Metacarpal chondrosarcoma, from negligence to rareness : a case report and review of the literature

Chondrosarcoma is rarely found in the extremities but it remains the most common primary malignant bone tumor of the hand. We report an unusual case of a 46-year-old man with a huge chondrosarcoma on his left hand that has been evolving for more than 30 years. The mass has always been painless, the symptoms were only the deformation and a slight loss of motion. We did a subtotal resection since the patient refused the amputation. The investigation, which in- cluded thoracoabdominal tomography, scintigraphy and blood analysis, turned out to be negative. In the literature, CS are usually associated with a locally destructive growth but metastasis hasn’t been often described. CS seems to be an aggressive tumor locally but, unlike in other sites, it seems to rarely metastasize when in the hands.

Research Progress of Micro-RNAs in Apoptosis of Osteosarcoma

Osteosarcoma is a primary malignant bone tumor with no effective treatment. Apoptosis, one of the programmed cell death, is any pathological form of cell death mediated by intracellular processes. Under the pathological state, the unregulated regulation of apoptosis can disrupt the balance between cell proliferation and death, causing osteosarcoma proliferation and metastasis. As carcinogenic or tumor suppressor factors, microRNAs (miRNAs) regulate apoptosis of osteosarcoma cells by regulating apoptosis-related signaling pathways and apoptosis-related genes. This review provides the current knowledge of miRNAs and their target genes related to the apoptosis of osteosarcoma.

The Bateman-Type Soft Tissue Reconstruction around Proximal or Total Humeral Megaprostheses in Patients with Primary Malignant Bone Tumors—Functional Outcome and Endoprosthetic Complications

We aimed to evaluate the functional outcome and endoprosthetic complications following the Bateman-type soft tissue reconstruction around proximal or total humeral replacements in patients undergoing resection of a primary malignant bone tumor. Between September 2001 and December 2018, a total of 102 patients underwent resection of a primary malignant bone tumor and subsequent reconstruction with a modular humeral megaprosthesis in our department. Fifteen (15%) of these patients underwent a Bateman-type soft tissue reconstruction and were included in this retrospective study. The median Musculoskeletal Tumor Society (MSTS) score was 21, the median Toronto Extremity Salvage Score (TESS) was 70, and the median American Shoulder and Elbow Surgeons (ASES) score was 72. Fifty-three percent (8/15) of all patients required a revision surgery after a median time of 6 months. There were 2 soft tissue failures, 3 infections and 3 tumor recurrences. The revision-free implant survivorship amounted to 53% (95% confidence interval (CI) 28–81) after 1 year and 47% (95% CI 22–73) at last follow-up. The Bateman-type reconstruction is a feasible option for soft tissue reconstruction but functional outcome is overall limited and the risk for revision surgery within the first postoperative year is high.

Sensitive Osteosarcoma Diagnosis Through Five-Base Telomerase Product-Triggered CRISPR-Cas12a Enhanced Rolling Circle Amplification

Osteosarcoma is the most frequent primary malignant bone tumor composed of mesenchymal cells producing osteoid and immature bone. Sensitive detection of telomerase plays a pivotal role for the early diagnosis...

Hsa_circ_0003732 promotes osteosarcoma cells proliferation via miR-545/CCNA2 axis

Osteosarcoma (OS) is a primary malignant bone tumor with a high fatality rate. Circular RNAs (circRNAs) are a type of endogenous noncoding RNA that have been verified to participate in cancer pathophysiological processes. We aim to investigate the roles of circRNAs in osteosarcoma tumorigenesis. In the present study, we showed that hsa_circ_0003732 was up-regulated in OS tissues and elevated level of hsa_circ_0003732 was linked to poor prognosis of OS patients. Functional investigation indicated that hsa_circ_0003732 promoted proliferation of OS cells. Furthermore, we identified miR-545 as the hsa_circ_0003732-associated microRNA and CCNA2 was a direct target of miR-545. In addition, hsa_circ_0003732 could elevate CCNA2 expression via miR-545, resulting in the promotion of OS cells proliferation. Altogether, our findings demonstrate that hsa_circ_0003732 promotes OS cells proliferation via miR-545/CCNA2 axis and imply hsa_circ_0003732 may be a potential prognosis biomarker and therapeutic target for OS.

