainstay of treatment involves surgical intervention. Curettage has been a surgical option, although marginal excision or wide en bloc resection are preferred options. Adjuvant radiotherapy and chemotherapy are generally not undertaken, although some have advocated their use after less aggressive surgical maneuvers or with residual tumor. In this manuscript, the authors have aimed to systematically review the literature and to put forth an extensive, comprehensive overview of this rare osseous tumor.

113. En bloc resection for primary bone tumors of the spine

2003 ◽  
Vol 3 (5) ◽  
pp. 122
Author(s):  
Charles Fisher ◽  
Marcel Dvorak ◽  
Michael Boyd
Keyword(s):  
Bone Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Primary Bone Tumors ◽  
Primary Bone

scholarly journals Endoscopic submucosal dissection of malignant non-pedunculated colorectal lesions

2018 ◽  
Vol 06 (08) ◽  
pp. E961-E968 ◽  
Author(s):  
Carl-Fredrik Rönnow ◽  
Jacob Elebro ◽  
Ervin Toth ◽  
Henrik Thorlacius
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Curative Resection ◽  
Residual Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
R0 Resection ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Additional Surgery ◽  
Procedural Time

Abstract Background and study aims Endoscopic submucosal dissection (ESD) is an established method for en bloc resection of large non-pedunculated colorectal lesions in Asia but dissemination of ESD in Western countries is limited. The aim of this study was to evaluate the role of ESD in the management of malignant non-pedunculated colorectal lesions in a European center. Patients and methods Among 255 patients undergoing colorectal ESD between 2014 and 2016, 29 cases were identified as submucosal invasive cancers and included in this study. The main outcomes were en bloc, R0 and curative resection as well as procedural time, complications and recurrence. Results Median tumor size was 40 mm (range 20 – 70 mm). Thirteen cancers were located in the colon and 16 were located in the rectum. Procedural time was 89 minutes (range 18 – 594 minutes). Complete resection was achieved in 28 cases, en bloc and R0 resection rates were 83 % and 69 %, respectively. Curative resection rate was 38 %. One case had a perforation in the sigmoid colon requiring emergency surgery. No significant bleeding occurred. Six patients underwent additional surgery after ESD, one of whom had residual tumor. One recurrence was detected in 20 patients that were followed-up endoscopically, median follow-up time was 13 months (range 2 – 30 months). Conclusion ESD seems to be a safe and effective method for treating non-pedunculated malignant colorectal lesions after careful patient selection and proper endoscopic training.

Parosteal Osteosarcoma of the Fourth Metatarsal Bone

Foot & Ankle ◽  
1982 ◽  
Vol 3 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Michael E. Kliman ◽  
Victor L. Fornasier ◽  
David E. Hastings
Keyword(s):  
Foreign Body Reaction ◽  
Functional Result ◽  
Bone Destruction ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Metatarsal Bone ◽  
Parosteal Osteosarcoma ◽  
New Bone Formation ◽  
En Bloc ◽  
Excellent Functional Result

The authors present a case of a parosteal osteosarcoma of the fourth metatarsal in a 19-year-old male. This location has never been previously reported. The periosteal new bone formation without bone destruction must be differentiated from foreign body reaction and stress fractures. En bloc resection of the fourth and fifth rays was done. There has been no evidence of recurrence to date, 1 year and 10 months following the surgery. There has been an excellent functional result.

scholarly journals Giant Retroperitoneal Sarcoma: A Case Report and Review of Literature

2020 ◽  
Vol 6 (01) ◽  
pp. 41-44
Author(s):  
Melissa K. Saad ◽  
Elias Fiani ◽  
Ali Abdullah ◽  
Elias Saikaly
Keyword(s):  
Soft Tissue Sarcomas ◽  
Average Diameter ◽  
Mass Effect ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Large Space ◽  
Retroperitoneal Liposarcoma ◽  
Retroperitoneal Sarcomas ◽  
The Right

