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Sample records for bone tumor resections

  1. Results of the megaprosthesis replacement reconstruction proximal femoral resection bone tumors.

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    Mazurkiewicz, Tomasz; Warda, Edward; Kopacz, Jacek; Mazurkiewicz, Maria

    2005-12-30

    Background. Proximal femur defects resulting from tumor resections can be repaired with various types of hip endoprostheses. Major surgical procedures involving muscle detachments and extensive endoprosthesis implantation are prone to deep infections and the hip instability. The purpose of our study was to assess the outcome of hip prosthesoplasty after resection of large tumors from the proximal femur. Material and methods. Over the last 5 years, 49 patients have undergone hip prosthesoplasty after tumor resection in the proximal femur for 37 bone metastases and 12 primary neoplasms during the last 5 years. Three total megaprostheses were used, as well as 34 conventional long stem endoprostheses, including 26 bipolar and 12 Austin Moore prostheses. Results. Two patients died shortly after surgery, and another 4 were nonambulatory due to diffusion of the cancer. There were 3 cases of endoprosthesis luxation, 1 deep implant infection and 1 metastasis recurrence. We had 28% excellent functional outcomes and 60% good; the latter were complicated by Trendelenburg gait. Conclusions. Hip instability is the most common complication in prosthesoplasty after tumor resection in the proximal femur.

  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

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

  4. Reconstruction by bone transport after resection of benign tumors of tibia: A retrospective study of 38 patients

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    Borzunov, Dmitry Y; Balaev, Pavel I; Subramanyam, Koushik N

    2015-01-01

    Background: The commonly used reconstructive options after post resection defects in bone tumors like megaprosthesis, autograft, allograft, bone graft substitutes and recycled bone have their own demerits on a long term. Bone transport that regenerates patient's own bone is a less explored option of reconstruction after resection of benign bone tumors and reports on this are limited. This technique is very much relevant in tibia where Ilizarov fixator is surgeon and patient friendly. We report our experience. Materials and Methods: This is a retrospective series of resection and bone transport in 38 patients with benign tumor of tibia. There were 14 males and 24 females with mean age of 23.40 years (range 9–40 years). Lesion was located in proximal third tibia in 27, middle third in two and distal third in nine patients. The diagnosis was giant cell tumor in 32, chondroblastoma in three, chondromyxoid fibroma, enchondroma and desmoplasic fibroma in one patient each. The resection was intercalary in 28 and transarticular in 10 patients. Osteosynthesis was monofocal in three, bifocal in 31 and polyfocal in four cases. Results: Mean followup was 7.22 years (range 1.5–15 years). Mean resection length was 10.21 cm (range 3–22 cm). The mean duration of external fixator was 308.03 days (range 89–677 days) and mean external fixator index was 36.14 days/cm (range 16.84–97.43 days/cm). Twelve patients had difficulties in the form of 11 problems and five obstacles that were successfully managed. None of the patients had local recurrence of tumor or any long term complication. Mean Musculo-skeletal Tumour Society score at final followup was 27.18 (90.60%). Conclusions: Bone transport is an excellent option after resection of benign tumors of tibia with good local control and functional outcome, despite minor difficulties that need timely management. PMID:26538757

  5. Analysis of limb function after various reconstruction methods according to tumor location following resection of pediatric malignant bone tumors

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    Tokuhashi Yasuaki

    2010-05-01

    Full Text Available Abstract Background In the reconstruction of the affected limb in pediatric malignant bone tumors, since the loss of joint function affects limb-length discrepancy expected in the future, reconstruction methods that not only maximally preserve the joint function but also maintain good limb function are necessary. We analysis limb function of reconstruction methods by tumor location following resection of pediatric malignant bone tumors. Patients and methods We classified the tumors according to their location into 3 types by preoperative MRI, and evaluated reconstruction methods after wide resection, paying attention to whether the joint function could be preserved. The mean age of the patients was 10.6 years, Osteosarcoma was observed in 26 patients, Ewing's sarcoma in 3, and PNET(primitive neuroectodermal tumor and chondrosarcoma (grade 1 in 1 each. Results Type I were those located in the diaphysis, and reconstruction was performed using a vascularized fibular graft(vascularized fibular graft. Type 2 were those located in contact with the epiphyseal line or within 1 cm from this line, and VFG was performed in 1, and distraction osteogenesis in 1. Type III were those extending from the diaphysis to the epiphysis beyond the epiphyseal line, and a Growing Kotz was mainly used in 10 patients. The mean functional assessment score was the highest for Type I (96%: n = 4 according to the type and for VFG (99% according to the reconstruction method. Conclusion The final functional results were the most satisfactory for Types I and II according to tumor location. Biological reconstruction such as VFG and distraction osteogenesis without a prosthesis are so high score in the MSTS rating system. Therefore, considering the function of the affected limb, a limb reconstruction method allowing the maximal preservation of joint function should be selected after careful evaluation of the effects of chemotherapy and the location of the tumor.

  6. Metacarpal resection with a contoured iliac bone graft and silicone rubber implant for metacarpal giant cell tumor: a case report.

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    Carlow, S B; Khuri, S M

    1985-03-01

    A definitive surgical procedure for a giant cell tumor that combines metacarpal resection with an iliac bone graft and arthroplasty with a silicone rubber implant is proposed for the elderly patient. The results were encouraging in one patient who had a cosmetically and functionally acceptable hand and no evidence of recurrence.

  7. Computer-Assisted Planning and Patient-Specific Instruments for Bone Tumor Resection within the Pelvis: A Series of 11 Patients

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    François Gouin

    2014-01-01

    Full Text Available Pelvic bone tumor resection is challenging due to complex geometry, limited visibility, and restricted workspace. Accurate resection including a safe margin is required to decrease the risk of local recurrence. This clinical study reports 11 cases of pelvic bone tumor resected by using patient-specific instruments. Magnetic resonance imaging was used to delineate the tumor and computerized tomography to localize it in 3D. Resection planning consisted in desired cutting planes around the tumor including a safe margin. The instruments were designed to fit into unique position on the bony structure and to indicate the desired resection planes. Intraoperatively, instruments were positioned freehand by the surgeon and bone cutting was performed with an oscillating saw. Histopathological analysis of resected specimens showed tumor-free bone resection margins for all cases. Available postoperative computed tomography was registered to preoperative computed tomography to measure location accuracy (minimal distance between an achieved and desired cut planes and errors on safe margin (minimal distance between the achieved cut planes and the tumor boundary. The location accuracy averaged 2.5 mm. Errors in safe margin averaged −0.8 mm. Instruments described in this study may improve bone tumor surgery within the pelvis by providing good cutting accuracy and clinically acceptable margins.

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

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    Andersen, Mikkel R; Petersen, Michael M

    2015-01-01

    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 ...

  9. Radiotherapy for marginally resected, unresectable or recurrent giant cell tumor of the bone: a rare cancer network study

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    Robert C. Miller

    2011-10-01

    Full Text Available The role of radiotherapy for local control of marginally resected, unresectable, and recurrent giant cell tumors of bone (GCToB has not been well defined. The number of patients affected by this rare disease is low. We present a series of 58 patients with biopsy proven GCToB who were treated with radiation therapy. A retrospective review of the role of radiotherapy in the treatment of GCToB was conducted in participating institutions of the Rare Cancer Network. Eligibility criteria consisted of the use of radiotherapy for marginally resected, unresectable, and recurrent GCToB. Fifty-eight patients with biopsy proven GCToB were analyzed from 9 participating North American and European institutions. Forty-five patients had a primary tumor and 13 patients had a recurrent tumor. Median radiation dose was 50 Gy in a median of 25 fractions. Indication for radiation therapy was marginal resection in 33 patients, unresectable tumor in 13 patients, recurrence in 9 patients and palliation in 2 patients. Median tumor size was 7.0 cm. A significant proportion of the tumors involved critical structures. Median follow- up was 8.0 years. Five year local control was 85% . Of the 7 local failures, 3 were treated successfully with salvage surgery. All patients who received palliation achieved symptom relief. Five year overall survival was 94%. None of the patients experienced grade 3 or higher acute toxicity. This study reports a large published experience in the treatment of GCToB with radiotherapy. Radiotherapy can provide excellent local control for incompletely resected, unresectable or recurrent GCToB with acceptable morbidity.

  10. The effect of walking speed on gait kinematics and kinetics after endoprosthetic knee replacement following bone tumor resection.

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    Okita, Yusuke; Tatematsu, Noriatsu; Nagai, Koutatsu; Nakayama, Tomitaka; Nakamata, Takeharu; Okamoto, Takeshi; Toguchida, Junya; Ichihashi, Noriaki; Matsuda, Shuichi; Tsuboyama, Tadao

    2014-09-01

    Gait function is one of the most important components of functional outcome evaluation in patients with a tumor around the knee. In addition to walking at a preferred speed, the patients might be sometimes required to walk fast in daily life (e.g., schooling and working) because the major types of bone tumors often occur in adolescence and young adults. Therefore, recovering the ability to walk fast would increase the quality of life of these patients. To clarify which parts of the lower limb are exerted while walking fast, we investigated the kinematic and kinetic changes during fast walking in patients who underwent endoprosthetic knee replacement after bone tumor resection. Laboratory-based gait analysis was performed on eight patients who had undergone endoprosthetic knee replacement following resection of a tumor around the knee. Patients walked at a preferred and faster speed, and the gait parameters were compared between the two walking speeds for each leg. To increase walking speed, patients tended to rely on the bilateral hip, ankle, and contralateral knee to generate additional power. Kinetic analysis showed that involved-side vertical body support was not significantly increased during late stance to increase walking speed, which was associated with a small increase in ankle plantarflexion moment and concentric power. These results suggest to patients after knee reconstruction how to effectively increase their walking speed or redistribute the mechanical load on the muscles and joints to prevent excessive stress on the lower limbs.

  11. [Resection of Klatskin tumors].

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    Seehofer, D; Kamphues, C; Neuhaus, P

    2012-03-01

    Curative treatment of Klatskin tumors by radical surgical procedures with surgical preparation distant to the tumor region results in 5-year survival rates of 30-50%. This requires mandatory en bloc liver resection and resection of the extrahepatic bile duct often together with vascular resection. Nevertheless, the ideal safety margin of 0.5-1 cm remote from the macroscopic tumor extensions cannot be achieved in all cases. Based on hilar anatomy the probability of an adequate safety margin is higher using extended right hemihepatectomy together with portal vein resection compared to left hemihepatectomy. However, due to severe atrophy of the left liver lobe solely left-sided hepatectomy is feasible in some patients. In cases of eligibility for both procedures right hemihepatectomy is preferentially used due to the higher oncological radicality if sufficient liver function is present. Postoperative hepatic insufficiency and bile leakage after demanding biliary reconstruction, often with several small orifices, contribute to the postoperative complication rate of this complex surgical disease pattern.

  12. Bone graft options for spinal fusion following resection of spinal column tumors: systematic review and meta-analysis.

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    Elder, Benjamin D; Ishida, Wataru; Goodwin, C Rory; Bydon, Ali; Gokaslan, Ziya L; Sciubba, Daniel M; Wolinsky, Jean-Paul; Witham, Timothy F

    2017-01-01

    OBJECTIVE With the advent of new adjunctive therapy, the overall survival of patients harboring spinal column tumors has improved. However, there is limited knowledge regarding the optimal bone graft options following resection of spinal column tumors, due to their relative rarity and because fusion outcomes in this cohort are affected by various factors, such as radiation therapy (RT) and chemotherapy. Furthermore, bone graft options are often limited following tumor resection because the use of local bone grafts and bone morphogenetic proteins (BMPs) are usually avoided in light of microscopic infiltration of tumors into local bone and potential carcinogenicity of BMP. The objective of this study was to review and meta-analyze the relevant clinical literature to provide further clinical insight regarding bone graft options. METHODS A web-based MEDLINE search was conducted in accordance with preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines, which yielded 27 articles with 383 patients. Information on baseline characteristics, tumor histology, adjunctive treatments, reconstruction methods, bone graft options, fusion rates, and time to fusion were collected. Pooled fusion rates (PFRs) and I(2) values were calculated in meta-analysis. Meta-regression analyses were also performed if each variable appeared to affect fusion outcomes. Furthermore, data on 272 individual patients were available, which were additionally reviewed and statistically analyzed. RESULTS Overall, fusion rates varied widely from 36.0% to 100.0% due to both inter- and intrastudy heterogeneity, with a PFR of 85.7% (I(2) = 36.4). The studies in which cages were filled with morselized iliac crest autogenic bone graft (ICABG) and/or other bone graft options were used for anterior fusion showed a significantly higher PFR of 92.8, compared with the other studies (83.3%, p = 0.04). In per-patient analysis, anterior plus posterior fusion resulted in a higher fusion rate

  13. Hemicortical Resection and Inlay Allograft Reconstruction for Primary Bone Tumors A Retrospective Evaluation in the Netherlands and Review of the Literature

    NARCIS (Netherlands)

    Bus, M. P. A.; Bramer, J. A. M.; Schaap, G. R.; Schreuder, H. W. B.; Jutte, P. C.; van der Geest, I. C. M.; van de Sande, M. A. J.; Dijkstra, P. D. S.

    2015-01-01

    Background: Selected primary tumors of the long bones can be adequately treated with hemicortical resection, allowing for optimal function without compromising the oncological outcome. Allografts can be used to reconstruct the defect. As there is a lack of studies of larger populations with sufficie

  14. Hemicortical resection and inlay allograft reconstruction for primary bone tumors: a retrospective evaluation in the Netherlands and review of the literature

    NARCIS (Netherlands)

    Bus, M.P.; Bramer, J.A.; Schaap, G.R.; Schreuder, H.W.B.; Jutte, P.C.; Geest, I.C.M. van der; Sande, M.A. van de; Dijkstra, P.D.

    2015-01-01

    BACKGROUND: Selected primary tumors of the long bones can be adequately treated with hemicortical resection, allowing for optimal function without compromising the oncological outcome. Allografts can be used to reconstruct the defect. As there is a lack of studies of larger populations with sufficie

  15. Endoscopic resection of subepithelial tumors

    Institute of Scientific and Technical Information of China (English)

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

    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 of SET arising from deeper layers of the gastrointestinal wall requires advanced endoscopic methods and harbours the risk of perforation. Innovative techniques such as submucosal tunneling and full thickness resection have expanded the frontiers of endoscopic therapy in the past years. This review will give an overview about endoscopic resection techniques of SET with a focus on novel methods.

  16. Awake craniotomy for tumor resection

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    Mohammadali Attari

    2013-01-01

    Full Text Available Surgical treatment of brain tumors, especially those located in the eloquent areas such as anterior temporal, frontal lobes, language, memory areas, and near the motor cortex causes high risk of eloquent impairment. Awake craniotomy displays major rule for maximum resection of the tumor with minimum functional impairment of the Central Nervous System. These case reports discuss the use of awake craniotomy during the brain surgery in Alzahra Hospital, Isfahan, Iran. A 56-year-old woman with left-sided body hypoesthesia since last 3 months and a 25-year-old with severe headache of 1 month duration were operated under craniotomy for brain tumors resection. An awake craniotomy was planned to allow maximum tumor intraoperative testing for resection and neurologic morbidity avoidance. The method of anesthesia should offer sufficient analgesia, hemodynamic stability, sedation, respiratory function, and also awake and cooperative patient for different neurological test. Airway management is the most important part of anesthesia during awake craniotomy. Tumor surgery with awake craniotomy is a safe technique that allows maximal resection of lesions in close relationship to eloquent cortex and has a low risk of neurological deficit.

  17. Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized Autograft and a Vascularized Fibula

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    Koichi Ogura

    2015-01-01

    Full Text Available Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autograft and a vascularized fibula graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years undergoing reconstruction using a devitalized autograft (pasteurization (n=6, deep freezing (n=5 and a vascularized fibula graft composite for lower extremity malignant bone tumors (femur (n=10, tibia (n=1. Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autograft, 1 frozen autograft and 1 fracture and 1 implant failure (both in pasteurized autografts. Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autograft, our novel method involving a combination of a frozen autograft with a vascularized fibula graft and rigid fixation with a locking plate may offer better outcomes than previously reported allografts or devitalized autografts.

  18. 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%.

  19. Large Segment Bone Allograft Reconstruction Following Femur Tumors Resection%大段异体骨移植重建股骨肿瘤性缺损

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    贾金鹏; 毕文志; 韩纲; 王威; 许猛; 李静东

    2012-01-01

    目的 探讨大段异体骨移植在股骨肿瘤扩大切除后缺损重建中的作用及临床效果.方法 回顾性分析从2005年1月至2010年1月共30例患者.均行股骨肿瘤保肢手术并采用大段异体骨重建肿瘤切除后缺损的患者.结果 22例患者获得随访,8例患者失访.10例患者死于多发转移.12例存活的患者随访时间为20个月至7年,平均随访时间4.2年.所有患者术后X线片显示异体骨位置良好.6例发生延迟愈合或不愈合.其中有5例发生应力性骨折,1例患者发生深部感染.2例患者发生内固定失败.1例患者局部复发.所有患者中未发现明显的排斥反应.结论 大段异体骨移植能够获重建股骨肿瘤后较大的骨缺损,满足了部分股骨肿瘤保肢治疗的需要,是股骨肿瘤保肢治疗中一种可以选择的方法.%Objective Probe into the feasibility of the clinical outcome of large segment bone allograft for reconstruction of the defect after femur tumor resection. Methods During January 2005 to January 2010, 30 patients were carried out limb-spanng surgery due to femur tumors, and large segment bone allograft was used to reconstruction the bone defects after tumor resection. Results 22 patients were followed up; 8 patients were lost of follow-up. 10 patients died of generalized metastases. Patients were followed up from 20 months to 7 years. The mean follow-up was 4. 2 years. There were 6 patients had delayed union or nonunion, 5 patients had stress fractures, 1 patient occurred primary deep infection. Failure of the internal fixation system occurred in 2 patients, lpatient had local recurrences. No evident immune rejection was observed. Conclusions Large segment bone allograft can meet to the present demand in reconstruction of the massive defect following femur tumor resection, and still to be a very useful alternative to prosthesis in limb-sparing surgery of femur tumors.

  20. 髋臼周围恶性骨肿瘤的切除与重建%Resection and reconstruction for malignant bone tumors involving the acetabulum

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    邹昌业; 王晋; 黄纲; 尹军强; 谢显彪; 王永谦; 沈靖南

    2013-01-01

    Background:The location of the malignant tumors involving the acetabulum are comparatively deep, and they are usually very closed to some vital blood vessels, nerves and visceral organs, thus are very difficult to be resected. Methods to restore the continuity of pelvis and the function of acetabulum still need further improving. Objective: To investigate the methods and effects of the resection and reconstruction for malignant tumors involving the acetabulum. Methods:Retrospectively study 22 cases of resection and reconstruction for malignant bone tumors involving the acetabu-lum during January 2004 to December 2010. Analyze the survival of the patients, the recurrence and metastasis of the tu-mor, and the complications after the surgery, then evaluate the function of the patients via MSTS score system. Results:All the 22 patients were followed up for a mean period of 37.0 months (7.1 to 84.3 months). 15 patients gained a disease-free survival, 5 patients died of recurrence and metastasis of tumor, and 2 patients survived with the tumor. 7 pa-tients underwent local recurrence, which leads to a local recurrence rate of 31.82%. The mean interval from the operation to the local recurrence was 17.1 months (3 to 41.2 months). 4 patients had lung metastasis with an interval of 5.8 to 38.1 months after the operation, the mean interval was 16.6 months. The mean MSTS score detected six months after the opera-tion was 68.6%(32.5%-83.7%). Conclusions:Treat the malignant bone tumor involving the acetabulum with extensive resection and reconstruct the acetabu-lum with customized modular prostheses according to the degree of bone defects can achieve satisfactory curative effects and good function of the acetabulum .%  累及髋臼的恶性肿瘤由于位置较深,毗邻重要的血管神经和内脏器官,因而切除困难。切除后如何恢复骨盆连续性和髋臼功能的方法仍需完善。目的:探讨累及髋关节恶性肿瘤切除和重建的方法和

  1. Radical Carinal Resection for a Glomic Tumor.

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    Bellier, Jocelyn; Sage, Edouard; Gonin, François; Longchampt, Elisabeth; Chapelier, Alain

    2016-08-01

    We report the case of a 33-year-old woman who presented with increasing dyspnea secondary to a tumor arising from the carina. After desobstruction by bronchoscopy, the pathologic analysis revealed a glomic tumor. Carinal resection and reconstruction were performed with venoarterial extracorporeal membrane oxygenation support. The patient's postoperative course was uneventful, and the long-term result was excellent.

  2. Osteochondroma (Bone Tumor)

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    ... to be the most common benign bone tumor, accounting for 35% to 40% of all benign bone ... imaging scans. Doctors may also request computed tomography (CT) scans or magnetic resonance imaging (MRI) scans to ...

  3. 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

  4. Pseudoanaplastic tumors of bone

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    Bahk, Won-Jong [Uijongbu St. Mary Hospital, The Catholic University of Korea, Department of Orthopaedic Surgery, Gyunggido, 480-821 (Korea); Mirra, Joseph M. [Orthopaedic Hospital, Orthopedic Oncology, Los Angeles, California (United States)

    2004-11-01

    To discuss the concept of pseudoanaplastic tumors of bone, which pathologically show hyperchromatism and marked pleomorphism with quite enlarged, pleomorphic nuclei, but with no to extremely rare, typical mitoses, and to propose guidelines for their diagnosis. From a database of 4,262 bone tumors covering from 1971 to 2001, 15 cases of pseudoanaplastic bone tumors (0.35% of total) were retrieved for clinical, radiographic and pathologic review. Postoperative follow-up after surgical treatment was at least 3 years and a maximum of 7 years. There were eight male and seven female patients. Their ages ranged from 10 to 64 years with average of 29.7 years. Pathologic diagnoses of pseudoanaplastic variants of benign bone tumors included: osteoblastoma (4 cases), giant cell tumor (4 cases), chondromyxoid fibroma (3 cases), fibrous dysplasia (2 cases), fibrous cortical defect (1 case) and aneurysmal bone cyst (1 case). Radiography of all cases showed features of a benign bone lesion. Six cases, one case each of osteoblastoma, fibrous dysplasia, aneurysmal bone cyst, chondromyxoid fibroma, giant cell tumor and osteoblastoma, were initially misdiagnosed as osteosarcoma. The remaining cases were referred for a second opinion to rule out sarcoma. Despite the presence of significant cytologic aberrations, none of our cases showed malignant behavior following simple curettage or removal of bony lesions. Our observation justifies the concept of pseudoanaplasia in some benign bone tumors as in benign soft tissue tumors, especially in their late evolutionary stage when bizarre cytologic alterations strongly mimic a sarcoma. (orig.)

  5. MRI Evaluation of Resection Margins in Bone Tumour Surgery

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    Simon Vandergugten

    2014-01-01

    Full Text Available In 12 patients operated on for bone sarcoma resection, a postoperative magnetic resonance imaging of the resection specimens was obtained in order to assess the surgical margins. Margins were classified according to MRI in R0, R1, and R2 by three independent observers: a radiologist and two orthopaedic surgeons. Final margin evaluation (R0, R1, and R2 was assessed by a confirmed pathologist. Agreement for margin evaluation between the pathologist and the radiologist was perfect (κ=1. Agreement between the pathologist and an experienced orthopaedic surgeon was very good while it was fair between the pathologist and a junior orthopaedic surgeon. MRI should be considered as a tool to give quick information about the adequacy of margins and to help the pathologist to focus on doubtful areas and to spare time in specimen analysis. But it may not replace the pathological evaluation that gives additional information about tumor necrosis. This study shows that MRI extemporaneous analysis of a resection specimen may be efficient in bone tumor oncologic surgery, if made by an experienced radiologist with perfect agreement with the pathologist.

  6. 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

  7. 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

  8. 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

  9. Modular Tumor Resection Prosthesis in Osteosarcoma Treatment

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    Alper Cirakli

    2016-07-01

    Full Text Available Aim: The aim of the study is to evaluate the cases who underwent tumor resection prosthesis due to osteosarcoma. Material and Method: 14 cases who underwent tumor resection prosthesis due to osteosarcoma in our clinic between 2000 and 2012 and who had sufficient follow-ups were evaluated. The cases were examined in terms of gender, age, direction, tumor location, follow-up time, success of the treatment, complication, recurrence, and survival. The data obtained were transferred to the SPSS 15.0 program and analyzed. Normality distributions of the data were analyzed with the Shapiro-Wilk test. Results: 8 of the 14 cases were male, 6 were female, and the average age of the cases was 21.9±7.02. Osteosarcoma was in the distal femur in 9 (64.3% of the patients, in the proximal tibia in 5 (35.7% of the patients, in the right lower extremity in 5 of the patients, and in the left lower extremity in 9 of the patients. Average follow-up time was 33 months (3-144 months range. Average MSTS score was found as 81.9 (53-96 range, perfect results were taken in 11 (78.6% patients while insufficient results were taken in 3 (21.4% patients. As for complications, aseptic softening was observed in 3 cases, peroneal nerve paralysis was observed in 2 cases, skin necrosis was observed in 2 cases, periprostatic fracture was observed in 2 cases, prosthesis infection was observed in 1 case, and local recurrence was observed in 1 case. Except for the two cases with peroneal nerve paralysis, cases with complications recovered without any problems. The patient who developed local recurrence was lost due to lung metastasis. Discussion: Treatment of osteosarcoma through tumor resection prosthesis raises question marks due to possible complications that can affect the survival of the prosthesis in the long term. However, this treatment method is favorable in terms of stability, early load efficiency, and causing less anxiety than osteosynthesis; it is also psychologically

  10. Pure Laparoscopic Liver Resection for Malignant Liver Tumor: Anatomic Resection Versus Nonanatomic Resection

    Institute of Scientific and Technical Information of China (English)

    Ya-Xi Chen; Dian-Rong Xiu; Chun-Hui Yuan; Bin Jiang; Zhao-Lai Ma

    2016-01-01

    Background: Laparoscopic liver resection (LLR) has been considered to be safe and feasible.However, few studies focused on the comparison between the anatomic and nonanatomic LLR.Therefore, the purpose of this study was to compare the perioperative factors and outcomes of the anatomic and nonanatomic LLR, especially the area of liver parenchymal transection and blood loss per unit area.Methods: In this study, surgical and oncological data of patients underwent pure LLR procedures for malignant liver tumor were prospectively collected.Blood loss per unit area of liver parenchymal transection was measured and considered as an important parameter.All procedures were conducted by a single surgeon.Results: During nearly 5 years, 84 patients with malignant liver tumor received a pure LLR procedure were included.Among them, 34 patients received anatomic LLR and 50 received nonanatomic LLR, respectively.Patients of the two groups were similar in terms of demographic features and tumor characteristics, despite the tumor size was significantly larger in the anatomic LLR group than that in the nonanatomic LLR group (4.77 ± 2.57 vs.2.87 ± 2.10 cm, P =0.001).Patients who underwent anatomic resection had longer operation time (364.09 ± 131.22 vs.252.00 ± 135.21 min, P < 0.001) but less blood loss per unit area (7.85 ± 7.17 vs.14.17 ± 10.43 ml/cm2,P =0.018).Nonanatomic LLR was associated with more blood loss when the area of parenchymal transection was equal to the anatomic LLR.No mortality occurred during the hospital stay and 30 days after the operation.Moreover, there was no difference in the incidence of postoperative complications.The disease-free and overall survival rates showed no significant differences between the anatomic LLR and nonanatomic LLR groups.Conclusions: Both anatomic and nonanatomic pure LLR are safe and feasible.Measuring the area ofparenchymal transection is a simple and effective method to estimate the outcomes of the liver resection surgery

  11. Endoscopic resection of tumors in the lower digestive tract

    Institute of Scientific and Technical Information of China (English)

    Shi-Lun; Cai; Qiang; Shi; Tao; Chen; Yun-Shi; Zhong; Li-Qing; Yao

    2015-01-01

    As endoscopic technology has developed and matured,the endoscopic resection of gastrointestinal tract polyps has become a widely used treatment. Colorectal polyps are the most common type of polyp, which are best managed by early resection before the polyp undergoes malignant transformation. Methods for treating colorectal tumors are numerous, including argon plasma coagulation, endoscopic mucosal resection, endoscopic submucosal dissection, and laparoscopic-endoscopic cooperative surgery. In this review, we will highlight several currently used clinical endoscopic resection methods and how they are selected based on the characteristics of the targeted tumor. Specifically, we will focus on laparoscopic-endoscopic cooperative surgery.

  12. A comparison of planned and ifnal resection lengths in limb salvage surgery for bone tumors%瘤段截除计划长度与最终截除长度的差异研究

    Institute of Scientific and Technical Information of China (English)

    邓志平; 牛晓辉; 张清; 郝林; 丁易

    2014-01-01

    Objective The resection length should be designed before the limb salvage surgery for bone tumors. To compare the differences of planned and final resection lengths in limb salvage surgery for bone tumors. Methods Fifty-three cases receiving limb salvage surgery were enrolled in the study, including 34 cases of osteosarcomas, 5 cases of giant cell tumors, 5 cases of spindle cell sarcomas, 3 cases of chondrosarcomas, 3 cases of bone metastases, 1 case of lymphoma, 1 case of undifferentiated pleomorphic sarcoma, and 1 case of soft tissue sarcoma with the bone involvement. The tumors were located in the distal femur ( n=29 ), in the proximal tibia ( n=8 ), in the proximal humerus ( n=7 ), in the proximal femur ( n=5 ), in the distal tibia ( n=3 ) and in the distal humerus ( n=1 ). The planned and ifnal resection lengths were compared. The patients were classiifed according to the tumor location, and the differences were compared. Results The range of the length error was from-30 mm to 15 mm in the 53 cases. 95%conifdence interval ( CI ) was ( 2.0±7.7 ) mm. The length error was less than 10 mm in 40 cases ( 75.5%), which was more than 10 mm in 9 cases ( 17%), and only in 4 cases ( 7.5%) was less than-10 mm. The length error was ( 2.9±6.7 ) mm in 29 cases in the distal femur, ( 3.8±5.1 ) mm in 8 cases in the proximal tibia, ( 3.6±8.0 ) mm in 7 cases in the proximal humerus, (-0.2±6.0 ) mm in 5 cases in the proximal femur, 0 mm in 3 cases in the distal tibia and-30 mm in 1 case in the distal humerus. Conclusions The anatomical landmark and resection length are planned before the surgery. The accuracy of resection length is acceptable in this method. More precise resection could be achieved after avoiding the error-making factors.%目的:探讨骨肿瘤行瘤段截除时计划截除长度与实际截除长度的差异。方法对53例行瘤段截除的患者进行研究,骨肉瘤34例,骨巨细胞瘤5例,梭形细胞肉瘤5例,软骨肉瘤3

  13. Reconstruction of large tibial bone defects following osteosarcoma resection using bone transport distraction: A report of two cases

    Science.gov (United States)

    Yang, Zhengming; Jin, Libin; Tao, Huimin; Yang, Disheng

    2016-01-01

    The clinical efficiency of bone transport distraction osteogenesis in the reconstruction of large tibial defects following resection of osteosarcoma remains unclear. The current study presents two cases of large tibial defects treated with bone transport distraction using an Orthofix external fixator. Case 1 was a 29-year-old man with a tibial defect 11 cm in length, while case 2 was a 16-year-old girl with a 15-cm-long defect. Bone transport distraction osteogenesis was initiated for the both cases on day 14 following resection of the tibial osteosarcoma. Bone transport distraction in case 1 and 2 was continued for 16 and 28 months, respectively, and the patients were followed up for 51 and 56 months, respectively. The two patients did not exhibit any signs of tumor recurrence or tumor metastasis during the follow-up period. The Musculoskeletal Tumor Society functional scores at final follow-up visits were 22 and 18 for case 1 and 2, respectively. Based on the experience gained in these 2 cases, a bone transport is a viable option for the reconstruction of large tibial defects following osteosarcoma resection. PMID:27446450

  14. Unilateral pulmonary edema during laparoscopic resection of adrenal tumor

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    Prakash, Smita; Nayar, Pavan; Virmani, Pooja; Bansal, Shipra; Pawar, Mridula

    2015-01-01

    Despite technological, therapeutic and diagnostic advancements, surgical intervention in pheochromocytoma may result in a life-threatening situation. We report a patient who developed unilateral pulmonary edema during laparoscopic resection of adrenal tumor. PMID:26330724

  15. Unilateral pulmonary edema during laparoscopic resection of adrenal tumor

    Directory of Open Access Journals (Sweden)

    Smita Prakash

    2015-01-01

    Full Text Available Despite technological, therapeutic and diagnostic advancements, surgical intervention in pheochromocytoma may result in a life-threatening situation. We report a patient who developed unilateral pulmonary edema during laparoscopic resection of adrenal tumor.

  16. One-step reconstruction with a 3D-printed, biomechanically evaluated custom implant after complex pelvic tumor resection.

    Science.gov (United States)

    Wong, K C; Kumta, S M; Geel, N V; Demol, J

    2015-01-01

    Resection of a pelvic tumor is challenging because of its complex three-dimensional (3D) anatomy and deep-seated location with nearby vital structures. The resection is technically demanding if a custom implant is used for reconstruction of the bone defect as the surgeon needs to ensure the resection margin is sufficiently wide and the orientation of intended resection planes must match that of the custom implant. We describe a novel workflow of performing a partial acetabular resection in a patient with pelvic chondrosarcoma and reconstruction with a custom pelvic implant in a one-step operation. A multi-planar bone resection was virtually planned. A computer-aided design implant that both matched the bone defect and biomechanically evaluated was prefabricated with 3D printing technology. The 3D-printed patient-specific instruments (PSIs) were used to reproduce the same planned resection. The histology of the tumor specimen showed a clear resection margin. The errors of the achieved resection and implant position were deviating (1-4 mm) from the planned. The patient could walk unaided with a good hip function. No tumor recurrence and implant loosening were noted at 11 months after surgery. The use of this novel CT-based method for surgical planning, the engineering software for implant design and validation, together with 3D printing technology for implant and PSI fabrication makes it possible to generate a personalized, biomechanically evaluated implant for accurate reconstruction after a pelvic tumor resection in a one-step operation. Further study in a larger population is needed to assess the clinical efficacy of the workflow in complex bone tumor surgery.