A phase II study of anlotinib in treating patients with relapsed or metastatic primary malignant bone tumor.

11525 Background: Primary malignant bone tumors are rare forms of cancer and include mainly bone sarcomas, which are categorized into 3 common types based on tissue origin: osteosarcoma, chondrosarcoma and Ewing sarcoma. A phase II trial was designed to explore the anlotinib activity in patients with relapsed or metastatic primary malignant bone tumor. Methods: Eligible pts were received 12mg of anlotinib once daily, 2 weeks on and 1 week off until progression or unacceptable toxicity. Key-eligibility criteria were aged 14-70 years, histologically confirmed diagnosis of osteosarcoma, chondrosarcoma, bone derived malignant fibrous histiocytoma, giant cell tumor, Ewing sarcoma and PNET, confirmed previous chemotherapy failure, ECOG 0-1(0-2 for amputation pts), required at least one measurable lesion. We observed PFS, OS, ORR, DCR and AE in this study. Results: From August 2018 to April 2019, 42 pts were included. Of 42 efficacy-evaluable pts, 25 were man, median age was 28 (14-68) years. There were 29 pts of osteosarcoma, 9 pts of chondrosarcoma, 3pts of Ewing sarcoma and 1 pt of bone derived malignant fibrous histiocytoma. The progression-free rate at 12 weeks (PFR12weeks), ORR and DCR were 71.3%, 9.52% and 78.57%. Median PFS was 5.26 months (95%CI = 3.48-8.44). Median OS was 11.40 months (95%CI = 10.09, [ ). Median PFS of osteosarcoma and chondrosarcoma was 4.83 months (95%CI = 3.48, 7.13 ) and 2.76 months (95%CI = 1.31, [ ) respectively. The most common Gr 3-5 anlotinib-related AEs were hypertension (19.05%), hypertriglyceridemia (9.52%), hand-foot syndrome (7.14%), and proteinuria (4.76%). Conclusions: The phase II study shows a promising activity of anlotinib in patients with relapsed or metastatic primary malignant bone tumor and an acceptable toxicity. Clinical trial information: NCT03527888 .

A Case of Ewing Sarcoma Presenting With Cardiac Metastasis

Ewing sarcoma is the second most prevalent primary malignant bone tumor. Metastases from Ewing sarcoma to the heart are very rare. Herein, we present a case of undiagnosed Ewing sarcoma in a 12-year-old boy who presented with metastasis to the left atrium. The mass was prolapsing across the mitral valve. In view of the potential risk of embolization, urgent cardiac surgery was performed before the establishment of a definitive diagnosis. Histopathology was consistent with Ewing sarcoma. Subsequent magnetic resonance imaging revealed a mass in his left fibula. The patient was referred to the oncology center and received chemotherapy. One year later, he is alive with no evidence of recurrent cardiac involvement.

Malignant Chondroid Matrix Bone Tumors

Chapter 55 discusses malignant chondroid matrix bone tumors. Chondrosarcoma is a malignant bone tumor of cartilage origin. It represents the third most common primary malignant bone tumor, after multiple myeloma and osteosarcoma. Conventional intramedullary chondrosarcoma is its most common subtype, with rarer subtypes that include clear cell, mesenchymal, dedifferentiated, and periosteal chondrosarcoma. Secondary chondrosarcoma represents a lesion that arises in a preexisting benign chondroid lesion (enchondroma or osteochondroma). Chondrosarcomas demonstrate some specific imaging features that can improve diagnostic accuracy and help guide clinical management. Histological grade of central chondrosarcoma usually dictates surgical management. As with other sarcomas, outcome of chondrosarcoma depends on histological grade, surgical margins, and staging.