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Sample records for bone tumor resections

  1. Resection followed by vascularized bone autograft in patients with possible recurrence of malignant bone tumors after conservative treatment

    International Nuclear Information System (INIS)

    In conservative treatment of malignant bone tumors, assessment of the local condition is difficult. The radiological changes seen in the irradiated tumor and the frequent occurrence of pathological fractures at this site may give rise to the fear that the tumor has relapsed. Resection of the whole of the involved bone is the best way to assure adequate local control but the extent of the bone defect and the bad local conditions secondary to irradiation make reconstruction hazardous. In two patients (one with Ewing's sarcoma of the femur and one with osteogenic sarcoma of the humerus) the authors used a free, vascularized fibular graft for the reconstruction having obtained consolidation of the limb after resection of the irradiated tumor, with preservation of its function. The encouraging results obtained have suggested a conservative attitude as primary treatment of specific malignant bone tumors

  2. Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee

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    Aggarwal Aditya

    2007-01-01

    Full Text Available Background: Segmental resection of bone in Giant Cell Tumor (GCT around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Materials and Methods: Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years. Resection arthrodesis with telescoping (shortening over intramedullary nail ( n=5, resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail ( n=3 and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening ( n=5 were the procedure performed. Results: Shortening was the major problem following resection arthrodesis with telescoping (shortening over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (~15cm was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an

  3. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  4. Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem.

    Science.gov (United States)

    Andersen, Mikkel R; Petersen, Michael M

    2016-01-01

    Loss of bone stock and stress shielding is a significant challenge in limb salvage surgery. This study investigates the adaptive bone remodeling of the femoral bone after implantation of a tumor prosthesis with an uncemented press fit stem. We performed a prospective 1 yr follow-up of 6 patients (mean age: 55 (26-78) yr, female/male=3/3) who underwent bone tumor resection surgery of the proximal femur (n=3) or distal femur (n=3). Reconstruction was done using a Global Modular Replacement System (Stryker® Orthopaedics, Mahwah, NJ) tumor prosthesis, and all patients received a straight-fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using dual-energy X-ray absorptiometry. BMD was measured in 3 regions of interest (ROIs) in the femur bone. Nonparametric analysis of variance (Friedman test) for evaluation of changes in BMD over time. BMD decreased in all 3 ROIs with time. In ROI 1 (p=0.01), BMD decreased by 10% after 3 mo and ended with a total decrease of 14% after 1 yr. In ROI 2 (p=0.006), BMD was decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 9% below the postoperative value. In ROI 3 (p=0.009), BMD decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 8% below the postoperative value. A bone loss of 8%-9% during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14%, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling. PMID:25843447

  5. Denosumab Chemotherapy for Recurrent Giant-Cell Tumor of Bone: A Case Report of Neoadjuvant Use Enabling Complete Surgical Resection

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    Amit Agarwal

    2013-01-01

    Full Text Available Giant-cell tumor of the bone (GCTB is a rare neoplasm that affects young adults. The tumor is generally benign but sometimes can be locally aggressive. There are no standardized approaches to the treatment of GCTB. Recently, the RANKL inhibitor denosumab has shown activity in this tumor type. We present the case of a young female who presented with locally advanced disease and was successfully managed with the neoadjuvant use of denosumab allowing for surgical resection of the tumor that was previously deemed unresectable. Following surgery, the patient is being managed with continued use of denosumab as ‘maintenance,’ and she continues to be free of disease. Our case highlights a novel approach for the management of locally advanced and aggressive giant cell tumor of the bone.

  6. Combined use of free vascularized bone graft and extracorporeally-irradiated autograft for reconstruction of massive bone and joint defects after resection of malignant tumor

    International Nuclear Information System (INIS)

    Reconstruction of massive bone defect after resection of malignant tumor by irradiated bone graft is reported. But because irradiated bone graft is dead-bone, it poses are many problems such as fracture, infection, and non-union. To resolve these problems, we combined use of the free vascularized bone graft (VBG) and irradiated bone graft (IRBG). We reviewed 10 patients with a, mean age of 28 years old. The locations were one proximal humerus, one shaft of ulna, two acetabular, one distal femur, and five shaft of tibia. One case developed necrosis by venous thrombus, but the other nine cases survived. Two cases developed nonunion, but the other eight cases achieved union. Oncological outcome was nine none eridence of disease (NED) and one dead of disease (DOD). Muskloskeltal tumor society (MTS) score was 84.5% on average (67-100). Three patients with weight-bearing joint reconstruction using IRBG showed osteoarthritic change in the long-term. Combined use of VBG and IRBG provides good functional assessment by compensating each other. If irradiated osteochondral grafts are used for weight-bearing joints, osteoarthritic changes cannot be avoided but clinical outcome is excellent. (author)

  7. Bone tumors: Nursing care

    International Nuclear Information System (INIS)

    Bone tumors represent approximately 5% of childhood malignancies. osteosarcoma is the primary malignant bone tumor, accounting for 60% of cancer with peak incidence in the 2nd decade of life. Ewing's sarcoma is the second most common bone cancer with peak at a slightly younger age. This presentation discusses similarities and differences in the diagnosis and treatment of these two malignancies. Diagnostic procedures include plain radiographs, CT and MRI of the primary site, plain x-ray and CT of the chest, bone scan, and biopsy of the primary tumor. For patients diagnosed with Ewing's sarcoma, a bone marrow aspirate and biopsy will also be required. Our current approach to the treatment of bone tumors includes preoperative combination chemotherapy and en bloc surgical removal of the tumor followed by postoperative chemotherapy. In the case of Ewing's sarcoma, radiation therapy may be employed in addition to surgery, if margins are questionable of instead of surgery, if the tumor is not resectable

  8. Endoscopic resection of subepithelial tumors

    OpenAIRE

    Schmidt, Arthur; Bauder, Markus; Riecken, Bettina; Caca, Karel

    2014-01-01

    Management of subepithelial tumors (SETs) remains challenging. Endoscopic ultrasound (EUS) has improved differential diagnosis of these tumors but a definitive diagnosis on EUS findings alone can be achieved in the minority of cases. Complete endoscopic resection may provide a reasonable approach for tissue acquisition and may also be therapeutic in case of malignant lesions. Small SET restricted to the submucosa can be removed with established basic resection techniques. However, resection o...

  9. Clinical impact of different detection methods for disseminated tumor cells in bone marrow of patients undergoing surgical resection of colorectal liver metastases: a prospective follow-up study

    International Nuclear Information System (INIS)

    Large number of patients with colorectal liver metastasis show recurrent disease after curative surgical resection. Identification of these high-risk patients may guide therapeutic strategies. The aim of this study was to evaluate whether the presence of disseminated tumor cells in bone marrow from patients undergoing surgical resection of colorectal liver metastases can predict clinical outcome. Sixty patients with colorectal liver metastases were planned for a curative resection between 2001 and 2007. All patients underwent bone marrow aspiration before surgery. Detection of tumor cells was performed using immunocytochemical staining for cytokeratin (CK-ICC) combined with automated microscopy or indirectly using reverse transcription-polymerase chain reaction (RT-PCR). Disseminated tumor cells were found in 15 of the 46 patients (33%) using CK-ICC and in 9 of 44 of the patients (20%) using RT-PCR. Patients with negative results for RT-PCR had a significant better disease-free survival after resection of their liver metastases (p = 0.02). This group also showed significant better overall survival (p = 0.002). CK-ICC did not predict a worse clinical outcome. The presence of disseminated tumor cells in bone marrow detected using RT-PCR did predict a worse clinical outcome. The presence of cells detected with CK-ICC did not correlate with poor prognosis

  10. Bone Tumor

    Science.gov (United States)

    ... the knee in either the femur (thigh) or tibia (shinbone). Other common locations include the hip and ... bone that is weakened by a tumor to fracture, or break. This may be severely painful. Occasionally, ...

  11. Long Term Behavior of Pedicled Vascularized Fibular Grafts in Reconstruction of Middle and Distal Tibia after Resection of Malignant Bone Tumors

    International Nuclear Information System (INIS)

    Objectives: The aim of this study was to evaluate the long term behavior of pedicled vascualrized fibula graft in reconstruction of middle and distal tibia defects following malignant tumor resection with particular emphasis on success in limb salvage and the specific late related complications. Patients and Methods: Between 1997 and 2006, 16 patients having malignant bone tumors of the middle tibia (10 cases) and distal tibia (6 cases) were candidate for wide resection of their tumors and reconstruction of the bony defect by ipsilateral vascularized pedicled fibular graft based on the peroneal vessels. There were 9 males and 7 females with a mean age of 13 years at time of surgery (range 11-23 years). Mean follow up period was 52 months (range 32 -110 months). Fixation was done by cast in 14 cases and by plate and screws in 2 patients. According to the Enneking staging system (1), 9 patients had stage IIB and 7 had stage IIA. Bony union and hypertrophy were assessed radio graphically on regular basis. Hypertrophy was estimated in a percentage. Functional limb results were also reported according to MSTS functional scores [2]. Results: The mean length of bony gap bridged was 14 cm (range of 11.0-16.0 cm) and the mean length of fibula harvested was 15.5 cm (range 12-17 cm). Ninety seven percent of patients (15 cases) healed primarily at a mean time of 4.8 months (range 3.5-6 months). Hypertrophy was evident in all patients and ranged from 60 to 210% (mean 91%). Increase in size of the hypertrophied fibula beyond the recipient bone was noticed in three cases (18.7%) and we relate this to weight-bearing forces and not to the size of the recipient bone. The mean time of the fibula to double its size (10 cases) was 21 months (range 18-31 months). Young patients developed full hypertrophy earlier than older patients. Complication rate was low. One patient had non union at the proximal end of the fibulotibial junction and two patients had stress fracture of the fibula

  12. The use of a modular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation and analysis of 37 cases

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    Croci Alberto Tesconi

    2000-01-01

    Full Text Available We analyzed 37 patients who underwent segmental wide resection of bone tumors and reconstruction with a modular titanium endoprosthesis at the Orthopaedic Oncology Group, between 1992 and 1998. Twelve patients were male and 25 were female, with a mean age of 30 years (9 - 81. The mean follow-up was 14 months (2 - 48. The diagnoses were: osteosarcoma (14 cases, metastatic carcinoma (10, Ewing's sarcoma (4, giant cell tumor (4, malignant fibrous histiocytoma (3, chondrosarcoma (1, and aneurysmal bone cyst (1. Eleven articulated total knee, 8 partial proximal femur with bipolar acetabulum, 8 partial proximal humerus, 3 total femur, 2 partial proximal tibia, 2 diaphyseal femur, 2 diaphyseal humerus, and 1 total proximal femur with cementless acetabulum endoprosthesis implant procedures were done. The complications related to the procedure included: infection (5 cases, dislocation (3, module loosening (1, and ulnar nerve paresthesia (1. We used the following criteria for the clinical evaluation: presence of pain, range of motion, reconstruction stability, surgical and oncologic complications, and patient acceptance. The results were good in 56.8% of the cases, regular in 32.4% and poor in 10.8%.

  13. Bone tumor

    Science.gov (United States)

    ... physical exam. Tests that may be done include: Alkaline phosphatase blood level Bone biopsy Bone scan Chest x- ... also affect the results of the following tests: Alkaline phosphatase isoenzyme Blood calcium level Parathyroid hormone Blood phosphorus ...

  14. Delta method and bootstrap in linear mixed models to estimate a proportion when no event is observed: application to intralesional resection in bone tumor surgery.

    Science.gov (United States)

    Francq, Bernard G; Cartiaux, Olivier

    2016-09-10

    Resecting bone tumors requires good cutting accuracy to reduce the occurrence of local recurrence. This issue is considerably reduced with a navigated technology. The estimation of extreme proportions is challenging especially with small or moderate sample sizes. When no success is observed, the commonly used binomial proportion confidence interval is not suitable while the rule of three provides a simple solution. Unfortunately, these approaches are unable to differentiate between different unobserved events. Different delta methods and bootstrap procedures are compared in univariate and linear mixed models with simulations and real data by assuming the normality. The delta method on the z-score and parametric bootstrap provide similar results but the delta method requires the estimation of the covariance matrix of the estimates. In mixed models, the observed Fisher information matrix with unbounded variance components should be preferred. The parametric bootstrap, easier to apply, outperforms the delta method for larger sample sizes but it may be time costly. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26990871

  15. Percutaneous Bone Tumor Management

    OpenAIRE

    Gangi, Afshin; Buy, Xavier

    2010-01-01

    Interventional radiology plays a major role in the management of bone tumors. Many different percutaneous techniques are available. Some aim to treat pain and consolidate a pathological bone (cementoplasty); others aim to ablate tumor or reduce its volume (sclerotherapy, thermal ablation). In this article, image-guided techniques of primary and secondary bone tumors with vertebroplasty, ethanol injection, radiofrequency ablation, laser photocoagulation, cryoablation, and radiofrequency ioniza...

  16. Anterior and middle skull base reconstruction after tumor resection

    Institute of Scientific and Technical Information of China (English)

    WANG Bo; WU Sheng-tian; LI Zhi; LIU Pi-nan

    2010-01-01

    Background Surgical management of skull base tumors is still challenging today due to its sophisticated operation procedure. Surgeons who specialize in skull base surgery are making endeavor to promote the outcome of patients with skull base tumor. A reliable skull base reconstruction after tumor resection is of paramount importance in avoiding life-threatening complications, such as cerebrospinal fluid leakage and intracranial infection. This study aimed at investigating the indication, operation approach and operation technique of anterior and middle skull base reconstruction.Methods A retrospective analysis was carried out on 44 patients who underwent anterior and middle skull base reconstruction in the Department of Neurosurgery at Beijing Tiantan Hospital between March 2005 and March 2008. Different surgical approaches were selected according to the different regions involved by the tumor. Microsurgery was carried out for tumor resection and combined endoscopic surgery was performed in some cases. According to the different locations and sizes of various defects after tumor resection, an individualized skull base soft tissue reconstruction was carried out for each case with artificial materials, pedicled flaps, free autologous tissue, and free vascularized muscle flaps, separately. A skull base bone reconstruction was carried out in some cases simultaneously.Results Soft tissue reconstruction was performed in all 44 cases with a fascia lata repair in 9 cases, a free vascularized muscle flap in 1 case, a pedicled muscle flap in 14 cases, and a pedicled periosteal flap in 20 cases. Skull base bone reconstruction was performed on 10 cases simultaneously. The materials for bone reconstruction included titanium mesh, free autogenous bone, and a Medpor implant. The result of skull base reconstruction was satisfactory in all patients. Postoperative early-stage complications occurred in 10 cases with full recovery after conventional treatment.Conclusions The specific

  17. Resection arthrodesis for giant cell tumors around the knee

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    Kapoor Sudhir

    2007-01-01

    Full Text Available Background: Giant cell tumors (GCTs of bone are aggressive benign tumors. Wide resection is reserved for a small subset of patients with biologically more aggressive, recurrent and extensive tumors. As the patients affected with GCT are young or middle-aged adults with a normal life expectancy, arthrodesis is an attractive option for reconstruction in these patients. Materials and Methods: Thirty-six patients of mean age 33.1 years with Campanacci Grade III giant cell tumors around the knee (20 distal femoral and 16 proximal tibial were treated with wide resection and arthrodesis from January 1996 through January 2006. Arthrodesis was performed using plating with free fibular graft (n = 18, IM nail with free fibular graft (n = 8 and IM nail combined with ring fixator using bone transport (n = 10. Results: Fusion after the first surgery was achieved in 77.7%, 75% and 90% of the patients in the three groups respectively. Local recurrence was seen in two patients and repeat surgery for nonunion/ graft fracture had to be done in four patients and two patients in the plating and nailing groups respectively. Conclusion: Wide resection and arthrodesis in aggressive GCTs around the knee is a good treatment option. IM nail combined with a ring fixator seems to be a good method of arthrodesis with high fusion rates, least shortening and early rehabilitation.

  18. Speaking without Broca's area after tumor resection.

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    Plaza, Monique; Gatignol, Peggy; Leroy, Marianne; Duffau, Hugues

    2009-08-01

    We present the case of a right-handed patient who received surgical treatment for a left frontal WHO grade II glioma invading the left inferior and middle frontal gyri, the head of the caudate nucleus, the anterior limb of the internal capsule and the anterior insula, in direct contact also with the anterior-superior part of the lentiform nucleus. The tumor resection was guided by direct electrical stimulation on brain areas, while the patient was awake. Adding a narrative production task to the neuropsychological assessment, we compared pre-, peri- and post-surgical language skills in order to analyze the effects of the tumor infiltration and the consequences of the left IFG resection, an area known to be involved in various language and cognitive processes. We showed that the tumor infiltration and its resection did not lead to the severe impairments predicted by the localization models assigning a significant role in language processing to the left frontal lobe, notably Broca's area. We showed that slow tumor evolution - the patient had been symptom-free for a long time - enabled compensatory mechanisms to process most language functions endangered by the tumor infiltration. However, a subtle fragility was observed in two language devices, i.e., reported speech and relative clauses, related to minor working memory deficits. This case study of a patient speaking without Broca's area illustrates the efficiency of brain plasticity, and shows the necessity to broaden pre-, peri-, post-surgery language and cognitive assessments. PMID:19274574

  19. Transurethral en bloc resection of bladder tumors

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    A. G. Martov

    2015-01-01

    Full Text Available Background. The high incidence of recurrent non-muscle-invasive bladder carcinoma (BC necessitates searches for new surgical methods. Objective: to comparatively evaluate the efficiency and safety of en block resection of bladder tumors versus transurethral resection (TUR. Subjects and methods. In January 2010 to June 2013, a total of 292 patients with primary and recurrent bladder tumor stages, cTa-T2, underwent transurethral endoscopic treatment (as TUR at the Unit of Minimally Invasive Urology, Moscow City Clinical Hospital Fifty-Seven. A major portion of these patients were included in the study of the efficiency and safety of en bloc TUR of bladder tumors. The criteria for study inclusion were primary or recurrent non-muscle-invasive bladder tumor measuring 1 to 3 cm, stage pTa-T1, signed informed consent to participate in the study and patients» readiness to undergo control examinations in inpatient setting for one year. The exclusion criteria were a confirmed or detected muscleinvasive tumor, multiple bladder involvement (> 3 tumors, as well as detected tumors spreading to the ureter, bladder neck, and prostatic urethra. The primary study endpoint was considered to be a recurrence of a tumor after TUR of the bladder (TURB. The secondary endpoint was the frequency of concealed bladder perforation, blood transfusions, recystoscopies for bladder tamponade, early recystoscopies to specify a BC stage, and the frequency of immediate intravesical injection of a chemical. For final analysis, the investigators selected 106 patients in a group where tumors were removed en bloc (a study group and 133 patients in a group where tumors were retrieved using traditional TURB (a control group. In the study group, the tumor was removed en bloc by a monopolar J-shaped electrode (sand wedge electrode in 45 patients, by a hook-like electrode in 14, by a hybrid procedure (hydropreparation and monopolar electrosurgery by a water-jet hybrid knife in 10, and by

  20. Transurethral en bloc resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    A. G. Martov

    2015-03-01

    Full Text Available Background. The high incidence of recurrent non-muscle-invasive bladder carcinoma (BC necessitates searches for new surgical methods. Objective: to comparatively evaluate the efficiency and safety of en block resection of bladder tumors versus transurethral resection (TUR. Subjects and methods. In January 2010 to June 2013, a total of 292 patients with primary and recurrent bladder tumor stages, cTa-T2, underwent transurethral endoscopic treatment (as TUR at the Unit of Minimally Invasive Urology, Moscow City Clinical Hospital Fifty-Seven. A major portion of these patients were included in the study of the efficiency and safety of en bloc TUR of bladder tumors. The criteria for study inclusion were primary or recurrent non-muscle-invasive bladder tumor measuring 1 to 3 cm, stage pTa-T1, signed informed consent to participate in the study and patients» readiness to undergo control examinations in inpatient setting for one year. The exclusion criteria were a confirmed or detected muscleinvasive tumor, multiple bladder involvement (> 3 tumors, as well as detected tumors spreading to the ureter, bladder neck, and prostatic urethra. The primary study endpoint was considered to be a recurrence of a tumor after TUR of the bladder (TURB. The secondary endpoint was the frequency of concealed bladder perforation, blood transfusions, recystoscopies for bladder tamponade, early recystoscopies to specify a BC stage, and the frequency of immediate intravesical injection of a chemical. For final analysis, the investigators selected 106 patients in a group where tumors were removed en bloc (a study group and 133 patients in a group where tumors were retrieved using traditional TURB (a control group. In the study group, the tumor was removed en bloc by a monopolar J-shaped electrode (sand wedge electrode in 45 patients, by a hook-like electrode in 14, by a hybrid procedure (hydropreparation and monopolar electrosurgery by a water-jet hybrid knife in 10, and by

  1. Complications of bone tumors after multimodal therapy

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    Shapeero, L.G., E-mail: lshapeero@usuhs.edu [Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 (United States); Bone and Soft Tissue Program, United States Military Cancer Institute, 6900 Georgia Ave, NW, Washington, DC 20307 (United States); Poffyn, B. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); De Visschere, P.J.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Sys, G. [Department of Orthopaedic Surgery, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Uyttendaele, D. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Vanel, D. [Department of Radiology, Rizzoli Institute, 40136 Bologna (Italy); Forsyth, R. [Department of Pathology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium); Verstraete, K.L. [Department of Radiology and Magnetic Resonance/MR-1K12 IB, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent (Belgium)

    2011-01-15

    Purpose: To define and compare the complications of bone tumors after resection, extracorporeal irradiation and re-implantation, with or without radiotherapy. Materials and methods: Eighty patients (40 males and 40 females, ages 4-77 years) with 61 malignant and 19 benign bone tumors were evaluated for local and distant complications after treatment. Two groups of patients were studied: (1) 53 patients had resection without (43 patients) or with external beam radiotherapy (RadRx) (10 patients) and (2) 27 patients underwent extracorporeal irradiation and re-implantation without (22 patients) or with RadRx (5 patients). Patient follow-up varied from 1 month to 13.63 years with mean follow-up of 4.7 years. Imaging studies included bone and chest radiography, spin echo T1- and T2-weighted (or STIR) magnetic resonance imaging (MRI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), computed tomography (CT) for thoracic and abdominopelvic metastases and 3-phase technetium-99m-labeled-methylene-diphosphonate (Tc99m MDP) scintigraphy for bone metastases. Results: DCE-MRI differentiated the rapidly enhancing recurrences, residual tumors and metastases from the slowly enhancing inflammation, and the non-enhancing seromas and fibrosis. Recurrences, metastases (mainly to lung and bone), and seromas were greater than twice as frequent in patients after resection than after ECCRI. Although 11.3% of post-resection patients had residual tumor, no ECRRI-treated patient had residual tumor. In contrast, after ECRRI, infection was almost three times as frequent and aseptic loosening twice as frequent as compared with the post-resection patients. Bones treated with RadRx and/or ECRRI showed increased prevalence of fractures and osteoporosis. In addition, muscle inflammation was more common in the externally irradiated patient as compared with the patient who did not receive this therapy. However, another soft tissue complication, heterotopic ossification, was rare in the

  2. Multiple remote epidural hematomas following pineal gland tumor resection

    OpenAIRE

    Jeong-Wook Lim; Seung-Hwan Yang; Jong-Soo Lee; Shi-Hun Song

    2010-01-01

    In cases of pineal tumor combined with obstructive hydrocephalus, preoperative ventriculostomy or ventriculoperitoneal shunting is typically required prior to tumor resection. The objectives of preoperative ventriculostomy are gradual reduction of intracranial pressure and consequent preoperative brain protection. Here we report a case of pineal tumor resection with preoperative ventriculostomy that was complicated by multiple epidural hematomas. While postoperative intracranial hemorrhage ma...

  3. Surgical Guides (Patient-Specific Instruments for Pediatric Tibial Bone Sarcoma Resection and Allograft Reconstruction

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    Laura Bellanova

    2013-01-01

    Full Text Available To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI and computerized tomography (CT were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.

  4. The Influence of Liver Resection on Intrahepatic Tumor Growth.

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    Brandt, Hannes H; Nißler, Valérie; Croner, Roland S

    2016-01-01

    The high incidence of tumor recurrence after resection of metastatic liver lesions remains an unsolved problem. Small tumor cell deposits, which are not detectable by routine clinical imaging, may be stimulated by hepatic regeneration factors after liver resection. It is not entirely clear, however, which factors are crucial for tumor recurrence. The presented mouse model may be useful to explore the mechanisms that play a role in the development of recurrent malignant lesions after liver resection. The model combines the easy-to-perform and reproducible techniques of defined amounts of liver tissue removal and tumor induction (by injection) in mice. The animals were treated with either a single laparotomy, a 30% liver resection, or a 70% liver resection. All animals subsequently received a tumor cell injection into the remaining liver tissue. After two weeks of observation, the livers and tumors were evaluated for size and weight and examined by immunohistochemistry. After a 70% liver resection, the tumor volume and weight were significantly increased compared to a laparotomy alone (p number of variables like the length of postoperative observation, the cell line used for injection or the timing of injection and liver resection offer multiple angles when exploring a specific question in the context of post-hepatectomy metastases. The limitations of this procedure are the authorization to perform the procedure on animals, access to an appropriate animal testing facility and acquisition of certain equipment. PMID:27166736

  5. 3-Tesla functional magnetic resonance imaging-guided tumor resection

    International Nuclear Information System (INIS)

    Objective: We sought to determine the safety and efficacy of using 3-tesla (T) functional magnetic resonance imaging (fMRI) to guide brain tumor resection. Material and methods: From February 2004 to March 2006, fMRI was performed on 13 patients before surgical resection. Functional imaging was used to identify eloquent cortices for motor (8), speech (3), and motor and speech (2) activation using two different 3-T magnetic resonance (MR) scanners. Surgical resection was accomplished using a 1.5-T intraoperative MR system. Appropriate MR scan sequences were performed intraoperatively to determine and maximize the extent of the surgical resection. Results: Tumors included six oligodendrogliomas, three meningiomas, two astrocytomas and two glioblastomas multiforme. The fMRI data was accurate in all cases. After surgery, two patients had hemiparesis, two had worsening of their speech, and one had worsening of speech and motor function. Neurological function returned to normal in all patients within 1 month. Complete resections were possible in 10 patients (77%). Two patients had incomplete resections because of the proximity of their tumors to functional areas. Biopsy was performed in another patient with an astrocytoma in the motor strip. Conclusion: 3-T fMRI was accurate for locating neurologic function before tumor resection near eloquent cortex. (orig.)

  6. 3-Tesla functional magnetic resonance imaging-guided tumor resection

    Energy Technology Data Exchange (ETDEWEB)

    Hall, W.A. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Depts. of Neurosurgery; Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Radiation Oncology; Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Radiology; University of Minnesota Medical Center (MMC), Minneapolis, MN (United States); Truwit, C.L. [Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Radiology; Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Pediatrics; Univ. of Minnesota Medical School, Minneapolis, MN (United States). Dept. of Neurology; Hennepin Country Medical Center, Minneapolis, MN (United States). Dept. of Radiology

    2006-12-15

    Objective: We sought to determine the safety and efficacy of using 3-tesla (T) functional magnetic resonance imaging (fMRI) to guide brain tumor resection. Material and methods: From February 2004 to March 2006, fMRI was performed on 13 patients before surgical resection. Functional imaging was used to identify eloquent cortices for motor (8), speech (3), and motor and speech (2) activation using two different 3-T magnetic resonance (MR) scanners. Surgical resection was accomplished using a 1.5-T intraoperative MR system. Appropriate MR scan sequences were performed intraoperatively to determine and maximize the extent of the surgical resection. Results: Tumors included six oligodendrogliomas, three meningiomas, two astrocytomas and two glioblastomas multiforme. The fMRI data was accurate in all cases. After surgery, two patients had hemiparesis, two had worsening of their speech, and one had worsening of speech and motor function. Neurological function returned to normal in all patients within 1 month. Complete resections were possible in 10 patients (77%). Two patients had incomplete resections because of the proximity of their tumors to functional areas. Biopsy was performed in another patient with an astrocytoma in the motor strip. Conclusion: 3-T fMRI was accurate for locating neurologic function before tumor resection near eloquent cortex. (orig.)

  7. Persistent wound drainage after tumor resection and endoprosthetic reconstruction of the proximal femur

    DEFF Research Database (Denmark)

    Hettwer, Werner H; Horstmann, Peter F; Grum-Schwensen, Tomas A;

    2014-01-01

    PURPOSE: To examine the prevalence of prolonged wound drainage (PWD) after tumor resection and endoprosthetic reconstruction of the hip. METHODS: Retrospective review of 86 consecutive patients with metastatic bone disease, malignant hematologic bone disease or bone sarcoma, treated with tumor...... (mean 8.7 days) and length of hospital stay (mean 10.2 days). Total femur replacement, bone sarcoma and additional pelvic reconstruction were identified as significant independent risk factors for an even longer duration of PWD. CONCLUSION: Compared to conventional hip arthroplasty, PWD appears to be...... significantly more prevalent in patients undergoing tumor arthroplasty procedures of the hip. Given the potentially increased risk for periprosthetic joint infection (PJI), increased awareness, identification and implementation of adequate strategies for prevention and treatment of this avoidable complication...

  8. Improved outcome of resection of hilar cholangiocarcinoma (Klatskin tumor)

    NARCIS (Netherlands)

    S. Dinant; M.F. Gerhards; E.A.J. Rauws; O.R.C. Busch; D.J. Gouma; T.M. van Gulik

    2006-01-01

    Background: Treatment of hilar cholangiocarcinoma (Klatskin tumors) has changed in many aspects. A more extensive surgical approach, as proposed by Japanese surgeons, has been applied in our center over the last 5 years; it combines hilar resection with partial hepatectomy for most tumors. The aim o

  9. Simulation of brain tumor resection in image-guided neurosurgery

    Science.gov (United States)

    Fan, Xiaoyao; Ji, Songbai; Fontaine, Kathryn; Hartov, Alex; Roberts, David; Paulsen, Keith

    2011-03-01

    Preoperative magnetic resonance images are typically used for neuronavigation in image-guided neurosurgery. However, intraoperative brain deformation (e.g., as a result of gravitation, loss of cerebrospinal fluid, retraction, resection, etc.) significantly degrades the accuracy in image guidance, and must be compensated for in order to maintain sufficient accuracy for navigation. Biomechanical finite element models are effective techniques that assimilate intraoperative data and compute whole-brain deformation from which to generate model-updated MR images (uMR) to improve accuracy in intraoperative guidance. To date, most studies have focused on early surgical stages (i.e., after craniotomy and durotomy), whereas simulation of more complex events at later surgical stages has remained to be a challenge using biomechanical models. We have developed a method to simulate partial or complete tumor resection that incorporates intraoperative volumetric ultrasound (US) and stereovision (SV), and the resulting whole-brain deformation was used to generate uMR. The 3D ultrasound and stereovision systems are complimentary to each other because they capture features deeper in the brain beneath the craniotomy and at the exposed cortical surface, respectively. In this paper, we illustrate the application of the proposed method to simulate brain tumor resection at three temporally distinct surgical stages throughout a clinical surgery case using sparse displacement data obtained from both the US and SV systems. We demonstrate that our technique is feasible to produce uMR that agrees well with intraoperative US and SV images after dural opening, after partial tumor resection, and after complete tumor resection. Currently, the computational cost to simulate tumor resection can be up to 30 min because of the need for re-meshing and the trial-and-error approach to refine the amount of tissue resection. However, this approach introduces minimal interruption to the surgical workflow

  10. [Classification of primary bone tumors].

    Science.gov (United States)

    Dominok, G W; Frege, J

    1986-01-01

    An expanded classification for bone tumors is presented based on the well known international classification as well as earlier systems. The current status and future trends in this area are discussed. PMID:3461626

  11. Rehabilitation of Posterior Maxilla with Zygomatic and Dental Implant after Tumor Resection: A Case Report

    Directory of Open Access Journals (Sweden)

    Faysal Ugurlu

    2013-01-01

    Full Text Available Zygomatic implants have been used for dental rehabilitation in patients with insufficient bone in the posterior upper jaw, due to, for example, tumor resection, trauma, or atrophy. Zygomatic implants are an alternative to complex free or vascularized bone grafting and distraction osteogenesis. A 42-year-old male patient with a severe defect in the right posterior maxilla, starting from the first canine region, which had occurred after tumor resection 3 years earlier, was referred to our department. One zygomatic implant (Brenemark System, Nobel Biocare, Goteborg, Sweden to the zygoma and one dental implant to the canine region were placed. After a 5-month osseointegration period, a fixed denture was fabricated and adapted to the implants. Although the surgical and prosthetic procedures for zygoma implants are not easy, the final outcomes can be successful with appropriate planning.

  12. Thoracic Wall Reconstruction after Tumor Resection

    OpenAIRE

    HARATI, KAMRAN; Kolbenschlag, Jonas; Behr, Björn; Goertz, Ole; Hirsch, Tobias; Kapalschinski, Nicolai; Ring, Andrej; Lehnhardt, Marcus; Daigeler, Adrien

    2015-01-01

    Introduction Surgical treatment of malignant thoracic wall tumors represents a formidable challenge. In particular, locally advanced tumors that have already infiltrated critical anatomic structures are associated with a high surgical morbidity and can result in full-thickness defects of the thoracic wall. Plastic surgery can reduce this surgical morbidity by reconstructing the thoracic wall through various tissue transfer techniques. Sufficient soft-tissue reconstruction of the thoracic w...

  13. Risk factors for residual tumor after resection of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Xiao-Hong Chen; Bo-Heng Zhang; Yin Xin; Zheng-Gang Ren; Jia Fan; Shuang-Jian Qiu; Jian Zhou

    2011-01-01

    AIM: To identify the clinicopathological risk factors correlated with residual tumor in hepatocellular carcinoma (HCC) patients after resection.METHODS: From January 2001 to April 2007, 766 HCC patients who had undergone resection were included in this research.Lipiodol angiography was performed within 2 mo after surgery and followed by post-Lipiodol computed tomography (CT) 4 wk later for all 766 patients to monitor tumor in the remnant liver.Tumor detected within the first 3-mo postoperative period was defined as residual tumor.Patients were divided into 2 groups: disease or disease-free within the first 3 mo after surgery.Risk factors for residual tumor were investigated among various clinicopathological variables.RESULTS: A total of 63 (8.22%) patients were found to have residual tumor after surgery.Three independent factors associated with residual tumor were identified by multivariate analysis: preoperative serum α -fetoprotein (AFP) level [odds ratio (OR) = 1.68 (95% confidence interval (CI): 1.20-2.36)], tumor size [OR = 1.73 (95% CI: 1.29-2.31)] and microvascular invasion [OR = 1.91 (95% CI: 1.12-3.24)].CONCLUSION: Residual tumor is related to AFP level, tumor size and microvascular invasion.Patients at high risk should undergo closer follow-up and could be candidates for multimodality therapy.

  14. Endoscopically assisted laparoscopic local resection of gastric tumor

    OpenAIRE

    Kosmidis, Christoforos; Efthimiadis, Christoforos; Anthimidis, Georgios; Vasileiadou, Kalliopi; Stavrakis, Thomas; Ioannidou, Georgia; Basdanis, Georgios

    2013-01-01

    Background Minimally invasive procedures have been applied in treatment of gastric submucosal tumors. Currently, combined laparoscopic - endoscopic rendezvous resection (CLERR) emerges as a new technique which further reduces operative invasiveness. Case presentation A-57-year-old female patient presented with epigastric pain. She was submitted to gastroscopy, which revealed a tumor located at the angle of His. Biopsy specimens demonstrated a leiomyoma. The patient underwent endoscopically as...

  15. Extended Resection of Chest Wall Tumors with Reconstruction Using Poly Methyl Methacrylate-Mesh Prosthesis

    International Nuclear Information System (INIS)

    This prospective study evaluates the early result of patients with massive chest wall tumors treated by extended resection and reconstruction using Prolene or Marlex mesh-enforced with Poly Methyl Methacrylate Bone Cement (PMMC) prosthesis. Material and Methods: This surgery was performed on 40 patients with a mean age of 45±18 (12-62) at the Department of Surgery, National Cancer Institute, Cairo University between 1998-2001. Primary chest wall tumors were the indications of surgery in 42.5%, while secondary involvement extending from other sites principally breast cancer were the indications for 57.5%. In 85% of patients more than 3 ribs were involved by tumors and lesions were more than 10 cm in the greatest dimension in 50% of cases. Resection involved sternum in 15 (37.5%) cases and in 45% of cases complete extensive rib resections extended between costovertebral junctions and the costochondral junctions were performed. Additional resections of nearby organs were needed in 20 (50%) of cases including partial lung resection in 14 cases, partial vertebral resection in 3 cases and diaphragm resection for 3 cases. Immediate bony reconstruction by inserting Prolene or Marlex mesh-enforced with Poly Methyl Methacrylate Bone Cement (PMMC) prosthesis to the resulting chest wall defect was performed in 36 cases, whereas, 4 cases had delayed reconstruction. Primary simple soft tissue closure was sufficient for 37.5% of patients; whereas 35% were covered by local rotational flap and 27.5% needed myocutaneous flaps. No patient with this immediate reconstruction needed ventilatory support or tracheostomy and flail chest was not noticed ICU stay was markedly reduced; whereas 85% required less than 7 days. Immediate post operative (40 days) complications were found in 14 patients (35%) and cases with additional lung resection had more complication rate than others (64% vs 19%). Infection occurred in 3 patients and conservative treatment for 3-4 weeks using frequent

  16. Morphometric Analysis of Bone Resection in Anterior Petrosectomies.

    Science.gov (United States)

    Ahmed, Osama; Walther, Jonathan; Theriot, Krystle; Manuel, Morganne; Guthikonda, Bharat

    2016-06-01

    Introduction The anterior petrosectomy is a well-defined skull base approach to lesions such as petroclival meningiomas, posterior circulation aneurysms, petrous apex lesions (chondrosarcomas, cholesteatomas), ventrolateral brainstem lesions, clival chordomas, trigeminal neurinomas, and access to cranial nerves III, IV, V, and VII. Methods and Materials Fourteen anterior petrosectomies on eight cadaveric heads were performed in a skull base dissection laboratory. Predissection and postdissection thin-cut computed tomography scans were obtained to compare the bone resection. A computer program was used (InVivo5, Anatomage, San Jose, California, United States) to measure the bone resection and the improved viewing angle. Results The average bone removed in each plane was as follows: anterior to posterior plane was 10.57 mm ± 2.00 mm, superior to inferior was 9.39 mm ± 1.67 mm, and lateral to medial was 17.46 mm ± 4.64 mm. The average increased angle of view was 13.01 ± 2.35 degrees (Table 1). The average volume was 1786.94 ± 827.40 mm(3). Conclusions Anterior petrosectomy is a useful approach to access the ventrolateral brainstem region. We present a cadaveric study quantitating the volume of bone resection and improvement in the viewing angle. These data provide useful preoperative information on the utility of this skull base approach and the gain in the viewing angle after bony removal. PMID:27175319

  17. [Surgical therapy of liver tumors: resection vs. ablation].

    Science.gov (United States)

    Hübner, M; McCormack, L; Clavien, P A

    2005-08-17

    A few years ago surgical resection was the only treatment modality for primary and metastatic liver tumors. However, most of the liver tumors are diagnosed at advanced stage and are unresectable. Criteria for unresectability are: uncontrolled extrahepatic disease, extensive intrahepatic tumor growth, insufficient remnant liver volume and severe co-morbid disease. Several therapeutic strategies have been developed to deal with primarily unresectable tumors. A downstaging ("downsizing") of hepatocellular carcinoma (HCC) can be reached by transarterial chemoembolisation (TACE) or local tumor ablation using ethanol injection, cryosurgery and radiofrequency. Preoperative unilateral portal vein embolization resulting in hypertrophy of the remnant liver volume permits to resect some patients with former unresectable liver tumors. Furthermore, liver transplantation is an option for patients with early stage HCC and liver cirrhosis. Preoperative downstaging of colorectal metastases can be achieved with neoadjuvant chemotherapy, whereas TACE, ethanol injection and liver transplantation are no established options for these patients. So far, there are no standardized guidelines for the treatment of patients with unresectable primary or metastatic liver tumors. In this review we aim to describe the different approaches suggested in the literature and to present our algorithms for the management of patients with liver tumors. PMID:16138770

  18. Maxillary Swing Approach for Surgical Resection of Recurrent Nasopharyngeal Tumors

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of salvage nasopharyngectomy for locally recurrent nasopharyngeal tumors through the maxillary swing approach. Methods: Antero-Jateral access to the nasopharynx and its vicinity through the maxillary swing approach was used. Through a Weber-Fergusson-Longmire incision, the whole maxilla is freed and swung laterally while remaining attached to the masseter muscle and cheek flap. The nasopharynx, para-pharyngeal space and infratemporal fossa are now exposed facilitating complete resection of the tumor. Results: Seven patients were treated with this approach at the National Cancer Institute, Cairo University. There were 6 males and one female with a range of age 16-57 years. Three patients had recurrent carcinoma of the nasopharynx after primary radiation therapy, while four patients had locally advanced recurrent juvenile nasopharyngeal angiofibroma UNA). Using the operating microscope, complete tumor resection was achieved in all patients except one patient with intracranial extension of JNA. There was no surgical mortality. Complications occurred in three patients, one patient developed osteoradionecrosis following re-irradiation, a patient had epiphora while palatal fistula occurred in another patient. The follow-up period ranged from 3 months to 6 years, one patient died from distant disease and another patient is alive with residual intra-cranial disease. Conclusion: Salvage nasopharyngectomy is a valid option for selected patients with recurrent nasopharyngeal tumors. The maxillary swing approach allows safe and complete resection for nasopharyngeal carcinoma as well as juvenile angiofibroma with intracranial extension

  19. Endoscopic Submucosal Tunnel Dissection for Esophageal Granular Cell Tumor Resection

    Directory of Open Access Journals (Sweden)

    Francisco Baldaque-Silva

    2014-01-01

    We aim to describe the role of ESTD for the resection of an esophageal GCT. A 51 year-old patient was referred to us due to the presence of an esophageal submucosal lesion with increased size in the follow-up. Deep biopsy specimens were positive for granular cell tumor. Suboptimal submucosal lifting precluded conventional endoscopic submucosal dissection (ESD. In this context an ESTD was performed. First, a submucosal tunnel was created starting 5 cm above the tumor. Afterwards, the GCT was carefully dissected from the overlying submucosa and muscularis propria using TT knife and IT knife2. The ESTD procedure was possible and en bloc resection achieved, being the 25 mm long lesion retrieved. The mucosal orifices were closed using conventional clips. The patient started oral diet 1 day after ESTD and was discharged at day 4 without any complications. In this first report of ESTD for esophageal GCT resection, this technique shown to be feasible, reliable and safe, enabling complete resection, even in this case with poor submucosal lifting.

  20. Verbal Memory Impairments in Children after Cerebellar Tumor Resection

    Directory of Open Access Journals (Sweden)

    Matthew P. Kirschen

    2008-01-01

    Full Text Available This study was designed to investigate cerebellar lobular contributions to specific cognitive deficits observed after cerebellar tumor resection. Verbal working memory (VWM tasks were administered to children following surgical resection of cerebellar pilocytic astrocytomas and age-matched controls. Anatomical MRI scans were used to quantify the extent of cerebellar lobular damage from each patient's resection. Patients exhibited significantly reduced digit span for auditory but not visual stimuli, relative to controls, and damage to left hemispheral lobule VIII was significantly correlated with this deficit. Patients also showed reduced effects of articulatory suppression and this was correlated with damage to the vermis and hemispheral lobule IV/V bilaterally. Phonological similarity and recency effects did not differ overall between patients and controls, but outlier patients with abnormal phonological similarity effects to either auditory or visual stimuli were found to have damage to hemispheral lobule VIII/VIIB on the left and right, respectively. We postulate that damage to left hemispheral lobule VIII may interfere with encoding of auditory stimuli into the phonological store. These data corroborate neuroimaging studies showing focal cerebellar activation during VWM paradigms, and thereby allow us to predict with greater accuracy which specific neurocognitive processes will be affected by a cerebellar tumor resection.

  1. Delayed tumor resection in a 5-year-old child with bilateral Wilms tumor.

    Science.gov (United States)

    Carmichael, Samuel P; Pulliam, Joseph F; D'Orazio, John A

    2013-01-01

    We describe the case of a 5-year-old girl whose abdominal pain and distension were caused by Wilms tumor of the kidney. Because of the bilateral nature of her disease, she was spared biopsy or initial nephrectomy as part of her treatment course. Rather, she was treated presumptively for Wilms tumor based primarily on radiologic findings. Neoadjuvant chemotherapy consisting of vincristine, dactinomycin and doxorubicin was given to facilitate nephron-sparing surgery for tumor resection. Her initial chemotherapeutic course was complicated by tumor lysis syndrome manifested by elevated serum uric acid and was treated effectively with hyperhydration and alkalization of intravenous fluids. The patient's disease responded well to chemotherapy, and she underwent successful tumor excision after 12 weeks of chemotherapy. The resected tumor was identified as anaplastic Wilms tumor, illustrating that pathologic identification of Wilms tumor is possible even after multiple cycles of neoadjuvant chemotherapy and marked tumor shrinkage. PMID:24964423

  2. Resection of the primary tumor in stage IV breast cancer

    OpenAIRE

    Shien, Tadahiko; Doihara, Hiroyoshi

    2014-01-01

    Stage IV breast cancer refers to breast cancer that has already metastasized to distant regions when initially diagnosed. Treatment for stage IV is intended to “prolong survival and palliate symptoms”. Resection of a primary tumor is considered to be “effective only at alleviating chest symptoms and providing local control” in spite of the advances of imaging examination and medication for breast cancer. Molecular target and endocrine drugs are very effective and useful to tailor-make a treat...

  3. The Use of Iliac Stem Prosthesis for Acetabular Defects following Resections for Periacetabular Tumors

    Science.gov (United States)

    De Paolis, Massimiliano; Romagnoli, Carlo; Alì, Nikolin; Giannini, Sandro; Donati, Davide Maria

    2013-01-01

    Introduction. The management of pelvic tumors is a challenge for orthopaedic oncologists due to the complex anatomy of the pelvis and the need to have extensive exposure. Various reconstructive techniques have been proposed with poor functional results and a high percentage of complications. Our purpose is to determine the functional results and the rate of complications of iliac stem prosthesis for acetabular defects following resections for periacetabular tumors. Materials and Methods. Between 1999 and 2012, 45 patients underwent pelvic resections for periacetabular bone tumors followed by reconstruction with stem cup prosthesis. The most common diagnosis was CS (chondrosarcoma, 29 cases), followed by OS (osteosarcoma, 9 cases) and metastasis (3 cases). In 33 cases, this implant was associated with massive bone allografts. Minimum follow-up required to evaluate functional outcome was 2 years. We classified pelvic resections according to Enneking and Dunham's classification and we used MSTS (musculoskeletal tumor system) score to evaluate functional outcomes. Results and Discussion. Sixteen patients died of their disease, three were lost to follow-up, four are alive with disease, and twenty-two are alive with no evidence of disease. Fifteen patients had local recurrence. Sixteen patients had bone or lung metastasis. We have had 6 infections, 2 aseptic loosening, and 2 cases of hip dislocation. Iliac sovracetabular osteotomy was fused in all cases at 10 months from surgery. Functional results were good or excellent in 25 of 31 patients with long-term follow-up (77%), with a percentage similar to that reported in the literature. Conclusion. The use of iliac stem prosthesis is a simple reconstructive technique that reduces operative times and risk of infection. It allows having good results and low rate of complications, but it should be performed in selected cases and centres of reference. PMID:24250275

  4. 四肢骨肿瘤切除后应用大段同种异体骨移植交锁髓内钉内固定修复骨缺损%Rebuilding bone with massive allograft and interlocking intramedullary nail after bone tumor resection

    Institute of Scientific and Technical Information of China (English)

    杨祚璋; 许建波; 詹辉; 袁涛; 张晋煜; 钱保生; 李文忠

    2006-01-01

    , the progression of transplantation of allografts has put forward to a new way to repair massive bone and joint defect caused by various reasons, which was a difficult subject in the past.OBJECTIVE: To probe into the effect of massive allograft and interlocking intramedullary nail on rebuilding bone and joint after bone tumor resection.DESIGN: Self-control observation SETTING: Department of Orthopaedics, Yunnan Provincial Tumor Hospital PARTICIPANTS: From April 1998 to January 2003, totally 18 patients with 15 cases of malignant bone tumor and 3 of osteoma-like disease, accepted bone tumor focus removal followed by intrmedullary nailing and allogenic bone transplantation, consented to join the study, were recruited.INTERVENTIONS: Allografts were taken from fresh cadaveric bone (Prepared and stored in Yunnan Provincial Tumor). The bone segment of osteoma was cut completely and the allografts were transplanted at the bone defects. The proximal and distal intrmedullary nailing were inserted in order. Auto cancellous bone particles were transplanted at the bone joint to promote the healing at bone end. The upper part of shoulder bone was transplanted to perform reconstruct of retotar and triangular muscle; half knee joint was transplanted to attach important muscle and ligament. After external fixation of 4 to 6 weeks following operation, the functional exercise was conducted in order sequence. Evaluating the curative effect of functional recovery of the limbs at postoperative 3,6 and 12 months as well as follow-up was carried out according to the criteria of Mankin(excellent ,good , moderate , unsatisfied).MAIN OUTCOME MEASURES: ①Functional recovery of limb of the patients. ② Adverse and side effectRESULTS: Date of totally 18 patients was entered result analysis. ①Functional recovery result of the limbs: According to evaluated criteria put forward by Mankin. In this group, 7 cases of excellent, 6 of good, 4 of moderate and 1 of unsatisfied. Bony callus and the

  5. Does hyoid bone resection according to Sistrunk influence normal craniofacial growth? A cephalometric study.

    NARCIS (Netherlands)

    Joss-Vassalli, I.M.; Joss, C.U.; Gebauer, U.

    2009-01-01

    PURPOSE: To retrospectively evaluate the influence of hyoid bone resection according to Sistrunk in early age due to a thyroglossal duct cyst on craniofacial growth. MATERIALS AND METHODS: We retrospectively examined 10 patients (2 females and 8 males) having had hyoid bone resection according to Si

  6. The Effect of Preceding Biopsy on Complete Endoscopic Resection in Rectal Carcinoid Tumor

    OpenAIRE

    Lee, Sang Pyo; Sung, In-Kyung; Kim, Jeong Hwan; Lee, Sun-Young; Park, Hyung Seok; Shim, Chan Sup

    2014-01-01

    Biopsy of rectal carcinoid tumor is commonly taken before endoscopic resection. However the preceding biopsy can inhibit complete resection by causing blurred tumor border and fibrosis of the tissue. The objective of the study was to investigate the effect of preceding biopsy on complete endoscopic resection in rectal carcinoid tumor. It was also determined if rectal carcinoid tumors can be macroscopically distinguished by endoscopy. We reviewed retrospectively the records of patients with re...

  7. Delayed tumor resection in a 5-year-old child with bilateral Wilms tumor

    OpenAIRE

    Carmichael, Samuel P.; Pulliam, Joseph F.; D'Orazio, John A.

    2012-01-01

    We describe the case of a 5-year-old girl whose abdominal pain and distension were caused by Wilms tumor of the kidney. Because of the bilateral nature of her disease, she was spared biopsy or initial nephrectomy as part of her treatment course. Rather, she was treated presumptively for Wilms tumor based primarily on radiologic findings. Neoadjuvant chemotherapy consisting of vincristine, dactinomycin and doxorubicin was given to facilitate nephron-sparing surgery for tumor resection. Her ini...

  8. Transoral laser resections of oral cavity and oropharyngeal tumors

    Directory of Open Access Journals (Sweden)

    M. V. Bolotin

    2016-03-01

    Full Text Available The incidence of squamous cell carcinoma of the head and neck remains high and ranks tenth in the structure of overall cancer morbidity. Surgical radicality has remained one of the major determinants of the long-term results of treatment so far. In the period December 2014 to January 2016, our clinic performed surgical interventions as transoral laser oral cavity and oropharyngeal resections using carbon dioxide (CO2 laser in 34 patients. Tumors are most commonly located in the area of the tongue root and oropharynx in 16 (47.1 % patients, tongue (its anterior two thirds in 14 (41.2 %, and mouth floor in 4 (11.7 %. The average length of hospital stay after transoral laser resections was 10.14 days. A nasogastric tube was postoperatively placed in 6 (17.6 % patients for 8 to 17 days. According to the results of planned histological examination, surgical interventions were microscopically radical in all cases. Transoral CO2 laser resections make possible to perform rather large radical surgical interventions with a satisfactory functional and cosmetic results, without deteriorating the long-term results of treatment. 

  9. Clinical results of carbon ion radiotherapy for bone and soft tissue tumors

    International Nuclear Information System (INIS)

    First choice of treatment for bone and soft tissue tumors is surgical tumor resection, but some cases have difficulties to resect radically because of tumor size, location, or their reduction in QOL after surgery. Carbon ion radiotherapy has been reported that have both good local tumor control and high QOL for patients with bone and soft tissue tumors, especially sacral chordoma and unresectable osteosarcoma of the tract. Some articles of the results with carbon ion radiotherapy for sacral chordoma show better local control and QOL than that of surgery. Moreover, several reports show good local control and preservation of QOL for patients with unresectable osteosarcoma of the tract, retroperitoneal sarcoma, and other situations of sarcomas. Now carbon ion radiotherapy can offer a promising alternative to surgery for patients with unresectable sarcomas. We will discuss about the results of carbon ion radiotherapy for bone and soft tissue tumors in this issue. (author)

  10. Conservative resection for benign tumors of the proximal pancreas

    Institute of Scientific and Technical Information of China (English)

    Hai Huang; Xin Dong; Shun-Liang Gao; Yu-Lian Wu

    2009-01-01

    AIM:To evaluate the safety and long-term prognosis of conservative resection (CR) for benign or borderline tumor of the proximal pancreas.METHODS:We retrospectively analyzed 20 patients who underwent CR at the Second Affiliated Hospital of Zhejiang University School of Medicine between April 2000 and October 2008.For pancreaticojejunostomy,a modified invagination method,continuous circular invaginated pancreaticojejunostomy (CCI-PJ) was used.Modified continuous closed lavage (MCCL) was performed for patients with pancreatic fistula.RESULTS:The indications were:serous cystadenomas in eight patients,insulinomas in six,non-functional islet cell tumors in three and solid pseudopapillary tumors in three.Perioperative mortality was zero and morbidity was 25%.Overall,pancreatic fistula was present in 25% of patients.At a mean follow up of 42.7 mo,all patients were alive with no recurrence and no new-onset diabetes mellitus or exocrine dysfunction.CONCLUSION:CR is a safe and effective procedure for patients with benign tumors in the proximal pancreas,with careful CCI-PJ and postoperative MCCL.

  11. Complications of massive allograft reconstruction for bone tumors

    Directory of Open Access Journals (Sweden)

    Abolhasan Borjian

    2006-11-01

    Full Text Available BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD. Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60% were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb

  12. MR imaging of edema accompanying benign and malignant bone tumors

    International Nuclear Information System (INIS)

    To evaluate the incidence, quantity, and presentation of intra- and extraosseous edema accompanying benign and malignant primary bone lesions, the magnetic resonance (MR) studies of 63 consecutive patients with histologically proven primary bone tumors were reviewed. MR scans were assessed for the presence and quantity of marrow and soft tissue edema and correlated with preoperative findings, resected specimens and follow-up data. The signal intensity and enhancement of tumor and edema prior to and after intravenous administration (if any) of gadolinium-labled diethylene triamine pentaacetate (Gd-DTPA) was analyzed. Marrow edema was encountered adjacent to 8 of 39 maglinant tumors and 14 of 24 benign lesions. Soft tissue edema was found accompanying 28 of 39 malignancies and 10 of 24 benign disorders. On enhanced T1-weighted MR images tumor and edema were difficult to differentiate. Tumor inhomogeneity made this differentiation easier on T2-weighted sequences. In 36 patients the contrast medium Gd-DTPA was used. Edema was present in 27 of these patients and the respective enhancement of tumor and edema could be compared. Edema always enhanced homogeneously, and in most cases it enhanced to a similar degree as or more than tumor. Marrow and, more specifically, soft tissue edema is a frequent finding adjacent to primary bone tumors. The mere presence and quantity of marrow and soft tissue edema are unreliable indicators of the biologic potential of a lesion. Unenhanced MR scans cannot always differentiate between tumor and edema, but the administration of Gd-DTPA is of assistance in differentiating tumor from edema. Awareness of marrow and/or soft tissue edema adjacent to bone lesions is of importance because edema can be a pitfall in the diagnostic work-up and staging prior to biopsy or surgery. (orig.)

  13. A solitary pleural metastasis of benign giant cell tumor of bone

    Science.gov (United States)

    Mitsui, Ai; Doi, Masatomo; Hoshikawa, Masahiro; Hayashi, Akinobu; Nakamura, Haruhiko

    2016-01-01

    Abstract Giant cell tumor of bone (GCTB) usually appears as a benign tumor. We describe an extremely rare case of a metastatic pleural tumor arising from a benign GCTB. The patient had undergone radial resection of a GCTB in his left wrist. After 6 years, he was sent to us for diagnosis of a large mass detected upon routine radiographic screening. We resected the tumor, which was found to be a solitary pleural metastasis of GCTB and had evidently spread arterially. To our knowledge, this is the first report of its kind.

  14. Microwave Therapy for Bone Tumors

    Science.gov (United States)

    Takakuda, Kazuo; Inaoka, Shuken; Saito, Hirokazu; Hassan, Moinuddin; Koyama, Yoshikazu; Kuroda, Hiroshi; Kanaya, Tomohiro; Kosaka, Toshifumi; Tanaka, Shigeo; Miyairi, Hiroo; Shinomiya, Kenichi

    In vivo microwave treatments for bone tumor are designed, which enable us to conserve the activity and functionality of the matrix of living tissues. This treatment is composed of two steps. In the first step, the tumor was coagulated by the application of microwaves emitted from the antenna inserted into the tumor tissue, and then removed. In the second step, the surrounding tissue suspected to be invaded with transformed cells was covered with hydro gels and heated similarly. The tissue itself was heated by the conduction from the gels. The tissue temperature should be kept at 60°C for 30 minutes. This treatment should kill the whole cells within the tissues, but the mechanical strength and the biochemical activity of the matrix should be left intact. The matrix preserves the mechanical functions and ensures the maximum regeneration ability of the tissue. In this study, various hydro gels were examined and the most promising one was selected. Animal experiments were carried out and successful heating verified the applicability of the treatment.

  15. Three cases of bone metastases in patients with gastrointestinal stromal tumors

    OpenAIRE

    Maurizio Zompatori; Giorgio Garzillo; Guido Biasco; Maristella Saponara; Cristian Lolli; Anna Mandrioli; Monica Di Battista; Alberto Bazzocchi; Margherita Nannini; Alessandra Maleddu; Laura Greco; Maria Caterina Pallotti; Maria Abbondanza Pantaleo; Valerio Di Scioscio

    2011-01-01

    Gastrointestinal stromal tumors (GISTs) are rare, but represent the most common mesenchymal neoplasms of the gastrointestinal tract. Tumor resection is the treatment of choice for localized disease. Tyrosine kinase inhibitors (imatinib, sunitinib) are the standard therapy for metastatic or unresectable GISTs. GISTs usually metastasize to the liver and peritoneum. Bone metastases are uncommon. We describe three cases of bone metastases in patients with advanced GISTs: two women (82 and 54 year...

  16. Primary 4T1 tumor resection provides critical "window of opportunity" for immunotherapy.

    Science.gov (United States)

    Ghochikyan, Anahit; Davtyan, Arpine; Hovakimyan, Armine; Davtyan, Hayk; Poghosyan, Anna; Bagaev, Alexander; Ataullakhanov, Ravshan I; Nelson, Edward L; Agadjanyan, Michael G

    2014-02-01

    It is believed that primary tumor resection modulates host-tumor immune interaction, but this has not been characterized in a stringent breast cancer tumor model. This report, using the 4T1 murine mammary tumor model, characterizes for the first time the dynamic longitudinal changes in immunosuppressive and effector components of the immune system after resection of an established orthotopic primary tumor with a defined natural history of developing lung metastases. More specifically, we analyzed changes of absolute numbers and frequencies of MDSC, regulatory T cells (Treg), as well as activated CD4 and CD8 positive T cells in spleens and, in some studies, lungs of 4T1 tumor-bearing mice and mice after primary tumor resection. Importantly, using mathematical analyses we established that primary resection of an orthotopic tumor had created a "window of opportunity" with decreased tumor-associated immune suppression that existed for approximately 10 days. Although tumor resection did slightly prolong survival, it did not affect the ultimate development of metastatic disease since animals with resected tumors or intact primary tumors eventually died by day 47 and 43, respectively. This window of opportunity likely occurs in humans providing a rationale and parameters for integration and testing of immunotherapeutic strategies in this critical "window of opportunity" to combat the development of metastatic disease. PMID:24096737

  17. Role of radiologic imaging in management planning of giant cell tumor of bone

    International Nuclear Information System (INIS)

    The radiologic studies of 24 patients with giant cell tumors were evaluated with respect to their ability to determine tumor extent and to influence management. Computed tomography (CT) was the most accurate method for detecting soft tissue tumor extension, and conventional tomography was the best technique for evaluating penetration of subarticular cortical bone. Detection of these findings led to performance of en bloc tumor resection rather than curettage and grafting in patients with lower extremity tumors. Arthrotomography was helpful in some instances in detecting cartilage and joint invasion by tumor, joint invasion being an indication for extra-articular rather than transarticular tumour resection. Scintigraphy was not as accurate as conventional tomography or CT in determining intraosseous tumor extent because of increased tracer uptake beyond the true tumor limits in several cases. Angiography has been largely replaced by CT in evaluating giant cell tumors. (orig.)

  18. Mid-foot reconstruction following involvement of five bones by giant cell tumor

    Energy Technology Data Exchange (ETDEWEB)

    Szendroei, M.; Antal, I.; Perlaky, G. [Dept. of Orthopaedics, Semmelweis Univ., Budapest (Hungary)

    2000-11-01

    We report on a patient who had giant cell tumor involving multiple bones of the mid-foot. The tumor originated from the navicular bone, but also destroyed the cuboid, and all cuneiform bones. This unusual presentation of giant cell tumor presented a therapeutic challenge for the surgeons. The patient was treated with en bloc resection and the bony defect replaced with a massive iliac crest graft which united within 9 months and has remained stable for 7 years without local recurrence, and with excellent function of the foot. (orig.)

  19. Mid-foot reconstruction following involvement of five bones by giant cell tumor

    International Nuclear Information System (INIS)

    We report on a patient who had giant cell tumor involving multiple bones of the mid-foot. The tumor originated from the navicular bone, but also destroyed the cuboid, and all cuneiform bones. This unusual presentation of giant cell tumor presented a therapeutic challenge for the surgeons. The patient was treated with en bloc resection and the bony defect replaced with a massive iliac crest graft which united within 9 months and has remained stable for 7 years without local recurrence, and with excellent function of the foot. (orig.)

  20. BROWN TUMOR OF THE FACIAL BONES

    Directory of Open Access Journals (Sweden)

    Violeta Trandafir

    2010-11-01

    Full Text Available Brown tumor arises as a direct result of the effect of parathyroid hormone on bone tissue in some patients with hyperparathyroidism. The lesion localizes in areas of intense bone resorbtion, and the bone defect becomes filled with fibroblastic tissue that can deform the bone and simulate a neoplastic process. Brown tumors can affect the mandible, maxilla, clavicle, ribs and pelvic bones. Most patients with hyperparathyroidism are asymptomatic. Skeletal changes may represent the first manifestations of the disease. Radiologically, brown tumor in the jaws presents as a well-defined radiolucent osteolytic lesion, making it hard to differentiate it from other maxillary expansive lesions that can present with a similar imaging. Brown tumors exhibit no pathognomonic histologic changes. Differentiating between a brown tumor and other giant-cell tumors may be very difficult, even with histology. A final diagnosis can be defined only by evaluating the radiological findings with histopathological, laboratory and clinical data. At present, brown tumor is considered as a reparative cellular process rather than a real neoplasia. This phenomenon is considered as pathognomonic of hyperparathyroidism secondary to renal failure, especially in patients on long-term hemodialysis. The initial treatment of brown tumor involves control of hyperparathyroidism, regardless of whether it is primary or secondary. The clinical management of brown tumor aims primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment. Surgical treatment is reserved to nonresponders or to patients with painful symptomatology or alteration of normal function. Brown tumor can recur if hyperparathyroidism persists or recurs.

  1. Autoclaved Tumor Bone for Skeletal Reconstruction in Paediatric Patients: A Low Cost Alternative in Developing Countries

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2013-01-01

    Full Text Available We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1 wide en bloc resection of the tumor; (2 curettage of tumor from the resected bone; (3 autoclaving for 8 minutes (4 bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used; (5 reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months, 31 patients had recovered without any complications. Thirty-eight patients successfully achieved a solid bony union between the graft and recipient bone. Three patients had surgical site infection. They were managed with wound debridement and flap coverage of the defect. Local recurrence and nonunion occurred in two patients each. One patient underwent disarticulation at hip due to extensive local disease and one died of metastasis. For patients with non-union, revision procedure with bone graft and compression plates was successfully used. The use of autoclaved tumor grafts provides a limb salvage option that is inexpensive and independent of external resources and is a viable option for musculoskeletal tumor management in developing countries.

  2. Holmium laser versus conventional transurethral resection of the bladder tumor

    Institute of Scientific and Technical Information of China (English)

    TENG Jing-fei; WANG Kai; YIN Le; QU Fa-jun; ZHANG Dong-xu; CUI Xin-gang; XU Dan-feng

    2013-01-01

    Background Transurethral resection of the bladder tumor (TURBT) remains the gold standard for non-muscle-invasive bladder cancer (NMIBC).Laser techniques have been widely used in urology.This analysis aimed to assess the safety and efficacy of holmium resection of the bladder tumor (HoLRBT) vs.TURBT.Methods A systemic search of MEDLINE,Embase,Web of Science,and The Cochrane Library as well as manual bibliography searches were performed to identify the relevant studies.The pooled estimates of operation time,obturator nerve reflex rate,bladder perforation rate,bladder irrigation rate,catheterization time,hospital stay,and one-and two-year recurrence free survivals were calculated.Results Five studies were enrolled into our meta-analysis.No significant difference was observed in the operation time between groups (weighted mean difference (WMD) 1.01,95% confidential interval (95% CI)-3.52-5.54,P=0.66).The significant difference in the obturator nerve reflex (OR 0.05,95% CI 0.01-0.04,P=0.004),bladder perforation (OR 0.14,95% CI 0.03-0.61,P=0.009),bladder irrigation (OR 0.13,95% CI 0.04-0.45,P=0.001),catheterization time (WMD -0.96,95% CI-1.11 to-0.82,P <0.00001),and hospital stay (WMD-1.46,95% C1-1.65 to-1.27,P <0.00001) showed advantages of HoLRBT over TURBT.The 2-year recurrence free survival rate favors the HoLRBT group (OR 1.46,95%CI 1.02-2.11,P=0.04).Conclusions As a promising technique,HoLRBT is safe and efficient,and showed several advantages over TURBT.HoLRBT can be used as an alternative procedure for TURBT in terms of low-grade papillary urothelial carcinoma or Iow-orade early TNM-staoe urothelial carcinoma.

  3. Real-time multi-modality imaging of Glioblastoma tumor resection and recurrence

    OpenAIRE

    Hingtgen, Shawn; Figueiredo, Jose-Luiz; Farrar, Christian; Duebgen, Matthias; Martinez-Quintanilla, Jordi; Bhere, Deepak; Shah, Khalid

    2012-01-01

    The lack of relevant pre-clinical animal models incorporating the clinical scenario of GBM resection and recurrence has contributed significantly to the inability to successfully treat the devastating brain tumor Glioblastoma multiforme (GBM). A multi-modality imaging approach that allows real-time assessment of tumor resection during surgery and non-invasive detection of post-operative tumor volumes is urgently needed. In this study, we report the development and implementation of an optical...

  4. Multicentric Giant Cell Tumor of Bone: Synchronous and Metachronous Presentation

    Directory of Open Access Journals (Sweden)

    Reiner Wirbel

    2013-01-01

    Full Text Available A 27-year-old man treated 2.5 years ago for synchronous multicentric giant cell tumor of bone located at the right proximal humerus and the right 5th finger presented now with complaints of pain in his right hip and wrist of two-month duration. Radiology and magnetic resonance revealed multicentric giant cell tumor lesions of the right proximal femur, the left ileum, the right distal radius, and the left distal tibia. The patient has an eighteen-year history of a healed osteosarcoma of the right tibia that was treated with chemotherapy, resection, and allograft reconstruction. A literature review establishes this as the first reported case of a patient with synchronous and metachronous multicentric giant cell tumor who also has a history of osteosarcoma.

  5. Scanning electron microscopy of primary bone tumors

    International Nuclear Information System (INIS)

    Critical-point-drying of tumor tissue fixed in a glutaraldehyde-paraformaldehyde solution and viewed by scanning electron microscopy (SEM) provides a 3-dimensional view of tumor cells and their matrices. This report describes the SEM appearance of three primary bone tumors: a canine osteosarcoma of the distal radius, a feline chondrosarcoma of the proximal tibia and a canine fibrosarcoma of the proximal humerus. The ultrastructural morphology is compared with the histologic appearance of each tumor

  6. New Technique of Reconstruction after Resection of Tumors of the Distal Femur: Role of Inverted Pedicled Fibular Graft

    International Nuclear Information System (INIS)

    Background and purpose: The fibular bone has been widely used as a free vascularized graft in reconstruction of defects of the femur after bone tumour resection which is technically demanding and time consuming. In this study, we describe a technique of rotating the ipsilateral fibula 1800 on its vascular pedicle to reconstruct lower femur defects after tumour resection aiming at avoiding the morbidity of microvascular anastomoses. Patients and methods: A prospective non-randomized study on seven patients (mean age 16.8 years) with osteogenic sarcoma of the lower femur was conducted at the NCI, Cairo University between January 2000 and January 2003. Those patients underwent preoperative chemotherapy regimens followed by radical resection and reconstruction of the resulting defect with pedicled vascularized fibular graft based on the peroneal artery. Internal fixation of the recipient bones was done by broad plate and screws. Staging and resectability were determined by preoperative CT chest, bone scan and MRI of the region around the tumor. Patients with pathological fractures or neurovascular bundle involvement were excluded. Six patients were stage II B and one patient was stage II A. Those patients were followed up for a period ranging from 15 to 33 months with an average of 24.2 months. Results: Most resections were wide (six patients), while one was marginal. The size of the defect ranged from 13 to 23 em in length (average 16.5 em). Radiological evidence of union was noted at an average of 4.2 months (range four to six months). One patient had nonunion at the proximal junction and required conventional bone grafting. Hypertrophy of the fibula was seen in two patients. The functional results were satisfactory (good in five patients, fair in one and poor in one). Postoperative complications included minor wound infection in one patient, lateral popliteal nerve palsy in two patients, one of whom recovered completely and local recurrence followed by lung

  7. Orbit-associated tumors: navigation and control of resection using intraoperative computed tomography.

    Science.gov (United States)

    Terpolilli, Nicole A; Rachinger, Walter; Kunz, Mathias; Thon, Niklas; Flatz, Wilhelm H; Tonn, Jörg-Christian; Schichor, Christian

    2016-05-01

    OBJECT Treatment of skull base lesions is complex and usually requires a multidisciplinary approach. In meningioma, which is the most common tumor entity in this region, resection is considered to be the most important therapeutic step to avoid tumor recurrence. However, resection of skull base lesions with orbital or optic nerve involvement poses a challenge due to their anatomical structure and their proximity to eloquent areas. Therefore the main goal of surgery should be to achieve the maximum extent of resection while preserving neurological function. In the postoperative course, medical and radiotherapeutic strategies may then be successfully used to treat possible tumor residues. Methods to safely improve the extent of resection in skull base lesions therefore are desirable. The current study reports the authors' experience with the use of intraoperative CT (iCT) combined with neuronavigation with regard to feasibility and possible benefits of the method. METHODS Those patients with tumorous lesions in relationship to the orbit, sphenoid wing, or cavernous sinus who were surgically treated between October 2008 and December 2013 using iCT-based neuronavigation and in whom an intraoperative scan was obtained for control of resection were included. In all cases a second iCT scan was performed under sterile conditions after completion of navigation-guided microsurgical tumor resection. The surgical strategy was adapted accordingly; if necessary, resection was continued. RESULTS Twenty-three patients (19 with WHO Grade I meningioma and 4 with other lesions) were included. The most common clinical symptoms were loss of visual acuity and exophthalmus. Intraoperative control of resection by iCT was successfully obtained in all cases. Intraoperative imaging changed the surgical approach in more than half (52.2%) of these patients, either because iCT demonstrated unexpected residual tumor masses or because the second scan revealed additional tumor tissue that was not

  8. Metastatic Bone Tumors in Biopsy Specimens

    OpenAIRE

    Tomas, Davor; Krušlin, Božo; Matejčić, Aljoša; Kejla, Zoran; Belicza, Mladen

    2003-01-01

    Metastatic bone tumors are the most common form of skeletal malignancy. The aim of the study was to present the main characteristics and to highlight the problems encountered in metastatic bone tumor biopsy. Data from the Thanatos database for the period from January 1, 1998 till December 31, 2001, were used. Pathohistologic analysis was done on formalin fixed, paraffin embedded, and hematoxylin-eosin stained tissue. Decalcification was done with nitric acid. There were 78 patients with metas...