  17. 组合生物重建用于四肢骨肿瘤切除后骨缺损修复%The combinative biological reconstruction of bony defect following limb bone tumor resections

    Institute of Scientific and Technical Information of China (English)

    李靖; 王臻; 郭征; 陈国景; 石磊

    2016-01-01

    -bearing bone and vascularized fibular flap for the reconstruction of bony defects following tumor resection,guiding clinical practice.Methods From March 2007 to June 2013,we enrolled 63 patients who had combinative biological reconstruction after bone tumor resection (11 in humerus,22 in femur,21 in tibia,4 in calcaneus).There were 36 male and 27 female in this series.The average age at time of operation was 20 years,ranging from 9 to 48 years.The follow-up ranged from 16 to 102 months with average of 48 months.We investigated the X-ray and CT images for all patients and histological findings of two patients.Patients were assessed functionally with the Musculoskeletal Tumor Society 93 score.Results Three patients with local soft tissue recurrence and one patient with infection underwent amputation.The survival of construct was 93.6%.Bone union achieved in all cases with the average MSTS score of 92.8%.Bone union ranged from 11 to 28 months in allograft group and 9 to 14 months in devitalized tumor bearing bone group.Significant difference of bone union time was found between two groups (Z=-3.638,P=0.000).Viability of the fibular grafts was verified in 58 of 63 patients (92%).Three types of images were observed in complex.Osteopenia and spongy change in fibula were found in 51 patients (81%) with stable fixation of the complex.Five complexes with failed blood supply of fibula and stable fixation revealed no density change of fibula,small amount of callous formation and relative delayed union.In seven complexes (11%) with unstable complex due to patients' incompliance,fibula reacted with dense hypertrophy and microfracture.Fusion of grafts with amount of callus was obviously observed.Union at allograft-host bone junctions occurred by residual host bone-derived external callus and fibular-derived internal callus that bridged the junction and filled the gap between abutting cortices.Callus from fibular graft was mature than that from periosteum of residual host bone

  18. Endoscopic resection of superficial gastrointestinal tumors

    Institute of Scientific and Technical Information of China (English)

    Giovannini Marc; Cesar Vivian Lopes

    2008-01-01

    Therapeutic endoscopy plays a major role in the management of gastrointestinal (GI) neoplasia.Its indications can be generalized into four broad categories; to remove or obliterate neoplastic lesion,to palliate malignant obstruction, or to treat bleeding.Only endoscopic resection allows complete histologicalstaging of the cancer, which is critical as it allowss tratification and refinement for further treatment.Although other endoscopic techniques, such asablation therapy, may also cure early GI cancer, they can not provide a definitive pathological specimen.Early stage lesions reveal low frequency of lymph node metastasis which allows for less invasive treatments and thereby improving the quality of life when compared to surgery. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are now accepted worldwide as treatment modalities for early cancers of the GI tract.

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

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    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.

  20. Resection of benign bone cysts in childhood and adolescence

    Energy Technology Data Exchange (ETDEWEB)

    Pflugfelder, H.; Pfister, U.; Holz, U.; Schmelzeisen, H.

    1983-03-25

    The problems of cystic tumors in adolescence lie in the danger of permanent fracture and in the readiness of the cyst to recur with increased growth. In recent years, therefore, we have turned to resection with subsequent closure using a chip of rib or fibula for benign cystic tumors. Experience so far is presented, the freedom from recurrence at the time of follow-up being particularly emphasized.

  1. 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.

  2. Carinal resection and reconstruction following inflammatory myofibroblastic tumor resection: A case report

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    Julia G. Lyon

    2016-02-01

    Full Text Available Inflammatory myofibroblastic tumors (IMT are rare tumors of the respiratory tract that most commonly occur in the lung and are rarely seen in the trachea. They present most often in young patients. We report on a case of an IMT of the carina in a seven year old girl, requiring carinal resection and reconstruction with a novel technique in pediatric airway surgery. Attempts at endoscopic excision of the carinal IMT were unsuccessful. An open approach for resection of the involved carina, distal trachea, and proximal mainstem bronchi was performed via sternotomy and cardiopulmonary bypass. The resulting triangular defect in the trachea and bronchi was reconstructed with anastomosis of the proximal trachea and left mainstem bronchus using a rotational flap of the right lateral mainstem bronchial wall. The remaining right mainstem bronchus was anastomosed, end to side, to the intact trachea proximal to the primary anastomosis. Bronchoscopy and MRI 22 months post resection and reconstruction revealed a healthy neo-carina and patent distal airway with no evidence of recurrent IMT. Pediatric patients with carinal inflammatory myofibroblastic tumors can be successfully managed with open resection and reconstruction of the airway.

  3. Short term complications from transurethral resection of bladder tumor

    DEFF Research Database (Denmark)

    Gregg, Justin R; McCormick, Benjamin; Wang, Li;

    2016-01-01

    INTRODUCTION: The diagnosis and subsequent management of bladder cancer often involves transurethral resection of bladder tumor (TURBT). Risks of TURBT include perioperative complications such as bleeding, pain and perforation. We aimed to determine TURBT complication rates and risk factors in a ...

  4. Functional assessment of endoprosthesis in the treatment of bone tumors

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    Denis Kiyoshi Fukumothi

    Full Text Available ABSTRACT OBJECTIVES: Evaluate the functional grade of these patients and to identify the types of complications found that influenced the average life span of endoprostheses the functions of the operated limb. METHODS: We analyzed 14 post-operative cases of endoprosthesis, patients with malignant bone tumors and aggressive benign bone tumors submitted to surgery between 2004 and 2014. The evaluation system used was proposed by Enneking, recommended by the Musculoskeletal Tumor Society (MSTS, in addition to the radiologic evaluation. RESULTS: Endoprosthesis are excellent choices for the treatment of bone tumors with limb preservation in relation to pain, strength, and patient's emotional acceptance. Another factor for good results is the immediate weight-bearing capacity, generating a greater independence. CONCLUSION: The authors conclude that all patients classified the therapy as excellent/good, regardless of the type of prosthesis used, extent of injury, and/or type of tumor resection performed.

  5. Craniofacial resection of advanced oral and maxillofacial malignant tumors

    Institute of Scientific and Technical Information of China (English)

    张志愿; 邱蔚六

    2003-01-01

    Objective To evaluate the clinical outcome of craniofacial resection for advanced malignant tumors in oral and maxillofacial regions.Methods Forty-six patients who underwent craniofacial resection for malignancies involving the anterior and middle cranial fossa over a 20-year period between June 1978 and December 1997 at our department were evaluated. Twenty patients received radiation therapy and an adjuvant therapy after the operation. Eleven patients received chemotherapy of various types as an adjuvant therapy.Results The 3- and 5-year survival rates were 48.8% (20/41) and 35.1% (13/37), respectively, while the 10-year survival rate was 20% (4/20).Conclusions Our results revealed good prospects of using craniofacial resection on patients with advanced malignancies in the oral and maxillofacial regions.

  6. Femoral head-neck junction reconstruction, after iatrogenic bone resection.

    Science.gov (United States)

    Guevara-Alvarez, Alberto; Lash, Nicholas; Beck, Martin

    2015-07-01

    Arthroscopic over-resection of the head-neck junction during the treatment of a cam deformity can be a devastating complication and is difficult to treat. Large defects of the femoral head-neck junction (FHNJ) increase the risk of femoral neck fracture and can also affect hip biomechanics. We describe a case of an iatrogenic defect of the FHNJ due to excessive bone resection, and a previously non-described treatment using iliac crest autograft to restore femoral head-neck sphericity and hip joint stability. After protecting the femoral neck with an angled blade plate, the large anterior FHNJ defect was reconstructed using autogenous iliac crest bone graft; sphericity was restored by contouring the graft using spherical templates. Clinical and radiographic follow-up was performed up to 2 years. Results at 2 years showed no residual groin pain and normal range of motion. The Oxford Hip Score was 46/48, rated as excellent. Computed tomography (CT) scanning showed union of bone graft without resorption, and CT arthrogram indicating retained sphericity of the FHNJ without evidence of degenerative changes in the articular surface. This novel surgical technique can be used to restore the structural integrity and contour of the FHNJ that contains a significant anterior defect.

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

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    Massimiliano De Paolis

    2013-01-01

    Full Text Available 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.

  8. Functional and Aesthetic Thorax Reconstruction after Desmoid Tumor Resection

    Science.gov (United States)

    Acosta-Ponce de Leon, Eric; Sanchez-Sosa, Sergio

    2017-01-01

    Summary: This study describes a case report of a 31-year-old patient who presented with a left thoracic tumor on costal cartilages 5 and 6 that was diagnosed as a desmoid tumor 3 years after receiving retropectoral breast implants for cosmetic reasons. The integral reconstruction of the thoracic wall, functional and aesthetic, was planned for a single surgical period. The defect secondary to the tumor resection, which left the pericardium and lung exposed, was closed using the pectoral muscle as a “pre-expanded” flap by the breast implant, and the breast aesthetic was treated bilaterally with new implants in the retromammary position. After 12 months, the patient remained free from tumor recurrence and had a satisfactory aesthetic result. PMID:28280682

  9. Optimizing brain tumor resection. High-field interventional MR imaging.

    Science.gov (United States)

    Tummala, R P; Chu, R M; Liu, H; Truwit, C L; Hall, W A

    2001-11-01

    High-field strength iMRI guidance is an effective tool for brain tumor resection. Although its use lengthens the average time for a craniotomy, the reward is a more extensive tumor excision compared with conventional neurosurgery without an increased risk to the patient (Table 4). Although intraoperative patient transfer into and out of the magnet is cumbersome, the possibility for complete resection, especially for a low-grade glioma, makes the effort worthwhile. The cost and technical support required for this system presently limits its use to only a few sites worldwide. As with any technology, further refinements will make this system less expensive and more attainable. Practical consideration aside, high-field strength iMRI is presently [table: see text] the most effective tool available for brain tumor resection. Because of its novelty, future studies are necessary to determine if this technology lowers the incidence of and extends the duration to tumor recurrence as the preliminary data in children suggests. These are the ultimate measures of efficacy for any brain tumor treatment. Based on the rapid advancement of technology, will today's high-field strength interventional magnet become tomorrow's low-field system? Very high-field strength designs may improve diagnostic capabilities through higher resolution, but their interventional applications may be hindered by increased sensitivity for clinically insignificant abnormalities and decreased specificity for clinically relevant lesions. As new technology is developed, clinicians must continue to explore and refine the existing high-field strength iMRI to make it cost-effective and widely applicable.

  10. 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

  11. Laser dosimetry planning tool for colonoscopic tumor resection

    Science.gov (United States)

    Pelayo-Fernández, M. L.; Fanjul-Vélez, F.; Salas-García, I.; Zverev, M.; Arce-Diego, J. L.

    2016-03-01

    Gastrointestinal tumoral pathologies are quite common nowadays. Diseases such as gastric antral vascular ectasia (GAVE) or actinic proctitis may require endoscopic surgery. Argon Plasma Coagulated (APC) or radiofrequency are usually employed. However, they present disadvantages, such as the reduced treated area, magnetic resonance incompatibility, or an uncontrolled ablation depth. Optical surgery could avoid these problems and contribute to a better and controlled treatment result, either ablative or coagulative, in a minimally invasive, non-contact and non-ionizing way. The treatment area could also be increased by adequate optical fiber probe design. In this work laser surgery is analyzed for resection of colonic tumors. A Monte Carlo model is employed to study optical propagation, and an optical ablation approach allows the estimation of the resected volume. The ablation approach is based on plasma-induced ablation, particularly taking into account the freeelectron density generated in the tissue by the pulsed optical source. Several wavelengths, radii and malignant tissue types are considered, either healthy, adenomatous or even coagulated tissues. Optimum source parameters as a function of tumor geometry can be estimated for treatment planning.

  12. Transoral laser resections of oral cavity and oropharyngeal tumors

    Directory of Open Access Journals (Sweden)

    M. V. Bolotin

    2016-01-01

    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. 

  13. Single-stage en bloc resection using a posterior approach for sacral tumors

    Institute of Scientific and Technical Information of China (English)

    Zhong Fang; Wei Wu; Wei Xiong; Guanghui Li; Hui Liao; Jun Xiao; Fengjing Guo; Anmin Chen; Feng Li 

    2016-01-01

    Objective This study aims to investigate the surgical results of single-stage en bloc resections using a posterior approach for sacral tumors and evaluate its benefit for these tumors. Methods A total of 32 cases involving patients with sacral tumors who were treated with single-stage en bloc resection by posterior approach from April 2004 to January 2010 were reviewed. The patient cohort included 20 males and 12 females. The average patient age was 49.1 years old (range, 18 to 75 years old). Twenty-seven patients suf ered from primary sacral tumors, including 17 patients with chordomas, 5 patients with giant cel tumors of the bone, 3 patients with chondrosarcoma, 1 patient with sarcoma of the nerve fibers, and 1 patient with neurofibromatosis. Five patients were diagnosed with sacral metastatic tumors, including 2 cases of breast cancer, 1 case of renal carcinoma, 1 case of thyroid cancer, and 1 case of lung cancer. According to the Frankel grading system, there were 3 Grade B tumors, 4 Grade C tumors, 10 Grade D tumors, and 15 Grade E tumors. Results The operation took 265 min on average (range, 130–360 min), and blood loss was 1676 mL on average (range, 800–1800 mL) during the operation. The fol ow-up period ranged from 6 months to 6.2 years. Al patients had pain prior to operation. Twenty-eight patients experienced complete pain-relief, and 4 patients experienced partial pain-relief after their operations. In al patients, neurological function was improved more than one grade using the Frankel grading system. Up to now, 5 patients experienced local recurrence after operation, and 2 patients were deceased. The remaining patients are stil alive without recurrence. Conclusion Single-stage en bloc resection through a posterior approach for sacral tumors is feasible, safe, and ef ective. It has many advantages, such as control ing local recurrence, thorough decompression of the spinal cord, relieving pain, improving quality of life, and prolonging survival.

  14. 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.

  15. Follow-up study of cartilaginous bone tumors.

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    Suzuki,Atsushi

    1986-06-01

    Full Text Available A series of clinical and pathological studies were performed on 74 cartilaginous bone tumors including osteochondromas, multiple cartilaginous exostoses, chondromas, chondromatoses, benign chondroblastomas and chondrosarcomas. Resection was adequate for the osteochondromas, and no recurrence was observed. Out of 14 multiple cartilaginous exostoses, three, all in flat bones showed malignant change. The predominant sites of chondroma were the finger and toe bones, and curettage and bone graft was adequate treatment. Neither recurrence nor malignant change was observed. Two cases of chondromatosis, one of Ollier's disease and one of Maffucci's syndrome, were included in our series. Leg length discrepancy and pathologic fracture were common problems in chondromatosis. Moreover, malignant change was suspected in a hemangioma of the Maffucci's syndrome patient. Benign chondroblastoma was treated by curettage and bone graft, with no recurrence. In our series, 4 primary and 3 secondary chondrosarcomas were observed. Metastasis was seen in only one case. Because of the discrepancy between the biological behavior and histological findings of cartilaginous bone tumors, the malignancy of tumors should be evaluated by clinical signs and symptoms as well as by histological findings.

  16. Case Report: En Bloc Resection of Pancoast Tumor with Adjuvant Aortic Endograft and Chemoradiation

    OpenAIRE

    Lu, Tony; Fischer, Uwe M.; Rex A. Marco; Naoum, Joseph J.; Reardon, Michael J.; Lumsden, Alan B; Blackmon, Shanda H.; Davies, Mark G.

    2015-01-01

    “Pancoast” tumors frequently require a multidisciplinary approach to therapy and are still associated with high morbidity and mortality. Due to their sensitive anatomic location, complex resections and chemoradiation regimens are typically required for treatment. Those with signs of aortic invasion pose an even greater challenge, given the added risks of cardiopulmonary bypass for aortic resection and interposition. Placement of an aortic endograft can facilitate resection if the tumor is in ...

  17. Synchronous resections of primary colorectal tumor and liver metastasis by laparoscopic approach

    OpenAIRE

    2013-01-01

    Liver metastasis of colorectal cancer is common. Resection of solitary tumors of primary and metastatic colorectal cancer can have a favorable outcome. Open resection of primary colorectal tumor and liver metastasis in one operation or in separate operations is currently common practice. Reports have shown that synchronous resections do not jeopardize short or long-term surgical outcomes and that this is a safe and effective approach in open surgery. The development of laparoscopic colorectal...

  18. Stereoscopic virtual reality models for planning tumor resection in the sellar region

    Directory of Open Access Journals (Sweden)

    Wang Shou-sen

    2012-11-01

    Full Text Available Abstract Background It is difficult for neurosurgeons to perceive the complex three-dimensional anatomical relationships in the sellar region. Methods To investigate the value of using a virtual reality system for planning resection of sellar region tumors. The study included 60 patients with sellar tumors. All patients underwent computed tomography angiography, MRI-T1W1, and contrast enhanced MRI-T1W1 image sequence scanning. The CT and MRI scanning data were collected and then imported into a Dextroscope imaging workstation, a virtual reality system that allows structures to be viewed stereoscopically. During preoperative assessment, typical images for each patient were chosen and printed out for use by the surgeons as references during surgery. Results All sellar tumor models clearly displayed bone, the internal carotid artery, circle of Willis and its branches, the optic nerve and chiasm, ventricular system, tumor, brain, soft tissue and adjacent structures. Depending on the location of the tumors, we simulated the transmononasal sphenoid sinus approach, transpterional approach, and other approaches. Eleven surgeons who used virtual reality models completed a survey questionnaire. Nine of the participants said that the virtual reality images were superior to other images but that other images needed to be used in combination with the virtual reality images. Conclusions The three-dimensional virtual reality models were helpful for individualized planning of surgery in the sellar region. Virtual reality appears to be promising as a valuable tool for sellar region surgery in the future.

  19. Preoperative embolization of primary bone tumors: A case control study

    Science.gov (United States)

    Jha, Roushan; Sharma, Raju; Rastogi, Shishir; Khan, Shah Alam; Jayaswal, Arvind; Gamanagatti, Shivanand

    2016-01-01

    AIM: To study the safety and effectiveness of preoperative embolization of primary bone tumors in relation to intraoperative blood loss, intraoperative blood transfusion volume and surgical time. METHODS: Thirty-three patients underwent preoperative embolization of primary tumors of extremities, hip or vertebrae before resection and stabilization. The primary osseous tumors included giant cell tumors, aneurysmal bone cyst, osteoblastoma, chondroblastoma and chondrosarcoma. Twenty-six patients were included for the statistical analysis (embolization group) as they were operated within 0-48 h within preoperative embolization. A control group (non-embolization group, n = 28) with bone tumor having similar histological diagnosis and operated without embolization was retrieved from hospital record for statistical comparison. RESULTS: The mean intraoperative blood loss was 1300 mL (250-2900 mL), the mean intraoperative blood transfusion was 700 mL (0-1400 mL) and the mean surgical time was 221 ± 76.7 min for embolization group (group I, n = 26). Non-embolization group (group II, n = 28), the mean intraoperative blood loss was 1800 mL (800-6000 mL), the mean intraoperative blood transfusion was 1400 mL (700-8400 mL) and the mean surgical time was 250 ± 69.7 min. On comparison, statistically significant (P < 0.001) difference was found between embolisation group and non-embolisation group for the amount of blood loss and requirement of blood transfusion. There was no statistical difference between the two groups for the surgical time. No patients developed any angiography or embolization related complications. CONCLUSION: Preoperative embolization of bone tumors is a safe and effective adjunct to the surgical management of primary bone tumors that leads to reduction in intraoperative blood loss and blood transfusion volume. PMID:27158424

  20. Primary bone tumors of the spine.

    Science.gov (United States)

    Cañete, A Navas; Bloem, H L; Kroon, H M

    2016-04-01

    Primary bone tumors of the spine are less common than metastases or multiple myeloma. Based on the patient's age and the radiologic pattern and topography of the tumor, a very approximate differential diagnosis can be established for an osseous vertebral lesion. This article shows the radiologic manifestations of the principal primary bone tumors of the spine from a practical point of view, based on our personal experience and a review of the literature. If bone metastases, multiple myeloma, lymphomas, hemangiomas, and enostoses are excluded, only eight types of tumors account for 80% of all vertebral tumors. These are chordomas, osteoblastomas, chondrosarcomas, giant-cell tumors, osteoid osteomas, Ewing's sarcomas, osteosarcomas, and aneurysmal bone cysts.

  1. Metastatic Insulinoma Following Resection of Nonsecreting Pancreatic Islet Cell Tumor

    Directory of Open Access Journals (Sweden)

    Anoopa A. Koshy MD

    2013-01-01

    Full Text Available A 56-year-old woman presented to our clinic for recurrent hypoglycemia after undergoing resection of an incidentally discovered nonfunctional pancreatic endocrine tumor 6 years ago. She underwent a distal pancreatectomy and splenectomy, after which she developed diabetes and was placed on an insulin pump. Pathology showed a pancreatic endocrine neoplasm with negative islet hormone immunostains. Two years later, computed tomography scan of the abdomen showed multiple liver lesions. Biopsy of a liver lesion showed a well-differentiated neuroendocrine neoplasm, consistent with pancreatic origin. Six years later, she presented to clinic with 1.5 years of recurrent hypoglycemia. Laboratory results showed elevated proinsulin, insulin levels, and c-peptide levels during a hypoglycemic episode. Computed tomography scan of the abdomen redemonstrated multiple liver lesions. Repeated transarterial catheter chemoembolization and microwave thermal ablation controlled hypoglycemia. The unusual features of interest of this case include the transformation of nonfunctioning pancreatic endocrine tumor to a metastatic insulinoma and the occurrence of atrial flutter after octreotide for treatment.

  2. Successful Re-resection for Locally Recurrent Retroperitoneal Liposarcoma at Four Years After Ex Vivo Tumor Resection and Autotransplantation of the Liver: A Case Report.

    Science.gov (United States)

    Kobayashi, T; Miura, K; Ishikawa, H; Soma, D; Zhang, Z; Yuza, K; Hirose, Y; Takizawa, K; Nagahashi, M; Sakata, J; Kameyama, H; Kosugi, S; Wakai, T

    2016-05-01

    Surgical resection should be considered for isolated locally recurrent retroperitoneal liposarcomas. We experienced a case of successful re-resection for locally recurrent retroperitoneal liposarcomas 4 years after ex vivo tumor resection and autotransplantation of the liver. A 75-year-old man was admitted to our hospital. His diagnosis was local recurrence of liposarcomas. He had previously undergone ex vivo tumor resection and autologous orthotopic liver transplantation for a retroperitoneal tumor 4 years earlier. The resected tumor size was 23.5 × 15.5 × 12.5 cm. The tumor was revealed by means of histopathologic study to be a myxoid liposarcoma. Follow-up computerized tomography showed 2 recurrent tumors in the retropancreatic and para-aortic lesions. Although adhesion was severe within the operative field, we successfully performed complete en bloc re-resection of each recurrent tumor. The operative time was 250 minutes, and blood loss was 300 mL. The resected tumor sizes were 3.9 × 3.2 × 1.5 cm and 4.5 × 3.3 × 3.0 cm. The tumors were revealed by means of histopathologic study to be dedifferentiated liposarcomas. Postoperative complications included intestinal obstruction and colocutaneous fistula formation, both of which were treated surgically. The patient was discharged in an ambulatory state at 80 days after re-resection of the recurrent tumors. At the time of writing, he was alive with no evidence of recurrence, 14 months after re-resection and 62 months after primary ex vivo tumor resection. This is the first case of successful surgical re-resection for locally recurrent liposarcoma after ex vivo tumor resection and autotransplantation of the liver.

  3. Computer-Assisted Navigation During an Anterior-Posterior En Bloc Resection of a Sacral Tumor.

    Science.gov (United States)

    Al Eissa, Sami; Al-Habib, Amro F; Jahangiri, Faisal R

    2015-11-04

    Previously, a computer-based navigation system has not been used routinely for en-bloc resection of sacral tumors. In order to improve the accuracy of tumor resection, O-arm navigation was used to join anterior and posterior osteotomies during an en-bloc resection of a sacral Ewing's sarcoma. This case study describes the technique for en-bloc resection of a sacral Ewing's sarcoma guided by O-arm computer navigation and intraoperative neurophysiological monitoring (IONM). An 18-year-old male presented with weakness in his left lower extremity. MRI of the patient's spine showed a sacral mass causing compression of left S1 and S2 roots. A surgical resection was planned with anterior and posterior approaches. An O-arm computer navigation system was used to assist in meeting anterior osteotomy cuts with the posterior cuts to ensure complete resection of the sacral tumor with a safe margin. Computer-assisted navigation was used along with IONM during this procedure to help guide the surgical team in an adequate tumor resection. There were no complications related to the use of the O-arm or the navigation system. Computer navigation guidance is both useful and safe in sacral tumor resections. It enhanced the accuracy of the en-bloc removal of a sacral tumor with safe margins while protecting neural function and minimizing recurrence.

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

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    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.

  5. Comparison of Endoscopic and Open Resection for Small Gastric Gastrointestinal Stromal Tumor

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    Fan Feng

    2015-12-01

    Full Text Available The National Comprehensive Cancer Network recommends conservative follow-up for gastric gastrointestinal stromal tumors (GISTs less than 2 cm. We have previously reported that the mitotic index of 22.22% of small gastric GISTs exceeded 5 per 50 high-power fields and recommended that all small gastric GISTs should be resected once diagnosed. The aim of the present study is to compare the safety and outcomes of endoscopic and open resection of small gastric GISTs. From May 2010 to March 2014, a total of 90 small gastric GIST patients were enrolled in the present study, including 40 patients who underwent surgical resection and 50 patients who underwent endoscopic resection. The clinicopathological characteristics, resection-related factors, and clinical outcomes were recorded and analyzed. The clinicopathological characteristics were comparable between the two groups except for tumor location and DOG-1 expression. Compared with the surgical resection group, the operation time was shorter (P = .000, blood loss was less (P = .000, pain intensity was lower (P < .05, duration of first flatus and defecation was shorter (P < .05, and medical cost of hospitalization was lower (P = .027 in the endoscopic resection group. The complications and postoperative hospital stay were comparable between the two groups. No in situ recurrence or liver metastasis was observed during follow-up. Endoscopic resection of small gastric GISTs is safe and feasible compared with surgical resection, although perforation could not be totally avoided during and after resection. The clinical outcome of endoscopic resection is also favorable.

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

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    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.

  7. Submucosal tunnel endoscopy: Peroral endoscopicmyotomy and peroral endoscopic tumor resection

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Peroral endoscopic myotomy (POEM) is an innovative,minimally invasive, endoscopic treatment for esophagealachalasia and other esophageal motility disorders,emerged from the natural orifice transluminal endoscopicsurgery procedures, and since the first human caseperformed by Inoue in 2008, showed exciting results ininternational level, with more than 4000 cases globallyup to now. POEM showed superior characteristics thanthe standard 100-year-old surgical or laparoscopic Hellermyotomy (LHM), not only for all types of esophagealachalasia [classical (Ⅰ), vigorous (Ⅱ), spastic (Ⅲ),Chicago Classification], but also for advanced sigmoidtype achalasia (S1 and S2), failed LHM, or other esophagealmotility disorders (diffuse esophageal spasm,nutcracker esophagus or Jackhammer esophagus). POEMstarts with a mucosal incision, followed by submucosaltunnel creation crossing the esophagogastric junction(EGJ) and myotomy. Finally the mucosal entry is closedwith endoscopic clip placement. POEM permittedrelatively free choice of myotomy length and localization.Although it is technically demanding procedure, POEMcan be performed safely and achieves very goodcontrol of dysphagia and chest pain. Gastroesophagealreflux is the most common troublesome side effect,and is well controllable with proton pump inhibitors.Furthermore, POEM opened the era of submucosal tunnelendoscopy, with many other applications. Based onthe same principles with POEM, in combination withnew technological developments, such as endoscopicsuturing, peroral endoscopic tumor resection (POET), issafely and effectively applied for challenging submucosalesophageal, EGJ and gastric cardia tumors (submucosaltumors), emerged from muscularis propria. POET showedup to know promising results, however, it is restricted tospecialized centers. The present article reviews the recentdata of POEM and POET and discussed controversialissues that need further study and future perspectives.

  8. Synchronous resections of primary colorectal tumor and liver metastasis by laparoscopic approach.

    Science.gov (United States)

    Cheung, Tan To; Poon, Ronnie Tung Ping

    2013-06-27

    Liver metastasis of colorectal cancer is common. Resection of solitary tumors of primary and metastatic colorectal cancer can have a favorable outcome. Open resection of primary colorectal tumor and liver metastasis in one operation or in separate operations is currently common practice. Reports have shown that synchronous resections do not jeopardize short or long-term surgical outcomes and that this is a safe and effective approach in open surgery. The development of laparoscopic colorectal surgery and laparoscopic hepatectomy has made a minimally invasive surgical approach to treating colorectal cancer with liver metastasis feasible. Synchronous resections of primary colorectal tumor and liver metastasis by laparoscopy have recently been reported. The efficacy and safety of laparoscopic colorectal resection and laparoscopic hepatectomy have been proven separately but synchronous resections by laparoscopy are in hot debate. As it has been shown that open resection of primary colorectal tumor and liver metastasis in one operation results in an equally good short-term outcome when compared with that done in separate operations, laparoscopic resection of the same in one single operation seems to be a good option. Recent evidence has shown that this new approach is a safe alternative with a shorter hospital stay. Large scale randomized controlled trials are needed to demonstrate the effectiveness of this minimally invasive approach.

  9. Giant cell tumor of bone: Multimodal approach

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    Gupta A

    2007-01-01

    Full Text Available Background: The clinical behavior and treatment of giant cell tumor of bone is still perplexing. The aim of this study is to clarify the clinico-pathological correlation of tumor and its relevance in treatment and prognosis. Materials and Methods: Ninety -three cases of giant cell tumor were treated during 1980-1990 by different methods. The age of the patients varied from 18-58 yrs with male and female ratio as 5:4. The upper end of the tibia was most commonly involved (n=31, followed by the lower end of the femur(n=21, distal end of radius(n=14,upper end of fibula (n=9,proximal end of femur(n=5, upper end of the humerus(n=3, iliac bone(n=2,phalanx (n=2 and spine(n=1. The tumors were also encountered on uncommon sites like metacarpals (n=4 and metatarsal(n=1. Fifty four cases were treated by curettage and bone grafting. Wide excision and reconstruction was performed in twenty two cases . Nine cases were treated by wide excision while primary amputation was performed in four cases. One case required only curettage. Three inaccessible lesions of ilium and spine were treated by radiotherapy. Results: 19 of 54 treated by curettage and bone grafting showed a recurrence. The repeat curettage and bone grafting was performed in 18 cases while amputation was done in one. One each out of the cases treated by wide excision and reconstruction and wide excision alone recurred. In this study we observed that though curettage and bone grafting is still the most commonly adopted treatment, wide excision of tumor with reconstruction has shown lesser recurrence. Conclusion: For radiologically well-contained and histologically typical tumor, curettage and autogenous bone grafting is the treatment of choice . The typical tumors with radiologically deficient cortex, clinically aggressive tumors and tumors with histological Grade III should be treated by wide excision and reconstruction.

  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. Giant-Cell Tumor of the Distal Ulna Treated by Wide Resection and Ulnar Support Reconstruction: A Case Report

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    Akio Minami

    2010-01-01

    Full Text Available Giant-cell tumor of bone occurred in the distal end of the ulna is extremely uncommon. A 23-year-old male had a giant-cell tumor occurred in the distal end of the ulna. After wide resection of the distal segment of the ulna including giant-cell tumor, ulnar components of the wrist joint were reconstructed with modified Sauvé-Kapandji procedure using the iliac bone graft, preserving the triangular fibrocartilage complex and ulnar collateral ligament in order to maintain ulnar support of the wrist, and the proximal stump of the resected ulna was stabilized by tenodesis using the extensor carpi ulnaris tendon. One year after operation, the patient's wrist was pain-free and had a full range of motion. Postoperative X-rays showed no abnormal findings including recurrence of the giant-cell tumor and ulnar translation of the entire carpus. The stability of the proximal stump of the distal ulna was also maintained.

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

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    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. A massive chondroblastoma in the proximal humerus simulating malignant bone tumors.

    Science.gov (United States)

    Tonogai, Ichiro; Takahashi, Mitsuhiko; Manabe, Hiroaki; Nishisho, Toshihiko; Iwamoto, Seiji; Takao, Shoichiro; Kagawa, Seiko; Kudo, Eiji; Yasui, Natsuo

    2013-01-01

    Chondroblastoma is a mostly benign bone neoplasm that typically affects the second decade of life and exhibits a lytic lesion in the epiphysis of long bones. We report an extreme case of massive, destructive chondroblastoma of the proximal humerus in a 9-year-old girl. It was difficult to differentiate using imaging information the lesion from malignant bone tumors such as osteosarcoma. Histopathological examination from biopsy proved chondroblastoma. The tumor was resected after preoperative transcatheter embolization. Reconstructive procedure for the proximal humerus was not performed due to the local destruction. The present case demonstrates clinical and radiological differentiations of the massive chondroblastoma from the other lesions and histopathological understandings for this lesion.

  14. Submental tracheal intubation for resection of recurrent giant pituitary tumor:a case report

    Institute of Scientific and Technical Information of China (English)

    Zhong Hejiang; Wang Yunling; Yang Tiande

    2011-01-01

    Airway management in the patients who receive transmaxillary approach for resection of giant pituitary tumor presents a clinical challenge to the anesthesiologists. Oral or nasal route for tracheal intubation can interfere with surgical procedures. This report describes submental tracheal intubation for airway management in a patient who underwent resection of recurrent giant pituitary tumor via transmaxillary approach. Submental tracheal intubation is an adaptable and safe alternative technology for airway management during operation.

  15. Surgical treatment of multifocal giant cell tumor of carpal bones with preservation of wrist function: case report.

    Science.gov (United States)

    Tarng, Yih-Wen; Yang, Shan-Wei; Hsu, Chien-Jen

    2009-02-01

    We report a rare case of multifocal giant cell tumor of bone involving the trapezium, trapezoid, capitate, and scaphoid with soft tissue extension. Following intralesional resection, an autogenous corticocancellous iliac crest bone graft was used to fill the resultant defect and preserve carpal height and radiocarpal motion. Successful union with no recurrence was noted at 1-year follow-up.

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

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    Rocca, M., E-mail: michele.rocca@ior.it [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Salone, M. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Galletti, S. [Ultrasound Unit, The Rizzoli Orthopaedic Institute, Bologna (Italy); Balladelli, A. [Laboratory of Experimental Oncology, The Rizzoli Orthopaedic Institute, Bologna (Italy); Vanel, D. [Research in Imaging Musculo Skeletal Tumors, The Rizzoli Orthopaedic Institute, Bologna (Italy); Briccoli, A. [General and Thoracic Surgery, The Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy)

    2013-12-01

    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. Liver Metastasis Four Years after Whipple's Resection for Solid-Pseudopapillary Tumor of the Pancreas

    Directory of Open Access Journals (Sweden)

    Srikrishna Nagri

    2007-03-01

    Full Text Available Context Solid-pseudopapillary tumor of the pancreas is a rare tumor which usually affects young females in their second and third decade of life. Metastasis is very rare after a resection of curative intent. Case report We report a case of a 65-yearold white female who presented with metastasis to the liver four years after Whipple’s resection for a solid-pseudopapillary tumor of the pancreas. Conclusions Solid-pseudopapillary tumors of the pancreas can present with metastasis a long time after resection of the primary tumor. Long term close follow up of these patients should be done. The survival rate even after liver metastasis is good.