AbstractLiposarcomas are neoplasms of mesodermal origin derived from adipose tissue representing 10 to 14% of all soft tissue sarcomas, with the most frequent subtype being liposarcoma. Given that the retroperitoneum is a large space in which the retroperitoneal liposarcoma can grow asymptomatically up until a mass effect develop. Hence, patients usually present late with symptoms with possible invasion to nearby structures. These tumors are known to reach significantly large dimension, despite their poor vascularization and can grow to enormous size, the average diameter of the tumor is 20 to 25 cm with a weight of 15 to 20 kg. Surgery with en-bloc resection of the tumor and adherent nearby structures, with intact capsule, remains the gold standard in surgical management of retroperitoneal sarcomas. Herein, we present a case of 52 year old male patient with a huge 48 cm right-sided retroperitoneal liposarcoma, managed surgically by en bloc excision of the tumor, right kidney, right ureter, right adrenal gland, and the right colon.

scholarly journals Combined posterior hemiosteotomies and stabilization with lateral thoracotomy for en bloc resection of thoracic paraspinal primary bone tumors: technical note

2016 ◽  
Vol 24 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Mauricio J. Avila ◽  
Jesse Skoch ◽  
Vernard S. Fennell ◽  
Sheri K. Palejwala ◽  
Christina M. Walter ◽  
...  
Keyword(s):  
Bone Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Technical Note ◽  
En Bloc ◽  
Primary Bone Tumors ◽  
Primary Bone ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Lateral Thoracotomy

Primary bone tumors of the spine are rare entities with a poor prognosis if left untreated. En bloc excision is the preferred surgical approach to minimize the rate of recurrence. Paraspinal primary bone tumors are even less common. In this technical note the authors present an approach to the en bloc resection of primary bone tumors of the paraspinal thoracic region with posterior vertebral body hemiosteotomies and lateral thoracotomy. They also describe 2 illustrative cases.

scholarly journals Surgical treatment of aggressive vertebral hemangiomas

2016 ◽  
Vol 41 (2) ◽  
pp. E7 ◽  
Author(s):  
Viren S. Vasudeva ◽  
John H. Chi ◽  
Michael W. Groff
Keyword(s):  
Residual Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Gross Total Resection ◽  
Adjuvant Radiation ◽  
Total Resection ◽  
En Bloc ◽  
En Bloc Spondylectomy ◽  
Bloc Spondylectomy ◽  
Vertebral Hemangiomas

OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of “hemangioma” between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3–65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the patient who underwent en bloc resection who continued to have back pain. CONCLUSIONS Gross-total resection or subtotal resection in combination with vertebroplasty or adjuvant radiation therapy to treat residual tumor seems sufficient in the treatment of aggressive vertebral hemangiomas. En bloc resection appears to provide a similar oncological benefit, but it carries higher morbidity to the patient.

scholarly journals Ligation-assisted endoscopic mucosal resection for esophageal granular cell tumors is safe and effective

2020 ◽  
Vol 33 (8) ◽  
Author(s):  
Shria Kumar ◽  
Vinay Chandrasekhara ◽  
Michael L Kochman ◽  
Nuzhat Ahmad ◽  
Sara Attalla ◽  
...  
Keyword(s):  
Adverse Events ◽  
Granular Cell ◽  
Residual Tumor ◽  
En Bloc Resection ◽  
Lesion Size ◽  
Bloc Resection ◽  
En Bloc ◽  
First Line Therapy ◽  
Surveillance Endoscopy

SUMMARY Given their malignant potential, resection of esophageal granular cell tumors (GCTs) is often undertaken, yet the optimal technique is unknown. We present a large series of dedicated endoscopic resection using band ligation (EMR-B) of esophageal GCTs. Patients diagnosed with esophageal GCTs between 2002 and 2019 were identified using a prospectively collected pathology database. Endoscopic reports were reviewed, and patients who underwent dedicated EMR-B of esophageal GCTs were included. Medical records were queried for demographics, findings, adverse events, and follow-up. We identified 21 patients who underwent dedicated EMR-B for previously identified esophageal GCT. Median age was 39 years; 16 (76%) were female. Eight (38%) had preceding signs or symptoms, potentially attributable to the GCT. Upon endoscopic evaluation, 12 (57%) were found in the distal esophagus. Endoscopic ultrasound was used in 15 cases (71%). Median lesion size was 7 mm, interquartile range 4 mm—8 mm. The largest lesion was 12 mm. A total of 20 (95%) had en bloc resection confirmed with pathologic examination. The only patient with tumor extending to the resection margin underwent surveillance endoscopy that showed no residual tumor. No patients experienced bleeding, perforation, or stricturing in our series. No patients have had known recurrence of their esophageal GCT. EMR-B of esophageal GCT achieves complete histopathologic resection with minimal adverse events. EMR-B is safe and effective and seems prudent compared with observation for what could be an aggressive and malignant tumor. EMR-B should be considered first-line therapy when resecting esophageal GCT up to 12 mm in diameter.