  9. Knee bone tumors: findings on conventional radiology.

    Science.gov (United States)

    Andrade Neto, Francisco; Teixeira, Manuel Joaquim Diógenes; Araújo, Leonardo Heráclio do Carmo; Ponte, Carlos Eduardo Barbosa

    2016-01-01

    The knee is a common site for bone tumors, whether clinically painful or not. Conventional radiology has been established as the first line of investigation in patients with knee pain and can reveal lesions that often generate questions not only for the generalist physician but also for the radiologist or general orthopedist. History, image examination, and histopathological analysis compose the essential tripod of the diagnosis of bone tumors, and conventional radiology is an essential diagnostic tool in patients with knee pain. This pictorial essay proposes to depict the main conventional radiography findings of the most common bone tumors around the knee, including benign and malignant tumors, as well as pseudo-tumors. PMID:27403019

  10. Knee bone tumors: findings on conventional radiology*

    Science.gov (United States)

    Andrade Neto, Francisco; Teixeira, Manuel Joaquim Diógenes; Araújo, Leonardo Heráclio do Carmo; Ponte, Carlos Eduardo Barbosa

    2016-01-01

    The knee is a common site for bone tumors, whether clinically painful or not. Conventional radiology has been established as the first line of investigation in patients with knee pain and can reveal lesions that often generate questions not only for the generalist physician but also for the radiologist or general orthopedist. History, image examination, and histopathological analysis compose the essential tripod of the diagnosis of bone tumors, and conventional radiology is an essential diagnostic tool in patients with knee pain. This pictorial essay proposes to depict the main conventional radiography findings of the most common bone tumors around the knee, including benign and malignant tumors, as well as pseudo-tumors. PMID:27403019

  11. Intraoperative Transcranial Motor-Evoked Potential Monitoring of the Facial Nerve during Cerebellopontine Angle Tumor Resection

    OpenAIRE

    Cosetti, Maura K.; Xu, Ming; Rivera, Andrew; Jethanamest, Daniel; Kuhn, Maggie A.; Beric, Aleksandar; Golfinos, John G.; Roland, J. Thomas

    2012-01-01

    Objective To determine whether transcranial motor-evoked potential (TCMEP) monitoring of the facial nerve (FN) during cerebellopontine angle (CPA) tumor resection can predict both immediate and long-term postoperative FN function.

  12. Three dimensional model for surgical planning in resection of thoracic tumors

    Directory of Open Access Journals (Sweden)

    Min P. Kim

    2015-01-01

    Conclusion: Three-dimensional printed model provide better visualization of complex thoracic tumors, aid in counseling the patient about the surgical procedure and assisted in surgical resection of thoracic malignancy.

  13. Neoadjuvant Chemotherapy in Locally Advanced and Borderline Resectable Nonsquamous Sinonasal Tumors (Esthesioneuroblastoma and Sinonasal Tumor with Neuroendocrine Differentiation)

    OpenAIRE

    Patil, Vijay M.; Amit Joshi; Vanita Noronha; Vibhor Sharma; Saurabh Zanwar; Sachin Dhumal; Shubhada Kane; Prathamesh Pai; Anil D’Cruz; Pankaj Chaturvedi; Atanu Bhattacharjee; Kumar Prabhash

    2016-01-01

    Introduction. Sinonasal tumors are chemotherapy responsive which frequently present in advanced stages making NACT a promising option for improving resection and local control in borderline resectable and locally advanced tumours. Here we reviewed the results of 25 such cases treated with NACT. Materials and Methods. Sinonasal tumor patients treated with NACT were selected for this analysis. These patients received NACT with platinum and etoposide for 2 cycles. Patients who responded and were...

  14. Bone Scintigraphy in a Patient With Giant Malignant Solitary Fibrous Tumor of the Pleura.

    Science.gov (United States)

    Zhao, Long; Liu, JinJun; Li, Qiang; Wang, Huo-Qiang

    2016-06-01

    Chest radiograph performed in a 61-year-old woman to evaluate cough showed a large mass in the right lung. On chest CT images, the mass was measured approximately 8.5 cm. Malignancy was considered, and bone scintigraphy was performed to assess possible osseous metastases. The bone scan images demonstrated increased tracer uptake by the lung mass. The mass was surgically resected, and the pathologic examination confirmed the rare diagnosis of a malignancy solitary fibrous tumors of the pleura. PMID:26914570

  15. [High-dose chemotherapy and residual tumor resection in male germ cell tumors].

    Science.gov (United States)

    Lorch, A; Albers, P; Winter, C; Beyer, J

    2011-09-01

    As a consequence of the unsatisfactory results of conventional dose salvage regimens, in particular for patients with poor prognostic features at the time of relapse or in patients with refractory disease, high-dose chemotherapy (HDCT) was introduced into clinical practice in the late 1980s. The combination of carboplatin and etoposide (CE) still remains the backbone of most high-dose regimens. Multiple modifications with more dose escalations or addition of further drugs have been explored, most often with increased toxicity. With improved expertise in supportive care and the use of peripheral blood stem cells, hematopoetic recovery has been significantly shortened and the initial high treatment-related mortality reduced from more than 10% to about 3%. Since the incorporation of HDCT, even patients with unfavorable prognostic features or patients with second or subsequent relapses can achieve long-term remission. Following HDCT residual tumor resection plays a major role in achieving these long-term results. The proportion of vital residual tumor after HDCT is much higher than in patients after conventional chemotherapy. The role of HDCT remains controversial particularly as a first-line treatment and less so in the first salvage setting. As these patients are rare HDCT and residual tumor resection should only be be provided by high-volume centers with sufficient expertise in performing these complex procedures. PMID:21845425

  16. The role of imaging for the surgeon in primary malignant bone tumors of the chest wall

    International Nuclear Information System (INIS)

    Primary malignant chest wall tumors are rare. The most frequent primary malignant tumor of the chest wall is chondrosarcoma, less common are primary bone tumors belonging to the Ewing Family Bone Tumors (EFBT), or even rarer are osteosarcomas. They represent a challenging clinical entities for surgeons as the treatment of choice for these neoplasms is surgical resection, excluding EFBT which are normally treated by a multidisciplinary approach. Positive margins after surgical procedure are the principal risk factor of local recurrence, therefore to perform adequate surgery a correct preoperative staging is mandatory. Imaging techniques are used for diagnosis, to determine anatomic site and extension, to perform a guided biopsy, for local and general staging, to evaluate chemotherapy response, to detect the presence of a recurrence. This article will focus on the role of imaging in guiding this often difficult surgery and the different technical possibilities adopted in our department to restore the mechanics of the thoracic cage after wide resections

  17. Macrophage inflammatory protein-2 contributes to liver resection-induced acceleration of hepatic metastatic tumor growth

    Institute of Scientific and Technical Information of China (English)

    Otto Kollmar; Michael D Menger; Martin K Schilling

    2006-01-01

    AIM: To study the role of macrophage inflammatory protein (MIP)-2 in liver resection-induced acceleration of tumor growth in a mouse model of hepatic metastasis.METHODS: After a 50% hepatectomy, 1×105 CT26.WT cells were implanted into the left liver lobe of syngeneic balb/c mice (PHx). Additional animals were treated with a monoclonal antibody (MAB452) neutralizing MIP-2(PHx+mAB). Non-resected and non-mAB-treated mice (Con) served as controls. After 7 d, tumor angiogenesis and microcirculation as well as cell proliferation, tumor growth, and CXCR-2 expression were analyzed using intravital fluorescence microscopy, histology, immunohistochemistry, and flow cytometry.RESULTS: Partial hepatectomy increased (P<0.05) the expression of the MIP-2 receptor CXCR-2 on tumor cells when compared with non-resected controls, and markedly accelerated (P<0.05) angiogenesis and metastatic tumor growth. Neutralization of MIP-2 by MAB452 treatment significantly (P<0.05) depressed CXCR-2 expression. Further, the blockade of MIP-2 reduced the angiogenic response (P<0.05) and inhibited tumor growth (P< 0.05). Of interest, liver resection-induced hepatocyte proliferation was not effected by anti-MIP-2 treatment.CONCLUSION: MIP-2 significantly contributes to liver resection-induced acceleration of colorectal CT26.WT hepatic metastasis growth.

  18. Surgical Management of Intramedullary Spinal Cord Tumors: Surgical Resection and Prognosis

    Institute of Scientific and Technical Information of China (English)

    Gui-huai Wang; Gui-huai Wang; Chung-cheng Wang; Chung-cheng Wang

    2003-01-01

    BACKGROUND & OBJECTIVE: The majority of intramedullary spinal cord tumors (IMSCT) are low-grade gliomas.Radical resection for IMSCTs remains challenging.Recently, improved neuroimaging and advanced microsurgical technique have made great success in surgical management of the intramedullary spinal cord tumors.METHODS & RESULTS: Twenty-nine patients with intramedullary spinal cord tumors were treated by radical resection during the past 4 years in our institute.The histological results were as follows: 12 ependymomas, 4 astrocytomas, 4 hemangioblastomas, 4 epidermoids, 1 cavernoma, 2 lipomas, 2 metastatics.A gross-total resection (> 95%) was achieved in 25 surgical procedures.Subtotal resections (80-95%) were performed in 4 cases.There was no surgical death.When comparing the preoperative and 3-month postoperative functional grades, 12 patients were stable 14 improved, and 3 deteriorated.Patients with either no deficit or only mild deficit before surgery were rarely impaired by the procedure, reinforcing the importance of early diagnosis and treatment.The major determinant of long-term survival was histological composition of the tumor.Patients in whom an IMSCT was only partially resected (< 80%) fared significantly worse.CONCLUSIONS: The long-term survival and quality of life for patients with low-grade gliomas treated by radical resection alone is comparable or superior to minimal resection plus radiotherapy.The optimal therapy for patients with high-grade glioma is yet to be determined.For benign lesion, such as hemangioblastoma and cavernoma could be cured by total resection of the tumor.For lipoma and epidermoid, fibrous adhesions to the cord make total removal difficult, and thus, removal is not the goal of surgery.The carbon dioxide laser is particularly useful during surgery for this lesion.

  19. Awake brain tumor resection during pregnancy: Decision making and technical nuances.

    Science.gov (United States)

    Meng, Lingzhong; Han, Seunggu J; Rollins, Mark D; Gelb, Adrian W; Chang, Edward F

    2016-02-01

    The co-occurrence of primary brain tumor and pregnancy poses unique challenges to the treating physician. If a rapidly growing lesion causes life-threatening mass effect, craniotomy for tumor debulking becomes urgent. The choice between awake craniotomy versus general anesthesia becomes complicated if the tumor is encroaching on eloquent brain because considerations pertinent to both patient safety and oncological outcome, in addition to fetal wellbeing, are involved. A 31-year-old female at 30 weeks gestation with twins presented to our hospital seeking awake craniotomy to resect a 7 × 6 × 5 cm left frontoparietal brain tumor with 7 mm left-to-right subfalcine herniation on imaging that led to word finding difficulty, dysfluency, right upper extremity paralysis, and right lower extremity weakness. She had twice undergone tumor debulking under general anesthesia during the same pregnancy at an outside hospital at 16 weeks and 28 weeks gestation. There were considerations both for and against awake brain tumor resection over surgery under general anesthesia. The decision-making process and the technical nuances related to awake brain tumor resection in this neurologically impaired patient are discussed. Awake craniotomy benefits the patient who harbors a tumor that encroaches on the eloquent brain by allowing a greater extent of resection while preserving the language and sensorimotor function. It can be successfully done in pregnant patients who are neurologically impaired. The patient should be motivated and well informed of the details of the process. A multidisciplinary and collaborative effort is also crucial. PMID:26498092

  20. Effect of tumor resection on the characteristics of functional brain networks

    NARCIS (Netherlands)

    Wang, H.; Douw, L.; Hernández, J.M.; Reijneveld, J.C.; Stam, C.J.; Van Mieghem, P.

    2010-01-01

    Brain functioning such as cognitive performance depends on the functional interactions between brain areas, namely, the functional brain networks. The functional brain networks of a group of patients with brain tumors are measured before and after tumor resection. In this work, we perform a weighted

  1. Surgical resection of adrenal metastasis from primary liver tumors:a report of two cases

    Institute of Scientific and Technical Information of China (English)

    Durgatosh Pandey; Kai-Chah Tan

    2008-01-01

    BACKGROUND: Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative, solitary metastasis from such tumors offers a possibility of cure by surgical resection. The adrenal gland is an uncommon site for metastasis from primary liver tumors. METHOD: We report two cases of adrenalectomy for solitary adrenal metastasis: one from intrahepatic cholangiocarcinoma and the other from hepatocellular carcinoma. RESULTS: The patient with intrahepatic cholangiocar-cinoma had a synchronous adrenal metastasis and underwent simultaneous liver resection and adrenalectomy. However, he developed recurrent disease 17 months following surgery for which he is presently on palliative chemotherapy. The other patient underwent adrenalectomy for adrenal metastasis 3 months following liver transplantation for hepatocellular carcinoma. He is presently alive and disease-free 27 months after adrenalectomy. CONCLUSION: Carefully selected patients with solitary metastasis from primary liver tumors may be considered for resection.

  2. Metabolic approach for tumor delineation in glioma surgery: 3D MR spectroscopy image-guided resection.

    Science.gov (United States)

    Zhang, Jie; Zhuang, Dong-Xiao; Yao, Cheng-Jun; Lin, Ching-Po; Wang, Tian-Liang; Qin, Zhi-Yong; Wu, Jin-Song

    2016-06-01

    OBJECT The extent of resection is one of the most essential factors that influence the outcomes of glioma resection. However, conventional structural imaging has failed to accurately delineate glioma margins because of tumor cell infiltration. Three-dimensional proton MR spectroscopy ((1)H-MRS) can provide metabolic information and has been used in preoperative tumor differentiation, grading, and radiotherapy planning. Resection based on glioma metabolism information may provide for a more extensive resection and yield better outcomes for glioma patients. In this study, the authors attempt to integrate 3D (1)H-MRS into neuronavigation and assess the feasibility and validity of metabolically based glioma resection. METHODS Choline (Cho)-N-acetylaspartate (NAA) index (CNI) maps were calculated and integrated into neuronavigation. The CNI thresholds were quantitatively analyzed and compared with structural MRI studies. Glioma resections were performed under 3D (1)H-MRS guidance. Volumetric analyses were performed for metabolic and structural images from a low-grade glioma (LGG) group and high-grade glioma (HGG) group. Magnetic resonance imaging and neurological assessments were performed immediately after surgery and 1 year after tumor resection. RESULTS Fifteen eligible patients with primary cerebral gliomas were included in this study. Three-dimensional (1)H-MRS maps were successfully coregistered with structural images and integrated into navigational system. Volumetric analyses showed that the differences between the metabolic volumes with different CNI thresholds were statistically significant (p MRS maps and intraoperative navigation for glioma margin delineation. Optimum CNI thresholds were applied for both LGGs and HGGs to achieve resection. The results indicated that 3D (1)H-MRS can be integrated with structural imaging to provide better outcomes for glioma resection. PMID:26636387

  3. Video-Assisted Thoracoscopic Surgery in Patients With Clinically Resectable Lung Tumors

    Directory of Open Access Journals (Sweden)

    H. Sakai

    1996-01-01

    Full Text Available To investigate the feasibility of thoracoscopic resection, a pilot study was performed in patients with clinically resectable lung tumors. In 40 patients, Video-assisted thoracic surgery (VATS was performed because of suspicion of malignancy. There were 29 men and 11 women with a median age of 54.8 years (range 18 to 78. Preoperative indications were suspected lung cancer and tumor in 27 patients, assessment of tumor resectability in 7 patients, and probability of metastatic tumors in 6 patients. The final diagnoses in the 27 patients with suspected lung cancer were 12 primary lung cancers, 6 lung metastases, and 9 benign lesions. The success rates for VATS (no conversion to thoracotomy were 1 of 12 (8.3% for resectable stage I lung cancer, 8 of 12 (66.7% for metastatic tumors, and 9 of 9 (100% for benign tumors. With VATS, 6 of 7 patients (85.7%, possible stage III non-small cell lung cancer, an explorative thoracotomy with was avoided, significantly reducing morbidity. The reasons for conversion to thoracotomy were 1 oncological (N2 lymph node dissection and prevention of tumor spillage and 2 technical (inability to locate the nodule, central localization, no anatomical fissure, or poor lung function requiring full lung ventilation. The ultimate diagnoses were 19 lung cancers, 12 metastatic lung tumors, and 9 benign lung tumors. Our data show the limitations of VATS for malignant tumors in general use. These findings, together with the fact that experience in performing thoracoscopic procedures demonstrates a learning curve, may limit the use of thoracoscopic resection as a routine surgical procedure, especially when strict oncological rules are respected.

  4. Resection and debridement of chest-wall tumors and general aspects of reconstruction

    International Nuclear Information System (INIS)

    The main criterion for adequate local control of a chest-wall malignancy remains wide excision. With the available techniques of skeletal and soft-tissue reconstruction, even large lesions can be resected with safe margins. The primary purpose is to achieve a curative resection, although a significant number of symptomatic patients can benefit from palliative resection provided by such procedures. A key element in the success in treating chest-wall tumors is a multidisciplinary approach by all participating physicians, namely the thoracic surgeon, the plastic and reconstructive surgeon, the radiotherapist, and the medical oncologist. 70 references

  5. [Management of complications after residual tumor resection for metastatic testicular cancer].

    Science.gov (United States)

    Lusch, A; Zaum, M; Winter, C; Albers, P

    2014-07-01

    Residual tumor resection (RTR) in patients with metastatic testicular cancer plays a pivotal role in a multimodal treatment. It can be performed unilaterally or as an extended bilateral RTR. Additional surgical procedures might be necessary, such as nephrectomy, splenectomy, partial colectomy, or vascular interventions with possible caval resection, cavotomy, or aortic resection with aortic grafting. Consequently, several complications can be seen in the intra- and postoperative course, most common of which are superficial wound infections, intestinal paralysis, lymphocele, and chylous ascites. We sought to describe complication management and how to prevent complications before they arise. PMID:25023235

  6. Super bone scans on bone scintigraphy in patients with metastatic bone tumor

    International Nuclear Information System (INIS)

    Eight patients with malignant tumor (3 with gastric cancer, 4 with prostatic cancer, 1 with transitional cell carcinoma), which showed diffusely increased uptake of 99mTc labelled phosphorous compound in axial skeleton (''Super Bone Scan'') on bone scintigraphy were clinically studied. No relationship with its histological type of the tumor was recognized. All cases revealed extremely high serum ALP concentration, which might reflect increased osteoblastic activity. Furthermore, on bone roentgenograms all cases showed predominantly osteosclerotic change in the metastatic bones, while some did locally osteolytic change. In three cases with gastric cancer, although they had diffuse skeletal metastases, two had no evidence of liver metastases. Thus, it seemed that clinical study of patients with ''Super Bone Scan'' was interesting to evaluate the mechanism of accumulation of 99mTc labelled phosphorous compound to bone and bone metabolism, and the pathophysiology in the pathway of bone metastases. (author)

  7. [Complete Resection of Non-seminomatous Germ Cell Tumor with Plastron Approach].

    Science.gov (United States)

    Suzuki, Jun; Oizumi, Hiroyuki; Kato, Hirohisa; Endoh, Makoto; Watarai, Hikaru; Hamada, Akira; Suzuki, Katsuyuki; Nakahashi, Kenta; Sasage, Takayuki; Sadahiro, Mitsuaki

    2016-07-01

    A 17-year-old man was admitted to our hospital for the abnormal chest shadow. Chest computed tomography(CT) demonstrated mediastinal tumor, measuring 13 cm in diameter with high serum level of alpha fetoprotein (AFP) and human chorionic gonadotropin (hCG). The lesions were diagnosed as mixed germ cell tumors including a non-seminomatous malignant component by CT guided needle biopsy. After 5 courses of chemotherapy, the serum AFP and hCG were decreased almost normal level but the tumor size was not changed. Because it seemed to be difficult to get sufficient operating field with standard median sternotomy and patient wanted to treat funnel chest, we selected tumor resection with plastron approach. The tumor was completely resected with a good operation field by this procedure. PMID:27365059

  8. Multiple soft tissue aneurysmal cysts: An occurrence after resection of primary aneurysmal bone cyst of fibula

    Directory of Open Access Journals (Sweden)

    Karkuzhali P

    2007-01-01

    Full Text Available We report a case of multiple extraosseous aneurysmal cysts occurring in the muscle and subcutaneous plane of postero-lateral aspects of the upper right leg. They appeared about 15 months after resection of aneurysmal bone cyst of the upper end of the fibula. They varied in size from 2 cm to 5 cm. Radiologically they were well-defined lesions with central septate areas surrounded by a rim of calcification. Histologically they showed central cystic spaces separated by septa consisting of fibroblasts, osteoclast type of giant cells and reactive woven bone. Thus they showed histological similarity with aneurysmal bone cysts, but did not show any connection with the bone. Only very few examples of aneurysmal cysts of soft tissue had been described in the past one decade and they were reported in various locations including rare sites such as arterial wall and larynx. Recent cytogenetic analyses have shown abnormalities involving 17p11-13 and/or 16q22 in both osseous and extraosseous aneurysmal cysts indicating its probable neoplastic nature. Our case had unique features like multiplicity and occurrence after resection of primary aneurysmal bone cyst of the underlying bone.

  9. Resectable hepatoblastoma with tumor thrombus extending into the right atrium after chemotherapy: A case report

    Directory of Open Access Journals (Sweden)

    Kosuke Endo

    2016-04-01

    Full Text Available Hepatoblastoma with intraatrial tumor thrombus is relatively rare. We report a case of hepatoblastoma with tumor thrombus extending into the right atrium, which responded well to chemotherapy and was resected using extracorporeal circulation. A 4-year-old girl was referred to our hospital because of abdominal distention and tenderness. A computed tomography (CT scan showed a large tumor occupying the left 3 segments of the liver with tumor thrombus extending into the right atrium. There was also a small intrahepatic metastasis in the right lobe of the liver. She was diagnosed with hepatoblastoma on the basis of the results of open biopsy. Neoadjuvant chemotherapy with an intense CDDP-based regimen was performed. The tumor responded well to chemotherapy, and intrahepatic metastasis became undetectable on CT scan, although the tumor thrombus remained in the right atrium. After 7 courses of chemotherapy, we performed resection using extracorporeal circulation. The postoperative course was uneventful, and adjuvant chemotherapy was started 10 days after the operation. Her serum alpha-fetoprotein (AFP level decreased to the normal range, and she was free of disease for 1 year after the operation. Tumor resection using extracorporeal circulation can be performed safely and is justified in patients with intraatrial tumor thrombus.

  10. The value of bone scintigraphy on the determination of the full extent of tumor involvement in jaw bones%核素骨显像在预测颌骨肿瘤范围中的应用

    Institute of Scientific and Technical Information of China (English)

    Jiawei Xie; Chao Ma; Guoming Wang; Shuyao Zuo; Ningyi Li; Muyun Jia

    2009-01-01

    Objective: To prospectively investigate the value of bone scintigraphy on determining the full extent of tumor involvement in jaw bones and to assess the presence of metastases. Methods: This study had local ethical committee ap-proval, and all patients gave written informed consent. Thirty seven consecutive patients with primary malignant tumor in jaw bones were recruited for the study. Bone scintigraphy was performed in all patients before surgery to measure the full extent of bony involvement, which was compared with histologic findings. Results: Whole body scan revealed one case with multiple bony metastases. Resection specimens of 36 bone neoplasms were pathologically analyzed to identify type and size of each tumor. The lengths of the tumor involvement in jaw bones defined by bone scintigraphy and pathology were 5.62 ± 1.58 cm, 4.48 ± 1.57 cm, respectively (P < 0.05). The tumor negative margins from removed specimens according to bone scintigraphy were pathologically confirmed. With histologic findings as the standard of reference, the accuracy of bone scintigraphy was 100% (36 of 36 patients) in determining the full extent of tumor involvement in jaw bones. Conclusion: Bone scintigraphy tends to offer specific guidelines in determining the appropriate extent of bone resection while entirely clearing the tumor cells and preserving functions whenever possible and in establishing the bony metastases.

  11. Vascular invasion of klatskin tumor : computed tomography vs digital subtraction angiography in determining resectability

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Joo Hee; Han, Joon Koo; Kim, Tae Kyoung; Sin, Sang Jun; Hong, Hye Sook; Park, Jae Hyung; Choi, Byung Ihn; Kim, Sun Whe [College of Medicine, the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Song, Chi Sung [Borame Hospital, Seoul (Korea, Republic of)

    2000-02-01

    To compare the accuracy of computed tomography (CT) with that of digital subtraction angiography (DSA) in predicting the resectability of Klatskin tumor on the basis of vascular invasion. Twenty-five patients with Klatskin tumor who had undergone laparotomy were included in this study. In order to assess the surgical resectability of their tumors, the preoperative CT scans and DSA of these patients were retrospectively assessed in terms of vascular invasion. The criteria of unresectability were tumoral invasion of the proper hepatic artery or main portal vein, or simultaneous invasion of the hepatic artery on one side and the other side portal vein. Tumors were unresectable in 13 cases, and resectable in 12. CT and DSA predicted nine and three tumors as unresectable ones, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT in determining whether a tumor was unresectable were 61.5%, 91.7%, 88.9%, 68.8% and 76.0%, respectively. For DSA, the respective figures were 23.1%, 100%, 100%, 54.5%, and 60%. For the detection of vascular invasion without diameter change, CT was superior to DSA; for the evaluation of vascular anatomy, it was, however, less effective. CT failed to detect small hepatic metastasis (n=3D2), lymph node metastasis (n=3D1), variation of the bile duct (n=3D1), and the distal extent of tumor in the bile duct (n=3D1), factors which precluded surgical resection. CT is a reliable method for the detection of vascular invasion and tumor unresectability. For the detection of vascular anatomic variation, the combined use of CT and DSA would be helpful. (author)

  12. Pseudo-tumoral hepatic tuberculosis discovered after surgical resection

    Directory of Open Access Journals (Sweden)

    Miloudi Nizar

    2012-02-01

    Full Text Available Pseudo-tumoral hepatic tuberculosis is rare. It is characterized by non-specific symptoms and radiological polymorphism. Diagnosis is problematic. This article presents three cases, each clinically different from each other, that illustrate how difficult diagnosis can be. The definitive diagnosis of pseudo-tumoral hepatic tuberculosis was reached on the basis of histological examination of surgical samples. Treatment of the disease based on appropriate anti-tubercular therapy generally gives a positive outcome.

  13. Eye wall resections for intraocular tumors: Our experience

    Directory of Open Access Journals (Sweden)

    Tandava Krishnan

    2014-01-01

    Full Text Available We conducted a retrospective review of 11 eyes undergoing eye wall resection between October 1998 and October 2009. The median age of 11 patients was 29 years. Decreased vision (eight was the most common presenting symptom. Ciliary body medulloepithelioma was the most common clinical diagnosis (six. Medulloepithelioma was the most common histopathological diagnosis (four. The duration of follow-up ranged from 0.5 to 67 months (median 11 months. Three eyes needed to be enucleated in the postoperative period (margin involvement two eyes, recurrence one eye. Postoperative complications among others included retinal detachment (three, vitreous hemorrhage (three, cataract (two, and suprachoroidal hemorrhage (two. To conclude, prognosis of this procedure continues to be guarded needing close postoperative follow-up.

  14. Cardiac inflammatory myofibroblastic tumor: does it recur after complete surgical resection in an adult?

    Directory of Open Access Journals (Sweden)

    Yang Xuedong

    2012-05-01

    Full Text Available Abstract Inflammatory myofibroblastic tumor is currently considered to be a low-grade neoplasm, and it rarely involves the heart. We reported a rare case of a 59-year-old female who received cardiac surgery for complete resection of inflammatory myofibroblastic tumor in the left atrium. Five months after surgery, the patient presented with acute cardiogenic pulmonary edema and subsequent sudden death due to a left atrial tumor which protruded into the left ventricle through mitral annulus during diastole. The recurrence of inflammatory myofibroblastic tumor in the left atrium was strongly suggested clinically.

  15. Tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography: association with N categories

    OpenAIRE

    Li, Hang; Chen, Xiao-Li; Li, Jun-ru; Li, Zhen-lin; Chen, Tian-wu; Pu, Hong; Yin, Long-Lin; XU, GUO-HUI; Li, Zhen-wen; Reng, Jing; Zhou, Peng; Cheng, Zhu-zhong; Cao, Ying

    2016-01-01

    OBJECTIVE: To determine whether the gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict the presence of regional lymph node metastasis and could determine N categories. MATERIALS AND METHODS: A total of 202 consecutive patients with gastric adenocarcinoma who had undergone gastrectomy 1 week after contrast-enhanced multidetector computed tomography were retrospectively identified. The gross tumor volume was evaluated on multidetector comp...

  16. Tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography: association with N categories

    OpenAIRE

    Hang Li; Xiao-li Chen; Jun-ru Li; Zhen-lin Li; Tian-wu Chen; Hong Pu; Long-lin Yin; Guo-hui Xu; Zhen-wen Li; Jing Reng; Peng Zhou; Zhu-zhong Cheng; Ying Cao

    2016-01-01

    OBJECTIVE: To determine whether the gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict the presence of regional lymph node metastasis and could determine N categories. MATERIALS AND METHODS: A total of 202 consecutive patients with gastric adenocarcinoma who had undergone gastrectomy 1 week after contrast-enhanced multidetector computed tomography were retrospectively identified. The gross tumor volume was evaluated on multidetector com...

  17. Cutting edge of endoscopic full-thickness resection for gastric tumor

    Institute of Scientific and Technical Information of China (English)

    Tadateru; Maehata; Osamu; Goto; Hiroya; Takeuchi; Yuko; Kitagawa; Naohisa; Yahagi

    2015-01-01

    Recently,several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors,such as gastrointestinal stromal tumors,gastric carcinoid tumors,and early gastric cancer(EGC). These techniques have the advantage of allowing precise resection lines to be determined using intraluminal endoscopy. Thus,it is possible to minimize the resection area and subsequent deformity. Some of these methods include:(1) classical laparoscopic and endoscopic cooperative surgery(LECS);(2) inverted LECS;(3) combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique; and(4) non-exposed endoscopic wall-inversion surgery. Furthermore,a recent prospective multicenter trial of the sentinel node navigation surgery(SNNS) for EGC has shown acceptable results in terms of sentinel node detection rate and the accuracy of nodal metastasis. Endoscopic full-thickness resection with SNNS is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for EGC. In the future,the indications for these procedures for gastric tumors could be expanded.

  18. Differentiating benign from malignant bone tumors using fluid-fluid level features on magnetic resonance imaging

    International Nuclear Information System (INIS)

    To analyze different fluid-fluid level features between benign and malignant bone tumors on magnetic resonance imaging (MRI). This study was approved by the hospital ethics committee. We retrospectively analyzed 47 patients diagnosed with benign (n = 29) or malignant (n = 18) bone tumors demonstrated by biopsy/surgical resection and who showed the intratumoral fluid-fluid level on pre-surgical MRI. The maximum length of the largest fluid-fluid level and the ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane were investigated for use in distinguishing benign from malignant tumors using the Mann-Whitney U-test and a receiver operating characteristic (ROC) analysis. Fluid-fluid level was categorized by quantity (multiple vs. single fluid-fluid level) and by T1-weighted image signal pattern (high/low, low/high, and undifferentiated), and the findings were compared between the benign and malignant groups using the chi2 test. The ratio of the maximum length of the largest fluid-fluid level to the maximum length of bone tumors in the sagittal plane that allowed statistically significant differentiation between benign and malignant bone tumors had an area under the ROC curve of 0.758 (95% confidence interval, 0.616-0.899). A cutoff value of 41.5% (higher value suggests a benign tumor) had sensitivity of 73% and specificity of 83%. The ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane may be useful to differentiate benign from malignant bone tumors.

  19. Differentiating benign from malignant bone tumors using fluid-fluid level features on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Hong; Cui, Jian Ling; Cui, Sheng Jie; Sun, Ying Cal; Cui, Feng Zhen [Dept. of Radiology, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics, Shijiazhuang, Hebei (China)

    2014-12-15

    To analyze different fluid-fluid level features between benign and malignant bone tumors on magnetic resonance imaging (MRI). This study was approved by the hospital ethics committee. We retrospectively analyzed 47 patients diagnosed with benign (n = 29) or malignant (n = 18) bone tumors demonstrated by biopsy/surgical resection and who showed the intratumoral fluid-fluid level on pre-surgical MRI. The maximum length of the largest fluid-fluid level and the ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane were investigated for use in distinguishing benign from malignant tumors using the Mann-Whitney U-test and a receiver operating characteristic (ROC) analysis. Fluid-fluid level was categorized by quantity (multiple vs. single fluid-fluid level) and by T1-weighted image signal pattern (high/low, low/high, and undifferentiated), and the findings were compared between the benign and malignant groups using the chi2 test. The ratio of the maximum length of the largest fluid-fluid level to the maximum length of bone tumors in the sagittal plane that allowed statistically significant differentiation between benign and malignant bone tumors had an area under the ROC curve of 0.758 (95% confidence interval, 0.616-0.899). A cutoff value of 41.5% (higher value suggests a benign tumor) had sensitivity of 73% and specificity of 83%. The ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane may be useful to differentiate benign from malignant bone tumors.

  20. Neoadjuvant Chemotherapy in Locally Advanced and Borderline Resectable Nonsquamous Sinonasal Tumors (Esthesioneuroblastoma and Sinonasal Tumor with Neuroendocrine Differentiation

    Directory of Open Access Journals (Sweden)

    Vijay M. Patil

    2016-01-01

    Full Text Available Introduction. Sinonasal tumors are chemotherapy responsive which frequently present in advanced stages making NACT a promising option for improving resection and local control in borderline resectable and locally advanced tumours. Here we reviewed the results of 25 such cases treated with NACT. Materials and Methods. Sinonasal tumor patients treated with NACT were selected for this analysis. These patients received NACT with platinum and etoposide for 2 cycles. Patients who responded and were amenable for gross total resection underwent surgical resection and adjuvant CTRT. Those who responded but were not amenable for resection received radical CTRT. Patients who progressed on NACT received either radical CTRT or palliative radiotherapy. Results. The median age of the cohort was 42 years (IQR 37–47 years. Grades 3-4 toxicity with NACT were seen in 19 patients (76%. The response rate to NACT was 80%. Post-NACT surgery was done in 12 (48% patients and radical chemoradiation in 9 (36% patients. The 2-year progression free survival and overall survival were 75% and 78.5%, respectively. Conclusion. NACT in sinonasal tumours has a response rate of 80%. The protocol of NACT followed by local treatment is associated with improvement in outcomes as compared to our historical cohort.

  1. Giant cell tumor of bone: current review of morphological, clinical, radiological, and therapeutic characteristics

    Directory of Open Access Journals (Sweden)

    Georgi P. Georgiev

    2014-09-01

    Full Text Available Giant cell tumor of bone accounts for about 5% of all primary bone tumors in adults and is still one of the most obscure and intensively examined tumors of bone. This largely results from the lack of uniform clinical, radiographic, histological or morphological aspects that allow prediction of recurrence. Classified by the World Health Organization as “an aggressive, potentially malignant lesion”, the giant cell tumor of bone could give lung metastases, could undergo malignant degeneration or could have multicentric localization. It usually develops in long bones but can also occur in unusual locations. The common presenting symptom is increasing pain at the tumor site. Standard treatment ranges from curettage to wide resection, with reports of varying oncological and functional results. The recurrence rate is high during the first 2-3 years after surgery regardless of pre-operative tumor stage. Herein, we discuss the morphological, clinical, radiological, and therapeutic characteristics of this pathologic entity as well as its differential diagnosis. J Clin Exp Invest 2014; 5 (3: 475-485

  2. Can Bone Tissue Engineering Contribute to Therapy Concepts after Resection of Musculoskeletal Sarcoma?

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    Boris Michael Holzapfel

    2013-01-01

    Full Text Available Resection of musculoskeletal sarcoma can result in large bone defects where regeneration is needed in a quantity far beyond the normal potential of self-healing. In many cases, these defects exhibit a limited intrinsic regenerative potential due to an adjuvant therapeutic regimen, seroma, or infection. Therefore, reconstruction of these defects is still one of the most demanding procedures in orthopaedic surgery. The constraints of common treatment strategies have triggered a need for new therapeutic concepts to design and engineer unparalleled structural and functioning bone grafts. To satisfy the need for long-term repair and good clinical outcome, a paradigm shift is needed from methods to replace tissues with inert medical devices to more biological approaches that focus on the repair and reconstruction of tissue structure and function. It is within this context that the field of bone tissue engineering can offer solutions to be implemented into surgical therapy concepts after resection of bone and soft tissue sarcoma. In this paper we will discuss the implementation of tissue engineering concepts into the clinical field of orthopaedic oncology.

  3. Analysis of Complications after Reconstruction of Bone Defects Involving Complete Mandibular Resection Using Finite Element Modelling

    OpenAIRE

    Markwardt, Jutta; Pfeifer, Günther; Eckelt, Uwe; Reitemeier, Bernd

    2014-01-01

    Background: In a retrospective study, risk factors for complications after the bridging of mandibular defects using reconstruction plates were reviewed. Especially the loosening of the plate-screw-mandible complex should be analyzed with a finite element model in order to reduce plate complications in future. Patients and Methods: We examined 60 patients who underwent a treatment with reconstruction plates after tumor resection during a period of 10 years. The problem of screw loosening was a...

  4. Definition of Microscopic Tumor Clearance (R0) in Pancreatic Cancer Resections

    International Nuclear Information System (INIS)

    To date, curative resection is the only chance for cure for patients suffering from pancreatic ductal adenoacarcinoma (PDAC). Despite low reported rates of microscopic tumor infiltration (R1) in most studies, tumor recurrence is a common finding in patients with PDAC and contributes to extremely low long-term survival rates. Lack of international definition of resection margins and of standardized protocols for pathological examination lead to high variation in reported R1 rates. Here we review recent studies supporting the hypothesis that R1 rates are highly underestimated in certain studies and that a microscopic tumor clearance of at least 1 mm is required to confirm radicality and to serve as a reliable prognostic and predictive factor

  5. Definition of Microscopic Tumor Clearance (R0) in Pancreatic Cancer Resections

    Energy Technology Data Exchange (ETDEWEB)

    Schlitter, Anna Melissa [Institute of Pathology, Technische Universität München, Ismaningerstr. 22, 81675 Munich (Germany); Esposito, Irene, E-mail: Esposito@lrz.tum.de [Institute of Pathology, Technische Universität München, Ismaningerstr. 22, 81675 Munich (Germany); Institute of Pathology, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764 Neuherberg (Germany)

    2010-11-25

    To date, curative resection is the only chance for cure for patients suffering from pancreatic ductal adenoacarcinoma (PDAC). Despite low reported rates of microscopic tumor infiltration (R1) in most studies, tumor recurrence is a common finding in patients with PDAC and contributes to extremely low long-term survival rates. Lack of international definition of resection margins and of standardized protocols for pathological examination lead to high variation in reported R1 rates. Here we review recent studies supporting the hypothesis that R1 rates are highly underestimated in certain studies and that a microscopic tumor clearance of at least 1 mm is required to confirm radicality and to serve as a reliable prognostic and predictive factor.

  6. The Role of Hedgehog Signaling in Tumor Induced Bone Disease

    International Nuclear Information System (INIS)

    Despite significant progress in cancer treatments, tumor induced bone disease continues to cause significant morbidities. While tumors show distinct mutations and clinical characteristics, they behave similarly once they establish in bone. Tumors can metastasize to bone from distant sites (breast, prostate, lung), directly invade into bone (head and neck) or originate from the bone (melanoma, chondrosarcoma) where they cause pain, fractures, hypercalcemia, and ultimately, poor prognoses and outcomes. Tumors in bone secrete factors (interleukins and parathyroid hormone-related protein) that induce RANKL expression from osteoblasts, causing an increase in osteoclast mediated bone resorption. While the mechanisms involved varies slightly between tumor types, many tumors display an increase in Hedgehog signaling components that lead to increased tumor growth, therapy failure, and metastasis. The work of multiple laboratories has detailed Hh signaling in several tumor types and revealed that tumor establishment in bone can be controlled by both canonical and non-canonical Hh signaling in a cell type specific manner. This review will explore the role of Hh signaling in the modulation of tumor induced bone disease, and will shed insight into possible therapeutic interventions for blocking Hh signaling in these tumors

  7. The Role of Hedgehog Signaling in Tumor Induced Bone Disease

    Energy Technology Data Exchange (ETDEWEB)

    Cannonier, Shellese A.; Sterling, Julie A., E-mail: Julie.sterling@vanderbilt.edu [Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37235 (United States); Vanderbilt Center for Bone Biology, Department of Medicine, Division of Clinical Pharmacology Vanderbilt University, Nashville, TN 372335 (United States); Department of Cancer Biology, Vanderbilt University, Nashville, TN 37235 (United States)

    2015-08-26

    Despite significant progress in cancer treatments, tumor induced bone disease continues to cause significant morbidities. While tumors show distinct mutations and clinical characteristics, they behave similarly once they establish in bone. Tumors can metastasize to bone from distant sites (breast, prostate, lung), directly invade into bone (head and neck) or originate from the bone (melanoma, chondrosarcoma) where they cause pain, fractures, hypercalcemia, and ultimately, poor prognoses and outcomes. Tumors in bone secrete factors (interleukins and parathyroid hormone-related protein) that induce RANKL expression from osteoblasts, causing an increase in osteoclast mediated bone resorption. While the mechanisms involved varies slightly between tumor types, many tumors display an increase in Hedgehog signaling components that lead to increased tumor growth, therapy failure, and metastasis. The work of multiple laboratories has detailed Hh signaling in several tumor types and revealed that tumor establishment in bone can be controlled by both canonical and non-canonical Hh signaling in a cell type specific manner. This review will explore the role of Hh signaling in the modulation of tumor induced bone disease, and will shed insight into possible therapeutic interventions for blocking Hh signaling in these tumors.

  8. Biochemical parameters of bone metabolism in bone metastases of solid tumors (Review)

    NARCIS (Netherlands)

    Meijer, Wilhelmus; van der Veer, E; Willemse, P H

    1998-01-01

    The role of biochemical markers of bone metabolism in the diagnosis and monitoring of bone metastases in solid tumors is reviewed. Emphasis is on the recently developed markers, which may provide a more accurate quantitation of bone metabolism. In metastatic bone disease, bone formation and resorpti

  9. Detectability of metastatic bone tumor by Ga-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Koizumi, Kiyoshi; Uchiyama, Guio; Araki, Tsutomu; Hihara, Toshihiko; Ogata, Hitoshi; Monzawa, Shuichi; Kachi, Kenji; Matsusako, Masaki

    1989-03-01

    Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake, only 7 (10%) mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

  10. Current diagnostic approach of bone tumors in childhood

    International Nuclear Information System (INIS)

    The authors analyze the magnetic resonance imaging (MRI) as the imaging modality of choice for evaluation of patients with bone tumors or soft tissue tumors. The advent of such a sensitive imaging modality is fortuitous and coincides with a recent change in the therapeutic approach to primary bone tumors. MRI is extremely valuable in monitoring the tumor response to the initial chemotherapy and is accurate defining the margins of tumor, facilitating planning of limb salvage surgical procedures. (author). 5 refs., 8 figs

  11. Bone-metastasizing primary renal tumors in children

    International Nuclear Information System (INIS)

    Seven cases of childhood renal tumor with extensive bone involvement are reported. These neoplasms had been classified originally as wills tumors with atypical clinical and pathologic features. Subsequent to a retrospective histologic analysis, the lesions were reclassified as follows: three cases as bone-metastasizing renal tumors of childhood, one as rhabdomyosarcoma, two as indifferentiated Sarcomas and one case as indifferentiated malignant neoplasm. (Author)

  12. Laparoscopic resection of tumor recurrence after radical nephrectomy for localized renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Lessandro Curcio

    2014-06-01

    Full Text Available Introduction Local recurrence of Renal Cell Carcinoma (RCC after radical nephrectomy is a rare event. Some known risk factors are: clinical/pathological stage, locorregional disease and lyimph node positivity. Since up to 30-40% of patients can achieve a disease-free status, we show a case (video in which we performed a laparoscopic excision of a local RCC, taking advantage of all the well-known benefits of laparoscopy.Case report A 56 years old female with a history of open radical nephrectomy two years before was diagnosed with a mass at the time of surveillance CT imaging during follow-up. The suspected local recurrence was 12cm, and vascularized predominantly by tributaries originating from the iliac vessels. There was no other site of disease (i.e. brain, lung, liver, bones and laboratory tests were normal. Laparoscopic approach was approached, by inserting 4 trocars (2 of 10 and 2 of 5mm with the patient in the lateral position.Result The procedure lasted 130 minutes, with 220mL of estimated bleeding; the larger vessels were ligated with polymer clips (Hem-o-lok and the smaller handled by ultrasonic clamp. The specimen was removed by a small incision below the umbilicus in an appropriate bag. The patient was feed in the first postoperative day and discharged on the third day. Histopathology revealed sarcoma, with a high degree of mitosis, and negative surgical margins. She was referred to medical oncology for adjuvant therapy consideration.Conclusion The laparoscopic resection of recurrent tumor should be encouraged in highly selected cases. The minimally invasive method, with its known advantages, especially for more debilitated patients, can be advantageous when applied to suitable cases.

  13. Resection of Posterior Mediastinal Tumors by Video Assisted Thoracic Surgery.

    Science.gov (United States)

    Ali, Taimur Asif; Fatimi, Saulat Hasnain; Naeem, Syed Saad

    2015-07-01

    This case report illustrates successful Video Assisted Thoracic Surgery (VATS) performed on a 45-year-old woman and 52-year-old man presenting with a mass in left and right paravertebral space on the CT scan respectively. VATS has many benefits over traditional open operation (thoracotomy), resulting in less pain and shorten recovery time. However, VATS has higher equipment cost but when an experienced surgeon performs the surgery, better outcomes are achieved. VATS is not common in Pakistan's surgical setup as it is an expensive method of eradicating mediastinal pathologies and not every patient undergoes VATS. The primary objective of presenting these cases is to promote the use of VATS specifically for removal of posterior mediastinal tumors and improve the surgical outcomes. PMID:26208561

  14. Imaging appearance of bone tumors of the maxillofacial region

    OpenAIRE

    Razek, Ahmed Abdel Khalek Abdel

    2011-01-01

    This paper reviews the imaging appearance of benign and malignant bone tumors of the maxillofacial region. A benign bone tumor commonly appears as a well circumscribed lesion. The matrix of the tumor may be calcified or sclerotic. Malignancies often display aggressive characteristics such as cortical breakthrough, bone destruction, a permeative pattern and associated soft-tissue masses. Computed tomography scan is an excellent imaging modality for accurate localization of the lesion, characte...

  15. Resected Pancreatic Neuroendocrine Tumors: Patterns of Failure and Disease-Related Outcomes With or Without Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: Pancreatic neuroendocrine tumors (NET) are rare and have better disease-related outcomes compared with pancreatic adenocarcinoma. Surgical resection remains the standard of care, although many patients present with locally advanced or metastatic disease. Little is known regarding the use of radiotherapy in the prevention of local recurrence after resection. To better define the role of radiotherapy, we performed an analysis of resected patients at our institution. Methods: Between 1994 and 2009, 33 patients with NET of the pancreatic head and neck underwent treatment with curative intent at Duke University Medical Center. Sixteen patients were treated with surgical resection alone while an additional 17 underwent resection with adjuvant or neoadjuvant radiation therapy, usually with concurrent fluoropyrimidine-based chemotherapy (CMT). Median radiation dose was 50.4 Gy and median follow-up 28 months. Results: Thirteen patients (39%) experienced treatment failure. Eleven of the initial failures were distant, one was local only and one was local and distant. Two-year overall survival was 77% for all patients. Two-year local control for all patients was 87%: 85% for the CMT group and 90% for the surgery alone group (p = 0.38). Two-year distant metastasis-free survival was 56% for all patients: 46% and 69% for the CMT and surgery patients, respectively (p = 0.10). Conclusions: The primary mode of failure is distant which often results in mortality, with local failure occurring much less commonly. The role of radiotherapy in the adjuvant management of NET remains unclear.

  16. Resected Pancreatic Neuroendocrine Tumors: Patterns of Failure and Disease-Related Outcomes With or Without Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zagar, Timothy M. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC (United States); White, Rebekah R. [Department of Surgery, Duke University Medical Center, Durham, NC (United States); Willett, Christopher G. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Tyler, Douglas S. [Department of Surgery, Duke University Medical Center, Durham, NC (United States); Papavassiliou, Paulie [Department of Pathology, Duke University Medical Center, Durham, NC (United States); Papalezova, Katia T. [Department of Surgery, Duke University Medical Center, Durham, NC (United States); Guy, Cynthia D. [Department of Pathology, Duke University Medical Center, Durham, NC (United States); Broadwater, Gloria [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC (United States); Clough, Robert W. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Czito, Brian G., E-mail: czito001@mc.duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)

    2012-07-15

    Purpose: Pancreatic neuroendocrine tumors (NET) are rare and have better disease-related outcomes compared with pancreatic adenocarcinoma. Surgical resection remains the standard of care, although many patients present with locally advanced or metastatic disease. Little is known regarding the use of radiotherapy in the prevention of local recurrence after resection. To better define the role of radiotherapy, we performed an analysis of resected patients at our institution. Methods: Between 1994 and 2009, 33 patients with NET of the pancreatic head and neck underwent treatment with curative intent at Duke University Medical Center. Sixteen patients were treated with surgical resection alone while an additional 17 underwent resection with adjuvant or neoadjuvant radiation therapy, usually with concurrent fluoropyrimidine-based chemotherapy (CMT). Median radiation dose was 50.4 Gy and median follow-up 28 months. Results: Thirteen patients (39%) experienced treatment failure. Eleven of the initial failures were distant, one was local only and one was local and distant. Two-year overall survival was 77% for all patients. Two-year local control for all patients was 87%: 85% for the CMT group and 90% for the surgery alone group (p = 0.38). Two-year distant metastasis-free survival was 56% for all patients: 46% and 69% for the CMT and surgery patients, respectively (p = 0.10). Conclusions: The primary mode of failure is distant which often results in mortality, with local failure occurring much less commonly. The role of radiotherapy in the adjuvant management of NET remains unclear.

  17. A novel role of the tumor size in pancreatic cancer as an ancillary factor for predicting resectability

    Directory of Open Access Journals (Sweden)

    Kun-Chun Chiang

    2014-01-01

    Results: The tumor size in unresectable groups is significantly larger than that in the resectable group. The area under the ROC curve was 0.73 (95% confidence interval [CI], 0.665-0.789, which represented a good correlation between the tumor size and pancreatic cancer resectability. The PCA patients with a tumor diameter of > 4.8 cm had a 5.043-fold higher chance of unresectability than did those with a tumor diameter 4.8 cm is a potential ancillary parameter for determining the resectability of PCA in addition to traditional image studies. Diagnosis laparoscopy may be indicated for radiologically resectable PCA patients with tumor size > 4.8 cm to prevent unnecessary laparotomy.

  18. Prognostic factors of tumor recurrence in completely resected non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Tantraworasin A

    2013-06-01

    Full Text Available Apichat Tantraworasin,1 Somcharean Seateang,1 Nirush Lertprasertsuke,2 Nuttapon Arreyakajohn,3 Choosak Kasemsarn,4 Jayanton Patumanond5 1General Thoracic Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand; 2Department of Pathology, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand; 3Cardiovascular Thoracic Unit, Department of Surgery, Lampang Hospital, Lampang, Thailand; 4Cardiovascular Thoracic Unit, Department of Surgery, Chest Institute, Nonthaburi, Thailand; 5Department of Community Medicine, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand Background: Patients with completely resected non-small cell lung cancer (NSCLC have an excellent outcome; however tumor recurs in 30%-77% of patients. This study retrospectively analyzed the clinicopathologic features of patients with any operable stage of NSCLC to identify the prognostic factors that influence tumor recurrence, including intratumoral blood vessel invasion (IVI, tumor size, tumor necrosis, and nodal involvement. Methods: From January 2002 to December 2011, 227 consecutive patients were enrolled in this study. They were divided into two groups: the “no recurrence” group and the “recurrence” group. Recurrence-free survival was analyzed by multivariable Cox regression analysis, stratified by tumor staging, chemotherapy, and lymphatic invasion. Results: IVI, tumor necrosis, tumor diameter more than 5 cm, and nodal involvement were identified as independent prognostic factors of tumor recurrence. The hazard ratio (HR of patients with IVI was 2.1 times higher than that of patients without IVI (95% confident interval [CI]: 1.4–3.2 (P = 0.001.The HR of patients with tumor necrosis was 2.1 times higher than that of patients without tumor necrosis (95% CI: 1.3–3.4 (P = 0.001. Patients who had a maximum tumor diameter greater than 5 cm had significantly higher risk of recurrence than

  19. Analysis of surgical complications of primary tumor resection after neoadjuvant treatment in stage IV colon cancer

    OpenAIRE

    J. Arredondo; Martinez, P; J. Baixauli; Pastor, C.; RODRIGUEZ J; Pardo, F.; F. Rotellar; Chopitea, A; Hernandez-Lizoain, J.L. (José Luis)

    2014-01-01

    Assess the surgical complications of primary tumor resection in stage IV colon cancer patients previously treated with neoadjuvant chemotherapy. METHODS: Between July 2001 and September 2010, 67 consecutive patients received preoperative chemotherapy. Clinical and surgical complications were obtained from the medical records. This study was retrospective in design. RESULTS: All patients were affected with liver metastasis, and 29.8% had metastasis in additional organs. Three dif...

  20. Resection of spinal column tumors utilizing image-guided navigation: a multicenter analysis.

    Science.gov (United States)

    Nasser, Rani; Drazin, Doniel; Nakhla, Jonathan; Al-Khouja, Lutfi; Brien, Earl; Baron, Eli M; Kim, Terrence T; Patrick Johnson, J; Yassari, Reza

    2016-08-01

    OBJECTIVE The use of intraoperative stereotactic navigation has become more available in spine surgery. The authors undertook this study to assess the utility of intraoperative CT navigation in the localization of spinal lesions and as an intraoperative tool to guide resection in patients with spinal lesions. METHODS This was a retrospective multicenter study including 50 patients from 2 different institutions who underwent biopsy and/or resection of spinal column tumors using image-guided navigation. Of the 50 cases reviewed, 4 illustrative cases are presented. In addition, the authors provide a description of surgical technique with image guidance. RESULTS The patient group included 27 male patients and 23 female patients. Their average age was 61 ± 17 years (range 14-87 years). The average operative time (incision to closure) was 311 ± 188 minutes (range 62-865 minutes). The average intraoperative blood loss was 882 ± 1194 ml (range 5-7000 ml). The average length of hospitalization was 10 ± 8.9 days (range 1-36 days). The postoperative complications included 2 deaths (4.0%) and 4 radiculopathies (8%) secondary to tumor burden. CONCLUSIONS O-arm 3D imaging with stereotactic navigation may be used to localize lesions intraoperatively with real-time dynamic feedback of tumor resection. Stereotactic guidance may augment resection or biopsy of primary and metastatic spinal tumors. It offers reduced radiation exposure to operating room personnel and the ability to use minimally invasive approaches that limit tissue injury. In addition, acquisition of intraoperative CT scans with real-time tracking allows for precise targeting of spinal lesions with minimal dissection. PMID:27476839

  1. En masse resection of pancreas, spleen, celiac axis, stomach, kidney, adrenal, and colon for invasive pancreatic corpus and tail tumor.

    Science.gov (United States)

    Kutluturk, Koray; Alam, Abdul Hamid; Kayaalp, Cuneyt; Otan, Emrah; Aydin, Cemalettin

    2013-01-01

    Providing a more comfortable life and a longer survival for pancreatic corpus/tail tumors without metastasis depends on the complete resection. Recently, distal pancreatectomy with celiac axis resection was reported as a feasible and favorable method in selected pancreatic corpus/tail tumors which had invaded the celiac axis. Additional organ resections to the celiac axis were rarely required, and when necessary it was included only a single extra organ resection such as adrenal or intestine. Here, we described a distal pancreatic tumor invading most of the neighboring organs-stomach, celiac axis, left renal vein, left adrenal gland, and splenic flexure were treated by en bloc resection of all these organs. The patient was a 60-year-old man without any severe medical comorbidities. Postoperative course of the patient was uneventful, and he was discharged on postoperative day eight without any complication. Histopathology and stage of the tumor were adenocarcinoma and T4 N1 M0, respectively. Preoperative back pain of the patient was completely relieved in the postoperative period. As a result, celiac axis resection for pancreatic cancer is an extensive surgery, and a combined en masse resection of the invaded neighboring organs is a more extensive surgery than the celiac axis resection alone. This more extensive surgery is safe and feasible for selected patients with pancreatic cancer. PMID:24159408

  2. En Masse Resection of Pancreas, Spleen, Celiac Axis, Stomach, Kidney, Adrenal, and Colon for Invasive Pancreatic Corpus and Tail Tumor

    Directory of Open Access Journals (Sweden)

    Koray Kutluturk

    2013-01-01

    Full Text Available Providing a more comfortable life and a longer survival for pancreatic corpus/tail tumors without metastasis depends on the complete resection. Recently, distal pancreatectomy with celiac axis resection was reported as a feasible and favorable method in selected pancreatic corpus/tail tumors which had invaded the celiac axis. Additional organ resections to the celiac axis were rarely required, and when necessary it was included only a single extra organ resection such as adrenal or intestine. Here, we described a distal pancreatic tumor invading most of the neighboring organs—stomach, celiac axis, left renal vein, left adrenal gland, and splenic flexure were treated by en bloc resection of all these organs. The patient was a 60-year-old man without any severe medical comorbidities. Postoperative course of the patient was uneventful, and he was discharged on postoperative day eight without any complication. Histopathology and stage of the tumor were adenocarcinoma and T4 N1 M0, respectively. Preoperative back pain of the patient was completely relieved in the postoperative period. As a result, celiac axis resection for pancreatic cancer is an extensive surgery, and a combined en masse resection of the invaded neighboring organs is a more extensive surgery than the celiac axis resection alone. This more extensive surgery is safe and feasible for selected patients with pancreatic cancer.

  3. Intraoperative Transcranial Motor-Evoked Potential Monitoring of the Facial Nerve during Cerebellopontine Angle Tumor Resection.

    Science.gov (United States)

    Cosetti, Maura K; Xu, Ming; Rivera, Andrew; Jethanamest, Daniel; Kuhn, Maggie A; Beric, Aleksandar; Golfinos, John G; Roland, J Thomas

    2012-10-01

    Objective To determine whether transcranial motor-evoked potential (TCMEP) monitoring of the facial nerve (FN) during cerebellopontine angle (CPA) tumor resection can predict both immediate and long-term postoperative FN function. Design Retrospective review. Setting Tertiary referral center. Main Outcome Measures DeltaTCMEP (final-initial) and immediate and long-term facial nerve function using House Brackmann (HB) rating scale. Results Intraoperative TCMEP data and immediate and follow-up FN outcome are reported for 52 patients undergoing CPA tumor resection. Patients with unsatisfactory facial outcome (HB >2) at follow-up had an average deltaTCMEP of 57 V, whereas those with HB I or II had a mean deltaTCMEP of 0.04 V (t = -2.6, p  2) facial function in the immediate postoperative period. Conclusion Intraoperative TCMEP of the facial nerve can be a valuable adjunct to conventional facial nerve electromyography during resection of tumors at the CPA. Intraoperative deltaTCMEP >57 V may be worrisome for long-term recovery of satisfactory facial nerve function. PMID:24083121

  4. Resection of large recurrent third ventricular epidermoid tumors through the posterior interhemispheric transcallosal approach.

    Science.gov (United States)

    Hendricks, Benjamin K; Cohen-Gadol, Aaron A

    2016-01-01

    Epidermoid cysts or tumors comprise 1% of intracranial tumors with a predilection for the cerebellopontine angle or parasellar cisterns. These tumors are derived from an ectopic ectodermal implant seeded between fusing ectodermal surfaces. This results in a benign proliferation of stratified squamous epithelium along a cyst wall with a lumen composed of hyperkeratotic material derived from the desquamating cells. Surgical intervention is the treatment of choice for symptomatic patients. There is no role for radiotherapy or chemotherapy in the treatment of these lesions, including for residual or recurrent disease. The inherent adhesion of the proliferating epithelial lining to surrounding neurovascular structures significantly complicates attempts at gross-total resection. Epidermoid tumors or cysts are rarely reported within the third ventricular region. In this video, the authors demonstrate the technique of right-sided posterior interhemispheric transcallosal approach for maximal resection of a complex recurrent third ventricular epidermoid tumor with lateral ventricular extension. The video can be found here: https://youtu.be/wbXp7mc0vT4 . PMID:26722690

  5. Parosteal osteoliposarcoma: A new bone tumor (from imaging to immunophenotype)

    Energy Technology Data Exchange (ETDEWEB)

    Larousserie, F. [Université Paris Descartes, Sorbonne Paris Cité, Paris (France); Department of Pathology, Rizzoli Institute, Bologna (Italy); Chen, X. [Department of Orthopaedic Oncology Surgery, Beijing Jishuitan hospital, Beijing (China); Ding, Y. [Department of pathology, Beijing Jishuitan hospital, Beijing (China); Kreshak, J.; Cocchi, S. [Department of Pathology, Rizzoli Institute, Bologna (Italy); Huang, Xiaoyuan [Department of pathology, Beijing Jishuitan hospital, Beijing (China); Niu, Xiaohui, E-mail: niuxiaohui@263.net [Department of Orthopaedic Oncology Surgery, Beijing Jishuitan hospital, Beijing (China); Alberghini, M.; Vanel, D. [Department of Pathology, Rizzoli Institute, Bologna (Italy)

    2013-12-01

    Introduction: Parosteal osteosarcomas and well-differentiated liposarcomas (WDLPS) of soft tissue share several features: they are slowly progressive, locally aggressive tumors, tend to recur locally, and rarely or never metastasizes if not dedifferentiated. Their treatment is wide surgical resection. Microscopically, both are well differentiated tumors, very like their normal tissue counterpart. They share simple karyotypes with supernumerary ring chromosomes or giant marker chromosomes containing amplified 12q sequences including MDM2 and CDK4 genes, with subsequent overexpression of MDM2 and CDK4 proteins. We present the case of a parosteal osteoliposarcoma made of closely intermingled components of a low-grade osteosarcoma and a WDLPS. Case: In a 34 year-old woman with a slowly growing mass of the arm, imaging revealed a large well-defined heterogeneous parosteal mass of the upper humerus, with two main components: bone at the base and fat at the periphery. Microscopically, these two components were consistent respectively with low grade osteosarcoma and WDLPS. Cells of the two components were labeled with anti-CDK4 antibody. No labeling with anti-MDM2 antibody and no signal detected with MDM2 FISH analysis were likely due overdecalcification. No frozen tumor tissue was available for FISH analysis nor array-CGH. Discussion: Differential diagnoses of this new entity would be a well-differentiated liposarcoma with a low-grade osteosarcomatous component that originates from the soft tissues, ruled out on imaging, and an ossifying parosteal lipoma, ruled out on immunohistochemistry. Conclusion: This is the first description of a low-grade parosteal sarcoma with two components that morphologically and immunophenotypically demonstrate characteristics of a parosteal osteosarcoma and of a well-differentiated liposarcoma.

  6. Parosteal osteoliposarcoma: A new bone tumor (from imaging to immunophenotype)

    International Nuclear Information System (INIS)

    Introduction: Parosteal osteosarcomas and well-differentiated liposarcomas (WDLPS) of soft tissue share several features: they are slowly progressive, locally aggressive tumors, tend to recur locally, and rarely or never metastasizes if not dedifferentiated. Their treatment is wide surgical resection. Microscopically, both are well differentiated tumors, very like their normal tissue counterpart. They share simple karyotypes with supernumerary ring chromosomes or giant marker chromosomes containing amplified 12q sequences including MDM2 and CDK4 genes, with subsequent overexpression of MDM2 and CDK4 proteins. We present the case of a parosteal osteoliposarcoma made of closely intermingled components of a low-grade osteosarcoma and a WDLPS. Case: In a 34 year-old woman with a slowly growing mass of the arm, imaging revealed a large well-defined heterogeneous parosteal mass of the upper humerus, with two main components: bone at the base and fat at the periphery. Microscopically, these two components were consistent respectively with low grade osteosarcoma and WDLPS. Cells of the two components were labeled with anti-CDK4 antibody. No labeling with anti-MDM2 antibody and no signal detected with MDM2 FISH analysis were likely due overdecalcification. No frozen tumor tissue was available for FISH analysis nor array-CGH. Discussion: Differential diagnoses of this new entity would be a well-differentiated liposarcoma with a low-grade osteosarcomatous component that originates from the soft tissues, ruled out on imaging, and an ossifying parosteal lipoma, ruled out on immunohistochemistry. Conclusion: This is the first description of a low-grade parosteal sarcoma with two components that morphologically and immunophenotypically demonstrate characteristics of a parosteal osteosarcoma and of a well-differentiated liposarcoma

  7. Effects of atorvastatin on plasma matrix metalloproteinase-9 concentration after glial tumor resection; a randomized, double blind, placebo controlled trial

    OpenAIRE

    Mohebbi, Niayesh; Khoshnevisan, Alireza; Naderi, Soheil; Abdollahzade, Sina; Salamzadeh, Jamshid; Javadi, Mohammadreza; Mojtahedzadeh, Mojtaba; GHOLAMI, KHEIROLLAH.

    2014-01-01

    Background Neurosurgical procedures such as craniotomy and brain tumor resection could potentially lead to unavoidable cerebral injuries. Matrix metalloproteinase-9 (MMP-9) is up-regulated in neurological injuries. Statins have been suggested to reduce MMP- 9 level and lead to neuroprotection. Atorvastatin preoperatively administered to evaluate its neuroprotective effects and outcome assessment in neurosurgical-induced brain injuries after glial tumor resection. In this prospective, randomiz...

  8. Surgical technique and clinical results for scapular allograft reconstruction following resection of scapular tumors

    Directory of Open Access Journals (Sweden)

    Xiang Zhou

    2009-04-01

    Full Text Available Abstract Background Progress in developing effective surgical techniques, such as scapular allograft reconstruction, enhance shoulder stability and extremity function, in patients following scapular tumor resection. Methods Case details from seven patients who underwent scapular allograft reconstruction following scapular tumor resection were reviewed. A wide marginal resection (partial scapulectomy was performed in all patients and all affected soft tissues were resected to achieve a clean surgical margin. The glenoid-resected and glenoid-saved reconstructions were performed in three and four patients, respectively. The residual host scapula were fixed to the size-matched scapular allografts with plates and screws. The rotator cuff was affected frequently and was mostly resected. The deltoid and articular capsule were infrequently involved, but reconstructed preferentially. The remaining muscles were reattached to the allografts. Results The median follow-up was 26 months (range, 14–50 months. The average function scores were 24 points (80% according to the International Society of Limb Salvage criteria. The range of active shoulder abduction and forward flexion motion were 40°–110° and 30°–90°, respectively. There was no difference between the glenoid-saved and glenoid-resected reconstructions in the total scores (mean, 24.5 points/81% versus 24 points/79%, but the glenoid-saved procedure was superior to the later in terms of abduction/flexion motion (mean, 72°/61° versus 55°/43°. During the study follow-up period, one patient died following a relapse, one patient lived despite of local recurrence, and five patients survived with no evidence of recurrence of the original cancer. Post-surgical complications such as shoulder dislocations, non-unions, and articular degeneration were not noted during this study period. Conclusion Scapular allograft reconstruction had a satisfactory functional, cosmetic, and oncological outcome in

  9. [Contemporary management of bone tumors at Semmelweis University].

    Science.gov (United States)

    Szendrői, Miklós; Antal, Imre; Kiss, János; Perlaky, Tamás; Szalay, Krisztián

    2014-06-01

    The incidence of bone tumors is low therefore it is highly recommended to treat patients in specialized centers. In the late 70ies a bone tumor registry was initiated at the Department of Orthopedics of the Semmelweis University followed by the development of a specialized diagnostic unit and a bone cancer center. Several novel surgical procedures have been introduced, including the extremity-sparing surgery, leading to a significant improvement of the patients survival. This is fully supported by a specialized bone cancer oncoteam of experts. The 6000-sized registry and biobank now allows the development of translational research in this orphan tumor type. PMID:25010756

  10. Current diagnostic approach of bone tumors in childhood; Abordagem diagnostica atual dos tumores osseos na infancia

    Energy Technology Data Exchange (ETDEWEB)

    Torre, Marcia Barbosa; Scatigno Neto, Andre [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    1995-09-01

    The authors analyze the magnetic resonance imaging (MRI) as the imaging modality of choice for evaluation of patients with bone tumors or soft tissue tumors. The advent of such a sensitive imaging modality is fortuitous and coincides with a recent change in the therapeutic approach to primary bone tumors. MRI is extremely valuable in monitoring the tumor response to the initial chemotherapy and is accurate defining the margins of tumor, facilitating planning of limb salvage surgical procedures. (author). 5 refs., 8 figs.

  11. The Bone Microenvironment: a Fertile Soil for Tumor Growth.

    Science.gov (United States)

    Buenrostro, Denise; Mulcrone, Patrick L; Owens, Philip; Sterling, Julie A

    2016-08-01

    Bone metastatic disease remains a significant and frequent problem for cancer patients that can lead to increased morbidity and mortality. Unfortunately, despite decades of research, bone metastases remain incurable. Current studies have demonstrated that many properties and cell types within the bone and bone marrow microenvironment contribute to tumor-induced bone disease. Furthermore, they have pointed to the importance of understanding how tumor cells interact with their microenvironment in order to help improve both the development of new therapeutics and the prediction of response to therapy. PMID:27255469

  12. Vascularized fibula grafts for reconstruction of bone defects after resection of bone sarcomas

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen; Rechnitzer, Catherine; Daugaard, Søren; Muhic, Aida

    2010-01-01

    /3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing...