  18. A case of recurrent giant cell tumor of bone with malignant transformation and benign pulmonary metastases

    Directory of Open Access Journals (Sweden)

    Gray Robert

    2010-09-01

    Full Text Available Abstract Giant cell tumor (GCT of bone is a locally destructive tumor that occurs predominantly in long bones of post-pubertal adolescents and young adults, where it occurs in the epiphysis. The majority are treated by aggressive curettage or resection. Vascular invasion outside the boundary of the tumor can be seen. Metastasis, with identical morphology to the primary tumor, occurs in a few percent of cases, usually to the lung. On occasion GCTs of bone undergo frank malignant transformation to undifferentiated sarcomas. Here we report a case of GCT of bone that at the time of recurrence was found to have undergone malignant transformation. Concurrent metastases were found in the lung, but these were non-transformed GCT.

  19. Myxofibroma of the maxilla. Reconstruction with iliac crest graft and dental implants after tumor resection.

    Science.gov (United States)

    Infante-Cossío, Pedro; Martínez-de-Fuentes, Rafael; García-Perla-García, Alberto; Jiménez-Castellanos, Emilio; Gómez-Izquierdo, Lourdes

    2011-07-01

    Odontogenic fibromyxomas are benign odontogenic tumors of mesenchymal origin of rare presentation in the oral cavity, which exhibit locally aggressive behavior and are prone to local recurrence. The controversy has mainly been on therapeutic management with recommendations varying, depending on the clinical cases, from simple curettage of lesion to segmental bone resection. We present a case report describing the reconstruction of an osseous defect in the maxilla and the restoration with dental implants in a 32 year old female patient after radical surgical excision due to an odontogenic fibromyxoma with locally aggressive behavior. The primary reconstruction of maxillary discontinuity defect was carried out by an immediate non-vascularized cortico-cancellous iliac crest graft. Using a computer-guided system for the implant treatment-planning, three dental implants were secondary placed in the bone graft by means of flapless implant surgery. The patient was subsequently restored with an implant-supported fixed prosthesis that has remained in continuous function for a period of three years. The surgical, reconstructive and restorative treatment sequence and techniques are discussed.

  20. Segmental resection and reconstruction of bone neoplasms%骨肿瘤病段切除并骨缺损修复

    Institute of Scientific and Technical Information of China (English)

    杨安礼

    2001-01-01

    Objective To restore the function of extrimities in patients with bone neoplasms, segmental resection and reconstruction of bone neoplasms was performed. Methods The limb was conserved and bone defect repaired by artificial prosthesis vascularized bone graft, osteoarticular allograft, sliding graft, and bone cement following segmental resection of bone neoplasms. Results 26 patients were treated. No recurrence was found and a good union of bone observed locally in vascularized bone grafting and sliding grafting, in some sites osteoarticular allograft transplantation caused rejector reaction, bone cement plugging was appropriate to repair of neoplasms in special location, functions of the joint were well recovered in arthroplastey. Conclusion It is effective that a suitable bone substitutes to repair bone defect after segmental resection of bone neoplasms, in some patients with benign or low malignancy bone tumor.%目的修复切除骨肿瘤后的骨缺损肢体,恢复其功能。方法采用特制人工金属假体、带血管蒂游离骨、异体关节、自体骨、骨水泥等修复骨缺损。结果 26例中应用带血管蒂游离骨或自体骨植骨术愈合最佳并且无复发;异体骨移植有一定的排异反应;骨水泥填塞只适用于特殊部位骨缺损的修复;人工假体修复,功能恢复良好。结论对某些良性骨肿瘤及低度恶性的骨肿瘤作病段切除后,选择适当的替代物修复缺损行之有效。

  1. 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.

  2. 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.

  3. 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.

  4. OSTEOARTICULAR ALLOGRAFTS IN PAEDIATRIC BONE TUMOR RECONSTRUCTION OF THE KNEE.

    Science.gov (United States)

    Campanacci, D A; Dursky, S; Totti, F; Frenos, F; Scoccianti, G; Beltrami, G; Capanna, R

    2015-01-01

    Osteoarticular allografts represent a reconstructive option after bone tumor resection around the knee in growing children. The major advantage is the chance to preserve the growth plate of the remaining bone, but the disadvantage is the high failure rate eventually requiring definitive prosthetic replacement at skeletal maturity. We retrospectively reviewed 22 patients who underwent osteoarticular allograft reconstructions of the distal femur (16) or proximal tibia (6). There were 12 females and 10 males with an average age at surgery of 11 years (7-15). The diagnosis was osteosarcoma in 19 cases and Ewing sarcoma in 3. All patients underwent pre- and post-operative chemotherapy. At an average follow-up of 103 months (12-167), 18 patients (82%) were alive and 4 had died (18%). We observed 10 allograft failures requiring prosthetic replacement, 6 in distal femur and 4 in proximal tibia reconstructions. At last follow-up 8 allografts (36%) were still in place. Overall allograft survival was 79.6% at five and 45.8% at ten years. In distal femur, allograft survival was 86.2% at five and 59.1% at ten years. In proximal tibia, allograft survival was 62.5% at 5 years and 31.2% at 67 months. Average limb shortening was 3 cm (0- 5) in 8 patients with the allograft still in situ and 2 cm (0-4) in 10 patients after prosthetic replacement. Average MSTS functional score of the whole series was 25 (83.7%). The MSTS score of patients after revision with prosthetic replacement was 24 (80%) while patients who still had the allograft retained had an average MSTS scores of 26.8 (89.3%). In conclusion, osteoarticular allograft reconstruction of the knee after bone tumor resection in pediatric age can be considered a temporary solution with the aim to limit limb length discrepancy before definitive prosthetic replacement after skeletal maturity.

  5. 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.

  6. Clinical and pathological characteristics of septum pellucidum tumor and choice of surgical approaches for its resection

    Institute of Scientific and Technical Information of China (English)

    WANG Lei; ZHANG Mao-zhi; ZHANG Wei; ZHAO Shang-feng; ZHAO Ji-zong; JIA Jin-xiu

    2005-01-01

    Background Tumor involving the septum pellucidum is uncommon. Surgery as the main therapeutic procedure for this lesion is a challenge to neurosurgeons. We analyzed the clinical characteristics and pathological features of septum pellucidum tumor in 41 patients and compared the curative effects of frontal transcortical, trans-sulcal and interhemispheric transcallosal approaches. Methods Clinical characteristics and the pathological features of septum pellucidum tumor were investigated retrospectively in 41 patients. The differences in postoperative residual rates, extents of tumors and resection of normal brain tissues after use of the three approaches in these patients were analyzed statistically. Results Septum pellucidum tumor is more likely to attack young or middle-aged persons. The tumor mainly presents itself as a central neurocytoma or cerebral low-grade glioma in pathology and manifests as intracranial hypertension clinically. No difference was found in the extent of tumor resection but significant difference in the extent of normal brain tissue resection and in postoperative disability rate among the three approaches. The transcortical approach brought about the most serious injury to brain tissue and the highest disability rate, Whereas the frontal transcallosal approach the lightest injury and the lowest disability rate. The injury to brain tissue and the disability rate brought about by the front trans-sulcus approach were between the above two approaches. Conclusions Operation is still regarded the major treatment for septum pellucidum tumor. Transcallosal and trans-sulcus approaches are fit with the concept of minimally invasive surgery, and transcallosal approach is the first choice for septum pellucidum tumor.

  7. A pilot randomized control study to evaluate endoscopic resection using a ligation device for rectal carcinoid tumors

    Institute of Scientific and Technical Information of China (English)

    Hiroyuki Sakata; Sadahiro Amemori; Kotaro Mannen; Masanobu Mizuguchi; Kazuma Fujimoto; Ryuichi Iwakiri; Akifumi Ootani; Seiji Tsunada; Shinichi Ogata; Hibiki Ootani; Ryo Shimoda; Kanako Yamaguchi; Yasuhisa Sakata

    2006-01-01

    AIM: Rectal carcinoid tumors smaller than 10 mm can be resected with local excision using endoscopy. In order to remove rectal carcinoid tumors completely, we evaluated endoscopic mucosal resection with a ligation device in this pilot control randomized study.METHODS: Fifteen patients were diagnosed with rectal carcinoid tumor (less than 10 mm) in our hospital from 1993 to 2002. There were 9 males and 6 females,with a mean age 61.5 years (range, 34-77 years).The patientshad no complaints of carcinoid syndrome symptoms. Fifteen patients were randomly divided into 2 groups: 7 carcinoid tumors were treated by conventional endoscopic resection, and 8 carcinoid tumors were treated by endoscopic resection using a ligation device.RESULTS: All rectal carcinoid tumors were located at the middle to distal rectum. The size of the tumors varied from 3 mm to 10 mm and background characteristics of the patients were not different in the two groups.The rate of complete removal of carcinoid tumors using a ligation device (100%, 8/8) was significantly higher than that of conventional endoscopic resection (57.1%,4/7). The three patients had tumor involvement of deep margin, for which additional treatment was performed.No complications occurred during or after endoscopic resection using a ligation device. All patients in the both groups were alive during the 3-year observation period.CONCLUSION: Endoscopic resection using a ligation device is a useful and safe method for resection of small rectal carcinoid tumors.

  8. Microsurgical resectability, outcomes, and tumor control in meningiomas occupying the cavernous sinus.

    Science.gov (United States)

    Nanda, Anil; Thakur, Jai Deep; Sonig, Ashish; Missios, Symeon

    2016-08-01

    OBJECTIVE Cavernous sinus meningiomas (CSMs) represent a cohort of challenging skull base tumors. Proper management requires achieving a balance between optimal resection, restoration of cranial nerve (CN) function, and maintaining or improving quality of life. The objective of this study was to assess the pre-, intra-, and postoperative factors related to clinical and neurological outcomes, morbidity, mortality, and tumor control in patients with CSM. METHODS A retrospective review of a single surgeon's experience with microsurgical removal of CSM in 65 patients between January 1996 and August 2013 was done. Sekhar's classification, modified Kobayashi grading, and the Karnofsky Performance Scale were used to define tumor extension, tumor removal, and clinical outcomes, respectively. RESULTS Preoperative CN dysfunction was evident in 64.6% of patients. CN II deficits were most common. The greatest improvement was seen for CN V deficits, whereas CN II and CN IV deficits showed the smallest degree of recovery. Complete resection was achieved in 41.5% of cases and was not significantly associated with functional CN recovery. Internal carotid artery encasement significantly limited the complete microscopic resection of CSM (p < 0.0001). Overall, 18.5% of patients showed symptomatic recurrence after their initial surgery (mean follow-up 60.8 months [range 3-199 months]). The use of adjuvant stereotactic radiosurgery (SRS) after microsurgery independently decreased the recurrence rate (p = 0.009; OR 0.036; 95% CI 0.003-0.430). CONCLUSIONS Modified Kobayashi tumor resection (Grades I-IIIB) was possible in 41.5% of patients. CN recovery and tumor control were independent of extent of tumor removal. The combination of resection and adjuvant SRS can achieve excellent tumor control. Furthermore, the use of adjuvant SRS independently decreases the recurrence rates of CSM.

  9. Treatment of the lacrimal excretory system after resection of medial canthal and eyelid tumors.

    Science.gov (United States)

    Older, J J

    1979-06-01

    A simplified method of lacrimal excretory system repair is presented. If part of a canaliculus is resected during removal of an eyelid tumor, the remaining section of the canaliculus can be exteriorized to the lacrimal lake. A silicone tube is threaded into the canaliculus and allowed to remain in place for one to two weeks. If both canaliculi and the common canaliculus are removed during resection for a medial canthal tumor, a silicone tube can be threaded into the nasolacrimal duct and brought out the area of the medial canthal angle. Conjunctiva which is wrapped around the tube can then form a new drainage canal into the remainder of the lacrimal excretory system.

  10. Improving Surgical Resection of Metastatic Liver Tumors With Near-Infrared Optical-Guided Fluorescence Imaging.

    Science.gov (United States)

    Barabino, Gabriele; Porcheron, Jack; Cottier, Michèle; Cuilleron, Muriel; Coutard, Jean-Guillaume; Berger, Michel; Molliex, Serge; Beauchesne, Brigitte; Phelip, Jean Marc; Grichine, Alexei; Coll, Jean-Luc

    2016-08-01

    Objective The aim of this study was to investigate the feasibility and future clinical applications of near-infrared (NIR) fluorescence imaging to guide liver resection surgery for metastatic cancer to improve resection margins. Summary Background Data A subset of patients with metastatic hepatic tumors can be cured by surgery. The degree of long-term and disease-free survival is related to the quality of surgery, with the best resection defined as "R0" (complete removal of all tumor cells, as evidenced by microscopic examination of the margins). Although intraoperative ultrasonography can evaluate the surgical margins, surgeons need a new tool to perfect the surgical outcome. Methods A preliminary study was performed on 3 patients. We used NIR imaging postoperatively "ex vivo" on the resected liver tissue. The liver tumors were preoperatively labelled by intravenously injecting the patient with indocyanine green (ICG), a NIR fluorescent agent (24 hours before surgery, 0.25 mg/kg). Fluorescent images were obtained using a miniaturized fluorescence imaging system (FluoStic, Fluoptics, Grenoble, France). Results After liver resection, the surgical specimens from each patient were sliced into 10-mm sections in the operating room and analyzed with the FluoStic. All metastatic tumors presented rim-type fluorescence. Two specimens had incomplete rim fluorescence. The pathologist confirmed the presence of R1 margins (microscopic residual resection), even though the ultrasonographic analysis indicated that the result was R0. Conclusions Surgical liver resection guided by NIR fluorescence can help detect potentially uncertain anatomical areas that may be missed by preoperative imaging and by ultrasonography during surgery. These preliminary results will need to be confirmed in a larger prospective patient series.

  11. 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.

  12. 酒精灭活骨复合人工假体治疗股骨远端骨巨细胞瘤及有限元分析%Clinical and finite element analysis of alcohol-deactivated autograft-prosthesis composite after resection of bone giant cell tumor in distal femur

    Institute of Scientific and Technical Information of China (English)

    许宋锋; 杨阳; 徐明; 于秀淳

    2011-01-01

    Objective To evaluate the clinical outcome of alcohol-deactivated autograft-prosthesis composite after resection of bone giant cell tumor in distal femur.Methods From January 2007 to October 2008,5 patients with bone giant cell tumor in distal femur were treated with alcohol-deactivated autograftprosthesis composite,including 3 males and 2 females with an average age of 29.6 years(range,22-40).Three patients were diagnosed with postoperative recurrence,and 2 with pathological fracture.All patients were of Campanacci Ⅲ.Three-dimensional finite element models with 40% bone defect in distal femur were established based on CT images of a healthy volunteer.Three times of body mass load corresponding to the normal walking gait cycle was applied.The influence on stress distribution of femur-cement and prosthesis stem was analyzed.Results All patients were followed up for average 37 months,there was no infection,recurrence,loosening and limb length inequality.The bony healing time was 6 to 11 months.The mean MSTS function score was 25.7(range,25-27).The mean ISOLS graft score was 31.4 (range,28-35).The finite element analysis showed that for the short-term model,the maximum stress was 145.82 MPa in the proximal femur,40.90 MPa in the medial side of 1/4 proximal cement,and 389.24 MPa in the proximal prosthesis stem.The maximum stress was not exceeding the fatigue strength in three sites.For the long-term model,with the bone healing,the maximum stress on three sites decreased to 139.05,36.95,and 253.65 MPa,respectively.Conclusion These results suggest that the alcohol-deactivated autograft-prosthesis composite after resection ot bone giant cell tumor in distal femur can reduce the tumor recurrence and improve the short-term limb function,It is stable in short term and can reduce stress shielding in long term.%目的 探讨酒精灭活骨复合人工假体治疗股骨远端骨巨细胞瘤的临床疗效.方法 2007年1月至2008年10月应用酒精灭活骨复合旋转铰

  13. Pre-mental foramen mandibulotomy for resecting tumors of tongue base and parapharyngeal space

    Institute of Scientific and Technical Information of China (English)

    YU Guang-yan; ZHANG Lei; GUO Chuan-bin; HUANG Min-xian; MAO Chi; PENG Xin

    2005-01-01

    Background Resection of tumors arising from the tongue base and the parapharyngeal space is difficult for exposure and manipulation because of their obscure location. The aim of this study was to evaluate the surgical approach of the pre-mental foramen mandibulotomy for resecting the tumors of tongue base and parapharyngeal space.Methods Fifty-one patients with tumors of tongue base and parapharyngeal space were treated using the mandibulotomy approach on the pre-mental foramen. In the present study, this technique was described in detail. The patients were followed up for three months to six years with a mean of 26 months. Results The tumors of tongue base and parapharyngeal space could be exposed clearly and be resected radically by surgical approach of pre-mental foramen mandibulotomy. The surgical complications were reduced. Conclusions Compared to other surgical approaches, such as lateral mandibulotomy, midline mandibulotomy, the suprahyoid parapharyngeal approach, and paramedian mandibulotomy, we found that the pre-mental foramen mandibulotomy is the ideal choice for resecting the tumors of tongue base and parapharyngeal space.

  14. 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.

  15. Case Report: En Bloc Resection of Pancoast Tumor with Adjuvant Aortic Endograft and Chemoradiation

    Science.gov (United States)

    Lu, Tony; Fischer, Uwe M.; Marco, Rex A.; Naoum, Joseph J.; Reardon, Michael J.; Lumsden, Alan B.; Blackmon, Shanda H.; Davies, Mark G.

    2015-01-01

    “Pancoast” tumors frequently require a multidisciplinary approach to therapy and are still associated with high morbidity and mortality. Due to their sensitive anatomic location, complex resections and chemoradiation regimens are typically required for treatment. Those with signs of aortic invasion pose an even greater challenge, given the added risks of cardiopulmonary bypass for aortic resection and interposition. Placement of an aortic endograft can facilitate resection if the tumor is in close proximity to or is invading the aorta. Prophylactic endografting to prevent radiation-associated aortic rupture has also been described. This case describes a 60-year-old female who presented with a stage IIIa left upper lobe undifferentiated non-small-cell carcinoma encasing the subclavian artery with thoracic aorta and bony invasion. Following carotid-subclavian bypass with Dacron, en bloc resection of the affected lung, ribs, and vertebral bodies was performed. The aorta was prophylactically reinforced with a Gore TAG thoracic endograft prior to adjuvant chemoradiation. The patient remains disease-free at more than 5 years follow-up after completing her treatment course. Endovascular stenting with subsequent chemoradiation may prove to be a viable alternative to palliation or open operative management and prevention of aortic injury during tumor resection and/or adjuvant therapy in select patients with aortic involvement. PMID:26306134

  16. 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)

  17. Osteogenic tumors of bone; Osteogene Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Jobke, B. [Deutsches Krebsforschungszentrum (DKFZ), Abtl. Radiologie, Heidelberg (Germany); Werner, M. [MVZ des HELIOS Klinikum Emil von Behring, Orthopaedische Pathologie - Referenzzentrum, Institut fuer Gewebediagnostik Berlin, Berlin (Germany)

    2016-06-15

    Osteogenic tumors include malignant and benign tumors that produce tumor osteoid and/or bone tissue. Osteosarcoma is the most common malignant bone tumor, especially in children and young adults. The entities with their characteristic morphological features are described to enable the reader to come to a diagnosis and differential diagnosis on the basis of patient age, history and predominant location of the tumor. For this review we selectively used mainly large published patient cohorts. Our own and externally published data on widely accepted tumor criteria were also compared. Detection is the initial diagnostic step for an osseous lesion, and is determined by the sensitivity of the method applied. Plain X-ray films in two planes and CT are the basics in the radiological toolkit for osteogenic tumors. For evaluation of local tumor extension and biopsy planning MRI or scintigraphy should be combined. MRI as a stand-alone diagnostic tool is insufficient. For malignant bone tumors staging should be performed, applying a variable combination of thoracic CT, MRI, scintigraphy, and positron emission tomography (PET). Osteosarcoma, along with Ewing sarcoma and chondrosarcoma, are the most common malignant bone tumors; all sub-entities are significantly rarer. Among benign bone tumors, osteoid osteomas have the highest incidence, presenting with typical pain, location, and age predilection. Diagnostics and treatment of malignant bone tumors should preferably be performed in specialized centers because of significant therapeutic implications for patients. In uncertain cases, a second opinion should always be obtained. (orig.) [German] Osteogene Tumoren umfassen maligne und benigne Tumoren, die eine tumoreigene Produktion von Osteoid und/oder Knochengewebe aufweisen. Das Osteosarkom ist der haeufigste maligne Knochentumor v. a. bei Kindern und jungen Erwachsenen. Es werden die Entitaeten mit ihren morphologischen Charakteristika beschrieben, um anhand wichtiger

  18. 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.

  19. 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.

  20. Laparoscopic resection of submucosal tumor on posterior wall of gastric fundus

    Institute of Scientific and Technical Information of China (English)

    Zhong-Wei Ke; Cheng-Zhu Zheng; Ming-Gen Hu; Dan-Lei Chen

    2004-01-01

    AIM: Laparoscopic resection of tumors on the posterior wall of gastric fundus, especially when they are next to the esophagocardiac junction (ECJ), is both difficult and timeconsuming. Furthermore, it can lead to inadvertent esophagus stenosis and injury to the spleen. In order to overcome these difficulties, laparoscopically extraluminal resection of gastric fundus was designed to manage submucosal tumors located on the posterior wall of gastric fundus and next to ECJ.METHODS: From January 2001 to September 2003,laparoscopically extraluminal resection of gastric fundus was successfully carried out on 15 patients. There were11 males and 4 females with an average age of 58 years(range, 38 to 78 years). The mean diameter of the tumors was 4.8 cm. The distance of the tumor border from ECJ was about 1.5-2.5 cm. The four-portal operation procedures were as follows: localization of the tumor, dissection of the omentum, mobilization of the gastric fundus and the upper polar of spleen, exposure of ECJ, and resection of the gastric fundus with Endo GIA.RESULTS: The laparoscopic operation time averaged(66.2±10.4) min, the average amount of bleeding was(89.4±21.7) mL. The mean post-operative hospital stay was (5.3±1.1) d. Within 36 h post-operation, 73.3% of all the patients recovered their gastrointestinal function and began to eat something and to walk. In all the operations,no apparent tumor focus was left and no complication or conversion to open surgery occurred.CONCLUSION: Our newly designed procedure,laparoscopically extraluminal resection of the gastric fundus, can avoid contamination of the abdominal cavity,injury to the spleen and esophageal stenosis. The procedure seems to be both safe and effective.

  1. 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.

  2. 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.

  3. Characteristics of flexed knee gait and functional outcome of a patient who underwent knee reconstruction with a hingeless prosthesis for bone tumor resection: a case report with gait analysis and comparison with healthy subjects.

    Science.gov (United States)

    Okita, Y; Tatematsu, N; Nagai, K; Nakayama, T; Nakamata, T; Okamoto, T; Toguchida, J; Ichihashi, N; Tsuboyama, T

    2013-12-01

    We report on a patient after knee reconstruction for osteosarcoma in the distal femur using a hingeless prosthesis K-MAX KNEE system K-5 who walked without ipsilateral knee extension in the latter half of the stance phase (flexed knee gait). We evaluated the patient using three-dimensional gait analysis and isokinetic knee strength measurement, and compared the patient with five healthy subjects. The Musculoskeletal Tumor Society (MSTS) score was also used for evaluation. The patient kept his operated knee flexed during mid stance. The maximal ankle plantarflexion internal moment was lower on the ipsilateral side than on the contralateral side, and lower than in the healthy subjects. The negative ankle power during the stance phase was generally stronger on the ipsilateral side than on the contralateral side, and also in the healthy subjects. Unusual contralateral hip flexion occurred after the initial contact, indicating increased joint load on the ipsilateral ankle and the contralateral hip. The ratios of the peak knee extension/flexion torque were 0.7 on the ipsilateral side, 1.9 on the contralateral side, and 1.7 in the healthy subjects. The MSTS score of the patient was 23/30 (76.6%). Flexed knee gait might account for the reduction of ipsilateral hip flexion and ankle plantarflexion moment during the late stance phase. These results suggest the importance of focusing more on the ipsilateral ankle joint and the contralateral hip joint to maintain the function of the entire limb joints of the patients with flexed knee gait.

  4. 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.

  5. Neurosurgical venous considerations for tumors of the pineal region resected using the infratentorial supracerebellar approach.

    Science.gov (United States)

    Kodera, Toshiaki; Bozinov, Oliver; Sürücü, Oguzkan; Ulrich, Nils H; Burkhardt, Jan-Karl; Bertalanffy, Helmut

    2011-11-01

    The authors present a microsurgical technique for the resection of a heterogeneous group of pineal-region tumors and discuss the key points for successfully performing this surgery. Twenty-six consecutive patients with pineal-region tumors were resected by the senior author (H.B.) and analyzed retrospectively. For all 26 patients, the operation was conducted using the infratentorial supracerebellar (ITSC) approach in the sitting (23 patients) or Concorde (three patients) positions. Twenty-five patients had symptomatic obstructive hydrocephalus and were treated with ventricular drainage, a previously inserted ventriculoperitoneal shunt, or an endoscopic third ventriculostomy before undergoing resection of the pineal-region tumor. The gross total removal of the tumor was achieved in 23 patients and subtotal removal was achieved in three patients. The tumors were pathologically diagnosed mainly as pineocytomas (10), pilocytic astrocytomas (6), or pineal cysts (4). Twenty-five of the patients clinically improved after surgery, and there was no mortality. Two patients experienced transient postoperative neurological deterioration: one patient developed Parinaud syndrome, and one patient developed intermittent diplopia. Successful surgery and patient outcome when treating tumors of the pineal region using the ITSC approach requires: (i) preservation of the venous flow of the Galenic draining system; (ii) preservation of the thick bridging veins of the tentorial surface of the cerebellum, especially the hemispheric bridging veins; and (iii) minimizing retraction of the cerebellum during surgery to avoid adverse effects caused by both direct cerebellar compression and disturbance of the venous circulation.

  6. MODIFIED TRANSCRANIAL APPROACH FOR RESECTION OF TUMORS INVOLVING THE ANTERIOR CRANIAL FOSSA

    Institute of Scientific and Technical Information of China (English)

    赵素萍; 陶正德; 肖健云

    2001-01-01

    Objective: To introduce the method of a modified transcranial approach for resection of paranasal sinuses tumors involving the anterior skull base and to address our experience with the approach. Patients and Methods: Ten cases were operated by the approach. Among them, 4 suffered from benign meningeomas, 6 with malignant tumors included one chondrosarcoma, two malignant meningeomas, two olfactory neuroblastomas, and one squamous sarcoma. Of the patients, 4 cases had primary tumor and 6 cases had recurrent tumors. Result: All of the ten cases underwent operation and no postopertion complication occurred. 7 cases have survived for one to four years without tumor recurrence. 3 cases with malignant tumor died of tumor relapse in one to two years. Conclusion: This method significantly has helped to reduce the persistence and recurrence of the disease.

  7. 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.

  8. Indications for surgical resection of benign pancreatic tumors; Indikationen zur chirurgischen Therapie benigner Pankreastumoren

    Energy Technology Data Exchange (ETDEWEB)

    Isenmann, R.; Henne-Bruns, D. [Chirurgische Universitaetsklinik, Klinik fuer Allgemein-, Viszeral- und Transplantationschirurgie, Ulm (Germany)

    2008-08-15

    Benign pancreatic tumors should undergo surgical resection when they are symptomatic or - in the case of incidental discovery - bear malignant potential. This is the case for the majority of benign pancreatic tumors, especially for intraductal papillary mucinous neoplasms or mucinous cystic adenomas. In addition, resection is indicated for all tumors where preoperative diagnostic fails to provide an exact classification. Several different operative techniques are available. The treatment of choice depends on the localization of the tumor, its size and on whether there is evidence of malignant transformation. Partial duodenopancreatectomy is the oncological treatment of choice for tumors of the pancreatic head whereas for tumors of the pancreatic tail a left-sided pancreatectomy is appropriate. Middle pancreatectomy or duodenum-preserving resection of the pancreatic head is not a radical oncologic procedure. They should only be performed in cases of tumors without malignant potential. (orig.) [German] Die Indikationsstellung zur Resektion benigner Pankreastumoren ist gegeben, wenn es sich um einen symptomatischen Tumor handelt oder - bei einem Zufallsbefund - um einen Tumor mit Potenzial zur malignen Entartung. Dies besteht bei der Mehrzahl der benignen Pankreastumoren, insbesondere bei der intraduktalen papillaeren muzinoesen Neoplasie (IPMN) oder muzinoesen Zystadenomen. Operativer Abklaerung beduerfen auch Tumoren, die unter Ausschoepfung aller diagnostischer Moeglichkeiten nicht eindeutig klassifizierbar sind. An chirurgischen Therapieverfahren stehen verschiedene Techniken zur Verfuegung. Die Wahl des Verfahren haengt von der Groesse und Lokalisation des Tumors ab und von der Frage, ob eine maligne Entartung bereits stattgefunden hat. Das onkologisch korrekte Standardresektionsverfahren bei Tumoren des Pankreaskopfes ist die partielle Duodenopankreatektomie, bei Tumoren des Pankreasschwanzes die Pankreaslinksresektion. Eine segmentale Resektion des

  9. Holmium laser transurethral resection of bladder tumor: Our experience

    Directory of Open Access Journals (Sweden)

    Nischith D'souza

    2016-01-01

    Conclusions: HoL-EBRBT might prove to be preferable alternatives to CM-TURBT management of nonmuscle-invasive bladder cancer. HoL-EBRBT however did not demonstrate an obvious advantage over CM-TURBT in tumor recurrence rate.

  10. Hearing preservation in acoustic neuroma resection: Analysis of petrous bone measurement and intraoperative application

    Directory of Open Access Journals (Sweden)

    Levent Tanrikulu

    2016-01-01

    Conclusion: Petrous bone measurement by high-resolution MRI data enables safe surgical exposure of the internal acoustic canal with avoidance of injury to the labyrinth and a better postoperative prognosis, especially for intrameatal ANs and for the resection of intrameatal portions of larger neuromas. The prognostic factors enable the patients and the surgeon a better estimation of postoperative results regarding deafness and postoperative hypacusis and support a consolidated treatment planning.

  11. 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

  12. Tumor-induced osteomalacia originating from bones:a report of two cases and literature review

    Institute of Scientific and Technical Information of China (English)

    Zhuo Cai; Qiang Meng Co-first author; Hanfeng Guan; Qing Yang; Caihong Yang; Jun Xiao

    2016-01-01

    Tumor-induced osteomalacia (TIO) is caused by a smal mesenchymal tumor and characterized by hypo-phosphatemia, phosphaturia, low levels of 1,25(OH)2 vitamin D, and elevated levels of alkaline phosphatase and fibroblast growth factor 23 (FGF-23). The typical symptoms include bone pain, pseudofracture, osteo-porosis, and muscle weakness. These symptoms are due to the overproduction of FGF-23 as a phosphatu-ric agent. Diagnosis of this disease is chalenging because of the smal lesion size and chronic symptoms. The cases described in this report were two patients with bone pain, severe muscle weakness, and dificulty performing activities, who were found to have TIO. The tumors were found through various imaging mo-dalities, including computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). The tumors responsible for the symptoms were localized on their femurs and resection resulted in normalization of their blood chemistries and complaints.

  13. Endoscopic resection of duodenal bulb neuroendocrine tumor larger than 10 mm in diameter

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    Naka Teiji

    2011-06-01

    Full Text Available Abstract Background Endoscopic treatment for duodenal bulb neuroendocrine tumor larger than 10 mm is still controversial. This report presents four cases successfully treated with endosonography (EUS-assisted endoscopic mucosal resection (EMR procedure for duodenal bulb neuroendocrine tumor larger than 10 mm in diameter. Methods The case series of four patients diagnosed with neuroendocrine tumor from 2003 to 2008 were reviewed. EUS demonstrated well-defined hypoechoic tumors confined to the submucosal hyperechoic layer and the underlying hypoechoic muscularis propria was intact in all four patients. EMR were planned and performed for the duodenal bulb neuroendocrine tumors larger than 10 mm. Results En bloc resections with tumor free lateral and basal margins were accomplished using an endoscopic diathermic snare with forward-viewing instruments without any complications. Neither residual duodenal neuroendocrine tumors nor metastatic lesions were detected during the observation period ranging 19 to 78 months Conclusion Duodenal bulb neuroendocrine, larger than 10 mm in diameter, can be treated by endoscopic procedure, after confirming that the tumor confined to the submucosal layer in EUS examination, and no lymph node involvement by abdominal CT and US.

  14. Laparoscopic wedge resection of synchronous gastric intraepithelial neoplasia and stromal tumor: a case report.

    Science.gov (United States)

    Mou, Yi-Ping; Xu, Xiao-Wu; Xie, Kun; Zhou, Wei; Zhou, Yu-Cheng; Chen, Ke

    2010-10-21

    Synchronous occurrence of epithelial neoplasia and gastrointestinal stromal tumor (GIST) in the stomach is uncommon. Only rare cases have been reported in the literature. We present here a 60-year-old female case of synchronous occurrence of gastric high-level intraepithelial neoplasia and GIST with the features of 22 similar cases and detailed information reported in the English-language literature summarized. In the present patient, epithelial neoplasia and GIST were removed en bloc by laparoscopic wedge resection. To the best of our knowledge, this is the first reported case treated by laparoscopic wedge resection.

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

    Directory of Open Access Journals (Sweden)

    Shellese A. Cannonier

    2015-08-01

    Full Text Available 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.

  16. 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.

  17. Total reconstruction of mandible by transport distraction after complete resection for benign and malignant tumors

    Directory of Open Access Journals (Sweden)

    S M Balaji

    2016-01-01

    Conclusions: TDO potentially benefits patients with segmental bony defects following tumor ablation in mandible. It is an unswerving tool to achieve sufficient bone in mandible in patients who cannot undergo aggressive surgery or poor general health. Bone resorption remains a critical issue for this reconstruction technique, though blood supply is continuously maintained in TDO.

  18. 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.