Perioperative adverse events following surgery for primary bone tumors of the spine and en bloc resection for metastases

2020 ◽  
Vol 32 (1) ◽  
pp. 98-105
Author(s):  
Raphaële Charest-Morin ◽  
Alana M. Flexman ◽  
Shreya Srinivas ◽  
Charles G. Fisher ◽  
John T. Street ◽  
...  
Keyword(s):  
Adverse Events ◽  
Bone Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Primary Bone Tumors ◽  
True Incidence ◽  
Icu Stay ◽  
Primary Bone ◽  
Surgical Duration

OBJECTIVESurgical treatment of primary bone tumors of the spine and en bloc resection for isolated metastases are complex and challenging. Operative care is fraught with complications, though the true incidence and predictors of adverse events (AEs), length of stay (LOS), and mortality in this population remain poorly understood. The primary objective of this study was to describe the incidence and predictors of perioperative AEs in these patients. Secondary objectives included the determination of the incidence and predictors of admission to the intensive care unit (ICU), unanticipated reoperation during the same admission, hospital LOS, and mortality.METHODSIn this retrospective analysis of prospectively collected data, the authors included consecutive patients at a single quaternary care referral center (January 1, 2009, to September 30, 2018) who underwent either surgery for a primary bone tumor of the spine or an en bloc resection for an isolated spinal metastasis. Information on perioperative AEs, demographic data, primary tumor histology, neurological status, surgical variables, pathological margins, Enneking appropriateness, LOS, ICU stay, reoperation during the same admission period, and in-hospital mortality was collected prospectively in the institutional database. The modified frailty score was extracted retrospectively.RESULTSOne hundred thirteen patients met the inclusion criteria: 98 with primary bone tumors and 15 with isolated metastases. The cohort was 59% male, and the mean age was 49 years (SD 19 years). Overall, 79% of the patients experienced at least 1 AE. The median number of AEs per patient was 2 (IQR 0–4 AEs), and the median LOS was 16 days (IQR 9–32 days). No in-hospital deaths occurred in the cohort. Thirty-two patients (28%) required an ICU stay and 19% underwent an unanticipated second surgery during their admission. A longer surgical duration was associated with a higher likelihood of AEs (OR 1.21/hour, 95% CI 1.06–1.37, p = 0.005), longer ICU stay (OR 1.35/hour, 95% CI 1 1.20–1.52, p < 0.001), and reoperation (OR 1.001/hour, 95% CI 1.0003–1.003, p = 0.012). Longer hospital LOS was independently predicted by older age, female sex, upper cervical and sacral location of the tumor, surgical duration, preoperative neurological deficit, presence of AEs, and higher modified frailty index score.CONCLUSIONSSurgeries for primary bone tumors and en bloc resection for metastatic tumors are associated with a high incidence of perioperative AEs. Surgical duration predicts complications, reoperation, LOS, and ICU stay.

Giant Cell Tumor of the Metatarsal

Foot & Ankle ◽  
1988 ◽  
Vol 8 (4) ◽  
pp. 223-226 ◽  
Author(s):  
Thomas P. Burns ◽  
Mark Weiss ◽  
Mark Snyder ◽  
Clark N. Hopson
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cell Tumor ◽  
Giant Cell Tumors ◽  
En Bloc ◽  
Primary Bone Tumors ◽  
Metatarsal Bones ◽  
Primary Bone

The following is a report of a giant cell tumor of a metatarsal, description of treatment, and review of the literature. Giant cell tumors comprise approximately 5–8% of the primary bone tumors. Metatarsal bones are a very rare primary site of involvement. Clinically aggressive or benign behavior cannot be predicted histologically. Treatment should be aggressive, as in this case where en bloc resection and bone graft were performed. Results were excellent with 4 yr follow-up.

Sign in / Sign up

Export Citation Format

Share Document