  13. Development of combining bone scintigraphy and tumor markers in the diagnosis of bone metastases

    International Nuclear Information System (INIS)

    Bone is one of the most common metastatic sites for advanced cancers. The skeletal-related events caused by bone metastases could have a significant influence on patient's clinical outcome and quality of life. Currently, bone scintigraphy is the first choice for detecting bone metastases. Although the sensitivity is high, the specificity of bone scintigraphy is still very low. It has been reported that by combining bone scintigraphy and tumor markers, the specificity can be significantly increased. Meantime, the sensitivity and accuracy of bone scintigraphy in diagnosis of bone metastases can be improved. We reviewed the literatures in the recent years to evaluate the potential value of combination with bone scintigraphy and tumor markers in the diagnoses of bone metastases. (authors)

  14. BONE TUMOR ENVIRONMENT AS POTENTIAL THERAPEUTIC TARGET IN EWING SARCOMA

    Directory of Open Access Journals (Sweden)

    Françoise eREDINI

    2015-12-01

    Full Text Available Ewing sarcoma is the second most common pediatric bone tumor, with three cases per million worldwide. In clinical terms, ES is an aggressive, rapidly fatal malignancy that mainly develops in osseous sites (85%, but also in extraskeletal soft tissue. It spreads naturally to the lungs, bones and bone marrow with poor prognosis in the two latter cases. Bone lesions from primary or secondary (metastases tumors are characterized by extensive bone remodeling, more often due to osteolysis. Osteoclast activation and subsequent bone resorption is responsible for the clinical features of bone tumors including pain, vertebral collapse and spinal cord compression. Based on the vicious cycle concept of tumor cells and bone resorbing cells, drugs which target osteoclasts may be promising agents as adjuvant setting for treating bone tumors, including Ewing sarcoma. There is also increasing evidence that cellular and molecular protagonists present in the bone microenvironment play a part in establishing a favorable niche for tumor initiation and progression. The purpose of this review is to discuss the potential therapeutic value of drugs targeting the bone tumor microenvironment in Ewing Sarcoma. The first part of the review will focus on targeting the bone resorbing function of osteoclasts by means of bisphosphonates (BPs or drugs blocking the pro-resorbing cytokine Receptor Activator of NF-kappa B Ligand (RANKL. Second, the role of this peculiar hypoxic microenvironment will be discussed in the context of resistance to chemotherapy, escape from the immune system, or neo-angiogenesis. Therapeutic interventions based on these specificities could be then proposed in the context of Ewing sarcoma.

  15. The role of adjuvant radiotherapy in the treatment of resectable desmoid tumors

    International Nuclear Information System (INIS)

    Purpose/Objective: Desmoid tumors have a high propensity for local recurrence with surgical resection. There are many reports describing good responses of desmoid tumors to irradiation, but none have clearly proven the indications for adjuvant radiotherapy in treating resectable desmoid tumors. Materials and Methods: A retrospective analysis was performed on 61 patients with resectable desmoid tumors who were treated at our institution from 1965 to 1992. Fifty-six patients had unifocal disease, of which 34 had positive surgical margins. Forty-five were treated with surgery alone, while 11 received surgery plus adjuvant radiotherapy. Median follow-up was 6 years. Local control was measured from the last day of treatment, and all cases were reviewed by our Department of Pathology. Results: Univariate analysis of 56 patients with unifocal disease revealed that female gender (p=0.025) and positive margins (p=0.032) predicted for local recurrence. Multivariate analysis revealed that only positive margins (p=0.003) independently predicted for local recurrence. Only 3 of 22 patients had local recurrences with clear margins, with a 6 year actuarial local control of 85%. We analyzed 34 patients with positive margins by univariate analysis, and only adjuvant radiotherapy predicted for improved local control (p=0.031). Multivariate analysis of these 34 patients revealed that adjuvant radiotherapy independently predicted for local control (p=0.012), and patients with recurrent disease had a slightly higher risk of local recurrence (p=0.083). The 6 year actuarial local control determined by Kaplan-Meier for patients with unifocal disease and positive margins was 32%(±12%) with surgery alone, and 78%(±14%) with surgery plus adjuvant radiotherapy (p=0.019). None of the patients who received radiotherapy for unifocal disease developed serious complications, or a secondary malignancy. Conclusions: Adjuvant radiotherapy is indicated in the treatment of patients with resectable

  16. Benign bone tumors and tumor-like lesions: value of cross-sectional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Woertler, Klaus [Department of Radiology, Technische Universitaet Muenchen, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675, Munich (Germany)

    2003-08-01

    This article reviews the role of CT and MR imaging in the diagnosis of benign bone tumors and tumor-like lesions of bone with with regard to differential diagnosis, the assessment of tumor-related complications, and the detection of postoperative recurrence. Indications for cross-sectional imaging of specific lesions, including osteoid osteoma, osteoblastoma, enchondroma, osteochondroma, intraosseous lipoma, hemangioma, giant cell tumor, aneurysmal bone cyst, simple bone cyst, and eosinophilic granuloma, are discussed, and advantages and disadvantages of the different imaging modalities are illustrated on the basis of pathologically confirmed cases. (orig.)

  17. Desmoid tumor of bone with enchondromatous nodules, mistaken for chondrosarcoma

    International Nuclear Information System (INIS)

    Desmoid tumor of bone, also termed desmoplastic fibroma or aggressive fibromatosis, is a rare, locally aggressive fibroblastic tumor. We present a 16-year-old male with a huge desmoid tumor involving the iliac wing. It was associated with enchondromatous nodules mimicking malignancy. The tumor in this patient was mistaken for chondrosarcoma and hemipelvectomy was performed. To our knowledge, such a case has not previously been documented fully in the English literature. The radiographic and pathologic findings and a possible mechanism of enchondromatous nodule formation in fibrous bone tumors are discussed. (orig.)

  18. The imaging features of surrounding changes caused by bone tumors and tumor-like lesions

    International Nuclear Information System (INIS)

    Objective: To explore the imaging features of bone marrow edema (BME) and soft tissue edema (STE) caused by bone tumors and tumor-like lesions. Methods: Ninety nine patients with bone tumors and tumor-like lesions which were proved by surgical pathology were reviewed. The patients were divided into benign and malignant groups. Evaluation parameters included the size and signal intensity of BME and STE, the features of enhancement, the bone sclerosis and its relation with BME, and joint effusion, et al. The data of two groups were analyzed by χ2 test. Results: There were 40 patients in benign group and 59 patients belonged to malignant group. BME and STE demonstrated low signal on T1-weighted images and high signal on fat-suppressed T2-weighted images. Some BMEs demonstrated low signal on T2- weighted images, which corresponded to sclerosis on X-ray film and (or) CT. Both BME and STE demonstrated uniform enhancement. There were statistically significant differences between benign and malignant groups including the frequency of BME, sclerosis, the median of the size of the BME and STE (P0.05). Conclusions: Both benign bone tumors and tumor-like lesions and malignant bone tumors can be accompanied by BME and STE. The size of BME in the benign bone tumors and tumor-like lesions is bigger than those in malignant ones, and the size of STE in malignant bone tumors is bigger than benign ones. (authors)

  19. X-ray pathological-anatomical diagnosis of bone tumors

    International Nuclear Information System (INIS)

    The diagnosis of bone tumors is particularly difficult and requires specific knowledge and experience. This is done not only of clinical workers and X-ray specialists but also of pathologists, who are mostly unable to gather enough experience because those diseases are relatively rare. The specialities of the diagnosis of bone tumors are pointed out and the indispensable co-operation between the fields of work of clinical specialists, radiologists and pathologists is emphasized. Bone growths are classified according to the proposals of the World Health Organization, forming the basis for the subsequent therapy. An absolute pre-requisite for an exact diagnosis in the synopsis of the X-ray structures and the histologic findings. In various cases the dignity of a bone tumor cannot be determined; in such instances radical removal is recommended to preclude recidivation and possible malignity. In difficult cases a reference centre for bone tumors should be consulted. (orig.)

  20. Conditions for NIR fluorescence-guided tumor resectioning in preclinical lung cancer model (Conference Presentation)

    Science.gov (United States)

    Kim, Minji; Quan, Yuhua; Choi, Byeong Hyun; Choi, Yeonho; Kim, Hyun Koo; Kim, Beop-Min

    2016-03-01

    Pulmonary nodule could be identified by intraoperative fluorescence imaging system from systemic injection of indocyanine green (ICG) which achieves enhanced permeability and retention (EPR) effects. This study was performed to evaluate optimal injection time of ICG for detecting cancer during surgery in rabbit lung cancer model. VX2 carcinoma cell was injected in rabbit lung under fluoroscopic computed tomography-guidance. Solitary lung cancer was confirmed on positron emitting tomography with CT (PET/CT) 2 weeks after inoculation. ICG was administered intravenously and fluorescent intensity of lung tumor was measured using the custom-built intraoperative color and fluorescence merged imaging system (ICFIS) for 15 hours. Solitary lung cancer was resected through thoracoscopic version of ICFIS. ICG was observed in all animals. Because Lung has fast blood pulmonary circulation, Fluorescent signal showed maximum intensity earlier than previous studies in other organs. Fluorescent intensity showed maximum intensity within 6-9 hours in rabbit lung cancer. Overall, Fluorescent intensity decreased with increasing time, however, all tumors were detectable using fluorescent images until 12 hours. In conclusion, while there had been studies in other organs showed that optimal injection time was at least 24 hours before operation, this study showed shorter optimal injection time at lung cancer. Since fluorescent signal showed the maximum intensity within 6-9 hours, cancer resection could be performed during this time. This data informed us that optimal injection time of ICG should be evaluated in each different solid organ tumor for fluorescent image guided surgery.

  1. Efficacy of DR, CT and MRI in bone tumors

    Institute of Scientific and Technical Information of China (English)

    Yanjiao Zhang; Xuefeng Cui; Changcheng Li; Shenjiang Li

    2014-01-01

    Objective:The aim of the study was to investigate the ef icacy of digital radiography (DR), computed tomography (CT) and magnetic resonance imaging (MRI) in bone tumors. Methods:Fifty-five patients with histological y confirmed bone tumors underwent imaging examinations. Fifty-five patients were performed DR, 21 CT and 20 MRI. Results:DR of 51 pa-tients clearly revealed bone changes. DR of 40 patients wel showed marginal. Twenty tumors appeared periosteal reaction on DR and 19 calcification on DR. CT scan of 21 patients clearly depicted bone changes, marginal and calcification and CT scan of 8 revealed periosteal reaction. MRI scan of 20 patients al showed marginal and soft-tissue mass and bone marrow edema was prominent in 8 patients. Conclusion:DR is the first imaging approach for born tumors. CT wel reveal the extent and minute structure of the bone tumors, the extent, soft-tissue mass and bone marrow edema are more dramatical y demon-strated on MRI imaging. DR integrates with CT and MRI, is helpful in diagnosis of bone tumors.

  2. Supratentorial arterial ischemic stroke following cerebellar tumor resection in two children.

    Science.gov (United States)

    Catsman-Berrevoets, Coriene E; van Breemen, Melanie; van Veelen, Marie Lise; Appel, Inge M; Lequin, Maarten H

    2005-01-01

    We describe two children who developed ischemic strokes in the territory of the middle cerebral artery, one 7 days and one 11 days after resection of a cerebellar tumor. In the first child, another infarction occurred in the territory of the contralateral middle cerebral artery 5 days after the first stroke. No specific cause or underlying risk factor other than the surgical procedure was found. The subacute clinical course at stroke onset resembled that of the 'posterior fossa syndrome', suggesting a common underlying mechanism. PMID:16088257

  3. Minimally invasive liver resection to obtain tumor-infiltrating lymphocytes for adoptive cell therapy in patients with metastatic melanoma

    Directory of Open Access Journals (Sweden)

    Alvarez-Downing Melissa M

    2012-06-01

    Full Text Available Abstract Background Adoptive cell therapy (ACT with tumor-infiltrating lymphocytes (TIL in patients with metastatic melanoma has been reported to have a 56% overall response rate with 20% complete responders. To increase the availability of this promising therapy in patients with advanced melanoma, a minimally invasive approach to procure tumor for TIL generation is warranted. Methods A feasibility study was performed to determine the safety and efficacy of laparoscopic liver resection to generate TIL for ACT. Retrospective review of a prospectively maintained database identified 22 patients with advanced melanoma and visceral metastasis (AJCC Stage M1c who underwent laparoscopic liver resection between 1 October 2005 and 31 July 2011. The indication for resection in all patients was to receive postoperative ACT with TIL. Results Twenty patients (91% underwent resection utilizing a closed laparoscopic technique, one required hand-assistance and another required conversion to open resection. Median intraoperative blood loss was 100 mL with most cases performed without a Pringle maneuver. Median hospital stay was 3 days. Three (14% patients experienced a complication from resection with no mortality. TIL were generated from 18 of 22 (82% patients. Twelve of 15 (80% TIL tested were found to have in vitro tumor reactivity. Eleven patients (50% received the intended ACT. Two patients were rendered no evidence of disease after surgical resection, with one undergoing delayed ACT with generated TIL after relapse. Objective tumor response was seen in 5 of 11 patients (45% who received TIL, with one patient experiencing an ongoing complete response (32+ months. Conclusions Laparoscopic liver resection can be performed with minimal morbidity and serve as an effective means to procure tumor to generate therapeutic TIL for ACT to patients with metastatic melanoma.

  4. Clinical development of BLZ-100 for real-time optical imaging of tumors during resection

    Science.gov (United States)

    Franklin, Heather L.; Miller, Dennis M.; Hedges, Teresa; Perry, Jeff; Parrish-Novak, Julia

    2016-03-01

    Complete initial resection can give cancer patients the best opportunity for long-term survival. There is unmet need in surgical oncology for optical imaging that enables simple and precise visualization of tumors and consistent contrast with surrounding normal tissues. Near-infrared (NIR) contrast agents and camera systems that can detect them represent an area of active research and development. The investigational Tumor Paint agent BLZ-100 is a conjugate of a chlorotoxin peptide and the NIR dye indocyanine green (ICG) that has been shown to specifically bind to a broad range of solid tumors. Clinical efficacy studies with BLZ-100 are in progress, a necessary step in bringing the product into clinical practice. To ensure a product that will be useful for and accepted by surgeons, the early clinical development of BLZ- 100 incorporates multiple tumor types and imaging devices so that surgeon feedback covers the range of anticipated clinical uses. Key contrast agent characteristics include safety, specificity, flexibility in timing between dose and surgery, and breadth of tumor types recognized. Imaging devices should use wavelengths that are optimal for the contrast agent, be sensitive enough that contrast agent dosing can be adjusted for optimal contrast, include real-time video display of fluorescence and white light image, and be simple for surgeons to use with minimal disruption of surgical flow. Rapid entry into clinical studies provides the best opportunity for early surgeon feedback, enabling development of agents and devices that will gain broad acceptance and provide information that helps surgeons achieve more complete and precise resections.

  5. Tumor-resected kidney transplant – a quality of life survey

    Directory of Open Access Journals (Sweden)

    Sundararajan S

    2016-05-01

    Full Text Available Siva Sundararajan,1 Bulang He,1,2 Luc Delriviere,1,2 1WA Liver and Kidney Surgical Transplant Service, Department of General Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia; 2School of Surgery, The University of Western Australia, Perth, WA, Australia Background: To overcome the organ shortage, a program to use kidney grafts after excision of a small renal tumor (tumor resected kidney [TRK] was implemented in February 2007. All recipients were over 55 years old according to the selection criteria. The aim of this study is to assess the quality of life after kidney transplant in this cohort. Methods: From February 2007 to July 2013, 27 patients received a kidney graft after excision of the small kidney tumor. All patients were given the modified 36-Item Short Form Survey (SF-36 questionnaire with additional information regarding concerns about tumor recurrence and whether they would choose TRK transplantation or prefer to stay on dialysis if they have an option again. Results: Of them, 20 returned the completed questionnaire. There is no tumor recurrence on a mean follow-up of 38 months. The mean scores in all eight domains of the SF-36 were higher posttransplantation. The differences were statistically significant. Ninety-five percent of recipients would prefer to have TRK transplantation rather than remain on dialysis. Eighty percent of patients had no or minimal concerns regarding tumor recurrence. Conclusion: The patients who had kidney transplantation by using the graft after excision of a small tumor have achieved excellent quality of life. It is an important alternative for the solution of organ shortage in kidney transplantation. The concern of tumor recurrence is minimal. Performing a further study is worthwhile, with prospective data collection and a control group. Keywords: quality of life, kidney transplant, tumor, small renal cell carcinoma

  6. Malignant bone tumors of the pelvis and of the extremities

    International Nuclear Information System (INIS)

    Bone tumors of the extremities are usually diagnosed by conventional radiography. A good angiogram may render information not only about intra- and extraosseous extension of the tumor, but often also about the biological dignity. CT is usually not necessary, especially since it is sometimes difficult to define the extraosseous borders of these extremity tumors with this method. In bone tumors of the pelvis, however, neither conventional radiography nor angiography render reliable information about the extent of the tumor, which CT is very well able to do. Therefore CT is primarily indicated for evaluation of bone tumors in this region. Angiography is done only for preoperative evaluation of the vascular architecture or for potential therapeutic embolisation. (orig.)

  7. Reconstruction of full thickness abdominal wall defect following tumor resection: A case report

    Directory of Open Access Journals (Sweden)

    Kovačević Predrag

    2014-01-01

    Full Text Available Introduction. Reconstruction of a full thickness abdominal wall defect is a demanding procedure for general and also for plastic surgeons, requiring vigorous planning and reconstruction of three layers. Case Outline. We present a case of a 70-year-old patient with a huge abdominal wall tumor with 40 years evolution. Surgery was performed under general anesthesia. Full thickness abdominal defect appeared after the tumor resection. Reconstruction followed in the same act. The defect was reconstructed using a combination of techniques, including omental flap, fascia lata graft, local skin flaps and skin grafts. After surgery no major complications were noted, only a partial skin flap loss, which was repaired using partial thickness skin grafts. The final result was described by the patient as very good, without hernia formation. Conclusion. Omenthoplasty, abdominal wall reconstruction in combination with free fascia lata graft and skin grafts can be one of good options for the reconstruction of full thickness abdominal wall defects.

  8. RECONSTRUCTION FOLLOWING EXTENSIVE TUMOR RESECTION OF THE PELVIC AND SCAPULAR GIRDLE: A REPORT OF TWO CASES

    Science.gov (United States)

    Dallagnol, Juliana Corrêa; de Freitas, Rosyane Rena; Crivellaro, André Luiz Soares; Mello, Glauco José Pauka; Neto, Mário Armani; Filho, Geraldo de Freitas

    2015-01-01

    Radical surgeries for treatment of scapular and pelvic girdle tumors (hemipelvectomy and interscapulothoracic amputation) are generally extended procedures, with large areas of local tissue loss after tumor resection. The use of a flap that includes all the anterior and posterior thigh musculature after femur dissection, pedicled in the superficial femoral vessels, has been described was only once in the medical literature, and there have been no reports on a similar flap using the whole anterior and posterior musculature of the arm after humerus dissection, pedicled in the subclavian vessels, for reconstruction after interscapulothoracic amputation. Here, we describe two cases – one hemipelvectomy and one interscapulothoracicl amputation - using these two the flaps to close the defect. PMID:27027091

  9. Pedicle Anterolateral Thigh Flap Reconstruction after Pelvic Tumor Resection: A Case Report

    Directory of Open Access Journals (Sweden)

    Robert M. Whitfield

    2010-01-01

    Full Text Available A 47-year-old female with a locally advanced urologic malignancy previously managed with resection, diversion, and postoperative radiation therapy presented for management of her recurrent cancer that had eroded through the soft tissues of the left inner thigh and vulva. On all staging studies the tumor involved the left common femoral artery, and vein, both above and below the inguinal ligament. The difficulty with such tumors is the availability of tissue to reconstruct the defect. The patient had a history of deep venous thrombosis in the femoral venous system. A local flap was the most logical type of reconstruction. The patient had a right lower quadrant ureterostomy with a large parastomal hernia which further limited the local flap options. An anterolateral thigh flap from the opposite thigh was used to reconstruct the soft tissue deficit in this patient. This resurfaced the defect and provided coverage for the vascular reconstruction.

  10. [Solitary Neurofibroma of the Sigmoid Colon Presenting as a Subepithelial Tumor Successfully Removed by Endoscopic Resection].

    Science.gov (United States)

    Lee, Won Jik; Park, Sung Min; Kim, Byung Wook; Kim, Joon Sung; Ji, Jeong Seon; Choi, Hwang

    2016-07-25

    Neurofibromas are benign, slow-growing nerve sheath tumors of the peripheral nervous system, arising from Schwann cells, and classically associated with neurofibromatosis type 1 (Nf1, von Recklinghausen's disease). They occur rarely in the gastro-intestinal tract as isolated neoplasms, outside the classical clinical feature of neurofibromatosis. We herein present an isolated colonic neurofibroma without any systemic signs of neurofibromatosis. A 59-year-old female came to our hospital for constipation. On physical examination, general appearance showed no definite skin lesions. A subepithelial tumor measuring 0.8 cm was detected at the distal descending colon on colonoscopy. The lesion was removed completely by endoscopic resection. Microscopic examination showed proliferation of spindle cells in the mucosa and infiltration of inflammatory cells. Immunohistochemical staining was positive for S-100 protein. The above morphological and immunohistochemical characteristics were consistent with a diagnosis of a solitary neurofibroma of the sigmoid colon. PMID:27443624

  11. Three cases of bone metastases in patients with gastrointestinal stromal tumors

    Directory of Open Access Journals (Sweden)

    Maurizio Zompatori

    2011-04-01

    Full Text Available Gastrointestinal stromal tumors (GISTs are rare, but represent the most common mesenchymal neoplasms of the gastrointestinal tract. Tumor resection is the treatment of choice for localized disease. Tyrosine kinase inhibitors (imatinib, sunitinib are the standard therapy for metastatic or unresectable GISTs. GISTs usually metastasize to the liver and peritoneum. Bone metastases are uncommon. We describe three cases of bone metastases in patients with advanced GISTs: two women (82 and 54 years of age, and one man (62 years of age. Bones metastases involved the spine, pelvis and ribs in one patient, multiple vertebral bodies and pelvis in one, and the spine and iliac wings in the third case. The lesions presented a lytic pattern in all cases. Two patients presented with multiple bone metastases at the time of initial diagnosis and one patient after seven years during the follow-up period. This report describes the diagnosis and treatment of the lesions and may help clinicians to manage bones metastases in GIST patients.

  12. NI-49SMART SUCKER: NEXT GENERATION SMART SURGICAL TOOL FOR INTRAOPERATIVE BRAIN TUMOR RESECTION USING TIME RESOLVED LASER INDUCED FLUORESCENCE SPECTROSCOPY

    OpenAIRE

    Kittle, David S.; Butte, Pramod V.; Vasefi, Fartash; Patil, Chirag G.; Black, Keith

    2014-01-01

    Primary brain tumors are highly lethal tumors where surgical resection is the primary treatment of choice. It has been shown that survival rate is directly related to the extent of tumor resection. In order to aid the surgeon in achieving near-complete resection, novel technologies are required. Time-resolved laser induced fluorescence spectroscopy (TRLIFS) promises to be one such technology, where the tissue is excited using an ultra-short laser and the corresponding fluorescence intensity d...

  13. [A case of polymyositis associated with transverse colon cancer that responded to tumor resection and chemotherapy].

    Science.gov (United States)

    Uchida, Yuichiro; Okabe, Michio; Kawamoto, Yusuke; Tsukumo, Yuta; Ito, Tadashi

    2015-04-01

    A 72-year-old woman was admitted to our hospital because of muscle weakness and was diagnosed as having polymyositis. Whole-body evaluation revealed advanced transverse colon cancer, and we therefore considered it likely that the patient had paraneoplastic myositis. We performed a curative surgical resection for colon cancer, after which her serum creatine phosphokinase(CPK)level greatly decreased. Steroid therapy was administered postoperatively. However, her CPK levels remained persistently high, even after steroid pulse therapy, and we considered that this was due to steroid-resistance myositis. We administered chemotherapy for colon cancer using 5-fluorouracil plus Leucovorin(5-FU/LV), after which the CPK levels gradually decreased. There have been few previous reports of polymyositis associated with colon cancer and a standard treatment for paraneoplastic myositis has not been established. Most clinicians believe that treatment of the primary tumor may contribute to an improvement of myositis, and in our case, tumor resection and chemotherapy were effective. PMID:25963703

  14. Predictive factors for residual tumor and tumor upstaging on relook transurethral resection of bladder tumor in non-muscle invasive bladder cancer

    OpenAIRE

    Gill, Tejpal S.; Das, Ranjit K.; Supriya Basu; Dey, Ranjan K.; Subrata Mitra

    2014-01-01

    Context: Relook transurethral resection of bladder tumor (TURBT) improves the diagnostic and therapeutic efficacy of primary TURBT. However, it is still not established as to which category of patients would benefit most from this repeat invasive procedure. Aims: This prospective interventional study was designed to identify the category of patients with non-muscle invasive bladder cancer who may benefit from a routine relook procedure. Setting and Design: A total of 52 consecutive pa...

  15. Primary malignant bone tumors: diagnosis, radiological appearance and therapy

    International Nuclear Information System (INIS)

    Diagnosis, concepts of therapy and prognosis of primary malignant bone tumors require intensive cooperation between orthopedic surgeons, radiologists and pathologists with special knowledge in oncology. The present paper demonstrates relevant topics of diagnosis, radiological appearance and therapy of the osteosarcoma, Ewing's sarcoma, chondrosarcoma and malignant fibrous histiocytoma based on the material of the Vienna Bone Tumor Registry and more than 35 years of cooperation between the Institute of Pathology and Anatomy and the Department of Orthopedics at the University of Vienna. (orig.)

  16. Late Recurrence after Surgical Resection of a Pancreatic Tumor in von Hippel-Lindau Disease

    Directory of Open Access Journals (Sweden)

    Vito Domenico Corleto

    2009-09-01

    Full Text Available Context Patients with von Hippel-Lindau syndrome, a dominantly inherited familial cancer syndrome, develop a variety of tumors in different organ systems which make the clinical management of these patients complex. Case report The long clinical history of a 45-year-old woman started at 22 years of age when she had surgery for a right adrenal pheochromocytoma. Two years later, a pancreaticoduodenectomy was performed to remove a pancreatic mass which turned out to be a pancreatic neuroendocrine tumor. After a long period of relative wellness, 21 years after the surgical resection of her primary pancreatic neuroendocrine tumor, abdominal lymph node metastases of pancreatic neuroendocrine origin occurred. In fact, three abdominal nodules were removed by laparoscopic surgery, and the histological examination showed well-differentiated neuroendocrine tumors with similar immunohistochemical characteristics and Ki67 below 1%. Considering the patient’s clinical history, an inherited cause was postulated and multiple endocrine neoplasia type 1 was first investigated, but the result was negative. Then, a missense mutation in exon 3 of the VHL gene (ACT>ATT; Thr157Ile was found. Conclusion Although no local and/or distant tumor recurrences are usually reported in radically operated on von Hippel-Lindau pancreatic neuroendocrine tumor patients after a median time of five years of follow-up, the present patient had a recurrence after a very long period of time, suggesting that a pancreatic neuroendocrine tumor associated with von Hippel-Lindau syndrome may behave more aggressively than that has previously been described, thus requiring a life-long follow-up.

  17. Imaging of primary bone tumors in veterinary medicine: which differences?

    Science.gov (United States)

    Vanel, Maïa; Blond, Laurent; Vanel, Daniel

    2013-12-01

    Veterinary medicine is most often a mysterious world for the human doctors. However, animals are important for human medicine thanks to the numerous biological similarities. Primary bone tumors are not uncommon in veterinary medicine and especially in small domestic animals as dogs and cats. As in human medicine, osteosarcoma is the most common one and especially in the long bones extremities. In the malignant bone tumor family, chondrosarcoma, fibrosarcoma and hemangiosarcoma are following. Benign bone tumors as osteoma, osteochondroma and bone cysts do exist but are rare and of little clinical significance. Diagnostic modalities used depend widely on the owner willing to treat his animal. Radiographs and bone biopsy are the standard to make a diagnosis but CT, nuclear medicine and MRI are more an more used. As amputation is treatment number one in appendicular bone tumor in veterinary medicine, this explains on the one hand why more recent imaging modalities are not always necessary and on the other hand, that prognostic on large animals is so poor that it is not much studied. Chemotherapy is sometimes associated with the surgery procedure, depending on the aggressivity of the tumor. Although, the strakes differs a lot between veterinary and human medicine, biological behavior are almost the same and should led to a beneficial team work between all. PMID:22197093

  18. Imaging of primary bone tumors in veterinary medicine: Which differences?

    Energy Technology Data Exchange (ETDEWEB)

    Vanel, Maïa, E-mail: maiavanel@yahoo.fr [Diagnostic Imaging Department, Faculty of Veterinary Medicine, University of Montreal, 3200 Rue Sicotte, PO Box 5000, Saint-Hyacinthe, QC (Canada); Blond, Laurent [Diagnostic Imaging Department, Faculty of Veterinary Medicine, University of Montreal, 3200 Rue Sicotte, PO Box 5000, Saint-Hyacinthe, QC (Canada); Vanel, Daniel [The Rizzoli Institute, Via del Barbiano 1-10, 40136, Bologna (Italy)

    2013-12-01

    Veterinary medicine is most often a mysterious world for the human doctors. However, animals are important for human medicine thanks to the numerous biological similarities. Primary bone tumors are not uncommon in veterinary medicine and especially in small domestic animals as dogs and cats. As in human medicine, osteosarcoma is the most common one and especially in the long bones extremities. In the malignant bone tumor family, chondrosarcoma, fibrosarcoma and hemangiosarcoma are following. Benign bone tumors as osteoma, osteochondroma and bone cysts do exist but are rare and of little clinical significance. Diagnostic modalities used depend widely on the owner willing to treat his animal. Radiographs and bone biopsy are the standard to make a diagnosis but CT, nuclear medicine and MRI are more an more used. As amputation is treatment number one in appendicular bone tumor in veterinary medicine, this explains on the one hand why more recent imaging modalities are not always necessary and on the other hand, that pronostic on large animals is so poor that it is not much studied. Chemotherapy is sometimes associated with the surgery procedure, depending on the agressivity of the tumor. Although, the strakes differs a lot between veterinary and human medicine, biological behavior are almost the same and should led to a beneficial team work between all.

  19. Imaging of primary bone tumors in veterinary medicine: Which differences?

    International Nuclear Information System (INIS)

    Veterinary medicine is most often a mysterious world for the human doctors. However, animals are important for human medicine thanks to the numerous biological similarities. Primary bone tumors are not uncommon in veterinary medicine and especially in small domestic animals as dogs and cats. As in human medicine, osteosarcoma is the most common one and especially in the long bones extremities. In the malignant bone tumor family, chondrosarcoma, fibrosarcoma and hemangiosarcoma are following. Benign bone tumors as osteoma, osteochondroma and bone cysts do exist but are rare and of little clinical significance. Diagnostic modalities used depend widely on the owner willing to treat his animal. Radiographs and bone biopsy are the standard to make a diagnosis but CT, nuclear medicine and MRI are more an more used. As amputation is treatment number one in appendicular bone tumor in veterinary medicine, this explains on the one hand why more recent imaging modalities are not always necessary and on the other hand, that pronostic on large animals is so poor that it is not much studied. Chemotherapy is sometimes associated with the surgery procedure, depending on the agressivity of the tumor. Although, the strakes differs a lot between veterinary and human medicine, biological behavior are almost the same and should led to a beneficial team work between all

  20. Giant Cell Tumor Of The Long Bones: Results With Combination Of Cryosurgery, Curettage, And Cementation

    Directory of Open Access Journals (Sweden)

    Mortazavi S.M.J

    2005-07-01

    Full Text Available Background: In this study we evaluated the treatment of giant cell tumor (GCT of long bones using cryosurgery combined with curettage and polymethylmetacrylate (PMMA cementing. Material and methods: From January 1999 to December 2004, twenty patients (mean age at the time of surgery 29.2 years; 13 females and 7 males; were included in the study. Cortical disruption were presented in 7 patients; 4 with soft tissue extension, but none of them had intra-articular extension of tumor, 3 patients presented with pathologic fracture of distal femoral lesions. These tumors were located in distal femur in 6 patients, proximal tibia in 7, distal radius in 3, proximal femur in 2, and each of proximal humerus and distal ulna in one patient. In each case diagnostic biopsy was done and surgical procedure performed including curettage, power burr of the wall, cryosurgery with liquid nitrogen and finally filling the space with PMMA cementing. The mean follow-up was 34 months (7 to 61 . Results: During follow-up, we observed one recurrence of GCT of proximal tibia. Secondary Aneurysmal bone cyst was reported at the site of one primary distal femoral lesion, without any finding in favor of a recurrence. Neurapraxia of the proneal nerve was occurred in one patient with proximal tibia tumor improved after 8 months. Conclusion: Cryosurgery combined with power burr and PMMA cementing in the treatment of GCT could be an effective approach in tumor eradication. This method obviates the need for extensive resections and reconstructive procedure.

  1. Feasibility of multi-spectral imaging system to provide enhanced demarcation for skin tumor resection

    Science.gov (United States)

    de Roode, Rowland; Noordmans, Herke Jan; Verdaasdonk, Rudolf

    2007-02-01

    Invading tumors like basal cell carcinoma have usually no distinct demarcation for the human eye. Therefore, during resection, an additional rim around the tumor is removed. However, extending sprouts can be missed since most lesions are not uniform. To improve the visualization of the tumor demarcation, we developed a multi-spectral imaging system especially adapted for dermatological applications based on tunable liquid crystal spectral tunable filter technology and LED illumination. Enhanced visualization of skin tumor demarcation was achieved using three strategies. The first strategy is based on creating false color images by combining narrow band spectral filtered images by placing them into the red, green and blue image components of a color image at three specific wavelengths. These specific wavelengths were determined using a trial on error tool to achieve the highest contrast between malignant and healthy tissue. The second strategy is to make ratio images of narrow band spectral filtered images at specific wavelengths. A trail on error tool was created which enables the user to try multiple wavelengths to obtain optimal contrast. This method could be applied in realtime. For the third strategy, on pixel spectral segmentation is applied by selecting the pixel spectra in the center of a tumor, surrounding tissue and healthy tissue far away from the tumor. The correlation between these specific spectra and all image pixels is calculated using a fast algorithm. The degree is correlation is graded by color coding and presented in a false color images showing a detailed demarcation of suspicious regions in the tissue. Although this strategy is expected to provide a higher specificity, it takes more time to calculate than the first strategy.

  2. Bone and lung tumor response following inhalation of transuranic nitrates

    International Nuclear Information System (INIS)

    Eight-hundred five rats exposed to transuranic nitrate aerosols developed 111 lung tumors and 24 bone tumors. Results for 239Pu(NO3)4, 238Pu(NO3)4, and 253Es(NO3)3 were similar, and comparable to what has been shown for the more refractory transuranic oxides

  3. PD-L1 and Tumor Infiltrating Lymphocytes as Prognostic Markers in Resected NSCLC

    Science.gov (United States)

    Ameratunga, Malaka; Asadi, Khashayar; Lin, Xihui; Walkiewicz, Marzena; Murone, Carmel; Knight, Simon; Mitchell, Paul; Boutros, Paul; John, Thomas

    2016-01-01

    Introduction Immune checkpoint inhibition has shifted treatment paradigms in non-small cell lung cancer (NSCLC). Conflicting results have been reported regarding the immune infiltrate and programmed death-ligand 1 (PD-L1) as a prognostic marker. We correlated the immune infiltrate and PD-L1 expression with clinicopathologic characteristics in a cohort of resected NSCLC. Methods A tissue microarray was constructed using triplicate cores from consecutive resected NSCLC. Immunohistochemistry was performed for CD8, FOXP3 and PD-L1. Strong PD-L1 expression was predefined as greater than 50% tumor cell positivity. Matched nodal samples were assessed for concordance of PD-L1 expression. Results Of 522 patients, 346 were node-negative (N0), 72 N1 and 109 N2; 265 were adenocarcinomas (AC), 182 squamous cell cancers (SCC) and 75 other. Strong PD-L1 expression was found in 24% cases. In the overall cohort, PD-L1 expression was not associated with survival. In patients with N2 disease, strong PD-L1 expression was associated with significantly improved disease-free (DFS) and overall survival (OS) in multivariate analysis (HR 0.49, 95%CI 0.36–0.94, p = 0.031; HR 0.46, 95%CI 0.26–0.80, p = 0.006). In this resected cohort only 5% harboured EGFR mutations, whereas 19% harboured KRAS and 23% other. KRAS mutated tumors were more likely to highly express PD-L1 compared to EGFR (22% vs 3%). A stromal CD8 infiltrate was associated with significantly improved DFS in SCC (HR 0.70, 95%CI 0.50–0.97, p = 0.034), but not AC, whereas FOXP3 was not prognostic. Matched nodal specimens (N = 53) were highly concordant for PD-L1 expression (89%). Conclusion PD-L1 expression was not prognostic in the overall cohort. PD-L1 expression in primary tumor and matched nodal specimens were highly concordant. The observed survival benefit in N2 disease requires confirmation. PMID:27104612

  4. Evaluation of the prognosis of cancer patients with metastatic bone tumors based on serial bone scintigrams

    Energy Technology Data Exchange (ETDEWEB)

    Ohmori, Kazuo; Matsui, Hisao; Yasuda, Taketoshi; Kanamori, Masahiko; Yudoh, Kazuo; Seto, Hikaru; Tsuji, Haruo [Toyama Medical and Pharmaceutical University (Japan)

    1997-08-01

    We counted the lesions at the time of detection of bone metastases and calculated the rate of increase in the number of bone metastases from changes in serial bone scintigrams, and investigated the usefulness of serial scintigrams as a prognostic indicator in patients with metastatic bone tumors. Subjects were 112 patients with bone metastases from four types of primary lesion: 21 with prostate cancer, 27 breast cancer, 39 lung cancer and 25 stomach cancer. Of these, 18 (prostate), 19 (breast), nine (lung) and eight (stomach) underwent serial bone scintigrams in which bone metastases were first detected and identified as progressing. The numbers of lesions at the time of detection of bone metastases for prostate and stomach cancers were significantly greater than those for lung cancer. The rate of increase in the number of bone metastases for stomach cancer was significantly higher than that for prostate or breast cancers. There was no correlation between the survival time after the detection of bone metastases and the number of lesions at the time of detection in the four types of cancer. However, in prostate cancer, a negative correlation existed between the survival time after the detection of bone metastases and the rate of increase in the number of bone metastases. Thus, in patients with bone metastases from prostate cancer, it appears that the rate of increase in the number of bone metastases, estimated from serial bone scintigrams, was indicative of prognosis. (author)

  5. A metastatic glomus jugulare tumor. A temporal bone report

    Energy Technology Data Exchange (ETDEWEB)

    El Fiky, F.M.; Paparella, M.M.

    1984-01-01

    The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed.

  6. Bone scintigraphic patterns in patients of tumor induced osteomalacia

    International Nuclear Information System (INIS)

    Tumor induced osteomalacia (TIO) or oncogenic osteomalacia is a rare condition associated with small tumor that secretes one of the phosphaturic hormones, i.e., fibroblast growth factor 23, resulting in abnormal phosphate metabolism. Patients may present with non-specific symptoms leading to delay in the diagnosis. Extensive skeletal involvement is frequently seen due to delay in the diagnosis and treatment. The small sized tumor and unexpected location make the identification of tumor difficult even after diagnosis of osteogenic osteomalacia. The bone scan done for the skeletal involvement may show the presence of metabolic features and the scan findings are a sensitive indicator of metabolic bone disorders. We present the bone scan findings in three patients diagnosed to have TIO

  7. Microsurgery Resection of Intrinsic Insular Tumors via Transsylvian Surgical Approach in 12 Cases

    International Nuclear Information System (INIS)

    To investigate the clinical characteristics, operative methods, and diffusion tensor imaging (DTI) in the resection of intrinsic insular gliomas via transsylvian approach. From June 2008 to June 2010, 12 patients with intrinsic insular gliomas were treated via transsylvian microsurgical approach, with preoperative magnetic resonance imaging diffusion tensor imaging (MR DTI) evaluation. The data of these patients were retrospectively analyzed. All patients had astrocytoma, including 8 patients of Grades I to II, 2 patients of Grades III to IV, and 2 patients of mixed glial tumors. The insular tumors were completely removed in 9 patients, whereas they were only partially removed from 3 patients. No death was related to the operations. Two patients had transient aphasia, 2 experienced worsened hemiplegia on opposite sides of their bodies, and 2 had mild hemiplegia and language function disturbance. Most of the insular gliomas are of low grade. By evaluating the damage of the corticospinal tract through DTI and using ultrasonography to locate the tumors during operation, microsurgery treatment removes the lesions as much as possible, protects the surrounding areas, reduces the mobility rate, and improves the postoperative quality of life

  8. Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the advantage of total intravenous anesthesia for transurethral resection of bladder tumor (TURBT). Methods: Sixty ASA Ⅰ-Ⅱ patients undergoing TURBT were randomly assigned to 2 groups. Spinal anesthesia with 0.75% pure bupivacaine (8-12 mg) was applied to patients in Group Ⅰ (n= 30). Patients in Group Ⅱ (n=30) received total intravenous anesthesia with continuous infusion of Propofol and Remifentanil; and a laryngeal mask was used to ensure the airway and ventilation. BP, HR, SPO2 and pertinent side effects were monitored and recorded. Results: The patients in group Ⅱ experienced more stable hemodynamics than those in group Ⅰ. Obturator nerve reflex was observed in 15 (50.0%) patients in Group Ⅰ, but none (0%) in Group Ⅱ (P<0.01). Conclusion: Total intravenous anesthesia with laryngeal mask is a safe, reliable, controllable and simple manual for patient undergoing TURBT.

  9. Curettage of benign bone tumors and tumor like lesions: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Zile Singh Kundu

    2013-01-01

    Full Text Available Background: Curettage is one of the most common treatment options for benign lytic bone tumors and tumor like lesions. The resultant defect is usually filled. We report our outcome curettage of benign bone tumors and tumor like lesions without filling the cavity. Materials and Methods: We retrospectively studied 42 patients (28 males and 14 females with benign bone tumors who had undergone curettage without grafting or filling of the defect by any other bone graft substitute. The age of the patients ranged from 14 to 66 years. The most common histological diagnosis was that of giant cell tumor followed by simple bone cyst, aneurysamal bone cyst, enchondroma, fibrous dysplasia, chondromyxoid fibroma, and chondroblastoma and giant cell reparative granuloma. Of the 15 giant cell tumors, 4 were radiographic grade 1 lesions, 8 were grade 2 and 3 grade 3. The mean maximum diameter of the cysts was 5.1 (range 1.1-9 cm cm and the mean volume of the lesions was 34.89 cm 3 (range 0.94-194.52 cm 3 . The plain radiographs of the part before and after curettage were reviewed to establish the size of the initial defect and the rate of reconstitution, filling and remodeling of the bone defect. Patients were reviewed every 3 monthly for a minimum period of 2 years. Results: Most of the bone defects completely reconstituted to a normal appearance while the rest filled partially. Two patients had preoperative and three had postoperative fractures. All the fractures healed uneventfully. Local recurrence occurred in three patients with giant cell tumor who were then reoperated. All other patients had unrestricted activities of daily living after surgery. The rate of bone reconstitution, risk of subsequent fracture or the incidence of complications was related to the size of the cyst/tumor at diagnosis. The benign cystic bone lesions with volume greater than approximately 70 cm 3 were found to have higher incidence of complications. Conclusion: This study

  10. Bone scintigraphy in the initial evaluation of dogs with primary bone tumors

    International Nuclear Information System (INIS)

    Bone scintigraphy was performed as part of an initial diagnostic evaluation of 70 dogs admitted with primary bone tumors during a 2-year period. Tumors involved major long bones of the appendicular skeleton and included 62 osteosarcomas, 6 fibrosarcomas, and 2 chondrosarcomas. All dogs were free of radiographically detectable pulmonary metastases. Bone scintigraphy was not of value in distinguishing among various types of primary tumors. One dog with an ulnar chondrosarcoma had a scintigraphically detectable occult osseous metastasis or synchronous primary tumor, and 1 dog with osteosarcoma had a scintigraphically detectable lymph node metastasis. Pulmonary metastases were not detected scintigraphically. Of the 70 dogs, 44.3% had areas of increased isotope uptake associated with nonneoplastic disease processes

  11. Duodenal Gastrointestinal Stromal Tumor Treated by Wedge Resection in a Patient with Neurofibromatosis Type 1: Report of a Case and Review of the Japanese Literature

    OpenAIRE

    Takeuchi, Hideya; Matsumoto, Toshihumi; Kusumoto, Tetsuya; Yoshikawa, Yasuji; Muto, Yoichi

    2009-01-01

    A case of duodenal gastrointestinal stromal tumor (GIST) treated by wedge resection in a patient with neurofibromatosis type 1 (NF-1) is reported. A 55-year-old man with a history of NF-1 was admitted for surgery for a duodenal tumor. Upper gastrointestinal endoscopy revealed a 2.5 cm duodenal submucosal tumor. Abdominal computed tomography showed a homogenously enhanced mass in the third portion of the duodenum. The patient successfully underwent wedge resection of the duodenal tumor. Histol...

  12. Synchronous intraoperative radiofrequency ablation for multiple liver metastasis and resection of giant solid pseudopapillary tumors of the pancreas

    Institute of Scientific and Technical Information of China (English)

    LI Jia-xin; WU Hong; HUANG Ji-wei; Pankaj Prasoon; ZENG Yong

    2012-01-01

    The solid pseudopapillary tumors of the pancreas (SPTP) are rare tumors,which are commonly found in adolescent women.Radical surgical resection of the primary tumor or metastases is the standard treatment for SPTP and could achieve long-term survival.We reported a case of a 20-year-old female with multiple liver metastases of SPTP,and performed surgical resection for primary tumor 14 cm in diameter and 2 major liver metastases (both 5 cm in diameter),radiofrequency ablation (RFA) for small lesions and one major liver metastase 6 cm in diameter successfully.No evidence of recurrence in situ or in the liver was found by computed tomography (CT) scan 3 months after the operation.RFA is a safe and effective treatment for unresectable multiple liver metastases of SPTP.

  13. Imaging of bone tumors for the musculoskeletal oncologic surgeon

    Energy Technology Data Exchange (ETDEWEB)

    Errani, C., E-mail: costantino.errani@ior.it [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Kreshak, J., E-mail: j.kreshak@yahoo.com [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Ruggieri, P., E-mail: pietro.ruggieri@ior.it [Department of Orthopaedic Oncology, Istituto Ortopedico Rizzoli, Bologna (Italy); Alberghini, M., E-mail: marco.alberghini@ior.it [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Picci, P., E-mail: piero.picci@ior.it [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy); Vanel, D., E-mail: daniel.vanel@ior.it [Department of Pathology, Istituto Ortopedico Rizzoli, Bologna (Italy); Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2013-12-01

    The appropriate diagnosis and treatment of bone tumors requires close collaboration between different medical specialists. Imaging plays a key role throughout the process. Radiographic detection of a bone tumor is usually not challenging. Accurate diagnosis is often possible from physical examination, history, and standard radiographs. The location of the lesion in the bone and the skeleton, its size and margins, the presence and type of periosteal reaction, and any mineralization all help determine diagnosis. Other imaging modalities contribute to the formation of a diagnosis but are more critical for staging, evaluation of response to treatment, surgical planning, and follow-up.When necessary, biopsy is often radioguided, and should be performed in consultation with the surgeon performing the definitive operative procedure. CT is optimal for characterization of the bone involvement and for evaluation of pulmonary metastases. MRI is highly accurate in determining the intraosseous extent of tumor and for assessing soft tissue, joint, and vascular involvement. FDG-PET imaging is becoming increasingly useful for the staging of tumors, assessing response to neoadjuvant treatment, and detecting relapses.Refinement of these and other imaging modalities and the development of new technologies such as image fusion for computer-navigated bone tumor surgery will help surgeons produce a detailed and reliable preoperative plan, especially in challenging sites such as the pelvis and spine.

  14. Perioperative fractionated high-dose rate brachytherapy for malignant bone and soft tissue tumors

    International Nuclear Information System (INIS)

    Purpose: To investigate the viability of perioperative fractionated HDR brachytherapy for malignant bone and soft tissue tumors, analyzing the influence of surgical margin. Methods and Materials: From July 1992 through May 1996, 16 lesions of 14 patients with malignant bone and soft tissue tumors (3 liposarcomas, 3 MFHs, 2 malignant schwannomas, 2 chordomas, 1 osteosarcoma, 1 leiomyosarcoma, 1 epithelioid sarcoma, and 1 synovial sarcoma) were treated at the Osaka University Hospital. The patients' ages ranged from 14 to 72 years (median: 39 years). Treatment sites were the pelvis in 6 lesions, the upper limbs in 5, the neck in 4, and a lower limb in 1. The resection margins were classified as intracapsular in 5 lesions, marginal in 5, and wide in 6. Postoperative fractionated HDR brachytherapy was started on the 4th-13th day after surgery (median: 6th day). The total dose was 40-50 Gy/7-10 fr/ 4-7 day (bid) at 5 or 10 mm from the source. Follow-up periods were between 19 and 46 months (median: 30 months). Results: Local control rates were 75% at 1 year and 48% in 2 years, and ultimate local control was achieved in 8 (50%) of 16 lesions. Of the 8 uncontrolled lesions, 5 (63%) had intracapsular (macroscopically positive) resection margins, and all the 8 controlled lesions (100%) had marginal (microscopically positive) or wide (negative) margins. Of the total, 3 patients died of both tumor and metastasis, 3 of metastasis alone, 1 of tumor alone, and 7 showed no evidence of disease. Peripheral nerve palsy was seen in one case after this procedure, but no infection or delayed wound healing caused by tubing or irradiation has occurred. Conclusion: Perioperative fractionated HDR brachytherapy is safe, well tolerated, and applicable to marginal or wide surgical margin cases

  15. Podoplanin expression in tumor-free resection margins of oral squamous cell carcinomas: an immunohistochemical and fractal analysis study

    OpenAIRE

    Margaritescu, C.; Raica, M; PIRICI, D.; Simionescu, C.; Mogoanta, L.; Stinga, A.C.; Stinga, A.S.; Ribatti, Doménico

    2010-01-01

    Podoplanin is involved in tumorigenesis and cancer progression in head and neck malignancies and its expression is not restricted to lymphatic vessel endothelium. The aim of this study was to establish podoplanin expression in the tumor-free resection margins of oral squamous cell carcinomas (OSCCs) and to evaluate the geometric complexity of the lymphatic vessels in oral mucosa by utilizing fractal analysis. As concerns the podoplanin expression in noncancerous tissue, forty tumor-free r...

  16. Is there a role for radioguided surgery with iodine-labeled metaiodobenzylguanidine in resection of neuroendocrine tumors?

    NARCIS (Netherlands)

    Hulsteijn, L.T. van; Corssmit, E.P.; Hiel, B. van der; Smit, J.W.A.; Stokkel, M.P.

    2012-01-01

    PURPOSE: The aim of this study was to systematically review literature, exploring the role of radioguided surgery with iodine-labeled metaiodobenzylguanidine (MIBG) in resection of neuroendocrine tumors. METHODS: PubMed, EMBASE, Web of Science, COCHRANE, CINAHL, Academic Search Premier, ScienceDirec

  17. Nodal involvement pattern in resectable lung cancer according to tumor location

    International Nuclear Information System (INIS)

    The aim in this study was to define the pattern of lymph node metastasis according to the primary tumor location. In this retrospective cohort study, each of the operable patients diagnosed with lung cancer was grouped by tumor mass location. The International Association for the Study of Lung Cancer nodal chart with stations and zones, established in 2009, was used to define lymph node levels. From 2006 to 2010, 197 patients underwent a lobectomy with systematic nodal resection for primary lung cancer at Chiang Mai University Hospital. There were 123 male and 74 female patients, with ages ranging from 16– 85 years old and an average age of 61.31. Analyses of tumor location, histology type, and nodal metastasis were performed. The locations were the right upper lobe in 63 patients (31.98%), the right middle lobe in 18 patients (9.14%), the right lower lobe in 30 patients (15.23%), the left upper lobe in 55 patients (27.92%), the left lower lobe in 16 patients (8.12%), and mixed lobes (more than one lobe) in 15 patients (7.61%). The mean tumor size was 4.45 cm in diameter (range 1.2–16.5 cm). Adenocarcinoma was the most common histological type, which occurred in 132 cases (67.01%), followed by squamous cell carcinoma in 41 cases (20.81%), bronchiolo alveolar cell carcinoma in nine cases (4.57%), and large cell carcinoma in seven cases (3.55%). Eighteen cases (9.6%) had skip metastasis (mediastinal lymph node metastasis without hilar node metastasis). Adenocarcinoma and intratumoral lymphatic invasion were the predictors of mediastinal lymph node metastases. There were statistically significant differences between a tumor in the right upper lobe and the right lower lobe. However, there were no statistically significant differences between tumors in the other lobes. In conclusion, tumor location is not a precise predictor of the pattern of nodal metastasis. Systematic lymph node dissection is the only way to accurately determine lymph node status. Further studies

  18. Three-dimensional visualization of functional brain tissue and functional magnetic resonance imaging-integrated neuronavigation in the resection of brain tumor adjacent to motor cortex

    International Nuclear Information System (INIS)

    Objective: To assess the value of three -dimensional visualization of functional brain tissue and the functional magnetic resonance imaging (fMRI)-integrated neuronavigation in the resection of brain tumor adjacent to motor cortex. Method: Sixty patients with tumor located in the central sulcus were enrolled. Thirty patients were randomly assigned to function group and 30 to control group. Patients in function group underwent fMRI to localize the functional brain tissues. Then the function information was transferred to the neurosurgical navigator. The patients in control group underwent surgery with navigation without function information. The therapeutic effect, excision rate. improvement of motor function, and survival quality during follow-up were analyzed. Result: All patients in function group were accomplished visualization of functional brain tissues and fMRI-integrated neuronavigation. The locations of tumors, central sulcus and motor cortex were marked during the operation. The fMRI -integrated information played a great role in both pre- and post-operation. Pre-operation: designing the location of the skin flap and window bone, determining the relationship between the tumor and motor cortex, and designing the pathway for the resection. Post- operation: real-time navigation of relationship between the tumor and motor cortex, assisting to localize the motor cortex using interoperation ultra-sound for correcting the displacement by the CSF outflow and collapsing tumor. The patients in the function group had better results than the patients in the control group in therapeutic effect (u=2.646, P=0.008), excision rate (χ=7.200, P<0.01), improvement of motor function (u=2.231, P=0.026), and survival quality (KPS uc= 2.664, P=0.008; Zubrod -ECOG -WHO uc=2.135, P=0.033). Conclusions: Using preoperative three -dimensional visualization of cerebral function tissue and the fMRI-integrated neuronavigation technology, combining intraoperative accurate positioning

  19. Intraoperative neurophysiological monitoring for the resection of brain tumors in pediatric patients.

    Science.gov (United States)

    Sala, F; Coppola, A; Tramontano, V; Babini, M; Pinna, G

    2015-12-01

    Intraoperative neurophysiology (ION) is the gold standard to map and monitor brain functions during supratentorial surgery in critical areas. This is of great value for the surgery of brain gliomas in adults, but the same ION techniques can be used in the pediatric population with respect to both epilepsy and brain tumor surgery. While the principles of most ION techniques are the same for adults and children, the developing nervous system has peculiar characteristics in terms of anatomical and physiological maturation of afferent and efferent pathways within the brain and the spinal cord. Accordingly, some adjustments, particularly with regards to stimulation parameters, are needed in younger children. This paper will review current ION techniques to assist during the resection of brain tumors in children, focusing on the aspects peculiar to mapping and monitoring of sensori-motor functions in the pediatric population. On the other hand, awake surgery, of common use in adult patients when aiming to identify cortical and subcortical cognitive functions, is of very limited use in children and will not be discussed here. PMID:26373668

  20. TUMOR MARKERS IN BONE MARROW IN PATIENTS WITH PROSTATIC CANCER

    OpenAIRE

    Iwai, Akio; Ozono, Seiichiro; Tanaka, Yozo; Nagayoshi, Junichi; Hirayama, Akihide; Kumon, Toshihiko; Joko, Masanori; Hirata, Naoya; Yoshikawa, Motoyoshi; Tabata, Shoichi; Uemura, Hirotsugu; Moriya, Akira; Kaneko, Yoshiteru; Okamoto, Shinji; Hirao, Yoshihiko

    1991-01-01

    We compared prostatic specific acid phosphatase (PAP), prostatic specificantigen (PA) and γ-seminoprotein (γ-SM) levels between bone marrow and serum for the purpose of assessing of the usefulness of these tumor markers in early detection ofbone metastasis in cases with prostatic cancer. Thirty-three patients were entered into this study. Of the patients, 20 had prostatic cancer including 11 with bone metastasis, and 13 patients had benign prostatic hypertrophy (BPH) served as controls. It se...

  1. Complete twelve month bone remodeling with a bi-phasic injectable bone substitute in benign bone tumors: a prospective pilot study

    OpenAIRE

    Kaczmarczyk, Jacek; Sowinski, Piotr; Goch, Maciej; Katulska, Katarzyna

    2015-01-01

    Background Benign primary bone tumors are commonly treated by surgery involving bone grafts or synthetic bone void fillers. Although synthetic bone grafts may provide early mechanical support while minimizing the risk of donor-site morbidity and disease transmission, difficult handling properties and less than optimal transformation to bone have limited their use. Methods In a prospective series, patients with benign bone tumors were treated by minimal invasive intervention with a bi-phasic a...

  2. Bone and soft tissue tumors of hip and pelvis

    Energy Technology Data Exchange (ETDEWEB)

    Bloem, Johan L., E-mail: j.l.bloem@lumc.nl [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands); Reidsma, Inge I., E-mail: i.i.reidsma@lumc.nl [Leiden University Medical Center, Department of Radiology, PO Box 9600, 2300 RC Leiden (Netherlands)

    2012-12-15

    Objective is to identify epidemiologic and radiologic criteria allowing specific diagnoses of tumors and tumor-like lesions in the hip region and pelvis, and to optimize pre-operative staging. Patients with pelvic tumors are usually older, and their tumors are larger relative to patients with tumors in extremities. The majority of tumors in the pelvis are malignant (metastases, myeloma, chondrosarcoma, Ewing-, osteo-, and MFH/fibrosarcoma), while those in the proximal femur are in majority benign (fibrous dysplasia, solitary bone cyst, and osteoid osteoma). Soft tissue masses in the thigh in the elderly are typically sarcomas without tumor specific signs. Common tumor-like lesions occurring in the hip and pelvis that can mimic neoplasm are: infections (including tuberculosis), insufficiency/avulsion fractures, cysts, fibrous dysplasia, aneurysmal bone cyst, Langerhans cell histiocytosis, and Paget's disease. Local MR staging is based on the compartmental anatomy. The psoas and gluteal muscles are easily invaded by sarcoma originating in the ileum. The pectineus muscle protects the neurovascular bundle at the level of the hip. The thigh is separated into three compartments, some structures (Sartorius muscle) cross borders between compartments. Immobile joints (SI-joints, osteoarthritic hip) are relatively easily crossed by sarcoma and giant cell tumor.

  3. Bone and soft tissue tumors of hip and pelvis

    International Nuclear Information System (INIS)

    Objective is to identify epidemiologic and radiologic criteria allowing specific diagnoses of tumors and tumor-like lesions in the hip region and pelvis, and to optimize pre-operative staging. Patients with pelvic tumors are usually older, and their tumors are larger relative to patients with tumors in extremities. The majority of tumors in the pelvis are malignant (metastases, myeloma, chondrosarcoma, Ewing-, osteo-, and MFH/fibrosarcoma), while those in the proximal femur are in majority benign (fibrous dysplasia, solitary bone cyst, and osteoid osteoma). Soft tissue masses in the thigh in the elderly are typically sarcomas without tumor specific signs. Common tumor-like lesions occurring in the hip and pelvis that can mimic neoplasm are: infections (including tuberculosis), insufficiency/avulsion fractures, cysts, fibrous dysplasia, aneurysmal bone cyst, Langerhans cell histiocytosis, and Paget's disease. Local MR staging is based on the compartmental anatomy. The psoas and gluteal muscles are easily invaded by sarcoma originating in the ileum. The pectineus muscle protects the neurovascular bundle at the level of the hip. The thigh is separated into three compartments, some structures (Sartorius muscle) cross borders between compartments. Immobile joints (SI-joints, osteoarthritic hip) are relatively easily crossed by sarcoma and giant cell tumor.

  4. Ex Vivo Behaviour of Human Bone Tumor Endothelial Cells

    International Nuclear Information System (INIS)

    Cooperation between endothelial cells and bone in bone remodelling is well established. In contrast, bone microvasculature supporting the growth of primary tumors and metastasis is poorly understood. Several antiangiogenic agents have recently been undergoing trials, although an extensive body of clinical data and experimental research have proved that angiogenic pathways differ in each tumor type and stage. Here, for the first time, we characterize at the molecular and functional level tumor endothelial cells from human bone sarcomas at different stages of disease and with different histotypes. We selected a CD31+ subpopulation from biopsies that displayed the capability to grow as adherent cell lines without vascular endothelial growth factor (VEGF). Our findings show the existence in human primary bone sarcomas of highly proliferative endothelial cells expressing CD31, CD44, CD105, CD146 and CD90 markers. These cells are committed to develop capillary-like structures and colony formation units, and to produce nitric oxide. We believe that a better understanding of tumor vasculature could be a valid tool for the design of an efficacious antiangiogenic therapy as adjuvant treatment of sarcomas

  5. Ex Vivo Behaviour of Human Bone Tumor Endothelial Cells

    Energy Technology Data Exchange (ETDEWEB)

    Infante, Teresa [SDN-Foundation, Institute of Diagnostic and Nuclear Development, IRCCS, 80143 Naples (Italy); Cesario, Elena [Department of Biochemistry and Biophysics, Second University of Naples, 80138 Naples (Italy); Gallo, Michele; Fazioli, Flavio [Division of Skeletal Muscles Oncology Surgery, National Cancer Institute, Pascale Foundation, 80131 Naples (Italy); De Chiara, Annarosaria [Anatomic Pathology Unit, National Cancer Institute, Pascale Foundation, 80131 Naples (Italy); Tutucci, Cristina; Apice, Gaetano [Medical Oncology of Bone and Soft Sarcoma tissues Unit, National Cancer Institute, Pascale Foundation, 80131 Naples (Italy); Nigris, Filomena de, E-mail: filomena.denigris@unina2.it [Department of Biochemistry and Biophysics, Second University of Naples, 80138 Naples (Italy)

    2013-04-11

    Cooperation between endothelial cells and bone in bone remodelling is well established. In contrast, bone microvasculature supporting the growth of primary tumors and metastasis is poorly understood. Several antiangiogenic agents have recently been undergoing trials, although an extensive body of clinical data and experimental research have proved that angiogenic pathways differ in each tumor type and stage. Here, for the first time, we characterize at the molecular and functional level tumor endothelial cells from human bone sarcomas at different stages of disease and with different histotypes. We selected a CD31{sup +} subpopulation from biopsies that displayed the capability to grow as adherent cell lines without vascular endothelial growth factor (VEGF). Our findings show the existence in human primary bone sarcomas of highly proliferative endothelial cells expressing CD31, CD44, CD105, CD146 and CD90 markers. These cells are committed to develop capillary-like structures and colony formation units, and to produce nitric oxide. We believe that a better understanding of tumor vasculature could be a valid tool for the design of an efficacious antiangiogenic therapy as adjuvant treatment of sarcomas.

  6. Utility of Fine Needle Aspiration Cytology in Diagnosing Bone Tumors

    Directory of Open Access Journals (Sweden)

    Sonal Mahajan

    2015-01-01

    Results: A total of 36 cases were studied, of which diagnostic material was adequately obtained in 32 cases (88.88%. The sensitivity (92.85% and specificity (94.44% of FNAC were high, with an accuracy of 93.75%, which is similar to findings in other studies. Conclusion: FNAC plays a vital role in diagnosing bone tumors. It is a rapid, easy, cheap, and minimum invasive outpatient department procedure. However histopathology is still important in diagnosing bone tumors that are unclear or undiagnosed on FNAC since histopathology gives a complete architectural pattern of tissue.

  7. Evaluation of bone scintigraphy in differential diagnosis of benign bone tumors

    International Nuclear Information System (INIS)

    Bone scintigraphy with sup(99m)Tc-phosphate compounds was evaluated from the analysis of 71 consecutive cases of various benign bone tumors whether the scintigrams could be helpful in their differential diagnosis. The characteristics of the scintigraphic image at the site of bone lesions were noticed as being marked (++), moderate (+) and poor or minimal (-), according to the degree of accumulation of the radioactivity. Fibrous dysplasia (8 among 9 cases) as well as aneurysmal bone cyst (3 among 4 cases) had strong tendency of marked accumulation. Poor or minimal accumulation was observed in almost all of the lesions of nonossifying fibroma including fibrous cortical defect (6 all cases), solitary bone cyst (4 among 6 cases) and enchondroma (3 among 4 cases). Moderate accumulation was said to be non-specific, since it could be encountered in any types of benign bone tumors. But it was noticed that the majority of the bone lesions of eosinophilic granuloma (7 among 9 cases) showed moderate accumulation and the scintigraphic evidence of the skeletal disease appeared to be less extensive than the roentgenogram. These scintigraphic characteristics realized in some benign bone tumors occasionally played an important role in clinical diagnosis, especially in the cases atypical on roentgenographic findings. Several instructive cases whose final diagnosis was strongly linked to the scintigraphic informations were demonstrated. (author)

  8. The role of succinylcholine in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors

    International Nuclear Information System (INIS)

    Objective was to present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors. This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection. Of the 57 patients received epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification failure, hematoma and 4 obturator nerve reflex events, despite the block, were observed and these patients were subjected to general anesthesia with succinylcholine. Fifty-six patients (32 patients initially had general anesthesia and 24 converted from epidural to general anesthesia) were all given succinylcholine prior to resection. Due to its mechanisms of action, succinylcholine is completely effective and represents a simple alternative to obturator nerve block. No contraction was observed in any patient given succinylcholine. (author)

  9. Submucosal tunnel endoscopy: Peroral endoscopic myotomy and peroral endoscopic tumor resection.

    Science.gov (United States)

    Eleftheriadis, Nikolas; Inoue, Haruhiro; Ikeda, Haruo; Onimaru, Manabu; Maselli, Roberta; Santi, Grace

    2016-01-25

    Peroral endoscopic myotomy (POEM) is an innovative, minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy (LHM), not only for all types of esophageal achalasia [classical (I), vigorous (II), spastic (III), Chicago Classification], but also for advanced sigmoid type achalasia (S1 and S2), failed LHM, or other esophageal motility disorders (diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus). POEM starts with a mucosal incision, followed by submucosal tunnel creation crossing the esophagogastric junction (EGJ) and myotomy. Finally the mucosal entry is closed with endoscopic clip placement. POEM permitted relatively free choice of myotomy length and localization. Although it is technically demanding procedure, POEM can be performed safely and achieves very good control of dysphagia and chest pain. Gastroesophageal reflux is the most common troublesome side effect, and is well controllable with proton pump inhibitors. Furthermore, POEM opened the era of submucosal tunnel endoscopy, with many other applications. Based on the same principles with POEM, in combination with new technological developments, such as endoscopic suturing, peroral endoscopic tumor resection (POET), is safely and effectively applied for challenging submucosal esophageal, EGJ and gastric cardia tumors (submucosal tumors), emerged from muscularis propria. POET showed up to know promising results, however, it is restricted to specialized centers. The present article reviews the recent data of POEM and POET and discussed controversial issues that need further study and future perspectives. PMID

  10. Treatment of the benign bone tumors including femoral neck lesion using compression hip screw and synthetic bone graft

    OpenAIRE

    Nakamura Tomoki; Matsumine Akihiko; Asanuma Kunihiro; Matsubara Takao; Sudo Akihiro

    2015-01-01

    Purpose: The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. Methods: Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentatio...

  11. Functional and Aesthetic Outcome of Reconstruction of Large Oro-Facial Defects Involving the Lip after Tumor Resection

    International Nuclear Information System (INIS)

    Background: Squamous cell carcinoma of the head and neck is a challenging disease to both surgeons and radiation oncologists due to proximity of many important anatomical structures. Surgery could be curative as these cancers usually metastasize very late by blood stream. Aim of the Work: This work addresses the oncologic, functional and aesthetic factors affecting reconstruction of large orofacial defects involving the lip following tumor resection. Patients and Methods: The study reviews the surgical outcome of one hundred and twelve patients with invasive tumors at. or extending to, the lip(s). treated at the Mansoura University - Surgical Oncology Department, from January 2000 to January 2005. Tumor stage were T2 (43), T3 (56) and T4 (13). Nodal state was N0 in 80, N1 in 29 and N2 in three cases. AJCC stage grouping was II (T2 N0) in 33 patients. stage III (T3N0 orT1-3N1) in 64 cases and stage IV (T4 due to bone erosion or N2) in 15 cases. The technique used for lip reconstruction was unilateral or bilateral myocutaneous depressor anguli oris flap (MCDAOF) for isolated lip defect (n=63). Bilateral myocutaneous depressor anguli oris (MCDAOF) plus local cervical rotational flap chin defects (n=3). pectorals major myocutaneous pedicled flap for cheek defects involving the lip together with a tongue flap for mucosal reconstruction (n=35). sternocleidomastoid clavicular myo-osseous flap for concomitant mandibular defects (n=] 2). Results: esthetic and functional results are evaluated regarding appearance, oral incompetence, disabling microstomia and eating difficulties. depressor anguli oris reconstruction allowed functioning static and dynamic oral function in all cases in contrast to the Pectorals major flap. there were 18 cases of oral incompetence (46.1%), nine cases of speech difficulty (23%) and five patients with poor cosmetic appearance within the second group total flap loss was not encountered, Partial nap loss affected thirteen depressor anguli oris flaps

  12. Lower Lip Reconstruction after Tumor Resection; a Single Author's Experience with Various Methods

    International Nuclear Information System (INIS)

    Background: Squamous cell carcinoma is the most frequently seen malignant tumor of the lower lip The more tissue is lost from the lip after tumor resection, the more challenging is the reconstruction. Many methods have been described, but each has its own advantages and its disadvantages. The author presents through his own clinical experience with lower lip reconstruction at tbe NCI, an evaluation of the commonly practiced techniques. Patients and Methods: Over a 3 year period from May 2002 till May 2005, 17 cases presented at the National Cancer Institute, Cairo University, with lower lip squamous cell carcinoma. The lesions involved various regions of the lower lip excluding the commissures. Following resection, the resulting defects ranged from 1/3 of lip to total lip loss. The age of the patients ranged from 28 to 67 years and they were 13 males and 4 females With regards to the reconstructive procedures used, Karapandzic technique (orbicularis oris myocutaneous flaps) was used in 7 patients, 3 of whom underwent secondary lower lip augmentation with upper lip switch flaps Primary Abbe (Lip switch) nap reconstruction was used in two patients, while 2 other patients were reconstructed with bilateral fan flaps with vermilion reconstruction by mucosal advancement in one case and tongue flap in the other The radial forearm free nap was used only in 2 cases, and direct wound closure was achieved in three cases. All patients were evaluated for early postoperative results emphasizing on flap viability and wound problems and for late results emphasizing on oral continence, microstomia, and aesthetic outcome, in addition to the usual oncological follow-up. Results: All flaps used in this study survived completely including the 2 free flaps. In the early postoperative period, minor wound breakdown occurred in all three cases reconstructed by utilizing adjacent cheek skin flaps, but all wounds healed spontaneously. The latter three cases Involved defects greater than 2

  13. Magnetic Resonance-Guided Growth Plate Bone Bridge Resection at 0.23 Tesla: Report of a Novel Technique

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    Blanco Sequeiros, R.; Vaehaesarja, V.; Ojala, R. (Dept. of Radiology, Musculoskeletal Div., and Dept. of Pediatrics, Pediatric Surgery Division, Oulu Univ. Hospital, Oulu (Finland))

    2008-07-15

    Background: Growth plate or physeal cartilage trauma may result in delayed or immediate failure of growth due to bone bridge formation at the insult site. With computed tomography (CT) and magnetic resonance imaging (MRI), the role of imaging has expanded from diagnosis to treatment planning and therapy guidance. Purpose: To describe a technique for MR-guided growth plate bone bridge resection and to evaluate feasibility of the procedure. Material and Methods: Three consecutive patients with growth plate bone bridges were treated surgically under MR guidance. All bridges were detected with prior MRI and radiographs. All patients were referred to procedure due to growth plate bridge associated growth anomaly and pertaining clinical symptoms. The effect of the treatment was evaluated after 48 months with a clinical follow-up. Results: All bridges were successfully detected, marked, and removed under MRI guidance. All patients had relief from their symptoms. Two patients had lasting results from the operation with no further operative treatment needed or scheduled at 48 months from primary treatment. There was one clinical failure, with the patient requiring repeated osteotomies. Conclusion: We have successfully implemented a novel therapy for growth plate bridge resection

  14. Quantification of radionuclide uptake levels for primary bone tumors

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    Hasford Francis

    2015-04-01

    Full Text Available The purpose of the study is to quantify the level of uptake of administered radionuclide in primary bone tumors for patients undergoing bone scintigraphy. Retrospective study on 48 patient's scintigrams to quantify the uptake levels of administered radiopharmaceuticals was performed in a nuclear medicine unit in Ghana. Patients were administered with activity ranging between 0.555 and 1.110 MBq (15–30 mCi, and scanned on Siemens e.cam SPECT system. Analyses on scintigrams were performed with Image J software by drawing regions of interest (ROIs over identified hot spots (pathologic sites. Nine skeletal parts namely cranium, neck, shoulder, sacrum, sternum, vertebra, femur, ribcage, and knee were considered in the study, which involved 96 identified primary tumors. Radionuclide uptakes were quantified in terms of the estimated counts of activity per patient for identified tumor sites. Average normalized counts of activity (nGMC per patient ranged from 5.2759 ± 0.6590 cts/mm2/MBq in the case of cranium tumors to 72.7569 ± 17.8786 cts/mm2/MBq in the case of ribcage tumors. The differences in uptake levels could be attributed to different mechanisms of Tc-99m MDP uptake in different types of bones, which is directly related to blood flow and degree of osteoblastic activity. The overall normalized count of activity for the 96 identified tumors was estimated to be 23.0350 ± 19.5424 cts/mm2/MBq. The study revealed highest uptake of activity in ribcage and least uptake in cranium. Quantification of radionuclide uptakes in tumors is important and recommended in assessing patient's response to therapy, doses to critical organs and in diagnosing tumors.