  19. 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

  20. Ideal number of biopsy tumor fragments for predicting HER2 status in gastric carcinoma resection specimens.

    Science.gov (United States)

    Ahn, Sangjeong; Ahn, Soomin; Van Vrancken, Michael; Lee, Minju; Ha, Sang Yun; Lee, Hyuk; Min, Byung-Hoon; Lee, Jun Haeng; Kim, Jae J; Choi, Sunkyu; Jung, Sin-Ho; Choi, Min Gew; Lee, Jun-Ho; Sohn, Tae Sung; Bae, Jae Moon; Kim, Sung; Kim, Kyoung-Mee

    2015-11-10

    Intratumoral heterogeneity of HER2 expression is common in gastric cancers and pose a challenge for identifying patients who would benefit from anti-HER2 therapy. The aim of this study is to compare HER2 expression in biopsy and resection specimens of gastric carcinoma by immunohistochemistry (IHC) and to find the ideal number of biopsy tumor fragments that can accurately predict HER2 overexpression in the corresponding surgically resected specimen. The HER2 IHC results of 702 paired biopsy and resection specimens of gastric cancer were compared.The mean number of biopsy fragments among all cases was 4.3 (range 1-11). HER2 was positive in 130 (18.5%) endoscopic biopsies and in 102 (14.5%) gastrectomy specimens. Intratumoral heterogeneity of HER2 was found in 80 (61.5%) biopsies and 70 (68.6%) resection specimens. Out of the 70 surgical specimens with intratumoral heterogeneity, 24 (34.3%) of the corresponding biopsies were categorized as negative (positive conversion). In the 86 (12.3%) discrepant cases, negative conversion was observed in 57 (66.3%) cases and positive conversion in 29 (33.7%). The fragment numbers were significantly correlated with the discrepancy of results and positive predictability (P = 0.0315 and P = 0.0052). ROC curve analysis and positive predictability showed that 4 fragments should be obtained to minimize the differences in HER2 scores between biopsy and resection specimen.In gastric carcinomas with discrepant HER2 results between biopsy and surgical resection specimens, intratumoral heterogeneity is common with most of them showing positive conversion. To predict HER2 status precisely, at least 4 biopsy fragments containing tumor cells are required.

  1. 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.

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

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    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.

  3. A Massive Chondroblastoma in the Proximal Humerus Simulating Malignant Bone Tumors

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    Ichiro Tonogai

    2013-01-01

    Full Text Available Chondroblastoma is a mostly benign bone neoplasm that typically affects the second decade of life and exhibits a lytic lesion in the epiphysis of long bones. We report an extreme case of massive, destructive chondroblastoma of the proximal humerus in a 9-year-old girl. It was difficult to differentiate using imaging information the lesion from malignant bone tumors such as osteosarcoma. Histopathological examination from biopsy proved chondroblastoma. The tumor was resected after preoperative transcatheter embolization. Reconstructive procedure for the proximal humerus was not performed due to the local destruction. The present case demonstrates clinical and radiological differentiations of the massive chondroblastoma from the other lesions and histopathological understandings for this lesion.

  4. Immunostimulatory sutures that treat local disease recurrence following primary tumor resection

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    Intra, Janjira; Zhang Xueqing; Salem, Aliasger K [Division of Pharmaceutics, College of Pharmacy, University of Iowa, Iowa City, IA 52242 (United States); Williams, Robin L; Zhu Xiaoyan [Department of Surgery, Roy J and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA 52242 (United States); Sandler, Anthony D, E-mail: aliasger-salem@uiowa.edu [Department of Surgery and Center for Cancer and Immunology Research, Children' s National Medical Center, Washington DC 20010 (United States)

    2011-02-15

    Neuroblastoma is a common childhood cancer that often results in progressive minimal residual disease after primary tumor resection. Cytosine-phosphorothioate-guanine oligonucleotides (CpG ODN) have been reported to induce potent anti-tumor immune responses. In this communication, we report on the development of a CpG ODN-loaded suture that can close up the wound following tumor excision and provide sustained localized delivery of CpG ODN to treat local disease recurrence. The suture was prepared by melt extruding a mixture of polylactic acid-co-glycolic acid (PLGA 75:25 0.47 dL g{sup -1}) pellets and CpG ODN 1826. Scanning electron microscopy images showed that the sutures were free of defects and cracks. UV spectrophotometry measurements at 260 nm showed that sutures provide sustained release of CpG ODN over 35 days. Syngeneic female A/J mice were inoculated subcutaneously with 1 x 10{sup 6} Neuro-2a murine neuroblastoma wild-type cells and tumors were grown between 5 to 10 mm before the tumors were excised. Wounds from the tumor resection were closed using CpG ODN-loaded sutures and/or polyglycolic acid Vicryl suture. Suppression of neuroblastoma recurrence and mouse survival were significantly higher in mice where wounds were closed using the CpG ODN-loaded sutures relative to all other groups. (communication)

  5. Intraoperative fluorescence imaging for personalized brain tumor resection: Current state and future directions

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    Evgenii Belykh

    2016-10-01

    Full Text Available Introduction: Fluorescence-guided surgery is one of the rapidly emerging methods of surgical theranostics. In this review, we summarize current fluorescence techniques used in neurosurgical practice for brain tumor patients, as well as future applications of recent laboratory and translational studies.Methods: Review of the literature.Results: A wide spectrum of fluorophores that have been tested for brain surgery is reviewed. Beginning with a fluorescein sodium application in 1948 by Moore, fluorescence guided brain tumor surgery is either routinely applied in some centers or is under active study in clinical trials. Besides the trinity of commonly used drugs (fluorescein sodium, 5-ALA and ICG, less studied fluorescent stains, such as tetracyclines, cancer-selective alkylphosphocholine analogs, cresyl violet, acridine orange, and acriflavine can be used for rapid tumor detection and pathological tissue examination. Other emerging agents such as activity-based probes and targeted molecular probes that can provide biomolecular specificity for surgical visualization and treatment are reviewed. Furthermore, we review available engineering and optical solutions for fluorescent surgical visualization. Instruments for fluorescent-guided surgery are divided into wide-field imaging systems and hand-held probes. Recent advancements in quantitative fluorescence-guided surgery are discussed.Conclusion: We are standing on the doorstep of the era of marker-assisted tumor management. Innovations in the fields of surgical optics, computer image analysis, and molecular bioengineering are advancing fluorescence-guided tumor resection paradigms, leading to cell-level approaches to visualization and resection of brain tumors.

  6. Surface primary bone tumors: Systematic approach and differential diagnosis

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    Mendez Diaz, Cristina; Soler Fernandez, Rafaela; Rodriguez Garcia, Esther; Fernandez Armendariz, Pablo; Diaz Angulo, Carolina [Complejo Hospitalario Universitario A Coruna, Department of Radiology, A Coruna (Spain)

    2015-09-15

    Surface primary bone tumors may appear similar to their intramedullary counterpart, but because they are rare, they may pose diagnostic challenges when showing different characteristics compared to their intramedullary counterpart. It is important for radiologists to recognize the imaging findings for various uncommon surface primary bone tumors, which may help to reduce the differential diagnosis or to lead to a specific diagnosis. Radiography is typically used for first-line imaging. If necessary, it is followed by CT or MRI for evaluation and characterization of surface bone tumors. The aim of this article is to review the imaging findings and differential diagnosis for surface primary bone tumors. (orig.)

  7. Endoscopic full-thickness resection of gastric stromal tumor arising from the muscularis propria

    Institute of Scientific and Technical Information of China (English)

    ZHANG Bo; HUANG Liu-ye; WU Cheng-rong; CUI Jun; JIANG Li-xin; ZHENG Hai-tao

    2013-01-01

    Background Gastric stromal tumors are the most common type of tumor originating from mesenchymal tissue.The traditional method for the treatment of gastric stromal tumor is surgical operation or therapeutic laparoscopy.More recently,endoscopic micro-traumatic surgery has become possible for gastric stromal tumors,with any perforation caused by endoscopic therapy mended endoscopically.We assessed the effectiveness of endoscopic full-thickness resection (EFR)in the treatment of gastric stromal tumors arising from the muscularis propria.Methods Of the 42 gastric stromal tumors,each >2.0 cm in diameter,arising from the muscularis propria,22 were removed by EFR and 20 by laparoscopic surgery.Tumor expression of CD34,CD117,Dog-1,S-100,and smooth muscle actin (SMA) was assessed immunohistochemically.Operating time,complete resection rate,length of hospital stay,incidence of complications,and recurrence rates were compared between the two groups.Continuous data were compared by using independent samples t-tests and categorical data by using X2 tests.Results Comparisons of the 22 gastric stromal tumors treated with EFR and the 20 treated with laparoscopic surgery showed similar operation times (60-155 minutes (mean,(90±17) minutes) vs.50-210 minutes (mean,(95±21) minutes),P >0.05),complete resection rates (100% vs.95%,P >0.05),and length of hospital stay (4-10 days (mean,(6.0±1.8)days) vs.4-12 days (mean,(7.3±1.7) days),P >0.05).None of the patients treated with EFR experienced complications,whereas one patient treated with laparoscopy required a conversion to laparotomy and one experienced postoperative gastroparesis.No recurrences were observed in either group.Immunohistochemical staining showed that of the 42 gastric stromal tumors diagnosed by gastroscopy and endoscopic ultrasound,six were leiomyomas (SMA-positive) and the remaining 36 were stromal tumors.Conclusions Gastric stromal tumors arising from the muscularis propria can be completely removed by

  8. Totally laparoscopic anatomical liver resection for centrally located tumors: A single center experience.

    Science.gov (United States)

    Kim, Wan-Joon; Kim, Ki-Hun; Shin, Min-Ho; Yoon, Young-In; Lee, Sung-Gyu

    2017-01-01

    Laparoscopic major hepatectomy is a common procedure that has been reported frequently; however, laparoscopic resection of centrally located tumors involving segments 4, 5, and 8 remains a technically difficult procedure because it requires 2 transection planes and dissection of numerous branches of the hepatic vein and glissonean capsule compared to hemi-hepatectomy. Here, we present 7 cases of totally laparoscopic right anterior sectionectomy (Lap-RAS) and 3 cases of totally laparoscopic central bisectionectomy (Lap-CBS).Between May 2013 and January 2015, 10 totally laparoscopic anatomical resections of centrally located tumors were performed in our institution. The median age of the patients was 54.2 (38-72) years and the median ICG-R15 was 10.4 (3.9-17.4). There were 8 patients with hepatocellular carcinoma (HCC) and 2 with metastatic colorectal cancer. All the HCC patients has the liver function impairment on the degree of Child-Pugh score A.The mean operation time was 330 ± 92.7 minutes with an estimated blood loss of 325 ± 234.5 mL. Only 1 patient required transfusion during surgery. Mean postoperative hospital stay was 9.5 ± 3.4 day and postop complication was reported only 1 case that has the fluid collection at the resection margin of the liver. Mean resection margin was 8.5 ± 6.1 mm and tumor size was 2.9 ± 1.9 cm.Totally lap-RAS and lap-CBS are feasible operative procedures in patients with centrally located tumor of the liver and particularly in patients with limited liver function such as those with cirrhosis.

  9. Resection-reconstruction arthroplasty for giant cell tumor of distal radius

    Directory of Open Access Journals (Sweden)

    Saikia Kabul

    2010-01-01

    Full Text Available Background: Giant cell tumor (GCT of the distal radius poses problems for reconstruction after resection. Several reconstructive procedures like vascularized and non-vascularized fibular graft, osteo-articular allograft, ceramic prosthesis and megaprosthesis are in use for substitution of the defect in the distal radius following resection. Most authors advocate wrist arthrodesis following resection of distal radius and non vascularized fibular graft. Here we have analyzed the results of aggressive benign GCTs of the distal radius treated by resection and reconstruction arthroplasty using autogenous non-vascularized fibular graft. Materials and Methods: Twenty-four cases of giant cell tumor of the distal radius (mean age 32 years, mean follow-up 6.6 years treated by en-bloc resection and reconstruction arthroplasty using autogenous non-vascularized ipsilateral fibular graft with a minimum followup of two years have been included in this retrospective study. Nineteen cases were of Campanacci grade III and five were of Grade II recurrence. The mean resected length of the radius was 9.5 (8-12 cm. Routine radiographs and clinical assessments regarding pain, instability, recurrence, hand grip strength and functional status were done at regular intervals and functional results were assessed using (musculoskeletal tumor society MSTS-87 scoring. Results: Early radiological union at host-graft junction was achieved at mean 12.5 weeks, (range 12-14 weeks and solid incorporation with callus formation was observed in mean 29 weeks (range 28-32 weeks in all the cases. Satisfactory range of motion (mean 63%, range 52-78% of the wrist was achieved in 18 cases. Grip strength compared to the contralateral hand was found to be 67% (range 58-74%. Functional results were excellent in six cases (25%, good in 14 cases (58.3% and four (16.7% cases had fair results. Soft tissue recurrence was seen in one patient. The most commonly encountered complication was fibulo

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

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    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.

  11. 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.

  12. The prognostic value of tumor length to resectable esophageal squamous cell carcinoma: a retrospective study

    Science.gov (United States)

    Zhang, Xiangwei; Wang, Yang; Li, Cheng; Helmersson, Jing; Jiang, Yuanzhu; Ma, Guoyuan; Wang, Guanghui; Dong, Wei

    2017-01-01

    Background The current TNM classification system does not consider tumor length for patients with esophageal carcinoma (EC). This study explored the effect of tumor length, in addition to tumor depth and lymph node involvement, on survival in patients with esophageal squamous cell carcinoma (ESCC). Methods A total of 498 ESCC patients who underwent surgical resection as the primary treatment were selected in the retrospective study. Pathological details were collected, which included tumor type, TNM stage, differentiation. Other collected information were: the types of esophageal resection, ABO blood group, family history and demographic and lifestyle factors. A time-dependent receiver operating characteristic (ROC) curve and a regression tree for survival were used to identify the cut-off point of tumor length, which was 3 cm. Univariate and multivariate Cox proportional hazard regression models were used to identify the prognostic factors to ESCC. Results & Discussion The 1-, 3-, 5-year overall survival rates were found to be 82.5%, 55.6%, and 35.1%, respectively. Patients who had larger tumor length (>3 cm) had a higher risk for death than the rest patients. From the univariate Cox proportional hazards regression model, the overall survival rate was significantly influenced by the depth of the tumor and lymph node involvement (either as dummy or continuous variables), Sex, and tumor length. Using these four variables in the multivariate Cox proportional hazard regression model, we found that the overall survival was significantly influenced by all variables except Sex. Therefore, in addition to the depth of the tumor and lymph node involvement (as either dummy or continuous variables), the tumor length is also an independent prognostic factor for ESCC. The overall survival rate was higher in a group with smaller tumor length (≤3 cm) than those patients with larger tumor length (>3 cm), no matter what the tumor stage was. Conclusion The tumor length was found

  13. Rare giant cell tumor involvement of the olecranon bone.

    Science.gov (United States)

    Yang, Chen; Gong, Yubao; Liu, Jianguo; Qi, Xin

    2014-06-01

    Giant cell tumor (GCT) of bone is a relatively common benign bone lesion and is usually located in long bones, but involvement of the olecranon is extremely rare. Here, we present a case of solitary GCT of bone in the olecranon that was confirmed by preoperative needle biopsy and postoperative histological examination. The treatment included intralesional curettage, allogeneic bone grafting, and plating. At 26 months follow-up, the patient had no local recurrence.

  14. Rare giant cell tumor involvement of the olecranon bone

    Directory of Open Access Journals (Sweden)

    Chen Yang

    2014-01-01

    Full Text Available Giant cell tumor (GCT of bone is a relatively common benign bone lesion and is usually located in long bones, but involvement of the olecranon is extremely rare. Here, we present a case of solitary GCT of bone in the olecranon that was confirmed by preoperative needle biopsy and postoperative histological examination. The treatment included intralesional curettage, allogeneic bone grafting, and plating. At 26 months follow-up, the patient had no local recurrence.

  15. Microsurgical resection of tumors lateroventral and ventral to the high cervical spinal cord

    Institute of Scientific and Technical Information of China (English)

    LEI Peng; WU Yi; LI Zhi-yun; WANG Yu

    2005-01-01

    Background Since there are a complex anatomic structure and vital function in the high cervical spinal cord, it is difficult to remove the tumors lateroventral and ventral to the high cervical spinal cord. This clinical study was undertaken to analyze surgical approaches, manner of tumor resection and postoperative management. Methods Thirty-four patients underwent microsurgical excision of tumors lateroventral and ventral to the high cervical spinal cord by means of three approaches. The tumors comprised mostly Schwannoma and meningioma (88.24%, 30/34) in this group. Tumor volume varied from 3.0 cm×2.5 cm×2.0 cm to 12 cm×3.0 cm×2.5 cm. Of the 34 patients, 4 had dumbbell-shaped tumors growing outside the spinal canal and 7 tumors growing into the intracranium. Results The tumor was totally removed in 32 patients (94.1%). Follow-up for 7 months to 6.4 years (median 3.6 years) showed a recovery of a normal life or work ability in 30 (83.3%) patients. Conclusion Modified operative approaches and microsurgical techniques can raise the rate of total tumor removal and reduce the disability of patients.

  16. The role of MRI in patients undergoing transurethral resection of the prostate; Assessment of residual tumor

    Energy Technology Data Exchange (ETDEWEB)

    Sugimura, Kazuro; Kaji, Yasushi; Okizuka, Hiromi; Ishida, Tetsuya; Mizutani, Masami (Shimane Medical Univ., Izumo (Japan))

    1992-03-01

    This prospective study was designed to evaluate the role of MRI in patients undergoing transurethral resection of the prostate (TURP). Ten patients with prostatic carcinoma and 12 patients with benign prostatic hyperplasia (BPH) as controls were studied. MR findings of detection of primary tumor, periprostatic tissue invasion and seminal vesicle invasion were compared with pathologic findings. MRI detected 16 of 22 lesions rendering a sensitivity of 73%. MRI sensitivity of tumor depiction within the peripheral zone was 83%, specificity 84% and accuracy 84%. However, MR imaging depicted only 25% of tumor in the transition zone. The diagnostic accuracy in the prediction of local invasion was better in MRI (73%) than TRUS (37%). MRI was useful in evaluation of residual tumor in patients who underwent TURP. (author).

  17. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

    Directory of Open Access Journals (Sweden)

    Kambiz Sheikhy

    2017-01-01

    Full Text Available A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result.

  18. Reconstruction of Chest Wall by Cryopreserved Sternal Allograft after Resection of Aneurysmal Bone Cyst of Sternum

    Science.gov (United States)

    Sheikhy, Kambiz; Abbasi Dezfouli, Azizollah

    2017-01-01

    A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result. PMID:28299230

  19. Improved patient quality of life following intradural extramedullary spinal tumor resection.

    Science.gov (United States)

    Viereck, Matthew J; Ghobrial, George M; Beygi, Sara; Harrop, James S

    2016-11-01

    OBJECTIVE Resection significantly improves the clinical symptoms and functional outcomes of patients with intradural extramedullary tumors. However, patient quality of life following resection has not been adequately investigated. The aim in this retrospective analysis of prospectively collected quality of life outcomes is to analyze the efficacy of resection of intradural extramedullary spinal tumors in terms of quality of life markers. METHODS A retrospective review of a single institutional neurosurgical administrative database was conducted to analyze clinical data. The Oswestry Disability Index (ODI), visual analog scale (VAS) for pain, and the EQ-5D-3 L descriptive system were used to analyze quality of life preoperatively, less than 1 month postoperatively, 1-3 months postoperatively, 3-12 months postoperatively, and more than 12 months postoperatively. RESULTS The ODI scores increased perioperatively at the 12 months to 23, 17, and 20, respectively. VAS scores significantly decreased from 6.1 to 3.5, 2.4, 2.0, and 2.9 at the 12-month follow-ups, respectively. EQ-5D mobility significantly worsened at the 12-month follow-ups. EQ-5D self-care significantly worsened at the 12-month follow-ups. EQ-5D pain and discomfort significantly improved at all follow-up points. EQ-5D anxiety and depression significantly improved at 1- to 3-month and 3- to 12-month follow-ups. CONCLUSIONS Resection of intradural extramedullary spine tumors appears to significantly improve patient quality of life by decreasing patient disability and pain and by improving each of the EQ-5D domains.

  20. 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.

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

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    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.

  2. Preliminary fsLIBS study on bone tumors.

    Science.gov (United States)

    Gill, Ruby K; Smith, Zachary J; Panchal, Ripul R; Bishop, John W; Gandour-Edwards, Regina; Wachsmann-Hogiu, Sebastian

    2015-12-01

    The aim of this study is to evaluate the capability of femtosecond Laser Induced Breakdown Spectroscopy (fsLIBS) to discriminate between normal and cancerous bone, with implications to femtosecond laser surgery procedures. The main advantage of using femtosecond lasers for surgery is that the same laser that is being used to ablate can also be used for a feedback system to prevent ablation of certain tissues. For bone tumor removal, this technique has the potential to reduce the number of repeat surgeries that currently must be performed due to incomplete removal of the tumor mass. In this paper, we performed fsLIBS on primary bone tumor, secondary tumor in bone, and normal bone. These tissues were excised from consenting patients and processed through the UC Davis Cancer Center Biorepository. For comparison, each tumor sample had a matched normal bone sample. fsLIBS was performed to characterize the spectral signatures of each tissue type. A minimum of 20 spectra were acquired for each sample. We did not detect significant differences between the fsLIBS spectra of secondary bone tumors and their matched normal bone samples, likely due to the heterogeneous nature of secondary bone tumors, with normal and cancerous tissue intermingling. However, we did observe an increase in the fsLIBS magnesium peak intensity relative to the calcium peak intensity for the primary bone tumor samples compared to the normal bone samples. These results show the potential of using femtosecond lasers for both ablation and a real-time feedback control system for treatment of primary bone tumors.

  3. A case of a gastric submucosal tumor treated with combined therapy using superselective TAE and endoscopic local resection.

    Science.gov (United States)

    Chikamori, Fumio; Kuniyoshi, Nobutoshi; Okamoto, Hiroshi; Kuniyoshi, Kazushige

    2012-10-01

    The case was a 76-year-old female, who was noted to have a gastric submucosal tumor 25 mm in size located at the lesser curvature of the gastric body. Computed tomography revealed that the tumor was located near the coronary loop between the left and right gastric arteries. On the day before endoscopic local resection, abdominal angiography was performed and it revealed that the tumor was supplied by the left and right gastric arteries. Superselective transarterial embolization of the left and right gastric arteries around the tumor was performed to prevent accidental bleeding during the endoscopic procedure. Endoscopic local resection using full-thickness resection and submucosal dissection techniques was performed under general anesthesia. The tumor was completely resected without accidental bleeding. A gastric wall defect was closed using metallic clips and loop snares. Histologic examination revealed that the tumor was a low-risk gastrointestinal stromal tumor. We suggest that the combined therapy using superselective transarterial embolization and endoscopic local resection is an optional safe method for the treatment of gastric submucosal tumors.

  4. Imaging of Pelvic Bone Metastasis from Malignant Phyllodes Breast Tumor

    OpenAIRE

    Nguyen, Ba D.

    2015-01-01

    The author reports a patient with a malignant phyllodes breast tumor, who then had a ten-year disease free interval before she developed a left pelvic bone metastasis and soft tissue invasion. Cross-sectional and radionuclide imaging of its musculoskeletal metastasis is presented. Literature concerning bone metastasis from phyllodes tumor is also briefly reviewed and discussed, along with its epidemiology.

  5. Painful scoliosis due to superposed giant cell bone tumor and aneurysmal bone cyst in a child.

    Science.gov (United States)

    Togral, Guray; Arikan, Murat; Hasturk, Askin E; Gungor, Safak

    2014-07-01

    Giant cell bone tumors are the most common precursor lesions of aneurysmal bone cysts (ABCs) developing secondarily. In giant cell bone tumors containing an explicit ABC component, the observation of the solid component of the giant cell bone tumor plays a critical role in the separation of the primary ABC. In general, ABC cases together with giant cell tumors in the bone are diagnosed histopathologically. The combination of giant cell bone tumor with superposed ABC and that of painful scoliosis with backache is rarely seen in children. In this case study, we discussed the diagnosis and the treatment of a giant cell tumor and superposed an ABC present in the fifth lumbar spine in a pediatric patient admitted to our clinic with a complaint of acute scoliotic back pain.

  6. Development of an autologous canine cancer vaccine system for resectable malignant tumors in dogs.

    Science.gov (United States)

    Yannelli, J R; Wouda, R; Masterson, T J; Avdiushko, M G; Cohen, D A

    2016-12-01

    While conventional therapies exist for canine cancer, immunotherapies need to be further explored and applied to the canine setting. We have developed an autologous cancer vaccine (K9-ACV), which is available for all dogs with resectable disease. K9-ACV was evaluated for safety and immunogenicity for a variety of cancer types in a cohort of companion dogs under veterinary care. The autologous vaccine was prepared by enzymatic digestion of solid tumor biopsies. The resultant single cell suspensions were then UV-irradiated resulting in immunogenic cell death of the tumor cells. Following sterility and endotoxin testing, the tumor cells were admixed with CpG ODN adjuvant and shipped to the participating veterinary clinics. The treating veterinarians then vaccinated each patient with three intradermal injections (10 million cells per dose) at 30-day intervals (one prime and two boost injections). In a cohort of 20 dogs completing the study, 17 dogs (85%) developed an augmented IgG response to autologous tumor antigens as demonstrated using western blot analysis of pre- and post-peripheral blood samples. We also report several dogs have lived beyond expected survival time based on previously published data. In summary, K9-ACV is an additional option to be considered for the treatment of dogs with resectable cancer.

  7. Bone tumors of the spine and sacral bone; Primaere Tumoren der Wirbelsaeule und des Sakrums

    Energy Technology Data Exchange (ETDEWEB)

    Freyschmidt, Juergen [Klinikum Bremen-Mitte gGmbH, Bremen (Germany). Beratungsstelle und Referenzzentrum fuer Osteoradiologie

    2010-12-15

    Bone tumors and tumorlike lesions of the spine are rare entities and may harbour diagnostic problems. In this article we discuss the epidemiology, topographic aspects, clinical and radiologic features as well as the diagnostic management of vertebral bone tumors. Entities that should be more familiar to the radiologist (i.e. osteoid osteoma, osteoblastoma, hemangioma, giant cell tumor, chordoma, aneurysmal bone cyst) are considered in more detail. (orig.)

  8. Brown Tumor Shown Flare Phenomenon On Bone Scan After Parathyroidectomy

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kwang Ho; Park, Seol Hoon; Baek, So Ra; Chae, Sun Young; Koh, Jung Min; Kim, Jae Seung; Moon, Dae Hyuk; Ryu, Jin Sook [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2009-10-15

    Brown tumor is the benign bone lesion consists of woven bone and fibrous tissue without matrix, which develop due to chronic excessive osteoclastic activity such as hyperparathyroidism. Usually they appear with normal uptake or occasionally focally increased uptake on bone scan. We present a case with brown tumor shown more increased uptake and more number of lesions on bone scan after parathyroidectomy, and lesser increased uptake on serial bone scans without any other treatment through several months. This finding is thought to be similar to 'flare phenomenon' which is occasionally seen after treatment of metastatic bone lesions of malignant cancer, and may represent curative process of brown tumor with rapid normal bone formation.

  9. Laparoscopic resection of sporadic synchronous gastric and jejunal gastrointestinal stromal tumors: report of a case.

    Science.gov (United States)

    Dell'Avanzato, Roberto; Carboni, Fabio; Palmieri, Maria Beatrice; Palmirotta, Raffaele; Guadagni, Fiorella; Pippa, Giovanna; Santeusanio, Giuseppe; Antimi, Mauro; Lopez, Massimo; Carlini, Massimo

    2009-01-01

    Multicentricity of gastrointestinal stromal tumors (GISTs) has been described only in patients with neurofibromatosis type 1 (NF1) or within the small intestine, and different pathogenetic mechanisms are involved. We report a case of synchronous sporadic gastric and jejunal GISTs, which were resected laparoscopically in a 67-year-old man. Immunohistochemical analysis revealed that both lesions were KIT (CD117)-positive, but that the gastric lesion was CD34-positive, whereas the jejunal one was Vimentin-, S-100-, and SMA-positive. Molecular analysis of mutations in KIT exons 9, 11, 13, and 17, and in PDGFRA exons 12 and 18 revealed the presence of a gastric sporadic GIST with a KIT mutation of the exon 11 and a jejunal sporadic GIST without KIT or PDGFRA mutations. To our knowledge, this is the first report of laparoscopically resected synchronous sporadic gastric and jejunal GISTs.

  10. Laparoscopic nephron-sparing resection of synchronous Wilms tumors in a case of hyperplastic perilobar nephroblastomatosis.

    Science.gov (United States)

    Rauth, Thomas P; Slone, Jeremy; Crane, Gabriella; Correa, Hernan; Friedman, Debra L; Lovvorn, Harold N

    2011-05-01

    Diffuse hyperplastic perilobar nephroblastomatosis (DHPLN) is a rare precursor lesion of Wilms tumor (WT). Because of the increased risk to develop WT in either kidney, current management algorithms of DHPLN merit nephron-sparing strategies, beginning with chemotherapy and close radiographic monitoring into late childhood. After resolution of DHPLN, subsequent detection of a renal nodule mandates resection to exclude WT. Here, we report the case of a 4-year-old girl who developed 2 synchronous nodules in the right kidney more than 2 years after completion of therapy for DHPLN. Because of the early detection and peripheral location of these 2 nodules, laparoscopic nephron-sparing resection of each was performed using ultrasonic dissection. Both nodules were determined on pathology to be favorable histology WT with negative surgical margins. The child was placed on vincristine and actinomycin D therapy for 18 weeks.

  11. Patients with oral tumors. Part 2: Quality of life after treatment with resection prostheses. Resection prosthetics: evaluation of quality of life.

    Science.gov (United States)

    Fierz, Janine; Bürgin, Walter; Mericske-Stern, Regina

    2013-01-01

    In the present study, the oral health-related quality of life of 18 patients (13 men and 5 women) was evaluated using validated questionnaires as proposed by the European Organization of Research and Treatment of Cancer (EORTC). The patients belonged to a cohort of 48 patients, whose prosthetic treatment was performed during the years 2004-2007. In the course of tumor resection, 12 patients underwent graft surgery and 14 patients radiotherapy. One patient required a nasal epithesis since resection of the nose became necessary. Five patients underwent a full block resection of the mandible, and tumor resection in 3 patients resulted in a large oronasal communication. Prosthetic rehabilitation was performed in all patients, and the follow-up period with regular care covered a minimum of 3 years. Eleven patients received dental implants for better support and retention of the prostheses. In spite of compromised oral conditions, functional restrictions, and some difficulties with the prostheses, the answers to the questionnaire were quite positive. The majority judged their general health as good or even excellent. The subjective perception of the patients may contradict the objective view by the dentist. In fact, the individual patient's history and experience provide a better understanding of the impact of oral tumors on daily life. The overall assessment identified 4 items that were perceived as major problems by all patients: swallowing solid food, dry mouth, limited mouth opening, and appearance. Prosthetic rehabilitation has only a limited influence on such problems.

  12. Dissecting Tumor-Stromal Interactions in Breast Cancer Bone Metastasis

    Directory of Open Access Journals (Sweden)

    Yibin Kang

    2016-06-01

    Full Text Available Bone metastasis is a frequent occurrence in breast cancer, affecting more than 70% of late stage cancer patients with severe complications such as fracture, bone pain, and hypercalcemia. The pathogenesis of osteolytic bone metastasis depends on cross-communications between tumor cells and various stromal cells residing in the bone microenvironment. Several growth factor signaling pathways, secreted micro RNAs (miRNAs and exosomes are functional mediators of tumor-stromal interactions in bone metastasis. We developed a functional genomic approach to systemically identified molecular pathways utilized by breast cancer cells to engage the bone stroma in order to generate osteolytic bone metastasis. We showed that elevated expression of vascular cell adhesion molecule 1 (VCAM1 in disseminated breast tumor cells mediates the recruitment of pre-osteoclasts and promotes their differentiation to mature osteoclasts during the bone metastasis formation. Transforming growth factor β (TGF-β is released from bone matrix upon bone destruction, and signals to breast cancer to further enhance their malignancy in developing bone metastasis. We furthered identified Jagged1 as a TGF-β target genes in tumor cells that engaged bone stromal cells through the activation of Notch signaling to provide a positive feedback to promote tumor growth and to activate osteoclast differentiation. Substantially change in miRNA expression was observed in osteoclasts during their differentiation and maturation, which can be exploited as circulating biomarkers of emerging bone metastasis and therapeutic targets for the treatment of bone metastasis. Further research in this direction may lead to improved diagnosis and treatment strategies for bone metastasis.

  13. Intraoperative neuronavigation integrated high resolution 3D ultrasound for brainshift and tumor resection control

    Directory of Open Access Journals (Sweden)

    Giovani A.

    2015-06-01

    Full Text Available INTRODUCTION: The link between the neurosurgeon’s knowledge and the scientific improvements made a dramatic change in the field expressed both in impressive drop in the mortality and morbidity rates that were operated in the beginning of the XXth century and in operating with high rates of success cases that were considered inoperable in the past. Neuronavigation systems have been used for many years on surgical orientation purposes especially for small, deep seated lesions where the use of neuronavigation is correlated with smaller corticotomies and with the extended use of transulcal approaches. The major problem of neuronavigation, the brainshift once the dura is opened can be solved either by integrated ultrasound or intraoperative MRI which is out of reach for many neurosurgical departments. METHOD: The procedure of neuronavigation and ultrasonic localization of the tumor is described starting with positioning the patient in the visual field of the neuronavigation integrated 3D ultrasonography system to the control of tumor resection by repeating the ultrasonographic scan in the end of the procedure. DISCUSSION: As demonstrated by many clinical trials on gliomas, the more tumor removed, the better long term control of tumor regrowth and the longer survival with a good quality of life. Of course, no matter how aggressive the surgery, no new deficits are acceptable in the modern era neurosurgery. There are many adjuvant methods for the neurosurgeon to achieve this maximal and safe tumor removal, including the 3T MRI combined with tractography and functional MRI, the intraoperative neuronavigation and neurophysiologic monitoring in both anesthetized and awake patients. The ultrasonography integrated in neuronavigaton comes as a welcomed addition to this adjuvants to help the surgeon achieve the set purpose. CONCLUSION: With the use of this real time imaging device, the common problem of brainshift encountered with the neuronavigation systems

  14. 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.)