  15. Mimicking biophysical stimuli within bone tumor microenvironment*

    Science.gov (United States)

    Marturano-Kruik, A.; Yeager, K.; Bach, D.; Villasante, A.; Cimetta, E.; Vunjak-Novakovic, G.

    2016-01-01

    In vivo, cells reside in a complex environment regulating their fate and function. Most of this complexity is lacking in standard in vitro models, leading to readouts falling short of predicting the actual in vivo situation. The use of engineering tools, combined with deep biological knowledge, leads to the development and use of bioreactors providing biologically sound niches. Such bioreactors offer new tools for biological research, and are now also entering the field of cancer research. Here we present the development and validation of a modular bioreactor system providing: (i) high throughput analyses, (ii) a range of biological conditions, (iii) high degree of control, and (iv) application of physiological stimuli to the cultured samples. The bioreactor was used to engineer a three-dimensional (3D) tissue model of cancer, where the effects of mechanical stimulation on the tumor phenotype were evaluated. Mechanical stimuli applied to the engineered tumor model activated the mechanotransduction machinery and resulted in measurable changes of mRNA levels towards a more aggressive tumor phenotype. PMID:26737062

  16. TGFβ and Hypoxia Drive Breast Cancer Bone Metastases through Parallel Signaling Pathways in Tumor Cells and the Bone Microenvironment

    Institute of Scientific and Technical Information of China (English)

    Lauren K. DUNN; Pierrick G.J. FOURNIE; Khalid S. MOHAMMAD; C. Ryan MCKENNA; Holly W. DAVIS; Maria NIEWOLNA; Xianghong PENG; John M. CHIRGWIN; Theresa A.GUISE

    2009-01-01

    @@ Breast cancers frequently metastasize to bone, a site of hypoxia and high concentrations of active TGFβ. Skeletal metastases involve interactions between tumor and bone cells driven by locally secreted proteins, many of which are increased by hypoxia and TGFβ.

  17. Intraoperative Anesthetic Management of Patients Undergoing Glomus Tumor Resection Using a Low-Dose Isoflurane-Fentanyl Technique

    OpenAIRE

    Jellish, W.S.; J Murdoch; Leonetti, J.

    1994-01-01

    Glomus jugulare and vagale tumors present unique problems to both anesthesiologists and surgeons. The anesthetic plant must be tailored to each patient and provide hemodynamic stability, a consistent intraoperative environment, and rapid awakening after prolonged administration. In this report, we describe our anesthetic method used for paraganglioma resection, which utilizes a combination technique of low-dose isoflurane with a narcotic infusion initiated after bolus administration. Results ...

  18. Lateral supracerebellar infratentorial approach for microsurgical resection of large midline pineal region tumors: techniques to expand the operative corridor.

    Science.gov (United States)

    Kulwin, Charles; Matsushima, Ken; Malekpour, Mahdi; Cohen-Gadol, Aaron A

    2016-01-01

    Pineal region tumors pose certain challenges in regard to their resection: a deep surgical field, associated critical surrounding neurovascular structures, and narrow operative working corridor due to obstruction by the apex of the culmen. The authors describe a lateral supracerebellar infratentorial approach that was successfully used in the treatment of 10 large (> 3 cm) midline pineal region tumors. The patients were placed in a modified lateral decubitus position. A small lateral suboccipital craniotomy exposed the transverse sinus. Tentorial retraction sutures were used to gently rotate and elevate the transverse sinus to expand the lateral supracerebellar operative corridor. This approach placed only unilateral normal structures at risk and minimized vermian venous sacrifice. The surgeon achieved generous exposure of the caudal midline mesencephalon through a "cross-court" oblique trajectory, while avoiding excessive retraction on the culmen. All patients underwent the lateral approach with no approach-related complication. The final pathological diagnoses were consistent with meningioma in 3 cases, pilocytic astrocytoma in 3 cases, intermediate grade pineal region tumor in 2 cases, and pineoblastoma in 2 cases. The entire extent of these tumors was readily reachable through the lateral supracerebellar route. Gross-total resection was achieved in 8 (80%) of the 10 cases; in 2 cases (20%) near-total resection was performed due to adherence of these tumors to deep diencephalic veins. Large midline pineal region tumors can be removed through a unilateral paramedian suboccipital craniotomy. This approach is simple, may spare some of the midline vermian bridging veins, and may be potentially less invasive and more efficient. PMID:26275000

  19. Arthroplasty with endoprosthesis after resection of tumors at the elbow%人工关节假体重建肘部肿瘤切除后骨缺损

    Institute of Scientific and Technical Information of China (English)

    郭卫; 汤小东

    2013-01-01

    Objective The tumors at the elbow bone account for 1% of the bone tumors of the whole body.Lymphoma is the most common malignant tumor and osteoid osteomais is the most common benign tumor.In the past,the treatment of elbow malignant tumors is amputation,which results in loss of limb after surgery.With the development of surgery and the technology of radiation and chemotherapy,it is possible to partially excise the tumors and retain upper limbs.However,due to the important anatomical structures of elbow,partial excision of tumor leads to instability and poor function of the joint of elbow,wrist and hand.Before the total endoprosthesis of elbow appeared, there were only several reconstruction methods to rebuild stable functional elbow after tumor resection.Arthrodesis or excisional arthroplasty of the elbow has their respective disadvantage:arthrodesis results in limited elbow motion,and excisional arthroplasty results in joint instability.At present,there are rare literatures guiding the elbow reconstruction after the tumor resection. Therefore,This study presented our results of limb salvage surgery using custom-made prostheses for reconstruction of the elbow after tumor excision.The oncologic results,complications,and functional outcomes were further discussed.Methods (1 )General information:The elbow tumor surgery cases from June 1998 to June 2010 were retrospectively collected in Peking University People′s Hospital. The inclusion criteria were as follows:malignant tumor involving the proximal ulna and distal humerus or benign invasive tumor,tumor excision with prostheses for reconstruction of the elbow.The benign tumors,revision and complete humerus surgery patients should be ruled out.There are 24 patients in this study,14 men and 10 women,with a mean age of 42.6 year-old.Pathological diagnosis of these cases were:6 cases of osteosarcoma,4 cases of Ewing′s sarcoma,3 cases of malignant fibrous histiocytoma,2 cases of giant cell tumor,each 1 case of

  20. Bronchoscopic resection of endobronchial inflammatory myofibroblastic tumor: A case report and systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Animesh Ray

    2014-01-01

    Full Text Available Inflammatory myofibroblastic tumour (IMT is a rare tumour affecting the tracheo-bronchial tree in the adult population. The clinical presentation of this tumour is diverse and diagnosis can be definitively clinched by histopathological examination. Treatment of this tumour usually requires surgical resection with bronchoscopic resection being described in few cases. We describe a 32 year old male presenting with hemoptysis who was diagnosed to have IMT. Resection of the tumour was done with the help of rigid bronchoscopy. Post-resection, hemoptysis stopped and no recurrence of tumour was noted on subsequent follow-up. We also present a systematic review of literature of all the cases of tracheo-bronchial IMT treated with bronchoscopic resection and conclude it to be a useful alternative to surgery in such cases.

  1. Multilobular tumor of the zygomatic bone in a dog

    Directory of Open Access Journals (Sweden)

    L. Leonardi

    2014-02-01

    Full Text Available Multilobular tumor of bone (MTB (also known as Multilobular Osteochondrosarcoma is an uncommon bone tumor frequently located on the skull of dogs, rarely on the ribs or pelvis. These neoplasms are slow growing, locally invasive, and have the potential to compress and invade the brain. A 10-year-old mixed breed dog was presented with a history of approximately 4 months of progressive growth of a left zygomatic mass. Radiographic investigation revealed a finely granular or stippled non homogeneous radiopaque mass involving the zygomatic arch. After surgery, grossly the neoplasm consisted of multiple, variably sized, grayish-white to yellow nodules separated by collagenous septa of different thickness. Histologically, the tumor was characterized by the presence of multiple lobules containing osteoid and cartilage, separated by a net of fibrous septae. This neoplastic pattern was consistent with a typical multilobular tumor of bone and based on clinical, radiographical, gross and light microscopic findings the definitive diagnosis was made. While reviewing veterinary literature only few cases of MTB were found in dogs.

  2. Impact of delay to cryopreservation on RNA integrity and genome-wide expression profiles in resected tumor samples.

    Directory of Open Access Journals (Sweden)

    Elodie Caboux

    Full Text Available The quality of tissue samples and extracted mRNA is a major source of variability in tumor transcriptome analysis using genome-wide expression microarrays. During and immediately after surgical tumor resection, tissues are exposed to metabolic, biochemical and physical stresses characterized as "warm ischemia". Current practice advocates cryopreservation of biosamples within 30 minutes of resection, but this recommendation has not been systematically validated by measurements of mRNA decay over time. Using Illumina HumanHT-12 v3 Expression BeadChips, providing a genome-wide coverage of over 24,000 genes, we have analyzed gene expression variation in samples of 3 hepatocellular carcinomas (HCC and 3 lung carcinomas (LC cryopreserved at times up to 2 hours after resection. RNA Integrity Numbers (RIN revealed no significant deterioration of mRNA up to 2 hours after resection. Genome-wide transcriptome analysis detected non-significant gene expression variations of -3.5%/hr (95% CI: -7.0%/hr to 0.1%/hr; p = 0.054. In LC, no consistent gene expression pattern was detected in relation with warm ischemia. In HCC, a signature of 6 up-regulated genes (CYP2E1, IGLL1, CABYR, CLDN2, NQO1, SCL13A5 and 6 down-regulated genes (MT1G, MT1H, MT1E, MT1F, HABP2, SPINK1 was identified (FDR <0.05. Overall, our observations support current recommendation of time to cryopreservation of up to 30 minutes and emphasize the need for identifying tissue-specific genes deregulated following resection to avoid misinterpreting expression changes induced by warm ischemia as pathologically significant changes.

  3. Fluorescence-Guided Probes of Aptamer-Targeted Gold Nanoparticles with Computed Tomography Imaging Accesses for in Vivo Tumor Resection.

    Science.gov (United States)

    Li, Cheng-Hung; Kuo, Tsung-Rong; Su, Hsin-Jan; Lai, Wei-Yun; Yang, Pan-Chyr; Chen, Jinn-Shiun; Wang, Di-Yan; Wu, Yi-Chun; Chen, Chia-Chun

    2015-01-01

    Recent development of molecular imaging probes for fluorescence-guided surgery has shown great progresses for determining tumor margin to execute the tissue resection. Here we synthesize the fluorescent gold nanoparticles conjugated with diatrizoic acid and nucleolin-targeted AS1411 aptamer. The nanoparticle conjugates exhibit high water-solubility, good biocompatibility, visible fluorescence and strong X-ray attenuation for computed tomography (CT) contrast enhancement. The fluorescent nanoparticle conjugates are applied as a molecular contrast agent to reveal the tumor location in CL1-5 tumor-bearing mice by CT imaging. Furthermore, the orange-red fluorescence emitting from the conjugates in the CL1-5 tumor can be easily visualized by the naked eyes. After the resection, the IVIS measurements show that the fluorescence signal of the nanoparticle conjugates in the tumor is greatly enhanced in comparison to that in the controlled experiment. Our work has shown potential application of functionalized nanoparticles as a dual-function imaging agent in clinical fluorescence-guided surgery. PMID:26507179

  4. Ultrasonographic Diagnosis of Bone Tumor of the Knee and Its Clinical Implication

    Institute of Scientific and Technical Information of China (English)

    ZENG; Hui; KANG; Bin; LIU; Guoping; TANG; Xingyu

    2001-01-01

    In order to evaluate the value of the ultrasonography in the diagnosis of tumor of the knee and its clinical implication, 57 patients with clinically suspected bone tumor of the knee were examined by ultrasound. The ultrasonographic characteristics of different bone tumors were studied and compared with the results of pathologic characters after operation. Ultrasonography can readily visualize the bony destruction and the pathologic change of the periosteum and the soft tissue related to bone tumor. Fifty-two cases of malignant bone tumors and 15 cases of giant cell tumors were diagnosed by ultrasonography. Pathologically, there were 54 cases of malignant bone tumor and 13 cases of giant cell tumor. It was concluded that ultrasonographic examination might be a useful method for the diagnoses of bone tumor of the knee and play an important role in guiding needle biopsy and electing operative method and approach.

  5. Normalization of gene expression measurement of tissue samples obtained by transurethral resection of bladder tumors

    Directory of Open Access Journals (Sweden)

    Pop LA

    2016-06-01

    housekeeping genes and one small nuclear RNA gene using the ViiA 7 platform, with specific primers. Results: Every step of the sample handling protocol, which begins with sample harvest and ends with the data analysis, is of utmost importance due to the fact that it is time consuming, labor intensive, and highly expensive. High temperature of the surgical procedure does not affect the small nucleic acid sequences in comparison with the mRNA. Conclusion: Gene expression is clearly affected by the RNA quality, but less affected in the case of small nuclear RNAs. We proved that the high-temperature, highly invasive transurethral resection of bladder tumor procedure damages the tissue and affects the integrity of the RNA from biological specimens. Keywords: bladder cancer, transurethral resection, RNA quality, real-time PCR

  6. Application of magnetic resonance imaging (MRI) in diagnosis and follow-up during treatment of bone tumors

    International Nuclear Information System (INIS)

    During the last decade, there has been a growing awareness of the value of wide but local en-bloc resection of malignant soft tissue and skeletal tumors followed by functional reconstruction. However resection and reconstructive procedures in patients with primary malignant bone tumors can only be performed if accurate information on the extension of tumor with respect to the anatomical planes and involvement of vessels and nerves can be obtained. The change in the operative approach has been facilitated by improved surgical technique, by computed tomography (CT) and other imaging technologies which provide abundant information about the extent of tumor involvement and by increased life expectancy due to effective chemotherapy. The combined modality approach with preoperative chemotherapy demands early insight into possible response to therapy to avoid delay in the surgical treatment. The recent introduction of Magnetic Resonance Imaging (MRI) in our department has given us the opportunity to compare the ability of CT and MRI to provide precise and useful anatomic information as part of the preoperative examination for patients with primary malignant musculoskeletal tumors. In addition the effect of chemotherapeutic treatment on the MRI was evaluated

  7. Perioperative fractionated high dose rate brachytherapy in bone and soft-tissue tumors

    International Nuclear Information System (INIS)

    Purpose/Objective: Perioperative fractionated HDR brachytherapy was applied for treatment of bone and soft-tissue tumors. We investigate the local control and side effect, and consider possibility to reduce surgical margin. Materials and Methods: The 13 lesions of 11 patients with bone and soft-tissue tumors (four primary and nine recurrent lesions) were treated at Osaka University Hospital between Aug. 1992 and Feb. 1995. Follow-up terms are between a year and 30 months (median; 15 months). They consisted of 8 males and 3 females. The age ranged from 14 to 75 (median; 38). The histology contained 3 MFH's, 2 liposarcomas, 1 chordoma, osteosarcoma, malignant schwanoma, synovial sarcoma, and epithelioid sarcoma. The sites of lesion are 4 pelvis, 4 neck or supraclavicle, 3 upper limbs, and 2 lower limbs. The surgical margins including intraoperative catheterizing are 3 wide, 6 marginal, and 4 intralesional resection. Postoperative fractionated high dose rate (HDR) brachytherapy started on 4-7th day after surgery. A total dose was 40-50 Gy/7-10 fr/6-7 d (bid) at 5 mm from the sources. Results: One case was dead of tumor, 4 cases were dead of metastasis, 1 case is alive with tumor, 2 cases are alive with distant metastasis, and 4 cases are no evidence of disease. Local control was achieved in eight of 13 lesions (62%). Four of the five uncontrolled lesions had macroscopic residual tumor after the surgery. In five of the six marginal resection, lesions were controlled. Local control rates with Kaplan-Mayer methods were 69% in 1 year and 58% in 2 years. Survival rates were 82% in 1 year and 66% in 2 years. There was one peripheral nerve palsy as a side effect. There was no infection or delayed heal of surgical scar, affected by tubing and interstitial radiation. Conclusion: This study indicates that the use of perioperative fractionated HDR brachytherapy is easy, safe, and well tolerated. Some cases with frequent recurrence previously, can also be controlled. A safe

  8. Tumor markers and bone scan in breast cancer patients

    International Nuclear Information System (INIS)

    Full text: The objective of this study was to compare the levels of CA15-3 and CEA with the bone scan findings in patients with breast cancer. Retrospective analysis of 76 bone scans from 61 patients diagnosed with breast cancer in the last 5 years was performed by two nuclear medicine specialists. All bone scans were performed after surgical treatment of the disease. Patients with loco-regional residual disease or distant metastases in the liver, lung or the brain were excluded from the study. According to the bone scan the patients were divided in 5 groups: normal bone scan (N), equivocal bone scan (E), single metastasis (1MS), three metastases (3MS) and multiple metastases (MMS). Tumor markers were determined within a month before or after the bone scan was performed. Cut-off value for CA 15-3 was 35 U/ml, and for CEA 3 ng/ml. Statistical analysis was performed using descriptive statistic and Kolmogorov-Smirnov test. Bone metastases were revealed in 38% of the patients referred for bone scintigraphy out of which 26% had MMS, 7.8% had single MS and 4% had 3MS. The results of 6.5% of the patients were determined as equivocal. The values of CA15-3 were higher in all patient groups compared with the group that had normal bone scan, but this difference reached statistical significance only in groups with 3MS and MMS (p < 0.01). The values of CEA were significantly higher only in patients with multiple metastases when compared with group N (p < 0.01). Values higher than cut-off value for CA 15-3 was found in 9 patients out of 42 in the group with normal bone scan. The highest value of CA 15-3 in this group was 47 U/ml. Only one patient in this group showed elevated levels for CEA. Three patients in the group with single metastasis had normal CA 15-3, while CEA was elevated only in one patient. All patients in the group with 3MS had elevated levels of CA 15-3 while CEA was in the normal range. All patients with MMS had elevated CA 15-3 values while CEA was elevated in

  9. 3D-printed guiding templates for improved osteosarcoma resection

    Science.gov (United States)

    Ma, Limin; Zhou, Ye; Zhu, Ye; Lin, Zefeng; Wang, Yingjun; Zhang, Yu; Xia, Hong; Mao, Chuanbin

    2016-03-01

    Osteosarcoma resection is challenging due to the variable location of tumors and their proximity with surrounding tissues. It also carries a high risk of postoperative complications. To overcome the challenge in precise osteosarcoma resection, computer-aided design (CAD) was used to design patient-specific guiding templates for osteosarcoma resection on the basis of the computer tomography (CT) scan and magnetic resonance imaging (MRI) of the osteosarcoma of human patients. Then 3D printing technique was used to fabricate the guiding templates. The guiding templates were used to guide the osteosarcoma surgery, leading to more precise resection of the tumorous bone and the implantation of the bone implants, less blood loss, shorter operation time and reduced radiation exposure during the operation. Follow-up studies show that the patients recovered well to reach a mean Musculoskeletal Tumor Society score of 27.125.

  10. Pediatric Malignant Bone Tumors: A Review and Update on Current Challenges, and Emerging Drug Targets.

    Science.gov (United States)

    Jackson, Twana M; Bittman, Mark; Granowetter, Linda

    2016-07-01

    Osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT) are the most common malignant bone tumors in children and adolescents. While significant improvements in survival have been seen in other pediatric malignancies the treatment and prognosis for pediatric bone tumors has remained unchanged for the past 3 decades. This review and update of pediatric malignant bone tumors will provide a general overview of osteosarcoma and the Ewing sarcoma family of tumors, discuss bone tumor genomics, current challenges, and emerging drug targets. PMID:27265835

  11. The Impact of Immune System in Regulating Bone Metastasis Formation by Osteotropic Tumors

    Directory of Open Access Journals (Sweden)

    Lucia D’Amico

    2015-01-01

    Full Text Available Bone metastases are frequent and debilitating consequence for many tumors, such as breast, lung, prostate, and kidney cancer. Many studies report the importance of the immune system in the pathogenesis of bone metastasis. Indeed, bone and immune system are strictly linked to each other because bone regulates the hematopoietic stem cells from which all cells of the immune system derive, and many immunoregulatory cytokines influence the fate of bone cells. Furthermore, both cytokines and factors produced by immune and bone cells promote the growth of tumor cells in bone, contributing to supporting the vicious cycle of bone metastasis. This review summarizes the current knowledge on the interactions among bone, immune, and tumor cells aiming to provide an overview of the osteoimmunology field in bone metastasis from solid tumors.

  12. Clinical Applications of Molecular Markers in Bone Tumors.

    Science.gov (United States)

    Hameed, Meera

    2015-11-01

    Pathologic diagnosis of primary bone neoplasms can be challenging primarily due to rarity of the disease entities, overlapping imaging and histologic findings, and lack of tumor-specific immunohistochemical stains. Although slow to evolve, in recent years there has been a rapid advance in the discovery of new and novel molecular markers in primary bone neoplasms, which has enhanced diagnostic accuracy and has shed light into their pathogenesis. Modern technological approaches such as next-generation sequencing including RNA sequencing are serving as "rapid discovery platforms" for new and novel mutations and translocations with diagnostic, prognostic, and possible therapeutic applicability. As next-generation sequencing technologies are finding their place in clinical laboratories, one could envision routine testing for mutations spanning across a gene or translocations with multiple breakpoints and partner genes. This review will focus on the clinical relevance and applicability of molecular markers in primary bone neoplasms with examples. PMID:26452209

  13. Imaging of bone tumors and tumor-like lesions. Techniques and applications

    International Nuclear Information System (INIS)

    This is a comprehensive textbook that provides a detailed description of the imaging techniques and findings in patients with benign and malignant bone tumors. In the first part of the book, the various techniques and procedures employed for imaging bone tumors are discussed in detail. Individual chapters are devoted to MRI, CT, nuclear medicine, and interventional procedures. The second part of the book gives an authoritative review of the role of these imaging techniques in diagnosis, surgical staging, biopsy, and assessment of response to therapy. The third part of the book covers the imaging features of each major tumor subtype, with separate chapters on osteogenic tumors, cartilaginous tumors, etc. The final part of the book reviews the imaging features of bone tumors at particular anatomical sites such as the spine, ribs, pelvis, and scapula. Each chapter is written by an acknowledged expert in the field, and a wealth of illustrative material is included. This book will be of great value to musculoskeletal and general radiologists, orthopedic surgeons, and oncologists. (orig.)

  14. Mechanism of sup(99m)Tc-methylene diphosphonate (sup(99m)Tc-MDP) localization in experimental studies of bone tumors

    International Nuclear Information System (INIS)

    [Materials and Methods] (I) VX2 carcinoma was transplanted to the rabbit tibia, sup(99m)Tc-MDP was intravenously injected when bone destruction was radiologically seen. Preoperative scintigraphs, postoperative one of the resected tibia and fibra and scintigraphs of sliced tumor were compared with each other. Tissue fragments were collected from the sliced tumor, and RI was measured to compare concentration rates at different parts together with histological investigations. (II) Tetracycline was given to the rabbit of Experiment (I) to compare with the concentration of sup(99m)Tc-MDP. (III) Microautoradiography method was done on the experimental animals for investigation of the concentration of sup(99m)Tc-MDP. [Results] (I) Localization of sup(99m)Tc-MDP was increased at the sites of tumorous bone formation, of reactive bone formation at tumor edges, and of cartilage calcification, with little concentration at tumor cells or necrotic tissue. (II) Deposition sites of tetracycline nearly corresponded with those showing higher concentration of sup(99m)Tc-MDP. (III) microautoradiograms showed high precipitation of silver granules at new bone formation sites. More remarkable localization of sup(99m)Tc-MDP were seen at sites of formation of tumorous bone, of reactive bone at tumor edges and of cartilage calcification. The results deny the view that localization of sup(99m)Tc-MDP was determined by increased blood flow and collagen metabolism, and affirm the view of Galasko et al. that it was determined by new bone formation. Further, results of studies on tetracycline distribution correspond with those of investigations on sup(99m)Tc-MDP localization, indicating that sup(99m)Tc-MDP concentration is strongly determined by tumorous and reactive new bone formation and in cartilage calcification. (author)

  15. 骨生化指标在骨肿瘤中的临床应用进展%Clinical application progress of bone biochemical markers in bone tumors

    Institute of Scientific and Technical Information of China (English)

    周定; 张琪琪; 胡勇

    2014-01-01

    Bone tumors refer to benign and malignant tumors which originate from mesenchymal stem cells and occur in bone tissues and their accessory structures. The pathogenesis and etiology of bone tumors still remain unclear, and the diagnosis methods of bone tumors are stagnating now. X-ray, computed tomography ( CT ) and magnetic resonance imaging ( MRI ) are important in diagnosing and evaluating bone tumors, but they cannot detect the lesions until the bone destruction reaches a certain degree. Isotope bone scan can detect the microscopic lesions of bone, whereas it is too expensive and the speciifcity is poor, with high false positive rates. At present, the golden standard for the diagnosis of bone tumors is the histopathological examination of bone. However, it is dififcult to achieve early diagnosis, and it is likely to miss the best treatment period. Every disease is inevitably accompanied by molecular biological changes in the body. Biochemical markers can promptly detect the property changes of bone tumor cells, including unlimited proliferation, apoptosis, active neoangiogenesis, inifltrative growth, metastatic growth and so on. Therefore, it is of great signiifcance for the diagnosis of bone tumors to detect appropriate biochemical markers in the patients. The normal bone metabolism is maintained by the dynamic balance of bone resorption and bone formation. When bone tumors occur, the balance will be disturbed. The bone biochemical markers which relfect bone resorption and bone formation are sensitive indicators of early abnormal bone metabolism. Recently, a large number of studies have explored the significance of bone biochemical markers in patients with bone tumors. The functions of bone biochemical markers in patients with bone tumors mainly include making an early detection of microscopic tumor lesions to start early treatment ( diagnostic effects ), evaluating the effects ( therapeutic monitoring ), evaluating the prognosis and predicting the risk of

  16. PD-L1 and Tumor Infiltrating Lymphocytes as Prognostic Markers in Resected NSCLC

    OpenAIRE

    Ameratunga, Malaka; Asadi, Khashayar; Lin, Xihui; Walkiewicz, Marzena; Murone, Carmel; Knight, Simon; Mitchell, Paul; Boutros, Paul; John, Thomas

    2016-01-01

    Introduction Immune checkpoint inhibition has shifted treatment paradigms in non-small cell lung cancer (NSCLC). Conflicting results have been reported regarding the immune infiltrate and programmed death-ligand 1 (PD-L1) as a prognostic marker. We correlated the immune infiltrate and PD-L1 expression with clinicopathologic characteristics in a cohort of resected NSCLC. Methods A tissue microarray was constructed using triplicate cores from consecutive resected NSCLC. Immunohistochemistry was...

  17. Tumores ósseos benignos e lesões ósseas Pseudotumorais: tratamento atual e novas tendências Benign bone tumors and tumor-like bone lesions: treatment update and new trends

    Directory of Open Access Journals (Sweden)

    José Marcos Nogueira Drumond

    2009-10-01

    , which have ossified bone lesions caused by fibrous dysplasia. Aneurismal bone cyst has been treated with sclerosing agents by percutaneous injection, yielding good results. Adjuvants allow joint salvage, maintenance of movements and function, with low rates of recurrence. Among them, the most used ones are bone cement (PMMA, phenol, nitrogen-based cryotherapy, hydrogen peroxide, ethanol and radiotherapy. New methods of treatment include thermal ablation with radiofrequency and laser, mainly utilized for treating osteoid osteoma. Arthroscopy allows resection of benign intra-joint lesions and assists the surgery of subchondral tumors. A great advance is the utilization of synthetic bone substitutes, which are a mixture of osteoinductive growth factors and osteoconductive ceramics, and have presented comparable results to autogenous bone grafts. There is a recent trend for closed treatments, with percutaneous injection of demineralized bone matrix (DBM and calcium sulfate. Autogenous cancellous bone graft remains as the gold standard. Vascularized fibula graft, on the other hand, incorporates faster in the treatment of large destructive lesions. Also, allogenic cortical support allows structural augmentation for aggressive tumors. Freeze-dried allografts are used to fill contained defects and as expanders of autografts. Joint endoprosthesis may be used in large destructive lesions of the distal femur, hip and shoulder.

  18. Clinical application of preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta in the resection of sacral tumors

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical application of preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta in performing the surgical resection of sacral tumors. Methods: Conventional surgical excision of sacral tumors was employed in 24 patients with sacral tumors (control group), while preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta was carried out in 32 patients with sacral tumors (study group). The operation time, blood loss during the surgery and the one-year recurrence rate of both groups were documented, and the results were statistically analyzed. Results: Angiography showed that in the study group the sacral tumors were supplied by several vessels, and these feeding arteries were occluded separately. The tumors were successfully removed in all patients with the help of intraoperative balloon occlusion of the abdominal aorta. During the surgery, the surgical area was clearly exposed and the blood loss wa remarkably reduced. After the surgery, no ectopic vascular embolization, renal ischemia, limb ischemia or other complications occurred. Statistically significant difference in the operation time, blood loss during the surgery and the one-year recurrence rate existed between the two groups (P<0.05). Conclusion: Preoperative embolization of tumor feeding artery combined with intraoperative balloon occlusion of the abdominal aorta can effectively shorten the operation time, reduce the blood loss during the surgery and provide a clear surgical field, and thus the surgical safety can be significantly ensured. (authors)

  19. Shift of the pyramidal tract during resection of the intraaxial brain tumors estimated by intraoperative diffusion-weighted imaging

    International Nuclear Information System (INIS)

    The present study evaluated the shift of the pyramidal tract during resection of 17 proximal intraaxial brain tumors. In each case intraoperative diffusion-weighted (iDW) magnetic resonance imaging with a motion-probing gradient applied in the anteroposterior direction was performed using a scanner with a 0.3 T vertical magnetic field. The position of the white matter bundles containing the pyramidal tract was estimated on the coronal images before and after resection of the neoplasm, and both quantitative and directional evaluation of its displacement was done. In all cases iDW imaging provided visualization of the structure of interest. The magnitude of the pyramidal tract displacement due to removal of the neoplasm varied from 0.5 to 8.7 mm (mean 4.4±2.5 mm) on the lesion side and from 0 to 3.6 mm (mean 1.3±1.1 mm) on the normal side (p<0.001). Tumor location in regards to the pyramidal tract was significantly associated with the direction of the pyramidal tract displacement (p<0.05). Outward shift occurred in 10 out of 13 cases of the lateral neoplasms, whereas in all 4 superomedial tumors inward shift was marked. In conclusion, the direction of the pyramidal tract displacement during resection of the proximal intraaxial brain tumors is mainly determined by position of the neoplasm, but can be unpredictable in some cases, which necessitates use of subcortical brain mapping and intraoperative imaging, particularly iDW imaging with updated neuronavigation. (author)

  20. Lung cancer: assessing resectability

    OpenAIRE

    Quint, Leslie E

    2003-01-01

    Staging classification in patients with non-small cell lung cancer does not always correlate perfectly with surgical resectability. Therefore, it is important to evaluate individual features of a patient’s tumor in order to determine if surgical resection is the optimal method of treatment, regardless of tumor stage. Such features include characteristics of the primary tumor, regional lymph nodes and distant sites.

  1. Patterns of localization of sup(99m)Tc-diphosphonate and tetracycline in bone tumors

    International Nuclear Information System (INIS)

    In the beginning of a study on mechanism of sup(99m)Tc-phosphoric acid compounds accumulation, regions where sup(99m)Tc-methylene diphosphonate (MDP) or tetracycline accumulated were compared in 5 patients with primary bone tumors (one with osteosarcoma, one with malignant fibrous histocytoma, one with osteochondroma, and two with chondrosarcoma). In accordance with regions where tetracycline accumulated, much sup(99m)Tc-MDP accumulated in neoplastic bone, calcified and ossified cartilage, and reactive new bone around bone tumors. It was concluded from above-mentioned results and mechanism of tetracycline accumulation that much sup(99m)Tc-MDP penetrated well and accumulated in reactive new bone around bone tumors probably because in reactive new bone around bone tumors, the size of hydroxyapatite was small, the density of matrix of bone was low, and surface area of hydroxyapatite crystal was very wide. (Tsunoda, M.)

  2. A comparative study of calcium sulfate artificial bone graft versus allograft in the reconstruction of bone defect after tumor curettage

    Institute of Scientific and Technical Information of China (English)

    Yang Yongkun; Niu Xiaohui; Zhang Qing; Hao Lin; Ding Yi; Xu Hairong

    2014-01-01

    Background Cavity reconstruction after benign bone tumor removal is varied and controversial.AIIograft is widely used but is associated with complications.New bone substitutes,such as calcium sulfate artificial bone,have been introduced for bone tumor operation.However,the bone healing response of artificial bone has not been compared with allograft bone.We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors.Methods We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction.The two groups were well matched.The mean follow-up time of the study group was 19.9 (12-55) months.We investigated bone healing response,complications,and factors affecting bone healing.Results At the last follow-up,84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P=0.013).The initial healing rate showed no significant difference between the two groups (100% vs.96%,P=0.153).The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months,respectively (P <0.01).Complications in the study group were minor and resolved.Implant volume was a significant factor affecting bone healing.Conclusion The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage,especially in smaller cavities.

  3. Significance of bone specific alkaline phosphatase as a tumor marker in malignant bone tumor

    International Nuclear Information System (INIS)

    The relationship between total alkaline phosphatase activity and bone forming lesion is a well known fact. But alkaline phosphatase consist mainly of two portion (liver, bone). To clarify the exact activity of bone forming tissue, quantitative measurement of BALP is essential. Two finds of tests were performed for their feasibility as a laboratory test (wheat germ lectin vs electrophoresis). We analyzed 40 bony lesion and got 58 samples. Lectin method was simple, economic, with reliable resproducability. Owing to the small number of test sample, we could not identify the relationship between the disease activity and measured BALP level. Further collection of clinical sample and analysis the pattern of BALP on each clinical settings. (author). 8 refs

  4. Typical tumors of the petrous bone; Typische Tumoren des Felsenbeins

    Energy Technology Data Exchange (ETDEWEB)

    Ahlhelm, F.; Mueller, U. [Kantonsspital Baden AG, Abteilung fuer Neuroradiologie, Institut fuer Radiologie, Baden (Switzerland); Ulmer, S. [Medizinisch-Radiologisches Institut, Zuerich (Switzerland)

    2014-04-15

    In the region of the petrous bone, inner acoustic canal and cerebellopontine angle, a variety of different tissues can be found, such as bony, epithelial, neural and vascular structures. Tumorous or tumor-like lesions, vascular or bony malformations or other pathologies can therefore be found in all of these areas. We discuss various frequently occurring tumorous or tumor-like pathologies including congential lesions, such as mucoceles, inflammatory disorders including osteomyelitis, pseudotumors and Wegener's granulomatosis. Benign non-neoplastic lesions, such as cholesteatoma, cholesterol granuloma, epidermoid and benign neoplastic tumors, such as the most commonly found vestibular schwannoma, meningeoma, paraganglioma, vascular pathologies and finally malignant lesions, such as metastasis, chordoma or chondrosarcoma and endolymphatic sac tumor (ELST) are also discussed. The emphasis of this article is on the appearance of these entities in computed tomography (CT) and more so magnetic resonance imaging (MRI), it provides key facts and typical images and discusses possibilities how to distinguish these pathologies. (orig.) [German] In der Region des Felsenbein, inneren Gehoerkanals und Kleinhirnbrueckenwinkels findet sich eine Vielzahl an unterschiedlichen Gewebearten inklusive knoechernes, epitheliales, nervales und vaskulaeres Gewebe. Tumoren oder tumoraehnliche Laesionen, ossaere oder vaskulaere Pathologien koennen entsprechend dort gefunden werden. Wir diskutieren verschiedene Tumoren oder tumoraehnliche Pathologien inklusive angeborene Laesionen wie Muko- und Meningozelen, entzuendliche Veraenderungen wie die Osteomyelitis, Pseudotumoren, die Wegener-Granulomatose, nichtneoplastische Tumoren wie das Epidermoid, Cholesteatom oder Cholesterolgranulom und gutartige neoplastische Tumoren wie das am haeufigsten zu findende Vestibularisschwannom, das Paragangliom und das Meningeom, Gefaessprozesse/-pathologien und schliesslich maligne Laesionen wie Metastasen

  5. Evaluation and management of the pregnant patient with suspected primary musculoskeletal tumor or metastatic carcinoma to bone.

    Science.gov (United States)

    Puvanesarajah, Varun; Spiker, Andrea M; Shannon, Brett A; Grundy, Maureen; Levin, Adam S; Morris, Carol D

    2016-09-01

    Primary musculoskeletal cancer and metastatic disease to bone in pregnant patients presents major treatment challenges. Although uncommon, musculoskeletal malignancies in pregnant women have been reported. When diagnosing and treating these patients, the mother's health must be managed appropriately while ensuring that fetal development is not deleteriously affected. Extensive radiographic imaging and more advanced techniques are often necessary to fully characterize the extent of disease. When possible, magnetic resonance imaging should be used instead of computed tomography to limit exposure of the conceptus to radiation. If treatment is needed, therapeutic radiation, chemotherapy, and surgery should be considered. Surgical resection is the foundation of treatment of early-stage primary bone tumors and soft-tissue sarcomas during pregnancy. With surgery, anesthesia and thromboprophylaxis are important considerations. If chemotherapy is required, administration should be avoided in the first trimester to limit harm to the fetus. Therapeutic radiation should similarly be avoided during the first trimester and often can be postponed until after delivery. PMID:27566025

  6. Mesenchymal stem cells increase proliferation but do not change quiescent state of osteosarcoma cells: Potential implications according to the tumor resection status

    Directory of Open Access Journals (Sweden)

    Pierre Avril

    2016-03-01

    Full Text Available Conventional therapy of primary bone tumors includes surgical excision with wide resection, which leads to physical and aesthetic defects. For reconstruction of bone and joints, allografts can be supplemented with mesenchymal stem cells (MSCs. Similarly, adipose tissue transfer (ATT is supplemented with adipose-derived stem cells (ADSCs to improve the efficient grafting in the correction of soft tissue defects. MSC-like cells may also be used in tumor-targeted cell therapy. However, MSC may have adverse effects on sarcoma development. In the present study, human ADSCs, MSCs and pre-osteoclasts were co-injected with human MNNG-HOS osteosarcoma cells in immunodeficient mice. ADSCs and MSCs, but not the osteoclast precursors, accelerated the local proliferation of MNNG-HOS osteosarcoma cells. However, the osteolysis and the metastasis process were not exacerbated by ADSCs, MSCs, or pre-osteoclasts. In vitro proliferation of MNNG-HOS and Saos-2 osteosarcoma cells was increased up to 2-fold in the presence of ADSC-conditioned medium. In contrast, ADSC-conditioned medium did not change the dormant, quiescent state of osteosarcoma cells cultured in oncospheres. Due to the enhancing effect of ADSCs/MSCs on in vivo/in vitro proliferation of osteosarcoma cells, MSCs may not be good candidates for osteosarcoma-targeted cell therapy. Although conditioned medium of ADSCs accelerated the cell cycle of proliferating osteosarcoma cells, it did not change the quiescent state of dormant osteosarcoma cells, indicating that ADSC-secreted factors may not be involved in the risk of local recurrence.

  7. Real-time intraoperative full-range complex FD-OCT guided cerebral blood vessel identification and brain tumor resection in neurosurgery

    Science.gov (United States)

    Zhang, Kang; Huang, Yong; Pradilla, Gustavo; Tyler, Betty; Kang, Jin U.

    2011-03-01

    This work utilized an ultra-high-speed full-range complex-conjugate-free optical coherence tomography (FD-OCT) system to perform real-time intraoperative imaging to guide two common neurosurgical procedures: the cerebral blood vessel identification and the brain tumor resection. The cerebral blood vessel identification experiment is conducted ex vivo on human cadaver specimen. Specific cerebral arteries and veins in different positions of the specimen are visualized and the spatial relations between adjacent vessels are indentified through real-time 3D visualization. The brain tumor resection experiment is conducted in vivo on 9L gliomas established in rat brains. The normal brain-tumor margin can be clearly identified in depth of the tissue from sagittal, coronal and axial slices of the intraoperatively acquired 3D data set. The real-time full-range FD-OCT guided in vivo rat flank tumor resection is also conducted.

  8. Studies on apoptosis in bone tumor cells induced by 153Sm

    Institute of Scientific and Technical Information of China (English)

    ZHU Shou-Peng; XIAO Dong; HAN Xiao-Feng

    2004-01-01

    The apoptosis in human bone tumor cells induced by internal irradiation with 153Sm was studied. The morphological changes in bone tumor cells were observed by electronic and fluorescent microscopy, as well as DNA agarose gel eletrophoresis. DNA chain fragmentation, microautoradiographic tracing and the inhibition rate of proliferation in bone tumor cells exposed to 153Sm with different duration time were examined. It was demonstrated that the bone tumor cells exposed to 153Sm displayed nuclear fragmentation, pyknosis, margination of condensed chromatin, and formation of membrane bounded apoptotic bodies, whereas the percentage of DNA chain fragmentation of bone tumor cells increases in direct proportion to the duration of irradiation with 153Sm, as well as DNA ladder formation in apoptotic cells. Also a marked inhibition effect of proliferation in bone tumor cells after exposure with 153Sm was observed.

  9. Studies on apoptosis in bone tumor cells induced by 153Sm

    International Nuclear Information System (INIS)

    The apoptosis in human bone tumor cells induced by internal irradiation with 153Sm was studied. The morphological changes in bone tumor cells were observed by electronic and fluorescent microscopy, as well as DNA agarose gel electrophoresis. DNA chain fragmentation, microautoradiographic tracing and the inhibition rate of proliferation in bone tumor cells exposed to 153Sm with different duration time were examined. It was demonstrated that the bone tumor cells exposed to 153Sm displayed nuclear fragmentation, pyknosis, margination of condensed chromatin, and formation of membrane bounded apoptotic bodies, whereas the percentage of DNA chain fragmentation of bone tumor cells increases in direct proportion to the duration of irradiation with 153Sm, as well as DNA ladder formation in apoptotic cells. Also a marked inhibition effect of proliferation in bone tumor cells after exposure with 153Sm was observed. (authors)

  10. Bone marrow-derived CD13+ cells sustain tumor progression

    OpenAIRE

    Dondossola, Eleonora; Corti, Angelo; Sidman, Richard L.; Arap, Wadih; Pasqualini, Renata

    2014-01-01

    Non-malignant cells found within neoplastic lesions express alanyl (membrane) aminopeptidase (ANPEP, best known as CD13), and CD13-null mice exhibit limited tumor growth and angiogenesis. We have recently demonstrated that a subset of bone marrow-derived CD11b+CD13+ myeloid cells accumulate within neoplastic lesions in several murine models of transplantable cancer to promote angiogenesis. If these findings were confirmed in clinical settings, CD11b+CD13+ myeloid cells could become a non-mali...

  11. SYNCHROTRON RADIATION XRF MICROPROBE STUDY OF HUMAN BONE TUMOR SLICE

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    The experimental apparatus of X-ray fluorescence (XRF) microprobe analysis at Beijing Synchrotron Radiation Facility (BSRF) is described Using the bovine liver as the standard reference.the minimum detection limit(MDL) of trace element was measured to determine the capability of biological sample analysis by synchrotron radiation XRF microprobe.The relative change of the content of the major or trace element in the normal and tumor part of human bone tissue slice was investigated The experimental result relation to the clinical medicine was also discussed.

  12. Factors related to recurrence of bladder transitional cell carcinoma after transurethral resection of bladder tumor (TUR-BT)

    International Nuclear Information System (INIS)

    The purpose of this study is to evaluate factors related to the recurrence of TCC (transitional cell carcinoma) in the urinary bladder after transurethal resection of bladder tumor (TUR-BT). We retrospectively reviewed 54 patients in whom TCC (transitional cell carcinoma) after TUR-BT had been confirmed. Recurrence was evaluated by US, CT, cystoscopy and urine smear during the follow-up period of 6 months. The multiplicity, shape, size, and calcification of TCC, as revealed by radiologic studies, were evaluated retrospectively before TUR-BT. After TUR-BT, the histologic grade and pathologic stage of TCC were evaluated. Radiologically, multiple and/or sessile type TCC had a higher recurrence rate than the single and/or pedunculated type. Pathologically, when the grade and stage of bladder tumor were higher, recurrent rates were higher. (author). 17 refs., 3 tabs., 3 figs

  13. En bloc pelvic resection for advanced ovarian cancer preceded by central ligation of vessels supplying the tumor bed: a description of surgical technique and a feasibility study

    OpenAIRE

    Sznurkowski, Jacek Jan

    2016-01-01

    Background The resection of all visible malignancies increases the likelihood for long-term survival in epithelial ovarian cancer. The complete extinguishment of pelvic disease is possible using en bloc pelvic resection. The no-touch isolation technique aims to reduce cancer cells flowing from the primary tumor site to the liver and other organs by ligating blood and lymphatic vessels first. objectives are to present the operative details and to establish the feasibility of the modified techn...

  14. A clinical study on radiotherapy for metastatic bone tumor

    International Nuclear Information System (INIS)

    Seventy patients with 102 lesions of painful bone metastasis treated by radiation were studied. The conclusion is as follows; 1. Cumulative survival rate after irradiation to bone metastasis was very poor. Fifty percent survival term was very short, that was about 4 months in total cases, and 3 months in the cases of lung cancer. 2. It seemed that pain often occured in weight bearing bones. 3. In total cases, response rate was 85 % and complete response rate was 57 %. Concerning irradiated metastatic bone tumors, response rate was low in the thoracic and lumber spine, and concerning primary lesion it was low in cancer of the digestive organs. 4. It is important for pain relief to estimate the prognosis of a patient. ''A large dosage short term irradiation'' was more effective to the patient whom long survival term was not expected, because it was more effective and adequate for pain relief within short duration. 5. It needed TDF about 100 for pain relief without any correlation to primary lesion and histological type. It is equal to 40 Gy/8 fr./10 days and 60 Gy/30 fr./40 days. 6. An analysis of prognostic factor for pain relief was performed using multivariate analysis. Such factors were related to the prognosis of pain relief. Those were following; 1) treatment site, 2) histological type, 3) primary lesion, 4) total dose, 5) age, 6) one dose, 7) sex and 8) mode of metastasis. 7. There was no severe side effect that made it impossible to continue radiotherapy. 8. It seemed that the radiotherapy for painful bone metastasis was more effective and useful treatment. (author)

  15. Reconstruction of the thoracic tracheal defects with portions of deepithelialized myocutaneous flaps after resection of a large tumor

    Institute of Scientific and Technical Information of China (English)

    Susheng Wang; Gang Liang; Zhihua Zhang; Hang Ji; Chun Hou; Jianxing He; Weiqiang Yin

    2013-01-01

    Objective:To study the possibility of using portions of deepithelialized myocutaneous flaps to the reconstruction of thoracic tracheal defects after resection of a large tumor.Methods:From June 2007 to June 2012,five cases of defects of the thoracic trachea were reconstructed by applying portions of deepithelialized myocutaneous flaps.The patients were 27-61 years old with 4 male cases and 1 female.The cervical trachea ranged in diameter from 4-8.5 cm with circumferences of approximately 1/3-2/5 of the bronchial circumference.Results:All five patients with thoracic tracheal defects after resection of a large tumor were cured of portions of deepithelialized myocutaneous flaps,with no tracheal stricture remaining and vomica successfully eliminated.During the first 1 to 3 months after the operation,bronchoscopy showed that the tracheal lumens were smooth,and the visible skin of the musculocutaneous flaps became gray and exhibited a small amount of white discharge.Conclusions:Despite this being a small series and short follow-up,this thoracic tracheal reconstruction with portions of deepithelialized myocutaneous flaps shows encouraging preliminary results and could be an alternative to other methods for the treatment of carefully selected patients with thoracic tracheal defects.

  16. Intraoperative anesthetic management of patients undergoing glomus tumor resection using a low-dose isoflurane-fentanyl technique.

    Science.gov (United States)

    Jellish, W S; Murdoch, J; Leonetti, J

    1994-01-01

    Glomus jugulare and vagale tumors present unique problems to both anesthesiologists and surgeons. The anesthetic plant must be tailored to each patient and provide hemodynamic stability, a consistent intraoperative environment, and rapid awakening after prolonged administration. In this report, we describe our anesthetic method used for paraganglioma resection, which utilizes a combination technique of low-dose isoflurane with a narcotic infusion initiated after bolus administration. Results from the last three patients anesthetized by this "balanced" technique were compared to a similar patient who received isoflurane anesthesia exclusively for a major portion of the surgical procedure. The patients receiving the balanced anesthesia required no hemodynamic support during the procedure and were awakened within 15 to 25 minutes of surgical completion. The patient receiving high-dose isoflurane, however, had a prolonged anesthetic wake-up time and did not follow verbal commands for approximately 12 hours after surgical completion. This patient also required hemodynamic support with a phenylephrine infusion during tumor resection. The balanced technique seems to be superior to a straight inhalational technique. Neurological assessment and intubation times after prolonged surgery were reduced with superb hemodynamic stability throughout. This anesthetic method produces a stable intraoperative environment and provides deep surgical anesthesia during periods when muscle relaxants cannot be utilized. PMID:17170932

  17. The role of imaging for translational research in bone tumors

    International Nuclear Information System (INIS)

    Sarcomas are a heterogeneous group of rare connective tissue tumors, representing 1% of adult and 15% of childhood cancers for which biological and pathological information is still incomplete. In bone tumors patients with metastatic disease at onset, those who relapse and those with post-surgical secondary lesions still have a dismal outcome because of poor response to current therapies. Different molecular biology approaches have identified activated cell signalling pathways or specific molecular endpoints that may be considered potential drug targets or markers useful for diagnosis/prognosis in musculoskeletal pathology. Recently, advances in the field of molecular imaging allow visualization of cell and metabolic functions with the use of targets that include cell membrane receptors, enzymes of intracellular transport. Moreover advanced non-invasive newer imaging techniques like 18-FDG PET, quantitative dynamic-contrast MR imaging, diffusion weighted imaging have all shown a potential in distinguish malignant from benign lesions, in revealing the efficacy of therapy in tumors, the onset of recurrence and a good reliability in reckoning the percentage of necrosis in Ewing sarcoma and osteosarcoma. Thus, in vivo detection of imaging cancer biomarkers may be useful to better characterize those complex pathologic processes, such as apoptosis, proliferation and angiogenesis that determine tumor aggressiveness, providing not only complementary information of prognostic metabolic indicators, but also data in real-time on the efficacy of the treatment through the modulation of the cell metabolism

  18. Ameloblastoma relapse after 16 years of resection in symphysis of mandible sparing the bone graft

    OpenAIRE

    Ram, Rangila

    2010-01-01

    Ameloblastoma is a tumor derived from epithelium involved in odontogenesis. Although it is considered a benign tumor, its clinical behavior may be regarded as lying between benign and malignant. It is characterized by slow but persistent growth, local infiltration into adjacent tissues and recurrences; however, metastases are rare. Diagnosis mainly from tissue biopsy and characteristic finding on plain X-rays does assist in differentiating between types of ameloblastoma. The challenges in the...

  19. Reconstruction with fascia lata allograft of the posterior vertebra elements after resection for aneurysmal bone cyst in a child.

    Science.gov (United States)

    Errani, Costantino; Schuster, Sergio; Biagini, Roberto; Casadei, Roberto; De Paolis, Massimiliano; Bertoni, Franco; Boriani, Stefano; Mercuri, Mario

    2007-09-01

    We report a case of ABC in a child where, after resection of the posterior spinal column of L1, we did a biological reconstruction using a posterior tension band with a segment of fascia lata allograft in tension between T12 and L2. After the long term follow up, X-ray and MRI controls showed a satisfactory alignment of the spine and no local recurrence. The patient now has no sign of spinal instability or deviation, with no kind of discomfort or pain, and has a normal life. In our experience this biological tension band interferes minimally with the growth of the spine, and has a less number of complications in comparison with other more aggressive methods and so is a good option for restoring the stability in young patients with benign spinal tumors that arises on the posterior column without having any kind of potential deviations. PMID:17426986

  20. Reconstruction with fascia lata allograft of the posterior vertebra elements after resection for aneurysmal bone cyst in a child

    Science.gov (United States)

    Schuster, Sergio; Biagini, Roberto; Casadei, Roberto; De Paolis, Massimiliano; Bertoni, Franco; Boriani, Stefano; Mercuri, Mario

    2007-01-01

    We report a case of ABC in a child where, after resection of the posterior spinal column of L1, we did a biological reconstruction using a posterior tension band with a segment of fascia lata allograft in tension between T12 and L2. After the long term follow up, X-ray and MRI controls showed a satisfactory alignment of the spine and no local recurrence. The patient now has no sign of spinal instability or deviation, with no kind of discomfort or pain, and has a normal life. In our experience this biological tension band interferes minimally with the growth of the spine, and has a less number of complications in comparison with other more aggressive methods and so is a good option for restoring the stability in young patients with benign spinal tumors that arises on the posterior column without having any kind of potential deviations. PMID:17426986

  1. Recurrence after gross-total resection of low-grade pediatric brain tumors: the frequency and timing of postoperative imaging

    Science.gov (United States)

    Kim, Albert H.; Thompson, Elizabeth A.; Governale, Lance S.; Santa, Catalina; Cahill, Kevin; Kieran, Mark W.; Chi, Susan N.; Ullrich, Nicole J.; Scott, R. Michael; Goumnerova, Liliana C.

    2016-01-01

    Object Low-grade glial and glioneuronal brain tumors are frequently encountered in the pediatric population and can be effectively treated by resection. The authors aimed to use imaging to evaluate how often tumors recurred and to determine if recurrences were associated with any clinical symptoms, along with the financial costs of imaging, in patients with radiographically proven gross-total resection (GTR) at Boston Children’s Hospital. These data were assessed to propose guidelines regarding postoperative surveillance. Methods The authors performed a retrospective cohort analysis of the Pediatric Brain Tumor Program database from 1993 to 2003 to identify patients with glial or glioneuronal tumors initially evaluated at Boston Children’s Hospital. Among the 888 patients evaluated for any type of brain tumor during this period, 67 patients had WHO Grade I glial or glioneuronal lesions with radiographically proven GTR and available follow-up data. The frequency and timing of postoperative imaging was compared with the institutional protocol. Recurrence-free survival was calculated using the Kaplan-Meier method. Financial costs of imaging were available from 2001 to 2009 and were averaged to extrapolate the postoperative surveillance costs. Results Among the 67 patients with GTR, 13 recurrences were detected radiographically with a mean time to recurrence of 32.4 months (range 2.9–128.5 months). The mean duration of follow-up after surgery was 6.6 years. The recurrence-free survival at 2 and 5 years after GTR for all low-grade glial and glioneuronal tumors was 0.90 (95% CI 0.82–0.97) and 0.82 (95% CI 0.73–0.92), respectively. No clinical symptoms were associated with any of the recurrences, and no deaths occurred. Under the institutional protocol of surveillance imaging, the estimated cost per recurrence at 5 years was $104,094 per patient. The proposed protocol would reduce the number of MR scans in the first 5 years from 10 to 5, providing a potential

  2. Percutaneous treatment of bone tumors by radiofrequency thermal ablation

    International Nuclear Information System (INIS)

    We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean (±SD) reduction in visual analogue scale (VAS) pain score from 9.0 ± 0.4 before the procedure to <4 during the follow-up period.

  3. Percutaneous treatment of bone tumors by radiofrequency thermal ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Santiago, Fernando, E-mail: ferusan@ono.com [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Mar Castellano Garcia, Maria del; Guzman Alvarez, Luis [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Martinez Montes, Jose Luis [Department of Traumatology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain); Ruiz Garcia, Manuel; Tristan Fernandez, Juan MIguel [Department of Radiology, Hospital of Traumatology (Ciudad Sanitaria Virgen de las Nieves), Carretera de Jaen SN, 18013 Granada (Spain)

    2011-01-15

    We present our experience of the treatment of bone tumors with radiofrequency thermal ablation (RFTA). Over the past 4 years, we have treated 26 cases (22 benign and 4 malignant) using CT-guided RFTA. RFTA was the sole treatment in 19 cases and was combined with percutaneous cementation during the same session in the remaining seven cases. Our approach to the tumors was simplified, using a single point of entrance for both RFTA and percutaneous osteoplasty. In the benign cases, clinical success was defined as resolution of pain within 1 month of the procedure and no recurrence during the follow-up period. It was achieved in 19 out of the 21 patients in which curative treatment was attempted. The two non-resolved cases were a patient with osteoid osteoma who developed a symptomatic bone infarct after a symptom-free period of 2 months and another with femoral diaphysis osteoblastoma who suffered a pathological fracture after 8 months without symptoms. The procedure was considered clinically successful in the five cases (4 malign and 1 benign) in which palliative treatment was attempted, because there was a mean ({+-}SD) reduction in visual analogue scale (VAS) pain score from 9.0 {+-} 0.4 before the procedure to <4 during the follow-up period.

  4. [Genetic Aberration and Pathological Diagnosis in Bone and Soft-Tissue Tumors].

    Science.gov (United States)

    Iura, Kunio; Oda, Yoshinao

    2016-03-01

    Bone and soft-tissue sarcomas comprise a rare, complex, and heterogeneous group of tumors for which it is difficult for even experienced pathologists to provide a conclusive diagnosis. The number of diagnoses made using genetic analysis has increased since the detection of fusion genes in several soft-tissue tumors in the 1990s. Moreover, other specific genetic aberrations have been reported in various bone and soft-tissue tumors. In addition, molecular therapeutic targets have been sought in advanced cases of soft-tissue and bone tumors similar to other organ malignancies. To enable the pathological diagnosis of bone and soft-tissue tumors, it is necessary to combine histological diagnosis with immunohistochemistry and gene analysis findings including fusion gene or other genetic aberrations. In this review, we describe the fusion genes recently reported in bone and soft-tissue tumors such as solitary fibrous tumor, aneurysmal bone cyst, nodular fasciitis, CIC-DUX4 fusion gene-positive small round cell tumors, or BCOR-CCNB3-positive sarcoma as well as other genetic aberrations in dedifferentiated liposarcoma, malignant rhabdoid tumor, cartilaginous tumor, Langerhans cell histiocytosis chondroblastoma, or giant cell tumor of the bone. We also demonstrate their association with pathological diagnosis. PMID:27067846

  5. Studies on anti-tumor effects of continuous intra-arterial infusion chemotherapy in the treatment of bone and soft tissue tumors using 99mTc-MAA RI-angiography

    International Nuclear Information System (INIS)

    99mTc-macroaggregated albumin (MAA) RI-angiographies were carried out in 43 patients having bone and soft tissue tumors. The diagnoses were osteosarcoma (20), Ewing's sarcoma (4), leiomyosarcoma of the bone (2), malignant fibrous histocytoma (3) giant cell tumor of the bone (5), liposarcoma (3), synovial sarcoma (3) and other types of tumors. Five mCi MAA was infused through an indwelling arterial catheter, and its flow was traced immediately afterward by a scintillation camera. This procedure was performed every 2 or 4 weeks during intra-arterial infusion chemotherapy. The RI-angiographies offer an excellent way to evaluate catheter placement and tumor perfusion, in addition to providing a way to evaluate A-V shunts with lung scans. From the comparison with the histological findings of the resected tumor specimen, the apparent result that the RI-angiographic images obtained at each stage of chemotherapy period also demonstrated the degree of tumor tissue response to intra-arterial chemotherapy, is highly suggestive. Regions where 99mTc-MAA uptake decreased with increasing peripheral accumulation were found to be markedly necrotic. But regions where 99mTc-MAA uptake was obscure during the course of chemotherapy were found to consist of viable cells. Therefore it was concluded that 99mTc-MAA RI-angiography combined with intra-arterial infusion chemotherapy is a very useful method for the assessment of anti-tumor effects in cases involving limb saving surgery. (author)

  6. Site and number of liver tumors recorded at angiography and computed tomography compared with the findings at laparotomy and of resected liver specimens

    International Nuclear Information System (INIS)

    Angiography and computed tomography (CT) were performed in 96 patients before laparotomy for an intended liver resection. Of these, 73 patients underwent liver resection, from a local excision to a trisegmentectomy. The accuracy of angiography in tumor localization was 77% when the results were compared with the findings at laparotomy and from resected specimens. With CT the accuracy was 85%. In 47 patients an analysis of the number of tumor nodules was possible. There were 76 nodules, and 42 (55%) were correctly identified by angiography and 58% (76%) byCT. Thirty-four tumor nodules were not seen at angiography, with the majority of these situated in the left liver lobe. At CT, 18 nodules were not observed, about equal numbers in right and left lobes. Five lesions thought to be present at angiography (9 at CT), could not be verified upon inspecting the resected specimens. Neither angiography nor CT seems to be reliable enough for an accurate prediction of resectability of liver tumors prior to laparotomy. (orig.)

  7. Awake brain tumor resection during pregnancy: Decision making and technical nuances

    OpenAIRE

    Meng, L.; Han, SJ; Rollins, MD; Gelb, AW; Chang, EF

    2016-01-01

    © Published by Elsevier Ltd. The co-occurrence of primary brain tumor and pregnancy poses unique challenges to the treating physician. If a rapidly growing lesion causes life-threatening mass effect, craniotomy for tumor debulking becomes urgent. The choice between awake craniotomy versus general anesthesia becomes complicated if the tumor is encroaching on eloquent brain because considerations pertinent to both patient safety and oncological outcome, in addition to fetal wellbeing, are invol...

  8. Robot-assisted laparoscopic resection of a huge pelvic tumor: A case report.

    Science.gov (United States)

    Jia, Zhuomin; Lyu, Xiangjun; Xu, Yong; Leonardi, Rosario; Zhang, Xu

    2016-01-01

    The traditional open surgery, for the treatment of huge tumor in the narrow space of pelvic cavity and in close proximity to pelvic organs and neurovascular structures, is very difficult and challenging. We report a case of huge neurilemmoma operated using the robot-assisted laparoscopy. We used interventional pre-operation embolization to control blood supply of tumor because MRI showed the tumor had a sufficient blood supply. PMID:27377092

  9. Intraoperative ultrasound in determining the extent of resection of parenchymal brain tumors - a comparative study with computed tomography and histopathology

    International Nuclear Information System (INIS)

    Radical excision of parenchymal brain tumours is generally associated with a better long-term outcome; however, it is difficult to ascertain the extent of resection at surgery. We used intra-operative ultrasound [IOUS] to help detect residual tumour and define the tumour-brain interface. Thirty-five patients with parenchymal brain lesions including 11 low-grade and 22 high-grade tumours and 2 inflammatory granulomata were included in the study. The IOUS was used to localize tumours not seen on the surface, define their margins and assess the extent of resection at the end of surgery. Multiple samples from the tumour-brain interface which were reported as tumour or normal tissue an IOUS were submitted to histopathology. The IOUS findings were compared with a postoperative contrast enhanced computed tomogram [CT] and with histopathology. All tumours irrespective of histology were hyperechoic an IOUS. IOUS was useful in localizing those tumours not seen on the surface of the brain. In 71.4 % of cases IOUS was useful in defining their margins, however in the remaining cases the margins were ill-defined. The tumour margins were ill-defined in those treated previously by radiation. With regard to the extent of excision, after excluding the cases who were irradiated, it was found that in the 28 patients who had parenchymal neoplasms, there was concordance between the ultrasound findings and the postoperative CT scan in 23 cases. Of the 79 samples taken from the tumor-brain interface which were reported as tumour on ultrasound, 66 had histopathological evidence of tumour while 13 samples were negative for tumour. On the other hand, in the tissue sent from 17 sites where the IOUS showed no residual tumour, 2 were positive for tumour on histopathology while 15 were negative. In conclusion, IOUS is a cheap and useful real-time tool for localizing tumours not seen on the brain surface, for defining their margins and for determining the extent of resection. (author)

  10. CT assessment of the correlation between clinical examination and bone involvement in oral malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Albuquerque, Marco Antonio Portela; Oliveira, Ilka Regina Souza; Cavalcanti, Marcelo Gusmao Paraiso [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Radiologia], e-mail: mgpcaval@usp.br; Kuruoshi, Marcia Etsuko [Universidade de Sao Paulo (USP), SP (Brazil). Hospital Universitario. Dept. de Radiologia

    2009-07-01

    Oral cancers have a tendency to invade the surrounding bone structures, and this has a direct influence on the treatment management and on outcomes. The objective of this study was to correlate the clinical parameters (location, clinical presentation and TNM staging) of oral malignant tumors that can be associated with a potential of bone invasion and determine the accuracy of clinical examination to predict bone involvement, using computed tomography (CT). Twenty five patients, with oral malignant tumors were submitted to clinical and CT examinations. CT was considered the standard parameter to evaluate the presence of bone involvement. Clinical assessment of location, presentation form and TNM staging of the tumors were then compared to the CT findings in predicting bone involvement. Bone involvement was observed in 68% of the cases. It was predicted that tumors located in the retromolar trigone and hard palate, with a clinical aspect of infiltrative ulcer or nodule and classified in stage IV had a high potential to cause bone involvement. The clinical examination assessment of these tumors showed to be a valuable tool to predict bone invasion, with high sensitivity (82%) and specificity (87.5%), based on the results found in the CT images. No statistical significance was found between the CT and clinical examinations regarding bone involvement. The identification of some clinical parameters such as location, clinical presentation, and TNM stage, associated with a detailed clinical examination, was considered a valuable tool for the assessment of bone destruction by oral malignant tumors. (author)

  11. 骨肿瘤临床研究的探讨%Clinical research of bone tumors

    Institute of Scientific and Technical Information of China (English)

    王臻

    2013-01-01

    Bone tumors occur in the bone or its affiliated organizations ( blood vessels, nerves, bone marrow, etc. ) .The bone tumors incidence in the population is about 0.01%. The clinical treatment of bone tumors in recent years has made a rapid development, clinical treatment becomes more professional and standard, meanwhile, more attention focus on the application of clinical epidemiology and evidence-based medicine theory. Imaging is playing a great role in the diagnosis and treatment of bone tumors, especially in the determination of the tumor border and tumor nature. Meanwhile, with the application of neoadjuvant chemotherapy and new technologies, the surgery and reconstruction of such as osteosarcoma has made great progress, the survival rate and survival time increase signiifcantly. So the late recurrence of osteosarcoma begins to attract attention. Furthermore, bone cyst as a common bone tumor-like lesions, which hormone therapy is a treatment for choice. “Chinese Journal of Bone and Joint”published some articles about the topics above. These articles discussed the issues from different angles, which were worth to read and discussion and further research.

  12. Tumor-derived Jagged1 Promotes Osteolytic Bone Metastasis of Breast Cancer by Engaging Notch Signaling in Bone Cells

    OpenAIRE

    Sethi, Nilay; Dai, Xudong; Winter, Christopher G.; Kang, Yibin

    2011-01-01

    Despite evidence supporting an oncogenic role in breast cancer, the Notch pathway’s contribution to metastasis remains unknown. Here we report that the Notch ligand Jagged1 is a clinically and functionally important mediator of bone metastasis by activating the Notch pathway in bone cells. Jagged1 promotes tumor growth by stimulating IL-6 release from osteoblasts and directly activates osteoclast differentiation. Furthermore, Jagged1 is a potent downstream mediator of the bone metastasis cyto...

  13. Histological Regression of Giant Cell Tumor of Bone Following RANK Ligand Inhibition.

    Science.gov (United States)

    Dietrich, Martin F; Cavuoti, Dominick; Landay, Michael; Arriaga, Yull E

    2014-01-01

    Lung metastases are a rare complication of giant cell tumors of bone. We herein describe an interesting case of histological regression and size reduction of lung metastases originating from a primary giant cell tumor of bone in response to the RANK ligand inhibitor denosumab. PMID:26425630

  14. MRI Risk Stratification for Tumor Relapse in Rectal Cancer Achieving Pathological Complete Remission after Neoadjuvant Chemoradiation Therapy and Curative Resection.

    Directory of Open Access Journals (Sweden)

    Honsoul Kim

    Full Text Available Rectal cancer patients achieving pCR are known to have an excellent prognosis, yet no widely accepted consensus on risk stratification and post-operative management (e.g., adjuvant therapy has been established. This study aimed to identify magnetic resonance imaging (MRI high-risk factors for tumor relapse in pathological complete remission (pCR achieved by rectal cancer patients who have undergone neoadjuvant concurrent chemoradiation therapy (CRT and curative resection.We analyzed 88 (male/female = 55/33, median age, 59.5 years [range 34-78] pCR-proven rectal cancer patients who had undergone pre-CRT MRI, CRT, post-CRT MRI and curative surgery between July 2005 and December 2012. Patients were observed for post-operative tumor relapse. We analyzed the pre/post-CRT MRIs for parameters including mrT stage, mesorectal fascia (mrMRF status, tumor volume, tumor regression grade (mrTRG, nodal status (mrN, and extramural vessel invasion (mrEMVI. We performed univariate analysis and Kaplan-Meier survival analysis.Post-operative tumor relapse occurred in seven patients (8.0%, n = 7/88 between 5.7 and 50.7 (median 16.8 months. No significant relevance was observed between tumor volume, volume reduction rate, mrTRG, mrT, or mrN status. Meanwhile, positive mrMRF (Ppre-CRT = 0.018, Ppre/post-CRT = 0.006 and mrEMVI (Ppre-CRT = 0.026, Ppre-/post-CRT = 0.008 were associated with higher incidence of post-operative tumor relapse. Kaplan-Meier survival analysis revealed a higher risk of tumor relapse in patients with positive mrMRF (Ppre-CRT = 0.029, Ppre-/post-CRT = 0.009 or mrEMVI (Ppre-CRT = 0.024, Ppre-/post-CRT = 0.003.Positive mrMRF and mrEMVI status was associated with a higher risk of post-operative tumor relapse of pCR achieved by rectal cancer patients, and therefore, can be applied for risk stratification and to individualize treatment plans.

  15. Giant cell tumor of the metatarsal bone: case report and review of the literature

    International Nuclear Information System (INIS)

    Giant cell tumor of bone is a rare neoplasm and account for 5% of all primary bone tumors. It is common in the knee and wrist, but rare in the small bones of the foot. The authors report a 32-year old male patient presented with a four-month history of right foot pain. Plain radiographs showed an expansive lytic lesion involving the first right metatarsal bone. Computed tomography scan demonstrated a radiolucent lesion with well-defined borders. Biopsy was performed and the histological diagnostic was giant cell tumor. The authors emphasize the correlation between the imaging and histological findings. (author)

  16. Imaging of limb salvage surgery and pelvic reconstruction following resection of malignant bone tumours

    International Nuclear Information System (INIS)

    Highlights: • Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. • The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. • This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases. • By being aware of the various types of reconstructive techniques used in limb salvage surgery as well as the potential complications, the reporting radiologist should possess greater confidence in making an accurate assessment of the expected post-operative imaging findings in the management of such cases. - Abstract: Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases

  17. Imaging of limb salvage surgery and pelvic reconstruction following resection of malignant bone tumours

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Tien Jin, E-mail: tien_jin_tan@cgh.com.sg [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada); Aljefri, Ahmad M. [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada); Clarkson, Paul W.; Masri, Bassam A. [Department of Orthopaedics, University of British Columbia, Vancouver, BC (Canada); Ouellette, Hugue A.; Munk, Peter L.; Mallinson, Paul I. [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada)

    2015-09-15

    Highlights: • Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. • The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. • This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases. • By being aware of the various types of reconstructive techniques used in limb salvage surgery as well as the potential complications, the reporting radiologist should possess greater confidence in making an accurate assessment of the expected post-operative imaging findings in the management of such cases. - Abstract: Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases.

  18. Papillary Ependymoma WHO Grade II of the Aqueduct Treated by Endoscopic Tumor Resection

    Directory of Open Access Journals (Sweden)

    Andreas M. Stark

    2009-01-01

    Full Text Available Papillary ependymoma is a rare tumor that may be located along the ventricular walls or within the spinal cord. We report the case of a 54-year-old patient with a papillary ependymoma WHO grade II arising at the entrance of the aqueduct. The tumor caused hydrocephalus. The tumor was completely removed via a right-sided endoscopic approach with restoration of the aqueduct. The free cerebrospinal fluid passage through the aqueduct was not only visualized by endoscopy but also controlled by intraoperative high-field magnetic resonance imaging. Therefore, an additional endoscopic third ventriculostomy was unneccessary.

  19. Tumor regression of multiple bone metastases from breast cancer after administration of strontium-89 chloride (Metastron)

    International Nuclear Information System (INIS)

    We report a case of tumor regression of multiple bone metastases from breast carcinoma after administration of strontium-89 chloride. This case suggests that strontium-89 chloride can not only relieve bone metastases pain not responsive to analgesics, but may also have a tumoricidal effect on bone metastases

  20. Preparation of bone tumor therapeutic radiopharmaceuticals 153Sm-EDTMP

    International Nuclear Information System (INIS)

    Samarium-153-EDTMP (ethylene diamine tetramethylene phosphonate), for its promising biological properties, has been proved as a palliating therapeutic agent for bone tumor in human beings. 153Sm with high radionuclear purity and specific activity of 5.18 GBq (140 mCi)/mg Sm2O3 was prepared by irradiating natural Sm2O3(152Sm, 26.7%) sample, replacing costly enriched samarium oxide target, at a flux of 4 x 1013 n·cm-2·s-1 for 110 h. The yield of 153Sm complexing with EDTMP is greater than 98% at pH 8∼10 in boiling water bath for 30 min, and not significantly decreases within one week after 153Sm-EDTMP complex formation

  1. Autograft-prosthesis composite for aggressive giant cell tumor of bone around knee%自体骨复合旋转铰链膝关节治疗骨巨细胞瘤

    Institute of Scientific and Technical Information of China (English)

    Xiuchun Yu; Ming Xu; Zhihou Fu; Songfeng Xu

    2009-01-01

    Objective: The aim of the research was to study the clinical feasibility of autograft-prosthesis composite for aggressive giant cell tumor of bone around knee. Methods: Seven patients (5 males and 2 females, the mean age of 30.5 years old) with giant cell tumor of bone around knee underwent tumor resection and reconstructed with autograft-prosthesis composites since January 2006. Five lesions located at the distal femur and 2 at the proximal tibia. There were 3 patients with primary tumor and 4 with recurrent. Three patients with pathological fracture and all patients were of Campanacci Ⅲ. Results:All patients were done follow-up from 12 to 36 months. No recurrence, metastasis, and prosthesis loosening were found. The mean healing time between autograft and host bone was 5 months. The mean motion range of affected knee were 90° (70°-110°). Conclusion: Our data documented the clinical feasibility of autograft-prosthesis composite for giant cell tumor of bone around knee which should be performed tumor resection and reconstructed with prosthesis. The long-term outcomes remain to be further proven.

  2. Use of three-dimensional models to assist in the resection of malignant cardiac tumors.

    Science.gov (United States)

    Al Jabbari, Odeaa; Abu Saleh, Walid K; Patel, Avni P; Igo, Stephen R; Reardon, Michael J

    2016-09-01

    The application of three-dimensional (3D) printing enables the creation of material objects from digital images by depositing layers of plastic material into 3D structures and can be used for training, education, and surgical planning. We report two patients with large complex cardiac tumors where 3D technology was utilized to analyze the tumor size, location, and extension more precisely, allowing better preoperative planning and decision making. PMID:27455392

  3. Intraductal Radiofrequency Ablation Followed by Locoregional Tumor Treatments for Treating Occluded Biliary Stents in Non-Resectable Malignant Biliary Obstruction: A Single-Institution Experience

    OpenAIRE

    Xu-Hua Duan; Yan-Li Wang; Xin-Wei Han; Jian-Zhuang Ren; Teng-Fei Li; Jian-Hao Zhang; Kai Zhang; Peng-Fei Chen

    2015-01-01

    Objectives To determine the safety and feasibility of intraductal radiofrequency ablation (RFA) followed by locoregional tumor treatments in patients with non-resectable malignant biliary obstruction and stent re-occlusion. Methods Fourteen patients with malignant biliary obstruction and blocked metal stents were studied retrospectively. All had intraductal RFA followed by locoregional tumor treatments and were monitored clinically and radiologically. The practicality, safety, postoperative c...

  4. Endoscopic resection of sparganosis presenting as colon submucosal tumor: A case report.

    Science.gov (United States)

    Kim, Joong Keun; Baek, Dong Hoon; Lee, Bong Eun; Kim, Gwang Ha; Song, Geun Am; Park, Do Youn

    2016-05-21

    Human sparganosis is a rare parasitic disease caused by infection with the tapeworm Sparganum, the migrating plerocercoid (second stage) larva of Spirometra species. Sparganosis usually involves subcutaneous tissues and/or muscles of various parts of the body, but involvement of other sites such as the brain, eye, peritoneopleural cavity, urinary track, scrotum, and abdominal viscera has also been documented. Infections caused by sparganum have a worldwide distribution but are most common in Southeast Asia such as China, Japan, and South Korea. Rectal sparganosis is an uncommon disease but should be considered in the differential diagnosis of unusual and suspicious rectal submucosal tumors. We report a case of rectal sparganosis presenting as rectal submucosal tumor. We performed endoscopic submucosal dissection of the rectal submucosal tumor. The sparganosis was confirmed based on the presence of calcospherules in the submucosal layer on histological examination. Moreover, the result of the immunoglobulin G antibody test for sparganosis was positive but became negative after endoscopic submucosal dissection. Though rare, rectal sparganosis should be considered in the differential diagnosis of rectal submucosal tumor-like lesions. This case suggests that physicians should make effort to exclude sparganosis through careful diagnostic approaches, including detailed history taking and serological tests for parasites. In this report, we aimed to highlight the clinical presentation of Sparganum infection as a rectal submucosal tumor. PMID:27217709

  5. Bone

    International Nuclear Information System (INIS)

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  6. Aggressive Behavior of a Giant Cell Tumor Involving the Metacarpal Bone During Pregnancy: Case Report

    International Nuclear Information System (INIS)

    Giant cell tumors are benign osteolytic tumors with a variable degree of aggressiveness. We report a rare case of a giant cell tumor involving the metacarpal bone, which was detected during pregnancy and showed rapid progression on a follow-up examination.

  7. Galectin-3 in bone tumor microenvironment: a beacon for individual skeletal metastasis management.

    Science.gov (United States)

    Nakajima, Kosei; Kho, Dong Hyo; Yanagawa, Takashi; Zimel, Melissa; Heath, Elisabeth; Hogan, Victor; Raz, Avraham

    2016-06-01

    The skeleton is frequently a secondary growth site of disseminated cancers, often leading to painful and devastating clinical outcomes. Metastatic cancer distorts bone marrow homeostasis through tumor-derived factors, which shapes different bone tumor microenvironments depending on the tumor cells' origin. Here, we propose a novel insight on tumor-secreted Galectin-3 (Gal-3) that controls the induction of an inflammatory cascade, differentiation of osteoblasts, osteoclasts, and bone marrow cells, resulting in bone destruction and therapeutic failure. In the approaching era of personalized medicine, the current treatment modalities targeting bone metastatic environments are provided to the patient with limited consideration of the cancer cells' origin. Our new outlook suggests delivering individual tumor microenvironment treatments based on the expression level/activity/functionality of tumor-derived factors, rather than utilizing a commonly shared therapeutic umbrella. The notion of "Gal-3-associated bone remodeling" could be the first step toward a specific personalized therapy for each cancer type generating a different bone niche in patients afflicted with non-curable bone metastasis. PMID:27067726

  8. Resección tumoral en bloque y reconstrucción de pared torácica In-bloc tumor resection and chest wall reconstruction

    Directory of Open Access Journals (Sweden)

    D. Palafox

    2011-09-01

    Full Text Available La resección de una neoplasia pulmonar o mediastínica que afecta simultáneamente a la pared torácica y la reconstrucción del defecto originado por la misma, son procedimientos quirúrgicos que se pueden realizar en un mismo tiempo operatorio. Con la reconstrucción primaria se busca preservar la función respiratoria y la integridad de la caja torácica, permitiendo al paciente una buena mecánica respiratoria, a la vez que un resultado estético satisfactorio y evitando la necesidad de una nueva intervención quirúrgica. Existen diversas técnicas y disponemos de diferentes materiales protésicos para su realización. Presentamos a continuación el caso de un paciente al que se le realizó satisfactoriamente una resección tumoral en bloque y reconstrucción de la pared torácica.Resection of a pulmonary or mediastinic neoplasm which simultaneously affects chest wall and reconstruction of the defect, are surgical proceedings that can be performed in the same surgical time. The objectives of reconstructing primarily the chest wall are to preserve the respiratory function and the thoracic wall integrity, therefore offering the patient appropriate respiratory mechanics, satisfactory aesthetic result and avoiding the needding for a second surgical intervention. There are several techniques and materials available for the surgery performance. We present the case of a patient who underwent successfully tumoral resection in-bloc and chest wall reconstruction.

  9. NI-49SMART SUCKER: NEXT GENERATION SMART SURGICAL TOOL FOR INTRAOPERATIVE BRAIN TUMOR RESECTION USING TIME RESOLVED LASER INDUCED FLUORESCENCE SPECTROSCOPY

    Science.gov (United States)

    Kittle, David S.; Butte, Pramod V.; Vasefi, Fartash; Patil, Chirag G.; Black, Keith

    2014-01-01

    Primary brain tumors are highly lethal tumors where surgical resection is the primary treatment of choice. It has been shown that survival rate is directly related to the extent of tumor resection. In order to aid the surgeon in achieving near-complete resection, novel technologies are required. Time-resolved laser induced fluorescence spectroscopy (TRLIFS) promises to be one such technology, where the tissue is excited using an ultra-short laser and the corresponding fluorescence intensity decay is captured. Based on the fluorescence spectrum and the decay characteristics at various color bands from TRLIFS, differentiation of tumor from the normal brain tissue is possible in real-time. We built a portable TRLIFS system using custom optics and hardware (laser excitation: 355nm, 400ps pulse width, 5 uJ/pulse; PMT detector: Photek, rise time 80 picoseconds; digitizer: 7 Giga-samples per second) which is capable of providing the results in real time (every 50 milliseconds). We have designed a custom probe which is attached to a Roton sucker "Smart sucker" to collect the data during surgical resection from patients at Cedars-Sinai Medical Center. The histopathological diagnosis of the site under study with TRLIFS is confirmed with a biopsy and H-E staining. We will present our preliminary data from human brain tumor samples collected in-vivo. Our preliminary study shows that TRLIFS is capable of classifying low grade tumors with high sensitivity and specificity. This study will also demonstrate the potential of using the TRLIFS system to enhance the surgical instrumentation, aiding surgeons in near-complete excision of tumors and bringing these instruments into the next generation of smart tools.

  10. The separation of a mixture of bone marrow stem cells from tumor cells: an essential step for autologous bone marrow transplantation

    International Nuclear Information System (INIS)

    KHT tumor cells were mixed with mouse bone marrow to simulate a sample of bone marrow containing metastatic tumor cells. This mixture was separated into a bone marrow fraction and a tumor cell fraction by centrifugal elutriation. Elutriation did not change the transplantability of the bone marrow stem cells as measured by a spleen colony assay and an in vitro erythroid burst forming unit assay. The tumorogenicity of the KHT cells was similarly unaffected by elutriation. The data showed that bone marrow cells could be purified to less than 1 tumor cell in more than 106 bone marrow cells. Therefore, purification of bone marrow removed prior to lethal radiation-drug combined therapy for subsequent autologous transplantation appears to be feasible using modifications of this method if similar physical differences between human metastatic tumor cells and human bone marrow cells exist. This possibility is presently being explored

  11. 同种异体骨复合自体骨髓干细胞移植治疗良性骨肿瘤和瘤样病变%Allogeneic bone combined with autologous bone marrow stem cell transplantation for the treatment of benign bone tumors and tumor-like lesions

    Institute of Scientific and Technical Information of China (English)

    刘英飞; 王涛; 张平德

    2013-01-01

      背景:同种异体骨是临床常用的骨移植材料,但缺乏诱导成骨能力是最大的问题。目的:评价良性骨肿瘤及瘤样病变刮除或切除后应用同种异体骨复合自体骨髓干细胞修复骨缺损的效果。方法:65例良性骨肿瘤(包括瘤样病变)患者,根据植骨情况分为2组。复合骨髓干细胞植骨组35例患者根据预计植骨量从每位患者两侧的髂前上棘或髂后上棘抽取红骨髓20-40 mL,经体外分离、纯化、培养扩增骨髓基质干细胞备用,在植骨前将同种异体骨颗粒与骨髓基质干细胞充分混匀。肿瘤刮除或切除后,将混匀的骨髓基质干细胞与同种异体骨颗粒,植入骨缺损区内。单纯植骨组将用生理盐水浸泡半小时的同种异体骨植入骨缺损区内。分别于治疗后1,3,6,12个月进行植骨区X射线检查,比较两组病例同种异体骨颗粒界限模糊、消失的时间,同时观察术后并发症发生情况。结果与结论:62例患者均获得12个月以上随访。复合骨髓干细胞植骨组移植骨界限模糊时间和消失时间均短于单纯植骨组(P <0.05)。复合骨髓干细胞植骨组1例出现排异反应,使用免疫抑制剂治疗2周后痊愈,两组病例均未出现感染。结果表明同种异体骨复合自体骨髓干细胞植骨能明显促进骨融合和骨缺损的愈合。%BACKGROUND:Al ogenic bone is a clinical commonly used bone graft material, but the osteoinductive capacity is the biggest problem. OBJECTIVE:To evaluate the effect of al ogeneic bone combined with autologous bone marrow stem cells on the repair of bone defects after scraping or resection of benign bone tumors and tumor-like lesions. METHODS:Sixty-five cases of benign bone tumors (including patients with tumor-like lesions) were divided into two groups according to bone graft. There were 35 cases in the composite bone marrow stem cells for bone graft group, and 20-40 mL red

  12. Resection of tumors in the third ventricle and thalamus by laser endoscopy: report of three cases

    Science.gov (United States)

    Li, Zhi-Qiang; Li, Han-Jie; Li, Chan-Yuan

    1998-11-01

    Common intraventricular operation often brings about some server complications such as high fever, lost of consciousness, stress ulcer and serious encephaledema etc. this is changing with the development of minimally invasive neurosurgery. SLT contact laser has advantages of little thermal effect, slight brain tissue injury and working normally in liquid environment. Endoscopy makes it possible that the operation can be carried out in tiny space. Combination of both techniques mentioned above leads to convenient removal of cerebral tumors in vital part of the brain like ventricle, thalamus and cerebellopontile angle et at. with little even without brian harm or no complications. The article reports three cases of patient of grain tumors in the third ventricle and thalamus and underwent such operations. It also discusses the indications of this kind of operation and presented the experience about this aspect.

  13. Multicenter results of stereotactic body radiotherapy (SBRT) for non-resectable primary liver tumors

    International Nuclear Information System (INIS)

    Background. An excess of 100 000 individuals are diagnosed with primary liver tumors every year in USA but less than 20% of those patients are amenable to definitive surgical management due to advanced local disease or comorbidities. Local therapies to arrest tumor growth have limited response and have shown no improvement on patient survival. Stereotactic body radiotherapy (SBRT) has emerged as an alternative local ablative therapy. The purpose of this study was to evaluate the tumor response to SBRT in a combined multicenter database. Study design. Patients with advanced hepatocellular carcinoma (HCC, n = 21) or intrahepatic cholangiocarcinoma (ICC, n = 11) treated with SBRT from four Academic Medical Centers were entered into a common database. Statistical analyses were performed for freedom from local progression (FFLP) and patient survival. Results. The overall FFLP for advanced HCC was 63% at a median follow-up of 12.9 months. Median tumor volume decreased from 334.2 to 135 cm3 (p < 0.004). The median time to local progression was 6.3 months. The 1- and 2-years overall survival rates were 87% and 55%, respectively. Patients with ICC had an overall FFLP of 55.5% at a median follow-up of 7.8 months. The median time to local progression was 4.2 months and the six-month and one-year overall survival rates were 75% and 45%, respectively. The incidence of grade 1-2 toxicities, mostly nausea and fatigue, was 39.5%. Grade 3 and 4 toxicities were present in two and one patients, respectively. Conclusion. Higher rates of FFLP were achieved by SBRT in the treatment of primary liver malignancies with low toxicity

  14. Modified Hughes procedure for reconstruction of large full-thickness lower eyelid defects following tumor resection

    OpenAIRE

    Hishmi, Ahmed M.; Koch, Konrad R.; Matthaei, Mario; Bölke, Edwin; Cursiefen, Claus; Heindl, Ludwig M.

    2016-01-01

    Background Tarsoconjunctival flap advancement, or the Hughes procedure, is among the techniques of choice for reconstructing full-thickness lower eyelid defects so as to restore normal anatomy and function with the best possible cosmetic outcome. The purpose of this study is to report the outcome of a series of patients treated with a modified Hughes procedure following malignant tumor removal. Methods This retrospective study included 45 consecutive cases of modified Hughes procedures perfor...

  15. A New Treatment Paradigm: Neoadjuvant Radiosurgery Before Surgical Resection of Brain Metastases With Analysis of Local Tumor Recurrence

    International Nuclear Information System (INIS)

    Purpose: Resected brain metastases (BM) require radiation therapy to reduce local recurrence. Whole brain radiation therapy (WBRT) reduces recurrence, but with potential toxicity. Postoperative stereotactic radiosurgery (SRS) is a strategy without prospective data and problematic target delineation. SRS delivered in the preoperative setting (neoadjuvant, or NaSRS) allows clear target definition and reduction of intraoperative dissemination of tumor cells. Methods and Materials: Our treatment of resectable BM with NaSRS was begun in 2005. Subsequently, a prospective trial of NaSRS was undertaken. A total of 47 consecutively treated patients (23 database and 24 prospective trial) with a total of 51 lesions were reviewed. No statistical difference was observed between the 2 cohorts, and they were combined for analysis. The median follow-up time was 12 months (range, 1-58 months), and the median age was 57. A median of 1 day elapsed between NaSRS and resection. The median diameter of lesions was 3.04 cm (range, 1.34-5.21 cm), and the median volume was 8.49 cc (range, 0.89-46.7 cc). A dose reduction strategy was used, with a median dose of 14 Gy (range, 11.6-18 Gy) prescribed to 80% isodose. Results: Kaplan-Meier overall survival was 77.8% and 60.0% at 6 and 12 months. Kaplan-Meier local control was 97.8%, 85.6%, and 71.8% at 6, 12, and 24 months, respectively. Five of 8 failures were proved pathologically without radiation necrosis. There were no perioperative adverse events. Ultimately, 14.8% of the patients were treated with WBRT. Local failure was more likely with lesions >10 cc (P=.01), >3.4 cm (P=.014), with a trend in surface lesions (P=.066) and eloquent areas (P=.052). Six of the 8 failures had an obvious dural attachment or proximity to draining veins. Conclusions: NaSRS can be performed safely and effectively with excellent results without documented radiation necrosis. Local control was excellent even in the setting of large (>3 cm) lesions. The strong

  16. A New Treatment Paradigm: Neoadjuvant Radiosurgery Before Surgical Resection of Brain Metastases With Analysis of Local Tumor Recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Asher, Anthony L., E-mail: asher@cnsa.com [Department of Neurosurgery, Levine Cancer Institute and Carolinas Medical Center, Charlotte, North Carolina (United States); Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina (United States); Burri, Stuart H. [Department of Radiation Oncology, Levine Cancer Institute and Carolinas Medical Center, Charlotte, North Carolina (United States); Wiggins, Walter F. [Wake Forest School of Medicine MD/PhD Program, Winston-Salem, North Carolina (United States); Kelly, Renee P. [Brain Tumor Fund for the Carolinas, Charlotte, North Carolina (United States); Boltes, Margaret O.; Mehrlich, Melissa [Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina (United States); Norton, H. James [Department of Biostatistics, Carolinas Medical Center, Charlotte, North Carolina (United States); Fraser, Robert W. [Department of Radiation Oncology, Levine Cancer Institute and Carolinas Medical Center, Charlotte, North Carolina (United States)

    2014-03-15

    Purpose: Resected brain metastases (BM) require radiation therapy to reduce local recurrence. Whole brain radiation therapy (WBRT) reduces recurrence, but with potential toxicity. Postoperative stereotactic radiosurgery (SRS) is a strategy without prospective data and problematic target delineation. SRS delivered in the preoperative setting (neoadjuvant, or NaSRS) allows clear target definition and reduction of intraoperative dissemination of tumor cells. Methods and Materials: Our treatment of resectable BM with NaSRS was begun in 2005. Subsequently, a prospective trial of NaSRS was undertaken. A total of 47 consecutively treated patients (23 database and 24 prospective trial) with a total of 51 lesions were reviewed. No statistical difference was observed between the 2 cohorts, and they were combined for analysis. The median follow-up time was 12 months (range, 1-58 months), and the median age was 57. A median of 1 day elapsed between NaSRS and resection. The median diameter of lesions was 3.04 cm (range, 1.34-5.21 cm), and the median volume was 8.49 cc (range, 0.89-46.7 cc). A dose reduction strategy was used, with a median dose of 14 Gy (range, 11.6-18 Gy) prescribed to 80% isodose. Results: Kaplan-Meier overall survival was 77.8% and 60.0% at 6 and 12 months. Kaplan-Meier local control was 97.8%, 85.6%, and 71.8% at 6, 12, and 24 months, respectively. Five of 8 failures were proved pathologically without radiation necrosis. There were no perioperative adverse events. Ultimately, 14.8% of the patients were treated with WBRT. Local failure was more likely with lesions >10 cc (P=.01), >3.4 cm (P=.014), with a trend in surface lesions (P=.066) and eloquent areas (P=.052). Six of the 8 failures had an obvious dural attachment or proximity to draining veins. Conclusions: NaSRS can be performed safely and effectively with excellent results without documented radiation necrosis. Local control was excellent even in the setting of large (>3 cm) lesions. The strong

  17. Survival outcomes of hepatic resection compared with transarterial chemoembolization or sorafenib for hepatocellular carcinoma with portal vein tumor thrombosis

    Science.gov (United States)

    Lee, Jung Min; Jang, Byoung Kuk; Lee, Yoo Jin; Choi, Wang Yong; Choi, Sei Myong; Chung, Woo Jin; Hwang, Jae Seok; Kang, Koo Jeong; Kim, Young Hwan; Chauhan, Anil Kumar; Park, Soo Young; Tak, Won Young; Kweon, Young Oh; Kim, Byung Seok; Lee, Chang Hyeong

    2016-01-01

    Background/Aims: Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT. Methods: Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II). Results: The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both psorafenib groups (p=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, p=0.036; HR vs. sorafenib: hazard ratio=2.262, p=0.006), involved lobe (hazard ratio=1.705, p=0.008), PVTT type (hazard ratio=1.617, p=0.013), and CTP class (hazard ratio=1.712, p=0.012). Conclusions: Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC. PMID:27044767

  18. Tumor vaccine strategies after allogeneic T-cell depleted bone marrow transplantation

    Directory of Open Access Journals (Sweden)

    Ferrara James L.M.

    2002-01-01

    Full Text Available Allogeneic bone marrow transplantation is currently restricted to hematological malignancies because of a lack of anti-tumor activity against solid cancers. We have tested a novel treatment strategy to stimulate specific anti-tumor activity against a solid tumor after transplantation by vaccination with irradiated tumor cells engineered to secrete granulocyte-macrophage colony-stimulating factor. Using the B16 melanoma model, we found that vaccination elicited potent anti-tumor activity in recipients of syngeneic bone marrow transplantation in a time dependent fashion, and that immune reconstitution was critical for the development of anti-tumor activity. Vaccination did not stimulate anti-tumor immunity after allogeneic bone marrow transplantation because of the post-transplantation immunodeficiency associated with graft-versus-host disease. Remarkably, vaccination was effective in stimulating potent and long-lasting anti-tumor activity in recipients of T cell-depleted allogeneic bone marrow. Thus T cells derived from donor stem cells were able to recognize tumor antigens even though they remained tolerant to host histocompatibility antigens. Donor leukocyte infusion from a donor immunized with the recipient-derived B16 vaccines enhanced clinical activity of tumor vaccines without exacerbating graft-versus-host disease and CD4+ T cells are essential for this enhancement. These results demonstrate that vaccination of both donors and recipients can stimulate potent anti-tumor effects without the induction of graft-versus-host disease, and this strategy has important implications for the treatment of patients with solid malignancies.

  19. [Chondromyxoid fibroma of bone: a rare benign bone tumor in children].

    Science.gov (United States)

    Rouas, L; Malihy, A; Cherradi, N; Lamalmi, N; Alhamany, Z

    2004-12-01

    Chondromyxoid fibroma is a rare benign tumor that is typically found in the metaphyseal ends of long tubular bones, such as the tibia. The radiographic appearances are those of a single, lytic lesion with lobulated margins, septations, cortical expansion and a sclerotic rim. The classic histological feature of a chondromyxoid fibroma is stellate or spindle-shaped cells arranged in lobules in a myxoid or chondroid background. Two cases are presented here: 8, and 12-year-old patients, both with lesions in the proximal tibia. The first case showed an unusual feature: it was diaphyseal chondromyxoid fibroma. In the second case, the lesion was metaphyso-diaphyseal. The differential diagnosis includes chondroblastoma, myxoma, aneurysmal cyst as well as chondrosarcoma. A surgical conservative treatment with complete excision is recommended even in case of recurrence. PMID:15688891

  20. Preoperative therapies for resectable and borderline resectable pancreatic cancer

    OpenAIRE

    Varadhachary, Gauri R.

    2011-01-01

    In the era of multidetector high quality CT imaging, it is feasible and critical to use objective criteria to define resectable pancreatic cancer. This allows accurate pretreatment staging and the development of stage-specific therapy. Tumors of borderline resectability have emerged as a distinct subset and the definition has been expanded in the last few years. Borderline resectable tumors are defined as those with tumor abutment of

  1. How to read a pathology report of a bone tumor

    International Nuclear Information System (INIS)

    The interpretation of a biopsy specimen involving bone is one of the most challenging feats for a pathologist, as it is often difficult to distinguish between benign or reactive lesions and malignant tumors on microscopic analysis. Therefore, correlation with the clinical data and imaging is essential and sometimes it is only the evolution of certain characteristics over time or information garnered from molecular analysis that can provide an accurate diagnosis. The pathology report is critical in that it will define subsequent patient management; its wording must precisely reflect those elements that are known with certainty and those that are diagnostic hypotheses. It must be systematic, thorough, and complete and should not be limited to a simple conclusion. The pathologist must first ensure the completeness and correct transcription of the information provided with the specimen, then describe and analyze the histology as well as the quality and representative nature of the sample (as they relate to the radiographic findings and preliminary/final diagnoses), and finally, compare what is seen under the microscope with the assessment made by the radiologist and/or surgeon. This analysis helps to identify difficult cases requiring further consultation between the radiologist and pathologist. There are multiple reasons for misinterpretation of a pathology report. An important and largely underestimated reason is varied interpretations of terms used by the pathologist. Standardized pathology reports with concise phrases as well as multidisciplinary meetings may limit errors and should be encouraged for optimal diagnostic accuracy

  2. How to read a pathology report of a bone tumor

    Energy Technology Data Exchange (ETDEWEB)

    Guinebretière, Jean-Marc, E-mail: jean-marc.guinebretiere@curie.net [Department of Pathology, Hôpital René-Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud (France); Kreshak, Jennifer [Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy); Suciu, Voichita [Department of Pathology, Hôpital René-Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud (France); Maulmont, Charles De [Department of Radiology, Hôpital René-Huguenin, Institut Curie, 35 rue Dailly, 92210 Saint Cloud (France); Mascard, Eric; Missenard, Gilles [Institut Gustave-Roussy, 35 rue Camille Desmoulins, 94805 Villejuif (France); Larousserie, Frederique [Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy); Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris (France); Vanel, Daniel [Department of Research, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2013-12-01

    The interpretation of a biopsy specimen involving bone is one of the most challenging feats for a pathologist, as it is often difficult to distinguish between benign or reactive lesions and malignant tumors on microscopic analysis. Therefore, correlation with the clinical data and imaging is essential and sometimes it is only the evolution of certain characteristics over time or information garnered from molecular analysis that can provide an accurate diagnosis. The pathology report is critical in that it will define subsequent patient management; its wording must precisely reflect those elements that are known with certainty and those that are diagnostic hypotheses. It must be systematic, thorough, and complete and should not be limited to a simple conclusion. The pathologist must first ensure the completeness and correct transcription of the information provided with the specimen, then describe and analyze the histology as well as the quality and representative nature of the sample (as they relate to the radiographic findings and preliminary/final diagnoses), and finally, compare what is seen under the microscope with the assessment made by the radiologist and/or surgeon. This analysis helps to identify difficult cases requiring further consultation between the radiologist and pathologist. There are multiple reasons for misinterpretation of a pathology report. An important and largely underestimated reason is varied interpretations of terms used by the pathologist. Standardized pathology reports with concise phrases as well as multidisciplinary meetings may limit errors and should be encouraged for optimal diagnostic accuracy.

  3. Malignant Tumors of the Ear and Temporal Bone: A Study of 27 Patients and Review of Their Management

    OpenAIRE

    Martinez-Devesa, Pablo; Barnes, Martyn L.; Milford, Chris A.

    2008-01-01

    Objective: To evaluate the management of patients with malignant tumors of the ear and temporal bone. Design: Retrospective analysis of data. Setting: Radcliffe Infirmary, Oxford, United Kingdom. Participants: Twenty-seven patients were classified into two groups according to the site of origin of the tumor: (1) superficial (17 tumors): tumors arising from the skin of the pinna, parotid, and temporomandibular joint area; (2) deep (10 tumors): tumors arising in the ear canal and temporal bone....

  4. Vascular bone tumors: a proposal of a classification based on clinicopathological, radiographic and genetic features

    Energy Technology Data Exchange (ETDEWEB)

    Errani, Costantino [Istituto Ortopedico Rizzoli, Ortopedia Generale, Orthopaedic Service, Bagheria (Italy); Struttura Complessa Ortopedia Generale, Dipartimento Rizzoli-Sicilia, Bagheria, PA (Italy); Vanel, Daniel; Gambarotti, Marco; Alberghini, Marco [Istituto Ortopedico Rizzoli, Pathology Service, Bologna (Italy); Picci, Piero [Istituto Ortopedico Rizzoli, Laboratory for Cancer Research, Bologna (Italy); Faldini, Cesare [Istituto Ortopedico Rizzoli, Ortopedia Generale, Orthopaedic Service, Bagheria (Italy)

    2012-12-15

    The classification of vascular bone tumors remains challenging, with considerable morphological overlap spanning across benign to malignant categories. The vast majority of both benign and malignant vascular tumors are readily diagnosed based on their characteristic histological features, such as the formation of vascular spaces and the expression of endothelial markers. However, some vascular tumors have atypical histological features, such as a solid growth pattern, epithelioid change, or spindle cell morphology, which complicates their diagnosis. Pathologically, these tumors are remarkably similar, which makes differentiating them from each other very difficult. For this rare subset of vascular bone tumors, there remains considerable controversy with regard to the terminology and the classification that should be used. Moreover, one of the most confusing issues related to vascular bone tumors is the myriad of names that are used to describe them. Because the clinical behavior and, consequently, treatment and prognosis of vascular bone tumors can vary significantly, it is important to effectively and accurately distinguish them from each other. Upon review of the nomenclature and the characteristic clinicopathological, radiographic and genetic features of vascular bone tumors, we propose a classification scheme that includes hemangioma, hemangioendothelioma, angiosarcoma, and their epithelioid variants. (orig.)

  5. Vascular bone tumors: a proposal of a classification based on clinicopathological, radiographic and genetic features

    International Nuclear Information System (INIS)

    The classification of vascular bone tumors remains challenging, with considerable morphological overlap spanning across benign to malignant categories. The vast majority of both benign and malignant vascular tumors are readily diagnosed based on their characteristic histological features, such as the formation of vascular spaces and the expression of endothelial markers. However, some vascular tumors have atypical histological features, such as a solid growth pattern, epithelioid change, or spindle cell morphology, which complicates their diagnosis. Pathologically, these tumors are remarkably similar, which makes differentiating them from each other very difficult. For this rare subset of vascular bone tumors, there remains considerable controversy with regard to the terminology and the classification that should be used. Moreover, one of the most confusing issues related to vascular bone tumors is the myriad of names that are used to describe them. Because the clinical behavior and, consequently, treatment and prognosis of vascular bone tumors can vary significantly, it is important to effectively and accurately distinguish them from each other. Upon review of the nomenclature and the characteristic clinicopathological, radiographic and genetic features of vascular bone tumors, we propose a classification scheme that includes hemangioma, hemangioendothelioma, angiosarcoma, and their epithelioid variants. (orig.)

  6. Bone marrow transplantation in aplastic anemia, acute leukemia and solid tumors

    International Nuclear Information System (INIS)

    Results of bone marrow transplantation for the treatment of aplastic anemia, acute leukemia and solid tumors in the first 141 patients treated between September 1973 and January 1980 are reviewed. Preparation for transplantation with total body irradiation is described. (Auth.)

  7. CyberKnife with tumor tracking: An effective alternative to wedge resection for high-risk surgical patients with stage I non-small cell lung cancer (NSCLC

    Directory of Open Access Journals (Sweden)

    Sean eCollins

    2012-02-01

    Full Text Available Published data suggests that wedge resection for stage I NSCLC results in improved overall survival compared to stereotactic body radiation therapy (SBRT. We report CyberKnife outcomes for high-risk surgical patients with biopsy-proven stage I NSCLC. PET/CT imaging was completed for staging. Three-to-five gold fiducial markers were implanted in or near tumors to serve as targeting references. Gross tumor volumes (GTVs were contoured using lung windows; the margins were expanded by 5 mm to establish the planning treatment volume (PTV. Treatment plans were designed using hundreds of pencil beams. Doses delivered to the PTV ranged from 42-60 Gy in 3 fractions. The 30-Gy isodose contour extended at least 1cm from the GTV to eradicate microscopic disease. Treatments were delivered using the CyberKnife system with tumor tracking. Examination and PET/CT imaging occurred at 3-month follow-up intervals. Forty patients (median age 76 with a median maximum tumor diameter of 2.6 cm (range, 1.4-5.0 cm and a mean post-bronchodilator percent predicted forced expiratory volume in 1 second (FEV1 of 57% (range, 21 - 111% were treated. A mean dose of 50 Gy was delivered to the PTV over 3 to 13 days (median, 7 days. The 30-Gy isodose contour extended a mean 1.9 cm from the GTV. At a median 44 months (range, 12 -72 months follow-up, the 3-year Kaplan-Meier locoregional control and overall survival estimates compare favorably with contemporary wedge resection outcomes at 91% and 75% , respectively. CyberKnife is an effective treatment approach for stage I NSCLC that is similar to wedge resection, eradicating tumors with 1 to 2 cm margins in order to preserve lung function. Prospective randomized trials comparing CyberKnife with wedge resection are necessary to confirm equivalence.

  8. A comparison of standard radiological examinations, computed tomography, scintigraphy and angiography in the recidivistic diagnostic of bone tumors

    International Nuclear Information System (INIS)

    In a retrospective study the diagnostic efficiency of standard radiography, computed tomography (CT), bone scintigraphy and angiography in the diagnosis of tumor recidivism was studied using 54 patients with an operatively treated bone tumor. The highest diagnostic sensitivity (100%) was achieved with the help of CT. For the determination or exclusion of a recidivistic bone tumor, the diagnostic strength of the individual procedures lies in their combinations, but these combinations should be made on the basis of the tumor type and disease. (MBC)

  9. Radius neck-to-humerus trochlea transposition elbow reconstruction after proximal ulnar metastatic tumor resection: case and literature review

    Directory of Open Access Journals (Sweden)

    Chen FeiYan

    2012-07-01

    Full Text Available Abstract Wide en bloc excision of proximal ulna sections is used to treat traumatic and pathological fractures of the ulna, though poor standardization of clinical treatment often results in long-term failure of such reconstructed biomechanical structures. In order to provide insight into effective ulnar reconstructive treatments, the case of an 80-year-old Chinese Han male presenting with pathological fracture caused by a proximal ulnar metastatic tumor concurrent with metastatic renal cancer complicated by occurrence in the brain and lungs is reported and contrasted with alternative treatment techniques. Wide resectioning of the proximal ulna and reconstruction with local radius neck-to-humerus trochlea transposition resulted in preservation of functionality, sensitivity, and biomechanical integrity after postsurgical immobilization, 6 weeks of passive- and active-assisted flexion, and extension with a hinged brace. The resultant Musculoskeletal Tumor Society rating score was 25 of 30 (83 %. Full sensitivity and mobility of the left hand and elbow (10° to 90° with minimally impaired supination and pronation was restored with minimal discomfort. No evidence of local recurrence or other pathological complications were observed within a 1-year follow-up period. Efficient reconstruction of osseous and capsuloligamentous structures in the elbow is often accomplished by allografts, prosthesis, and soft tissue reconstruction, though wide variations in risk and prognosis associated with these techniques has resulted in disagreements regarding the most effective standards for clinical treatment. Current findings suggest that radius neck-to-humerus trochlea transposition offers a superior range of elbow movement and fewer complications than similar allograft and prosthetic techniques for patients with multiple metastatic cancers.

  10. The nuclide imaging of primary malignant bone tumor before and after HIFU treatment

    International Nuclear Information System (INIS)

    Objective: To investigate the difference of bone nuclide imaging on primary malignant bone tumor before and after high intensity focused ultrasound (HIFU) treatment. Methods: 99Tcm-methylene-diphosphonate (MDP) bone imaging was applied before and after HIFU treatment and 99Tcm(V)-dimercaptosuccinic acid (DMSA) imaging was used when it was needed. Results: 1) There were areas of abnormal high uptake of 99Tcm-MDP in bone foci, while the lower uptake or no-uptake areas of 99Tcm-MDP outside the foci were found simultaneously. 2) The high uptake of 99Tcm(V)-DMSA in 5 cases after the HIFU treatment in the foci indicated the relapse of the former bone tumor. Conclusions: The location and extent of the tumor, and effectiveness of HIFU treatment can be estimated sensitively with 99Tcm-MDP bone imaging. The high uptake of 99Tcm(V)-DMSA in the focus indicates the relapse of the primary malignant bone tumor or new bone lesion in a certain degree

  11. Integrated multimodal imaging of dynamic bone-tumor alterations associated with metastatic prostate cancer.

    Science.gov (United States)

    Brisset, Jean-Christophe; Hoff, Benjamin A; Chenevert, Thomas L; Jacobson, Jon A; Boes, Jennifer L; Galbán, Stefanie; Rehemtulla, Alnawaz; Johnson, Timothy D; Pienta, Kenneth J; Galbán, Craig J; Meyer, Charles R; Schakel, Timothy; Nicolay, Klaas; Alva, Ajjai S; Hussain, Maha; Ross, Brian D

    2015-01-01

    Bone metastasis occurs for men with advanced prostate cancer which promotes osseous growth and destruction driven by alterations in osteoblast and osteoclast homeostasis. Patients can experience pain, spontaneous fractures and morbidity eroding overall quality of life. The complex and dynamic cellular interactions within the bone microenvironment limit current treatment options thus prostate to bone metastases remains incurable. This study uses voxel-based analysis of diffusion-weighted MRI and CT scans to simultaneously evaluate temporal changes in normal bone homeostasis along with prostate bone metatastsis to deliver an improved understanding of the spatiotemporal local microenvironment. Dynamic tumor-stromal interactions were assessed during treatment in mouse models along with a pilot prospective clinical trial with metastatic hormone sensitive and castration resistant prostate cancer patients with bone metastases. Longitudinal changes in tumor and bone imaging metrics during delivery of therapy were quantified. Studies revealed that voxel-based parametric response maps (PRM) of DW-MRI and CT scans could be used to quantify and spatially visualize dynamic changes during prostate tumor growth and in response to treatment thereby distinguishing patients with stable disease from those with progressive disease (pprostate tumor-stromal responses to therapies thus demonstrating the potential of multi-modal PRM image-based biomarkers as a novel means for assessing dynamic alterations associated with metastatic prostate cancer. These results establish an integrated and clinically translatable approach which can be readily implemented for improving the clinical management of patients with metastatic bone disease. PMID:25859981

  12. Differential diagnosis of tumorous lesions in the iliac bone in children

    International Nuclear Information System (INIS)

    The radioilogic appearance of inflammatory and tumorous lesions in the iliac bone is characterized by destructive alterations and consolidations simultaneously. This pattern is nonspecific. The value of plain films of this area is compromised by the anatomy of the iliac bone and by overlying structures. Therefore tomography, computertomography and bone scans are necessary. Difficulties in differentiation between benign and malignant lesions are discussed and case reports are given. The importance of histologic examination is stressed. (orig.)

  13. Severe cheek and lower eyelid lymphedema after resection of oropharyngeal tumor and radiation.

    Science.gov (United States)

    Silverman, Adam T; Hoffman, Ryan; Cohen, Mimis; Garza, Rebecca

    2010-03-01

    Facial lymphedema, a rare condition with poorly understood pathogenesis, is commonly associated with previous infection, radiation therapy, local tumor growth, or previous surgery in the head and neck region. Few cases of isolated facial lymphedema have been reported in the literature. Surgical excision has emerged as the mainstay of therapy in such cases, although the long-term efficacy and recurrence rate after excision remain unknown. We present a unique case of a patient with severe unilateral facial lymphedema, which manifested many years after extirpation of a floor-of-the-mouth squamous cell carcinoma, bilateral supraomohyoid neck dissections, and radiation therapy. The massive cheek and eyelid lymphedema, which extended from the patient's left lower eyelid to patient's oral commissure measured 11 x 15 cm with a thickened, brawny, lobulated, and bosselated skin surface. This mass interfered with activities of daily life, caused poor oral intake, and contributed to the patient's severe kyphosis. Because the mass did not clinically or radiologically appear to be malignant, we decided to perform a salvage procedure consisting of wide excision of the massive lymphedematous mass and immediate coverage with a split-thickness skin grafting. Temporary tarsorraphy sutures were also used to provide support to the lower eyelid. The patient tolerated the procedure well, with no complications and with full take of the skin graft. Postoperatively, he was very grateful to be relieved of his debilitating symptoms. PMID:20489462

  14. Extraosseous accumulation of bone scanning agents in malignant brain tumors. Comparison to semi-quantitative evaluation with 99mTc SPECT/201Tl SPECT and histological findings

    International Nuclear Information System (INIS)

    Although 201Tl chloride (Tl) SPECT has been used in the differential diagnosis between recurrence of malignant brain tumor and necrosis after treatment, it is not generally recognized as a definite modality to distinguish them. We conducted a preliminary study using Tl SPECT and 99mTc-MDP or 99mTc-HMDP (Tc) SPECT because it has been said that extraosseous accumulation was caused by calcium deposits in necrotic tissues. In our study, for the purposes of clarifying the mechanism of extraosseous uptake and the correlation between extraosseous accumulation of bone-scanning agent and tumor viability in malignant brain tumors, we compared whether Tc uptake was correlated with the histopathological findings and further performed semi-quantitative evaluation between Tc SPECT and Tl SPECT. The correlation coefficients between the ratio of tumor to normal skull count obtained from Tc SPECT (Tc-T/N) and those of tumor to normal brain count (T/N) and to normal scalp count (T/S) both obtained from Tl SPECT were calculated. Using contrast enhanced CT (CE-CT) or contrast enhanced MRI (CE-MRI), 8 of 10 cases showed intensely ring-enhanced tumor with necrotic lesion. Histopathologically, 7 of 8 cases whose tumor had been resected before treatment had necrosis with increased vascularity or bleeding. Of the remaining 2 cases one case, malignant lymphoma had only hypervascularity by biopsy, while the other one was excluded for resection after treatment. Three of these 8 cases whose CE-CT or CE-MRI showed necrotic lesions exhibited Tc and Tl accumulations in the area corresponding to necrosis. In contrast, 2 showed no Tc nor Tl uptake. Tc-T/N had no significant correlation with any of early-, delayed-T/N or T/S. In conclusion, there was no significant correlation between Tc and Tl uptakes by malignant brain tumors in semi-quantitative evaluation. (author)

  15. ExtraLevatory AbdominoPerineal Excision (ELAPE) Does Not Result in Reduced Rate of Tumor Perforation or Rate of Positive Circumferential Resection Margin

    DEFF Research Database (Denmark)

    Klein, Mads; Fischer, Anders; Rosenberg, Jacob;

    2015-01-01

    OBJECTIVE: To evaluate the oncological results and possible benefits associated with extralevatory abdominoperineal excision (ELAPE) when compared with conventional abdominoperineal excision (APE). BACKGROUND: ELAPE was introduced in 2007 with the purpose of reducing the rate of positive resection...... margin (CRM+). RESULTS: A total of 554 patients were included, 301(54%) were operated by ELAPE; 253(46%) by APE. Sixty-three percent were men, median (interquartile range) age was 69 (61-76 years) years, and tumors removed had predominantly T-stages T2 and T3 (32% and 45%, respectively). Overall, CRM......+ was found in 13% of patients. When divided according to type of procedure, we found no significant differences in demography and tumor T- and N-stages. Resections with a CRM+ were more common after ELAPE (16% vs 7%; P = 0.006). After uni- and multivariate logistic regression analyses, surgery by ELAPE...

  16. Microvascular Radial Forearm Fasciocutaneous Free Flap for Palatomaxillary Reconstruction Following Malignant Tumor Resection

    International Nuclear Information System (INIS)

    The aim of this study is to report on the patient's quality of life and outcomes after reconstruction of palatomaxillary defects by microvascular radial forearm fasciocutaneous free flap (RFFF) and dental obturator. Material and Methods: During the period between 2005-2007, 10 patients who had palato maxillary defects were immediately reconstructed using RFFF to restore physiologic oronasal separation. All patients were treated for malignant tumors of hard palate or maxilla and all had preservation of orbital floor. Vascular anastomoses were done with the facial vessels in the neck. All the patients underwent a lateral thigh split-thickness skin graft for closure of the donor site. Outcome measurements included post-operative assessment of flap survival and healing, speech, swallowing and diet evaluation and quality of life. Dental rehabilitation was done 3 months postoperatively for all patients. Results: Flap survival was successful in all cases. In the first 2 weeks post operatively, 80% of patients had very good swallowing, speech and diet ability in the form of soft chewable foods and by the end of 6 months, all patients had very good swallowing and speech function and were able to eat all types of foods. Dental rehabilitation with obturator was easily applied and the presence of the flap did not interfere with its application. The technique improved chewing ability and cosmosis. Complications included, small oronasal fistula in 2 patients (20%) who required secondary sutures and delayed wound healing of donor site in one patient. Conclusion: RFFF for soft tissue reconstruction after maxillectomy is a reliable technique that provides a definitive physiologic separation between oral and nasal cavity. This allows very early improvement of speech and swallowing without being totally dependent on obturator. Dental rehabilitation to improve chewing and cosmoses can be done easily with minimal home care. Subsequently, the quality of life is markedly improved

  17. Studies on anti-tumor effects of continuous intra-arterial infusion chemotherapy in the treatment of bone and soft tissue tumors using sup 99m Tc-MAA RI-angiography

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Masao (Gifu Univ. (Japan). Faculty of Medicine)

    1992-01-01

    {sup 99m}Tc-macroaggregated albumin (MAA) RI-angiographies were carried out in 43 patients having bone and soft tissue tumors. The diagnoses were osteosarcoma (20), Ewing's sarcoma (4), leiomyosarcoma of the bone (2), malignant fibrous histocytoma (3) giant cell tumor of the bone (5), liposarcoma (3), synovial sarcoma (3) and other types of tumors. Five mCi MAA was infused through an indwelling arterial catheter, and its flow was traced immediately afterward by a scintillation camera. This procedure was performed every 2 or 4 weeks during intra-arterial infusion chemotherapy. The RI-angiographies offer an excellent way to evaluate catheter placement and tumor perfusion, in addition to providing a way to evaluate A-V shunts with lung scans. From the comparison with the histological findings of the resected tumor specimen, the apparent result that the RI-angiographic images obtained at each stage of chemotherapy period also demonstrated the degree of tumor tissue response to intra-arterial chemotherapy, is highly suggestive. Regions where {sup 99m}Tc-MAA uptake decreased with increasing peripheral accumulation were found to be markedly necrotic. But regions where {sup 99m}Tc-MAA uptake was obscure during the course of chemotherapy were found to consist of viable cells. Therefore it was concluded that {sup 99m}Tc-MAA RI-angiography combined with intra-arterial infusion chemotherapy is a very useful method for the assessment of anti-tumor effects in cases involving limb saving surgery. (author).

  18. Culture medium of bone marrow-derived human mesenchymal stem cells effects lymphatic endothelial cells and tumor lymph vessel formation

    OpenAIRE

    ZHAN, JIE; Li, Yahong; Yu, Jing; ZHAO, YUANYAUN; CAO, WENMING; Ma, Jie; Sun, Xiaoxian; Sun, Li; QIAN, HUI; Zhu, Wei; Xu, Wenrong

    2015-01-01

    Human bone marrow mesenchymal stem cells (hBM-MSCs) favor tumor growth and metastasis in vivo and in vitro. Neovascularization is involved in several pathological conditions, including tumor growth and metastasis. Previous studies have demonstrated that human bone marrow MSC-derived conditioned medium (hBM-MSC-CM) can promote tumor growth by inducing the expression of vascular epidermal growth factor (VEGF) in tumor cells. However, the effect of BM-MSCs on tumor lymph vessel formation has yet...

  19. Bone marrow-derived mesenchymal stem cells promote growth and angiogenesis of breast and prostate tumors

    OpenAIRE

    Zhang, Ting; Lee, Yuk Wai; Rui, Yun Feng; Cheng, Tin Yan; Jiang, Xiao Hua; Li, Gang

    2013-01-01

    Introduction Mesenchymal stem cells (MSCs) are known to migrate to tumor tissues. This behavior of MSCs has been exploited as a tumor-targeting strategy for cell-based cancer therapy. However, the effects of MSCs on tumor growth are controversial. This study was designed to determine the effect of MSCs on the growth of breast and prostate tumors. Methods Bone marrow-derived MSCs (BM-MSCs) were isolated and characterized. Effects of BM-MSCs on tumor cell proliferation were analyzed in a co-cul...

  20. Lytic bone tumor biopsy with a thin needle under CT guidance

    International Nuclear Information System (INIS)

    Forty biopsies of lytic bone tumors were performed with 19-22-gauge needles under direct CT guidance, along a safe trajectory traced on a selected section identified through guide marks on the skin. Cytologic and histologic examination permitted correct diagnosis in 32 cases (overall accuracy rate, 76%) without false-positive results or complications. The procedure proved effective in diagnosis of small, juxtamedullary, or deep-seated tumors of pelvic or long bones. It is routinely helpful in cases of unproved myeloma or metastasis, whether or not the primary tumor is known. In the authors experience, accurately guided intratumoral puncture secures better results than trocar diameter

  1. A Survey of Bone Tumors in Dogs and Cats from 1986 to 2000 in Ankara

    OpenAIRE

    Kutsal, Osman

    2003-01-01

    In the present study, bone tumor samples obtained from 18 dogs and 21 cats from various clinics between 1986 and 2000 were clinically and pathologically examined at the Pathology Department, Faculty of Veterinary Medicine, University of Ankara. Most bone tumors examined were from 5-8-year-old dogs (43.75%) and cats (45%). A significant decrease was detected in animals over 8 years old. These tumors were observed in large breeds, mostly in German shepherd (38.4%) and Anatolian shepherd (Kanga...

  2. Contribution of bone marrow derived cells to the pancreatic tumor microenvironment

    OpenAIRE

    Scarlett, Christopher J.

    2013-01-01

    Pancreatic cancer is a complex, aggressive, and heterogeneous malignancy driven by the multifaceted interactions within the tumor microenvironment. While it is known that the tumor microenvironment accommodates many cell types, each playing a key role in tumorigenesis, the major source of these stromal cells is not well-understood. This review examines the contribution of bone marrow-derived cells (BMDC) to pancreatic carcinogenesis, with respect to their role in constituting the tumor microe...

  3. Circulating cytokeratin 18 fragments and activation of dormant tumor cells in bone marrow of cancer patients

    OpenAIRE

    Ausch, Christoph; Buxhofer-Ausch, Veronika; Olszewski, Ulrike; Hamilton, Gerhard

    2010-01-01

    In cancer patients detection of systemic disease is of great importance to obtain prognostic information and to guide therapy. Bone marrow (BM) seems to be a common homing tissue for the early spread of tumor cells from various epithelial tumors; however, verification of the prognostic significance of BM-disseminated tumor cells (BM-DTCs), is restricted to breast cancer so far. These cells may be dormant for a long time, and signals triggering their activation leading to recurrence remain to ...

  4. CD13-positive bone marrow-derived myeloid cells promote angiogenesis, tumor growth, and metastasis

    OpenAIRE

    Dondossola, Eleonora; Rangel, Roberto; Guzman-Rojas, Liliana; Barbu, Elena M.; Hosoya, Hitomi; St. John, Lisa S.; Molldrem, Jeffrey J.; Corti, Angelo; Sidman, Richard L.; Arap, Wadih; Pasqualini, Renata

    2013-01-01

    The progression of many solid tumors is associated with increased vascularization. We previously recognized involvement in tumor development and angiogenesis of tumor stromal cells expressing the CD13 protease aminopeptidase. The basic biological concept of participation of nontumor cells in the cancer stroma microenvironment is strengthened in the present study by our finding that a CD11b+CD13+ myeloid subset of bone marrow-derived cells affects pericyte biology and angiogenesis and thereby ...

  5. Defective TGFβ signaling in bone marrow-derived cells prevents Hedgehog-induced skin tumors

    OpenAIRE

    Fan, Qipeng; Gu, Dongsheng; Liu, Hailan; Yang, Ling; Zhang, Xiaoli; Yoder, Mervin C.; Kaplan, Mark H.; Xie, Jingwu

    2013-01-01

    Hedgehog (Hh) signaling in cancer cells drives changes in the tumor microenvironment that are incompletely understood. Here we report that Hh- driven tumors exhibit an increase in myeloid-derived suppressor cells (MDSC) and a decrease in T cells, indicative of an immune suppressive tumor microenvironment. This change was associated with activated TGFβ signaling in several cell types in BCCs. We determined that TGFβ signaling in bone marrow (BM)-derived cells, not keratinocytes, regulates MDSC...

  6. New Mechanism of Bone Cancer Pain: Tumor Tissue-Derived Endogenous Formaldehyde Induced Bone Cancer Pain via TRPV1 Activation.

    Science.gov (United States)

    Wan, You

    2016-01-01

    In recent years, our serial investigations focused on the role of cancer cells-derived endogenous formaldehyde in bone cancer pain. We found that cancer cells produced formaldehyde through demethylation process by serine hydroxymethyltransferase (SHMT1 and SHMT2) and lysine-specific histone demethylase 1 (LSD1). When the cancer cells metastasized into bone marrow, the elevated endogenous formaldehyde induced bone cancer pain through activation on the transient receptor potential vanilloid subfamily member 1 (TRPV1) in the peripheral nerve fibers. More interestingly, TRPV1 expressions in the peripheral fibers were upregulated by the local insulin-like growth factor I (IGF-I) produced by the activated osteoblasts. In conclusion, tumor tissue-derived endogenous formaldehyde induced bone cancer pain via TRPV1 activation. PMID:26900062

  7. Massive chest wall resection and reconstruction for malignant disease

    Science.gov (United States)

    Foroulis, Christophoros N; Kleontas, Athanassios D; Tagarakis, George; Nana, Chryssoula; Alexiou, Ioannis; Grosomanidis, Vasilis; Tossios, Paschalis; Papadaki, Elena; Kioumis, Ioannis; Baka, Sofia; Zarogoulidis, Paul; Anastasiadis, Kyriakos

    2016-01-01

    Objective Malignant chest wall tumors are rare neoplasms. Resection with wide-free margins is an important prognostic factor, and massive chest wall resection and reconstruction are often necessary. A recent case series of 20 consecutive patients is reported in order to find any possible correlation between tumor histology, extent of resection, type of reconstruction, and adjuvant treatment with short- and long-term outcomes. Methods Twenty patients were submitted to chest wall resection and reconstruction for malignant chest wall neoplasms between 2006 and 2014. The mean age (ten males) was 59±4 years. The size and histology of the tumor, the technique of reconstruction, and the short- and long-term follow-up records were noted. Results The median maximum diameter of tumors was 10 cm (5.4–32 cm). Subtotal sternal resection was performed in nine cases, and the resection of multiple ribs was performed in eleven cases. The median area of chest wall defect was 108 cm2 (60–340 cm2). Histology revealed soft tissue, bone, and cartilage sarcomas in 16 cases (80%), most of them chondrosarcomas. The rest of the tumors was metastatic tumors in two cases and localized malignant pleural mesothelioma and non-Hodgkin lymphoma in one case. The chest wall defect was reconstructed by using the “sandwich technique” (propylene mesh/methyl methacrylate/propylene mesh) in nine cases of large anterior defects or by using a 2 mm polytetrafluoroethylene (e-PTFE) mesh in nine cases of lateral or posterior defects. Support from a plastic surgeon was necessary to cover the full-thickness chest wall defects in seven cases. Adjuvant oncologic treatment was administered in 13 patients. Local recurrences were observed in five cases where surgical reintervention was finally necessary in two cases. Recurrences were associated with larger tumors, histology of malignant fibrous histiocytoma, and initial incomplete resection or misdiagnosis made by nonthoracic surgeons. Three patients died

  8. Bone tumors with an associated pathologic fracture: Differentiation between benign and malignant status using radiologic findings

    International Nuclear Information System (INIS)

    To determine whether benign and malignant bone tumors with associated pathologic fractures can be differentiated using radiologic findings. Seventy-eight patients (47 men and 31 women, age range: 1-93 years) with a bone tumor and an associated pathologic fracture from 2004 to 2013 constituted the retrospective study cohort. The tumor size, margin, and enhancement patterns; the presence of sclerotic margin, the peritumoral bone marrow, soft tissue edema, extra-osseous soft tissue mass, intratumoral cystic/hemorrhagic/necrotic regions, mineralization/sclerotic regions, periosteal reaction and its appearance; and cortical change and its appearance were evaluated on all images. Differences between the imaging characteristics of malignant and benign pathologic fractures were compared using Pearson's chi-square test and the 2-sample t-test. There were 22 benign and 56 malignant bone tumors. Some factors were found to significantly differentiate between benign and malignant tumors; specifically, ill-defined tumor margin, the presence of sclerotic tumor margin and an extra-osseous soft tissue mass, the absence of cystic/necrotic/hemorrhagic portions in a mass, the homogeneous enhancement pattern, and the presence of a displaced fracture and of underlying cortical change were suggestive of malignant pathologic fractures. Some imaging findings were helpful for differentiating between benign and malignant pathologic fractures

  9. Bone tumors with an associated pathologic fracture: Differentiation between benign and malignant status using radiologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Ji Hyun; Lee, In Sook; Song, You Seon [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Kim, Jeung Il [Dept. of Radiology, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu (Korea, Republic of); Lee, Moon Sung [Dept. of Radiology, Keimyung University College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of); Lee, Young Hwan [Dept. of Radiology, Catholic University of Daegu College of Medicine, Daegu Catholic University Hospital, Daegu (Korea, Republic of); Song, Jong Woon [Dept. of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan (Korea, Republic of)

    2015-10-15

    To determine whether benign and malignant bone tumors with associated pathologic fractures can be differentiated using radiologic findings. Seventy-eight patients (47 men and 31 women, age range: 1-93 years) with a bone tumor and an associated pathologic fracture from 2004 to 2013 constituted the retrospective study cohort. The tumor size, margin, and enhancement patterns; the presence of sclerotic margin, the peritumoral bone marrow, soft tissue edema, extra-osseous soft tissue mass, intratumoral cystic/hemorrhagic/necrotic regions, mineralization/sclerotic regions, periosteal reaction and its appearance; and cortical change and its appearance were evaluated on all images. Differences between the imaging characteristics of malignant and benign pathologic fractures were compared using Pearson's chi-square test and the 2-sample t-test. There were 22 benign and 56 malignant bone tumors. Some factors were found to significantly differentiate between benign and malignant tumors; specifically, ill-defined tumor margin, the presence of sclerotic tumor margin and an extra-osseous soft tissue mass, the absence of cystic/necrotic/hemorrhagic portions in a mass, the homogeneous enhancement pattern, and the presence of a displaced fracture and of underlying cortical change were suggestive of malignant pathologic fractures. Some imaging findings were helpful for differentiating between benign and malignant pathologic fractures.

  10. 关节外整块切除肩胛带恶性肿瘤的手术及术后功能研究%Limb-sparing resections for malignant tumors of shoulder girdle:11-year experience of classical or modified tikhoff-linberg procedures in a single institution

    Institute of Scientific and Technical Information of China (English)

    谢璐; 郭卫; 汤小东; 杨荣利

    2015-01-01

    to 82 y).All patients were followed up for a mean of 34 months (range,6 to 109 months).The pathologic diagnosis obtained by needle or open biopsies included 10 metastatic tumors (4 from lung cancer,3 from breast cancer,1 from thyroid cancer and 2 from unknown origin),7 chondrosarcomas,4 osteosarcomas,3 Ewing sarcoma/PNET,3 synovial sarcomas,2 malignant peripheral nerve sheath tumors,1 malignant fibrous histocytoma,1 fibrous sarcoma,1 liposarcoma and 1 malignant hemangiopericytoma.The stage and extent of the tumor were evaluated according to the Enneking system.Neoadjuvant chemotherapy was administered to patients with osteosarcoma,Ewing's sarcoma/PNET and partial malignant soft tissue sarcoma.As for other anatomical sites,limb salvage procedures for bone tumors of the shoulder girdle comprise three steps:complete resection of tumors,reconstruction of bone defects and good soft tissue covering.According to the surgical classification system proposed by Linberg and Malawer et al,classical Tikhoff-Linberg resection (also called shoulder girdle resection Malawer type Ⅳ )contained extraarticular en bloc resection of proximal humerus or humeral head,glenohumeral joint,the whole scapular and lateral clavicle.While modified Tikhoff-Linberg procedure (Malawer type Ⅴ)meant extra-articular resection of proximal humerus,glenohumeral joint,lateral clavicle and the neck of scapular glenoid.The surgical margins of the resected tumor were grossly and microscopically evaluated by two different experienced pathologists respectively.If they disagreed in opinion,the margins would be judged by another doctor who usually would be a senior pathologist.Results All those 33 patients survived the perioperative period and were followed up clinically after surgery (mean follow-up time 34 m,range 6 to 109 m).At the final follow-up,6 patients were alive without evidence of disease,2 patients remained alive but with disease,and 25 had died of their disease.In patients with metastatic bone

  11. Large Duodenal Gastrointestinal Stromal Tumor Presenting with Acute Bleeding Managed by a Whipple Resection. A Review of Surgical Options and the Prognostic Indicators of Outcome

    Directory of Open Access Journals (Sweden)

    Norman Oneil Machado

    2011-03-01

    Full Text Available Context Duodenal gastrointestinal stromal tumors (GISTs are uncommon and constitute a relatively small subset of GISTs which presents a unique dilemma having various surgical options. A case of a large ulcerating duodenal GIST arising from the second and third parts of the duodenum and involving the pancreas which was managed by a Whipple resection is presented. The literature is also reviewed to present the current status on surgical options, outcome, prognostic indicators and the role of imatinib mesylate in its management. Case report A 58-year-old patient presented with acute gastrointestinal bleeding which was diagnosed to be due to a duodenal GIST following CT scan and endoscopic biopsy. The mass which measured about 10x9 cm originated from the 2nd part and extended into the 3rd part of the duodenum. He underwent a Whipple resection, and histopathology confirmed a duodenal GIST having a greater than 10 mitotic count per fifty high power field and areas of necrosis. Postoperatively, he received imatinib mesylate 400 mg bid; however, 4 months later, he presented with multiple disseminated peritoneal metastases and succumbed to the disease 2 months later. Conclusion GISTs of the duodenum which are small in size and do not involve the papilla of Vater are better resolved using a limited resection of the duodenum since the outcome in terms of operative risk or disease recurrence is not influenced in these cases. However, large tumors with more extensive involvement would require a pancreaticoduodenectomy to achieve adequate tumor clearance. Even though duodenal GISTs have a relatively better prognosis as compared to GISTs at other sites, their aggressiveness ranges from small indolent tumors to aggressive sarcomas. Following tumor resection, a recurrence rate of about 40% has been reported. A more favorable prognosis in duodenal GISTs is attributed to a lower prevalence of P53 loss, the duodenal location of the tumor, a smaller size of the

  12. Comparative imaging study for soft tissue changes in osteomyelitis and malignant bone tumor

    International Nuclear Information System (INIS)

    Objective: To investigate the value of the imaging findings of soft tissue abnormality in the differential diagnosis between osteomyelitis and malignant bone tumor. Methods: The CT and MRI findings of soft tissue changes in 57 cases of osteomyelitis and 70 cases of malignant bone tumor were retrospectively defined,observed, recorded and statistically analyzed. Results: In 57 cases of osteomyelitis, 54 cases were examined with CT, and soft tissue swelling was presented in 52 cases (degree I in 19 cases, degree II in 16 cases, degree III in 17 cases). Abscess-like cysts in soft tissue occurred in 6 cases, masses in 5, air in 1, fat-fluid level in 1 and sinus tract in 1. Among 14 cases examined with MR imaging, soft tissue swelling was presented in all cases (degree I in 2 cases, degree II in 6 cases and degree III in 6 cases). Abscess-like cysts appeared in 3 cases and showed high signal in diffusion weighted imaging, mass in 1 and fat-fluid level in 1. Among 54 cases examined with CT in 70 cases of malignant bone tumor, soft tissue swelling was presented in 44 cases (degree I in 29 cases, degree II in 12 cases, degree III in 3 cases). Soft tissue masses appeared in 49 cases, bone shell and shell-like calcification in 16 cases, and neoplastic bone and neoplastic calcified cartilage within soft tissue mass in 25 cases. Among 49 cases examined with MR imaging, soft tissue swelling was presented in 46 cases (degree I in 21 cases, degree II in 17 cases and degree III in 8 cases), and soft tissue masses appeared in 43 cases. The degree of soft tissue swelling and the occurrence of abscess-like cyst, mass, bone shell or shell-liked calcification in the rim of mass, neoplastic bone or neoplastic calcified cartilage in masses showed significant difference (P<0.05) between osteomyelitis group and malignant bone tumor group on CT examination. The degree of Soft tissue swelling and the occurrence frequency of abscess-like cysts and mass were significantly different (P<0

  13. Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

    Directory of Open Access Journals (Sweden)

    Ajay Puri

    2012-01-01

    Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

  14. Binocular Goggle Augmented Imaging and Navigation System provides real-time fluorescence image guidance for tumor resection and sentinel lymph node mapping

    Science.gov (United States)

    B. Mondal, Suman; Gao, Shengkui; Zhu, Nan; Sudlow, Gail P.; Liang, Kexian; Som, Avik; Akers, Walter J.; Fields, Ryan C.; Margenthaler, Julie; Liang, Rongguang; Gruev, Viktor; Achilefu, Samuel

    2015-07-01

    The inability to identify microscopic tumors and assess surgical margins in real-time during oncologic surgery leads to incomplete tumor removal, increases the chances of tumor recurrence, and necessitates costly repeat surgery. To overcome these challenges, we have developed a wearable goggle augmented imaging and navigation system (GAINS) that can provide accurate intraoperative visualization of tumors and sentinel lymph nodes in real-time without disrupting normal surgical workflow. GAINS projects both near-infrared fluorescence from tumors and the natural color images of tissue onto a head-mounted display without latency. Aided by tumor-targeted contrast agents, the system detected tumors in subcutaneous and metastatic mouse models with high accuracy (sensitivity = 100%, specificity = 98% ± 5% standard deviation). Human pilot studies in breast cancer and melanoma patients using a near-infrared dye show that the GAINS detected sentinel lymph nodes with 100% sensitivity. Clinical use of the GAINS to guide tumor resection and sentinel lymph node mapping promises to improve surgical outcomes, reduce rates of repeat surgery, and improve the accuracy of cancer staging.

  15. High Birth Weight Increases the Risk for Bone Tumor: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Songfeng Chen

    2015-09-01

    Full Text Available There have been several epidemiologic studies on the relationship between high birth weight and the risk for bone tumor in the past decades. However, due to the rarity of bone tumors, the sample size of individual studies was generally too small for reliable conclusions. Therefore, we have performed a meta-analysis to pool all published data on electronic databases with the purpose to clarify the potential relationship. According to the inclusion and exclusion criteria, 18 independent studies with more than 2796 cases were included. As a result, high birth weight was found to increase the risk for bone tumor with an Odds Ratio (OR of 1.13, with the 95% confidence interval (95% CI ranging from 1.01 to 1.27. The OR of bone tumor for an increase of 500 gram of birth weight was 1.01 (95% CI 1.00–1.02; p = 0.048 for linear trend. Interestingly, individuals with high birth weight had a greater risk for osteosarcoma (OR = 1.22, 95% CI 1.06–1.40, p = 0.006 than those with normal birth weight. In addition, in the subgroup analysis by geographical region, elevated risk was detected among Europeans (OR = 1.14, 95% CI 1.00–1.29, p = 0.049. The present meta-analysis supported a positive association between high birth weight and bone tumor risk.