  15. Bone single photon emission computed tomography (SPECT in a patient with Pancoast tumor: a case report

    Directory of Open Access Journals (Sweden)

    Hamid Javadi

    Full Text Available CONTEXT: Non-small cell lung carcinomas (NSCLCs of the superior sulcus are considered to be the most challenging type of malignant thoracic disease. In this disease, neoplasms originating mostly from the extreme apex of the lung expand to the chest wall and thoracic inlet structures. Multiple imaging procedures have been applied to identify tumors and to stage and predict tumor resectability in surgical operations. Clinical examinations to localize pain complaints in shoulders and down the arms, and to screen for Horner's syndrome and abnormalities seen in paraclinical assessments, have been applied extensively for differential diagnosis of superior sulcus tumors. Although several types of imaging have been utilized for diagnosing and staging Pancoast tumors, there have been almost no reports on the efficiency of whole-body bone scans (WBBS for detecting the level of abnormality in cases of superior sulcus tumors. CASE REPORT: We describe a case of Pancoast tumor in which technetium-99m methylene diphosphonate (Tc-99m MDP bone single-photon emission-computed tomography (SPECT was able to accurately detect multiple areas of abnormality in the vertebrae and ribs. In describing this case, we stress the clinical and diagnostic points, in the hope of stimulating a higher degree of suspicion and thereby facilitating appropriate diagnosis and treatment. From the results of this study, further clinical trials to evaluate the potential of SPECT as an efficient imaging tool for the work-up on cases of Pancoast tumor are recommended.

  16. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Won-Jong [Musculoskeletal Oncology Study Group, Catholic University of Korea (Korea); Department of Orthopaedic Surgery, Uijongbu St. Mary' s Hospital, 65-1 Geumohdong, Uijongbu, Gyunggido, 480-130 (Korea); Kang, Yong-Koo; Lee, An-Hee [Musculoskeletal Oncology Study Group, Catholic University of Korea (Korea); Mirra, Joseph M. [Orthpaedic Oncology, Orthopaedic Hospital, Los Angeles, CA (United States)

    2003-04-01

    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. 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;

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4......'s sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26-75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis...... (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients....

  19. 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

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4....../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......'s sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26-75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis...

  20. Survival and complications in total knee replacement with custom-prosthesis after bone tumors resection%定制肿瘤型铰链膝关节假体置换术后假体生存率及并发症分析

    Institute of Scientific and Technical Information of China (English)

    杨志平; 田永昊; 杨强; 李昕; 李振峰; 李建民

    2011-01-01

    目的 探讨定制肿瘤型膝关节假体置换术后的假体生存率及并发症发生率.方法 对1996年4月至2007年4月接受定制肿瘤型铰链膝关节假体置换且随访资料完整的85例进行回顾性分析,男54例,女31例;年龄11~72岁,平均(31.33±15.3)岁.骨肉瘤43例,骨巨细胞瘤31例,软骨肉瘤4例,转移瘤3例,恶性纤维组织细胞瘤2例,Ewing肉瘤1例,纤维肉瘤1例.股骨远端43例,胫骨近端42例.均行瘤段广泛切除及国产骨水泥定制肿瘤型铰链膝关节假体重建.结果 随访3~124个月,平均45.8个月.并发症发生率27.1%(23/85),股骨远端25.6%(11/43),胫骨近端28.6%(12/42);发生于术后3年内13例次,3~5年3例次,5年以上7例次.与手术相关的并发症(切口不愈合、假体周围深部感染、腓总神经损伤等)6例次,全部发生于术后3年内;与假体相关的并发症(假体松动及断裂、假体关节脱位、假体周围骨折等)17例次,发生于术后3年以内7例次、3~5年3例次、5年以上7例次.假体生存率三年79.4%、五年67.7%、七年62.3%,股骨假体分别为86.6%、79.2%、73.5%,胫骨假体分别为66.1%、53.7%、48.8%.结论 与手术相关的并发症多发生于术后3年内,与假体相关的并发症于术后3年内及5年以上高发.使用国产定制肿瘤型膝关节假体置换术后早期即可发生与假体相关的并发症.%Objective To retrospectively investigate the endoprosthetic survival and complications after custom-made tumor prosthesis replacement of knee joint.Methods From April 1996 to April 2007,85 patients with bone tumors around knee joints undergoing custom-prosthetic replacement were respectively analyzed,including 54 males and 31 females with an average of 31.33±15.3 years(range,11-72).The diagnoses were osteosarcoma(43 patients),giant cell tumor(31),chondrosarcoma(4),metastatic tumor(3),malignant fibrohistiocytoma(2),Ewing sarcoma(1),and fibrosarcoma(1).The distal femar was affected in 43

  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. 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.

  3. Vascularized Fibula Grafts for Reconstruction of Bone Defects after Resection of Bone Sarcomas

    Science.gov (United States)

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

    2010-01-01

    We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1–24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4/3/1) 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's sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26–75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients. PMID:20490263

  4. 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

  5. Clinical outcome of en-block resection and reconstruction with nonvascularized fibular autograft for the treatment of giant cell tumor of distal radius

    Directory of Open Access Journals (Sweden)

    Mohammad H Taraz-Jamshidi

    2014-01-01

    Full Text Available Background: Although giant cell tumor (GCT is considered to be a primary benign bone tumor, its aggressive behavior makes its diagnosis and treatment, difficult and challenging. This is especially true in distal radius where GCT appears to be more aggressive and difficult to control locally. We report our clinical outcome of en-block resection and reconstruction with non-vascularized fibular autograft in 15 patients with distal radius GCT. Materials and Methods: We retrospectively reviewed 15 patients with GCT (Grade 2 and 3 of distal radius who were treated with en-block resection and non-vascularized fibular autograft. Five of 15 were recurrent GCT treated initially with extended curettage; local adjuvant therapy and filling the cavity with cement or bone graft. We followed the patients for mean 7.2 years post operation (range: 4-11 years. Patients were evaluated post operation with clinical examination, plain radiography of distal radius and chest X-ray and/or computed tomography scan. Furthermore pain, function, range of motion and grip strength of the affected limb were evaluated and mMayo wrist score was assessed. Results: A total of 11 patients were women and 4 were men. Mean age of patients was 29 years (range: 19-48. We had no lung metastasis and bony recurrence occurred in one patient (6.6%. Nearly 53.3% of patients had excellent or good functional wrist score, 80% of the patients were free of pain or had only occasional pain and 80% of patients returned to work. Mean range of motion of the wrist was 77° of flexion-extension and mean grip strength was 70% of the normal hand. Conclusion: En-block resection of distal radius GCT and reconstruction with non-vascularized fibular autograft is an effective technique for treatment in local control of the tumor and preserving function of the limb.

  6. Guiding brain tumor resection using surface-enhanced Raman scattering nanoparticles and a hand-held Raman scanner.

    Science.gov (United States)

    Karabeber, Hazem; Huang, Ruimin; Iacono, Pasquale; Samii, Jason M; Pitter, Ken; Holland, Eric C; Kircher, Moritz F

    2014-10-28

    The current difficulty in visualizing the true extent of malignant brain tumors during surgical resection represents one of the major reasons for the poor prognosis of brain tumor patients. Here, we evaluated the ability of a hand-held Raman scanner, guided by surface-enhanced Raman scattering (SERS) nanoparticles, to identify the microscopic tumor extent in a genetically engineered RCAS/tv-a glioblastoma mouse model. In a simulated intraoperative scenario, we tested both a static Raman imaging device and a mobile, hand-held Raman scanner. We show that SERS image-guided resection is more accurate than resection using white light visualization alone. Both methods complemented each other, and correlation with histology showed that SERS nanoparticles accurately outlined the extent of the tumors. Importantly, the hand-held Raman probe not only allowed near real-time scanning, but also detected additional microscopic foci of cancer in the resection bed that were not seen on static SERS images and would otherwise have been missed. This technology has a strong potential for clinical translation because it uses inert gold-silica SERS nanoparticles and a hand-held Raman scanner that can guide brain tumor resection in the operating room.

  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. Infratentorial supracerebellar resection of a pineal tumor using a high definition video exoscope (VITOM®).

    Science.gov (United States)

    Mamelak, Adam N; Drazin, Doniel; Shirzadi, Ali; Black, Keith L; Berci, George

    2012-02-01

    A telescope based high definition (HD) video system (VITOM®, Karl Storz GmBH & Co., Tuttlingen, Germany) has recently been proposed as an alternative to the operating microscope for microneurosurgery. It remains unclear which clinical situations will benefit from its advantages. In light of the uncomfortable surgeon position and fatigue often associated with pineal region surgery, we used the VITOM® HD exoscope system to perform an infratentorial supracerebellar resection of a pineal tumor. The VITOM® dramatically improved surgeon comfort and ease of operating by permitting the surgeon to stand upright and in a comfortable position and avoid the need to extend the arm or assume an awkward. position commonly encountered when using the microscope for these approaches. The marked improvement in surgeon comfort afforded by the VITOM® exoscope indicates that this system may have significant advantages over traditional microscope based surgery for tumors of the pineal region approached using an infratentorial supracerebellar approach.

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

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    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. Disseminated Tumor Cells in Bone Marrow of Gastric Cancer Patients: Correlation with Tumor Hypoxia and Clinical Relevance

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    Larissa Bubnovskaya

    2014-01-01

    Full Text Available Aim. The evaluation of the clinical relevance of disseminated tumor cells (DTCs in bone marrow (BM of patients with gastric cancer (GC and their association with primary tumor hypoxia. Patients and Methods. 89 resected specimens were used. DTCs were detected using immunocytochemistry, the level of tumor hypoxia using NMR spectroscopy, CD68, CD34, VEGF, and VEGFR-1 (Flt-1 expression using immunohistochemistry, and MMP-2 and MMP-9 activity using zymography. Results. DTCs were detected in 51.4% of GC patients with M0. There was significant correlation between frequency of DTCs in BM and level of tumor hypoxia (P<0.024. DTCs presence was accompanied with Flt-1 positivity of BM. The correlation between DTCs and tumor VEGF expression in patients with M0 was shown (P<0.0248. Activity of MMP-2 and MMP-9 in BM was linked with DTCs in patients with M0 (P<0.05. Overall survival (OS of patients with M0 and DTCs was shorter than that of patients without DTCs (patients in both groups were operated only (P=0.0497. Conclusion. Appearance of DTCs correlates with hypoxia level in primary tumors. Detection of DTCs in GC patients may be relevant indicator for adjuvant chemotherapy using.

  11. Aneurysmal bone cyst secondary to a giant cell tumor of the patella: A case report

    Science.gov (United States)

    YU, XIAOLONG; GUO, RUNSHENG; FAN, CONGLIANG; LIU, HUCHENG; ZHANG, BIN; NIE, TAO; TU, YI; DAI, MIN

    2016-01-01

    The patella is an unusual location for primary and metastatic bone tumors to develop. The most frequently encountered primary osteolytic lesions at the patella include giant cell tumors of the bone (GCT), chondroblastoma and aneurysmal bone cysts (ABC). However, the presentation of an ABC originating secondary to a GCT at the patella is rare. The present study describes such a case in a 46-year-old female. The differential diagnosis of the condition was extensive. The patient underwent curettage and the addition of bone cement to fill the defect. Pathological analysis of the resected tissue demonstrated that the lesion was consistent with an ABC forming secondary to a GCT. A 3-month follow-up was completed subsequent to the surgery, with a computed tomography scan demonstrating no evidence of recurrence. However, frequent and continuous observations of the patient following diagnosis are planned in order to evaluate the long-term efficacy of the surgical treatment. To the best of our knowledge, the present study describes the third reported case in the literature of this rare, double synchronous, benign tumor located at the patella. PMID:26893764

  12. [Case of ischemic heart disease resulting from persistent diuresis after giant ovarian tumor resection].

    Science.gov (United States)

    Sata, Naho; Satoh, Masaaki; Seo, Norimasa

    2010-02-01

    A patient with a giant ovarian tumor weighing about 7 kg was successfully removed by operation. However, her ECG demonstrated ischemic changes after the operation. We report a case of ischemic heart disease due to persistent diuresis after giant ovarian tumor resection. A 75-year-old, 56.5 kg, 143.5 cm woman was admitted to our hospital for ovarian tumor resection. The preoperative ECG showed normal sinus rhythm and no ischemic changes. Both general anesthesia and epidural anesthesia were planed. An epidural catheter was inserted at T12-L1. Anesthesia was induced with propofol 100 mg, fentanyl 100 microg and vecuronium 8 mg under 100% oxygen inhalation. General anesthesia was maintained with sevoflurane while epidural anesthesia was achieved using 0.375% ropivacaine 6 ml. During the operation, blood pressure was 90-110/70-80 mmHg, with SaO2, 100% and heart rate, 70-80 beats x min(-1). The content of tumor was suctioned for 30 minutes. Surgery was successfully finished without any other incidence. After extubation, her ECG changed to atrial fibrillation from normal sinus rhythm and showed ST-T depression. And then her systolic blood pressure became 80 mmHg or below, but we found continued diuresis at about 10 ml x kg(-1) x hr(-1) for over 2 hr. The total of 7 unit vasopressin was intermittently given for vasoconstriction and antidiuresis. Her hemodynamic was immediately restored, and ECG turned to normal ST-T. The patient had uneventful postoperative recovery.

  13. MRI Findings of Causalgia of the Lower Extremity Following Transsphenoidal Resection of Pituitary Tumor

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    D. Ryan Ormond

    2012-01-01

    Full Text Available Background. Causalgia is continuing pain, allodynia, or hyperalgesia after nerve injury with edema, changes in skin blood flow, or abnormal sudomotor activity. Here we report a case of lower extremity causalgia following elective transsphenoidal resection of a pituitary tumor in a young man. Clinical Presentation. A 33-year-old man with acromegaly underwent elective sublabial transsphenoidal resection of his pituitary tumor. During the three-hour surgery, the lower limbs were kept in a supine, neutral position with a pillow under the knees. The right thigh was slightly internally rotated with a tape to expose fascia lata, which was harvested to repair the sella. Postoperatively, he developed causalgia in a distal sciatic and common peroneal nerve distribution. Pain was refractory to several interventions. Finally, phenoxybenzamine improved his pain significantly. Conclusions. Malpositioning in the operating room resulted in causalgia in this young man. Phenoxybenzamine improved, and ultimately resolved, his symptoms. Improvement in his pain symptoms correlated with resolution of imaging changes in the distal sciatic and peroneal nerves on the side of injury.

  14. Updated therapeutic strategy for adult low-grade glioma stratified by resection and tumor subtype.

    Science.gov (United States)

    Nitta, Masayuki; Muragaki, Yoshihiro; Maruyama, Takashi; Iseki, Hiroshi; Ikuta, Soko; Konishi, Yoshiyuki; Saito, Taichi; Tamura, Manabu; Chernov, Michael; Watanabe, Atsushi; Okamoto, Saori; Maebayashi, Katsuya; Mitsuhashi, Norio; Okada, Yoshikazu

    2013-01-01

    The importance of surgical resection for patients with supratentorial low-grade glioma (LGG) remains controversial. This retrospective study of patients (n = 153) treated between 2000 to 2010 at a single institution assessed whether increasing the extent of resection (EOR) was associated with improved progression-free survival (PFS) and overall survival (OS). Histological subtypes of World Health Organization grade II tumors were as follows: diffuse astrocytoma in 49 patients (32.0%), oligoastrocytoma in 45 patients (29.4%), and oligodendroglioma in 59 patients (38.6%). Median pre- and postoperative tumor volumes and median EOR were 29.0 cm(3) (range 0.7-162 cm(3)) and 1.7 cm(3) (range 0-135.7 cm(3)) and 95%, respectively. Five- and 10-year OS for all LGG patients were 95.1% and 85.4%, respectively. Eight-year OS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 70.7%, 91.2%, and 98.3%, respectively. Five-year PFS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 42.6%, 71.3%, and 62.7%, respectively. Patients were divided into two groups by EOR ≥90% and oligodendroglioma. Multivariate analysis identified age and EOR as parameters significantly associated with OS. The only parameter associated with PFS was EOR. Based on these findings, we established updated therapeutic strategies for LGG. If surgery resulted in EOR oligodendroglioma or oligoastrocytoma, which are sensitive to chemotherapy, will be treated with chemotherapy.

  15. Nonrigid Registration of Brain Tumor Resection MR Images Based on Joint Saliency Map and Keypoint Clustering

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    Binjie Qin

    2009-12-01

    Full Text Available This paper proposes a novel global-to-local nonrigid brain MR image registration to compensate for the brain shift and the unmatchable outliers caused by the tumor resection. The mutual information between the corresponding salient structures, which are enhanced by the joint saliency map (JSM, is maximized to achieve a global rigid registration of the two images. Being detected and clustered at the paired contiguous matching areas in the globally registered images, the paired pools of DoG keypoints in combination with the JSM provide a useful cluster-to-cluster correspondence to guide the local control-point correspondence detection and the outlier keypoint rejection. Lastly, a quasi-inverse consistent deformation is smoothly approximated to locally register brain images through the mapping the clustered control points by compact support radial basis functions. The 2D implementation of the method can model the brain shift in brain tumor resection MR images, though the theory holds for the 3D case.

  16. Dural Arteriovenous Fistula Following Translabyrinthine Resection of Cerebellopontine Angle Tumors: Report of Two Cases

    Science.gov (United States)

    Li, Peter M.M.C.; Fischbein, Nancy J.; Do, Huy M.; Blevins, Nikolas H.

    2011-01-01

    We describe two cases of dural arteriovenous fistula (DAVF) developing in a delayed fashion after translabyrinthine resection of cerebellopontine angle tumors. Two patients in an academic tertiary referral center, a 46-year-old woman and a 67-year-old man, underwent translabyrinthine resection of a 2-cm left vestibular schwannoma and a 4-cm left petrous meningioma, respectively. Both patients subsequently developed DAVF, and in each case the diagnosis was delayed despite serial imaging follow-up. In one patient, cerebrospinal fluid diversion before DAVF was identified as the cause of her intracranial hypertension; the other patient was essentially asymptomatic but with a high risk of hemorrhage due to progression of cortical venous drainage. Endovascular treatment was effective but required multiple sessions due to residual or recurrent fistulas. Dural arteriovenous fistula is a rare complication of translabyrinthine skull base surgery. Diagnosis requires a high index of clinical suspicion and an understanding of subtle imaging findings that may be present on follow-up studies performed for tumor surveillance. Failure to recognize this complication may lead to misguided interventions for treatment of hydrocephalus and other complications, as well as ongoing risks related to venous hypertension and intracranial hemorrhage. As this condition is generally curable with neurointerventional and/or surgical methods, timely diagnosis and treatment are essential. PMID:23984203

  17. Hipbone Biomechanical Finite Element Analysis and Clinical Study after the Resection of Ischiopubic Tumors

    Institute of Scientific and Technical Information of China (English)

    Ya-qi He; Xue-lin Zhang; Bing-hang Tang; Ang Yang

    2012-01-01

    Objective To investigate the changes of hipbone biomechanics after the resection of ischiopubic tumors and their relationships with the complications in the convalescent stage,and directing the postoperative pelvic reconstruction.Methods DICOM data were used to create an intact hipbone finite element model and postoperative model.The biomechanical indices on the same region in the two models under the same boundary condition were compared.The differences of displacement,stress,and strain of the two models were analyzed with statistical methods.Results The distribution areas of the hipbone nodes' displacement,stress,and strain were similar before and after the simulated operation.The sacroiliac joint nodes' displacement (P=0.040) and strain (P=0.000),and the acetabular roof nodes' stress (P=0.000) and strain (P=0.005) of two models had signifi-cant differences,respectively.But the sacroiliac joint nodes' stress (P=0.076) and the greater sciatic notch nodes' stress (P=0.825) and strain (P=0.506) did not have significant differences.Conclusions The resection of ischiopubic tumors mainly affect the biomechanical states of the homolateral sacroiliac joint and acetabular roof.The complications in the convalescent stage are due to the biomechanical changes of the sacroiliac joint and the acetabular roof and disappearances of the stabilization and connection functions of the pubic symphysis and superior ramus of pubis.

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

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    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.

  19. Guiding Brain Tumor Resection Using Surface-Enhanced Raman Scattering Nanoparticles and a Hand-Held Raman Scanner

    OpenAIRE

    Karabeber, Hazem; Huang, Ruimin; Iacono, Pasquale; Samii, Jason M.; Pitter, Ken; Holland, Eric C.; Kircher, Moritz F.

    2014-01-01

    The current difficulty in visualizing the true extent of malignant brain tumors during surgical resection represents one of the major reasons for the poor prognosis of brain tumor patients. Here, we evaluated the ability of a hand-held Raman scanner, guided by surface-enhanced Raman scattering (SERS) nanoparticles, to identify the microscopic tumor extent in a genetically engineered RCAS/tv-a glioblastoma mouse model. In a simulated intraoperative scenario, we tested both a static Raman imagi...

  20. Rectal laterally spreading tumors successfully treated in two steps by endoscopic submucosal dissection and endoscopic mucosal resection

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    Palmieri Giovanni

    2010-11-01

    Full Text Available Abstract Background Endoscopic submucosal dissection (ESD is an advanced technique of therapeutic endoscopy alternative to endoscopic mucosal resection (EMR for superficial gastrointestinal neoplasms >2 cm. ESD allows for the direct dissection of the submucosa and large lesions can be resected en bloc. ESD is not limited by resection size, increases histologically complete resection rates and may reduce the local recurrence. Nevertheless, the technique is time-consuming, technically demanding and associated with a high complication rate. To reduce the risk of complications, different devices and technical advances have been proposed with conflicting results and, still, ESD en bloc resections of huge lesions are associated with increased complications. Case Presentation We successfully used a combined ESD/EMR technique for huge rectal laterally spreading tumors (LSTs. ESD was used for circumferential resection of 2/3 of the lesion followed by piecemeal resection (2-3 pieces of the central part of the tumour. In all three patients we obtained the complete dissection of the polyp and the complete histological evaluation in absence of complications and recurrence at 6 months' follow up. Conclusions In the treatment of rectal LSTs, the combined treatment - ESD/EMR resection may be considered a suitable therapeutic option, indicated in selected cases as an alternative to surgery, in which the two techniques are neither reliable nor safe separately. However, to confirm our results, larger trials with longer follow up are required together with improvement of the technique and of the technical devices.

  1. Marrow-tumor interactions: the role of the bone marrow in controlling chemically induced tumors

    Energy Technology Data Exchange (ETDEWEB)

    Rosse, C

    1980-01-01

    This report summarizes work done to evaluate the role of the bone marrow in tumor growth regulation. Work done with the MCA tumor showed that several subclasses of mononuclear bone marrow cells (e.g. natural regulatory cell, NRC) play a major role in the regulation of tumor growth. Experiments with the spontaneous CE mammary carcinoma system illustrate that a rapid growth of certain neoplasms may be due to the fact that through some as yet undefined mechanism the tumor eliminates mononuclear cells in the bone marrow of the host and stops their production. (KRM)

  2. Massive allograft replacement in management of bone tumors%冷冻异体骨移植治疗骨肿瘤切除后骨缺损

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Niu; Lin Hao; Qing Zhang; Yi Ding

    2008-01-01

    Objective: To evaluate the functional outcome and complications of allograft replacement in management of bone tumors. Methods: Between March 1992 and September 2002, 164 patients underwent bone tumor resection and massive allograft reconstruction of bone defects. The length of the resected part ranged from 5-35 cm. The resections were dassified as marginal or wide resections of the tumor on the basis of the Musculoskeletal Tumor Society staging system. Fresh-frozen allografts were employed as osteoarticular grafts (n = 95), hemi-condylar (n = 15), massive (n = 23), allograft-prosthesis composite (n=12), intercalary grafts (n=15) or hemi-pelvic grafts (n=4). Most of the lesions were osteosarcoma and giant cell tumor of bone and located in proximal and distal femur, proximal tibia and humerus. Results: At a median follow-up of 47 months (range, 12 to 168 months) after the operation, 154 of the patients in the study were free of disease and 10 died of disease. Twenty-one (12.8%) patients had local recurrence and 38 (23.2%) nonunion. Late complications included 11 (6.7%)fractures of the allograft and 18 (11.0%) infections of the graft. Instability of the joint in the form of subluxation was noted in 13 (7.9%) patients. Ten extremities were amputated due to local recurrence or severe infection. Conclusion: Allografts can be used for reconstruction of bony defects after tumor resection. Allograft has nearly similar shape, strength, osteo-inductivity and osteo-conductivity with host bone. Allograft implantation is a high complication reconstruction method, and the risk of recurrence increases when less surgical margin achieves.

  3. Direct cortical stimulation but not transcranial electrical stimulation motor evoked potentials detect brain ischemia during brain tumor resection.

    Science.gov (United States)

    Li, Fenghua; Deshaies, Eric M; Allott, Geoffrey; Canute, Gregory; Gorji, Reza

    2011-09-01

    Motor evoked potentials (MEPs) elicited by both direct cortical stimulation (DCS) and transcranial electrical stimulation are used during brain tumor resection. Parallel use of direct cortical stimulation motor evoked potentials (DCS-MEPs) and transcranial electrical stimulation motor evoked potentials (TCeMEPs) has been practiced during brain tumor resection. We report that DCS-MEPs elicited by direct subdural grid stimulation, but not TCeMEPs, detected brain ischemia during brain tumor resection. Following resection of a brainstem high-grade glioma in a 21-year-old, the threshold of cortical motor-evoked-potentials (cMEPs) increased from 13 mA to 20 mA while amplitudes decreased. No changes were noted in transcranial motor evoked potentials (TCMEPs), somatosensory evoked potentials (SSEPs), auditory evoked potentials (AEPs), anesthetics, or hemodynamic parameters. Our case showed the loss of cMEPs and SSEPs, but not TCeMEPs. Permanent loss of DCS-MEPs and SSEPs was correlated with permanent left hemiplegia in our patient even when appropriate action was taken. Parallel use of DCS- and TCeMEPs with SSEPs improves sensitivity of intraoperative detection of motor impairment. DCS may be superior to TCeMEPs during brain tumor resection.

  4. 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.

  5. 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.

  6. TUMOR CONTAMINATION IN THE BIOPSY PATH OF PRIMARY MALIGNANT BONE TUMORS

    OpenAIRE

    Oliveira,Marcelo Parente; Lima, Pablo Moura de Andrade; Mello,Roberto José Vieira de

    2015-01-01

    Objective: To study factors possibly associated with tumor contamination in the biopsy path of primary malignant bone tumors. Method: Thirty-five patients who underwent surgical treatment with diagnoses of osteosarcoma, Ewing's tumor and chondrosarcoma were studied retrospectively. The sample was analyzed to characterize the biopsy technique used, histological type of the tumor, neoadjuvant chemotherapy used, local recurrences and tumor contamination in the biopsy path. Results: Among the 35 ...

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

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    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.

  8. Central pancreatectomy:a new technique for resection of selected pancreatic tumors

    Institute of Scientific and Technical Information of China (English)

    Omar J Shah; Irfan Robbani; Parvez Nazir; Athar B Khan

    2009-01-01

    BACKGROUND: Pancreatic tumors located in the neck region usually require pancreaticoduodenectomy or splenopancreatectomy. For small benign tumors enucleation is not usually feasible due to their size and localization; then pancreatectomy is often needed. Central pancreatectomy consists of a limited resection of the midportion of the pancreas and can be offered in benign and low-grade malignant tumors of the neck of the pancreas. The study aimed to evaluate whether central pancreatectomy has a place in pancreatic surgery. METHODS: In this study, which covered a period of 14 months, we performed central pancreatectomy in four selected patients. Preoperative evaluation and operative frozen section biopsy in indicated cases allowed proper selection for the procedure. Operative details, complications and follow-up were recorded. RESULTS: Four patients, two with serous cystadenoma, and one with an islet cell tumor, and one with a hydatid cyst, were identiifed for the procedure. The mean tumor size was 3 cm, the mean operative time was 217.5 minutes, and the mean blood loss was 382.5 ml. There was no morbidity or mortality in this series. No endocrine or exocrine deifciency was observed in any patient during a mean follow-up of 22.7 months. CONCLUSIONS: Central pancreatectomy is a procedure that offers excellent results in benign and low-grade malignant tumors. It preserves functional elements (endocrine and exocrine) of the pancreas and also eliminates the infective and hematological effects of splenectomy. Thus, central pancreatectomy should be included in the armamentarium of pancreatic surgery, and in order to obtain good results, proper indications and adequate experience are recommended.

  9. Evaluation of Clinical Results and Complications of Structural Allograft Reconstruction after Bone Tumor Surgery

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    Mohammad Gharedaghi

    2016-07-01

    Full Text Available Background: Massive bone allograft is an option in cases of limb preservation and reconstruction after massive benign and malignant bone tumor resection. The purpose of this study was to analyze the outcome of these procedures at Imam Reza Hospital, Mashhad University of Medical Sciences. Methods: In this study, 113 cases have been presented. Eleven cases were excluded (patients has a traumatic defect or they passed away before the completion of the study’s two-year follow up period. Each patient completed a questionnaire, went through a physical examination and, if indicated, X-ray information was collected. The patients were divided into three groups: chemotherapy, chemotherapy plus radiation therapy, and no-adjuvant-therapy. Results: Fifty-four cases were male and the mean age was 24.5±5.39. The number of cases and indications for surgery were: 33 cases of aggressive benign tumors or low grade malignant bone tumors (large bone defects including 16 germ cell tumors, eight aneurysmal bone cysts, five low grade osteosarcomas, and four chondrosarcomas. Another 69 cases were high-grade malignant bone tumors including 42 osteosarcomas, 21 Ewing’s sarcoma, and six other high grade osteosarcomas. Patients were divided into three groups: the first group received no adjuvant therapy, the second group received chemotherapy, and the third group received chemotherapy plus radiotherapy. The location of tumors were as follows: eight cases in the pelvic bone, 12 in the proximal femur, 18 in the femoral shaft, 36 in the distal femur, 12 in the proximal tibia, and 16 in the humeral bone. The 12 cases of proximal femoral defects were reconstructed by allograft composite prosthesis, 18 diaphyseal defects with intercalary allograft, and 36 distal femoral defects were reconstructed using osteoarticular allograft. The rate of deep infection was 7:8% (eight patients and in this regard, we found a significant difference among the three groups, such that most

  10. Rheumatic manifestations of primary and metastatic bone tumors and paraneoplastic bone disease.

    Science.gov (United States)

    Waimann, Christian A; Lu, Huifang; Suarez Almazor, Maria E

    2011-11-01

    Bone tumors can show a wide range of nonspecific rheumatic manifestations. The presence of unexplained or atypical chronic bone pain, an enlarging bone mass, neurovascular compression syndromes, or pathologic fractures should alert us to the possibility of a bone tumor causing these symptoms. These patients must undergo a complete physical examination; adequate imaging; and, if needed, a biopsy to confirm their diagnosis and offer them an opportune treatment. In addition, bone tumors and other malignancies can present remote clinical manifestations and unusual laboratory findings (eg, HOA, hypophosphatemia, hyperphosphaturia, and hypercalcemia) that may be the first and early manifestation of an occult cancer. These findings should motivate a cancer screening according to age, sex, and personal history. Cancer therapies also have a big impact on bone health, increasing the risk of osteoporosis, osteomalacia, and/or osteonecrosis. Rheumatologists should be aware of possible long-term adverse events of cancer treatment to avoid future complications.

  11. Bone Mineral Density Reduction Following Irradiation of Brain Tumors

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2006-11-01

    Full Text Available Total body bone mineral density (TBBMD was measured by X-ray absorptiometry in 46 brain tumor patients aged from 3.8 to 28.7 years (mean 14.9 y at a mean of 6.4 y (range 1.4-14.8 y after end of treatment for brain tumor.

  12. Portal vein-circulating tumor cells predict liver metastases in patients with resectable pancreatic cancer.

    Science.gov (United States)

    Bissolati, Massimiliano; Sandri, Maria Teresa; Burtulo, Giovanni; Zorzino, Laura; Balzano, Gianpaolo; Braga, Marco

    2015-02-01

    Pancreatic cancer patients underwent surgical resection often present distant metastases early after surgery. Detection of circulating tumor cells (CTCs) has been correlated to a worse oncological outcome in patients with advanced pancreatic cancer. The objective of this pilot study is to investigate the possible prognostic role of CTCs in patients undergoing surgery for pancreatic cancer. In 20 patients undergoing pancreatic resection, 10 mL blood sample was collected intraoperatively from both systemic circulation (SC) and portal vein (PV). Blood sample was analyzed for CTCs with CellSearch® system. All patients underwent an oncologic follow-up for at least 3 years, quarterly. CTCs were detected in nine (45%) patients: five patients had CTCs in PV only, three patients in both SC and PV, and one patient in SC only. CTC-positive and CTC-negative patients were similar for demographics and cancer stage pattern. No significant differences were found in both overall and disease-free survival between CTC-positive and CTC-negative patients. At 3-year follow-up, portal vein CTC-positive patients presented a higher rate of liver metastases than CTC-negative patients (53 vs. 8%, p = 0.038). CTCs were found in 45% of the patients. No correlation between CTCs and survival was found. The presence of CTCs in portal vein has been associated to higher rate of liver metastases after surgery.

  13. Segmental intercalary diaphyseal endoprosthetic replacement for malignant diaphyseal bone tumors MAO%节段型骨干肿瘤假体置换治疗骨干恶性肿瘤

    Institute of Scientific and Technical Information of China (English)

    毛震扬; 郝永强

    2013-01-01

    Radical excision of tumor segments should be used in the treatment of malignant bone tumors accompanied by the adjuvant therapies including chemotherapy, radiotherapy and so on. The reconstruction methods of limb salvage after the excision of malignant tumor segments is chosen based on the tumor site. For the malignant bone tumors in the metaphysis, reconstructive surgeries such as artificial endoprosthetic replacement, osteoarticular allograft transplantation, arthrodesis and so on can be applied after the oncologic resection. More reconstruction methods may be chosen when the diaphyseal malignant bone tumors are resected. Surgical margin is an important factor, which affects the prognosis of patients. Different grades of bone tumors determine different choices of the surgical margin. The surgical margin of wide excision is required in the surgeries for patients with malignant bone tumors. The previous surgical procedures for the long-tubular diaphyseal bone tumors include amputation, bone-joint resection, integrated bone resection and so on, with the disadvantages of severe surgical trauma, slow recovery and poor limb function postoperatively. With the gradual maturity of the neoadjuvant chemotherapy, the advance of the radiology and the development of the reconstruction technology for massive bone defects, the limb salvage treatment is proved to be developed rapidly. A great number of practices have proved that the limb salvage treatment is safe, and there is almost no difference in the survival rate and recurrence rate, when compared with that of the amputation. The functional reconstruction surgery after the excision of the long-tubular diaphyseal bone tumors is generally recognized and promoted because it retains good limb function in patients. Surgical options mainly include transplantationof massive bone allografts, autogenous bone graft, segmental intercalary endoprosthetic replacement and so on. Every surgical procedure mentioned above has its specific

  14. 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.

  15. 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.

  16. Pre-operative embolization facilitating a posterior approach for the surgical resection of giant sacral neurogenic tumors.