  16. Two cases of gastrointestinal stromal tumor of the small intestine with liver and bone metastasis.

    Science.gov (United States)

    Aktan, Meryem; Koc, Mehmet; Yavuz, Berrin Benli; Kanyilmaz, Gul

    2015-10-01

    Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. These tumors most commonly occur in the stomach (60%), jejunum and ileum (30%). Metastasis is characteristically the malignant behavior of the GISTs. GISTs most frequently metastasize to the liver and peritoneum, whereas bone and lung metastases are uncommon sites. Here, we described two cases of bone and liver metastases in patients with advanced GISTs. Both of them showed liver metastasis at disease presentation and bone metastasis in early time after the diagnosis. Bone metastases involved the lumber spine and right femur in first patient and L2 vertebral body in the second case. All of the lesions presented a lytic pattern. These cases are presented because of the rare incidence of bone metastasis to femur and vertebral bodies. More attention should be paid to the diagnosis of bone metastases from GISTs in clinical practice despite the shortage of available data on the sensitivity and specificity of bone scintigraphy and PET-CT. PMID:26605305

  17. A reappraisal of hemangiopericytoma of bone; analysis of cases reclassified as synovial sarcoma and solitary fibrous tumor of bone

    DEFF Research Database (Denmark)

    Verbeke, Sofie L J; Fletcher, Christopher D M; Alberghini, Marco; Daugaard, Søren; Flanagan, Adrienne M; Parratt, Tim; Kroon, Herman M; Hogendoorn, Pancras C W; Bovée, Judith V M G

    2010-01-01

    HPC of bone exists. We reviewed 9 primary "HPC" of bone from 4 institutions diagnosed between 1952 and 2002. Immunohistochemistry was performed for CD31, CD34, von Willebrand factor, smooth muscle actin, keratin AE1/AE3, and epithelial membrane antigen. There were 4 male and 5 female patients between...... and varying cellularity, consistent with SFT; 3 of 5 cases examined were CD34-positive. Three tumors showed more densely packed sheets and fascicles of poorly differentiated cells, resembling SS, of which 2 showed focal staining for keratin AE1/AE3 or epithelial membrane antigen. Fluorescent in...

  18. The prognostic value of ERCC1 and RRM1 gene expression in completely resected non-small cell lung cancer: tumor recurrence and overall survival

    International Nuclear Information System (INIS)

    The roles of excision repair cross-complementing group 1 gene (ERCC1) expression and ribonucleotide reductase subunit M1 gene (RRM1) expression in completely resected non-small cell lung cancer (NSCLC) are still debatable. Previous studies have shown that both genes affected the overall survival and outcomes of patients who received platinum-based chemotherapy; however, some studies did not show this correlation. The aim of this study was to evaluate the prognostic values of ERCC1 and RRM1 gene expression in predicting tumor recurrence and overall survival in patients with completely resected NSCLC who received adjuvant chemotherapy and in those who did not. A retrospective cohort study was conducted in 247 patients with completely resected NSCLC. All patients had been treated with anatomic resection (lobectomy or pneumonectomy) with systematic mediastinal lymphadenectomy between January 2002 and December 2011 at Chiang Mai University Hospital, Chiang Mai, Thailand. They were divided into two groups: recurrence and no recurrence. Protein expression of ERCC1 and RRM1 was determined by immunohistochemistry. Correlations between clinicopathologic variables, including ERCC1 and RRM1 expression and tumor recurrence, were analyzed. Univariate and multivariate Cox proportional hazards regression analysis stratified by nodal involvement, tumor staging, intratumoral blood vessel invasion, intratumoral lymphatic invasion, and tumor necrosis was used to identify the prognostic roles of ERCC1 and RRM1. ERCC1 and RRM1 expression did not demonstrate prognostic value for tumor recurrence and overall survival in patients with completely resected NSCLC. In patients who did not receive adjuvant chemotherapy treatment, those with high ERCC1 and high RRM1 expression seemed to have greater potential for tumor recurrence and shorter overall survival than did those who had low ERCC1 and low RRM1 (hazard ratio [HR] =1.7, 95% confidence interval [CI] =0.6–4.3, P=0.292 and HR =1.6, 95% CI

  19. Giant cell tumor of the metatarsal bone: case report and review of the literature; Tumor de celulas gigantes do metatarso: relato de caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Benites Filho, Paulo R.; Escuissato, Dante L. [Hospital de Clinicas da Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Servico de Radiologia]. E-mail: danteluiz@onda.com.br; Urban, Linei A.B.D. [DAPI - Diagnostico Avancado por Imagem, Curitiba, PR (Brazil); Gasparetto, Taisa P. Davaus [Hospital Universitario Antonio Pedro (HUAP), Niteroi, RJ (Brazil). Dept. de Radiologia; Sakamoto, Danielle; Ioshii, Sergio [Hospital de Clinicas da Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Servico de Anatomia Patologica; Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia

    2007-07-01

    Giant cell tumor of bone is a rare neoplasm and account for 5% of all primary bone tumors. It is common in the knee and wrist, but rare in the small bones of the foot. The authors report a 32-year old male patient presented with a four-month history of right foot pain. Plain radiographs showed an expansive lytic lesion involving the first right metatarsal bone. Computed tomography scan demonstrated a radiolucent lesion with well-defined borders. Biopsy was performed and the histological diagnostic was giant cell tumor. The authors emphasize the correlation between the imaging and histological findings. (author)

  20. A case of secondary somatosensory epilepsy with a left deep parietal opercular lesion: successful tumor resection using a transsubcentral gyral approach during awake surgery.

    Science.gov (United States)

    Maesawa, Satoshi; Fujii, Masazumi; Futamura, Miyako; Hayashi, Yuichiro; Iijima, Kentaro; Wakabayashi, Toshihiko

    2016-03-01

    Few studies have examined the clinical characteristics of patients with lesions in the deep parietal operculum facing the sylvian fissure, the region recognized as the secondary somatosensory area (SII). Moreover, surgical approaches in this region are challenging. In this paper the authors report on a patient presenting with SII epilepsy with a tumor in the left deep parietal operculum. The patient was a 24-year-old man who suffered daily partial seizures with extremely uncomfortable dysesthesia and/or occasional pain on his right side. MRI revealed a tumor in the medial aspect of the anterior transverse parietal gyrus, surrounding the posterior insular point. Long-term video electroencephalography monitoring with scalp electrodes failed to show relevant changes to seizures. Resection with cortical and subcortical mapping under awake conditions was performed. A negative response to stimulation was observed at the subcentral gyrus during language and somatosensory tasks; thus, the transcortical approach (specifically, a transsubcentral gyral approach) was used through this region. Subcortical stimulation at the medial aspect of the anterior parietal gyrus and the posterior insula around the posterior insular point elicited strong dysesthesia and pain in his right side, similar to manifestation of his seizure. The tumor was completely removed and pathologically diagnosed as pleomorphic xanthoastrocytoma. His epilepsy disappeared without neurological deterioration postoperatively. In this case study, 3 points are clinically significant. First, the clinical manifestation of this case was quite rare, although still representative of SII epilepsy. Second, the location of the lesion made surgical removal challenging, and the transsubcentral gyral approach was useful when intraoperative mapping was performed during awake surgery. Third, intraoperative mapping demonstrated that the patient experienced pain with electrical stimulation around the posterior insular point

  1. The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients

    International Nuclear Information System (INIS)

    Skeletal bone accretion occurs throughout childhood. The integrity of this process can influence future adult bone health and the risk of osteoporosis. Although surveillance of children who are at risk of poor bone accretion is important, the most appropriate method to monitor childhood bone health has not been established. Previous investigators have proposed using bone age (BA) rather than chronological age (CA) when interpreting bone mineral density (BMD) values in children. To investigate the value of BA assessment for BMD measurement in a cohort of children at risk of poor accretion. A cohort of 163 children with brain tumors who completed both a BMD assessment (quantitative computed tomography, QCT) and who had a BA within a 6-month interval were identified. The difference in BMD Z-scores determined by CA and BA was determined. The impact of salient clinical features was assessed. No significant difference between CA and BA Z-scores was detected in the overall cohort (P 0.056). However, the scores in 18 children (all boys between the ages of 11 years and 15 years) were statistically determined to be outliers from the values in the rest of the cohort. Interpretation of BMD with BA measurement might be appropriate and affect treatment decisions in peripubertal males. (orig.)

  2. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, P. van; Venstermans, C.; Gielen, J.; Parizel, P.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Vanhoenacker, F.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); AZ St-Maarten, Department of Radiology, Duffel/Mechelen (Belgium); Vogel, J. [Leiden University Medical Centre, Department of Orthopedics, Leiden (Netherlands); Kroon, H.M.; Bloem, J.L. [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Schepper, A.M.A. de [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands)

    2006-12-15

    The purpose of this study was to determine the prevalence, extension and signal characteristics of fluid-fluid levels in a large series of 700 bone and 700 soft tissue tumors. Out of a multi-institutional database, MRI of 700 consecutive patients with a bone tumor and MRI of 700 consecutive patients with a soft tissue neoplasm were retrospectively reviewed for the presence of fluid-fluid levels. Extension (single, multiple and proportion of the lesion occupied by fluid-fluid levels) and signal characteristics on magnetic resonance imaging of fluid-fluid levels were determined. In all patients, pathologic correlation was available. Of 700 patients with a bone tumor, 19 (10 male and 9 female; mean age, 29 years) presented with a fluid-fluid level (prevalence 2.7%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included aneurysmal bone cyst (ten cases), fibrous dysplasia (two cases), osteoblastoma (one case), simple bone cyst (one case), telangiectatic osteosarcoma (one case), ''brown tumor'' (one case), chondroblastoma (one case) and giant cell tumor (two cases). Of 700 patients with a soft tissue tumor, 20 (9 males and 11 females; mean age, 34 years) presented with a fluid-fluid level (prevalence 2.9%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included cavernous hemangioma (12 cases), synovial sarcoma (3 cases), angiosarcoma (1 case), aneurysmal bone cyst of soft tissue (1 case), myxofibrosarcoma (1 case) and high-grade sarcoma ''not otherwise specified'' (2 cases). In our series, the largest reported in the literature to the best of our knowledge, the presence of fluid-fluid levels is a rare finding with a prevalence of 2.7 and 2.9% in bone and soft tissue tumors, respectively. Fluid-fluid levels remain a non-specific finding and can

  3. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the prevalence, extension and signal characteristics of fluid-fluid levels in a large series of 700 bone and 700 soft tissue tumors. Out of a multi-institutional database, MRI of 700 consecutive patients with a bone tumor and MRI of 700 consecutive patients with a soft tissue neoplasm were retrospectively reviewed for the presence of fluid-fluid levels. Extension (single, multiple and proportion of the lesion occupied by fluid-fluid levels) and signal characteristics on magnetic resonance imaging of fluid-fluid levels were determined. In all patients, pathologic correlation was available. Of 700 patients with a bone tumor, 19 (10 male and 9 female; mean age, 29 years) presented with a fluid-fluid level (prevalence 2.7%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included aneurysmal bone cyst (ten cases), fibrous dysplasia (two cases), osteoblastoma (one case), simple bone cyst (one case), telangiectatic osteosarcoma (one case), ''brown tumor'' (one case), chondroblastoma (one case) and giant cell tumor (two cases). Of 700 patients with a soft tissue tumor, 20 (9 males and 11 females; mean age, 34 years) presented with a fluid-fluid level (prevalence 2.9%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included cavernous hemangioma (12 cases), synovial sarcoma (3 cases), angiosarcoma (1 case), aneurysmal bone cyst of soft tissue (1 case), myxofibrosarcoma (1 case) and high-grade sarcoma ''not otherwise specified'' (2 cases). In our series, the largest reported in the literature to the best of our knowledge, the presence of fluid-fluid levels is a rare finding with a prevalence of 2.7 and 2.9% in bone and soft tissue tumors, respectively. Fluid-fluid levels remain a non-specific finding and can occur in a wide range of bone and soft

  4. Tc-MDP bone scintigraphy in a case with sporodical tumoral calcinosis

    International Nuclear Information System (INIS)

    Tumoral calcinosis is an uncommon and benign condition characterized by the presence of large calcific soft tissue deposits occurring predominantly in a periarticular location. It generally occurs as a complication of renal dialysis or trauma, and is rarely seen in familial and sporadic cases. Bone scintigraphy is a sensitive method for diagnosing tumoral calcinosis. A 28-year-old female patient with a history of operation due to tumoral calcinosis located bilateral hips, referred to our department. She had a tender palpable mass in the right knee and a fistulized incisional scar overlying the bilateral hip joints. A sporadic case of tumoral calcinosis with relapses was presented. (author)

  5. Preliminary study of 3T 1H MR spectroscopy in bone and soft tissue tumors

    Institute of Scientific and Technical Information of China (English)

    QI Zi-hua; LI Chuan-fu; LI Zhen-feng; ZHANG Kai; WANG Qian; YU De-xin

    2009-01-01

    Background Magnetic resonance spectroscopy (MRS) is one method that can examine noninvasively the alive specimen of the organ, metabolism of the organ and cell, and the biochemistry change. MRS provides the biochemistry information that may be used to diagnose tumors or differentiate the malignant tumor from benign. The objective of this study is to investigate the benign and malignant bone and soft tissue tumors by 1H-MR spectroscopy (1H-MRS) on a 3 Tesla MR scanner, then to assess the usefulness of 'H-MRS in diagnosing bone and soft tissue tumors and distinguishing benign from malignant tumors. Methods Fifty-six patients with bone and soft tissue tumors proved clinically and pathologically were examined with 1H-MRS. 1H-MRS was performed to study malignant musculoskeletal tumors, benign tumors and normal muscle adjacent to lesions to analyze the characteristics, and single-voxel point-resolved spectroscopy sequence was used. Proton brain exam-single voxel of 1H-MRS which directly appeared in the spectrum, was observed to find the peak height of choline compounds (Cho) opposite to the creatine (Cr), and whether there was a Cho peak. Metabolite values were calculated automatically from the area under each metabolite peak by the Functool 3.1 software. Metabolite ratios of Cho/Cr were manually calculated. Then according to the results, it was judged whether there existed benign or malignant tumors. The Kappa statistical test was used to analyze the MRS results, the histopathology data and the surgical situation. Statistics processing was performed using the software package SPSS11.5 for Windows. Results1H-MRS spectra style of bone and soft tissue tumors was different from that of normal muscle, and differences also existed between benign and malignant tumors. Choline level in malignant tumor was markedly higher than that in benign tumors. Cho/Cr in malignant tumor was higher than in benign tumor significantly (P<0.05). The true positive rate of bone and soft tissue

  6. Differentiating giant cell tumor of bone from patellofemoral syndrome: a case study.

    Science.gov (United States)

    Bonar, Jason; Carr, Shannon Clutton; De Carvalho, Diana; Wunder, Jay S

    2016-03-01

    Balancing the assessment of musculoskeletal dysfunctions with a high level of suspicion for non-mechanical origins can be a challenge for the clinician examining a sports injury. Without timely diagnosis, non-mechanical complaints could result in surgery or loss of limb. This case describes the discovery of a Giant Cell Tumor of Bone (GCTB) following the re-evaluation of an athlete who had undergone five years of conservative management for patellofemoral pain syndrome (PFPS). Knee injuries account for 32.6% of sports injuries with PFPS being the most common and most likely diagnosis for anterior knee pain. GCTB is a benign aggressive bone tumor with a predilection for the juxta-articular region of the knee, comprising up to 23% of all benign bone tumors, and commonly occurs in the second to fourth decades. This case report illustrates the difficulty in accurately diagnosing healthy athletes, reviews common differentials for knee complaints and explores helpful diagnostic procedures. PMID:27069267

  7. Endoscopic ultrasound-assisted endoscopic resection of carcinoid tumors of the gastrointestinal tract Resección endoscópica asistida por ecoendoscopia de tumores carcinoides del aparato digestivo

    Directory of Open Access Journals (Sweden)

    D. Martínez-Ares

    2004-12-01

    Full Text Available Introduction: usually found in the gastrointestinal tract, carcinoids are the most frequent neuroendocrine tumors. Most of these lesions are located in areas that are difficult to access using conventional endoscopy (small intestine and appendix; carcinoid tumors found in the gastroduodenal tract and in the large intestine can be studied endoscopically; in these cases, if localized disease is confirmed, local treatment by endoscopic resection may be the treatment of choice. Since endoscopic ultrasonography has been shown to be the technique of choice for the study of tumors exhibiting submucosal growth, the selection of patients who are candidates for a safe and effective local resection should be based on this technique. Patients and method: we selected patients with gastrointestinal carcinoid tumors who were endoscopically treated between 1997 and 2002. Those patients with tumors measuring less than 10 mm, which had not penetrated the muscularis propria, and those with localized disease were considered candidates for endoscopic resection. The endpoints of this study were to assess the effectiveness (complete resection and safety (complications of the technique. Follow-up consisted of eschar biopsies performed one month and twelve months after the resection. Results: during the aforementioned period, we resected endoscopically 24 tumors in 21 patients (mean age: 51.7 years; 71.5% males. Most lesions were incidental discoveries made during examinations indicated for other reasons. Resection was indicated in most cases as a result of the suspected presence of a carcinoid tumor after endoscopic ultrasonography. Endoscopic ultrasonography also enabled us to clearly identify the layer where the lesion had originated, as well as the size of the lesion. The carcinoid tumor was removed in 13 cases (54.2% by using the conventional snare polypectomy technique, in 9 cases (37.5% assisted by a submucosal injection of saline solution and/or adrenaline, and

  8. Integrated multimodal imaging of dynamic bone-tumor alterations associated with metastatic prostate cancer.

    Directory of Open Access Journals (Sweden)

    Jean-Christophe Brisset

    Full Text Available Bone metastasis occurs for men with advanced prostate cancer which promotes osseous growth and destruction driven by alterations in osteoblast and osteoclast homeostasis. Patients can experience pain, spontaneous fractures and morbidity eroding overall quality of life. The complex and dynamic cellular interactions within the bone microenvironment limit current treatment options thus prostate to bone metastases remains incurable. This study uses voxel-based analysis of diffusion-weighted MRI and CT scans to simultaneously evaluate temporal changes in normal bone homeostasis along with prostate bone metatastsis to deliver an improved understanding of the spatiotemporal local microenvironment. Dynamic tumor-stromal interactions were assessed during treatment in mouse models along with a pilot prospective clinical trial with metastatic hormone sensitive and castration resistant prostate cancer patients with bone metastases. Longitudinal changes in tumor and bone imaging metrics during delivery of therapy were quantified. Studies revealed that voxel-based parametric response maps (PRM of DW-MRI and CT scans could be used to quantify and spatially visualize dynamic changes during prostate tumor growth and in response to treatment thereby distinguishing patients with stable disease from those with progressive disease (p<0.05. These studies suggest that PRM imaging biomarkers are useful for detection of the impact of prostate tumor-stromal responses to therapies thus demonstrating the potential of multi-modal PRM image-based biomarkers as a novel means for assessing dynamic alterations associated with metastatic prostate cancer. These results establish an integrated and clinically translatable approach which can be readily implemented for improving the clinical management of patients with metastatic bone disease.

  9. The retinoblastoma protein tumor suppressor is important for appropriate osteoblast differentiation and bone development

    OpenAIRE

    Berman, Seth D.; Yuan, Tina L.; Miller, Emily S.; Lee, Eunice; Caron, Alicia; Lees, Jacqueline A

    2008-01-01

    Mutation of the Rb tumor suppressor gene is strongly linked to osteosarcoma formation. This observation, and the documented interaction between the retinoblastoma protein (pRb) and Runx2, suggests that pRb is important in bone development. To assess this hypothesis, we used a conditional knockout strategy to generate pRb-deficient embryos that survive to birth. Analysis of these embryos shows that Rb-inactivation causes the abnormal development and impaired ossification of several bones, corr...

  10. Receptor-Activator of Nuclear KappaB Ligand Expression as a New Therapeutic Target in Primary Bone Tumors

    Science.gov (United States)

    Yamagishi, Tetsuro; Kawashima, Hiroyuki; Ogose, Akira; Ariizumi, Takashi; Sasaki, Taro; Hatano, Hiroshi; Hotta, Tetsuo; Endo, Naoto

    2016-01-01

    The receptor-activator of nuclear kappaB ligand (RANKL) signaling pathway plays an important role in the regulation of bone growth and mediates the formation and activation of osteoclasts. Osteoclasts are involved in significant bone resorption and destruction. Denosumab is a fully human monoclonal antibody against RANKL that specifically inhibits osteoclast differentiation and bone resorption. It has been approved for use for multiple myeloma and bone metastases, as well as for giant cell tumor of bone. However, there is no previous report quantitatively, comparing RANKL expression in histologically varied bone tumors. Therefore, we analyzed the mRNA level of various bone tumors and investigated the possibility of these tumors as a new therapeutic target for denosumab. We examined RANKL mRNA expression in 135 clinical specimens of primary and metastatic bone tumors using real-time PCR. The relative quantification of mRNA expression levels was performed via normalization with RPMI8226, a human multiple myeloma cell line that is recognized to express RANKL. Of 135 cases, 64 were also evaluated for RANKL expression by using immunohistochemistry. Among all of the tumors investigated, RANKL expression and the RANKL/osteoprotegerin ratio were highest in giant cell tumor of bone. High RANKL mRNA expression was observed in cases of aneurysmal bone cyst, fibrous dysplasia, osteosarcoma, chondrosarcoma, and enchondroma, as compared to cases of multiple myeloma and bone lesions from metastatic carcinoma. RANKL-positive stromal cells were detected in six cases: five cases of GCTB and one case of fibrous dysplasia. The current study findings indicate that some primary bone tumors present new therapeutic targets for denosumab, particularly those tumors expressing RANKL and those involving bone resorption by osteoclasts. PMID:27163152

  11. Comparison of bone tumors induced by beta-emitting or alpha-emitting radionuclides: Schemes of pathogenesis

    International Nuclear Information System (INIS)

    Life-span studies in Beagle dogs have documented the occurrence of bone tumors following exposure to bone-seeking alpha- or beta-emitting radionuclides administered by different routes of exposure. Bone tumors from dogs in four different life-span studies were analyzed according to tumor phenotype, tumor location, radiographic appearance, incidence of metastasis, and association with radiation osteodystrophy. Marked differences in these parameters were observed that did not correlate with differences in radionuclide type, route of exposure, or duration of radionuclide uptake. Radiation osteodystrophy, which is postulated to be a preneoplastic lesion, was not a significant component in one of the studies. Analysis of the data from these four studies suggests that at least two different mechanisms of bone tumor pathogenesis occur for radiation-induced bone tumors. (author)

  12. EVALUATION OF RESULTS OF WIDE RESECTION AND RECONSTRUCTION USING NON - VASCULARISED IPSILATERAL PROXIMAL FIBULA FOR GIANT CELL TUMOR OF LOWER END OF RADIUS

    Directory of Open Access Journals (Sweden)

    Sujai

    2015-06-01

    Full Text Available BACKGROUND: Giant cell tumour of bone can occur at lower end of Radius and it is the third common site. The tumour has to be treated properly to prevent recurrence. Various methods of treatment are available and resection and reconstruction using ipsilateral upper en d of fibula is one of the methods available. METHOD S : The patients who had GCT lower end of Radius and attended the hospital for treatment were taken in this retrospective study. The tumour was evaluated clinically and with X - ray and MRI. The tumour was co nfirmed by FNAC or biopsy. The tumour was resected and reconstruction of the Radius was done using non - vascularised ipsilateral fibula. RESULTS: There were ten patients in this study, six males and four females with age varying from 25 to 41 years and foll ow up period varied from 36 to 60 months. The results were assessed by musculoskeletal tumour society score. Average grip strength was 65% of normal and over all functional range combined movements was 155 degrees which is comparable to published reports. The result was good in eight patients and in two cases there was mild subluxation of wrist joint which was graded as fair.. There was no recurrence of tumour. CONCLUSIONS: GCT of lower end of Radius treated with resection and reconstruction using nonvacula rised ipsilater a l fibula gives good result cosmetically and functionally.

  13. Liver resection for cancer

    Institute of Scientific and Technical Information of China (English)

    RW Parks; OJ Garden

    2001-01-01

    STORY OF HEPATIC RESECTION The earliest hepatic surgery was almost exclusively performed for trauma with records from as for tumor were those of Langenbuch in 1888 [3] , Tiffany in 1890 [4],and Lucke in 1891[5].By1899,76 cases of liver resection had been reported with a mortality rate of 14.9% [6], a remarkably low figure for operations of this magnitude,all performed at the end of the 19th century.

  14. The importance of radiographic imaging in the microscopic assessment of bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Larousserie, F., E-mail: frederique.larousserie@cch.aphp.fr [Université Paris Descartes, Sorbonne Paris Cité, Paris (France); Department of pathology, Rizzoli Institute, Bologna (Italy); Kreshak, J.; Gambarotti, M.; Alberghini, M.; Vanel, D. [Department of pathology, Rizzoli Institute, Bologna (Italy)

    2013-12-01

    Introduction: Primary bone tumors are rare and require a multidisciplinary approach. Diagnosis involves primarily the radiologist and the pathologist. Bone lesions are often heterogeneous and the microscopic diagnostic component(s) may be in the minority, especially on core needle biopsies. Reactive processes, benign, and malignant tumors may have similar microscopic aspects. For these challenging cases, the correlation of microscopic and radiologic information is critical, or diagnostic mistakes may be made with severe clinical consequences for the patient. The purpose of this article is to explain how pathologists can best use imaging studies to improve the diagnostic accuracy of bone lesions. Diagnosis: Many bone lesions are microscopically and/or radiographically heterogeneous, especially those with both lytic and matrix components. Final diagnosis may require specific microscopic diagnostic features that may be present in the lesion, but not the biopsy specimen. A review of the imaging helps assess if sampling was adequate. The existence of a pre-existing bone lesion, syndrome (such as Ollier disease or multiple hereditary exostosis), or oncologic history may be of crucial importance. Finally, imaging information is very useful for the pathologist to perform accurate local and regional staging during gross examination. Conclusion: Close teamwork between pathologists, radiologists, and clinicians is of utmost importance in the evaluation and management of bone tumors. These lesions can be very difficult to interpret microscopically; imaging studies therefore play a crucial role in their accurate diagnosis.

  15. Preoperative imaging study of the spinal cord vascularization: Interest and limits in spine resection for primary tumors

    Energy Technology Data Exchange (ETDEWEB)

    Soubeyrand, Marc, E-mail: soubeyrand.marc@wanadoo.fr [Hopital Universitaire de Bicetre, AP-HP, Bicetre F-94270, Univ Paris-Sud, Department of Orthopaedic Surgery 78 rue du General Leclerc 94270 Le Kremlin-Bicetre (France); Court, Charles, E-mail: charles.court@bct.aphp.fr [Hopital Universitaire de Bicetre, AP-HP, Bicetre F-94270, Univ Paris-Sud, Department of Orthopaedic Surgery 78 rue du General Leclerc 94270 Le Kremlin-Bicetre (France); Fadel, Elie, E-mail: efadel@free.fr [Hopital Marie Lannelongue, 133 avenue de la Resistance, F-92350 Le Plessis-Robinson (France); Vincent-Mansour, Cesar, E-mail: cesar.vincent@hotmail.fr [Hopital Universitaire de Bicetre, AP-HP, Bicetre F-94270, Univ Paris-Sud, Department of Orthopaedic Surgery 78 rue du General Leclerc 94270 Le Kremlin-Bicetre (France); Mascard, Eric, E-mail: eric.mascard@wanadoo.fr [Clinique Arago, 95 boulevard Arago, 75014 Paris (France); Vanel, Daniel, E-mail: daniel.vanel@ior.it [Rizzoli Institute, Research, via del Barbiano 1/10, 40124 Bologna (Italy); Missenard, Gilles, E-mail: missenard.gilles@wanadoo.fr [Institut Gustave Roussy, 39 rue Camille Desmoulins, 94, Villejuif (France)

    2011-01-15

    The necessicity to localize the anterior spinal arteries before anterior approach of the spine stays controversial by orthopaedic surgeons. On the other hand the surgical treatment of thoracoabdominal aneurisms routinely sacrifices many segmental arteries pairs without spinal arteries localization. This, associated with spinal cord protection, results to few neurological complication. However, during vertebrectomies, the roots ligation completely interrupts the spinal cord blood supply at this level. In our experience the spinal arteries localization was systematically done before ninety-eight spine resections. In five cases an anterior radiculomedullary artery was ligated (four anterior radiculomedullary and one great anterior radiculomedullary arteries) without neurological complication, in two cases of extended resection (more than four levels) a neurological complication occurred. No spinal artery was identified at the resection level and the neurological complications were resolutive and did not seem related to definitive vascular problem. These accomplishments lead to discuss the importance of spinal arteries localization and preservation in this surgery. The discovery of an anterior radiculomedullary artery is not a contraindication to en-bloc vertebrectomy at this level, nevertheless in the case of great anterior radiculomedullary artery (Adamkiewicz) the surgical indication must be seriously debated. In fact, this case and those where multilevel resections (more than three levels) are indicated seem the most dangerous situations and the use of the different means of spinal cord protection could be indicated to decrease neurological risk. So before spine resection the spinal arteries localization could improve patient information and give more deciding factors for planning treatment.

  16. Preoperative Y-90 microsphere selective internal radiation treatment for tumor downsizing and future liver remnant recruitment: a novel approach to improving the safety of major hepatic resections

    Directory of Open Access Journals (Sweden)

    Gulec Seza A

    2009-01-01

    Full Text Available Abstract Background Extended liver resections are being performed more liberally than ever. The extent of resection of liver metastases, however, is restricted by the volume of the future liver remnant (FLR. An intervention that would both accomplish tumor control and induce compensatory hypertrophy, with good patient tolerability, could improve clinical outcomes. Case presentation A 53-year-old woman with a history of cervical cancer presented with a large liver mass. Subsequent biopsy indicated poorly differentiated carcinoma with necrosis suggestive of squamous cell origin. A decision was made to proceed with pre-operative chemotherapy and Y-90 microsphere SIRT with the intent to obtain systemic control over the disease, downsize the hepatic lesion, and improve the FLR. A surgical exploration was performed six months after the first SIRT (three months after the second. There was no extrahepatic disease. The tumor was found to be significantly decreased in size with central and peripheral scarring. The left lobe was satisfactorily hypertrophied. A formal right hepatic lobectomy was performed with macroscopic negative margins. Conclusion Selective internal radiation treatment (SIRT with yttrium-90 (Y-90 microspheres has emerged as an effective liver-directed therapy with a favorable therapeutic ratio. We present this case report to suggest that the portal vein radiation dose can be substantially increased with the intent of inducing portal/periportal fibrosis. Such a therapeutic manipulation in lobar Y-90 microsphere treatment could accomplish the end points of PVE with avoidance of the concern regarding tumor progression.

  17. A short-term in vivo model for giant cell tumor of bone

    International Nuclear Information System (INIS)

    Because of the lack of suitable in vivo models of giant cell tumor of bone (GCT), little is known about its underlying fundamental pro-tumoral events, such as tumor growth, invasion, angiogenesis and metastasis. There is no existing cell line that contains all the cell and tissue tumor components of GCT and thus in vitro testing of anti-tumor agents on GCT is not possible. In this study we have characterized a new method of growing a GCT tumor on a chick chorio-allantoic membrane (CAM) for this purpose. Fresh tumor tissue was obtained from 10 patients and homogenized. The suspension was grafted onto the CAM at day 10 of development. The growth process was monitored by daily observation and photo documentation using in vivo biomicroscopy. After 6 days, samples were fixed and further analyzed using standard histology (hematoxylin and eosin stains), Ki67 staining and fluorescence in situ hybridization (FISH). The suspension of all 10 patients formed solid tumors when grafted on the CAM. In vivo microscopy and standard histology revealed a rich vascularization of the tumors. The tumors were composed of the typical components of GCT, including (CD51+/CD68+) multinucleated giant cells whichwere generally less numerous and contained fewer nuclei than in the original tumors. Ki67 staining revealed a very low proliferation rate. The FISH demonstrated that the tumors were composed of human cells interspersed with chick-derived capillaries. A reliable protocol for grafting of human GCT onto the chick chorio-allantoic membrane is established. This is the first in vivo model for giant cell tumors of bone which opens new perspectives to study this disease and to test new therapeutical agents

  18. The value of recognizing suspect diagnoses in the triple diagnosis of giant cell tumor of bone

    Directory of Open Access Journals (Sweden)

    Kotru Mrinalini

    2007-01-01

    Full Text Available Giant cell tumor (GCT of bone is the most frequently over-diagnosed neoplasm in orthopedic pathology because giant cells are a common component of many neoplastic and nonneoplastic conditions of bone. Triple diagnosis, requiring substantial individual and collective inputs by orthopedic surgeons, radiologists and pathologists, is the preferred method for the workup of patients with suspected bone neoplasms. At each stage in triple diagnosis, deviations from the typical must be regarded as clues to alternate diagnoses: the greater the deviation, the more a diagnosis of GCT must be considered suspect. A suspect diagnosis must trigger renewed analysis of the available data and a diligent search to exclude alternate diagnoses.

  19. Bone marrow micrometastases and circulating tumor cells: current aspects and future perspectives

    International Nuclear Information System (INIS)

    Early tumor cell dissemination at the single-cell level can be revealed in patients with breast cancer by using sensitive immunocytochemical and molecular assays. Recent clinical studies involving more than 4000 breast cancer patients demonstrated that the presence of disseminated tumor cells in bone marrow at primary diagnosis is an independent prognostic factor. In addition, various assays for the detection of circulating tumor cells in the peripheral blood have recently been developed and some studies also suggest a potential clinical relevance of this measure. These findings provide the basis for the potential use of disseminated tumor cells in bone marrow or blood as markers for the early assessment of therapeutic response in prospective clinical trials

  20. Assessment of Chemotherapy Response Using FDG-PET in Pediatric Bone Tumors: A Single Institution Experience

    OpenAIRE

    Kim, Dong Hwan; Kim, Seung Yeon; Lee, Hyeon Jeong; Song, Bong Sup; Kim, Dong Ho; Cho, Joong Bum; Lim, Jung Sub; Lee, Jun Ah

    2011-01-01

    Purpose Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imag...

  1. Multiple Tumor Types May Originate from Bone Marrow-Derived Cells

    OpenAIRE

    Chunfang Liu; Zhongwei Chen; Zhihong Chen; Tao Zhang; Yuan Lu

    2006-01-01

    It was believed that tumors originated from the transformation of their tissue-specific stem cells. However, bone marrow-derived cells (BMDCs), which possess an unexpected degree of plasticity and often reside in other tissues, might also represent a potential source of malignancy. To study whether BMDCs play a role in the source of other tumors, BMDCs from mice were treated with 3-methycholanthrene until malignant transformation was achieved. Here we show that transformed BMDCs could form ma...

  2. Multiple Tumor Types May Originate from Bone Marrow-Derived Cells1*

    OpenAIRE

    LIU, CHUNFANG; Chen, Zhongwei; Chen, Zhihong; Zhang, Tao; Lu, Yuan

    2006-01-01

    It was believed that tumors originated from the transformation of their tissue-specific stem cells. However, bone marrow-derived cells (BMDCs), which possess an unexpected degree of plasticity and often reside in other tissues, might also represent a potential source of malignancy. To study whether BMDCs play a role in the source of other tumors, BMDCs from mice were treated with 3-methycholanthrene until malignant transformation was achieved. Here we show that transformed BMDCs could form ma...

  3. Recurrent giant cell tumor of bone with simultaneous regional lymph node and pulmonary metastases

    Energy Technology Data Exchange (ETDEWEB)

    Qureshi, Sajid S.; Puri, Ajay; Agarwal, Manish [Tata Memorial Hospital, Department of Bone and Soft Tissue, Bombay (India); Desai, Saral; Jambhekar, Nirmala [Tata Memorial Hospital, Department of Pathology, Bombay (India)

    2005-04-01

    Giant cell tumors of bone are known for their unpredictable behavior characterized occasionally even by metastases. Most metastases lodge in the lungs but other rare sites are regional lymph nodes, mediastinum, skin, scalp and the pelvis. In this case report we document a case of giant cell tumor of the patella in which, associated with local recurrence, there were simultaneous metastases to lymph nodes and lungs. (orig.)

  4. Bone Marrow-Derived Endothelial Progenitors Expressing Delta-Like 4 (Dll4) Regulate Tumor Angiogenesis

    OpenAIRE

    Real, Carla; Remédio, Leonor; Caiado, Francisco; Igreja, Cátia; Borges, Cristina; Trindade, Alexandre; Pinto-do-Ó, Perpétua; Yagita, Hideo; Duarte, Antonio; Dias, Sérgio

    2011-01-01

    Neo-blood vessel growth (angiogenesis), which may involve the activation of pre-existing endothelial cells (EC) and/or the recruitment of bone marrow-derived vascular precursor cells (BM-VPC), is essential for tumor growth. Molecularly, besides the well established roles for Vascular endothelial growth factor (VEGF), recent findings show the Notch signalling pathway, in particular the ligand Delta-like 4 (Dll4), is also essential for adequate tumor angiogenesis; Dll4 inhibition results in imp...

  5. Role of blood tumor markers in predicting metastasis and local recurrence after curative resection of colon cancer

    OpenAIRE

    Peng, Yifan; Zhai, Zhiwei; Li, Zhongmin; Wang, Lin; Gu, Jin

    2015-01-01

    Aim: To investigate the prognostic value of carcinoembryonic antigen (CEA), CA199, CA724 and CA242 in peripheral blood and local draining venous blood in colon cancer patients after curative resection. Methods: 92 colon cancer patients who received curative resection were retrospectively analyzed. The CEA, CA199, CA724 and CA242 were detected in peripheral blood and local draining venous blood. Results: Metastasis or local recurrence was found in 29 (29/92, 31.5%) patients during follow-up pe...

  6. Can p63 serve as a biomarker for giant cell tumor of bone? A Moroccan experience

    Directory of Open Access Journals (Sweden)

    Hammas Nawal

    2012-09-01

    Full Text Available Abstract Background Multinucleated giant cell-containing tumors and pseudotumors of bone represent a heterogeneous group of benign and malignant lesions. Differential diagnosis can be challenging, particularly in instances of limited sampling. The purpose of this study was to evaluate the contribution of the P63 in the positive and differential diagnosis of giant cell tumor of bone. Methods This study includes 48 giant cell-containing tumors and pseudotumors of bone. P63 expression was evaluated by immunohistochemistry. Data analysis was performed using Epi-info software and SPSS software package (version 17. Results Immunohistochemical analysis showed a P63 nuclear expression in all giant cell tumors of bone, in 50% of osteoid osteomas, 40% of aneurysmal bone cysts, 37.5% of osteoblastomas, 33.3% of chondromyxoide fibromas, 25% of non ossifiant fibromas and 8.3% of osteosarcomas. Only one case of chondroblastoma was included in this series and expressed p63. No P63 immunoreactivity was detected in any of the cases of central giant cell granulomas or langerhans cells histiocytosis. The sensitivity and negative predictive value (NPV of P63 immunohistochemistry for the diagnosis of giant cell tumor of bone were 100%. The specificity and positive predictive value (PPV were 74.42% and 59.26% respectively. Conclusions This study found not only that GCTOB expresses the P63 but it also shows that this protein may serve as a biomarker for the differential diagnosis between two morphologically similar lesions particularly in instances of limited sampling. Indeed, P63 expression seems to differentiate between giant cell tumor of bone and central giant cell granuloma since the latter does not express P63. Other benign and malignant giant cell-containing lesions express P63, decreasing its specificity as a diagnostic marker, but a strong staining was seen, except a case of chondroblastoma, only in giant cell tumor of bone. Clinical and radiological

  7. Study of single voxel 1H MR spectroscopy of bone tumors: Differentiation of benign from malignant tumors

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical application of single voxel 1H MRS in the discrimination of benign and malignant bone tumors. Materials and methods: Eighty-three patients (64 male, 19 female), presenting with a bone tumor, were examined on a 1.5 T MRI scanner. Using pathological results as a gold standard, there were 34 benign and 49 malignant tumors. After plain MRI scans, a 3D fast SPGR sequence was used for dynamic contrast-enhanced scanning. Dynamic images were transferred to the workstation, where the region of maximal enhancement was identified for prescription of the 1H MRS sequence. Single-voxel 1H MRS was then performed with the probe-p sequence, TR/TE = 1500/110 ms, VOI ranging from 14.4 mm × 7.3 mm × 20.2 mm to 27.9 mm × 25.5 mm × 20.1 mm, automatic shimming and water suppression, 15 min post-contrast. For control purposes, the 3rd lumbar spine vertebral body of six patients having lumbar disc herniation (LDH) without systemic disease was examined with 1H MRS of normal bone marrow. The static contrast enhancement scan was used for these LDH patients. Conversion of raw MR signal to an MR spectrum was performed using SAGE 7. Cho/Lip (choline/lipids) peak height ratios were calculated. ROC curve analysis was used to determine the cut-off of Cho/Lip ratio for discrimination. Results: For malignant tumors, one resonance at 3.30–3.19 ppm attributed to choline and another at 1.14–1.55 ppm attributed to lipid were detected. With normal bone marrow and most benign tumors, no choline signal was detected. Choline was only found in six benign lesions. With a threshold for Cho/Lip peak height ratio of 0.2, the area under ROC curve was 0.819. The corresponding sensitivity and specificity of 1H MRS were 76% and 88%. Conclusions: Single voxel 1H MRS can help in discriminating benign and malignant bone tumors

  8. Study of single voxel {sup 1}H MR spectroscopy of bone tumors: Differentiation of benign from malignant tumors

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jing; Cheng, Kebin [Department of Radiology, Beijing Jishuitan Hospital, Beijing (China); Ding, Yi [Department of Orthopaedic Oncology, Beijing Jishuitan Hospital, Beijing (China); Liang, Wei [Department of Radiology, Beijing Jishuitan Hospital, Beijing (China); Ding, Yi [Department of Pathology, Beijing Jishuitan Hospital, Beijing (China); Vanel, Daniel [Rizzoli Institute, Bologna (Italy); Cheng, Xiaoguang, E-mail: xiao65@263.net [Department of Radiology, Beijing Jishuitan Hospital, Beijing (China)

    2013-12-01

    Objective: To evaluate the clinical application of single voxel {sup 1}H MRS in the discrimination of benign and malignant bone tumors. Materials and methods: Eighty-three patients (64 male, 19 female), presenting with a bone tumor, were examined on a 1.5 T MRI scanner. Using pathological results as a gold standard, there were 34 benign and 49 malignant tumors. After plain MRI scans, a 3D fast SPGR sequence was used for dynamic contrast-enhanced scanning. Dynamic images were transferred to the workstation, where the region of maximal enhancement was identified for prescription of the {sup 1}H MRS sequence. Single-voxel {sup 1}H MRS was then performed with the probe-p sequence, TR/TE = 1500/110 ms, VOI ranging from 14.4 mm × 7.3 mm × 20.2 mm to 27.9 mm × 25.5 mm × 20.1 mm, automatic shimming and water suppression, 15 min post-contrast. For control purposes, the 3rd lumbar spine vertebral body of six patients having lumbar disc herniation (LDH) without systemic disease was examined with {sup 1}H MRS of normal bone marrow. The static contrast enhancement scan was used for these LDH patients. Conversion of raw MR signal to an MR spectrum was performed using SAGE 7. Cho/Lip (choline/lipids) peak height ratios were calculated. ROC curve analysis was used to determine the cut-off of Cho/Lip ratio for discrimination. Results: For malignant tumors, one resonance at 3.30–3.19 ppm attributed to choline and another at 1.14–1.55 ppm attributed to lipid were detected. With normal bone marrow and most benign tumors, no choline signal was detected. Choline was only found in six benign lesions. With a threshold for Cho/Lip peak height ratio of 0.2, the area under ROC curve was 0.819. The corresponding sensitivity and specificity of {sup 1}H MRS were 76% and 88%. Conclusions: Single voxel {sup 1}H MRS can help in discriminating benign and malignant bone tumors.

  9. 博宁联合化疗治疗恶性肿瘤骨转称疼痛%Combined chemotherapy with Boning in the treatment of pain due to bone metastases from malignant tumors

    Institute of Scientific and Technical Information of China (English)

    安晓华; 焦立新; 王正艳

    2002-01-01

    Objective To investigate the effect of Boning on pain due to bone metastases from malignant tumors. Method From December,1998 to December,2000,86 patients with pathologically proved bone metastases from malignant tumors were randomly divided into two groups, study group(combined chemotherapy with boning),control group(simple chemotherapy).Boning (60 mg) dissolved in saline solution(500 ml) were given IV for consecutive 3 days. Then 60 mg Boning was given every half month .Patients in control group accepted simple chemotherapy. Results Efficacy in study group was 88.37% which was significantly superior to that in control group (66.47% ).Boning could repair injured bone. Adverse reaction associated with Boning was weak. Boning quickly relieved symptoms for a long time. Conclusion Effect of large dose Boning for relieving pain due to bone metastases from malignant tumors is satisfying. At the same time, Boning play important role in repair of destructed bone.

  10. Complex treatment of localized bone marrow sarcoma in children

    International Nuclear Information System (INIS)

    The retrospective analysis included the results of the treatment of 67 children suffering from localized sarcomas of bone (Ewing's sarcoma, lymphosarcoma). The advantage was demonstrated in patients, received combination of chemotherapy and radiotherapy on the involved bone. The resection of the primary tumor in combination with radio-chemotherapy improves the 10-year survival

  11. The Feasibility of 18F Fluorothymidine PET for Prediction of Tumor Response after Induction Chemotherapy Followed by Chemoradiotherapy with S 1/Oxaliplatin in Patients with Resectable Esophageal Cancer

    International Nuclear Information System (INIS)

    The aim of this study was to determine whether 18F fluorothymidine (FLT) PET is feasible for the early prediction of tumor response to induction chemotherapy followed by concurrent chemoradiotherapy in patients with esophageal cancer. This study was prospectively performed as a collateral study of randomized phase II study of preoperative concurrent chemoradiotherapy with S 1/oxaliplatin in patients with resectable esophageal cancer. 18F FLT positron emission tomography (PET) images were obtained before and after two cycles of induction chemotherapy, and the percent change of maximum standardized uptake value (SUVmax) was calculated. All patients underwent esophagography, gastrofiberoscopy, endoscopic ultrasonography (EUS), computed tomography (CT) and 18F fluorodeoxyglucose (FDG) PET at baseline and 3-4 weeks after completion of concurrent chemoradiotherapy. Final tumor response was determined by both clinical and pathologic tumor responses after surgery. The 13 patients for induction chemotherapy group were enrolled until interim analysis. In a primary tumor visual analysis, the tumor detection rates of baseline 18F FLT and 18F FDG PET were 85% and 100%, respectively. The tumor uptakes on 18F FLT PET were lower than those of 18F FDG PET. Among nine patients who completed second 18F FLT PET, eight patients were responders and one patient was a non responder in the assessment of final tumor response. The percent change of SUVmax in responders ranged from 41.2% to 79.2% (median 57.1%), whereas it was 10.2% in one non responder. The percent change of tumor uptake in 18F FLT PET after induction chemotherapy might be feasible for early prediction of tumor response after induction chemotherapy and concurrent chemoradiotherapy in patients with esophageal cancer

  12. Multiple Tumor Types May Originate from Bone Marrow-Derived Cells

    Directory of Open Access Journals (Sweden)

    Chunfang Liu

    2006-09-01

    Full Text Available It was believed that tumors originated from the transformation of their tissue-specific stem cells. However, bone marrow-derived cells (BMDCs, which possess an unexpected degree of plasticity and often reside in other tissues, might also represent a potential source of malignancy. To study whether BMDCs play a role in the source of other tumors, BMDCs from mice were treated with 3-methycholanthrene until malignant transformation was achieved. Here we show that transformed BMDCs could form many tumor types, including epithelial tumors, neural tumors, muscular tumors, tumors of fibroblasts, blood vessel endothelial tumors, and tumors of poor differentiation in vivo. Moreover, a single transformed BMDC has the ability to self-renew, differentiate spontaneously into various types of tumor cells in vitro, express markers associated with multipotency, and form teratoma in vivo. These data suggest that multipotent cancer stem cells seemed to originate from transformed BMDCs. Conclusively, these findings reveal that BMDCs might be a source of many tumor types, even teratoma. In addition, multipotent cancer stem cells might originate from malignant transformed BMDCs.

  13. Multiple Tumor Types May Originate from Bone Marrow-Derived Cells1*

    Science.gov (United States)

    Liu, Chunfang; Chen, Zhongwei; Chen, Zhihong; Zhang, Tao; Lu, Yuan

    2006-01-01

    Abstract It was believed that tumors originated from the transformation of their tissue-specific stem cells. However, bone marrow-derived cells (BMDCs), which possess an unexpected degree of plasticity and often reside in other tissues, might also represent a potential source of malignancy. To study whether BMDCs play a role in the source of other tumors, BMDCs from mice were treated with 3-methycholanthrene until malignant transformation was achieved. Here we show that transformed BMDCs could form many tumor types, including epithelial tumors, neural tumors, muscular tumors, tumors of fibroblasts, blood vessel endothelial tumors, and tumors of poor differentiation in vivo. Moreover, a single transformed BMDC has the ability to self-renew, differentiate spontaneously into various types of tumor cells in vitro, express markers associated with multipotency, and form teratoma in vivo. These data suggest that multipotent cancer stem cells seemed to originate from transformed BMDCs. Conclusively, these findings reveal that BMDCs might be a source of many tumor types, even teratoma. In addition, multipotent cancer stem cells might originate from malignant transformed BMDCs. PMID:16984729

  14. Therapeutic strategy for lower limb lymphedema and lymphatic fistula after resection of a malignant tumor in the hip joint region: a case report.

    Science.gov (United States)

    Hara, H; Mihara, M; Hayashi, A; Kanemaru, M; Todokoro, T; Yamamoto, T; Iida, T; Hino, R; Koshima, I

    2014-03-01

    Lymphatic fistula complicating lymphedema is thought to occur due to communication between lymph vessels and the skin, which has yet to be shown objectively. The objective of this case report is to show the pathology and treatment using simultaneous lymphatic fistula resection and lymphatico-venous anastomosis (LVA). A 40-year-old woman underwent extended resection and total hip arthroplasty for primitive neuroectodermal tumor in the right proximal femur 23 years ago. Right lower limb lymphedema developed immediately after surgery and lymphatic fistula appeared in the posterior thigh. On ICG lymphography, lymph reflux toward the distal side dispersing in a fan-shape reticular pattern from the lymphatic fistula region was noted after intracutaneous injection of ICG into the foot. We performed simultaneous lymphatic fistula resection and of LVA. Pathological examination showed that the epidermis and stratum corneum of the healthy skin were lost in the lymphatic fistula region. Dilated lymph vessels were open in this region. The examinations provide the first objective evidence that the cause of lymphatic fistula may be lymph reflux from lymphatic stems to precollectors through lymphatic perforators. PMID:23908155

  15. Secretion of MCP-1 and other paracrine factors in a novel tumor-bone coculture model

    International Nuclear Information System (INIS)

    The bone-tumor microenvironment encompasses unique interactions between the normal cells of the bone and marrow cavity and the malignant cells from a primary or metastasized cancer. A multitude of paracrine factors within this microenvironment such as the growth factor, TGF-β, and the chemokine, MCP-1, are secreted by many of these cell types. These factors can act in concert to modulate normal and malignant cell proliferation, malignant cell migration and invasion and, often, mediate bone cancer pain. Although many valuable in vitro and in vivo models exist, identifying the relevant paracrine factors and deciphering their interactions is still a challenge. The aim of our study is to test an ex vivo coculture model that will allow monitoring of the expression, release and regulation of paracrine factors during interactions of an intact femur explant and tumor cells. Intact or marrow-depleted neonatal mouse femurs and select murine and human sarcoma or carcinoma cell lines were incubated singly or in coculture in specialized well plates. Viability of the bone and cells was determined by immunohistochemical stains, microscopy and marrow cytopreps. Secretion and mRNA expression of paracrine factors was quantitated by ELISA and real-time RT-PCR. Compartments of the bone were optimally viable for up to 48 h in culture and tumor cells for up to 4 days. Bone was the major contributor of TGF-β and MMP2 whereas both bone and sarcoma cells secreted the chemokine MCP-1 in cocultures. Synergistic interaction between the femur and sarcoma resulted in enhanced MCP-1 secretion and expression in cocultures and was dependent on the presence of the hematopoietic component of the bone as well as other bone cells. In contrast, coculturing with breast carcinoma cells resulted in reduction of TGF-β and MCP-1 secretion from the bone. These studies illustrate the feasibility of this model to examine paracrine interactions between intact bone and tumor cells. Further study of unique

  16. Giant cells tumor of radius distal end and bone reconstruction

    International Nuclear Information System (INIS)

    This is the case of a black women aged 40 presenting with a tumor of distal end of right radium with histological diagnosis of low-grade malignancy giant cells tumor and proposal of limb amputation. A conservative surgery was performed with a two-steps total exeresis of lesion sparing the oncologic margin. A fibular free-graft was used and wrist arthrodesis and internal fixation of graft using AO system. There was a good graft consolidation and an active incorporation of patient to social activities. The diagnosis, treatment, follow-up, rehabilitation and case prognosis are exposed

  17. The use of alfaxalone and remifentanil total intravenous anesthesia in a dog undergoing a craniectomy for tumor resection.

    Science.gov (United States)

    Warne, Leon N; Beths, Thierry; Fogal, Sandra; Bauquier, Sébastien H

    2014-11-01

    A 7-year-old castrated border collie dog was anesthetised for surgical resection of a hippocampal mass. Anesthesia was maintained using a previously unreported TIVA protocol for craniectomy consisting of alfaxalone and remifentanil. Recovery was uneventful, and the patient was discharged from hospital. We describe the anesthetic management of this case. PMID:25392553

  18. Chondrosarcoma of the bones of the feet.

    Science.gov (United States)

    Patil, Sanjeev; de Silva, M V Chandu; Crossan, Jim; Reid, Robin

    2003-01-01

    Twelve chondrosarcomas of the bones of the feet from 11 patients in the Scottish Bone Tumor Registry were reviewed. One patient with diaphyseal aclasis (osteochondromatosis) developed 2 chondrosarcomas. The mean age of patients was 52.3 years (range, 17 to 83 years). Men were predominantly affected. Four tumors affected the tarsal bones; the rest involved the short tubular bones. The usual clinical presentation was a painful, progressively enlarging swelling. Radiologically, most showed some bone expansion, cortical destruction with indistinct margins, and soft-tissue extension. Histologically, the majority were middle-grade tumors. Treatment included curettage or local excision for 4 tumors and amputation or ray resection for 8 tumors. Follow-up varied from 6 months to 18 years (average, 5.8 years). Local recurrence after surgery was seen in 3 patients. All 3 died because of metastases to the lungs or brain. PMID:14566721

  19. Transarticular invasion of the sacroiliac joints by malignant pelvic bone tumors

    International Nuclear Information System (INIS)

    To describe modes of transarticular invasion, with reference to the size and location of a tumor, the anatomic characteristics of invaded cartilage,and the existence of ankylosis in SI joint. Eleven histologically confirmed malignant pelvic bone tumors involving transarticular invasion of sacroiliac joints, were retrospectively analysed. Transarticular invasion of a joint was defined as involvement of its opposing bones. The anatomic site and size of the tumors were analysed, and invaded sacroiliac joint was divided into upper, middle and lower parts on the basis of the anatomic characteristics of the intervening cartilage: synovial hyaline or fibrous ligamentous. the existence of ankylosis was determined, and transarticular invasion directly across a joint was classified as direct invasion. Extension of tumors around a joint from its periphery to the opposing bone were considered as indirect invasion. All tumors were located near the sacroiliac joint, eight at the ilium and three at the sacrum. Six invasions were indirect and five were direct. Average tumor area was larger in indirect cases than in direct: 191.8 cm2 vs. 69.6 cm2. In all indirect invasions, a huge soft tissue mass abutted onto the peripheral portion of the sacroiliac joint. In five of six cases of indirect transarticular invasion, the upper part of the joint posteriorly located fibrous ligamentous cartilage. In the other, the lower part was invaded, and this involved a detour around the joint space, avoiding the invasion of intervening cartilage. Ankylosis occurred in one of the indirect cases. Among the five cases of direct invasion, there was invasion of the posteriorly located ligamentous fibrous cartilage in three without ankylosis. In the other two cases, involving ankylosis, the synovial hyaline cartilage was invaded directly at the lower part of the joint. Transarticular invasions of sacroiliac joint via fibrous cartilage are most common. Ankylosis of the sacroiliac joint facilitates hyaline

  20. Metastatic tumors to the jaw bones: Retrospective analysis from an Indian tertiary referral center

    Directory of Open Access Journals (Sweden)

    S S Muttagi

    2011-01-01

    Full Text Available Aim: Being a tertiary referral center, we encounter the highest number of oral cancer patients in India, and there is direct involvement of the jaw bone in approximately 40% of these cases. There are no large case series from the Indian subcontinent on metastatic tumors to the jaw bones. With this retrospective analysis, we intend to estimate the incidence of this rare manifestation in the jaw bones in our patients and compare it with the available literature. Materials and Methods: All patients with biopsy proven metastatic disease involving jaw bones having complete clinical data were included. Results: Nineteen out of 10,411 oral cancer patients who reported between the years 2000 and 2005 were included. Breast and thyroid malignancies (5/19 each were commonest in the females to metastasize to the mandible, whereas in the males, there was no predominant site that resulted in jaw bone metastasis, although mandible was commonly affected. Neuroblastoma of adrenal gland metastasized to maxilla in the age group ranging from 4 months to 16 years. Maxilla was the commonest jaw bone affected in this age group. In five cases, jaw bone was found to be the first site of metastasis. Conclusions: There is variation in the primary site that causes metastasis to the jaw bones depending on age, sex and geographic distribution. Jaw bone metastases are rare and can be the first site of metastasis. We get approximately four cases in a year with metastatic disease manifesting in the jaw bones. Metastasis to jaw bone is associated with poor prognosis.

  1. X-ray manifestations of tumors of gnathic bones in adults

    International Nuclear Information System (INIS)

    Roentgenologic manifestations of the neoplasms of qnathic bones in adults are considered in details. Odontogenous tumors and neodontogeneous tumors are among the cases under analysis. It is shown that the roentgenologic features of manifestation of every neoplasm are determined by the character of variations in the form of bone affection section and in the architectonics of it's pattern, by the outlines sharphness, by the total delimitation from unaffected bone sections, by the presence of internal inclusions or calcifications, by the cartical plates safety by the presence and character of pathologic osteogenesis and ossification periostitis. Necessity of the histological studies of punctates or bioptates in certain cases is outlined because of the nonabsolutely reliability of radiological data

  2. MR perfusion and diffusion imaging in diagnosing benign and malignant bone tumors

    International Nuclear Information System (INIS)

    Objective: To assess the diagnostic potential of MR- PWI and MR-DWI in differentiating benign from malignant bone tumors. Methods: MR- PWI and MR- DWI were performed on 39 patients by using GE Signa 1.5 T MR imager. The perfusion imaging was started with GRE- EPI sequence, signal intensities were measured on delineated ROI and TIC was gotten using the Functool 2 software system Type of TIC, signal decreasing in first- pass period, maximum slope of TIC and signal difference between two standard states were compared between benign and malignant bone tumors MR-DWI was performed with SE-EPI fast scan sequence with diffusion in three directions ADC values were obtained and compared on delineated ROI using the Functool 2 software system. The resultant data were analyzed with software (SPSS, version 13.0). Subjective overall performance of two techniques was evaluated with Receiver Uperating Characteristic (ROC) analysis. Results: 1.MR-PWI: 1.The patterns of TIC of most benign bone tumors (17/21) were type Ⅰ and Ⅱ, and that of all malignant bone tumors were type Ⅲ and Ⅳ. 2.There were significant differences in signal decreasing in first- pass period [(17.52±.37)% vs. (52.42±5.74)%], maximum slope of TIC [(4.69±2.84)% s-1 vs. (9.63±4.05)%·s-1] and signal difference between two standard states [(6.87±3.34)% vs. (31.75±1.09)%] between benign and malignant groups. And their diagnostic accuracy was 82.1%, 79.5% and 87.2% respectively. 3. 4 highly vascularized benign bone tumors were mistaken in diagnosis as malignant ones according to their perfusion characteristics. 2. MR-DWI: There was significant difference between ADC of benign and malignant groups [(1.86±0.38)×10-3 mm2/s vs. (1.44±0.26))×10-3 mm2/s] when b value was 300 s/mm3. The diagnostic accuracy was 79.5% when ADC value less than 1.63)×10-3 mm2/s was considered as malignant ones. 3 The diagnostic accuracy of MR-PWI and MR-DWI were 89.7% and 79.5% respectively. Conclusion: MR-PWI is the better

  3. CT-MR image data fusion for computer assisted navigated neurosurgery of temporal bone tumors

    International Nuclear Information System (INIS)

    Purpose: To demonstrate the value of multi detector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the preoperative work up of temporal bone tumors and to present, especially, CT and MR image fusion for surgical planning and performance in computer assisted navigated neurosurgery of temporal bone tumors. Materials and methods: Fifteen patients with temporal bone tumors underwent MDCT and MRI. MDCT was performed in high-resolution bone window level setting in axial plane. The reconstructed MDCT slice thickness was 0.8 mm. MRI was performed in axial and coronal plane with T2-weighted fast spin-echo (FSE) sequences, un-enhanced and contrast-enhanced T1-weighted spin-echo (SE) sequences, and coronal T1-weighted SE sequences with fat suppression and with 3D T1-weighted gradient-echo (GE) contrast-enhanced sequences in axial plane. The 3D T1-weighted GE sequence had a slice thickness of 1 mm. Image data sets of CT and 3D T1-weighted GE sequences were merged utilizing a workstation to create CT-MR fusion images. MDCT and MR images were separately used to depict and characterize lesions. The fusion images were utilized for interventional planning and intraoperative image guidance. The intraoperative accuracy of the navigation unit was measured, defined as the deviation between the same landmark in the navigation image and the patient. Results: Tumorous lesions of bone and soft tissue were well delineated and characterized by CT and MR images. The images played a crucial role in the differentiation of benign and malignant pathologies, which consisted of 13 benign and 2 malignant tumors. The CT-MR fusion images supported the surgeon in preoperative planning and improved surgical performance. The mean intraoperative accuracy of the navigation system was 1.25 mm. Conclusion: CT and MRI are essential in the preoperative work up of temporal bone tumors. CT-MR image data fusion presents an accurate tool for planning the correct surgical procedure and is a

  4. CT-MR image data fusion for computer assisted navigated neurosurgery of temporal bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Nemec, Stefan Franz [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)]. E-mail: stefan.nemec@meduniwien.ac.at; Donat, Markus Alexander [Department of Neurosurgery, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Mehrain, Sheida [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Friedrich, Klaus [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Krestan, Christian [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Matula, Christian [Department of Neurosurgery, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Imhof, Herwig [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Czerny, Christian [Department of Radiology/Osteology, Medical University Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)

    2007-05-15

    Purpose: To demonstrate the value of multi detector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the preoperative work up of temporal bone tumors and to present, especially, CT and MR image fusion for surgical planning and performance in computer assisted navigated neurosurgery of temporal bone tumors. Materials and methods: Fifteen patients with temporal bone tumors underwent MDCT and MRI. MDCT was performed in high-resolution bone window level setting in axial plane. The reconstructed MDCT slice thickness was 0.8 mm. MRI was performed in axial and coronal plane with T2-weighted fast spin-echo (FSE) sequences, un-enhanced and contrast-enhanced T1-weighted spin-echo (SE) sequences, and coronal T1-weighted SE sequences with fat suppression and with 3D T1-weighted gradient-echo (GE) contrast-enhanced sequences in axial plane. The 3D T1-weighted GE sequence had a slice thickness of 1 mm. Image data sets of CT and 3D T1-weighted GE sequences were merged utilizing a workstation to create CT-MR fusion images. MDCT and MR images were separately used to depict and characterize lesions. The fusion images were utilized for interventional planning and intraoperative image guidance. The intraoperative accuracy of the navigation unit was measured, defined as the deviation between the same landmark in the navigation image and the patient. Results: Tumorous lesions of bone and soft tissue were well delineated and characterized by CT and MR images. The images played a crucial role in the differentiation of benign and malignant pathologies, which consisted of 13 benign and 2 malignant tumors. The CT-MR fusion images supported the surgeon in preoperative planning and improved surgical performance. The mean intraoperative accuracy of the navigation system was 1.25 mm. Conclusion: CT and MRI are essential in the preoperative work up of temporal bone tumors. CT-MR image data fusion presents an accurate tool for planning the correct surgical procedure and is a

  5. Radiation therapy for glomus tumors of the temporal bone

    International Nuclear Information System (INIS)

    The treatment of glomic tumors has been controversial since its first description. It can be done with surgery, radiotherapy or just expectation. Aim: the objective of this paper was to evaluate the effectiveness and complications of radiotherapy.Study Design: clinical with transversal cohort. Material and method: it was made a retrospective review in the charts of the patients with glomus jugular tumors treated with radiotherapy. Disease control was determined by (1) no progression of symptoms or cranial nerve dysfunction or (2) no progression of the lesion in radiological follow-up. It was also evaluated the follow-up period and the sequelae of the treatment. Results: twelve patients were included, 8 of then women. The follow-up period was from 3 to 35 years, with a media of 11,6 years. The main symptoms were: hearing loss, pulsate tinnitus, dizziness and vertigo. The signs were pulsate retrotympanic mass, facial palsy and cofosis. The tumors were staged using Fischs classification. The radiotherapy was performed with linear accelerator with dose ranging from 4500-5500 in 4-6 weeks. In the follow-up period were possible to identify sequelaes like dermatitis, meatal stenosis, cofosis and facial palsy. Discussion: the signs and symptoms were the same found in the medical literature. The type and dosages of the radiotherapy were also the same of others reports. All patients had improvement of the symptoms and only one was not considered as having disease controlled. Complications were, in general, minor complications, with exception of the cofosis and facial palsy. Conclusion: radiotherapy is a viable alternative to treatment of these tumors because their good response and low level of complications. It should be considered specially in advanced tumors where a surgical procedure could bring a high level of morbidity. (author)

  6. Fluorescence microscopic and microautoradiographic studies on apoptosis of bone tumor cells induced by 153Sm-EDTMP

    International Nuclear Information System (INIS)

    The apoptosis of bone tumor cells treated with internal irradiation by 153Sm-EDTMP was studied. The morphological changes in bone tumor cells were observed by fluorescence microscopic and microautoradiographic observations. It was found that bone tumor cells internally irradiated with 153Sm-EDTMP, displayed significant nuclear fragmentation and marked pyknosis as well as apoptotic bodies formation. The microautoradiographic study showed that 153Sm-EDTMP could permeate through cell membrane and displayed membrane-seeking condensation in tumor cells. Soon afterwards 153Sm-EDTMP could be phagocytized by the tumor cells and distributed in cytoplasm and nucleus in the form of phagosome. With the prolongation of observing time, the membrane-bounded apoptotic bodies was observed. With the lengthening of internal irradiation time by 153Sm-EDTMP, the inhibition rate of proliferation of bone tumor cells increased progressively. (10 refs., 9 figs., 1 tab.)

  7. Change in peripheral blood lymphocyte count in dogs following adoptive immunotherapy using lymphokine-activated T killer cells combined with palliative tumor resection.

    Science.gov (United States)

    Mie, Keiichiro; Shimada, Terumasa; Akiyoshi, Hideo; Hayashi, Akiyoshi; Ohashi, Fumihito

    2016-09-01

    We evaluated changes in peripheral blood lymphocyte (PBL) count in dogs following adoptive immunotherapy using lymphokine-activated T killer cells (T-LAK) in combination with surgery. Fifteen tumor-bearing dogs treated with T-LAK therapy combined with palliative resection of tumors were enrolled in the present study. T-LAK were generated from autologous peripheral blood mononuclear cells (PBMC) by culture with recombinant human interleukin -2 (rhIL-2) and solid phase anti-canine cluster of differentiation (CD)3 antibody. T-LAK were administrated intravenously at 2-4-week intervals. After the first administration of T-LAK, counts of PBL and T lymphocyte subsets (CD3(+), CD4(+) and CD8(+) cells) increased and the CD4/CD8 ratio decreased, with significant increases in CD8(+) cells (P<0.05). In 8 tumor-bearing dogs that were administered sequential T-LAK, available data on changes in PBL and T lymphocyte phenotypes until the fifth administration were also analyzed. In tumor-bearing dogs administered 5 rounds of T-LAK, CD8(+) cell counts were maintained high until the fifth administration of T-LAK. Moreover, the CD4/CD8 ratio remained low until the fifth administration of T-LAK. These results indicate that T-LAK therapy combined with surgery may increase peripheral blood T lymphocytes, particularly CD8(+) cells, in tumor-bearing dogs. PMID:27436446

  8. Giant cell tumor of the patella with a secondary aneurysmal bone cyst: A case report

    Science.gov (United States)

    SONG, MINGZHI; DAI, WEI; SUN, RAN; LIANG, HONGFENG; LIU, BINGWU; WU, YUXUAN; MA, KAI; LU, MING

    2016-01-01

    The substance of the patella is an uncommon location for tumor occurrence and development. The present study reports a case of giant cell tumor (GCT) of the patella, combined with an aneurysmal bone cyst (ABC). To the best of our knowledge, this is the second report of GCT with ABC published in English. GCT is the most common type of benign tumor. Secondary ABC is frequently associated with GCT, but this symbiotic tumor rarely occurs in the patella. A 27-year-old male patient was examined at the outpatient clinic, and clinicopathological characteristics of the tumor were observed. X-ray and computed tomography (CT) scans revealed a lytic lesion located in the center of the right patella. Curettage, followed by autogenic and allograft bone grafting, was performed. Histopathologically, the lesion was diagnosed as a GCT with secondary ABC. No recurrence or metastasis was identified during the 1-year follow-up period. The present study reports a case of GCT with secondary ABC, and discusses the rare location and histopathological type of this tumor, in order to improve diagnosis and treatment of patellar tumors in general. PMID:27313738

  9. [Color Doppler controlled needle biopsy in diagnosis of soft tissue and bone tumors].

    Science.gov (United States)

    Schulte, M; Heymer, B; Sarkar, M R; Negri, G; von Baer, A; Hartwig, E

    1998-10-01

    In a prospective study we investigated 168 patients with musculoskeletal tumors, including 71 sarcomas, by core needle biopsy using the high-speed device Autovac. Monitoring with colour-coded duplex sonography allowed a well-aimed puncture of smaller or deeply localized lesions and also permitted the discrimination of necrotic and viable parts of the tumor. Adequate material for histologic diagnosis including grading and determination of tumor subtype was obtained from soft tissue sarcomas, soft tissue metastases, malignant lymphomas, plasmacytomas, and osteolytic skeletal secondaries. In contrast, in benign soft tissue and bone tumors the diagnosis could be established in only 66% of cases. Although skeletal sarcomas were identified as malignant mesenchymal lesions, a complete histologic classification of tumor subtype frequently was not possible due to an insufficient tissue specimen. With an accuracy of 97% for the diagnosis of malignancy and of 94% for the diagnosis of soft tissue sarcoma the results of core needle biopsies were comparable to those of incisional biopsies, the reference standard in the diagnosis of musculoskeletal tumors. Regarding the known disadvantages and the oncological risks of incisional biopsies, needle biopsy should replace the open procedure as the primary means of diagnosis in soft tissue and osteolytic bone tumors. PMID:9833186

  10. Myelopotentiating effect of curcumin in tumor-bearing host: Role of bone marrow resident macrophages

    Energy Technology Data Exchange (ETDEWEB)

    Vishvakarma, Naveen Kumar; Kumar, Anjani; Kumar, Ajay; Kant, Shiva [School of Biotechnology, Banaras Hindu University, Varanasi-221 005, U.P. (India); Bharti, Alok Chandra [Division of Molecular Oncology, Institute of Cytology and Preventive Oncology, Noida, UP (India); Singh, Sukh Mahendra, E-mail: sukhmahendrasingh@yahoo.com [School of Biotechnology, Banaras Hindu University, Varanasi-221 005, U.P. (India)

    2012-08-15

    The present investigation was undertaken to study if curcumin, which is recognized for its potential as an antineoplastic and immunopotentiating agent, can also influence the process of myelopoiesis in a tumor-bearing host. Administration of curcumin to tumor-bearing host augmented count of bone marrow cell (BMC) accompanied by an up-regulated BMC survival and a declined induction of apoptosis. Curcumin administration modulated expression of cell survival regulatory molecules: Bcl2, p53, caspase-activated DNase (CAD) and p53-upregulated modulator of apoptosis (PUMA) along with enhanced expression of genes of receptors for M-CSF and GM-CSF in BMC. The BMC harvested from curcumin-administered hosts showed an up-regulated colony forming ability with predominant differentiation into bone marrow-derived macrophages (BMDM), responsive for activation to tumoricidal state. The number of F4/80 positive bone marrow resident macrophages (BMM), showing an augmented expression of M-CSF, was also augmented in the bone marrow of curcumin-administered host. In vitro reconstitution experiments indicated that only BMM of curcumin-administered hosts, but not in vitro curcumin-exposed BMM, augmented BMC survival. It suggests that curcumin-dependent modulation of BMM is of indirect nature. Such prosurvival action of curcumin is associated with altered T{sub H1}/T{sub H2} cytokine balance in serum. Augmented level of serum-borne IFN-γ was found to mediate modulation of BMM to produce enhanced amount of monokines (IL-1, IL-6, TNF-α), which are suggested to augment the BMC survival. Taken together the present investigation indicates that curcumin can potentiate myelopoiesis in a tumor-bearing host, which may have implications in its therapeutic utility. Highlights: ► Curcumin augments myelopoiesis in tumor-bearing host. ► Bone marrow resident macrophages mediate curcumin-dependent augmented myelopoiesis. ► Serum borne cytokine are implicated in modulation of bone marrow resident

  11. Myelopotentiating effect of curcumin in tumor-bearing host: Role of bone marrow resident macrophages

    International Nuclear Information System (INIS)

    The present investigation was undertaken to study if curcumin, which is recognized for its potential as an antineoplastic and immunopotentiating agent, can also influence the process of myelopoiesis in a tumor-bearing host. Administration of curcumin to tumor-bearing host augmented count of bone marrow cell (BMC) accompanied by an up-regulated BMC survival and a declined induction of apoptosis. Curcumin administration modulated expression of cell survival regulatory molecules: Bcl2, p53, caspase-activated DNase (CAD) and p53-upregulated modulator of apoptosis (PUMA) along with enhanced expression of genes of receptors for M-CSF and GM-CSF in BMC. The BMC harvested from curcumin-administered hosts showed an up-regulated colony forming ability with predominant differentiation into bone marrow-derived macrophages (BMDM), responsive for activation to tumoricidal state. The number of F4/80 positive bone marrow resident macrophages (BMM), showing an augmented expression of M-CSF, was also augmented in the bone marrow of curcumin-administered host. In vitro reconstitution experiments indicated that only BMM of curcumin-administered hosts, but not in vitro curcumin-exposed BMM, augmented BMC survival. It suggests that curcumin-dependent modulation of BMM is of indirect nature. Such prosurvival action of curcumin is associated with altered TH1/TH2 cytokine balance in serum. Augmented level of serum-borne IFN-γ was found to mediate modulation of BMM to produce enhanced amount of monokines (IL-1, IL-6, TNF-α), which are suggested to augment the BMC survival. Taken together the present investigation indicates that curcumin can potentiate myelopoiesis in a tumor-bearing host, which may have implications in its therapeutic utility. Highlights: ► Curcumin augments myelopoiesis in tumor-bearing host. ► Bone marrow resident macrophages mediate curcumin-dependent augmented myelopoiesis. ► Serum borne cytokine are implicated in modulation of bone marrow resident macrophages.