    Science.gov (United States)

    Chen, Kangwu; Zhou, Ming; Yang, Huilin; Qian, Zhonglai; Wang, Genlin; Wu, Guizhong; Zhu, Xiaoyu; Sun, Zhiyong

    2013-07-01

    The present study aimed to assess a posterior approach for the surgical resection of giant sacral neurogenic tumors, and to evaluate the oncological and functional outcomes. A total of 16 patients with giant sacral neurogenic tumors underwent pre-operative embolization and subsequent posterior sacral resection between January 2000 and June 2010. Benign tumors were identified in 12 cases, while four cases exhibited malignant peripheral nerve sheath tumors (MPNSTs). An evaluation of the operative techniques used, the level of blood loss, any complications and the functional and oncological outcomes was performed. All tumor masses were removed completely without intra-operative shock or fatalities. The mean tumor size was 17.5 cm (range, 11.5-28 cm) at the greatest diameter. The average level of intra-operative blood loss was 1,293 ml (range, 400-4,500 ml). Wound complications occurred in four patients (25%), including three cases of cutaneous necrosis and one wound infection. The mean follow-up time was 59 months (range, 24-110 months). Tumor recurrence or patient mortality as a result of the disease did not occur in any of the patients with benign sacral neurogenic tumors. The survival rate of the patients with malignant lesions was 75% (3/4 patients) since 25 % (1/4 patients) had multiple local recurrences and succumbed to the disease. The patients with benign tumors scored an average of 92.8% on the Musculoskeletal Tumor Society (MSTS) score functional evaluation, while the patients with malignant tumors scored an average of 60.3%. A posterior approach for the surgical resection of giant sacral neurogenic tumors, combined with pre-operative embolization may be safely conducted with satisfactory oncological and functional outcomes.

  17. 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

  18. 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

  19. Low Infection Rate after Tumor Hip Arthroplasty for Metastatic Bone Disease in a Cohort Treated with Extended Antibiotic Prophylaxis

    Directory of Open Access Journals (Sweden)

    Werner H. Hettwer

    2015-01-01

    Full Text Available Background. Compared to conventional hip arthroplasty, endoprosthetic reconstruction after tumor resection is associated with a substantially increased risk of periprosthetic joint infection (PJI, with reported rates of around 10% in a recent systematic review. The optimal duration of antibiotic prophylaxis for this patient population remains unknown. Material and Methods. To establish the infection rate associated with prolonged antibiotic prophylaxis in our department, we performed a retrospective review of all adult patients who underwent endoprosthetic reconstruction of the proximal femur after tumor resection for metastatic bone disease during a 4-year period from 2010 to 2013 (n=105 patients. Results. Intravenous antibiotic prophylaxis was administrated for an extended duration of a mean of 7.4 days. The overall infection rate was 3.6% (4/111 implants, infection free survival was 96% at 2 years, and the risk of amputation associated with infection was 25% (1/4 patients. Discussion. Preemptive eradication of bacterial contamination may be of value in certain clinical situations, where the risk level and consequences of implant-associated infection are unacceptable. Our findings suggest that extended postoperative antibiotic prophylaxis may reduce the risk of PJI in patients undergoing tumor resection and endoprosthetic replacement for metastatic bone disease associated impending or de facto pathologic fractures of the proximal femur.

  20. Low Infection Rate after Tumor Hip Arthroplasty for Metastatic Bone Disease in a Cohort Treated with Extended Antibiotic Prophylaxis

    Science.gov (United States)

    Hettwer, Werner H.; Horstmann, Peter Frederik; Hovgaard, Thea Bechmann; Grum-Scwensen, Tomas Andreas; Petersen, Michael M.

    2015-01-01

    Background. Compared to conventional hip arthroplasty, endoprosthetic reconstruction after tumor resection is associated with a substantially increased risk of periprosthetic joint infection (PJI), with reported rates of around 10% in a recent systematic review. The optimal duration of antibiotic prophylaxis for this patient population remains unknown. Material and Methods. To establish the infection rate associated with prolonged antibiotic prophylaxis in our department, we performed a retrospective review of all adult patients who underwent endoprosthetic reconstruction of the proximal femur after tumor resection for metastatic bone disease during a 4-year period from 2010 to 2013 (n = 105 patients). Results. Intravenous antibiotic prophylaxis was administrated for an extended duration of a mean of 7.4 days. The overall infection rate was 3.6% (4/111 implants), infection free survival was 96% at 2 years, and the risk of amputation associated with infection was 25% (1/4 patients). Discussion. Preemptive eradication of bacterial contamination may be of value in certain clinical situations, where the risk level and consequences of implant-associated infection are unacceptable. Our findings suggest that extended postoperative antibiotic prophylaxis may reduce the risk of PJI in patients undergoing tumor resection and endoprosthetic replacement for metastatic bone disease associated impending or de facto pathologic fractures of the proximal femur. PMID:25705521

  1. Low infection rate after tumor hip arthroplasty for metastatic bone disease in a cohort treated with extended antibiotic prophylaxis.

    Science.gov (United States)

    Hettwer, Werner H; Horstmann, Peter Frederik; Hovgaard, Thea Bechmann; Grum-Scwensen, Tomas Andreas; Petersen, Michael M

    2015-01-01

    Background. Compared to conventional hip arthroplasty, endoprosthetic reconstruction after tumor resection is associated with a substantially increased risk of periprosthetic joint infection (PJI), with reported rates of around 10% in a recent systematic review. The optimal duration of antibiotic prophylaxis for this patient population remains unknown. Material and Methods. To establish the infection rate associated with prolonged antibiotic prophylaxis in our department, we performed a retrospective review of all adult patients who underwent endoprosthetic reconstruction of the proximal femur after tumor resection for metastatic bone disease during a 4-year period from 2010 to 2013 (n = 105 patients). Results. Intravenous antibiotic prophylaxis was administrated for an extended duration of a mean of 7.4 days. The overall infection rate was 3.6% (4/111 implants), infection free survival was 96% at 2 years, and the risk of amputation associated with infection was 25% (1/4 patients). Discussion. Preemptive eradication of bacterial contamination may be of value in certain clinical situations, where the risk level and consequences of implant-associated infection are unacceptable. Our findings suggest that extended postoperative antibiotic prophylaxis may reduce the risk of PJI in patients undergoing tumor resection and endoprosthetic replacement for metastatic bone disease associated impending or de facto pathologic fractures of the proximal femur.

  2. Normalization of hypothalamic serotonin (5-HT 1B) receptor and NPY in cancer anorexia after tumor resection: an immunocytochemical study.

    Science.gov (United States)

    Makarenko, Irina G; Meguid, Michael M; Gatto, Louis; Chen, Chung; Ramos, Eduardo J B; Goncalves, Carolina G; Ugrumov, Michael V

    2005-08-05

    Tumor growth leads to anorexia and decreased food intake, the regulation of which is via the integrated hypothalamic peptidergic and monoaminergic system. Serotonin (5-HT), an anorectic monoamine acts primarily via 5-HT 1B-receptors in hypothalamic nuclei while neuropeptide Y (NPY) acts an orexigenic peptide. We previously reported that 5-HT 1B-receptors are up regulated while NPY is down regulated in tumor-bearing (TB)-related anorexia, contributing to food intake reduction. In anorectic TB rats we hypothesize that after tumor resection when food intake has reverted to normal, normalization of 5-HT 1B-receptor and NPY will occur. The aim of this study was to demonstrate normalization of these hypothalamic changes compared to Controls. In anorectic tumor-bearing rats after tumor resection (TB-R) and in sham-operated (Control) rats, distribution of 5-HT 1B-receptors and NPY in hypothalamic nuclei was analyzed using peroxidase antiperoxidase immunocytochemical methods. Image analysis of immunostaining was performed and the data were statistically analyzed. Immunostaining specificity was controlled by omission of primary or secondary antibodies and pre-absorption test. Our results show that after TB-R versus Controls a normalization of food intake, 5-H-1B-receptor and NPY expression in the hypothalamus occurs. These data, discussed in context with our previous studies, support the hypothesis that tumor resection results not only in normalization of food intake but also in reversible changes of anorectic and orexigenic hypothalamic modulators.

  3. 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.

  4. Thallium-201 scintigraphy for bone and soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tokuumi, Yuji; Tsuchiya, Hiroyuki; Sunayama, Chiaki; Matsuda, Eizo; Asada, Naohiro; Taki, Junichi; Sumiya, Hisashi; Miyauchi, Tsutomu; Tomita, Katsuro [Kanazawa Univ. (Japan). School of Medicine

    1995-05-01

    This study was undertaken to assess the usefulness of thallium-201 scintigraphy in bone and soft tissue tumors. Pre-therapy scintigraphy was undertaken in a total of 136 patients with histologically confirmed diagnosis, consisting of 74 with malignant bone and soft tissue tumors, 39 with benign ones, 12 with diseases analogous to tumors, and 11 others. Thallium activity was graded on a scale of 0-4: 0=background activity, 1=equivocal activity, 2=definitive activity, but less than myocardium, 3=definite activity equal to myocardium, and 4=activity greater than myocardium. In the group of malignant tumors, thallium-201 uptake was found in 80%, although it was low for chondrosarcoma (2/8) and malignant Schwannoma (one/3). The group of benign tumors, however, showed it in only 41%, being restricted to those with giant cell tumors, chondroblastoma, fibromatosis, and osteoid osteoma. Thallium-201 uptake was also found in all 8 patients with metastatic tumors. In 23 patients undergoing thallium imaging before and after chemotherapy, scintigraphic findings revealed a high correlation with histopathological findings. Thus, thallium-201 scintigraphy may be potentially used to distinguish malignant from benign bone and soft tissue tumors, except for a few histopathological cases, as well as to determine loco-regional metastases and response to chemotherapy. (N.K.).

  5. Bone Metastases in carcinoid tumors : Clinical features, imaging characteristics, and markers of bone metabolism

    NARCIS (Netherlands)

    Meijer, WG; van der Veer, E; Jager, PL; van der Jagt, EJ; Piers, BA; Kema, IP; de Vries, EGE; Willemse, PHB

    2003-01-01

    The purpose of this study was to describe the clinical presentation of bone metastases in patients with carcinoid tumors and to determine the diagnostic value of imaging techniques and markers of bone metabolism. Methods: This retrospective study was performed on the entire group of patients with ca

  6. Successful surgical management of osteonecrosis of the jaw due to RANK-ligand inhibitor treatment using fluorescence guided bone resection.

    Science.gov (United States)

    Otto, Sven; Baumann, Sebastian; Ehrenfeld, Michael; Pautke, Christoph

    2013-10-01

    Osteonecrosis of the jaw has recently been described in patients receiving subcutaneous administration of RANKL-inhibitors (denosumab). However, due to promising study results, more patients will receive denosumab in order to avoid skeletal complications due to metastatic bone disease and osteoporosis. Therefore, this has the potential to become a comparable challenge to the bisphosphonate induced jaw necrosis in the area of Oral and Maxillofacial Surgery. Indeed, so far no convincing surgical technique has been described to overcome the non-healing mucosal lesions with exposed bone due to RANKL-inhibitor therapy. In this technical note, we report two successful cases of surgical treatment of jaw-bone necrosis under RANKL-inhibitor treatment using fluorescence guided bone resection. In conclusion, the technique is suggested as treatment option for this entity of osteonecrosis of the jaw.

  7. 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.

  8. 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.

  9. 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.

  10. Responsiveness of human prostate carcinoma bone tumors to interleukin-2 therapy in a mouse xenograft tumor model.

    Science.gov (United States)

    Kocheril, S V; Grignon, D J; Wang, C Y; Maughan, R L; Montecillo, E J; Talati, B; Tekyi-Mensah, S; Pontes, J e; Hillman, G G

    1999-01-01

    We have tested an immunotherapy approach for the treatment of metastatic prostate carcinoma using a bone tumor model. Human PC-3 prostate carcinoma tumor cells were heterotransplanted into the femur cavity of athymic Balb/c nude mice. Tumor cells replaced marrow cells in the bone cavity, invaded adjacent bone and muscle tissues, and formed a palpable tumor at the hip joint. PC-3/IF cell lines, generated from bone tumors by serial in vivo passages, grew with faster kinetics in the femur and metastasized to inguinal lymph nodes. Established tumors were treated with systemic interleukin-2 (IL-2) injections. IL-2 significantly inhibited the formation of palpable tumors and prolonged mouse survival at nontoxic low doses. Histologically IL-2 caused vascular damage and infiltration of polymorphonuclear cells and lymphocytes in the tumor as well as necrotic areas with apoptotic cells. These findings suggest destruction of tumor cells by systemic IL-2 therapy and IL-2 responsiveness of prostate carcinoma bone tumors.

  11. Is laparoscopic resection the appropriate management of a jejunal gastrointestinal stromal tumor (GIST)? Report of a case.

    Science.gov (United States)

    Pitiakoudis, Michail; Zezos, Petros; Courcoutsakis, Nikos; Papanas, Nikolaos; Giatromanolaki, Alexandra; Sivridis, Efthimios; Kouklakis, Georgios; Simopoulos, Constantinos

    2010-10-01

    A 51-year-old female patient presented with iron deficiency anemia. Upper and lower gastrointestinal endoscopy were unremarkable. Computed tomography enteroclysis showed an ovoid 3×4-cm jejunal tumor with intraluminal protrusion and exophytic growth pattern, without lymphadenopathy or metastatic disease. Laparoscopic resection of the tumor was successfully carried out. Histologically, a mesenchymal tumor composed of spindle cells with an interlacing bundle pattern and high-mitotic activity greater than 10 mitoses/50 high-power fields were observed. The immunohistochemistry showed that the tumor was KIT (CD117)-, vimentin-, smooth muscle actin-, and S-100-positive, whereas it was CD34-negative. These findings were consistent with the features of a gastrointestinal stromal tumor. The patient had an uneventful postoperative course, and after 10 months of follow-up, she is well without any evidence of tumor recurrence.

  12. Comparison of Different Risk Classification Systems in 558 Patients with Gastrointestinal Stromal Tumors after R0-Resection

    Science.gov (United States)

    Schmieder, Michael; Henne-Bruns, Doris; Mayer, Benjamin; Knippschild, Uwe; Rolke, Claudia; Schwab, Matthias; Kramer, Klaus

    2016-01-01

    Background: Due to adjuvant treatment concepts for patients with R0-resected gastrointestinal stromal tumors (GIST), a reproducible and reliable risk classification system proved of utmost importance for optimal treatment of patients and prediction of prognosis. The aim of this study was to reevaluate the impact of five widely-applied and well-established GIST risk classification systems (i.e., scores by Fletcher, Miettinen, Huang, Joensuu, and TNM classification) on a series of 558 GIST patients with long-term follow-up after R0 resection. Methods: Tumor size, mitotic count and site were used in variable combination to predict high- and low risk patients by the use of the five risk classification models. For survival analyses disease-specific survival, disease-free survival and overall-survival were investigated. Patients with initial metastatic disease or incompletely resectable tumors were excluded. Results: All GIST classification models distinguished well between patients with high-risk and low-risk tumors and none of the five risk systems was superior to predict patient outcome. The models showed significant heterogeneity. There was no significant difference between the different risk-groups regarding overall-survival. Subdivision of GIST patients with very low- and low-risk appeared to be negligible. Conclusions: Currently applied GIST risk classification systems are comparable to predict high- or low-risk patients with initial non-metastatic and completely resected GIST. However, the heterogeneity of the high-risk group and the absence of differences in overall survival indicate the need for more precise tumor- and patient-related criteria for better stratification of GIST and identification of patients who would benefit best from adjuvant tyrosine kinase inhibitor therapy. PMID:28082898

  13. Establishment of a biomarker model for predicting bone metastasis in resected stage III non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Zhou Zhen

    2012-04-01

    Full Text Available Abstract Background This study was designed to establish a biomarker risk model for predicting bone metastasis in stage III non-small cell lung cancer (NSCLC. Methods The model consists of 105 cases of stage III NSCLC, who were treated and followed up. The patients were divided into bone metastasis group (n = 45 and non-bone metastasis group (other visceral metastasis and those without recurrence (n = 60. Tissue microarrays were constructed for immunohistochemical study of 10 molecular markers associated with bone metastasis, based on which a model was established via logistic regression analysis for predicting the risk of bone metastases. The model was prospectively validated in another 40 patients with stage III NSCLC. Results The molecular model for predicting bone metastasis was logit (P = − 2.538 + 2.808 CXCR4 +1.629 BSP +0.846 OPN-2.939 BMP4. ROC test showed that when P ≥ 0.408, the sensitivity was up to 71% and specificity of 70%. Model validation in the 40 cases in clinical trial (NCT 01124253 demonstrated that the prediction sensitivity of the model was 85.7%, specificity 66.7%, Kappa: 0.618, with a high degree of consistency. Conclusion The molecular model combining CXCR4, BSP, OPN and BMP4 could help predict the risk of bone metastasis in stage IIIa and IIIb resected NSCLC.

  14. Endoscopic submucosal dissection for small submucosal tumors of the rectum compared with endoscopic submucosal resection with a ligation device

    Science.gov (United States)

    Harada, Hideaki; Suehiro, Satoshi; Murakami, Daisuke; Nakahara, Ryotaro; Shimizu, Takanori; Katsuyama, Yasushi; Miyama, Yasunaga; Hayasaka, Kenji; Tounou, Shigetaka

    2017-01-01

    AIM To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for small rectal submucosal tumors (SMTs). METHODS Between August 2008 and March 2016, 39 patients were treated with endoscopic submucosal resection with a ligation device (ESMR-L) (n = 21) or ESD (n = 18) for small rectal SMTs in this study. Twenty-five lesions were confirmed by histological evaluation of endoscopic biopsy prior to the procedure, and 14 lesions were not evaluated by endoscopic biopsy. The results for the ESMR-L group and the ESD group were retrospectively compared, including baseline characteristics and therapeutic outcomes. RESULTS The rate of en bloc resection was 100% in both groups. Although the rate of complete endoscopic resection was higher in the ESD group than in the ESMR-L group (100% vs 95.2%), there were no significant differences between the two groups (P = 0.462). In one patient in the ESMR-L group with a previously biopsied tumor, histological complete resection with a vertical margin involvement of carcinoid tumor could not be achieved, whereas there was no incomplete resection in the ESD group. The mean length of the procedure was significantly greater in the ESD group than in the ESMR-L group (14.7 ± 6.4 min vs 5.4 ± 1.7 min, P < 0.05). The mean period of the hospitalization was also significantly longer in the ESD group than in the ESMR-L group (3.7 ± 0.9 d vs 2.8 ± 1.5 d, P < 0.05). Postoperative bleeding was occurred in one patient in the ESMR-L group. CONCLUSION Both ESMR-L and ESD were effective for treatment of small rectal SMTs. ESMR-L was simpler to perform than ESD and took less time. PMID:28250899

  15. Efficacy of transurethral resection of bladder tumor in treatment of elderly muscle-invasive bladder cancer

    Institute of Scientific and Technical Information of China (English)

    Yu Zhou; Min He; Hong-Tao Jia; Yun-Fei Li; Mao-Hua Luo

    2016-01-01

    Objective:To study the clinical efficacy of transurethral resection of bladder tumor (TURBT) in the treatment of elderly muscle-invasive bladder cancer (MIBC), and observe the changes of serum IGF-1, VEGF, BLCA-4, and IL-8 levels before and after treatment.Methods: A total of 56 elderly patients with MIBC who were admitted in our hospital were included in the study and divided into the treatment group (n=30) and the control group (n=26). The patients in the control group were given radical cystectomy, while the patients in the treatment group were given TURBT and bladder irrigation chemotherapy after operation. The surgical complications and survival in the two groups were observed. The serum IGF-1 and VEGF levels, and urine BLCA-4 and IL-8 levels before and after treatment in the two groups were detected.Results:The difference of serum IGF-1 and VEGF levels before operation between the two groups was not statistically significant (P>0.05). The serum IGF-1 and VEGF levels 7 d after operation were significantly reduced when compared with before operation (P<0.01), and the difference between the two groups was statistically significant (P<0.05 orP<0.01). The tumor-free survival rate 2 and 3 years after operation in the observation group were significantly higher than those in the control group (P<0.05).Conclusions: TURBT in the treatment of elderly MIBC has a preferable clinical effect, and can shorten the operation time, with a small trauma and less side effects.

  16. Late cardiotoxicity after treatment for a malignant bone tumor

    NARCIS (Netherlands)

    Postma, A; BinkBoelkens, MTE; BeaufortKrol, GCM; Kengen, RAM; Elzenga, NJ; SchasfoortvanLeeuwen, MJM; Kamps, WA; Schraffordt Koops, H.

    1996-01-01

    Cardiac function was assessed in longterm survivors of malignant bone tumors who were treated according to Rosen's T-5 or T-10 protocol, both including doxorubicin. Thirty-one patients, ages 10-45 years (median age 17.8 years) were evaluated 2.3-14.1 years (median 8.9 years) following completion of

  17. External bone remodeling after injectable calcium-phosphate cement in benign bone tumor: two cases in the hand.

    Science.gov (United States)

    Ichihara, S; Vaiss, L; Acciaro, A L; Facca, S; Liverneaux, P

    2015-12-01

    Bone remodeling commonly occurred after fracture and curettage benign bone tumor. A lot of previous articles reported "internal" trabecular bone remodeling. There were no previous clinical reports about "external" cortical bone remodeling. We present here 2 clinical cases of "external" bone remodeling after injectable calcium-phosphate in benign bone tumor in the hand. In two cases of benign bone tumor, we performed complete removal of the tumor and immediate filling of the metacarpal bone with injectable calcium-phosphate cement Arexbone(®) from the mechanical viewpoint. With respect to the shape of the calcium-phosphate, by using an injection-type, calcium-phosphate is adhered uniformly to the bone cortex by injecting, remodeling has been promoted. After 5 and 8years, both cases were no recurrences, and the shape of the metacarpal looked close to the contralateral side. These findings supposed to be concerned with potential self-healing and self-protection mechanism in human body.

  18. The Findings of {sup 99m}Tc-MDP Bone Scan in Primary malignant Bone Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, In Young; Lee, Kung Han; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Kang, Heung Sik; Lee, Sang Hoon; Lee, Han Koo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1995-03-15

    Tc-99m-MDP bone scan was performed in 31 patients with primary malignant bone tumors, 22 patients with osteogenic sarcoma, 5 patients with chondrosarcoma and 4 patients with Ewing's sarcoma. The findings were classified by isotope intensity of accumulation in tumor as grade 1 to 3, overall pattern of isotope distribution in tumor as grade 1 to 3, and distortion of bony outline as grade 1 to 3. Histologic classifications were correlated with scan findings in 22 patients with osteogenic sarcoma. The results were as follows. 1) In 22 patients with osteogenic sarcoma, markedly increased isotope intensity higher than sacroiliac joint with patchy areas of decreased intensity and severe bony distortion were found in 16 patients. The correlations between histologic classification and scan findings were not discovered. 2) In 5 patients with chondrosarcoma, mildly increased isotope intensity with patchy areas of increased intensity and mild bony distortion were found in 4 patients. 3) In 4 patients with Ewing's sarcoma, markedly increased homogenous intensity with moderate bony distortion were found in 3 patients. Conclusively there were common findings in each 3 primary malignant bone tumors and Tc-99m-MDP bone scan was complemented with radiologic studies in differentiating primary malignant bone tumors.

  19. Image-guided ablation therapy of bone tumors.

    Science.gov (United States)

    Sabharwal, Tarun; Katsanos, Konstantinos; Buy, Xavier; Gangi, Afshin

    2009-04-01

    A wide range of thermal and cryoablation methods is currently available for the curative eradication or palliative treatment of a variety of bone and soft-tissue tumors. Radiofrequency ablation has been developed as a multipurpose tool for the skeletal system. Cryoablation has the added advantages of direct computed tomography or magnetic resonance visualization and monitoring of treatment outcome with less peri- and postoperative pain. Use of appropriate thermo-sensors and insulation techniques, like carbon dioxide insufflation, results in enhanced safety and efficacy. Ablation of weight-bearing bones has to be supplemented with cement consolidation. The authors present an overview of the current status of percutaneous image-guided ablation therapy of bone and soft-tissue tumors, analyze the merits and limitations of the various systems available, and discuss possible new applications for the future.

  20. Quantification of radionuclide uptake levels for primary bone tumors

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Margaritescu, C; Raica, M; Pirici, D; Simionescu, C; Mogoanta, L; Stinga, A C; Stinga, A S; Ribatti, D

    2010-06-01

    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 resection margins from OSCCs were investigated utilizing immunohistochemistry for D2-40 antibody and image densitometry analysis. Podoplanin expression was extremely low in basal cells, especially in resection margins of OSCCs developed in the lower lip regions. However, a highly variable D2-40 expression in tumor-free resection margins associated with hyperplastic or dysplastic lesions was identified. Moreover, podoplanin expression also extended to the basal layer of the lower lip skin appendages, the myoepithelial cells of acini and ducts of minor salivary glands, and other structures from the oral cavity. As concerns the study of the density and complexity of oral lymphatic vessels architecture by means of immunohistochemistry (D2-40, CD31 and Ki-67 antibodies) and fractal analysis, we demonstrated that in normal oral mucosa the geometry of the lymphatic vessels was less complex at the level of the lower lip compared to the anterior part of the oral floor mucosa or the tongue. A comparative analysis between the normal and pathological aspects revealed statistically significant differences between the fractal dimension (FD) of the vessels' outline, especially in the tongue. Fractal analysis proved an increasing lymphatic network complexity from normal to premalignant oral mucosal lesions, providing additional prognostic information in oral malignant tumors.

  2. Complete resection and immediate reconstruction with costochondral graft for recurrent aneurysmal bone cyst of the mandibular condyle.

    Science.gov (United States)

    Ziang, Zhuo; Chi, Yang; Minjie, Chen; Yating, Qiu; Xieyi, Cai

    2013-11-01

    Aneurysmal bone cyst is a non-neoplastic expansile lesion characterized by replacement with fibro-osseous tissue and blood-filled cavernous spaces. Involvement of the condyle is rare, and only 11 cases have been reported in English-language literature to date. Its common treatment modalities are lesion excision or condylar resection, but recurrence is high in patients treated with the former. The authors reported a 19-year-old female patient with swelling of the right preauricular region, who had a surgical curettage history in another hospital. The lesion was completely resected and the jaw was immediately reconstructed with costochondral graft with the help of SurgiCase software. The patient has been symptom-free for 6 months postoperatively.

  3. 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.

  4. 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

  5. Transarticular invasion of joints by bone tumors: Hypothesis

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Miller, T.T.; Hermann, G. (Dept. of Radiology, Mount Sinai Medical Center, New York, NY (USA)); Klein, M.J. (Dept. of Pathology, Mount Sinai Medical Center, New York, NY (USA)); Kenan, S.; Lewis, M.M. (Dept. of Orthopedic Surgery, Mount Sinai Medical Center, New York, NY (USA))

    1991-05-01

    Eight bone tumors with associated transarticular invasion of the sacroiliac joints are described. All invaded the true synovial joint and spread to the opposing bone. One tumor was benign, and the other seven were malignant. Five of the seven were primary and two were metastatic cancer. One, a myeloma, invaded the disc spaces between the fourth and fifth lumbar vertebrae and the fifth lumbar vertebra and sacrum as well as the sacroiliac joint. The right facet joints of the two vertebrae were also invaded. After a thorough search of the literature, we find that the sacroiliac joints is the most common joint to be invaded by tumors. This is followed by the vertebral disc spaces and, last, the facet joints. Apart from these joints we were unable to find any radiographic documentation of other joints being transarticularly invaded by tumors. We noted that there is a direct relation between transarticular tumor spread and joints that lack mobility and that certain tumors, benign and malignant, tend to invade these joints. (orig.).

  6. [Radical resection following to concurrent chemoradiotherapy for eighty-five year-old patient with superior sulcus tumor].

    Science.gov (United States)

    Kobayashi, Satoru; Inoue, Takashi; Araki, Osamu; Karube, Yoko; Hayama, Makio; Tamura, Motohiko; Oyaizu, Takeshi; Chida, Masayuki

    2011-06-01

    An 85-year-old male with superior sulcus tumor was referred to our hospital complaining right brachial pain and omalgia. Chest computed tomography showed right apical lung tumor involving the 1st rib, and bronchoscopy established a diagnosis of squamous cell carcinoma, cT3NOM0. After concurrent chemoradiotherapy [cisplatin (CDDP) + 60 Gy], functional examination indicated him to be tolerable to lobectomy, and he underwent right upper lobectomy + chest wall resection (1st-3rd ribs) + lymph-node dissection. Pathological examination revealed that the effect of chemoradiotherapy was Ef. 3. The postoperative course was uneventful. He is free from recurrence for 7 years after the surgery.

  7. Simultaneous laparoscopic resection of colorectal cancer and synchronous metastatic liver tumor.

    Science.gov (United States)

    Hayashi, Michihiro; Komeda, Koji; Inoue, Yoshihiro; Shimizu, Tetsunosuke; Asakuma, Mitsuhiro; Hirokawa, Fumitoshi; Okuda, Junji; Tanaka, Keitaro; Kondo, Keisaku; Tanigawa, Nobuhiko

    2011-01-01

    Laparoscopic colorectal resection has been applied to advanced colorectal cancer. Synchronous liver metastasis of colorectal cancer would be treated safely and effectively by simultaneous laparoscopic colorectal and hepatic resection. Seven patients with colorectal cancer and synchronous liver metastasis treated by simultaneous laparoscopic resection were analyzed retrospectively. Three patients received a hybrid operation using a small skin incision, 2 patients underwent hand-assisted laparoscopic surgery using a small incision produced for colonic anastomosis, and 2 patients were treated with pure laparoscopic resection. The mean total operation duration was 407 minutes, and mean blood loss was 207 mL. Negative surgical margins were achieved in all cases. Mean postoperative hospital stay was 16.4 days. No recurrence at the surgical margin was observed in the liver. For selected patients with synchronous liver metastasis of colorectal cancer, simultaneous laparoscopic resection is useful for minimizing operative invasiveness while maintaining safety and curability, with satisfying short- and long-term results.

  8. 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.

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

    Science.gov (United States)

    Caboux, Elodie; Paciencia, Maria; Durand, Geoffroy; Robinot, Nivonirina; Wozniak, Magdalena B; Galateau-Salle, Françoise; Byrnes, Graham; Hainaut, Pierre; Le Calvez-Kelm, Florence

    2013-01-01

    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.

  10. 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.

  11. Pre-operative endostent placement to allow the complete and safe resection of a recurrent tumor that had tightly adhered to the subclavian artery: A case report

    Directory of Open Access Journals (Sweden)

    Takuya Nakayama

    2015-04-01

    Full Text Available Radiation and tumor infiltration confer a high risk of bleeding on surgical removal of tumor. We report on the case of a 42-year-old woman with a recurrent occult subclavian tumor in her right breast. Computed tomography revealed enhanced tumor adhesion to the subclavian artery at the infraclavicular lymph node. No other metastases were detected. We pre-operatively performed stenting of the right subclavian artery, and the tumor was resected completely and safely.

  12. 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

  13. Frozen Autograft-Prosthesis Composite Reconstruction in Malignant Bone Tumors.

    Science.gov (United States)

    Subhadrabandhu, Saran; Takeuchi, Akihiko; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Miwa, Shinji; Tsuchiya, Hiroyuki

    2015-10-01

    Several methods are available using an endoprosthesis or biological reconstruction for malignant bone tumors. Methods that use allograft-prosthesis composites have shown promising results. In 1999, the authors developed a method of reconstruction that uses a tumor-bearing autograft treated with liquid nitrogen. This technique was modified to produce a pedicle frozen autograft to maintain anatomical continuity on one side. In this study, the results of bone reconstructions using frozen autograft-prosthesis composites were retrospectively evaluated. The demographic data, histological records, surgical procedures, functional scores, and complications of 22 patients who had bone sarcoma or metastasis and at least 2 years of follow-up were reviewed. There were 19 patients with primary bone sarcoma and 3 with bone metastasis. Average age was 36 years (range, 9-73 years), and mean follow-up was 63 months (range, 24-176 months). Reconstructions were performed on 10 proximal femurs, 5 distal femurs, 4 proximal tibias, 1 proximal humerus, 1 proximal radius, and 1 hemipelvis. There were 12 pedicle-freezing and 10 free-freezing procedures. Union rate was 90% (9/10), and average union time was 9.5 months. Average Musculoskeletal Tumor Society score was 89.3%. Complications included 1 fracture, 2 infections, 3 soft tissue recurrences, and 1 posterior interosseous nerve palsy. The authors concluded that the frozen autograft-prosthesis composite demonstrated excellent Musculoskeletal Tumor Society scores, a low complication rate, and a good union rate and was superior when used with the pedicle-freezing technique.

  14. 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.

  15. Radiological long-term follow-up of grafted xenogeneic bone in patients with bone tumors.

    OpenAIRE

    Ozaki, Toshifumi; Inoue, Hajime; Sugihara, Shinsuke; Sumii, Hiroshi

    1992-01-01

    Radiological findings on the fate of grafted Kiel bone implants for the treatment of bone tumors were evaluated in 25 lesions. The mean follow-up period was 14.8 years, ranging from 5 to 21.8 years. We classified the radiological findings into 4 grades; Excellent (4 lesions), Good (14 lesions), Fair (2 lesions), and Poor (5 lesions). All cases of the Poor grade were polyostotic fibrous dysplasia. The younger the patient at the time of the operation, the more rapidly Kiel bone grafts tended to...

  16. 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.

  17. Lung metastasis of benign giant cell tumor: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Bosi, Thiago Carneiro da Cunha; Andrade, Fernando Coelho Goulart de; Turtelli, Celso Montenegro; Ribeiro Junior, Helio Antonio [Universidade Federal do Triangulo Mineiro (UFMT), Uberaba, MG (Brazil). Dept. of Radiology and Imaging Diagnosis]. E-mail: tccbosi@yahoo.com.br; Fatureto, Marcelo Cunha [Universidade Federal do Triangulo Mineiro (UFMT), Uberaba, MG (Brazil). Dept. of Thoracic Surgery; Etchebehere, Renata Margarida [Universidade Federal do Triangulo Mineiro (UFMT), Uberaba, MG (Brazil). Dept. of Pathology

    2008-05-15

    Giant cell tumor is the sixth most frequent primary bone neoplasm, affecting long bone metaphysis, most frequently in young adults. On radiological images, this tumor appears as a lytic, well-defined, eccentric lesion. The authors report a case of benign giant cell tumor in a patient who presented with lung metastases five years after undergoing resection of the primary tumor. (author)

  18. 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.