  12. Vitamin B-6 Supplementation Could Mediate Antioxidant Capacity by Reducing Plasma Homocysteine Concentration in Patients with Hepatocellular Carcinoma after Tumor Resection

    Directory of Open Access Journals (Sweden)

    Shao-Bin Cheng

    2016-01-01

    Full Text Available Vitamin B-6 has a strong antioxidative effect. It would be useful to determine whether vitamin B-6 supplementation had effects on antioxidant capacities in patients with hepatocellular carcinoma (HCC who had recently undergone tumor resection. Thirty-three HCC patients were randomly assigned to either the placebo (n=16 group or the vitamin B-6 50 mg/d (n=17 group for 12 weeks. Plasma pyridoxal 5′-phosphate, homocysteine, indicators of oxidative stress, and antioxidant capacities were measured. Plasma homocysteine in the vitamin B-6 group was significantly decreased at week 12, while the level of trolox equivalent antioxidant capacity (TEAC was significantly increased at the end of the intervention period. Vitamin B-6 supplementation had a significant reducing effect on the change of plasma homocysteine (β=-2.4, p=0.02 but not on the change of TEAC level after adjusting for potential confounders. The change of plasma homocysteine was significantly associated with the change of TEAC after adjusting for potential confounders (β=-162.0, p=0.03. Vitamin B-6 supplementation seemed to mediate antioxidant capacity via reducing plasma homocysteine rather than having a direct antioxidative effect in HCC patients who had recently undergone tumor resection. The clinical trial number is NCT01964001, ClinicalTrials.gov.

  13. Vitamin B-6 Supplementation Could Mediate Antioxidant Capacity by Reducing Plasma Homocysteine Concentration in Patients with Hepatocellular Carcinoma after Tumor Resection

    Science.gov (United States)

    Cheng, Shao-Bin; Lin, Ping-Ting; Liu, Hsiao-Tien; Peng, Yi-Shan; Huang, Shih-Chien

    2016-01-01

    Vitamin B-6 has a strong antioxidative effect. It would be useful to determine whether vitamin B-6 supplementation had effects on antioxidant capacities in patients with hepatocellular carcinoma (HCC) who had recently undergone tumor resection. Thirty-three HCC patients were randomly assigned to either the placebo (n = 16) group or the vitamin B-6 50 mg/d (n = 17) group for 12 weeks. Plasma pyridoxal 5′-phosphate, homocysteine, indicators of oxidative stress, and antioxidant capacities were measured. Plasma homocysteine in the vitamin B-6 group was significantly decreased at week 12, while the level of trolox equivalent antioxidant capacity (TEAC) was significantly increased at the end of the intervention period. Vitamin B-6 supplementation had a significant reducing effect on the change of plasma homocysteine (β = −2.4, p = 0.02) but not on the change of TEAC level after adjusting for potential confounders. The change of plasma homocysteine was significantly associated with the change of TEAC after adjusting for potential confounders (β = −162.0, p = 0.03). Vitamin B-6 supplementation seemed to mediate antioxidant capacity via reducing plasma homocysteine rather than having a direct antioxidative effect in HCC patients who had recently undergone tumor resection. The clinical trial number is NCT01964001, ClinicalTrials.gov. PMID:27051670

  14. Tumor-targeting Salmonella typhimurium A1-R prevents experimental human breast cancer bone metastasis in nude mice

    OpenAIRE

    Miwa, Shinji; Yano, Shuya; Zhang, Yong; Matsumoto, Yasunori; Uehara, Fuminari; Yamamoto, Mako; Hiroshima, Yukihiko; Kimura, Hiroaki; Hayashi, Katsuhiro; Yamamoto, Norio; Bouvet, Michael; Tsuchiya, Hiroyuki; Hoffman, Robert M.; Ming ZHAO

    2014-01-01

    Bone metastasis is a lethal and morbid late stage of breast cancer that is currently treatment resistant. More effective mouse models and treatment are necessary. High bone-metastatic variants of human breast cancer cells were selected in nude mice by cardiac injection. After cardiac injection of a high bone-metastatic variant of breast cancer, all untreated mice had bone metastases compared to only 20% with parental cells. Treatment with tumor-targeting Salmonella typhimurium A1-R completely...

  15. Study of human bone tumor slice by SRXRF microprobe

    International Nuclear Information System (INIS)

    The SRXRF microprobe at the BSRF is described. The minimum detection limits (MDLs) of trace elements were measured to determine the capability for biological sample analysis. The changes of the trace elements and their ratios in the normal and tumor parts of a human osteosarcoma tissue were investigated. It was found that our results were in agreement with those of other analytical methods, such as spectrophotometric analysis, NAA and PIXE as well as an early clinic study of serum

  16. A novel 3-D mineralized tumor model to study breast cancer bone metastasis.

    Directory of Open Access Journals (Sweden)

    Siddharth P Pathi

    Full Text Available BACKGROUND: Metastatic bone disease is a frequent cause of morbidity in patients with advanced breast cancer, but the role of the bone mineral hydroxyapatite (HA in this process remains unclear. We have developed a novel mineralized 3-D tumor model and have employed this culture system to systematically investigate the pro-metastatic role of HA under physiologically relevant conditions in vitro. METHODOLOGY/PRINCIPAL FINDINGS: MDA-MB231 breast cancer cells were cultured within non-mineralized or mineralized polymeric scaffolds fabricated by a gas foaming-particulate leaching technique. Tumor cell adhesion, proliferation, and secretion of pro-osteoclastic interleukin-8 (IL-8 was increased in mineralized tumor models as compared to non-mineralized tumor models, and IL-8 secretion was more pronounced for bone-specific MDA-MB231 subpopulations relative to lung-specific breast cancer cells. These differences were pathologically significant as conditioned media collected from mineralized tumor models promoted osteoclastogenesis in an IL-8 dependent manner. Finally, drug testing and signaling studies with transforming growth factor beta (TGFbeta confirmed the clinical relevance of our culture system and revealed that breast cancer cell behavior is broadly affected by HA. CONCLUSIONS/SIGNIFICANCE: Our results indicate that HA promotes features associated with the neoplastic and metastatic growth of breast carcinoma cells in bone and that IL-8 may play an important role in this process. The developed mineralized tumor models may help to reveal the underlying cellular and molecular mechanisms that may ultimately enable more efficacious therapy of patients with advanced breast cancer.

  17. Impact of medical academic genealogy on publication patterns: An analysis of the literature for surgical resection in brain tumor patients.

    Science.gov (United States)

    Hirshman, Brian R; Tang, Jessica A; Jones, Laurie A; Proudfoot, James A; Carley, Kathleen M; Marshall, Lawrence; Carter, Bob S; Chen, Clark C

    2016-02-01

    "Academic genealogy" refers to the linking of scientists and scholars based on their dissertation supervisors. We propose that this concept can be applied to medical training and that this "medical academic genealogy" may influence the landscape of the peer-reviewed literature. We performed a comprehensive PubMed search to identify US authors who have contributed peer-reviewed articles on a neurosurgery topic that remains controversial: the value of maximal resection for high-grade gliomas (HGGs). Training information for each key author (defined as the first or last author of an article) was collected (eg, author's medical school, residency, and fellowship training). Authors were recursively linked to faculty mentors to form genealogies. Correlations between genealogy and publication result were examined. Our search identified 108 articles with 160 unique key authors. Authors who were members of 2 genealogies (14% of key authors) contributed to 38% of all articles. If an article contained an authorship contribution from the first genealogy, its results were more likely to support maximal resection (log odds ratio = 2.74, p < 0.028) relative to articles without such contribution. In contrast, if an article contained an authorship contribution from the second genealogy, it was less likely to support maximal resection (log odds ratio = -1.74, p < 0.026). We conclude that the literature on surgical resection for HGGs is influenced by medical academic genealogies, and that articles contributed by authors of select genealogies share common results. These findings have important implications for the interpretation of scientific literature, design of medical training, and health care policy. PMID:26727354

  18. Reconstruction of the Midfoot Using a Free Vascularized Fibular Graft After En Bloc Excision for Giant Cell Tumor of the Tarsal Bones: A Case Report.

    Science.gov (United States)

    Hara, Hitomi; Kawamoto, Teruya; Onishi, Yasuo; Fujioka, Hiroyuki; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro; Akisue, Toshihiro

    2016-01-01

    We report the case of a 32-year-old Japanese female with a giant cell tumor of bone involving multiple midfoot bones. Giant cell tumors of bone account for approximately 5% of all primary bone tumors and most often arise at the ends of long bones. The small bones, such as those of the hands and feet, are rare sites for giant cell tumors. Giant cell tumors of the small bones tend to exhibit more aggressive clinical behavior than those of the long bones. The present patient underwent en bloc tumor excision involving multiple tarsals and metatarsals. We reconstructed the longitudinal arch of the foot with a free vascularized fibular graft. At the 2-year follow-up visit, bony union had been achieved, with no tumor recurrence. PMID:26213165

  19. An osteoblast-derived proteinase controls tumor cell survival via TGF-beta activation in the bone microenvironment.

    Directory of Open Access Journals (Sweden)

    Sophie Thiolloy

    Full Text Available Breast to bone metastases frequently induce a "vicious cycle" in which osteoclast mediated bone resorption and proteolysis results in the release of bone matrix sequestered factors that drive tumor growth. While osteoclasts express numerous proteinases, analysis of human breast to bone metastases unexpectedly revealed that bone forming osteoblasts were consistently positive for the proteinase, MMP-2. Given the role of MMP-2 in extracellular matrix degradation and growth factor/cytokine processing, we tested whether osteoblast derived MMP-2 contributed to the vicious cycle of tumor progression in the bone microenvironment.To test our hypothesis, we utilized murine models of the osteolytic tumor-bone microenvironment in immunocompetent wild type and MMP-2 null mice. In longitudinal studies, we found that host MMP-2 significantly contributed to tumor progression in bone by protecting against apoptosis and promoting cancer cell survival (caspase-3; immunohistochemistry. Our data also indicate that host MMP-2 contributes to tumor induced osteolysis (μCT, histomorphometry. Further ex vivo/in vitro experiments with wild type and MMP-2 null osteoclast and osteoblast cultures identified that 1 the absence of MMP-2 did not have a deleterious effect on osteoclast function (cd11B isolation, osteoclast differentiation, transwell migration and dentin resorption assay; and 2 that osteoblast derived MMP-2 promoted tumor survival by regulating the bioavailability of TGFβ, a factor critical for cell-cell communication in the bone (ELISA, immunoblot assay, clonal and soft agar assays.Collectively, these studies identify a novel "mini-vicious cycle" between the osteoblast and metastatic cancer cells that is key for initial tumor survival in the bone microenvironment. In conclusion, the findings of our study suggest that the targeted inhibition of MMP-2 and/or TGFβ would be beneficial for the treatment of bone metastases.

  20. Valuation of autologeous bone marrow transplantation in radio- and chemotherapy of malignant tumors

    International Nuclear Information System (INIS)

    The prerequisites of bone marrow autotransplantation performed as part of cancer therapy, the emphasis being on the condition of the patient, the facilities available to the institution for the treatment of cancer patients, the biology of the tumor, and the present possibilities of carrying out what is called superdose cancer therapy are discussed. The practical performance of a bone marrow autograft is based upon the withdrawal of bone marrow with indefinite vital stem cell preservation by deep cooling at a time when the tumor has not yet led to bone marrow metastasizing. The conserved bone marrow is used, in subsequent radiological and/or cytostatic superdose therapy, as a reserve in the case of extreme damage to hematopoiesis. The discussion of the current status of this method and the prospects for its general use reflects the whole spectrum of the problems associated with the most favorable procedure to be used, the type of superdose therapy to be employed, the time of regrafting, and the accurate assessment of the results obtained. (author)

  1. DNA gel electrophoretic and microaut oradiographic studies on apoptosisin bone tumor cells after exposure with 153Sm-EDTMP

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    The apoptosis in bone tumor cells is studied after 153Sm-EDTMP irradiation.Fragmented DNA is analyzed by agarose gel electrophoresis.Experimental observations show that 153Sm-EDTMP exposureinduces the internucleosomal DNA damage in bone tumor cells the DNAladder pattern formation in bone tumor cells is shown.At the same time,the microautoradiographic study indicates that 153153Sm-EDTMP could permeate through cell membrane and displays membrane-seeking condensation in bone tumor cells.Soon afterwards 153Sm-EDTMP could be phagocytized by the tumor cells and distributed in cytoplasm as well as nucleus in the form of phagosome.With the prolongation of observing time, the membrane-bounded apoptotic bodies are observed.

  2. Objective assessment of utility of intraoperative ultrasound in resection of central nervous system tumors: A cost-effective tool for intraoperative navigation in neurosurgery

    Directory of Open Access Journals (Sweden)

    Aliasgar Moiyadi

    2011-01-01

    Full Text Available Background: Localization and delineation of extent of lesions is critical for safe maximal resection of brain and spinal cord tumors. Frame-based and frameless stereotaxy and intraoperative MRI are costly and not freely available especially in economically constrained nations. Intraoperative ultrasound has been around for a while but has been relegated to the background. Lack of objective evidence for its usefulness and the perceived "user unfriendliness" of US are probably responsible for this. We recount our experience with this "forgotten" tool and propose an objective assessment score of its utility in an attempt to revive this practice. Materials and Methods: Seventy seven intraoperative ultrasound (IOUS studies were carried out in patients with brain and spinal cord tumors. Seven parameters were identified to measure the "utility" of the IOUS and a "utility score" was devised (minimum 0 and maximum 7. Individual parameter and overall scores were calculated for each case. Results: IOUS was found to be useful in many ways. The median overall score was 6 (mean score 5.65. There were no scores less than 4 with the majority demonstrating usefulness in 5 or more parameters (91%. The use of the IOUS significantly influenced the performance of the surgery in these cases without significantly prolonging surgery. Conclusions: The IOUS is a very useful tool in intraoperative localization and delineation of lesions and planning various stages of tumor resection. It is easy, convenient, reliable, widely available, and above all a cost-effective tool. It should be increasingly used by neurosurgeons in the developing world where costlier intraoperative localization and imaging is not available freely.

  3. The role of MRS in the differentiation of benign and malignant soft tissue and bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Doganay, Selim, E-mail: selimdoganay@gmail.com [Erciyes University, Faculty of Medicine, Department of Radiology, Kayseri (Turkey); Altinok, Tayfun; Alkan, Alpay; Kahraman, Bayram; Karakas, Hakki Muammer [Inonu University, Faculty of Medicine, Department of Radiology, Malatya (Turkey)

    2011-08-15

    Objective: The aim of our study was to investigate the value of choline in the discrimination of benign and malignant soft tissue and bone tumors. Materials and methods: The study group consisted of thirty subjects with bone or soft tissue tumors larger than 1.5 cm in diameter. The experiments were performed in a 1.5 T MR scanner. Coils were selected according to specific locations. A single-voxel MRS was performed for three different TE (time to echo) (31, 136, 272 ms). The volume of interest was positioned on the brightest enhancement. The presence of a cholin peak on at least 2 of these spectrums was considered as the marker of malignancy. The sensitivity, specificity and accuracy of the MRS in the detection and diagnosis of malignant lesions were calculated. The reproducibility of MRS and histopathological results were tested with kappa statistics. Results: Histopathologically, 18 (60%) of the lesions were classed as malignant whereas 12 (40%) were classed as benign. With MRS, 15 (50%) of these lesions were classed as malignant and 15 (50%) as benign. Two patients who were found spectroscopically to have malignant tumors were shown histopathologically to have benign types. Five patients with an MRS showing a benign type were classed with malignant types in histopathological examinations. MRS had a sensitivity rate of 72.2%, specificity of 83.3%, and an accuracy rate of 76.6% in detecting malignant bone and soft tissue tumors. The interrater reliability of both techniques had a kappa value of 0.533. Conclusions: MRS may help in the differentiation of benign and malignant soft tissue and bone tumors.

  4. Electron microscopic observations and DNA chain fragmentation studies on apoptosis in bone tumor cells induced by 153Sm—EDTMP

    Institute of Scientific and Technical Information of China (English)

    ZhuShou-Peng; XiaoDong; 等

    1997-01-01

    The morphological changes observed by electron microscopy indicate that after internal irradiation with 153Sm-ESTMP bone tumor cells displayed feature of apoptosis,such as margination of condensed chromatin,chromatin fragmentation.as well as the membranebouded apoptotic bodies formation.THe quantification analysis of fragmentation DNA for bone tumor cells induced by 153Sm-EDTMP shows that the DNA fragmentation is enhanced with the prolongation of internally irradiated time.These characteristics suggest that 153Sm-EDTMP internal irradiation could induce bone tumor cells to go9 to apoptosis.

  5. Electron microscopic observations and DNA chain fragmentation studies on apoptosis in bone tumor cells induced by 153Sm-EDTMP

    International Nuclear Information System (INIS)

    The morphological changes observed by electron microscopy indicate that after internal irradiation with 153Sm-EDTMP bone tumor cells displayed feature of apoptosis, such as margination of condensed chromatin, chromatin fragmentation, as well as the membrane bounded apoptotic bodies formation. The quantification analysis of fragmentation DNA for bone tumor cells induced by 153Sm-EDTMP shows that the DNA fragmentation is enhanced with the prolongation of internally irradiated time. These characteristics suggest that 153Sm-EDTMP internal irradiation could induce bone tumor cells to go to apoptosis

  6. Image-guided installation of 3D-printed patient-specific implant and its application in pelvic tumor resection and reconstruction surgery.

    Science.gov (United States)

    Chen, Xiaojun; Xu, Lu; Wang, Yiping; Hao, Yongqiang; Wang, Liao

    2016-03-01

    Nowadays, the diagnosis and treatment of pelvic sarcoma pose a major surgical challenge for reconstruction in orthopedics. With the development of manufacturing technology, the metal 3D-printed customized implants have brought revolution for the limb-salvage resection and reconstruction surgery. However, the tumor resection is not without risk and the precise implant placement is very difficult due to the anatomic intricacies of the pelvis. In this study, a surgical navigation system including the implant calibration algorithm has been developed, so that the surgical instruments and the 3D-printed customized implant can be tracked and rendered on the computer screen in real time, minimizing the risks and improving the precision of the surgery. Both the phantom experiment and the pilot clinical case study presented the feasibility of our computer-aided surgical navigation system. According to the accuracy evaluation experiment, the precision of customized implant installation can be improved three to five times (TRE: 0.75±0.18 mm) compared with the non-navigated implant installation after the guided osteotomy (TRE: 3.13±1.28 mm), which means it is sufficient to meet the clinical requirements of the pelvic reconstruction. However, more clinical trials will be conducted in the future work for the validation of the reliability and efficiency of our navigation system. PMID:26652978

  7. Inhibition of proliferation in bone tumor cells after irradiation by 235U, 147Pm, 153Sm

    International Nuclear Information System (INIS)

    The inhibition of proliferation in bone tumor cells after simple or mixed irradiation by 235U, 147Pm, 153Sm was studied. Experimental results indicated that proliferation of bone tumor cells was significantly inhibited at 12 h∼24 h after a simple irradiation by 235U (128.4 Bq), 147Pm (7.4 x 105 Bq), and 153Sm (7.4 x 105 Bq) as well as mixed irradiation by 235U + 147Pm (64.2 Bq + 3.7 x 105 Bq), 235U + 153Sm (64.2 Bq + 3.7 x 105 Bq), 147Pm + 153Sm (3.7 x 105 Bq + 3.7 x 105 Bq). The findings show that the inhibition rate with mixed irradiation was more than that with simple irradiation

  8. Primary malignant bone tumors: diagnosis, radiological appearance and therapy; Primaer maligne Knochentumoren: Klinik und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Dominkus, M.; Kotz, R. [Universitaetsklinik fuer Orthopaedie, Wien (Austria); Kainberger, F. [Abt. fuer Osteoradiologie, Universitaetsklinik fuer Radiologie, Wien (Austria); Lang, S. [Wien Univ. (Austria). Universitaetsklinik fuer Pathologische Anatomie

    1998-06-01

    Diagnosis, concepts of therapy and prognosis of primary malignant bone tumors require intensive cooperation between orthopedic surgeons, radiologists and pathologists with special knowledge in oncology. The present paper demonstrates relevant topics of diagnosis, radiological appearance and therapy of the osteosarcoma, Ewing`s sarcoma, chondrosarcoma and malignant fibrous histiocytoma based on the material of the Vienna Bone Tumor Registry and more than 35 years of cooperation between the Institute of Pathology and Anatomy and the Department of Orthopedics at the University of Vienna. (orig.) [Deutsch] Fuer die Diagnose, Therapieplanung und Prognosebeurteilung von primaer malignen Knochentumoren ist eine intensive Kooperation von onkologisch speziell ausgebildeten Fachdisziplinen wie Orthopaedie, Radiologie und Pathologie erforderlich. Die vorliegende Arbeit basiert auf dem Material des Wiener Knochengeschwulstregisters und der 35jaehrigen Zusammenarbeit des Pathologisch/Anatomischen Instituts der Universitaet Wien mit der Universitaetsklinik fuer Orthopaedie und beschreibt Diagnose, radiologisches Erscheinungsbild und Therapie der 4 haeufigsten primaer malignen Knochentumoren: Osteosarkom, Ewing`s Sarkom, Chondrosarkom und malignes fibroeses Histiozytom. (orig.)

  9. The clinical application of percutaneous vertebroplasty on bone metastatic tumor

    International Nuclear Information System (INIS)

    Objective: To study the primary volume of hone cement and the method of perfusion and the clinical effect of percutaneous vertebroplasty for hone metastatic tumors. Methods: Percutaneous vertebroplasty was performed in 218 vertebral bodies of total 150 patients, including 92 males and 58 females with age of 26-85, averaging 56.8 y. 218 vertebral bodies included 73 dorsal vertebra and 138 lumber vertebra and 7 sacral vertebra. Operations were taken under the DSA monitoring. The approach route was selected according to the morphology of the vertebrae, damage extent and puncture site. Results: Operation was successful in all 218 vertebrae of total 150 patients with a ratio of 100%. The primary volume of hone cement needed to fill dorsal vertebra was 2-5 ml, average 3.5 ml; that for lumber vertebra was 3-8 ml, average 5.5 ml; and that for sacral vertebra was 4-7, average 5.5 ml. 134 patients showed total pain relief (89.3%); 15 patients had partial remission (10%) and 1 failure (0.7%). The cement extravasated to intervertehral disk in 12 patients, to scleromeninx capsula externa in 10, to para-vertebra plexus venosus in 3 and to paravertebra soft tissue in 4. The incidence of leakage of hone cement was 13.3%, but no complications occurred during and after the operation. Conclusion: Percutaneous vertebroplasty provides obvious pain relief effect for vertebral metastasis, worthy to be recommended widely in clinical application. (authors)

  10. Intraductal Radiofrequency Ablation Followed by Locoregional Tumor Treatments for Treating Occluded Biliary Stents in Non-Resectable Malignant Biliary Obstruction: A Single-Institution Experience.

    Directory of Open Access Journals (Sweden)

    Xu-Hua Duan

    Full Text Available To determine the safety and feasibility of intraductal radiofrequency ablation (RFA followed by locoregional tumor treatments in patients with non-resectable malignant biliary obstruction and stent re-occlusion.Fourteen patients with malignant biliary obstruction and blocked metal stents were studied retrospectively. All had intraductal RFA followed by locoregional tumor treatments and were monitored clinically and radiologically. The practicality, safety, postoperative complications, jaundice remission, stent patency and survival time were analyzed.Combination treatment was successful for all patients. There were no severe complications during RFA or local treatments. All patients had stent patency restored, with a decline in serum bilirubin. Three patients had recurrent jaundice by 195, 237 and 357 days; two patients underwent repeat intraductal RFA; and one required an internal-external biliary drain. The average stent patency time was 234 days (range 187-544 days. With a median follow-up of 384 days (range 187-544 days, six patients were alive, while eight had died. There was no mortality at 30 days. The 3, 6, 12 and 18 month survival rates were 100%, 100%, 64.3% and 42.9%, respectively.Intraductal RFA followed by locoregional tumor treatments for occluded metal stents is safe and practically feasible and potential increase stent patency and survival times.

  11. A lamella nodular periosteal reaction occuring in osteomyelitis: useful finding for differentiation from malignant bone tumor

    International Nuclear Information System (INIS)

    The first role of radiologist concerning with tumors or tumor like lesions of bone is to differentiate natures of their benignancy or malignancy. It is true that there were much of difficulties to distinguish osteomyelitis from malignant lesions radiographically. Although there is no single periosteal reaction that is unique for any disease process, we had confirmed a certain periosteal reaction, that is, a lamellar nodular pattern, might aid to differentiate osteomyelitis from malignant bone tumor. The thirty patients of acute osteomyelitis in whom the follow-up studies were possible, eighteen patients with osteosarcoma and five patients with Ewing's sarcoma were retrospectively evaluated : periosteal reactions in acute osteomyelitis (30 cases) undergo changes in their appearance that can be categorized : thin solid (18 cases), Codman's triangle (2 cases), no periosteal reaction (10 cases) in early phase ; lamellated (7 cases) and lamellar nodular patterns (7 cases) in the course of the disease with pronounced reactive osteoblastic change in the medullary cavity ; in chronic forms (14 cases), cortical thickening (11 cases), cortical thickening with involucrum (2 cases) and cortical thickening with sequestrum (1 case) were noted. In 18 cases of osteosarcoma were included : thin solid (1 case), lamellated (2 cases), sunburst (5 cases), and Codman's triangle (2 cases) ; combined forms (5 cases) i.e., thin solid and lamellated (1 case), lamellated and sunburst (2 cases), sunburst and Codman's triangle (1 case), lamellated, sunburst and Codman's triangle (1 case) ; and no periosteal reaction (3 cases). 5 cases of Ewing's sarcoma showed sunburst (1 case), interrupted periosteal reaction (1 case), and no periosteal reaction (3 cases). It is advised when a lamellar nodular periosteal reaction appeared with reactive osteoblastic reaction in the host bone, even though their looking might be suggested to aggressiveness of the lesion, it should be considered osteomyelitis

  12. MicroRNA function and dysregulation in bone tumors: the evidence to date

    International Nuclear Information System (INIS)

    Micro ribonucleic acids (miRNAs) are small non-coding RNA segments that have a role in the regulation of normal cellular development and proliferation including normal osteogenesis. They exert their effects through inhibition of specific target genes at the post-transcriptional level. Many miRNAs have altered expression levels in cancer (either increased or decreased depending on the specific miRNA). Altered miRNA expression profiles have been identified in several malignancies including primary bone tumors such as osteosarcoma and Ewing’s sarcoma. It is thought that they may function as tumor suppressor genes or oncogenes and hence when dysregulated contribute to the initiation and progression of malignancy. miRNAs are also thought to have a role in the development of bone metastases in other malignancies. In addition, evidence increasingly suggests that miRNAs may play a part in determining the response to chemotherapy in the treatment of osteosarcoma. These molecules are readily detectable in tissues, both fresh and formalin fixed paraffin embedded and, more recently, in blood. Although there are fewer published studies regarding circulating miRNA profiles, they appear to reflect changes in tissue expression. Thus miRNAs may serve as potential indicators of disease presence but more importantly, may have a role in disease characterization or as potential therapeutic targets. This review gives a brief overview of miRNA biochemistry and explores the evidence to date implicating these small molecules in the pathogenesis of bone tumors

  13. Value of the region of interest technique in the scintigraphic diagnosis of primary bone tumors

    International Nuclear Information System (INIS)

    Employing ROI-technique, a ratio Q was obtained from relating accumulation of 99sup(m)Tc-MDP at the site of the bone lesion (n = 150) with that of contralateral non-involved osseous areas. Values of Q were correlated with histologic tumor diagnosis, its dignity and frequency. Values of Q of greater than 3.0 were found in 95% of all sarcomas, in 100% of the osteosarcomas but in only 3.8% of all benign bone tumors. Values ranging from 1.0 to 1.2 were exclusively measured in benign tumors (e.g., in 52% of juvenile bone cysts and in 67% of non-ossifing fibromas). Since the threshold - separating benign from malignant lesions - at Q = 3.0 was blurred by tumorlike lesions, metastases and especially by Paget's disease, this method does not precisely predict dignity. However, this method may complement radiographic evaluation with low values supporting the diagnosis of a benign lesion. The combined findings of radiography and these rations gained by nuclear imaging may help determine the pathway of a patient through further diagnosis and treatment. (orig.)

  14. MicroRNA function and dysregulation in bone tumors: the evidence to date.

    LENUS (Irish Health Repository)

    Nugent, Mary

    2014-01-01

    Micro ribonucleic acids (miRNAs) are small non-coding RNA segments that have a role in the regulation of normal cellular development and proliferation including normal osteogenesis. They exert their effects through inhibition of specific target genes at the post-transcriptional level. Many miRNAs have altered expression levels in cancer (either increased or decreased depending on the specific miRNA). Altered miRNA expression profiles have been identified in several malignancies including primary bone tumors such as osteosarcoma and Ewing\\'s sarcoma. It is thought that they may function as tumor suppressor genes or oncogenes and hence when dysregulated contribute to the initiation and progression of malignancy. miRNAs are also thought to have a role in the development of bone metastases in other malignancies. In addition, evidence increasingly suggests that miRNAs may play a part in determining the response to chemotherapy in the treatment of osteosarcoma. These molecules are readily detectable in tissues, both fresh and formalin fixed paraffin embedded and, more recently, in blood. Although there are fewer published studies regarding circulating miRNA profiles, they appear to reflect changes in tissue expression. Thus miRNAs may serve as potential indicators of disease presence but more importantly, may have a role in disease characterization or as potential therapeutic targets. This review gives a brief overview of miRNA biochemistry and explores the evidence to date implicating these small molecules in the pathogenesis of bone tumors.

  15. Electron microscopic morphology and DNA chain fragmentation studies on apoptosis in bone tumor cells induced by 153Sm

    International Nuclear Information System (INIS)

    Objective: To study the apoptosis and fraction of DNA chain fragmentation in bone tumor cells induced by 153Sm-EDTMP. Methods: Apoptosis in bone tumor cells exposed to different time periods of 153Sm-EDTMP internal irradiation was observed by electron microscopic morphology and DNA chain fragmentation studies. Results: It was demonstrated that the bone tumor cells internally exposed to 153Sm-EDTMP displayed nuclear fragmentation, margination of condensed chromatin, and formation of membrane bounded apoptotic bodies. The study showed that the percentage of DNA chain fragmentation increases in direct proportion to the duration of internal exposure to 153Sm-EDTMP. Conclusion: Apoptosis induced by 153Sm-EDTMP in bone tumor cells was dependent on the time of 153Sm-EDTMP exposure

  16. Bone cement enhanced pedicle screw fixation combined with vertebroplasty for elderly patients with malignant spinal tumors

    Institute of Scientific and Technical Information of China (English)

    TAN Jiang-wei; SHEN Bing-hua; DU Wei; LIU Jiang-qing; LU Shi-qiao

    2013-01-01

    Background Older patients with malignant spinal tumors are difficult to treat because they have many co-morbidities including osteoporosis.The purpose of this research is to discuss the technique and clinical outcome of bone cement enhanced pedicle screw fixation combined with vertebroplasty (the Sandwich Procedure) for elderly patients with severe osteoporosis and malignant spinal tumors.Methods This study includes 28 consecutive elderly patients with malignant thoracic or lumbar spinal tumors.There were nine patients with myelomas,and 19 patients with metastatic bone tumors.The Sandwich Procedure began with curettage of the tumor and a vertebroplasty with bone cement (polymethyl methacrylate,PMMA),followed by PMMA enhanced pedicle screw fixation.Patients were evaluated with the visual analogue scale (VAS),oswestry disability index (ODI),American Spinal Cord Injury Association (ASIA) neurological function classification,and the radiographic degree of kyphosis (Cobb angle).Data were analyzed using paired t-test to compare the pre-and post-operative values.The complications,local recurrences,and the survival status were also recorded.Results There was no operative mortality,and the mean operative time was 210 minutes (range 150-250 minutes).The average blood loss was 1550 ml (range 650-3300 ml).The average amount of cement for vertebroplasty was 3.6 ml (range 3-5 ml).The VAS,ODI,and ASIA scores were significantly improved after surgery (P <0.05).However,we found no differences between the pre and post-operative Cobb angles.The shortest survival time was 3 months,and we found no evidence of local recurrence in this group of patients.Conclusion The Sandwich Procedure is a safe operation and provides symptomatic relief in these difficult patients,permitting further treatment with chemotherapy or radiotherapy.

  17. Massive chest wall resection and reconstruction for malignant disease

    Directory of Open Access Journals (Sweden)

    Foroulis CN

    2016-04-01

    Full Text Available Christophoros N Foroulis,1 Athanassios D Kleontas,1 George Tagarakis,1 Chryssoula Nana,1 Ioannis Alexiou,1 Vasilis Grosomanidis,1 Paschalis Tossios,1 Elena Papadaki,2 Ioannis Kioumis,2 Sofia Baka,3 Paul Zarogoulidis,2 Kyriakos Anastasiadis11Department of Cardiothoracic Surgery, Aristotle University School of Medicine, AHEPA University Hospital, 2Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 3Oncology Department, European Interbalkan Medical Center, Thessaloniki, GreeceObjective: Malignant chest wall tumors are rare neoplasms. Resection with wide-free margins is an important prognostic factor, and massive chest wall resection and reconstruction are often necessary. A recent case series of 20 consecutive patients is reported in order to find any possible correlation between tumor histology, extent of resection, type of reconstruction, and adjuvant treatment with short- and long-term outcomes.Methods: Twenty patients were submitted to chest wall resection and reconstruction for malignant chest wall neoplasms between 2006 and 2014. The mean age (ten males was 59±4 years. The size and histology of the tumor, the technique of reconstruction, and the short- and long-term follow-up records were noted.Results: The median maximum diameter of tumors was 10 cm (5.4–32 cm. Subtotal sternal resection was performed in nine cases, and the resection of multiple ribs was performed in eleven cases. The median area of chest wall defect was 108 cm2 (60–340 cm2. Histology revealed soft tissue, bone, and cartilage sarcomas in 16 cases (80%, most of them chondrosarcomas. The rest of the tumors was metastatic tumors in two cases and localized malignant pleural mesothelioma and non-Hodgkin lymphoma in one case. The chest wall defect was reconstructed by using the “sandwich technique” (propylene mesh/methyl methacrylate/propylene mesh in nine cases of large anterior defects or by using a 2

  18. [Liver trasplantation for the treatment of non-resectable metastases of neuroendocrine tumors: first report in Argentina].

    Science.gov (United States)

    Quiñonez, Emilio; Capitanich, Pablo; Anders, Margarita; Fernández, José Luis; Serafini, Víctor; Viola, Luis; Mastai, Ricardo; McCormack, Lucas

    2011-09-01

    Neuroendocrine tumors are uncommon cancers characterized by a slow grow rate. Unresectable liver metastases are the main cause of death in patients with these tumors. This is the first Argentine report of a liver transplantation as an indication for the treatment of unresectable liver metastases from a pancreatic neuroendocrine tumor. We present a 48-year-old woman with diagnosis of a pancreatic neuroendocrine tumor with multiple bilobar unresectable liver metastases. A splenopancreatectomy was performed after a complete staging revealed absence of extrahepatic disease. Six months later, a follow-up performed with thoracoabdominal CT scan and octreo-scan was consistent with no tumor recurrence or extrahepatic disease. As the huge hepatomegaly caused a notorius deterioration in the patient's quality of life, we decided to include her in the waiting list for liver transplantation. Priority points were requested to the MELD (model for end stage liver disease) Exceptions Experts Committee with a positive response. Twelve months after the primary surgery, with a MELD score of 23 points, a deceased donor liver transplantation was performed without evidence at that moment of residual disease. Eighteen months after liver transplantation, the patient required the surgical repair of a stenosis in the biliary anastomosis. At the surgery peritoneal tumor recurrence was diagnosed. Now, 24 months after liver transplantation the patient has an excellent quality of life and a well functioning graft. We report this case of a liver transplantation as an indication for the treatment of liver metastases from a neuroendocrine tumor and we review the literature on this controversial issue. PMID:22233004

  19. Giant Cell Tumor of Bone With Pseudosarcomatous Changes Leading to Premature Denosumab Therapy Interruption: A Case Report With Review of the Literature.

    Science.gov (United States)

    Sanchez-Pareja, Andrea; Larousserie, Frédérique; Boudabbous, Sana; Beaulieu, Jean-Yves; Mach, Nicolas; Saiji, Essia; Rougemont, Anne-Laure

    2016-06-01

    Denosumab has shown promising results in the management of giant cell tumor of bone, a primary bone tumor with locally aggressive behaviour. We report a case of premature denosumab interruption due to radiological and clinical tumor expansion of a giant cell tumor of the distal ulna. Although denosumab is known to induce tumor regression, with progressive ossification and loss of the characteristic morphology of giant cell tumor of bone, the ulnar tumor specimen showed a moderately to highly cellular proliferation of short spindle-shaped cells, and no osteoclast-like giant cells. There were no abnormal mitotic figures. We considered the surgical specimen as a giant cell tumor of bone with partial regression after prematurely interrupted denosumab treatment. This case illustrates the diagnostic issues of an initially unfavourable evolution raising concern for malignancy, and the difficulties in histological assessment of a partially treated giant cell tumor of bone, that may mimic osteosarcoma. PMID:26842345

  20. Decreased Autocrine EGFR Signaling in Metastatic Breast Cancer Cells Inhibits Tumor Growth in Bone and Mammary Fat Pad

    OpenAIRE

    Nickerson, Nicole K.; Mohammad, Khalid S.; Gilmore, Jennifer L.; Crismore, Erin; Bruzzaniti, Angela; Guise, Theresa A.; Foley, John

    2012-01-01

    Breast cancer metastasis to bone triggers a vicious cycle of tumor growth linked to osteolysis. Breast cancer cells and osteoblasts express the epidermal growth factor receptor (EGFR) and produce ErbB family ligands, suggesting participation of these growth factors in autocrine and paracrine signaling within the bone microenvironment. EGFR ligand expression was profiled in the bone metastatic MDA-MB-231 cells (MDA-231), and agonist-induced signaling was examined in both breast cancer and oste...

  1. Soluble Neural-cadherin as a novel biomarker for malignant bone and soft tissue tumors

    International Nuclear Information System (INIS)

    Neural-cadherin (N-cadherin) is one of the most important molecules involved in tissue morphogenesis, wound healing, and the maintenance of tissue integrity. Recently, the cleavage of N-cadherin has become a focus of attention in the field of cancer biology. Cadherin and their ectodomain proteolytic shedding play important roles during cancer progression. The aims of this study are to investigate the serum soluble N-cadherin (sN-CAD) levels in patients with malignant bone and soft tissue tumors, and to evaluate the prognostic significance of the sN-CAD levels. We examined the level of serum sN-CAD using an ELISA in 80 malignant bone and soft tissue tumors (bone sarcoma, n = 23; soft tissue sarcoma, n = 50; metastatic cancer, n = 7) and 87 normal controls. The mean age of the patients was 51 years (range, 10–85 years) and the mean follow-up period was 43 months (range, 1–115 months). The median serum sN-CAD level was 1,267 ng/ml (range, 135–2,860 ng/ml) in all patients. The mean serum sN-CAD level was 1,269 ng/ml (range, 360–2,860 ng/ml) in sarcoma patients, otherwise 1,246 ng/ml (range, 135–2,140 ng/ml) in cancer patients. The sN-CAD levels in patient were higher than those found in the controls, who had a median serum level of 108 ng/ml (range, 0–540 ng/ml). The patients with tumors larger than 5 cm had higher serum sN-CAD levels than the patients with tumors smaller than 5 cm. The histological grade in the patients with higher serum sN-CAD levels was higher than that in the patients with lower serum sN-CAD levels. A univariate analysis demonstrated that the patients with higher serum sN-CAD levels showed a worse disease-free survival rate, local recurrence-free survival rate, metastasis-free survival rate, and overall survival rate compared to those with lower serum sN-CAD levels. In the multivariate analysis, sN-CAD was an independent factor predicting disease-free survival. sN-CAD is a biomarker for malignant bone and soft tissue tumors, and a

  2. Combined SPECT/CT improves detection of initial bone invasion and determination of resection margins in squamous cell carcinoma of the head and neck compared to conventional imaging modalities

    Energy Technology Data Exchange (ETDEWEB)

    Kolk, A. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Oral and Maxillofacial Surgery, Munich (Germany); Klinikum rechts der Isar, Technische Universitaet Muenchen, Klinik und Poliklinik fuer Mund-Kiefer und Gesichtschirurgie, Muenchen (Germany); Schuster, T. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Institute of Medical Statistics and Epidemiology, Munich (Germany); Chlebowski, A.; Kesting, M.; Bissinger, O.; Weitz, J. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Oral and Maxillofacial Surgery, Munich (Germany); Lange, P. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Diagnostic Radiology, Munich (Germany); Scheidhauer, K.; Schwaiger, M.; Dinges, J. [Technische Universitaet Muenchen, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich (Germany)

    2014-07-15

    Knowledge of the presence and extent of bone infiltration is crucial for planning the resection of potential bone-infiltrating squamous cell carcinomas of the head and neck (HNSCC). Routinely, plain-film radiography, multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) are used for preoperative staging, but they show relatively high rates of false-positive and false-negative findings. Scintigraphy with {sup 99m}Tc-bisphosphonate has the ability to show increased metabolic bone activity. If combined with anatomical imaging (e.g. (SPECT)/CT), it facilitates the precise localization of malignant bone lesions. The aim of this study was to analyse the indications and advantages of SPECT/CT compared with standard imaging modalities and histology with regard to specificity and sensitivity A longitudinally evaluated group of 30 patients with biopsy-proven HNSCC adjacent to the mandible underwent {sup 99m}Tc-bisphosphonate SPECT/CT, MRI, MSCT and conventional radiography before partial or rim resection of the mandible was performed. Bone infiltration was first evaluated with plain films, MSCT and MRI. In a second reading, SPECT/CT data were taken into account. The results (region and certainty of bone invasion) were evaluated among the different imaging modalities and finally compared with histological specimens from surgical resection as the standard of reference. For a better evaluation of the hybrid property of SPECT/CT, a retrospectively evaluated group of 20 additional patients with tumour locations similar to those of the longitudinally examined SPECT/CT group underwent SPECT, MSCT and MRI. To assess the influence of dental foci on the specificity of the imaging modalities, all patients were separated into two subgroups depending on the presence or absence of teeth in the area of potential tumour-bone contact. Histologically proven bone infiltration was found in 17 patients (57 %) when analysed by conventional imaging modalities. SPECT/CT data

  3. Osteogenic Matrix Cell Sheets Facilitate Osteogenesis in Irradiated Rat Bone

    Directory of Open Access Journals (Sweden)

    Yoshinobu Uchihara

    2015-01-01

    Full Text Available Reconstruction of large bone defects after resection of malignant musculoskeletal tumors is a significant challenge in orthopedic surgery. Extracorporeal autogenous irradiated bone grafting is a treatment option for bone reconstruction. However, nonunion often occurs because the osteogenic capacity is lost by irradiation. In the present study, we established an autogenous irradiated bone graft model in the rat femur to assess whether osteogenic matrix cell sheets improve osteogenesis of the irradiated bone. Osteogenic matrix cell sheets were prepared from bone marrow-derived stromal cells and co-transplanted with irradiated bone. X-ray images at 4 weeks after transplantation showed bridging callus formation around the irradiated bone. Micro-computed tomography images at 12 weeks postoperatively showed abundant callus formation in the whole circumference of the irradiated bone. Histology showed bone union between the irradiated bone and host femur. Mechanical testing showed that the failure force at the irradiated bone site was significantly higher than in the control group. Our study indicates that osteogenic matrix cell sheet transplantation might be a powerful method to facilitate osteogenesis in irradiated bones, which may become a treatment option for reconstruction of bone defects after resection of malignant musculoskeletal tumors.

  4. Effect of the pringle maneuver on tumor recurrence of hepatocellular carcinoma after curative resection (EPTRH): a randomized, prospective, controlled multicenter trial

    International Nuclear Information System (INIS)

    Hepatic resection is currently still the best choice of therapeutic strategies for liver cancer, but the long-term survival rate after surgery is unsatisfactory. Most patients develop intra- and/or extrahepatic recurrence. The reasons for this high recurrence rate are not entirely clear. Recent studies have indicated that ischemia-reperfusion injury to the liver may be a significant factor promoting tumor recurrence and metastasis in animal models. If this is also true in humans, the effects of the Pringle maneuver, which has been widely used in hepatectomy for the past century, should be examined. To date, there are no reported data or randomized controlled studies examining the relationship between use of the Pringle maneuver and local tumor recurrence. We hypothesize that the long-term prognosis of patients with liver cancer could be worsened by use of the Pringle maneuver due to an increase in the rate of tumor recurrence in the liver remnant. We designed a multicenter, prospective, randomized surgical trial to test this hypothesis. At least 498 eligible patients from five participating centers will be enrolled and randomized into either the Pringle group or the non-Pringle group in a ratio of 1:1 using a permuted-blocks randomization protocol. After the completion of surgical intervention, patients will be included in a 3-year follow-up program. This multicenter surgical trial will examine whether the Pringle maneuver has a negative effect on the long-term outcome of hepatocellular carcinoma patients. The trial will also provide information about prognostic differences, safety, advantages and disadvantages between Pringle and non-Pringle surgical procedures. Ultimately, the results will increase the available information about the effects of ischemia-reperfusion injury on tumor recurrence, which will be of immense benefit to general surgery.

  5. Tumor Size on Abdominal MRI Versus Pathologic Specimen in Resected Pancreatic Adenocarcinoma: Implications for Radiation Treatment Planning

    International Nuclear Information System (INIS)

    Purpose: We assessed the accuracy of abdominal magnetic resonance imaging (MRI) for determining tumor size by comparing the preoperative contrast-enhanced T1-weighted gradient echo (3-dimensional [3D] volumetric interpolated breath-hold [VIBE]) MRI tumor size with pathologic specimen size. Methods and Materials: The records of 92 patients who had both preoperative contrast-enhanced 3D VIBE MRI images and detailed pathologic specimen measurements were available for review. Primary tumor size from the MRI was independently measured by a single diagnostic radiologist (P.M.) who was blinded to the pathology reports. Pathologic tumor measurements from gross specimens were obtained from the pathology reports. The maximum dimensions of tumor measured in any plane on the MRI and the gross specimen were compared. The median difference between the pathology sample and the MRI measurements was calculated. A paired t test was conducted to test for differences between the MRI and pathology measurements. The Pearson correlation coefficient was used to measure the association of disparity between the MRI and pathology sizes with the pathology size. Disparities relative to pathology size were also examined and tested for significance using a 1-sample t test. Results: The median patient age was 64.5 years. The primary site was pancreatic head in 81 patients, body in 4, and tail in 7. Three patients were American Joint Commission on Cancer stage IA, 7 stage IB, 21 stage IIA, 58 stage IIB, and 3 stage III. The 3D VIBE MRI underestimated tumor size by a median difference of 4 mm (range, −34-22 mm). The median largest tumor dimensions on MRI and pathology specimen were 2.65 cm (range, 1.5-9.5 cm) and 3.2 cm (range, 1.3-10 cm), respectively. Conclusions: Contrast-enhanced 3D VIBE MRI underestimates tumor size by 4 mm when compared with pathologic specimen. Advanced abdominal MRI sequences warrant further investigation for radiation therapy planning in pancreatic adenocarcinoma before

  6. Chondroblastoma of the sphenoid bone

    Directory of Open Access Journals (Sweden)

    Patrocíni, Tomas Gomes

    2008-12-01

    Full Text Available Introduction: Chondroblastoma is an uncommon cartilaginous benign neoplasm, highly destructive, which specifically appears in the epiphysis of long bones in young patients. Its occurrence is extremely rare in the cranial base, normally occurring in the temporal bone. Objective: To describe a rare case in a patient presenting with a sphenoid bone chondroblastoma that invaded the middle cranial cavity, submitted to a successful surgical resection, without recurrence after 2 years. Case Report: W.J.S, 37 years old, male, forwarded to the otorhinolaryngology service with persistent and strong otalgia for 3 months. He had normal otoscopy and without visible tumorations. The computerized tomography confirmed tumor mass in the left infra-temporal cavity, invading the middle cranial cavity. The biopsy suggested giant cells tumor. After wide resection by frontal approach via orbitozygomatic osteotomy. During the surgery, we confirmed tomographic statements and didn't find temporal bone involvement. The histopathological exam confirmed chondroblastoma. After 18 months after the surgery, he doesn't present with complaints, without motor, sensitive deficits or of cranial nerves and without recurrence tomographic signals. Conclusion: The importance of differential diagnosis of chondroblastoma is remarkable in the cranial base lesions and its therapeutic approach, whose objective must always be the major possible resection with the maximum function conservation.

  7. Surgical Treatment of Pathologic Fractures in Patients with Metastatic Tumors

    OpenAIRE

    Zore, Zvonimir; Filipović Zore, Irina; Matejčić, Aljoša; Kamal, Mohamed; Arslani, Nuhi; Knezović Zlatarić, Dubravka

    2009-01-01

    The study presents results in treatment of pathologic fractures of long bones of all patients who underwent surgery in the last 10 years in our hospital. The study cohort comprised 133 consecutive patients divided in two groups who underwent surgery of long bone fractures caused by metastatic tumor or trauma. We used resection, open reduction and plating with bone cement application for pathologic fracture and some cases of femoral shaft fractures were stabilized with intramedullary nailing. ...

  8. Radiological diagnostics of skeletal tumors

    International Nuclear Information System (INIS)

    The book contains contributions concerning the following topics: 1. introduction and fundamentals: WHO classification of bone tumors, imaging diagnostics and their function; localization, typical clinical and radiological criteria, TNM classification and status classification, invasive tumor diagnostics; 2. specific tumor diagnostics: chondrogenic bone tumors, osseous tumors, connective tissue bony tumors, osteoclastoma, osteomyelogenic bone tumors, vascular bone tumors, neurogenic bone tumors, chordoma; adamantinoma of the long tubular bone; tumor-like lesions, bony metastases, bone granulomas, differential diagnostics: tumor-like lesions

  9. Imaging differentiation of pathologic fractures caused by primary and secondary bone tumors

    International Nuclear Information System (INIS)

    Objective: To describe pre-treatment imaging features of pathologic fractures caused by primary bone tumors (PBTs) and metastatic bone tumors (MBTs) and determine if radiographic or cross-sectional features can differentiate the underlying pathologies associated with the fractures. Methods: Sixty-nine patients with a diagnosis of a pathologic fracture were enrolled. Biopsy established PBT as the cause of the pathologic fracture in 16 (23%) cases and MBT in 53 (77%) cases. The radiographs, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans of the subjects were retrospectively reviewed for the presence of multiple imaging features. Results: Compared to pathologic fractures caused by MBTs, the fractures caused by PBTs demonstrated a higher incidence of lytic bone cortex, mineralization and a soft-tissue mass on radiographs, mineralization and a soft-tissue mass on CT scans, and periosteal abnormality on MRI scans (P < 0.01). These features also exhibited a high negative predictive value in supporting the diagnosis of an underlying PBT over MBT. Conclusion: Pathologic fractures caused by PBT and MBT may be differentiated by a few specific radiographic and CT imaging features, though MRI was poor for characterization of the underlying lesion. Such knowledge may assist radiologists in raising the possibility of a PBT as the cause of a pathologic fracture

  10. Clinical Analysis of Bisphosphonates Treatment on Bone Metastases and Hypercalcemia of Malignancy in Advanced Solid Tumor

    Institute of Scientific and Technical Information of China (English)

    MING Shu-hong; SUN Tie-ying

    2007-01-01

    Objective: To evaluate the efficacy and toleration of bisphosphonates therapy in patients with bone metastases and hypercalcemia of malignancy in advanced solid tumor. Methods: Patients with histologically or cytologically confirmed cancer and hypercalcemia with bone metastases were designed to open treatment with either 4mg zoledronic acid or 90mg pamidronate. The primary efficacy parameters were pain scores(NRS), Corrected serum calcium(CSC) and CSC effective rate. The vital signs, biochemical and hematological parameters were determined. Results: Twenty patients were enrolled in this study, twelve patients in zoledronic acid group and eight in pamidronate group. Zoledronic acid and pamidronate significantly palliated pain. Pain scores were significantly lower at end-point after Zoledronic acid or pamidronate infusion(5.92 vs 3.25,P<0.01;6.13 vs 4.38, P<0.01, respectively). The mean CSC level decreased significantly after Zoledronic acid or pamidronate infusion from 12.86 to 10.28mg/dl and 13.19 to 10.36mg/dl respectively. The CSC effective rate was about 90% at 14 days after infusion in two groups. There was no statistical significance for all primary efficacy parameters in zoledronic acid group compared with pamidronate group. An adverse reaction was mild fever after pamidronate infusion and then completely reversible. Conclusion: Zoledronic acid and pamidronate disodium were well tolerated and effective for bone metastases and hypercalcemia of malignancy in advanced solid tumor.

  11. Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis?

    Energy Technology Data Exchange (ETDEWEB)

    Diana Afonso, P., E-mail: p.diana.a@gmail.com [Department of Radiology, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710 (United States); Kosinski, A.S., E-mail: andrzej.kosinski@duke.edu [Department of Biostatistics and Bioinformatics, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710 (United States); Spritzer, C.E., E-mail: chuck.spritzer@duke.edu [Department of Radiology, Duke University Medical Center, P.O. Box 3808, Duke University Medical Center, Durham, NC (United States)

    2013-05-15

    Highlights: ► Gadolinium enhanced imaging improves reader confidence in detecting soft tissue tumor recurrence. ► Gadolinium enhanced imaging modestly improves inexperienced reader accuracy for detecting tumor recurrence. ► Where possible, gadolinium should be used in the assessment of MSK tumor residual or recurrence. -- Abstract: Purpose: Evaluate if gadolinium enhanced MR imaging (GeMRI) improves confidence, changes the final diagnosis, or improves accuracy in the assessment of musculoskeletal (MSK) tumor residual or recurrence following surgical resection. We also assess if different experience levels change the above results. Methods and materials: Initially, pre-contrast images were independently reviewed by two radiologists, one with 25 years of experience (R1) and one undergoing MSK specialty training (R2). Two questions were answered: (1) Mass present? and (2) Likelihood of malignancy? Subsequently, both pre-contrast and post-contrast images were independently reviewed. The same questions were again answered plus four others including if GeMRI changed mass characterization, better defined cystic versus solid, better defined tumor extent, or improved conspicuity. Lastly, the readers answered whether GeMRI changed confidence, and changed their final diagnosis. Histologic diagnoses were available in 43 cases, with the remaining 44 cases based upon clinical and/or imaging follow-up. Results: GeMRI definitely improved confidence in 8/7 cases, and slightly improved confidence in 20/29 cases and changed the final diagnosis in 11/8 cases for R1 and R2 respectively. Positive and negative predictive values statistically improved for R2 (positive predictive value 36.4% versus 50%, p = 0.02; negative predictive value 75.4% versus 79.1%, p = 0.04) but not for R1. Reader concordance for malignancy improved with GeMRI (κ = 0.44 pre-contrast and κ = 0.71 post-contrast). Conclusion: GeMRI improved reader confidence, improved reader concordance and modestly improved

  12. Following unenhanced MRI assessment for local recurrence after surgical resection of mesenchymal soft tissue tumors, do additional gadolinium-enhanced images change reader confidence or diagnosis?

    International Nuclear Information System (INIS)

    Highlights: ► Gadolinium enhanced imaging improves reader confidence in detecting soft tissue tumor recurrence. ► Gadolinium enhanced imaging modestly improves inexperienced reader accuracy for detecting tumor recurrence. ► Where possible, gadolinium should be used in the assessment of MSK tumor residual or recurrence. -- Abstract: Purpose: Evaluate if gadolinium enhanced MR imaging (GeMRI) improves confidence, changes the final diagnosis, or improves accuracy in the assessment of musculoskeletal (MSK) tumor residual or recurrence following surgical resection. We also assess if different experience levels change the above results. Methods and materials: Initially, pre-contrast images were independently reviewed by two radiologists, one with 25 years of experience (R1) and one undergoing MSK specialty training (R2). Two questions were answered: (1) Mass present? and (2) Likelihood of malignancy? Subsequently, both pre-contrast and post-contrast images were independently reviewed. The same questions were again answered plus four others including if GeMRI changed mass characterization, better defined cystic versus solid, better defined tumor extent, or improved conspicuity. Lastly, the readers answered whether GeMRI changed confidence, and changed their final diagnosis. Histologic diagnoses were available in 43 cases, with the remaining 44 cases based upon clinical and/or imaging follow-up. Results: GeMRI definitely improved confidence in 8/7 cases, and slightly improved confidence in 20/29 cases and changed the final diagnosis in 11/8 cases for R1 and R2 respectively. Positive and negative predictive values statistically improved for R2 (positive predictive value 36.4% versus 50%, p = 0.02; negative predictive value 75.4% versus 79.1%, p = 0.04) but not for R1. Reader concordance for malignancy improved with GeMRI (κ = 0.44 pre-contrast and κ = 0.71 post-contrast). Conclusion: GeMRI improved reader confidence, improved reader concordance and modestly improved

  13. Endoscopically assisted resection of a scapular osteochondroma causing snapping scapula syndrome

    Directory of Open Access Journals (Sweden)

    Futani Hiroyuki

    2007-03-01

    Full Text Available Abstract Background Osteochondroma is the most common benign bone tumor in the scapula. This condition might lead to snapping scapula syndrome, which is characterized by painful, audible, and/or palpable abnormal scapulothoracic motion. In the present case, this syndrome was successfully treated by use of endoscopically assisted resection of the osteochondroma. Case presentation A 41-year-old man had a tolerable pain in his scapular region over a 10 years' period. The pain developed gradually with shoulder motion, in particular with golf swing since he was aiming a professional golf player career. On physical examination, "clunking" was noted once from 90 degrees of abduction to 180 degrees of shoulder motion. A trans-scapular roentgenogram and computed tomography images revealed an osteochondroma located at the anterior and inferior aspect of the scapula. Removal of the tumor was performed by the use of endoscopically assisted resection. One portal was made at the lateral border of the scapula to introduce a 2.7-mm-diameter, 30 degrees Hopkins telescope. The tumor was resected in a piece-by-piece manner by the use of graspers through the same portal. Immediately after the operation pain relief was obtained, and the "clunking" disappeared. CT images showed complete tumor resection. The patient could start playing golf one week after the surgery. Conclusion Endoscopically assisted resection of osteochondroma of the scapula provides a feasible technique to treat snapping scapula syndrome and obtain early functional recovery with a short hospital stay and cosmetic advantage.

  14. Experimental study of chemical embolus therapy combined with radiotherapy for VX2 bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Hiroshi; Mochizuki, Kazuo; Ishii, Yoshiaki [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    2000-12-01

    We conducted an experimental study, using a combination of coarse crystal cisplatin and radiotherapy for bone tumors, to evaluate the possibility of the clinical application of chemical embolus therapy in the field of orthopedic surgery. Experimental femoral bone tumors were produced, in rabbits, using VX2 carcinoma. The rabbits were allocated to five groups: untreated control, embolus, chemical embolus, irradiation alone, and chemical embolus and irradiation combination. These therapies were evaluated comparatively, in terms of local antitumor effects (including body weight, X-ray findings, angiography, and histopathology) and in terms of inhibition of pulmonary metastasis. Local antitumor effects, as evaluated by all parameters, except for body weight, were significantly greater for the chemical and irradiation combination group than for the chemical embolus, irradiation alone, untreated control, and embolus groups. There was no significant difference in the inhibition of pulmonary metastasis among the chemical embolus and irradiation combination, chemical embolus, and irradiation alone groups. These findings demonstrated the synergistic effect of the combination of chemical embolus therapy and radiotherapy. In this study, however, no significant difference was found between the chemical embolus therapy alone and the combination therapy groups in the inhibitory effect on pulmonary tumor metastasis, suggesting the need to conduct combination therapy repeatedly in the clinical setting. (author)

  15. The selective Cox-2 inhibitor Celecoxib suppresses angiogenesis and growth of secondary bone tumors: An intravital microscopy study in mice

    International Nuclear Information System (INIS)

    The inhibition of angiogenesis is a promising strategy for the treatment of malignant primary and secondary tumors in addition to established therapies such as surgery, chemotherapy, and radiation. There is strong experimental evidence in primary tumors that Cyclooxygenase-2 (Cox-2) inhibition is a potent mechanism to reduce angiogenesis. For bone metastases which occur in up to 85% of the most frequent malignant primary tumors, the effects of Cox-2 inhibition on angiogenesis and tumor growth remain still unclear. Therefore, the aim of this study was to investigate the effects of Celecoxib, a selective Cox-2 inhibitor, on angiogenesis, microcirculation and growth of secondary bone tumors. In 10 male severe combined immunodeficient (SCID) mice, pieces of A549 lung carcinomas were implanted into a newly developed cranial window preparation where the calvaria serves as the site for orthotopic implantation of the tumors. From day 8 after tumor implantation, five animals (Celecoxib) were treated daily with Celecoxib (30 mg/kg body weight, s.c.), and five animals (Control) with the equivalent amount of the CMC-based vehicle. Angiogenesis, microcirculation, and growth of A549 tumors were analyzed by means of intravital microscopy. Apoptosis was quantified using the TUNEL assay. Treatment with Celecoxib reduced both microvessel density and tumor growth. TUNEL reaction showed an increase in apoptotic cell death of tumor cells after treatment with Celecoxib as compared to Controls. Celecoxib is a potent inhibitor of tumor growth of secondary bone tumors in vivo which can be explained by its anti-angiogenic and pro-apoptotic effects. The results indicate that a combination of established therapy regimes with Cox-2 inhibition represents a possible application for the treatment of bone metastases

  16. The role of scintigraphy using 99mTc MDP, radiography an MRI in the evaluation of bone tumors and tumor like lesions

    International Nuclear Information System (INIS)

    Out of the modern tomographic methods even nuclear magnetic resonance allows only in certain cases a precise final diagnosis of the space occupying lesion. Based on the high contrasts of the various tissues and the multiplanar imaging MRI permits the definite judgement on the extention of the tumor within the bone as well as infiltration of the surrounding soft tissue. 3 phase bone scintigraphy, which is always performed, allows for the judgement of tumor activity before, during and after the various therapies as well the confirmation of the presence or absence of secondary foci or metastases. The scintigraphic determination of the type of osseous tumors however is only limited. The definite judgement of the osseous space occupying lesion being benign is only possible, if no or only a slide increase of bone metabolism can be observed. In cases with markedly increased tracer accumulation a sufficient assessment of dignity is not possible. (orig.)

  17. Investigation on tumor hypoxia in resectable primary prostate cancer as demonstrated by 18F-FAZA PET/CT utilizing multimodality fusion techniques

    International Nuclear Information System (INIS)

    As hypoxia is believed to play an important role in the development and progression of prostate cancer, we evaluated whether 18F-labeled fluoroazomycin arabinoside (18F-FAZA) would be useful to identify tumor hypoxia in resectable prostate cancer. Positron emission tomography (PET)/CT was performed on 14 patients with untreated localized primary prostate cancer 3 h post-injection of approximately 390 MBq of 18F-FAZA using forced diuresis to decrease radioactivity in the urinary bladder. Anatomical trans-pelvic coil and pre- and post-contrast 1.5 T MRI with endorectal coil were performed on the same day. Patients underwent radical prostatectomy and ex vivo 3 T MRI of the prostatectomy specimen within 14 days following in vivo imaging. Imaging results were verified by whole mount histopathology plus tissue microarray (TMA) immunohistochemical (IHC) analysis for carbonic anhydrase IX (CAIX) and hypoxia-inducible factor 1α (HIF-1α). Registration of in vivo imaging with histology was achieved using mutual information software and performing ex vivo MRI of the prostatectomy specimen and whole mount sectioning with block face photography as intermediate steps. Whole mount histology identified 43 tumor nodules, 19 of them larger than 1 ml as determined on coregistered volumes featuring 18F-FAZA, MRI, and histological 3-D image information. None of these lesions was found to be positive for CAIX or visualized by 18F-FAZA PET/CT while IHC for HIF-1α showed variable staining of tumor tissues. Accordingly, no correlation was found between 18F-FAZA uptake and Gleason scores. Our data based on 18F-FAZA PET/CT and CAIX IHC do not support the presence of clinically relevant hypoxia in localized primary prostate cancer including high-grade disease. Activation of HIF-1α may be independent of tissue hypoxia in primary prostate cancer. (orig.)

  18. Clinical imaging diagnosis of bone and soft tissue peripheral primitive neuroectodermal tumor primarily research

    International Nuclear Information System (INIS)

    Objective: Retrospectively review manifestation of clinical and imaging peripheral primitive neuroectodermal tumor (pPNET) of 12 cases, to improve the diagnostic accuracy. Methods: Twelve eases of pPNET were collected, which were confirmed pathologically and immunohistochemically, the average age were 23.8 years old. Twelve cases were all performed X-ray examination. Ten of the 12 cases were performed multi-slice spiral CT, 9 of them were performed MR examination, both including pre-and post-contrast scans. Clinical and imaging characteristics of the 12 cases were analyzed. Results: Patients of pPNET is relatively younger, their symptoms are relatively severe. Ten cases of pPNET displayed osteolytic lesions on X-Ray films. On CT images 6 cases with soft tissue masses showed infringe on neighboring neurovascular space with neighboring bone embed or destroyed, whereas 6 cases with bone lesions exhibited osteolytic destruction with no periosteal reaction, calcification or tumor bone. Lesions showed iso-or hypo- intensity on MR T1WI, and heterogenerous hyper-intensity on T2WI. Six cases of pPNET of bone exhibited large soft tissue mass and has no clear interface with neighboring normal structure on MRI. Cross-segment permeating, growing along epidural and under ligaments space are features of MRI of 3 cases of diffused spine pPNET. Spreading along spinal nerve with severe neighboring structure infiltration were characteristics of 2 cases of MRI of spinal canal pPNET. Post-contrast CT and MR scans of the lesions appear heterogeneous enhancement. Immunohistochemistry of 12 cases demonstrated CD99 (+), Vimetin (+) and NSE, CgA, NF high expression. Conclusions: There are very unique characteristics of pPNET, key to correct diagnosis is to inosculate imaging and clinical characteristics. (authors)

  19. The entrance to bone tumor cells of 153Sm-EDTMP by microautoradiographic tracing

    International Nuclear Information System (INIS)

    The dynamic process of 153Sm-EDTMP entering into bone tumor cells and its behavior characteristic in osteosarcoma cells are studied by microautoradiographic tracing. The results show that 153Sm-EDTMP condense on membrane of osteosarcoma cells at first, then infiltrate through cell membrane or phagocytized by osteosarcoma cells and distributed in the form of phagosomes. In apoptotic osteosarcoma cells 153Sm-EDTMP could be observed in the membrane-bounded apoptotic bodies. So, the progression of apoptosis in osteosarcoma cells induced by 153Sm-EDTMP is dependent on the infiltration and phagocytosis of 153Sm-EDTMP through cell membrane

  20. Ewing’s Family of Tumors of the Sinonasal Tract and Maxillary Bone

    OpenAIRE

    Hafezi, Sara; Seethala, Raja R.; Stelow, Edward B.; Mills, Stacey E.; Leong, Iona T.; MacDuff, Elaine; Hunt, Jennifer L.; Perez-Ordoñez, Bayardo; Weinreb, Ilan

    2010-01-01

    The Ewing’s family of tumors (EFT) are malignant neoplasms affecting children and young adults. Most cases arise in the long bones or the pelvis. Primary EFT of head and neck is uncommon and primary sinonasal EFT is even rarer. Previous studies have not focused on the sinonasal region specifically, and the published literature on sinonasal EFT consists of sporadic case reports. Fourteen cases of sinonasal EFT were available and had H&Es for review and immunohistochemical stains for CD99, S100...

  1. Surgktu management of benign bone tumors in proximal femur%股骨近端良性骨肿瘤的外科治疗

    Institute of Scientific and Technical Information of China (English)

    王守丰; 熊进; 骆东山; 陈一心; 王骏飞; 施鸿飞

    2009-01-01

    Objective To investigate the method and efficacy of surgical management of benign tumors of the proximal femur. Methods Sixteen patients with benign bone tumors in the proximal femur were treated with different surgical methods. The results were evaluated by Enceking scoring during follow up. Results Tumor resection was performed in 3 cases, curcttage of lesion in 4 cases curettage plus bone allograft in 5 cases, eurettage with bone cement in 1 case, curettagc plus allografts and instrumentation with dynamic condyle screw(DCS) in one case, curettage with allograft and internal fixation with dynamic hip screw DHS in one case and total hip replacement in one case. The average follow-up was 24. 4 (3-46) months. All patients had a full Enncking's function score of 30 points except for one patient treated with wide resection and total hip replacement, whose Enncking's function score was 27 points on the 6~(th) week and 29 points on the 3~(rd) month. Conclusion The successful outcome can be achieved in the patients with benign bone tumors in the proximal femur as long as a proper surgical tcchnigue is chosen,%目的 探讨股骨近端良性骨肿瘤外科治疗方法 及疗效.方法 股骨近端良性骨肿瘤患者16例.依据肿瘤类型及骨损害程度.选择不同术式行外科治疗.依据Enccking评分标准进行术后关节功能评估.结果 行单纯切除术3例,刮除术4例,舌吐除+植骨术5例,刮除+伴水泥填充、刮除+植骨+动力性髁螺钉(DCS)内固定、刮除+植骨+动力髋螺钉(DHS)预防性内固定、扩大切除+人工全髋关节置换术各1例.平均随防24. 4(3-46)个月,Enneking功能评分.除1例人工全髋关节置换术后6周为27分、3个月时为29分外.其余患者术后3个月均达满分.结论 股骨近端良性骨肿瘤根据肿瘤类型及损害程度选择台适的术式, 治疗效果及功能恢复均良好.