  19. Giant cell tumor complicating Paget disease of long bone

    Energy Technology Data Exchange (ETDEWEB)

    Hoch, Benjamin [Mount Sinai Medical Center, Department of Pathology, New York, NY (United States); Hermann, George [Mount Sinai Medical Center, Department of Radiology, New York, NY (United States); Klein, Michael J. [University of Alabama School of Medicine, Department of Pathology, Birmingham, AL (United States); Abdelwahab, Ibrahim F. [Coney Island Hospital affiliated with CUNY Downstate School of Medicine, Department of Radiology, New York, NY (United States); Springfield, Dempsey [Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston, MA (United States)

    2007-10-15

    Giant cell tumor (GCT) is a rare complication of Paget disease of bone. It usually occurs in the skull or pelvic bones of patients with long-standing polyostotic disease. This report describes a 62-year-old patient who presented with monostotic Paget disease of the distal femur complicated by GCT. He had a 2-year history of discomfort and pain in his left knee. Conventional plain films and MRI demonstrated the characteristic bone changes of Paget disease and an associated lytic lesion involving the epiphyseal and metaphyseal regions of the distal femur. A diagnostic curettage showed the characteristic histopathologic features of Paget disease and GCT. There was no evidence of malignancy. The clinicopathologic features of this rare lesion are described and correlated with a review of the literature. (orig.)

  20. 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.

  1. Comparison of Acetabular Bone Resection, Offset, Leg Length and Post Operative Function Between Hip Resurfacing Arthroplasty and Total Hip Arthroplasty.

    Science.gov (United States)

    Parry, Michael C; Povey, James; Blom, Ashley W; Whitehouse, Michael R

    2015-10-01

    Controversy exists regarding the amount of acetabular bone resection, biomechanics and function of patients receiving either total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA). A cohort of patients undergoing 36 mm ceramic-on-ceramic THA (89) or metal-on-metal HRA (86) were compared. No difference was observed when the ratio of native femoral head size was compared to the implanted acetabular component size (1.15 ± 0.1 HRA c.f. 1.13 ± 0.1 THA). No difference was observed in acetabular offset, vertical centre of rotation or function (OHS mean 47 in both groups) but leg length discrepancy (1.8 mm c.f. 5.5 mm) and femoral offset did differ (0.6 mm c.f. 4.1 mm). This demonstrates that 36 mm ceramic-on-ceramic THA is not associated with more bone resection than HRA and achieves equivalent function whilst avoiding the problems of metal-on-metal bearings.

  2. 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

  3. Systemic inflammation, nutritional status and tumor immune microenvironment determine outcome of resected non-small cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Marco Alifano

    Full Text Available BACKGROUND: Hypothesizing that nutritional status, systemic inflammation and tumoral immune microenvironment play a role as determinants of lung cancer evolution, the purpose of this study was to assess their respective impact on long-term survival in resected non-small cell lung cancers (NSCLC. METHODS AND FINDINGS: Clinical, pathological and laboratory data of 303 patients surgically treated for NSCLC were retrospectively analyzed. C-reactive protein (CRP and prealbumin levels were recorded, and tumoral infiltration by CD8+ lymphocytes and mature dendritic cells was assessed. We observed that factors related to nutritional status, systemic inflammation and tumoral immune microenvironment were correlated; significant correlations were also found between these factors and other relevant clinical-pathological parameters. With respect to outcome, at univariate analysis we found statistically significant associations between survival and the following variables: Karnofsky index, American Society of Anesthesiologists (ASA class, CRP levels, prealbumin concentrations, extent of resection, pathologic stage, pT and pN parameters, presence of vascular emboli, and tumoral infiltration by either CD8+ lymphocytes or mature dendritic cells and, among adenocarcinoma type, tumor grade (all p285 mg/L prealbumin levels and high (>96/mm2 CD8+ cell count had a 5-year survival rate of 80% [60.9-91.1] as compared to 18% [7.9-35.6] in patients with an opposite pattern of values. When stages I-II were considered alone, the prognostic significance of these factors was even more pronounced. CONCLUSIONS: Our data show that nutrition, systemic inflammation and tumoral immune contexture are prognostic determinants that, taken together, may predict outcome.

  4. Measurement of knee joint gaps without bone resection: "physiologic" extension and flexion gaps in total knee arthroplasty are asymmetric and unequal and anterior and posterior cruciate ligament resections produce different gap changes.

    Science.gov (United States)

    Nowakowski, Andrej Maria; Majewski, Martin; Müller-Gerbl, Magdalena; Valderrabano, Victor

    2012-04-01

    General agreement is that flexion and extension gaps should be equal and symmetrical in total knee arthroplasty (TKA) procedures. However, comparisons using a standard TKA approach to normal knee joints that have not undergone bone resection are currently unavailable. Since bony preparation can influence capsule and ligament tension, our purpose was to perform measurements without this influence. Ten normal cadaveric knees were assessed using a standard medial parapatellar TKA approach with patellar subluxation. Gap measurements were carried out twice each alternating 100 and 200 N per compartment using a prototypical force-determining ligament balancer without the need for bony resection. Initial measurements were performed in extension, followed by 908 of flexion. The ACL was then resected, and finally the PCL was resected, and measurements were carried out in an analogous fashion. In general, the lateral compartment could be stretched further than the medial compartment, and the corresponding flexion gap values were significantly larger. ACL resection predominantly increased extension gaps, while PCL resection increased flexion gaps. Distraction force of 100 N per compartment appeared adequate; increasing to 200 N did not improve the results.

  5. Differentially expressed genes in giant cell tumor of bone.

    Science.gov (United States)

    Babeto, Erica; Conceição, André Luis Giacometti; Valsechi, Marina Curado; Peitl Junior, Paulo; de Campos Zuccari, Débora Aparecida Pires; de Lima, Luiz Guilherme Cernaglia Aureliano; Bonilha, Jane Lopes; de Freitas Calmon, Marília; Cordeiro, José Antônio; Rahal, Paula

    2011-04-01

    Giant cells tumors of bone (GCTB) are benign in nature but cause osteolytic destruction with a number of particular characteristics. These tumors can have uncertain biological behavior often contain a significant proportion of highly multinucleated cells, and may show aggressive behavior. We have studied differential gene expression in GCTB that may give a better understanding of their physiopathology, and might be helpful in prognosis and treatment. Rapid subtractive hybridization (RaSH) was used to identify and measure novel genes that appear to be differentially expressed, including KTN1, NEB, ROCK1, and ZAK using quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry in the samples of GCTBs compared to normal bone tissue. Normal bone was used in the methodology RaSH for comparison with the GCTB in identification of differentially expressed genes. Functional annotation indicated that these genes are involved in cellular processes related to their tumor phenotype. The differential expression of KTN1, ROCK1, and ZAK was independently confirmed by qRT-PCR and immunohistochemistry. The expression of the KTN1 and ROCK1 genes were increased in samples by qRT-PCR and immunohistochemistry, and ZAK had reduced expression. Since ZAK have CpG islands in their promoter region and low expression in tumor tissue, their methylation pattern was analyzed by MSP-PCR. The genes identified KTN1, ROCK1, and ZAK may be responsible for loss of cellular homeostasis in GCTB since they are responsible for various functions related to tumorigenesis such as cell migration, cytoskeletal organization, apoptosis, and cell cycle control and thus may contribute at some stage in the process of formation and development of GCTB.

  6. 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

  7. Endo-laparoscopic reduction and resection of gastroduodenal intussuception of gastrointestinal stromal tumor (GIST): a synchronous endoscopic and laparoscopic treatment.

    Science.gov (United States)

    Chan, Christina Tin Yan; Wong, Simon Kin Hung; Ping Tai, Yuk; Li, Michael Ka Wah

    2009-06-01

    Gastrointestinal stromal tumor (GIST) commonly occurs in the stomach. We would like to report an uncommon presentation of gastric GIST with gastroduodenal intussuception. A patient with known history of gastric GIST at fundus for 10 years presented to the casualty department with recurrent epigastric pain, deranged liver function, and hyperamylasemia. Computed tomography of the abdomen showed intussuception of the gastric GIST into duodenum. Emergency operation with synchronous endoscopic reduction and laparoscopic wedge resection was performed and patient had uneventful recovery. This simultaneous endoscopic and laparoscopic treatment should be considered for this rare complication of GIST.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sug Jun; Jeon, Dae Geun; Huh, Kwang [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1998-01-01

    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.

  9. Instructive function of surface structure of calcium phosphate ceramics in bone regeneration

    NARCIS (Netherlands)

    Zhang, Jingwei

    2016-01-01

    The incidence of patients which require spinal fusion or bone regeneration in large bone defects caused by trauma, tumors, tumor resection, infections or abnormal skeletal development, is on the rise. Traditionally, in both spinal fusion surgery and other bone regeneration approaches, bone grafts ar

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

    Science.gov (United States)

    Avril, Pierre; Le Nail, Louis-Romée; Brennan, Meadhbh Á.; Rosset, Philippe; De Pinieux, Gonzague; Layrolle, Pierre; Heymann, Dominique; Perrot, Pierre; Trichet, Valérie

    2015-01-01

    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. PMID:26998421

  11. 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.

  12. 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.

  13. Hypothyroidism following struma ovarii tumor resection: a case report Hipotireoidismo após ressecção de tumor struma ovarii: relato de caso

    Directory of Open Access Journals (Sweden)

    Jesus Paula Carvalho

    2002-06-01

    Full Text Available Struma ovarii is an infrequent ovarian tumor, and there are only few reports with detailed data of thyroid function. In several cases, malignant struma ovarii have been shown to produce hyperthyroidism, but there is no reported case of hypothyroidism following struma ovarii tumor resection. A 62-year-old white woman underwent right ovary resection that had a pathologic diagnosis of struma ovarii. After 6 days, she developed weakness, myalgia, somnolence, nausea, and arterial hypotension. Laboratory tests showed a high level of thyroid-stimulating hormone (TSH and a decreased level thyroxin. Thyroxin replacement therapy was initiated, and the patient became completely asymptomatic. This is the first reported case of a previously asymptomatic woman who developed a definite clinical hypothyroidism after resection of a struma ovarii tumor.Struma ovarii é um tumor infreqüente com poucos relatos de casos abordando detalhadamente a função tireoidiana. Na maioria dos casos têm sido demonstrado que o struma ovarii produz hipertireoidismo, entretando não existe relatos de desenvolvimento de hipotireoidismo após a retirada deste tumor. Uma mulher branca de 62 anos foi submetida a oforectomia direita com diagnóstico anatomopatológico de struma ovarii. Após seis dias da cirurgia, a paciente desenvolveu fraqueza, mialgia, sonolência, náusea e hipotensão arterial. Exames laboratoriais demonstraram níveis elevados de hormônio tireo-estimulante (TSH e baixos de T3 e T4. Foi iniciado terapia de reposição de tiroxina e a paciente recuperou seus parâmetros clínicos e laboratoriais. Não existe, até o momento, relato de hipotireoidismo seguindo a exerese de struma ovarii. Este é o primeiro caso de uma mulher com função tireoidiana prévia normal que desenvolveu hipotireoidismo clínico após a ressecção de um tumor ovariano struma ovarii.

  14. Neuroendoscopic Resection of Intraventricular Tumors and Cysts through a Working Channel with a Variable Aspiration Tissue Resector: A Feasibility and Safety Study

    Directory of Open Access Journals (Sweden)

    Edjah Kweku-Ebura Nduom

    2013-01-01

    Full Text Available Pure neuroendoscopic resection of intraventricular lesions through a burr hole is limited by the instrumentation that can be used with a working channel endoscope. We describe a safety and feasibility study of a variable aspiration tissue resector, for the resection of a variety of intraventricular lesions. Our initial experience using the variable aspiration tissue resector involved 16 patients with a variety of intraventricular tumors or cysts. Nine patients (56% presented with obstructive hydrocephalus. Patient ages ranged from 20 to 88 years (mean 44.2. All patients were operated on through a frontal burr hole, using a working channel endoscope. A total of 4 tumors were resected in a gross total fashion and the remaining intraventricular lesions were subtotally resected. Fifteen of 16 patients had relief of their preoperative symptoms. The 9 patients who presented with obstructive hydrocephalus had restoration of cerebrospinal fluid flow though one required a ventriculoperitoneal shunt. Three patients required repeat endoscopic resections. Use of a variable aspiration tissue resector provides the ability to resect a variety of intraventricular lesions in a safe, controlled manner through a working channel endoscope. Larger intraventricular tumors continue to pose a challenge for complete removal of intraventricular lesions.

  15. One-stage laparoscopic resection for a large gastric gastrointestinal stromal tumor and synchronous liver metastases following preoperative imatinib therapy: A case report

    OpenAIRE

    2013-01-01

    Laparoscopic partial gastrectomy without lymph node dissection has been accepted worldwide for the treatment of small gastric gastrointestinal stromal tumors (GISTs). However, the role of laparoscopic surgery in the treatment of large gastric GISTs remains under debate due to the risk of tumor spillage or rupture of the tumor capsule leading to peritoneal seeding. To the best of our knowledge, one-stage laparoscopic resection for a large gastric GIST and synchronous liver metastases following...

  16. Metachronous multicentric giant-cell tumor of the bone in the lower limb. Case report and Ki-67 immunohistochemistry study.

    Science.gov (United States)

    Rousseau, Marc-Antoine; Handra-Luca, Adriana; Lazennec, Jean-Yves; Catonné, Yves; Saillant, Gérard

    2004-07-01

    Multicentric giant-cell tumors of the bone (GCTs) are rare. Little is known about the mechanisms by which these tumors spread and how 1% of GCT turn out to be multicentric. We report the case of a 19-year-old woman with metachronous multiple and recurrent GCTs that were unusual in their pattern of progression along the right lower limb over a 23-year period. Histology showed no evidence of malignant transformation. The treatment was repeated curettage and packing with cement. This did not permit a wide surgical margin, but avoided amputation and preserved full limb function. We tested the proliferation index marker Ki-67 in the tumor specimens. Ki-67 expression was limited to the mononuclear cell component of the tumors. The proliferation index was similar in each new tumor and higher in recurrences for each location. In this case, proliferation was initially low in the new tumor location, despite the time difference and independent from the initial clone evolution. Proliferation index increased in recurrent GCTs after marginal margin resection.

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

    Energy Technology Data Exchange (ETDEWEB)

    Benassi, Maria Serena, E-mail: mariaserena.benassi@ior.it [Laboratory of Experimental Oncology, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna (Italy); Rimondi, Eugenio, E-mail: eugenio.rimondi@ior.it [Radiology, Istituto Ortopedico Rizzoli, Bologna (Italy); Balladelli, Alba, E-mail: alba.balladelli@ior.it [Laboratory of Experimental Oncology, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna (Italy); Ghinelli, Cristina, E-mail: cristina.ghinelli@ior.it [Laboratory of Experimental Oncology, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna (Italy); Magagnoli, Giovanna, E-mail: giovanna.magagnoli@ior.it [Laboratory of Experimental Oncology, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna (Italy); Vanel, Daniel, E-mail: daniel.vanel@ior.it [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2013-12-01

    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. The negative prognostic impact of bone metastasis with a tumor mass

    Directory of Open Access Journals (Sweden)

    Birsen Yücel

    2015-08-01

    Full Text Available OBJECTIVE:Typically, bone metastasis causes osteolytic and osteoblastic lesions resulting from the interactions of tumor cells with osteoclasts and osteoblasts. In addition to these interactions, tumor tissues may grow inside bones and cause mass lesions. In the present study, we aimed to demonstrate the negative impact of a tumor mass in a large cohort of patients with bone metastatic cancer.METHODS:Data from 335 patients with bone metastases were retrospectively reviewed. For the analysis, all patients were divided into three subgroups with respect to the type of bone metastasis: osteolytic, osteoblastic, or mixed. The patients were subsequently categorized as having bone metastasis with or without a tumor mass, and statistically significant differences in median survival and 2-year overall survival were observed between these patients (the median survival and 2-year overall survival were respectively 3 months and 16% in patients with a tumor mass and 11 months and 26% in patients without a tumor mass; p<0.001.RESULTS:According to multivariate analysis, the presence of bone metastasis with a tumor mass was found to be an independent prognostic factor (p=0.011, hazard ratio: 1.62, 95% confidence interval: 1.11–1.76. Bone metastasis with a tumor mass was more strongly associated with osteolytic lesions, other primary diseases (except for primary breast and prostate cancers, and spinal cord compression.CONCLUSION:Bone metastasis with a tumor mass is a strong and independent negative prognostic factor for survival in cancer patients.

  19. Use of Computed Tomography-Derived Prosthetics for Intraoperative Guidance of Tumor Resection.

    Science.gov (United States)

    Chukwueke, Victor; Vercler, Christian J; Ranganathan, Kavitha; Kline, Stephanie; Buchman, Steven R

    2016-05-01

    Preoperative computed tomography (CT)-derived design and modeling provides a useful guide for a more accurate reconstruction of a variety of complex maxillofacial deformities. While the use of three-dimensional CT imaging has focused mainly on bony reconstruction, the use of this technique to facilitate soft tissue reconstruction represents an important innovation that can assist surgeons with preoperative planning and intraoperative decision-making. In this study, the authors report the novel use of three-dimensional CT scan modeling to facilitate the resection of a large maxillofacial neurofibroma in a patient with neurofibromatosis. In conjunction with an anaplastologist, the combined use of tangible models and aesthetic judgments significantly optimizes the quality of the initial resection and subsequent reconstruction. By utilizing an interdisciplinary approach, it is possible to achieve optimal symmetry in the setting of complex maxillofacial deformities.

  20. Effect of tibial bone resection on the development of fast- and slow-twitch skeletal muscles in foetal sheep.

    Science.gov (United States)

    West, J M; Williams, N A; Luff, A R; Walker, D W

    2000-04-01

    To determine if longitudinal bone growth affects the differentiation of fast- and slow-twitch muscles, the tibial bone was sectioned at 90 days gestation in foetal sheep so that the lower leg was permanently without structural support. At 140 days (term is approximately 147 days) the contractile properties of whole muscles, activation profiles of single fibres and ultrastructure of fast- and slow-twitch muscles from the hindlimbs were studied. The contractile and activation profiles of the slow-twitch soleus muscles were significantly affected by tibial bone resection (TIBX). The soleus muscles from the TIBX hindlimbs showed: (1) a decrease in the time to peak of the twitch responses from 106.2 +/- 10.7 ms (control, n = 4) to 65.1 +/- 2.48 ms (TIBX, n = 5); (2) fatigue profiles more characteristic of those observed in the fast-twitch muscles: and (3) Ca2+ - and Sr2+ -activation profiles of skinned fibres similar to those from intact hindlimbs at earlier stages of gestation. In the FDL, TIBX did not significantly change whole muscle twitch contraction time, the fatigue profile or the Ca2+ - and Sr2+ -activation profiles of skinned fibres. Electron microscopy showed an increased deposition of glycogen in both soleus and FDL muscles. This study shows that the development of the slow-twitch phenotype is impeded in the absence of the physical support normally provided by the tibial bone. We suggest that longitudinal stretch is an important factor in allowing full expression of the slow-twitch phenotype.

  1. 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.

  2. Resective surgery for liver tumor:a multivariate analysis of causes and risk factors linked to postoperative complications

    Institute of Scientific and Technical Information of China (English)

    Enrico Benzoni; Dario Lorenzin; Umberto Baccarani; Gian Luigi Adani; Alessandro Favero; Alessandro Cojutti; Fabrizio Bresadola; Alessandro Uzzau

    2006-01-01

    BACKGROUND: In spite of accurate selection of patients eligible for resection, and although advances in surgical techniques and perioperative management have greatly contributed to reducing the rate of perioperative deaths, stress must be placed on reducing the postoperative complication rates reported to be still as high as 50%. This study was designed to analyze the causes and foreseeable risk factors linked to postoperative morbidity on the grounds of data derived from a single-center surgical population. METHODS: From September 1989 to March 2005, 287 consecutive patients, affected either with HCC or liver metastasis, had liver resection at our department. Among the HCC series we recorded 98 patients (73.2%) in Child-Pugh class A, 32 (23.8%) in class B and 4 in class C (3%). In 104 colorectal metastases, 71% were due to colon cancer, 25% rectal, 3% sigmoid, and 1% anorectal. In 49 non-colorectal metastases, 22.4% were derived from breast cancer, 63.2% gastrointestinal tumors (excluding colon) and 14.4%other cancers. We performed 80 wedge resections, 77 bisegmentectomies and/or left lobectomies, 74 segmentectomies, 22 major hepatectomies, 20 left hepatectomies, and 14 trisegmentectomies. RESULTS: The in-hospital mortality rate in this series was 4.5%, and the morbidity rate was 47.7%, because of pleural effusion (30%), hepatic abscess (25%), hepatic insufifciency (19%), ascites (10%), hemoperitoneum (10%), or biliary ifstula (6%). The variables associated with the technical aspects of the surgical procedure that were responsible for the complications were: a Pringle maneuver length more than 20 minutes (P=0.001);the type of liver resection procedure, including major hepatectomy (P=0.02), left hepatectomy (P=0.04), trisegmentectomy (P=0.04), bisegmentectomy and/or left lobectomy (P=0,04);and a blood transfusion of more than 600 ml (P=0.04). CONCLUSION: The evaluation of causes and foreseeable risk factors linked to postoperative morbidity during the planning of

  3. Long-term survival of a patient after resection of a gastrointestinal stromal tumor arising from the pancreas

    Institute of Scientific and Technical Information of China (English)

    FilipČečka; BohumilJon; AlexanderFerko; ZdeněkŠubrt; DimitarHNikolov; VěraTyčová

    2011-01-01

    BACKGROUND: Gastrointestinal stromal tumors (GISTs) may arise in any part of the gastrointestinal tract; extra-gastrointestinal locations are extremely rare. Only a few cases of extragastrointestinal stromal tumor arising from the pancreas were reported. None of the reports described a long-term follow-up of the patients. METHOD: This report describes an interesting and unusual case of GIST arising from the pancreas. RESULTS:  A 74-year-old female presented with a palpable abdominal mass. CT scan showed a large mass 11×8×4 cm originating from the tail of the pancreas. Percutaneous biopsy revealed a GIST predominantly with spindle cells, but some parts also contained epitheloid cells. The patient was treated by distal pancreatic resection with splenectomy. Immunohistochemistry of the tumor showed a staining pattern characteristic of GIST. The patient has achieved a long-term survival of five years and six months without any sign of recurrence of the disease. CONCLUSION: This is the first reported case of an extra-gastrointestinal stromal tumor arising from the pancreas treated surgically, with a long-term survival.

  4. Giant cell tumor of the temporal bone – a case report

    Directory of Open Access Journals (Sweden)

    Rao Saraswathi G

    2005-09-01

    Full Text Available Abstract Background Giant cell tumor is a benign but locally aggressive bone neoplasm which uncommonly involves the skull. The petrous portion of the temporal bone forms a rare location for this tumor. Case presentation The authors report a case of a large giant cell tumor involving the petrous and squamous portions of the temporal bone in a 26 year old male patient. He presented with right side severe hearing loss and facial paresis. Radical excision of the tumor was achieved but facial palsy could not be avoided. Conclusion Radical excision of skull base giant cell tumor may be hazardous but if achieved is the optimal treatment and may be curative.

  5. A case of a glomus tumor of the stomach resected by laparoscopy endoscopy cooperative surgery.

    Science.gov (United States)

    Nakajo, Keiichiro; Chonan, Akimichi; Tsuboi, Rumiko; Nihei, Kousuke; Iwaki, Tomoyuki; Yamaoka, Hajime; Sato, Shun; Matsuda, Tomomi; Nakahori, Masato; Endo, Mareyuki

    2016-09-01

    A 56-year-old woman who was found to have a submucosal tumor (SMT) of the stomach in a medical check-up was admitted to our hospital for a detailed investigation of the SMT. Upper gastrointestinal endoscopy revealed an SMT of 20mm at the anterior wall of the antrum of the stomach. Endoscopic ultrasonography showed a hyperechoic tumor in the fourth layer of the stomach wall. CT examination showed a strongly enhancing tumor on arterial phase images and persistent enhancement on portal venous phase images. Laparoscopy endoscopy cooperative surgery was performed with a diagnosis of SMT of the stomach highly suspicious of a glomus tumor. Immunohistochemistry revealed expression of α-SMA but no expression of desmin, c-kit, CD34, or S-100. The tumor was finally diagnosed as a glomus tumor of the stomach.

  6. [A Case of Resected Giant Gastrointestinal Stromal Tumor Associated with Intraperitoneal Bleeding Following Imatinib Administration].

    Science.gov (United States)

    Ide, Ryuta; Suzuki, Takahisa; Takakura, Yuji; Oshita, Akihiko; Ikeda, Satoshi; Matsugu, Yasuhiro; Nakahara, Hideki; Urushihara, Takashi; Itamoto, Toshiyuki; Shinozaki, Katsunori

    2016-09-01

    A 76-year-old woman with tarry stool was referred to our hospital for further examination. Contrast-enhanced computed tomography(CT)revealed a heterogeneous 15 cm tumor located in the left upper abdominal cavity. The tumor had a rich vascularity and was associated with intra-abdominal bleeding. Gastroscopy showed a large submucosal tumor in the gastric body. A biopsy was performed, and the patient was diagnosed with a c-kit-positive gastrointestinal stromal tumor(GIST)of the stomach. Imatinib mesylate(400mg/day)was administered for 6 months. Vascularity in the tumor was diminished and no new lesion had emerged, although there was no remarkable reduction in tumor size. The patient underwent partial gastrectomy and splenectomy with curative intent. She is currently alive 1 year and 4 months after surgery with no evidence of recurrence.

  7. Late sarcoma development after curettage and bone grafting of benign bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Picci, Piero, E-mail: piero.picci@ior.it [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Sieberova, Gabriela [Dept. of Pathology, National Cancer Institute, Bratislava (Slovakia); Alberghini, Marco; Balladelli, Alba; Vanel, Daniel [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Hogendoorn, Pancras C.W. [Dept. of Pathology, Leiden University Medical Center, Leiden (Netherlands); Mercuri, Mario [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2011-01-15

    Background and aim: Rarely sarcomas develop in previous benign lesions, after a long term disease free interval. We report the experience on these rare cases observed at a single Institution. Patients and methods: 12 cases curetted and grafted, without radiotherapy developed sarcomas, between 1970 and 2005, 6.5-28 years from curettage (median 18, average 19). Age ranged from 13 to 55 years (median 30, average 32) at first diagnosis; tumors were located in the extremities (9 GCT, benign fibrous histiocytoma, ABC, and solitary bone cyst). Radiographic and clinic documentation, for the benign and malignant lesions, were available. Histology was available for 7 benign and all malignant lesions. Results: To fill cavities, autogenous bone was used in 4 cases, allograft in 2, allograft and tricalcium-phosphate/hydroxyapatite in 1, autogenous/allograft in 1, heterogenous in 1. For 3 cases the origin was not reported. Secondary sarcomas, all high grade, were 8 osteosarcoma, 3 malignant fibrous histiocytoma, and 1 fibrosarcoma. Conclusions: Recurrences with progression from benign tumors are possible, but the very long intervals here reported suggest a different cancerogenesis for these sarcomas. This condition is extremely rare accounting for only 0.26% of all malignant bone sarcomas treated in the years 1970-2005 and represents only 8.76% of all secondary bone sarcomas treated in the same years. This incidence is the same as that of sarcomas arising on fibrous dysplasia, and is lower than those arising on bone infarcts or on Paget's disease. This possible event must be considered during follow-up of benign lesions.

  8. Intraoperative application of thermal camera for the assessment of during surgical resection or biopsy of human's brain tumors

    Science.gov (United States)

    Kastek, M.; Piatkowski, T.; Polakowski, H.; Kaczmarska, K.; Czernicki, Z.; Bogucki, J.; Zebala, M.

    2014-05-01

    Motivation to undertake research on brain surface temperature in clinical practice is based on a strong conviction that the enormous progress in thermal imaging techniques and camera design has a great application potential. Intraoperative imaging of pathological changes and functionally important areas of the brain is not yet fully resolved in neurosurgery and remains a challenge. A study of temperature changes across cerebral cortex was performed for five patients with brain tumors (previously diagnosed using magnetic resonance or computed tomography) during surgical resection or biopsy of tumors. Taking into account their origin and histology the tumors can be divided into the following types: gliomas, with different degrees of malignancy (G2 to G4), with different metabolic activity and various temperatures depending on the malignancy level (3 patients), hypervascular tumor associated with meninges (meningioma), metastatic tumor - lung cancer with a large cyst and noticeable edema. In the case of metastatic tumor with large edema and a liquid-filled space different temperature of a cerebral cortex were recorded depending on metabolic activity. Measurements have shown that the temperature on the surface of the cyst was on average 2.6 K below the temperature of surrounding areas. It has been also observed that during devascularization of a tumor, i.e. cutting off its blood vessels, the tumor temperature lowers significantly in spite of using bipolar coagulation, which causes additional heat emission in the tissue. The results of the measurements taken intra-operatively confirm the capability of a thermal camera to perform noninvasive temperature monitoring of a cerebral cortex. As expected surface temperature of tumors is different from surface temperature of tissues free from pathological changes. The magnitude of this difference depends on histology and the origin of the tumor. These conclusions lead to taking on further experimental research, implementation

  9. PREDICTION AND PREVENTION OF LIVER FAILURE AFTER MAJOR LIVER PRIMARY AND METASTATIC TUMORS RESECTION

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2016-01-01

    Full Text Available Abstract Purpose of the study. Improvement of results of treatment in patients with primary and metastatic liver cancer by decreasing the risk of post-resection liver failure on the basis of the evaluation of the functional reserves of the liver.Materials and Methods. The study included two independent samples of patients operated about primary or metastatic lesions of the liver at the Department of abdominal Oncology, P. A. Hertsen MORI. The first group included 53 patients who carried out 13C-breath test metallimovie and dynamic scintigraphy of the liver in the preoperative stage in addition to the standard algorithm of examination. Patients of the 2nd group (n=35 had a standard clinical and laboratory examination, the patients were not performed the preoperative evaluation of the functional reserve of the liver, the incidences of total bilirubin, albumin and prothrombin time did not reveal a reduction of liver function. Post-resection liver failure have been established on the basis of the 50/50 criterion in the evaluation on day 5 after surgery.Results. Analysis of operating characteristics of the functional tests showed the absolute methacin breath test sensitivity (SE≥100%, high specificity (SP≥67% of scintigraphy of the liver and the negative predictive value of outcome (VP≥100% at complex use of two diagnostic methods. The incidence of PROPS in the study group was significantly 2 times higher in the control group –15,1% and 26.8%, respectively (p<0.001.Conclusion. The combination of preoperative dynamic scintigraphy of the liver with carrying out 13C-breath methacin test allows you to conduct a comprehensive evaluation of the liver functional reserve and can significantly improve preoperative evaluation and postoperative results of anatomic resection in patients with primary and metastatic liver lesions.

  10. 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;

    2010-01-01

    21 and 73 years. All tumors were located within bone, either sited within spine or extremities. All tumors showed thin-walled branching vessels surrounded by undifferentiated spindle or round cells. These cells showed variation in their morphologic pattern: 6 tumors showed a pattern-less architecture...... are characterized by distinct morphology and immunohistochemical profile. SFT of bone is located within spine and has a better prognosis, whereas SS of bone is located within long bones having a poor prognosis.......Hemangiopericytoma (HPC) was first described as a neoplasm with distinct morphologic features, presumably composed of pericytes. In soft tissue, it is accepted that most such lesions are solitary fibrous tumors (SFTs), monophasic synovial sarcomas (SSs), or myofibromatoses. It is unclear whether...

  11. 髂骨肿瘤Ⅰ型切除后骨盆稳定性分析%Analysis of the pelvic stability after type Ⅰ resection of iliac tumor

    Institute of Scientific and Technical Information of China (English)

    贾永伟; 程黎明; 俞光荣; 于研; 楼永坚; 杨云峰; 丁祖泉

    2008-01-01

    Objective To analyze the pelvic stability after type Ⅰ resection of iliac tumor.Methods Six adult cadaveric specimens were tested.The iliac subtotal resection models were established according to Ennecking's type Ⅰ resection.Markers were affixed to the key region of the pelves.Axial loading from the proximal lumbar was applied by MTS load cell in the gradient of 0-500 N in the double feet standing state. Images in front view were obtained using CCD camera.Based on Image J software,displacements of the first sacral vertebrae(S1)of the resected pelves and the intact pelves were calculated using digital marker tracing method with center-of-mass algorithm.Results Serious instabilities were found in the resected pelves.S1 rotational movements around the normal side femoral head of the resected pelvis were found.The average vertical displacement of S1 of the resected pelvis was(7±3)mm under vertical load of 500 newtons,which were 8.3 times compared to the intact pelvis.The average angle of S1 rotation around the normal side femoral head of the resected pelvis was(4.0±1.8)°,which were 12.5 times compared to the intact pelvis. ConclusioIIs Biomechanical model of type Ⅰ resection of iliac tumor are established.Essential pelvic reconstruction must be introduced because of the serious instability of the bone defection after tumor resection.%目的 分析髂骨肿瘤Ⅰ型切除后骨盆的稳定性.方法 选择健康成人尸体骨盆标本6具,按照Ennecking对骨盆肿瘤Ⅰ型切除标准行髂骨大部分切除,模拟双足站立位,施加0~500 N垂直分级载荷,CCD采集骨盆图像,基于ImageJ软件采用数字标记点质心跟踪法对缺损骨盆位移进行检测,并与正常骨盆的相同载荷下位移进行对照分析.结果 双足站立位,垂直载荷下缺损骨盆以健侧股骨头为支点在冠状面向患侧产生下移及旋转运动.500 N垂直载荷下,S1椎体垂直位移为(7±3)mm,是正常组骨盆的8.3倍,在冠

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

    Science.gov (United States)

    Ozawa, Norihiko; Muragaki, Yoshihiro; Nakamura, Ryoichi; Hori, Tomokatsu; Iseki, Hiroshi

    2009-02-01

    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 iDW imaging with updated neuronavigation.