  2. Pathologic complete response confirmed by surgical resection for liver metastases of gastrointestinal stromal tumor after treatment with imatinib mesylate

    Institute of Scientific and Technical Information of China (English)

    Seiji Suzuki; Shotaro Maeda; Takashi Tajiri; Koji Sasajima; Masayuki Miyamoto; Hidehiro Watanabe; Tadashi Yokoyama; Hiroshi Maruyama; Takeshi Matsutani; Aimin Liu; Masaru Hosone

    2008-01-01

    A 39-year-old male underwent distal gastrectomy for a high grade gastrointestinal stromal tumor (GIST). Computed tomography (CT) and magnetic resonance imaging (MRI) 107 mo after the operation, revealed a cystic mass (14 cm in diameter) and a solid mass (9 cm in diameter) in the right and left lobes of the liver, respectively. A biopsy specimen of the solid mass showed a liver metastasis of GIST. The patient received imatinib mesylate (IM) treatment, 400mg/day orally. Following the IM treatment for a period of 35 mo, the patient underwent partial hepatectomy (S4+S5). The effect of IM on the metastatic lesions was interpreted as pathologic complete response (CR). Pathologically verified cases showing therapeutic efficacy of IM have been rarely reported.

  3. [Value of conventional roentgen diagnosis and angiography in evaluating bone tumors].

    Science.gov (United States)

    Pfeiffer, K J; Kierse, R

    1991-01-01

    Plain film radiographs are the basic imaging method for bone neoplasms, as the tumor and its relation to the surrounding tissue are shown in good detail. A classification of the destruction patterns enables us to determine the aggressivity of the lesion. Other criteria for diagnosis are periosteal reactions and calcifications in the surrounding soft tissues. Typical radiographic findings enable use to determine the dignity or even to diagnose a specific tumor in combination with the clinical settings. In case of a suspect scintigraphic finding plain film helps in differentiating metastasis from benign lesions. Angiography provides additional information about the extent of vascularization, the feeding arteries and venous situation. The pattern of vascular changes allows to determine the dignity of the tumor. In addition, angiography displays necrotic and the different degrees of vital tumor tissue enabling to define an appropriate site for needle biopsy. Short term follow up can be performed by angiography as chemotherapy and/or radiation therapy may lead to a decrease in vascularization. PMID:1797244

  4. Ex vivo MRI evaluation of breast tumors: a novel tool for verifying resection of nonpalpable only MRI detected lesions.

    Science.gov (United States)

    Agresti, Roberto; Trecate, Giovanna; Ferraris, Cristina; Valeri, Barbara; Maugeri, Ilaria; Pellitteri, Cristina; Martelli, Gabriele; Migliavacca, Silvana; Carcangiu, Maria Luisa; Bohm, Silvia; Maffioli, Lorenzo; Vergnaghi, Daniele; Panizza, Pietro

    2013-01-01

    A fundamental question in surgery of only magnetic resonance imaging (MRI)-detected breast lesions is to ensure their removal when they are not palpable by clinical examination and surgical exploration. This is especially relevant in the case of small tumors, carcinoma in situ or lobular carcinoma. Thirty-nine patients were enrolled in the study, 21 patients with breast lesions detected by both conventional imaging and breast MRI (bMRI) and 18 patients with bMRI findings only. Preoperative bMRI allowed staging the disease and localizing the lesion. In the operating theater, contrast medium was injected 1 minute before skin incision. After removal, surgical specimens were submitted to ex vivo MRI, performed using a dedicated surface coil and Spair inversion recovery sequences for suppression of fat signal intensity. All MRI enhancing lesions were completely included within the surgical specimen and visualized by ex vivo MRI. In the first 21 patients, bMRI was able to visualize branching margins or satellite nodules around the core lesion, and allowed for better staging of the surrounding in situ carcinoma; in the last 18 patients, eight of whom were breast cancer type 1 susceptibility protein (BRCA) mutation carriers, bMRI identified 12 malignant tumors, otherwise undetectable, that were all visualized by ex vivo MRI. This is the first description of a procedure that re-enhances breast lesions within a surgical specimen, demonstrating the surgical removal of nonpalpable breast lesions diagnosed only with bMRI. This new strategy reproduces the morphology and the entire extension of the primary lesion on the specimen, with potentially better local surgical control, reducing additional unplanned surgery. PMID:24102850

  5. Hemobilia secondary to hepatic artery pseudoaneurysm:An unusual complication of bile leakage in a patient with a history of a resected Ⅲb Klatskin tumor

    Institute of Scientific and Technical Information of China (English)

    Dimitrios Siablis; Zafiria G. Papathanassiou; Dimitrios Karnabatidis; Nikolaos Christeas; Constantine Vagianos

    2005-01-01

    we report a case of a 74-year-old woman with a 16-year history of a double bilo-enteric anastomosis due to resected hilar cholangiocarcinoma [Type Ⅲb Klatskin tumor]. The patient presented with cholangitis secondary to benign anastomotic stenosis which resulted in a large intrahepatic biloma. In order to restore the patency of the anastomosis and overcome cholangitis, several attempts took place,including endobiliary stenting, balloon-assisted biloplasty and transhepatic billiary drainage. Anastomotic patencywas achieved, complicated, however, by persistent upper gastro-intestinal bleeding, presented as hemobilia. A biloma-induced pseudoaneurysm of the left hepatic artery was diagnosed. This had ruptured into the biliary tract,and presented the actual cause of the hemobilia. Selective embolism of the pseudoaneurysm resulted in control of the hemorrhage, and was successfully combined with transhepatic dilatation of the anastomosis and percutaneous drainage of the biloma. The patient was ultimately cured and seems to be in excellent condition, 5 mo after treatment.

  6. Clinical Practice Pattern of Immediate Intravesical Chemotherapy following Transurethral Resection of a Bladder Tumor in Korea: National Health Insurance Database Study.

    Science.gov (United States)

    Seo, Gi Hyeon; Kim, Jae Heon; Ku, Ja Hyeon

    2016-01-01

    We evaluated the frequency and practice pattern of immediate postoperative intravesical chemotherapy (PIC) after transurethral resection of a bladder tumor (TURBT) in suspected non-muscle-invasive bladder cancer (NMIBC). Information from the Health Insurance Review and Assessment Service database from January 1, 2008 to December 31, 2013 was used. Patients with bladder cancer who received TURBT were considered as the cases (37,941 patients and 59,568 cases). The time of PIC after TURBT, types of PIC regimens, and the potential effect of PIC on the delay for additional treatment were analyzed. The study cohort included 23,726 subjects and 30,473 cases with a mean age of 66.8 ± 12.0 years, including 19,362 (81.6%) male patients. The rate of immediate PIC was 11.0% of cases (3,359 cases). There was significant difference in the frequency rate of additional treatment among patients with immediate PIC and patients without immediate PIC within 1 year from the first TURBT (15.2% vs 16.6%, p = 0.035). However, no difference was revealed for whole observational period (33.7% vs 34.5%, p = 0.373). The frequency rate of immediate PIC after TURBT for suspected NMIBC was low in real clinical practice. More efforts are needed to improve the usage rate of PIC after TURBT for suspected NMIBC. PMID:26976048

  7. Constitutive activation of p38 MAPK in tumor cells contributes to osteolytic bone lesions in multiple myeloma.

    Science.gov (United States)

    Yang, J; He, J; Wang, J; Cao, Y; Ling, J; Qian, J; Lu, Y; Li, H; Zheng, Y; Lan, Y; Hong, S; Matthews, J; Starbuck, M W; Navone, N M; Orlowski, R Z; Lin, P; Kwak, L W; Yi, Q

    2012-09-01

    Bone destruction is a hallmark of multiple myeloma and affects more than 80% of patients. However, current therapy is unable to completely cure and/or prevent bone lesions. Although it is accepted that myeloma cells mediate bone destruction by inhibition of osteoblasts and activation of osteoclasts, the underlying mechanism is still poorly understood. This study demonstrates that constitutive activation of p38 mitogen-activated protein kinase in myeloma cells is responsible for myeloma-induced osteolysis. Our results show that p38 is constitutively activated in most myeloma cell lines and primary myeloma cells from patients. Myeloma cells with high/detectable p38 activity, but not those with low/undetectable p38 activity, injected into severe combined immunodeficient (SCID) or SCID-hu mice caused bone destruction. Inhibition or knockdown of p38 in human myeloma reduced or prevented myeloma-induced osteolytic bone lesions without affecting tumor growth, survival, or homing to bone. Mechanistic studies showed that myeloma cell p38 activity inhibited osteoblastogenesis and bone formation and activated osteoclastogenesis and bone resorption in myeloma-bearing SCID mice. This study elucidates a novel molecular mechanism-activation of p38 signaling in myeloma cells-by which myeloma cells induce osteolytic bone lesions, and indicates that targeting myeloma cell p38 may be a viable approach to treating or preventing myeloma bone disease. PMID:22425892

  8. Survey for primary tumor site in patients with initial clinical presentation of bone metastasis

    International Nuclear Information System (INIS)

    Among the patients who were examined with bone scintigraphy between April 1985 and March 1991, there were 27 patients whose initial clinical manifestation was bone metastasis and who were surveyed for the primary tumor site. The primary tumor site could be identified in 20 patients (74%), consisting of 9 patients with lung cancer, 3 with prostate cancer, 3 with hepatoma, 2 with renal cancer, and one each with thyroid cancer, adrenal cancer, and pleural malignant mesothelioma. In 17 of the 20 patients, the primary site had been detected within two months after presentation. Examinations which were helpful in identifying the primary site included chest radiography, sputum cytology, abdominal sonography, serum prostatic acid phosphatase level and pathologic examination of biopsy specimens. 99mTc-pyridoxylenemethyl tryptophan (99mTc-PMT) scintigraphy was useful in the diagnosis of the hepatoma when accumulation was observed at the metastatic sites. In 2 patients, lung cancer had been recognized using follow-up chest, radiography 3 and 6 months after presentation, respectively. One patient was diagnosed at autopsy as having adrenal cancer. In 7 patients the primary site remains unknown. Histology examination of the biopsy specimen performed in 6 of these patients revealed 4 to be adenocarcinoma and 2 undifferentiated carcinoma. The average survival period of the 17 patients who died was 9.5 months. Four patients are alive, and the outcome in the remaining 6 could not be determined. (author)

  9. Iron-oxide-enhanced MR imaging of bone marrow in patients with non-Hodgkin's lymphoma: differentiation between tumor infiltration and hypercellular bone marrow

    International Nuclear Information System (INIS)

    The aim of this study was to differentiate normal, hypercellular, and neoplastic bone marrow based on its MR enhancement after intravenous administration of superparamagnetic iron oxides in patients with cancer of the hematopoietic system. Eighteen patients with cancer of the hematopoietic system underwent MRI of the spine before and after infusion of ferumoxides (n=9) and ferumoxtran (n=9) using T1- and T2-weighted turbo spin-echo (TSE) and short tau inversion recovery sequences (STIR). In all patients diffuse or multifocal bone marrow infiltration was suspected, based on iliac crest biopsy and imaging such as conventional radiographs, MRI, and positron emission tomography. In addition, all patients had a therapy-induced normocellular (n=7) or hypercellular (n=11) reconversion of the normal non-neoplastic bone marrow. The MRI data were analyzed by measuring pre- and post-contrast signal intensities (SI) of hematopoietic and neoplastic marrow and by calculating the enhancement as ΔSI(%) data and the tumor-to-bone-marrow contrast as contrast-to-noise ratios (CNR). Changes in bone marrow signal intensity after iron oxide administration were more pronounced on STIR images as compared with T1- and T2-weighted TSE images. The STIR images showed a strong signal decline of normal and hypercellular marrow 45-60 min after iron oxide infusion, but no or only a minor signal decline of neoplastic bone marrow lesions; thus, ΔSI% data were significantly higher in normal and hypercellular reconverted marrow compared with neoplastic bone marrow lesions (p<0.05). Additionally, the contrast between focal or multifocal neoplastic bone marrow infiltration and normal bone marrow, quantified by CNR data, increased significantly on post-contrast STIR images compared with precontrast images (p<0.05). Superparamagnetic iron oxides are taken up by normal and hypercellular reconverted bone marrow, but not by neoplastic bone marrow lesions, thereby providing significantly different

  10. Clinicodemographic aspect of resectable pancreatic cancer and prognostic factors for resectable cancer

    Directory of Open Access Journals (Sweden)

    Chiang Kun-Chun

    2012-05-01

    Full Text Available Abstract Background Pancreatic adenocarcinoma (PCA is one of the most lethal human malignancies, and radical surgery remains the cornerstone of treatment. After resection, the overall 5-year survival rate is only 10% to 29%. At the time of presentation, however, about 40% of patients generally have distant metastases and another 40% are usually diagnosed with locally advanced cancers. The remaining 20% of patients are indicated for surgery on the basis of the results of preoperative imaging studies; however, about half of these patients are found to be unsuitable for resection during surgical exploration. In the current study, we aimed to determine the clinicopathological characteristics that predict the resectability of PCA and to conduct a prognostic analysis of PCA after resection to identify favorable survival factors. Methods We retrospectively reviewed the medical files of 688 patients (422 men and 266 women who had undergone surgery for histopathologically proven PCA in the Department of Surgery at Chang Gung Memorial Hospital in Taiwan from 1981 to 2006. We compared the clinical characteristics of patients who underwent resection and patients who did not undergo resection in order to identify the predictive factors for successful resectability of PCA, and we conducted prognostic analysis for PCA after resection. Results A carbohydrate antigen 19–9 (CA 19–9 level of 37 U/ml or greater and a tumor size of 3 cm or more independently predicted resectability of PCA. In terms of survival after resection, PCA patients with better nutritional status (measured as having an albumin level greater than 3.5 g/dl, radical resection, early tumor stage and better-differentiated tumors were associated with favorable survival. Conclusions Besides traditional imaging studies, preoperative CA 19–9 levels and tumor size can also be used to determine the resectability of PCA. Better nutritional status, curative resection, early tumor stage and well

  11. T cells stimulate catabolic gene expression by the stromal cells from giant cell tumor of bone

    Energy Technology Data Exchange (ETDEWEB)

    Cowan, Robert W. [Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St. W., Hamilton, ON, Canada L8S 4L8 (Canada); Juravinski Cancer Centre, 699 Concession St., Hamilton, ON, Canada L8V 5C2 (Canada); Ghert, Michelle [Juravinski Cancer Centre, 699 Concession St., Hamilton, ON, Canada L8V 5C2 (Canada); Department of Surgery, McMaster University, 1280 Main St. W., Hamilton, ON, Canada L8S 4L8 (Canada); Singh, Gurmit, E-mail: gurmit.singh@jcc.hhsc.ca [Department of Pathology and Molecular Medicine, McMaster University, 1280 Main St. W., Hamilton, ON, Canada L8S 4L8 (Canada); Juravinski Cancer Centre, 699 Concession St., Hamilton, ON, Canada L8V 5C2 (Canada)

    2012-03-23

    Highlights: Black-Right-Pointing-Pointer Two T cell lines stimulate PTHrP, RANKL, MMP13 gene expression in GCT cell cultures. Black-Right-Pointing-Pointer CD40 expressed by stromal cells; CD40L detected in whole tumor but not cultures. Black-Right-Pointing-Pointer Effect of CD40L treatment on GCT cells increased PTHrP and MMP13 gene expression. Black-Right-Pointing-Pointer PTHrP treatment increased MMP13 expression, while inhibition decreased expression. Black-Right-Pointing-Pointer T cells may stimulate GCT stromal cells and promote the osteolysis of the tumor. -- Abstract: The factors that promote the localized bone resorption by giant cell tumor of bone (GCT) are not fully understood. We investigated whether T cells could contribute to bone resorption by stimulating expression of genes for parathyroid hormone-related protein (PTHrP), matrix metalloproteinase (MMP)-13, and the receptor activator of nuclear-factor {kappa}B ligand (RANKL). Two cell lines, Jurkat clone E6-1 and D1.1, were co-cultured with isolated GCT stromal cells. Real-time PCR analyses demonstrated a significant increase of all three genes following 48 h incubation, and PTHrP and MMP-13 gene expression was also increased at 24 h. Further, we examined the expression of CD40 ligand (CD40L), a protein expressed by activated T cells, and its receptor, CD40, in GCT. Immunohistochemistry results revealed expression of the CD40 receptor in both the stromal cells and giant cells of the tumor. RNA collected from whole GCT tissues showed expression of CD40LG, which was absent in cultured stromal cells, and suggests that CD40L is expressed within GCT. Stimulation of GCT stromal cells with CD40L significantly increased expression of the PTHrP and MMP-13 genes. Moreover, we show that inhibition of PTHrP with neutralizing antibodies significantly decreased MMP13 expression by the stromal cells compared to IgG-matched controls, whereas stimulation with PTHrP (1-34) increased MMP-13 gene expression. These

  12. Endoscopically assisted resection of a scapular osteochondroma causing snapping scapula syndrome

    OpenAIRE

    Futani Hiroyuki; Fukunaga Satoru; Yoshiya Shinichi

    2007-01-01

    Abstract Background Osteochondroma is the most common benign bone tumor in the scapula. This condition might lead to snapping scapula syndrome, which is characterized by painful, audible, and/or palpable abnormal scapulothoracic motion. In the present case, this syndrome was successfully treated by use of endoscopically assisted resection of the osteochondroma. Case presentation A 41-year-old man had a tolerable pain in his scapular region over a 10 years' period. The pain developed gradually...

  13. Reconstruction of Soft-Tissue Defects at the Foot and Ankle after Oncological Resection

    OpenAIRE

    Ring, Andrej; Kirchhoff, Pascal; Goertz, Ole; Behr, Bjorn; Daigeler, Adrien; Lehnhardt, Marcus; HARATI, KAMRAN

    2016-01-01

    Introduction Solid malignancies at the foot and ankle region are rare and include mainly soft-tissue sarcomas, bone sarcomas, and skin malignancies. Complete surgical resection with clear margins still remains the mainstay of therapy in these malignancies. However, attainment of negative surgical margins in patients with locally advanced tumors of the foot and ankle region may require extensive surgery and could result in loss of extremity function. In these circumstances, plastic surgical...

  14. Reconstruction of Soft-Tissue Defects at the Foot and Ankle after Oncological Resection

    OpenAIRE

    Ring, Andrej; Kirchhoff, Pascal; Goertz, Ole; Behr, Bjorn; Daigeler, Adrien; Lehnhardt, Marcus; HARATI, KAMRAN

    2016-01-01

    Introduction Solid malignancies at the foot and ankle region are rare and include mainly soft-tissue sarcomas, bone sarcomas, and skin malignancies. Complete surgical resection with clear margins still remains the mainstay of therapy in these malignancies. However, attainment of negative surgical margins in patients with locally advanced tumors of the foot and ankle region may require extensive surgery and could result in loss of extremity function. In these circumstances, plastic surgical te...

  15. Evaluation of mandibular bone involvement by oral malignant tumors using scintigraphy of Tc-99m MDP and Ga-67 citrate

    International Nuclear Information System (INIS)

    Ten patients with intensely invaded malignant tumors at the mandibles were studied with bone scintigraphy (Tc-99m MDP) and Ga-67 citrate scintigraphy. All patients were classified by type of accumulation of both radionuclide pharmaceuticals. In almost all patients with invaded malignant tumors, bone scintigraphy revealed decreasing uptake in the center of the lesion and increasing uptake in the peripheral region. Ga-67 citrate scintigram showed increasing concentrated accumulation which was smaller than the area of Tc-99m MDP uptake in almost all cases. These types of accumulation were compared with those of other oral and maxillo-facial diseases. The patterns of accumulation of both radionuclide pharmaceuticals in ameloblastoma (3 cases), radicular cyst (3 cases), bone fracture (2 cases), diffuse sclerosing osteomyelitis (2 cases), and one sagittal ramus osteotomy case were different from that of bone involvement of malignant tumor cases. From the types of accumulation, we may be able to differentiate the oral and maxillo-facial diseases to some extent. In addition, the intensity of accumulation of Tc-99m MDP was measured by using bone to soft tissue ratio (4 hrB/St ratio). The mean 4 hrB/St ratio was higher in moth-eaten absorbed type than in permeated type of resorption in roentgenogram. However, we could not obtain a definitive conclusion because of too few cases. The mean 4 hrB/St ratio in the bone involvement by malignant tumor was higher than that in radicular cyst, and lower than that of diffuse sclerosing osteomyelitis. Unfortunately, we could not differentiate each disease of the involved malignant tumor, ameloblastoma, or bone fracture by only the 4 hrB/St ratio. The Tc-99m MDP accumulated beyond the region where the radiolucencies exist in roentgenograms. We consider that both scintigraphies have a great role in planning surgical treatment, especially in selecting osteotomy. (author)

  16. Cisplatin inhibits bone healing during distraction osteogenesis.

    Science.gov (United States)

    Stine, Kimo C; Wahl, Elizabeth C; Liu, Lichu; Skinner, Robert A; Vanderschilden, Jacquelyn; Bunn, Robert C; Montgomery, Corey O; Suva, Larry J; Aronson, James; Becton, David L; Nicholas, Richard W; Swearingen, Christopher J; Lumpkin, Charles K

    2014-03-01

    Osteosarcoma (OS) is the most common malignant bone tumor affecting children and adolescents. Many patients are treated with a combination of chemotherapy, resection, and limb salvage protocols. Surgical reconstructions after tumor resection include structural allografts, non-cemented endoprostheses, and distraction osteogenesis (DO), which require direct bone formation. Although cisplatin (CDP) is extensively used for OS chemotherapy, the effects on bone regeneration are not well studied. The effects of CDP on direct bone formation in DO were compared using two dosing regimens and both C57BL/6 (B6) and tumor necrosis factor receptor 1 knockout (TNFR1KO) mice, as CDP toxicity is associated with elevated TNF levels. Detailed evaluation of the five-dose CDP regimen (2 mg/kg/day), demonstrated significant decreases in new bone formation in the DO gaps of CDP treated versus vehicle treated mice (p CDP regimen were observed in TNFR1KO mice. The two-dose regimen significantly inhibited new bone formation in B6 mice. These results demonstrate that CDP has profound short term negative effects on the process of bone repair in DO. These data provide the mechanistic basis for modeling peri-operative chemotherapy doses and schedules and may provide new opportunities to identify molecules that spare normal cells from the inhibitory effects of CDP. PMID:24259375

  17. Bone Fractures Following External Beam Radiotherapy and Limb-Preservation Surgery for Lower Extremity Soft Tissue Sarcoma: Relationship to Irradiated Bone Length, Volume, Tumor Location and Dose

    International Nuclear Information System (INIS)

    Purpose: To examine the relationship between tumor location, bone dose, and irradiated bone length on the development of radiation-induced fractures for lower extremity soft tissue sarcoma (LE-STS) patients treated with limb-sparing surgery and radiotherapy (RT). Methods and Materials: Of 691 LE-STS patients treated from 1989 to 2005, 31 patients developed radiation-induced fractures. Analysis was limited to 21 fracture patients (24 fractures) who were matched based on tumor size and location, age, beam arrangement, and mean total cumulative RT dose to a random sample of 53 nonfracture patients and compared for fracture risk factors. Mean dose to bone, RT field size (FS), maximum dose to a 2-cc volume of bone, and volume of bone irradiated to ≥40 Gy (V40) were compared. Fracture site dose was determined by comparing radiographic images and surgical reports to fracture location on the dose distribution. Results: For fracture patients, mean dose to bone was 45 ± 8 Gy (mean dose at fracture site 59 ± 7 Gy), mean FS was 37 ± 8 cm, maximum dose was 64 ± 7 Gy, and V40 was 76 ± 17%, compared with 37 ± 11 Gy, 32 ± 9 cm, 59 ± 8 Gy, and 64 ± 22% for nonfracture patients. Differences in mean, maximum dose, and V40 were statistically significant (p = 0.01, p = 0.02, p = 0.01). Leg fractures were more common above the knee joint. Conclusions: The risk of radiation-induced fracture appears to be reduced if V40 <64%. Fracture incidence was lower when the mean dose to bone was <37 Gy or maximum dose anywhere along the length of bone was <59 Gy. There was a trend toward lower mean FS for nonfracture patients.

  18. Bottom line in the treatment of bone tumors%浅谈骨肿瘤诊治中的底线

    Institute of Scientific and Technical Information of China (English)

    韦兴

    2014-01-01

    Medicine is the science of human diseases and health. The principles of all the treatment methods and techniques should be in consistent with what has been recognized in the treatment of bone and soft tumors. Clinical Practice Guidelines for Bone Cancer ( NCCN Guidelines ) printed by National Comprehensive Cancer Network is well known, in which the treatment of chondrosarcoma, chordoma, ewing’s sarcoma, giant cell tumor of bone and osteosarcoma were discussed in detail. Most important, principles of bone cancer management were emphasized in this guideline, including: ( 1 ) Biopsy diagnosis is necessary prior to any surgical procedures. ( 2 ) Wide excision should achieve histologically negative surgical margins. ( 3 ) Lab studies such as CBC, LDH, and ALP may have relevance in the diagnosis. ( 4 ) Care for bone cancer patients should be delivered directly by physicians of a multidisciplinary team. ( 5 ) Patients should have a survivorship prescription to schedule follow-up with a multidisciplinary team. Respect on the spirits of science is the bottom line of medicine, and we should regard the principle and guideline mentioned above as the bottom line in the treatment of bone and soft tumors.

  19. Giant myxoinflammatory fibroblastic sarcoma with bone invasion:a very rare clinical entity and literature review

    Institute of Scientific and Technical Information of China (English)

    Guray Togral; Murat Arikan; Elif Aktas; Safak Gungor

    2014-01-01

    Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have rarely been reported. We report a case involving the distal left femur of a middle-aged man and tumoral invasion of the bone, which, to our knowledge, has been previously described only once. He was treated with distal femoral tumor resection and reconstruction with a modular prosthesis. Histopathologic diagnosis confirmed MIFS. We reviewed literature of the diagnostic imaging and bone invasion findings associated with this tumor type.

  20. Diagnostic accuracy of computed tomography and magnetic resonance imaging obtained after neoadjuvant chemoradiotherapy in predicting the local tumor stage and circumferential resection margin status of rectal cancer

    International Nuclear Information System (INIS)

    To measure the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) obtained after neoadjuvant chemoradiotherapy (CRT) in patients with rectal cancer for a prediction of the local tumor stage and circumferential resection margin (CRM). Two independent radiologists reviewed CT and MRI obtained after neoadjuvant CRT. The accuracy of the local tumor staging and the diagnostic performance for the prediction of CRM involvement were calculated. The agreement between the measurements of the distance to potential CRM on both imaging modalities and the histopathology findings was assessed using Bland-Altman plots. 57 patients (mean age, 59.2 years; 24 females) were included. The accuracy of T and N staging were 43.9% (95% confidence interval, 30.8-57.7%) and 77.2% (64.2-87.3%) on CT and 63.2% (49.4-75.6%) and 77.2% (64.2-87.3%) on MRI for Observer 1. The accuracy of T and N staging were 54.4% (40.7-67.7%) and 77.2% (64.2-87.3%) on CT and 68.4% (54.7-80.1%) and 80.7% (68.1-90.0%) on MRI for Observer 2. Sensitivity and specificity on CRM involvement were 83.3% (43.7-97.0%) and 88.2% (76.6-94.5%) on CT and 100% (61.0-100%) and 90.2% (79.0-95.7%) on MRI for Observer 1. Sensitivity and specificity on CRM involvement were 66.7% (30.0-90.3%) and 88.2% (76.7-94.5%) on CT and 100% (61.0-100%) and 90.2% (79.0-95.7%) on MRI for Observer 2. Bland-Altman plots showed wide discrepancies between measurements of the distance to CRM on each CT and MRI and those on histopathology findings. CT and MRI showed limited performance in predicting the local tumor staging and CRM involvement in patients with neoadjuvant CRT although MRI tended to show a better performance than CT

  1. Radiation therapy for bone metastasis from hepatocellular carcinoma. Evaluation of pain relief and tumor regression

    Energy Technology Data Exchange (ETDEWEB)

    Wakisaka, Masaki; Mori, Hiromu; Matsumoto, Akira; Ochotorena, I. J.; Funakoshi, Takeshi [Oita Medical Univ. (Japan)

    1999-01-01

    The purpose of this retrospective study is to analyze the effectiveness of radiation therapy (RT) for the patients with bone metastasis from HCC with regard to tumor regression and pain relief. Twenty-five patients (42-78 years old) with 32 bone metastases (7 ribs, 13 vertebras, 6 iliums, 3 humeruses, 2 femurs and 1 scapula) from HCC received RT (10-60 Gy, mean 35.9 Gy). RT was performed using 5-10 MV x-rays or 12-18 MeV electron beams from a linear accelerator. Additional transcatheter arterial injection of anti-cancer drugs (TAI) and/or arterial embolization (TAE) were carried out for five lesions. Pain relief was obtained in 22 patients with 26 lesions (81%). Pain relief appeared at a dose of 12-30 Gy with a mean of 18.5 Gy. In 9 patients (82%) with 12 lesions out of 11 patients with 15 lesions who could be evaluated for duration of pain relief, recurrence of pain was not noted up to the last follow-up day or to the death of the patients (1-36 months). In 13 lesions, tumor regression was evaluated by CT and/or MRI; Complete regression (CR) was noted in 1 lesion, partial regression (PR) in 6 lesions, no change (NC) in 2 lesions, and progressive disease (PD) in 4 lesions. The tumor regression (CR+PR) rate was 53.8%. In 8 lesions treated with RT alone, there was PR in 2 lesions, NC in 2 lesions, PD in 4 lesions, and CR was not seen. In 5 lesions treated with a combination of RT and TAI and/or TAE, CR was noted in 1 lesion, PR in 4 lesions and no NC or PD. There was a correlation between the initial tumor volume and the degree of pain before RT, but there was no correlation between tumor regression and pain relief after RT. The one-year survival rate was 17%, and the two-year rate was 8%. (K.H.)

  2. Strain Assessment in Surgically Resected Inflammatory and Neoplastic Bowel Lesions

    DEFF Research Database (Denmark)

    Havre, R F; Leh, S; Gilja, O H;

    2014-01-01

    Purpose: To investigate whether ultrasound-based strain imaging can discriminate between colorectal adenocarcinomas and stenotic Crohn's lesions in newly resected surgical specimens.Materials and Methods: Resected surgical specimens from 27 patients electively operated for colorectal tumors or st...

  3. An algorithm for automatic surface labeling of planar surgical resections

    International Nuclear Information System (INIS)

    Three dimensional (3D) preoperative planning and navigation in bone tumor resections have been used in the last five years with good results. The purpose of this study is to develop a method capable of detecting and labeling the nearly planar surface generated by the cutting saw in the surgical specimen taken off the patient during the resection procedure. This surface area labeling is fundamental to track the path that the cutting saw took during the surgery and compare it to the planned cutting plane. The algorithm presented here works by using a 3D reconstruction of the surgical specimen computed tomography (CT) scan, registered against the 3D reconstruction of the preoperative patient CT scan, and the cutting plane defined during surgical planning. The results show a high labeling accuracy (a matching mean of 98.5%) and a non significant accuracy variation for a range of distance and angle offsets.

  4. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

    International Nuclear Information System (INIS)

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones

  5. Percutaneous CT-Guided Cryoablation as an Alternative Treatment for an Extensive Pelvic Bone Giant Cell Tumor

    Energy Technology Data Exchange (ETDEWEB)

    Panizza, Pedro Sergio Brito; Albuquerque Cavalcanti, Conrado Furtado de [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil); Yamaguchi, Nise Hitomi [Instituto Avanços em Medicina (Brazil); Leite, Claudia Costa; Cerri, Giovanni Guido; Menezes, Marcos Roberto de, E-mail: marcos.menezes@hc.fm.usp.br [Sírio Libânes Hospital, Radiology and Imaged Guided Intervention Service (Brazil)

    2016-02-15

    A giant cell tumor (GCT) is an intermediate grade, locally aggressive neoplasia. Despite advances in surgical and clinical treatments, cases located on the spine and pelvic bones remain a significant challenge. Failure of clinical treatment with denosumab and patient refusal of surgical procedures (hemipelvectomy) led to the use of cryoablation. We report the use of percutaneous CT-guided cryoablation as an alternative treatment, shown to be a minimally invasive, safe, and effective option for a GCT with extensive involvement of the pelvic bones and allowed structural and functional preservation of the involved bones.

  6. Osteoma of the pharynx that developed from the hyoid bone.

    Science.gov (United States)

    Hagiwara, Akira; Nagai, Noriko; Ogawa, Yasuo; Suzuki, Mamoru

    2014-01-01

    This paper reports on apparently the first case of a pharyngeal osteoma that developed from the hyoid bone. An 84-year-old man's, presenting symptom was a slight throat pain. Endoscopic examination revealed a huge mass occluding the pharyngeal space. CT scan of the neck showed a large osseous mass adjacent to the hyoid bone. Transoral resection with tracheostomy was performed. Histopathologically, the tumor consisted of mature lamellar bone without a fibrous component. For two years postoperatively, the patient has been free from throat symptoms and signs of recurrence. Osteomas are benign, slow-growing tumors. They rarely develop symptoms or cause functional disturbance. We performed total resection to avoid further functional disturbance as the osteoma was huge. To the best of our knowledge, this is the first report on an osteoma that occupied the pharyngeal space and developed from the hyoid bone. PMID:25580338

  7. Osteoma of the Pharynx That Developed from the Hyoid Bone

    Directory of Open Access Journals (Sweden)

    Akira Hagiwara

    2014-01-01

    Full Text Available This paper reports on apparently the first case of a pharyngeal osteoma that developed from the hyoid bone. An 84-year-old man’s, presenting symptom was a slight throat pain. Endoscopic examination revealed a huge mass occluding the pharyngeal space. CT scan of the neck showed a large osseous mass adjacent to the hyoid bone. Transoral resection with tracheostomy was performed. Histopathologically, the tumor consisted of mature lamellar bone without a fibrous component. For two years postoperatively, the patient has been free from throat symptoms and signs of recurrence. Osteomas are benign, slow-growing tumors. They rarely develop symptoms or cause functional disturbance. We performed total resection to avoid further functional disturbance as the osteoma was huge. To the best of our knowledge, this is the first report on an osteoma that occupied the pharyngeal space and developed from the hyoid bone.

  8. DNA gel electrophoretic and micro-autoradiographic studies on apoptosis in bone tumor cells after exposure to 153Sm-EDTMP

    International Nuclear Information System (INIS)

    Objective: To study the characteristics of injury in apoptotic bone tumor cells and behavior of radionuclide 153Sm in tumor cells. Methods: DNA gel electrophoresis and micro-autoradiographic tracing of apoptotic bone tumor cells at different intervals after 153Sm-EDTMP internal irradiation. Results: Bone tumor cells internally irradiated with 153Sm-EDTMP displayed characteristics of DNA ladder formation in apoptotic cells. 153Sm could permeate through tumor cell membrane and be phagocytized by the tumor cells, showing membrane-seeking and membrane-bounded apoptotic bodies condensation. Conclusion: Progression of apoptosis in bone tumor cells induced by 153Sm-EDTMP is dependent on the time elapse of 153Sm internal irradiation

  9. When should we biopsy a solitary central cartilaginous tumor of long bones? Literature review and management proposal

    Energy Technology Data Exchange (ETDEWEB)

    Parlier-Cuau, Caroline, E-mail: Caroline.parlier@lrb.aphp.fr [Department of Radiologie Osteo-Articulaire, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris (AP-HP), Faculte de Medecine Denis Diderot, Universite Paris 7, Paris (France); Bousson, Valerie [Department of Radiologie Osteo-Articulaire, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris (AP-HP), Faculte de Medecine Denis Diderot, Universite Paris 7, Paris (France); Ogilvie, Christian M.; Lackman, Richard D. [Department of Orthopedic Surgery, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107 (United States); Laredo, Jean-Denis [Department of Radiologie Osteo-Articulaire, Hopital Lariboisiere, Assistance Publique-Hopitaux de Paris (AP-HP), Faculte de Medecine Denis Diderot, Universite Paris 7, Paris (France); Department of Musculoskeletal Radiology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States)

    2011-01-15

    Differentiation between benign and low-grade malignant cartilaginous tumors is a radiological and pathological challenge. Based on a literature review, we propose the following guidelines for the management of a solitary central cartilaginous tumor of long bones distinguishing three situations: 1.The tumor is considered to be aggressive and requires surgery if one of the following criteria is present: cortical destruction, Moth-eaten or permeative osteolysis, spontaneous pathologic fracture, periosteal reaction, edema surrounding the tumor on MR images, and soft tissue mass. Tumor biopsy followed by complete intralesional treatment is indicated. 2.The tumor is classified as active if two of the following active criteria are present: pain related to the tumor, endosteal scalloping superior to two-thirds of the cortical thickness, extent of endosteal scalloping superior to two-thirds of the lesion length, cortical thickening and enlargement of the medullary cavity. Tumor biopsy or excision is indicated. 3.The tumor is classified as possibly active if one of the previous active criteria is present. In such cases, bone scintigraphy and dynamic-enhanced MR imaging should be obtained. Radionuclide uptake superior to the anterior iliac crest at bone scintigraphy and early and exponential enhancement at dynamic-enhanced MR are considered as two additional active criteria. After these two examinations, if only one criterion is still present, the lesion can be regarded as possibly quiescent, and the following monitoring is suggested: first follow-up at three to six months and then once a year. Otherwise, if two or more active criteria are present, biopsy is recommended. 4.The tumor is considered quiescent and does not require surgery if no active or aggressive criterion is present. A radiological follow-up can be proposed.

  10. When should we biopsy a solitary central cartilaginous tumor of long bones? Literature review and management proposal

    International Nuclear Information System (INIS)

    Differentiation between benign and low-grade malignant cartilaginous tumors is a radiological and pathological challenge. Based on a literature review, we propose the following guidelines for the management of a solitary central cartilaginous tumor of long bones distinguishing three situations: 1.The tumor is considered to be aggressive and requires surgery if one of the following criteria is present: cortical destruction, Moth-eaten or permeative osteolysis, spontaneous pathologic fracture, periosteal reaction, edema surrounding the tumor on MR images, and soft tissue mass. Tumor biopsy followed by complete intralesional treatment is indicated. 2.The tumor is classified as active if two of the following active criteria are present: pain related to the tumor, endosteal scalloping superior to two-thirds of the cortical thickness, extent of endosteal scalloping superior to two-thirds of the lesion length, cortical thickening and enlargement of the medullary cavity. Tumor biopsy or excision is indicated. 3.The tumor is classified as possibly active if one of the previous active criteria is present. In such cases, bone scintigraphy and dynamic-enhanced MR imaging should be obtained. Radionuclide uptake superior to the anterior iliac crest at bone scintigraphy and early and exponential enhancement at dynamic-enhanced MR are considered as two additional active criteria. After these two examinations, if only one criterion is still present, the lesion can be regarded as possibly quiescent, and the following monitoring is suggested: first follow-up at three to six months and then once a year. Otherwise, if two or more active criteria are present, biopsy is recommended. 4.The tumor is considered quiescent and does not require surgery if no active or aggressive criterion is present. A radiological follow-up can be proposed.

  11. The imaging characteristics of primary bone tumors less than 3 cm in diameter (an analysis of 57 cases)

    International Nuclear Information System (INIS)

    Objective: To analyze the imaging findings of primary bone tumors less than 3 cm in diameter, and to evaluate their imaging characteristics. Methods: Out of 400 cases of primary bone tumors, 57 cases less than 3 cm in diameter (0.6-3.0 cm, mean 1.6 cm) were retrospectively analyzed. There were 33 males and 24 females, and their age ranged from 3.5 to 80.0 years (mean 25.0 years). 31 of the 57 cases were younger than 14 years. 55 cases were benign tumors and 2 were malignant. Radiography was performed in all 57 cases, CT in 16 cases, and MR in 7. Results: X-ray and CT of osteoma showed clearly demarcated and homogeneous bony density (n=9) and inhomogeneous bony density with spot-like higher density within the lesion (n=1). Inhomogeneous iso- or hyperintensity on T1WI and hypo- or isointensity on T2WI without contrast enhancement were demonstrated. X-ray and CT of osteoid osteoma (n=6) revealed oval nidus and hyperdense spots within the nidus (n=5). X-ray and CT of osteoblastoma (n=1) showed a round lesion with clear and sclerosing border, and hyperdense spots were found within the lesion. Chondroma (n=17) included enchondroma (n=15) and ecchondroma (n=2). Sclerosing border at the medullary aspect (n=15) and cortical side (n=10) was demonstrated in enchondroma, but absent at cortical side in 5 cases. The cortex was discontinued and sclerosing border was absent on X-ray film for ecchondroma (n=2). Osteochondroma (n=7) originated from tubular bone (n=6) and flat bone (n=1). The growth direction of the tumor opposed the adjacent joints in tubular bone and protruded into the spinal canal as a lobulated mass in tabular bone (left lamina of vertebra at L3). Chondroblastoma (n=2) located at the proximal epiphysis of the tibia, presenting as a clear and sclerosing bordered oval and expanding lesion with bony destruction. Isointensity on T1WI and heterogeneous iso- or high signal on T2WI was revealed on MR imaging. X-ray, CT, and/or MR findings of ossifying fibroma (n=1), non

  12. Tumor infiltration of bone marrow in patients with hematological malignancies: dynamic contrast-enhanced magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lei; Catherine Mandel; YANG Zhen-yan; YANG Qing; Richard Nibbs; David Westerman; Alex Pitman

    2006-01-01

    Background Conventional magnetic resonance (MR) scanning techniques can identify bone marrow (BM)containing mostly fat cells. But they are not able to differentiate BM tumor infiltration, BM fibrosis and normalred BM. This is particularly problematic in assessment of recurrent or refractory hematological malignancy. Thispilot study used dynamic contrast-enhanced MR imaging (DCE-MRI) to evaluate the bone marrow status and todetermine whether several calculated parameters derived from the DCE-MRI correlate with histologicalcharacteristics of marrow, especially with the tumor fraction (TF).Methods DCE-MRI scans were performed in 25 patients with proven or known hematological malignancy whowere about to undergo bone marrow biopsy of the posterior iliac crest. The location chosen for biopsy wasexamined with MRI approximately one hour prior to the biopsy. Time-signal intensity curves (TIC) weregenerated from the region of the iliac crest corresponding to the planned biopsy site. Enhancement parameterswere calculated, including peak enhancement ratio (PER), maximum enhancement slope (Slopemax), time to peak(TTP) and mean time (MT). The biopsy specimen was reported synoptically, with relevant reported parametersincluding cellularity and tumor fraction (TF).Results PER values were significantly higher for the bone marrow tumor infiltration group than for the normalbone marrow group (P<0.05). A significant positive correlation was found between PER and TF as well asSlopemax and TF. A negative correlation was found between TTP and TF. There was no significant difference inthe mean TTP and MT values between the BM tumor infiltration group and the normal bone marrow group.Conclusions The presence of diffuse bone marrow infiltration in patients with haematological malignanciescould be verified using DCE-MRI.

  13. 18F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    International Nuclear Information System (INIS)

    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUVmax and greater SUVmax reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  14. {sup 18}F-FDG PET/CT compared to conventional imaging modalities in pediatric primary bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    London, Kevin [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Paediatrics and Child Health, Sydney Medical School, Sydney, NSW (Australia); Stege, Claudia; Kaspers, Gertjan [VU Medical Centre, Divisions of Paediatric Oncology/Haematology, Amsterdam (Netherlands); Cross, Siobhan; Dalla-Pozza, Luciano [The Children' s Hospital at Westmead, Department of Oncology, Sydney (Australia); Onikul, Ella [The Children' s Hospital at Westmead, Department of Medical Imaging, Sydney (Australia); Graf, Nicole [The Children' s Hospital at Westmead, Department of Pathology, Sydney (Australia); Howman-Giles, Robert [The Children' s Hospital at Westmead, Department of Nuclear Medicine, Sydney, NSW (Australia); University of Sydney, Discipline of Imaging, Sydney Medical School, Sydney, NSW (Australia)

    2012-04-15

    F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is useful in adults with primary bone tumors. Limited published data exist in children. To compare hybrid FDG positron emission tomography/computed tomography (PET/CT) with conventional imaging (CI) modalities in detecting malignant lesions, predicting response to chemotherapy and diagnosing physeal involvement in pediatric primary bone tumors. Retrospective analysis of PET/CT and CI reports with histopathology or follow-up > 6 months as reference standard. Response parameters and physeal involvement at diagnosis were compared to histopathology. A total of 314 lesions were detected in 86 scans. Excluding lung lesions, PET/CT had higher sensitivity and specificity than CI (83%, 98% and 78%, 97%, respectively). In lung lesions, PET/CT had higher specificity than CI (96% compared to 87%) but lower sensitivity (80% compared to 93%). Higher initial SUV{sub max} and greater SUV{sub max} reduction on PET/CT after chemotherapy predicted a good response. Change in tumor size on MRI did not predict response. Both PET/CT and MRI were very sensitive but of low specificity in predicting physeal tumor involvement. PET/CT appears more accurate than CI in detecting malignant lesions in childhood primary bone tumors, excluding lung lesions. It seems better than MRI at predicting tumor response to chemotherapy. (orig.)

  15. Diaphyseal chondroblastoma in a long bone: first report

    Energy Technology Data Exchange (ETDEWEB)

    Azorin, D.; Gonzalez-Mediero, I.; Colmenero, I.; Prada, I. de [Hospital Infantil Universitario Nino Jesus, Service of Anatomic Pathology, Madrid (Spain); Lopez-Barea, F. [Hospital Universitario La Paz, Department of Anatomic Pathology, Madrid (Spain)

    2006-01-01

    Chondroblastoma is a rare benign bone tumor typically located in the epiphysis. We describe the first case of chondroblastoma arising in the diaphysis of a long bone. The patient was a 13-year-old girl who presented with pain over her right thigh. Radiographs showed a lytic lesion in the diaphysis of her right femur. A core biopsy and a subsequent surgical resection were performed. (orig.)

  16. The effect of an osteolytic tumor on the three-dimensional trabecular bone morphology in an animal model

    International Nuclear Information System (INIS)

    Objective. To investigate the application of micro-computed tomography (μCT) for the assessment of density differences and deterioration of three-dimensional architecture of trabecular bone in an experimental rat model for tumor- induced osteolytic defects.Design and materials. Walker carcinosarcoma 256 malignant breast cancer cells (W256) were surgically implanted into the medullary canal of the left femur of 15 4-month-old rats. Twenty-eight days after surgery all animals were killed and both femora from each rat were harvested. A total of 30 specimens (left and right femur) were scanned in a desk-top μCT imaging system (μCT 20, Scanco Medical) to assess densitometric and architectural parameters. For each specimen a total of 200 micro-tomographic slices with a resolution of 30 μm in the distal metaphysis was taken. Bone mineral content (BMC) was analyzed for both cortical and trabecular bone (ctBMC), and for trabecular bone only (tBMC). Architectural indices (BV/TV, Tb.N, Tb.Th, Tb.Sp) according to standard definitions used in histomorphometry were calculated for trabecular bone.Results. The quantitative analysis of density parameters revealed significantly (P<0.001) lower values for ctBMC and tBMC in the tumor-bearing group (T) of 26% and 31%, respectively, compared with the contralateral control group. The quantitative analysis revealed significant (P<0.001) changes in the architectural parameters in the tumor-bearing bones compared with the contralateral control group: BV/TV was 30% lower, Tb.N and BS/TV decreased by 24% and 21%, respectively, Tb.Th. decreased by 10% and Tb.Sp. increased by 94%.Conclusions. This study demonstrates that μCT is able to provide three-dimensional parameters of bone mass and trabecular structure in an animal model for tumor-induced bone loss. Recent advances in therapeutic approaches for skeletal diseases such as osteoporosis and metastatic bone disease rely on an understanding of the effects of the agents on the mechanical

  17. The effect of an osteolytic tumor on the three-dimensional trabecular bone morphology in an animal model

    Energy Technology Data Exchange (ETDEWEB)

    Kurth, A.A. [Orthopedic Biomechanics Lab. (OBL), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (United States); Dept. of Orthopaedic Surgery, University Hospital Frankfurt (Germany); Mueller, R. [Orthopedic Biomechanics Lab. (OBL), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (United States)

    2001-02-01

    Objective. To investigate the application of micro-computed tomography ({mu}CT) for the assessment of density differences and deterioration of three-dimensional architecture of trabecular bone in an experimental rat model for tumor- induced osteolytic defects.Design and materials. Walker carcinosarcoma 256 malignant breast cancer cells (W256) were surgically implanted into the medullary canal of the left femur of 15 4-month-old rats. Twenty-eight days after surgery all animals were killed and both femora from each rat were harvested. A total of 30 specimens (left and right femur) were scanned in a desk-top {mu}CT imaging system ({mu}CT 20, Scanco Medical) to assess densitometric and architectural parameters. For each specimen a total of 200 micro-tomographic slices with a resolution of 30 {mu}m in the distal metaphysis was taken. Bone mineral content (BMC) was analyzed for both cortical and trabecular bone (ctBMC), and for trabecular bone only (tBMC). Architectural indices (BV/TV, Tb.N, Tb.Th, Tb.Sp) according to standard definitions used in histomorphometry were calculated for trabecular bone.Results. The quantitative analysis of density parameters revealed significantly (P<0.001) lower values for ctBMC and tBMC in the tumor-bearing group (T) of 26% and 31%, respectively, compared with the contralateral control group. The quantitative analysis revealed significant (P<0.001) changes in the architectural parameters in the tumor-bearing bones compared with the contralateral control group: BV/TV was 30% lower, Tb.N and BS/TV decreased by 24% and 21%, respectively, Tb.Th. decreased by 10% and Tb.Sp. increased by 94%.Conclusions. This study demonstrates that {mu}CT is able to provide three-dimensional parameters of bone mass and trabecular structure in an animal model for tumor-induced bone loss. Recent advances in therapeutic approaches for skeletal diseases such as osteoporosis and metastatic bone disease rely on an understanding of the effects of the agents on the

  18. Hepatic Resection Using a Water Jet Dissector

    OpenAIRE

    H. U. Baer; Stain, S. C.; Guastella, T.; G. J. Maddern; Blumgart, L. H.

    1993-01-01

    The mortality and morbidity in major hepatic resection is often related to hemorrhage. A high pressure, high velocity water jet has been developed and has been utilized to assist in hepatic parenchymal transection. Sixty-seven major hepatic resections were performed for solid hepatic tumors. The tissue fracture technique was used in 51 patients (76%), and the water jet dissector was used predominantly in 16 patients (24%). The extent of hepatic resection using each technique was similar. The ...

  19. Pitfalls in the MR diagnosis of primary malignant bone tumors; Pitfalls in der MR-Diagnostik primaer maligner Knochentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Bader, T.R. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Abt. fuer Osteologie; Imhof, H.; Breitenseher, M.J. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria). Abt. fuer Osteologie]|[Wien Univ. (Austria). Einrichtung UOG Magnetic Resonanz; Dominkus, M. [Universitaetsklinik fuer Orthopaedie, Wien (Austria)

    1998-06-01

    MRI has gained an undisputed place in the evaluation of malignant bone tumors, not only for verifying results of conventional radiography and clarifying differential diagnoses; it has also become increasingly important for the assessment of the malignant/benign nature of the tumor, its growth rate, definition of adequate sites for biopsy, local preoperative staging, and evaluation of the response to chemotherapy. However, several pitfalls have to be observed regarding choice of technical parameters (coils, sequences, imaging planes), tissue differentiation, and tumor staging. When staging malignant tumors, critical aspects which have to be observed are tumor extension, integrity of the cortical bone, soft tissue components, infiltration of a joint or neurovascular bundle. The use of contrast agents provides important additional information but can also give rise to misinterpretations. Thus, all features of a tumor have to be observed in order to establish a final diagnosis. Particular difficulties can occur with the interpretation of MR images of osteomyelitis, osteoid osteoma, stress and insufficiency fractures, bone infarcts, myositis ossificans, hemangiomas, and aneurysmal bone cysts. (orig.) [Deutsch] Bei der Diagnostik von malignen Knochentumoren hat die MRT einen fixen Platz nicht nur in der Verifikation der Nativdiagnostik und der Differentialdiagnostik, sondern zunehmende Bedeutung bei der primaeren Beurteilung von Dignitaet und Wachstumsgeschwindigkeit, Definition einer geeigneten Biopsiestelle, beim lokoregionaeren, praeoperativen Staging und der Evaluation des Ansprechens auf Chemotherapie. Zahlreiche Pitfalls finden sich jedoch bei der Wahl der technischen Parameter (Spulen, Sequenzen, Schichtebenen), der Tumordifferenzierung und beim Staging von malignen Tumoren. Beim Staging sind die kritischen Punkte die Beurteilung von Tumorausdehnung, Integritaet der Kortikalis, Vorhandensein einer Weichteilkomponente, Infiltration eines Gelenks oder des

  20. Bone marrow-derived myofibroblasts are the providers of pro-invasive matrix metalloproteinase 13 in primary tumor

    DEFF Research Database (Denmark)

    Lecomte, Julie; Masset, Anne; Blacher, Silvia;

    2012-01-01

    Carcinoma-associated fibroblasts are key contributors of the tumor microenvironment that regulates carcinoma progression. They consist of a heterogeneous cell population with diverse origins, phenotypes, and functions. In the present report, we have explored the contribution of bone marrow (BM...

  1. Bone Anchored Hearing Treatment Procedure

    Medline Plus

    Full Text Available ... One patient writes in that they have a history of a previous tumor resection, brain tumor resection, ... patient comes in is I take the case history and find out whether or not it sounds ...

  2.  An Uncommon Presentation of Giant Cell Tumor

    Directory of Open Access Journals (Sweden)

    Gopal Malhotra

    2011-09-01

    Full Text Available  Giant Cell Tumors commonly occur at the ends of long bones. However in rare cases, they can occur in the bones of the hands and feet. Tumors in these locations occur in younger patients; in addition, these tumors are more commonly multifocal and are associated with a higher risk for local recurrence than tumors at the ends of long bones. Since lesions in the small bones may be multifocal, a patient with a giant cell tumor of the small bones should undergo a skeletal survey to exclude similar lesions elsewhere. Primary surgical treatment ranges from curettage or excision with or without bone grafting to amputation. The success of surgical treatment depends on the completeness with which the tumor was removed. We are presenting a case report of a 34 year old female, who presented with a swelling in the right hand, following trauma. X-ray of the hand showed an osteolytic expansile lesion at the base of the 1st metacarpal bone. The lesion was initially curetted and then treated by local resection with bone grafting. Histological examination revealed a typical benign giant cell tumor composed of closely packed stromal cells with a variable admixture of giant cells. Follow up at the end of one year did not reveal any recurrence of the tumor.

  3. Perioperative nursing for laparoscopic liver resection

    Institute of Scientific and Technical Information of China (English)

    CHEN Li-jia; WEN Guo-fen

    2005-01-01

    Sir Run Run Shaw Hospital (SRRSH) has developed a form of laparoscopic hepatectomy, resecting by curettage and suction. Such resection has been carried out successfully in 6 patients who had liver tumors. The results are satisfactory. And after the operation, there is a very effective perioperative nursing ensuring the patient's recovery.

  4. Resection of a large ectopic parathyroid adenoma: A case report

    Science.gov (United States)

    Sato, Seijiro; Kitahara, Akihiko; Koike, Terumoto; Hashimoto, Takehisa; Ohashi, Riuko; Motoi, Noriko; Tsuchida, Masanori

    2016-01-01

    Introduction Parathyroid adenomas are the most common cause of primary hyperparathyroidism. However, cases of parathyroid adenomas greater than 4 cm with osteitis fibrosa cystica are extremely rare. Herein, we report a case of resection of a large ectopic mediastinal parathyroid adenoma. Case presentations A 46-year-old female with chief complaints of bone pain and gait disturbance was referred to our hospital. Physical examination revealed many mobile teeth in her oral cavity, distortion of the vertebral body, and bowlegs. Laboratory tests showed hypercalcemia, hypophosphatemia, and elevated serum levels of intact parathyroid hormone. Chest CT revealed a 42-mm well–defined, enhancing mass in front of the left-sided tracheal bifurcation. Her findings were diagnosed as primary hyperparathyroidism due to an ectopic mediastinal parathyroid tumor. We performed a median sternotomy and resected the tumor. The tumor was a solid, yellowish-brown mass measuring 42 × 42 mm. Pathologically, the tumor consisted mainly of chief cells with some oxyphil cells; there were no necrotic areas or nuclear atypia, and few mitotic figures. We diagnosed the tumor as an ectopic mediastinal parathyroid adenoma. Eight months after the resection, her serum calcium, phosphorus, and intact PTH levels were normal. Discussion and conclusions Parathyroid adenomas and parathyroid carcinomas have disparate natural histories, but they can be difficult to differentiate on the basis of preoperative clinical characteristics. We believe that long-term follow-up of these cases is required because there have been few reports on the postoperative natural history of large parathyroid adenomas. PMID:27078868

  5. Outcome of surgical resection for brain metastases and radical treatment of the primary tumor in Chinese non–small-cell lung cancer patients

    OpenAIRE

    Li, Zhenye; Zhang, Xiangheng; Jiang, Xiaobing; Guo, Chengcheng; Sai, Ke; Yang, Qunying; He, Zhenqiang; Wang, Yang; Chen, Zhongping; Li, Wei; Mou, Yonggao

    2015-01-01

    Purpose Brain metastasis is the most common complication of brain cancer; nevertheless, primary lung cancer accounts for approximately 20%–40% of brain metastases cases. Surgical resection is the preferred treatment for brain metastases. However, no studies have reported the outcome of surgical resection of brain metastases from non–small-cell lung cancer (NSCLC) in the People’s Republic of China. Moreover, the optimal treatment for primary NSCLC in patients with synchronous brain metastases ...

  6. Temporal bone chondroblastoma totally invisible on MRI.

    Science.gov (United States)

    Hiraumi, Harukazu; Arakawa, Yoshiki; Yamamoto, Norio; Sakamoto, Tatsunori; Ito, Juichi

    2016-08-01

    We report a case of temporal bone chondroblastoma that was totally invisible on MRI. The patient was a 64-year-old man who presented with several months history of vertigo. The CT scan with bone window setting showed destruction of the temporomandibular joint, the floor of the middle cranial fossa, and the superior semicircular canal. Calcific foci were seen within the tumor. On MR imaging, the tumor, situating mainly medial to the temporomandibular joint, showed no signal on both T1- and T2-weighted images. The tumor was not enhanced with gadolinium. In summary, the tumor was totally signal negative or "invisible" on pre- and postcontrast T1- and T2-weighted images. The tumor was resected through transpetrosal - transzygomatic approach. PMID:26743837

  7. Building of the animal model of bone bridge resection in rabbits after making the center epiphyseal plate defects%兔中心型骺板缺损后骨桥切除的动物模型建立

    Institute of Scientific and Technical Information of China (English)

    余黎; 余国荣; 张克勇; 张桃根; 陶圣祥

    2012-01-01

    目的 建立兔的股骨远端中心型骺板缺损后骨桥切除的动物模型,并对骨桥切除后的效果进行评价.方法 选用日本大耳白兔10只,观察β-TCP与骨组织相容性及对骨桥生长影响.另取30只日本大耳白兔,分为A组(β -TCP标记+骨桥切除+脂肪填塞)、B组(β-TCP标记+骨桥切除)、C组(单纯缺损),每组10只,评价β -TCP标记,导针引导的方法切除骨桥的手术效果.结果 β-TCP置入后组织相容性良好,对骺板缺损后股骨畸形的程度没有影响(P>0.05);标记侧股骨长度(85.29 ±4.73) mm,外翻角度(12.35 ±2.53)°;未标记侧分别为(84.34 ±2.76) mm,(12.52±3.26)°.通过β-TCP标记,导针引导的方法可完整切除骨桥.运用脂肪筋膜瓣填塞骨桥切除后的缺损,可减轻股骨畸形的程度(P<0.01).A、B、C组的股骨短缩程度分别为(4.20±1.36)、(10.26±3.31)、(6.52±1.62) mm;外翻角的差异分别为(12.00±2.11)°、(23.47±4.06)°、(18.38±10.65)°.结论 通过β-TCP标记,导针引导的方法可建立兔股骨远端中心型骺板缺损后骨桥切除的标准动物模型.%Objective To build the animal model of bone bridge resection in rabbits after making the center epiphyseal plate defects of distal femur and to evaluate the effectiveness of bone bridge resection.Methods The histocompatibility of β3-TCP and its impact on the growth of bone bridge were observed in 10 Japanese white rabbits.The other 30 Japanese white rabbits were divided into three groups ( n =10 for each):Group A ( β-TCP marker,bone bridge resection and fat filling),Group B ( β-TCP marker and bone bridge resection) and Group C (simple defect).The effect of bone bridge resection by the marker of β-TCP and the guidance of guide pin was evaluated.Results β-TCP had good biocompatibility after implantation and did not affect the degree of femoral deformity (P > 0.05).The average length of marked side' s femur was ( 85.29 ± 4.73 ) mm and the average valgus

  8. Role of denosumab in the management of skeletal complications in patients with bone metastases from solid tumors

    Directory of Open Access Journals (Sweden)

    Stopeck AT

    2012-04-01

    Full Text Available Ursa Brown-Glaberman, Alison T StopeckUniversity of Arizona Cancer Center, Tucson, AZ, USAAbstract: Skeletal-related events (SREs including pain, fractures, and hypercalcemia are a major source of morbidity for cancer patients with bone metastases. The receptor activator of NF-κB ligand (RANKL is a key mediator of osteoclast formation and activity in normal bone physiology as well as cancer-induced bone resorption. The first commercially available drug that specifically targets and inhibits the RANKL pathway is denosumab, a fully human monoclonal antibody that binds and neutralizes RANKL, thereby inhibiting osteoclast function. In this review, we summarize the major studies leading to the US Food and Drug Administration-approval of denosumab for the prevention of SREs in patients with bone metastases from solid tumors. Further, we discuss the role of denosumab in the prevention and treatment of SREs and bone loss in cancer patients. As a monoclonal antibody, denosumab has several advantages over bisphosphonates, including improved efficacy, better tolerability, and the convenience of administration by subcutaneous injection. In addition, as denosumab has no known renal toxicity, it may be the preferred choice over bisphosphonates in patients with baseline renal insufficiency or receiving nephrotoxic therapies. However, other toxicities, including osteonecrosis of the jaw and hypocalcemia, appear to be class effects of agents that potently inhibit osteoclast activity and are associated with both denosumab and bisphosphonate use. The data presented highlight the differences associated with intravenous bisphosphonate and denosumab use as well as confirm the essential role bone-modifying agents play in maintaining the quality of life for patients with bone metastases.Keywords: denosumab, bone metastases, solid tumor, breast cancer, prostate cancer, skeletal related events, skeletal complications 

  9. Array-based comparative genomic hybridization for genomic-wide screening of DNA copy number alterations in aggressive bone tumors

    Directory of Open Access Journals (Sweden)

    Kanamori Masahiko

    2012-11-01

    Full Text Available Abstract Background The genetic pathways of aggressive changes of bone tumors are still poorly understood. It is very important to analyze DNA copy number alterations (DCNAs, to identify the molecular events in the step of progression to the aggressive change of bone tissue. Methods Genome-wide array-based comparative genomic hybridization (array CGH was used to investigate DCNAs of 14 samples from 13 aggressive bone tumors, such as giant cell tumors (GCTs and osteosarcoma (OS, etc. Results Primary aggressive bone tumors had copy number gains of 17.8±12.7% in the genome, and losses of 17.3±11.4% in 287 target clones (threshold for each DCNA: ≦085, 1.15≦. Genetic unstable cases, which were defined by the total DCNAs aberration ≧30%, were identified in 9 of 13 patients (3 of 7 GCTs and all malignant tumors. High-level amplification of TGFβ2, CCND3, WI-6509, SHGC-5557, TCL1A, CREBBP, HIC1, THRA, AFM217YD10, LAMA3, RUNX1 and D22S543, were commonly observed in aggressive bone tumors. On the other hand, NRAS, D2S447, RAF1, ROBO1, MYB, MOS, FGFR2, HRAS, D13S319, D13S327, D18S552, YES1 and DCC, were commonly low. We compared genetic instability between a primary OS and its metastatic site in Case #13. Metastatic lesion showed increased 9 DCNAs of remarkable change (m/p ratio ≧1.3 folds, compared to a primary lesion. D1S214, D1S1635, EXT1, AFM137XA11, 8 M16/SP6, CCND2, IGH, 282 M15/SP6, HIC1 and LAMA3, were overexpressed. We gave attention to HIC1 (17p13.3, which was common high amplification in this series. Conclusion Our results may provide several entry points for the identification of candidate genes associated with aggressive change of bone tumors. Especially, the locus 17p11-13 including HIC1 close to p53 was common high amplification in this series and review of the literature.

  10. Chest wall resection and reconstruction using titanium micromesh covered with Marlex mesh for metastatic follicular thyroid carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Suganuma Nobuyasu

    2009-06-01

    Full Text Available Abstract Introduction The distant metastases from differentiated thyroid carcinomas are often untreatable. In particular, bone metastasis is significantly related to poor prognosis since radioactive iodine therapy is generally less effective. Therefore, surgical resection is considered one of the treatments for patients with bone metastases. We report chest wall resection and reconstruction using titanium micromesh covered with polypropylene mesh (Marlex mesh for metastatic rib bones as a result of follicular thyroid carcinoma. Case presentation A 51-year-old man was referred to our institution with a painful chest wall tumor. He presented with a 15 × 10 cm bony swelling on the left chest wall and multiple small lung nodules from follicular thyroid carcinoma. Completion total thyroidectomy, chest wall resection and reconstruction using titanium micromesh covered with Marlex mesh were performed. There were no critical complications associated with surgical treatments and tumor pain disappeared during the postoperative period. Then, he received radioactive iodine therapy and the uptake of radioactive iodine was well observed in bilateral lung fields. Conclusion Reconstruction using titanium micromesh covered with Marlex mesh is possible for repairing the wide chest wall resection required for thyroid carcinoma metastasis. This technique would help to enhance treatment efficacy in the combination therapy of radioactive iodine and surgery in patients with large thyroid carcinoma metastasis in the chest wall.

  11. Survival benefit in patients after palliative resection vs non-resection colon cancer surgery

    Institute of Scientific and Technical Information of China (English)

    A Beham; M Rentsch; K Püllmann; L Mantouvalou; H Spatz; HJ Schlitt; A Obed

    2006-01-01

    AIM: To evaluate survival in patients undergoing palliative resection versus non-resection surgery for primary colorectal cancer in a retrospective analysis.METHODS: Demographics, TNM status, operating details and survival were reviewed for 67 patients undergoing surgery for incurable colorectal cancer. Palliative resection of the primary tumor was performed in 46 cases in contrast to 21 patients with non-resection of the primary tumor and bypass surgery. Risk factors for postoperative mortality and poor survival were analyzed with univariate and multivariate analyses.RESULTS: The two groups were comparable in terms of age, gender, preoperative presence of ileus and tumor stage. Multivariate analysis showed that median survival was significantly higher in patients with palliative resection surgery (544 vs 233 d). Differentiation of the tumor and tumor size were additional independent factors that were associated with a significantly poorer survival rate.CONCLUSION: Palliative resection surgery for primary colorectal cancer is associated with a higher median survival rate. Also, the presence of liver metastasis and tumor size are associated with poor survival. Therefore,resection of the primary tumor should be considered in patients with non-curable colon cancer.

  12. DNA gel electrophoretic and micro-auto-radiographic studies on apoptosis in bone tumor cells after exposure with 153Sm-EDTMP

    International Nuclear Information System (INIS)

    The apoptosis in bone tumor cells is studied after 153Sm-EDTMP irradiation. Fragmented DNA is analyzed by agarose gel electrophoresis. Experimental observations show that 153-EDTMP exposure induces the inter-nucleo-somal DNA damage in bone tumor cells. The DNA ladder pattern formation in bone tumor cells is shown. At the same time, the micro-auto-radiographic study indicate that 153Se-EDTMP could permeate through cell membrane and displays membrane-seeking condensation in bone tumor cells. Soon afterwards 153Sm-EDTMP could be phagocytized by the tumor cells and distributed in cytoplasm as well as nucleus in the form of phagosome. With the prolongation of observing time, the membrane-bounded apoptotic bodies are observed

  13. Decreased autocrine EGFR signaling in metastatic breast cancer cells inhibits tumor growth in bone and mammary fat pad.

    Science.gov (United States)

    Nickerson, Nicole K; Mohammad, Khalid S; Gilmore, Jennifer L; Crismore, Erin; Bruzzaniti, Angela; Guise, Theresa A; Foley, John

    2012-01-01

    Breast cancer metastasis to bone triggers a vicious cycle of tumor growth linked to osteolysis. Breast cancer cells and osteoblasts express the epidermal growth factor receptor (EGFR) and produce ErbB family ligands, suggesting participation of these growth factors in autocrine and paracrine signaling within the bone microenvironment. EGFR ligand expression was profiled in the bone metastatic MDA-MB-231 cells (MDA-231), and agonist-induced signaling was examined in both breast cancer and osteoblast-like cells. Both paracrine and autocrine EGFR signaling were inhibited with a neutralizing amphiregulin antibody, PAR34, whereas shRNA to the EGFR was used to specifically block autocrine signaling in MDA-231 cells. The impact of these was evaluated with proliferation, migration and gene expression assays. Breast cancer metastasis to bone was modeled in female athymic nude mice with intratibial inoculation of MDA-231 cells, and cancer cell-bone marrow co-cultures. EGFR knockdown, but not PAR34 treatment, decreased osteoclasts formed in vitro (p<0.01), reduced osteolytic lesion tumor volume (p<0.01), increased survivorship in vivo (p<0.001), and resulted in decreased MDA-231 growth in the fat pad (p<0.01). Fat pad shEGFR-MDA-231 tumors produced in nude mice had increased necrotic areas and decreased CD31-positive vasculature. shEGFR-MDA-231 cells also produced decreased levels of the proangiogenic molecules macrophage colony stimulating factor-1 (MCSF-1) and matrix metalloproteinase 9 (MMP9), both of which were decreased by EGFR inhibitors in a panel of EGFR-positive breast cancer cells. Thus, inhibiting autocrine EGFR signaling in breast cancer cells may provide a means for reducing paracrine factor production that facilitates microenvironment support in the bone and mammary gland. PMID:22276166

  14. Decreased autocrine EGFR signaling in metastatic breast cancer cells inhibits tumor growth in bone and mammary fat pad.

    Directory of Open Access Journals (Sweden)

    Nicole K Nickerson

    Full Text Available Breast cancer metastasis to bone triggers a vicious cycle of tumor growth linked to osteolysis. Breast cancer cells and osteoblasts express the epidermal growth factor receptor (EGFR and produce ErbB family ligands, suggesting participation of these growth factors in autocrine and paracrine signaling within the bone microenvironment. EGFR ligand expression was profiled in the bone metastatic MDA-MB-231 cells (MDA-231, and agonist-induced signaling was examined in both breast cancer and osteoblast-like cells. Both paracrine and autocrine EGFR signaling were inhibited with a neutralizing amphiregulin antibody, PAR34, whereas shRNA to the EGFR was used to specifically block autocrine signaling in MDA-231 cells. The impact of these was evaluated with proliferation, migration and gene expression assays. Breast cancer metastasis to bone was modeled in female athymic nude mice with intratibial inoculation of MDA-231 cells, and cancer cell-bone marrow co-cultures. EGFR knockdown, but not PAR34 treatment, decreased osteoclasts formed in vitro (p<0.01, reduced osteolytic lesion tumor volume (p<0.01, increased survivorship in vivo (p<0.001, and resulted in decreased MDA-231 growth in the fat pad (p<0.01. Fat pad shEGFR-MDA-231 tumors produced in nude mice had increased necrotic areas and decreased CD31-positive vasculature. shEGFR-MDA-231 cells also produced decreased levels