  13. Taurolidine reduces the tumor stimulating cytokine interleukin-1beta in patients with resectable gastrointestinal cancer: a multicentre prospective randomized trial

    Directory of Open Access Journals (Sweden)

    Mueller Joachim M

    2009-03-01

    Full Text Available Abstract Background The effect of additional treatment strategies with antineoplastic agents on intraperitoneal tumor stimulating interleukin levels are unclear. Taurolidine and Povidone-iodine have been mainly used for abdominal lavage in Germany and Europe. Methods In the settings of a multicentre (three University Hospitals prospective randomized controlled trial 120 patients were randomly allocated to receive either 0.5% taurolidine/2,500 IU heparin (TRD or 0.25% povidone-iodine (control intraperitoneally for resectable colorectal, gastric or pancreatic cancers. Due to the fact that IL-1beta (produced by macrophages is preoperatively indifferent in various gastrointestinal cancer types our major outcome criterion was the perioperative (overall level of IL-1beta in peritoneal fluid. Results Cytokine values were significantly lower after TRD lavage for IL-1beta, IL-6, and IL-10. Perioperative complications did not differ. The median follow-up was 50.0 months. The overall mortality rate (28 vs. 25, p = 0.36, the cancer-related death rate (17 vs. 19, p = .2, the local recurrence rate (7 vs. 12, p = .16, the distant metastasis rate (13 vs. 18, p = 0.2 as well as the time to relapse were not statistically significant different. Conclusion Reduced cytokine levels might explain a short term antitumorigenic intraperitoneal effect of TRD. But, this study analyzed different types of cancer. Therefore, we set up a multicentre randomized trial in patients undergoing curative colorectal cancer resection. Trial registration ISRCTN66478538

  14. Experience with ultrasonographically guided vacuum-assisted resection of benign breast tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tagaya, N. [Second Department of Surgery, Dokkyo Medical University Mibu, Tochigi (Japan)], E-mail: tagaya@dokkyomed.ac.jp; Nakagawa, A. [Second Department of Surgery, Dokkyo Medical University Mibu, Tochigi (Japan); Ishikawa, Y. [Department of Breast and Endocrinological Surgery, Gunma University School of Medicine, Maebashi-shi, Gunma (Japan); Department of Pathology, Dokkyo Medical University Mibu, Tochigi (Japan); Oyama, T. [Department of Pathology, Dokkyo Medical University Mibu, Tochigi (Japan); Kubota, K. [Second Department of Surgery, Dokkyo Medical University Mibu, Tochigi (Japan)

    2008-04-15

    Aim: To evaluate the feasibility and safety of vacuum-assisted resection of benign breast tumours using an 8 G handheld device. Materials and Methods: Over a 2-year period, 22 patients with 26 breast tumours diagnosed as benign using aspiration biopsy cytology were enrolled. The mean patient age was 38 years, and the mean maximal diameter of the tumour was 13 mm. A handheld Aloka SSD 6500 ultrasonography device with a linear-type 7.5 MHz transducer was inserted into the posterior aspect of the tumour with the patient under local anaesthesia, and the tumour was resected under ultrasonographic guidance. Results: This method was employed successfully in all patients, and the mean operation time was 33 min. Post-procedure complications included subcutaneous bleeding in 12 cases and haematoma in one. The pathological diagnoses were fibroadenoma in 16 cases, mastopathy in six, and tubular adenoma and pseudoangiomatous stromal hyperplasia in two cases each, respectively. Follow-up ultrasonography revealed residual tumours in four cases (15.4%). Conclusions: Although this method is feasible and safe without severe complications, it is necessary to select appropriate patients, and to obtain informed consent regarding the possibility of recurrence or residual tumour.

  15. 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)

  16. Effect of neoadjuvant chemotherapy on malignant molecule levels in tumor tissue and serum of patients with locally advanced resectable colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Bin Huang

    2016-01-01

    Objective:To analyze the effect of neoadjuvant chemotherapy on malignant molecule levels in tumor tissue and serum of patients with locally advanced resectable colorectal cancer. Methods:A total of 86 cases of patients with locally advanced resectable colorectal cancer were selected and randomly divided into observation group and control group. Control group of patients received traditional postoperative chemotherapy and observation group of patients received preoperative neoadjuvant chemotherapy and traditional postoperative chemotherapy. After one cycle, two cycles and three cycles of neoadjuvant chemotherapy, serum samples were collected to determine the levels of malignant molecules; after surgical resection, the tumor tissues were collected to determine the expression levels of malignant molecules. Results:After one cycle, two cycles and three cycles of neoadjuvant chemotherapy, serum VEGF, Cath-D, MCP-1, ICAM-1, VCAM-1, sIL-2R and IL-18 levels of observation group were significantly lower than those of control group; after surgical resection, Beclin-1 and Caspase-3 mRNA expression levels in tumor tissue of observation group were significantly higher than those of control group, and mTOR, Livin and MTA1 mRNA expression levels were significantly lower than those of control group.Conclusion: Neoadjuvant chemotherapy can effectively inhibit the malignant degree of locally advanced resectable colorectal cancer and inhibit the expression of malignant molecules, and it is of positive significance in terms of improving overall treatment effect.

  17. Resection of Segments 4, 5 and 8 for a Cystic Liver Tumor Using the Double Liver Hanging Maneuver

    Directory of Open Access Journals (Sweden)

    Atsushi Nanashima

    2008-03-01

    Full Text Available To achieve complete anatomic central hepatectomy for a large tumor compressing surrounding vessels, transection by an anterior approach is preferred but a skillful technique is necessary. We propose the modified technique of Belghiti’s liver hanging maneuver (LHM. The case was a 77-year-old female with a 6-cm liver cystic tumor in the central liver compressing hilar vessels and the right hepatic vein. At the hepatic hilum, the spaces between Glisson’s pedicle and hepatic parenchyma were dissected, which were (1 the space between the right anterior and posterior Glisson pedicles and (2 the space adjacent to the umbilical Glisson pedicle. Two tubes were repositioned in each space and ‘double LHM’ was possible at the two resected planes of segments 4, 5 and 8. Cut planes were easily and adequately obtained and the compressed vessels were secured. Double LHM is a useful surgical technique for hepatectomy for a large tumor located in the central liver.

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

    Directory of Open Access Journals (Sweden)

    Martin F. Dietrich MD, PhD

    2014-11-01

    Full Text Available 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.

  19. 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.

  20. Right frontal lobe mediation of recollection- and familiarity-based verbal recognition memory: evidence from patients with tumor resections.

    Science.gov (United States)

    Anderson, Nicole D; Davidson, Patrick S R; Mason, Warren P; Gao, Fuqiang; Binns, Malcolm A; Winocur, Gordon

    2011-12-01

    Medial-temporal, parietal, and pFC regions have been implicated in recollection and familiarity, but existing evidence from neuroimaging and patient studies is limited and conflicting regarding the role of specific regions within pFC in these memory processes. We report a study of 20 patients who had undergone resection of right frontal lobe tumors and 20 matched healthy control participants. The location and extent of lesions were traced on the patients' scans. A process dissociation procedure was employed to yield estimates of the contributions of recollection and familiarity in verbal recognition performance. Group comparisons revealed deficits in recollection but not familiarity in the patient group relative to their healthy counterparts. We found a positive relationship between estimates of familiarity and lesion sizes in the right inferior pFC (BA 11, 47) which was significant upon bootstrap resampling. These results are discussed in terms of prior work linking this area to an overextended sense of familiarity.

  1. Stroke volume variation and pleth variability index to predict fluid responsiveness during resection of primary retroperitoneal tumors in Hans Chinese.

    Science.gov (United States)

    Fu, Q; Mi, W D; Zhang, H

    2012-02-01

    Respiration variation in arterial pulse pressure (ΔPP) and pulse oximetry plethysmographic waveform amplitude (ΔPOP) are accurate predictors of fluid responsiveness in mechanically ventilated patients. We hypothesized that stroke volume variation (SVV) and pleth variability index (PVI) can predict fluid responsiveness in mechanically ventilated patients during major surgical procedures in Hans Chinese. This prospective study consisted of fifty-five Hans Chinese patients undergoing resection of primary retroperitoneal tumors (PRPT). During the surgical procedures, hemodynamic data [central venous pressure (CVP), cardiac index (CI), stroke volume index (SVI), SVV, and PVI] were recorded before and after volume expansion (VE) (8 ml•kg-1 of 6% hydroxyethyl starch 130/0.4). Fluid responsiveness was defined as an increase in SVI ≥ 10% after VE. Four patients were excluded from analysis for arrhythmia or obvious hemorrhage during VE. Baseline SVV correlated well with baseline PVI and the changes in SVV was correlated with the changes in PVI (p Chinese.

  2. Postoperative Complications, In-Hospital Mortality and 5-Year Survival After Surgical Resection for Patients with a Pancreatic Neuroendocrine Tumor: A Systematic Review.

    Science.gov (United States)

    Jilesen, Anneke P J; van Eijck, Casper H J; in't Hof, K H; van Dieren, S; Gouma, Dirk J; van Dijkum, Els J M Nieveen

    2016-03-01

    Studies on postoperative complications and survival in patients with pancreatic neuroendocrine tumors (pNET) are sparse and randomized controlled trials are not available. We reviewed all studies on postoperative complications and survival after resection of pNET. A systematic search was performed in the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE from 2000-2013. Inclusion criteria were studies of resected pNET, which described postoperative complications separately for each surgical procedure and/or 5-year survival after resection. Prospective and retrospective studies were pooled separately and overall pooled if heterogeneity was below 75%. The random-effect model was used. Overall, 2643 studies were identified and after full-text analysis 62 studies were included. Pancreatic fistula (PF) rate of the prospective studies after tumor enucleation was 45%; PF-rates after distal pancreatectomy, pancreatoduodenectomy, or central pancreatectomy were, respectively, 14-14-58%. Delayed gastric emptying rates were, respectively, 5-5-18-16%. Postoperative hemorrhage rates were, respectively, 6-1-7-4%. In-hospital mortality rates were, respectively, 3-4-6-4%. The 5-year overall survival (OS) and disease-specific survival (DSS) of resected pNET without synchronous resected liver metastases were, respectively, 85-93%. Heterogeneity between included studies on 5-year OS in patients with synchronous resected liver metastases was too high to pool all studies. The 5-year DSS in patients with liver metastases was 80%. Morbidity after pancreatic resection for pNET was mainly caused by PF. Liver resection in patients with liver metastases seems to have a positive effect on DSS. To reduce heterogeneity, ISGPS criteria and uniform patient groups should be used in the analysis of postoperative outcome and survival.

  3. Pregnancy following Radical Resection of Solid Pseudopapillary Tumor of the Pancreas

    Directory of Open Access Journals (Sweden)

    James M. O’Brien

    2014-01-01

    Full Text Available Solid pseudopapillary tumor of the pancreas is a rare tumor seen in predominately young women and carries a low malignant potential. We discuss a patient, who presented to our high risk clinic, with a clinical history of solid pseudopapillary tumor of the pancreas, predating her pregnancy. The patient had undergone previous surgery and imaging which had excluded recurrence of disease; however, increased attention was paid to the patient during her pregnancy secondary to elevated hormonal levels of progesterone, which any residual disease would have a heightened sensitivity to. In cases of pregnant patients with a history of pancreatic tumors, a multidisciplinary approach with maternal fetal medicine, medicine, and general surgery is appropriate and can result in a healthy mother and healthy term infant.

  4. High relapse-free survival after preoperative and intraoperative radiotherapy and resection for sulcus superior tumors

    NARCIS (Netherlands)

    A.N. van Geel (Albert); P.P. Jansen (Peter); R.J. van Klaveren (Rob); J.R. van der Sijp (Joost)

    2003-01-01

    textabstractSTUDY OBJECTIVES: Relapse-free survival in patients with sulcus superior tumors. DESIGN: Prospective registration study. SETTING: Department of surgical oncology of a university hospital. PATIENTS: Twenty-one patients treated with preoperative radiotherapy (46 Gy), lobe

  5. 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.

  6. [The combination treatment of malignant bone tumors using fast neutrons].

    Science.gov (United States)

    Chernichenko, V A; Tolstopiatov, B A; Konovalenko, V F; Monich, A Iu; Palivets, A Iu

    1990-01-01

    The study deals with results of a clinical trial evaluating treatment efficacy of a 6 MeV neutron beam produced by Y-120 cyclotron (Kiev). Procedures of preoperative radiotherapy and radical treatment are discussed. Radiotherapy was administered to 52 patients suffering chondrosarcoma (30 cases), osteogenic sarcoma (15) or chordoma (7). Combined treatment (radiation + surgery) was given to 22 patients whereas neutron beam therapy--to 30. All patients with osteogenic sarcoma received adjuvant combination chemotherapy. Three-year survival rate was compared to that observed in controls in whom combined treatment had included gamma-therapy. A significant increase in three-year survival rate was observed for osteogenic sarcoma and chordoma whereas for chondrosarcoma the improvement in survival proved insignificant. The use of fast neutrons in combined treatment of bone tumors was considered promising.

  7. Hip fracture after radiofrequency ablation therapy for bone tumors : two case reports

    NARCIS (Netherlands)

    Dierselhuis, Edwin F.; Jutte, Paul C.; van der Eerden, Pepijn J. M.; Suurmeijer, Albert J. H.; Bulstra, Sjoerd K.

    2010-01-01

    Radiofrequency ablation (RFA) has become a valuable therapeutic modality in cancer treatment over the last decade. In orthopedic surgery, RFA is used for the treatment of benign bone tumors and bone metastases. Complications are rare and, to our knowledge, bone fracture as a complication due solely

  8. Long-term survival case of a recurrent colon cancer owing to successful resection of a tumor at hepaticojejunostomy: report of a case.

    Science.gov (United States)

    Natsume, Seiji; Shimizu, Yasuhiro; Sano, Tsuyoshi; Senda, Yoshiki; Ito, Seiji; Komori, Koji; Abe, Tetsuya; Yanagisawa, Akio; Yamao, Kenji

    2015-12-01

    With advances in surgical procedures and perioperative management, hepato-biliary-pancreatic surgery, including hepatectomy and pancreaticoduodenectomy, has been employed for recurrent colon cancer. However, no report has described a case of major hepatectomy with the combined resection of hepaticojejunostomy following pancreaticoduodenectomy for locoregionally recurrent colon cancer. Here, such a case is reported. The patient, a 37-year-old woman, had undergone pancreaticoduodenectomy for lymph node recurrence along the extrahepatic bile duct from cecal cancer. Thirteen months later, a biliary stricture was found at the hepaticojejunostomy site and right hepatectomy was performed. The resected specimen showed a papillary tumor at the hepaticojejunostomy. Based on its histological features, the pathogenesis of this tumor was considered to be intramural recurrence via lymphatic vessels. Although she underwent resection of a lymph node recurrence at her mesentery 12 months later, she has remained well thereafter, without any sign of further recurrence during 5 years of follow-up after hepatectomy.

  9. Preoperative breast MRI can reduce the rate of tumor-positive resection margins and reoperations in patients undergoing breast-conserving surgery

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie); M.M.A. Tilanus-Linthorst (Madeleine); S. Spronk (Sandra); C.H.M. van Deurzen (Carolien); C. de Monyé (Cécile); M.G.M. Hunink (Myriam); M.B. Menke (Marian )

    2013-01-01

    textabstractOBJECTIVE. In breast cancer patients eligible for breast-conserving surgery, we evaluated whether the information provided by preoperative MRI of the breast would result in fewer tumor-positive resection margins and fewer reoperations. SUBJECTS AND METHODS. The study group consisted of 1

  10. Predicting the "usefulness" of 5-ALA-derived tumor fluorescence for fluorescence-guided resections in pediatric brain tumors

    DEFF Research Database (Denmark)

    Stummer, Walter; Rodrigues, Floriano; Schucht, Philippe;

    2014-01-01

    fluorescence was "useful", i.e., leading to changes in surgical strategy or identification of residual tumor. Recursive partitioning analysis (RPA) was used for defining cohorts with high or low likelihoods for useful fluorescence. RESULTS: Data on 78 patients submitted by 20 centers...

  11. Contaminação tumoral em trajeto de biópsia de tumores ósseos malignos primários Tumor contamination in the biopsy path of primary malignant bone tumors

    Directory of Open Access Journals (Sweden)

    Marcelo Parente Oliveira

    2012-10-01

    chondrosarcoma were studied retrospectively. The sample was analyzed to characterize the biopsy technique used, histological type of the tumor, neoadjuvant chemotherapy used, local recurrences and tumor contamination in the biopsy path. RESULTS: Among the 35 patients studied, four cases of contamination occurred (11.43%: one from osteosarcoma, two from Ewing's tumor and one from chondrosarcoma. There was no association between the type of tumor and presence of tumor contamination in the biopsy path (p = 0.65. There was also no association between the presence of tumor contamination and the biopsy technique (p = 0.06. On the other hand, there were associations between the presence of tumor contamination and local recurrence (p = 0.01 and between tumor contamination and absence of neoadjuvant chemotherapy (p = 0.02. CONCLUSION: Tumor contamination in the biopsy path of primary malignant bone tumors was associated with local recurrence. On the other hand, the histological type of the tumor and the type of biopsy did not have an influence on tumor contamination. Neoadjuvant chemotherapy had a protective effect against this complication. Despite these findings, tumor contamination is a complication that should always be taken into consideration, and removal of the biopsy path is recommended in tumor resection surgery.

  12. 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.

  13. Multiple Tumors Located in the Same Section Are Associated with Better Outcomes After Hepatic Resection for HCC Patients Meeting the Milan Criteria.

    Science.gov (United States)

    Lv, Tao; Jiang, Li; Yan, Lunan; Yang, Jiayin; Li, Bo; Wen, Tianfu; Zeng, Yong; Wang, Wentao; Xu, Mingqing

    2015-12-01

    The impact of the tumor location on the outcome after hepatic resection (HR) in multifocal hepatocellular carcinoma (HCC) is still poorly understood. The aim of this study was to compare the short- and long-term outcomes of HR patients with multifocal tumors meeting the Milan criteria and tumors located in the same or different sections. A total of 219 consecutive HR patients with multifocal tumors meeting the Milan criteria were divided into group SS (n = 97; same section) and group DS (n = 122; different sections) according to their anatomical location (Couinaud's segmentation). The prognostic predictors were evaluated, and a subgroup analysis was performed. The 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly higher in group SS than group DS. The subgroup analysis showed that patients with two tumors in the same section and patients undergoing en bloc resection had better OS and RFS. A multivariate analysis revealed that tumors located in different sections and macrovascular invasion were independent predictors of poor prognosis. In HCC patients with multifocal tumors meeting the Milan criteria, tumors located in the same hepatic section may lead to better long-term survival and lower HCC recurrence rates than tumors in different sections after HR.

  14. [A Case of Von Hippel-Lindau Disease with Nonfunctioning Pancreatic Neuroendocrine Tumors Treated by Duodenum-Preserving Resection of the Head of the Pancreas and Spleen-Preserving Resection of the Tail of the Pancreas].

    Science.gov (United States)

    Umehara, Yutaka; Umehara, Minoru; Tokura, Tomohisa; Yachi, Takafumi; Takahashi, Kenichi; Morita, Takayuki; Hakamada, Kenichi

    2015-10-01

    A 26-year-old woman presented to our department with a diagnosis of multiple nonfunctioning pancreatic neuroendocrine tumors. She had a family history of pheochromocytoma and a medical history of bilateral adrenalectomy for pheochromocytoma at the age of 25 years. During follow-up treatment for adrenal insufficiency after the surgery, highly enhanced tumors in the pancreas were detected on contrast-enhanced CT. Other examinations found that the patient did not satisfy the clinical criteria for von Hippel-Lindau (VHL) disease. Considering her age and risk of developing multiple heterotopic and heterochronous tumors, we performed a duodenum-preserving resection of the head of the pancreas and spleen-preserving resection of the tail of the pancreas with informed consent. The histopathological findings revealed that all of the tumors were NET G1. She underwent genetic testing postoperatively and was diagnosed with VHL disease. This diagnosis meant that we were able to create an optimal treatment plan for the patient. If a tumor predisposition syndrome is suspected, VHL disease should be borne in mind and genetic testing after genetic counseling should be duly considered.

  15. Radiologic Evaluation of Compressive Osseointegration for the Fixation of Reconstruction Prostheses after Tumor Resection

    Directory of Open Access Journals (Sweden)

    Manol Lazarov

    2015-01-01

    Full Text Available Objective. In pursuance of thoroughly understanding and facilitating the evaluation of the radiological changes in the preloaded bone by Compliant Pre-Stress osseointegration (Compress Biomet, Warsaw, Indiana a new staging method was created depicting four stages. Methods. Two cohorts (10 and 17 patients resp., not-receiving and receiving chemotherapy were compared in terms of progression of osseointegration. Based on the changes at the bone-metal interface seen on röntgenorgrams four stages were defined: stage 0: immediate postoperative status, no ingrowth, or noncalcified callus; stage 1: early mineralization, calcified callus; stage 2: mature mineralization; and stage 3: hypertrophy at the level of the pins. Results. There were no significant differences between the two cohorts. Group 2, which was significantly younger than group 1 (p<0.001, presented a delayed initial rate of bone formation and reached stage 1 at 6 months instead of 3 months like group 1. The children from the group 2 demonstrated a visible rebound ingrowth. Conclusion. Despite the fact that the staging fails to demonstrate a statistical difference, it is rather simple and can be used for future studies.

  16. 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.

  17. Classification of 27 Tumor-Associated Antigens by Histochemical Analysis of 36 Freshly Resected Lung Cancer Tissues

    Directory of Open Access Journals (Sweden)

    Gene Kurosawa

    2016-11-01

    Full Text Available In previous studies, we identified 29 tumor-associated antigens (TAAs and isolated 488 human monoclonal antibodies (mAbs that specifically bind to one of the 29 TAAs. In the present study, we performed histochemical analysis of 36 freshly resected lung cancer tissues by using 60 mAbs against 27 TAAs. Comparison of the staining patterns of tumor cells, bronchial epithelial cells, and normal pulmonary alveolus cells and interalveolar septum allowed us to determine the type and location of cells that express target molecules, as well as the degree of expression. The patterns were classified into 7 categories. While multiple Abs were used against certain TAAs, the differences observed among them should be derived from differences in the binding activity and/or the epitope. Thus, such data indicate the versatility of respective clones as anti-cancer drugs. Although the information obtained was limited to the lung and bronchial tube, bronchial epithelial cells represent normal growing cells, and therefore, the data are informative. The results indicate that 9 of the 27 TAAs are suitable targets for therapeutic Abs. These 9 Ags include EGFR, HER2, TfR, and integrin α6β4. Based on our findings, a pharmaceutical company has started to develop anti-cancer drugs by using Abs to TfR and integrin α6β4. HGFR, PTP-LAR, CD147, CDCP1, and integrin αvβ3 are also appropriate targets for therapeutic purposes.

  18. Classification of 27 Tumor-Associated Antigens by Histochemical Analysis of 36 Freshly Resected Lung Cancer Tissues

    Science.gov (United States)

    Kurosawa, Gene; Sugiura, Mototaka; Hattori, Yoshinobu; Tsuda, Hiroyuki; Kurosawa, Yoshikazu

    2016-01-01

    In previous studies, we identified 29 tumor-associated antigens (TAAs) and isolated 488 human monoclonal antibodies (mAbs) that specifically bind to one of the 29 TAAs. In the present study, we performed histochemical analysis of 36 freshly resected lung cancer tissues by using 60 mAbs against 27 TAAs. Comparison of the staining patterns of tumor cells, bronchial epithelial cells, and normal pulmonary alveolus cells and interalveolar septum allowed us to determine the type and location of cells that express target molecules, as well as the degree of expression. The patterns were classified into 7 categories. While multiple Abs were used against certain TAAs, the differences observed among them should be derived from differences in the binding activity and/or the epitope. Thus, such data indicate the versatility of respective clones as anti-cancer drugs. Although the information obtained was limited to the lung and bronchial tube, bronchial epithelial cells represent normal growing cells, and therefore, the data are informative. The results indicate that 9 of the 27 TAAs are suitable targets for therapeutic Abs. These 9 Ags include EGFR, HER2, TfR, and integrin α6β4. Based on our findings, a pharmaceutical company has started to develop anti-cancer drugs by using Abs to TfR and integrin α6β4. HGFR, PTP-LAR, CD147, CDCP1, and integrin αvβ3 are also appropriate targets for therapeutic purposes. PMID:27834817

  19. Tumor resection cavity administered iodine-131-labeled antitenascin 81C6 radioimmunotherapy in patients with malignant glioma: neuropathology aspects

    Energy Technology Data Exchange (ETDEWEB)

    McLendon, Roger E. [Department of Pathology, Duke University Medical Center, Durham, NC 27710 (United States)]. E-mail: mclen001@mc.duke.edu; Akabani, Gamal [Department of Radiology, Duke University Medical Center, Durham, NC 27710 (United States); Friedman, Henry S. [Department of Pediatrics, Duke University Medical Center, Durham, NC 27710 (United States); Reardon, David A. [Department of Medicine, Duke University Medical Center, Durham, NC 27710 (United States); Cleveland, Linda [Department of Pathology, Duke University Medical Center, Durham, NC 27710 (United States); Cokgor, Ilkcan [Department of Pediatrics, Duke University Medical Center, Durham, NC 27710 (United States); Herndon, James E. [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC 27710 (United States); Wikstrand, Carol [Department of Pathology, Duke University Medical Center, Durham, NC 27710 (United States); Boulton, Susan T. [Department of Surgery, Duke University Medical Center, Durham, NC 27710 (United States); Friedman, Allan H. [Department of Surgery, Duke University Medical Center, Durham, NC 27710 (United States); Bigner, Darell D. [Department of Pathology, Duke University Medical Center, Durham, NC 27710 (United States); Zalutsky, Michael R. [Department of Radiology, Duke University Medical Center, Durham, NC 27710 (United States)

    2007-05-15

    Introduction: The neurohistological findings in patients treated with targeted {beta} emitters such as {sup 131}I are poorly described. We report a histopathologic analysis from patients treated with combined external beam therapy and a brachytherapy consisting of a {sup 131}I-labeled monoclonal antibody (mAb) injected into surgically created resection cavities during brain tumor resections. Methods: Directed tissue samples of the cavity walls were obtained because of suspected tumor recurrence from 28 patients. Samples and clinical follow-up were evaluated on all patients (Group A) based on total radiation dose received and a subset of these (n=18; Group B, proximal therapy subset) who had received external beam therapy within {<=}3 months of mAb therapy and undergoing 26 biopsies over 37 months. Histologic outcomes were 'proliferative glioma,' 'quiescent glioma' and negative for neoplasm. Statistical analysis was used to assess the casual relation between total absorbed dose ({sup 131}I-mAb+external beam) and histologic diagnosis. Results: The lesions observed after {sup 131}I-mAb therapy were qualitatively similar to those reported for other types of radiation therapy; however, the high localized dose rate and absorbed doses produced by the short range of {sup 131}I {beta} particles seem to have resulted in an earlier necrotic reaction in the tumor bed. Among all 28 (Group A) patients, median survival from tissue analysis after mAb therapy depended on histopathology and total radiation absorbed dose. Median survival for patients with tissue classified as proliferative glioma, quiescent glioma and negative for neoplasm were 3.5, 15 and 27.5 months, respectively. Without categorization, total dose was a significant predictor of survival (P<.002) where patients with higher doses had better prognoses. For example, median survival in patients receiving a total radiation dose greater than 86 Gy was 19 months compared with 7 months for those

  20. Synthesis of CAD/CAM, robotics and biomaterial implant fabrication: single-step reconstruction in computer-aided frontotemporal bone resection.

    Science.gov (United States)

    Weihe, S; Wehmöller, M; Schliephake, H; Hassfeld, S; Tschakaloff, A; Raczkowsky, J; Eufinger, H

    2000-10-01

    The preoperative manufacturing of individual skull implants, developed by an interdisciplinary research group at Ruhr-University Bochum, is based on the use of titanium as the most common material for implants at present. Using the existing technology for materials that can be milled or moulded, customized implants may be manufactured as well. The goal of the study was to examine biodegradable materials and to evaluate the practicability of intraoperative instrument navigation and robotics. Data acquisition of an adult sheep's head was performed with helical computer tomography (CT). The data were transferred onto a computer aided design/computer aided manufacturing system (CAD/CAM system), and two complex defects in the frontotemporal skull were designed. Standard individual titanium implants were milled for both of the defects. Additionally, for one of the defects a resection template, as well as a mould for the biodegradable poly(D,L-lactide) (PDLLA) implant, were fabricated by the CAD/CAM system. A surgeon carried out the first bone resection (#1) for the prefabricated titanium implant using the resection template and an oscillating saw. The robot system Stäubli RX90CR, modified for clinical use, carried out the other resection (#2). Both titanium implants and the PDLLA implant were inserted in their respective defects to compare the precision of their fit. A critical comparison of both implant materials and both resection types shows that fabrication of a PDLLA implant and robot resection are already possible. At present, the titanium implant and resection using a template are more convincing due to the higher precision and practicability.

  1. 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.

  2. [Proctocolectomy with ileoanal anastomoses and desmoid tumor treated with resection. One case of familial adenomatous polyposis].

    Science.gov (United States)

    Villalón-López, José Sebastián; Souto-del Bosque, Rosalía; Méndez-Sashida, Pedro Gonzalo

    2014-01-01

    Introducción: la poliposis adenomatosa familiar (PAF) es una rara enfermedad causada por una mutación en el gen de la poliposis adenomatosa coli (APC). Caso clínico: mujer de 32 años, con dolor y aumento del perímetro abdominal además de evacuaciones melénicas y pérdida de peso. La paciente presentó un tumor de 12 cm de diámetro en la fosa iliaca derecha. Tras la administración de medio de contraste, en una tomografía se apreció el tumor abdominal con reforzamiento compatible con sarcoma frente a tumor desmoide. Se realizó colonoscopia, por medio de la que se encontraron pólipos en el recto y el colon. La biopsia reportó adenomas túbulo-vellosos. Una panendoscopía demostró pólipos en fondo y cuerpo gástrico; el duodeno se encontraba en estado normal. Se realizó resección del tumor en pared abdominal y reconstrucción con malla además de proctocolectomía restaurativa con un reservorio íleo-anal con una ileostomía temporal. Se reportó tumor desmoide en la pared abdominal y se identificaron 152 pólipos túbulo-vellosos que afectaban todas las porciones del colon y el recto. Conclusiones: la PAF es una enfermedad autosómica dominante causada por una mutación en el gen APC que da como resultado el desarrollo de múltiples pólipos tanto en el colon como en el recto. Descrito en 1991, el gen APC se localiza en el cromosoma 5q21. Sin cirugía profiláctica, todos los pacientes desarrollarán cáncer colorrectal en la tercera década de la vida. Los tumores desmoides y los pólipos duodenales son ahora la causa de muerte en los pacientes con PAF.

  3. Circulating Tumor Cells Identify Early Recurrence in Patients with Non-Small Cell Lung Cancer Undergoing Radical Resection.

    Directory of Open Access Journals (Sweden)

    Clara Bayarri-Lara

    Full Text Available Surgery is the treatment of choice for patients with non-small cell lung cancer (NSCLC stages I-IIIA. However, more than 20% of these patients develop recurrence and die due to their disease. The release of tumor cells into peripheral blood (CTCs is one of the main causes of recurrence of cancer. The objectives of this study are to identify the prognostic value of the presence and characterization of CTCs in peripheral blood in patients undergoing radical resection for NSCLC.56 patients who underwent radical surgery for previously untreated NSCLC were enrolled in this prospective study. Peripheral blood samples for CTC analysis were obtained before and one month after surgery. In addition CTCs were phenotypically characterized by epidermal growth factor receptor (EGFR expression.51.8% of the patients evaluated were positive with the presence of CTCs at baseline. A decrease in the detection rate of CTCs was observed in these patients one month after surgery (32.1% (p = 0.035. The mean number of CTCs was 3.16 per 10 ml (range 0-84 preoperatively and 0.66 (range 0-3 in postoperative determination. EGFR expression was found in 89.7% of the patients at baseline and in 38.9% patients one month after surgery. The presence of CTCs after surgery was significantly associated with early recurrence (p = 0.018 and a shorter disease free survival (DFS (p = .008. In multivariate analysis CTC presence after surgery (HR = 5.750, 95% CI: 1.50-21.946, p = 0.010 and N status (HR = 0.296, 95% CI: 0.091-0.961, p = 0.043 were independent prognostic factors for DFS.CTCs can be detected and characterized in patients undergoing radical resection for non-small cell lung cancer. Their presence might be used to identify patients with increased risk of early recurrence.

  4. Circulating Tumor Cells Identify Early Recurrence in Patients with Non-Small Cell Lung Cancer Undergoing Radical Resection

    Science.gov (United States)

    Cueto Ladrón de Guevara, Antonio; Puche, Jose L.; Ruiz Zafra, Javier; de Miguel-Pérez, Diego; Ramos, Abel Sánchez-Palencia; Giraldo-Ospina, Carlos Fernando; Navajas Gómez, Juan A.; Delgado-Rodriguez, Miguel; Lorente, Jose A.; Serrano, María Jose

    2016-01-01

    Background Surgery is the treatment of choice for patients with non-small cell lung cancer (NSCLC) stages I-IIIA. However, more than 20% of these patients develop recurrence and die due to their disease. The release of tumor cells into peripheral blood (CTCs) is one of the main causes of recurrence of cancer. The objectives of this study are to identify the prognostic value of the presence and characterization of CTCs in peripheral blood in patients undergoing radical resection for NSCLC. Patients and Methods 56 patients who underwent radical surgery for previously untreated NSCLC were enrolled in this prospective study. Peripheral blood samples for CTC analysis were obtained before and one month after surgery. In addition CTCs were phenotypically characterized by epidermal growth factor receptor (EGFR) expression. Results 51.8% of the patients evaluated were positive with the presence of CTCs at baseline. A decrease in the detection rate of CTCs was observed in these patients one month after surgery (32.1%) (p = 0.035). The mean number of CTCs was 3.16 per 10 ml (range 0–84) preoperatively and 0.66 (range 0–3) in postoperative determination. EGFR expression was found in 89.7% of the patients at baseline and in 38.9% patients one month after surgery. The presence of CTCs after surgery was significantly associated with early recurrence (p = 0.018) and a shorter disease free survival (DFS) (p = .008). In multivariate analysis CTC presence after surgery (HR = 5.750, 95% CI: 1.50–21.946, p = 0.010) and N status (HR = 0.296, 95% CI: 0.091–0.961, p = 0.043) were independent prognostic factors for DFS. Conclusion CTCs can be detected and characterized in patients undergoing radical resection for non-small cell lung cancer. Their presence might be used to identify patients with increased risk of early recurrence. PMID:26913536

  5. Real-time tissue differentiation based on optical emission spectroscopy for guided electrosurgical tumor resection

    OpenAIRE

    Spether, Dominik; Scharpf, Marcus; Hennenlotter, Jörg; Schwentner, Christian; Neugebauer, Alexander; Nüßle, Daniela; Fischer, Klaus; Zappe, Hans; Stenzl, Arnulf; Fend, Falko; Seifert, Andreas; Enderle, Markus

    2015-01-01

    Complete surgical removal of cancer tissue with effective preservation of healthy tissue is one of the most important challenges in modern oncology. We present a method for real-time, in situ differentiation of tissue based on optical emission spectroscopy (OES) performed during electrosurgery not requiring any biomarkers, additional light sources or other excitation processes. The analysis of the optical emission spectra, enables the differentiation of healthy and tumorous tissue. By using m...

  6. Laparoscopic wedge resection of synchronous gastric intraepithelial neoplasia and stromal tumor: A case report

    OpenAIRE

    2010-01-01

    Synchronous occurrence of epithelial neoplasia and gastrointestinal stromal tumor (GIST) in the stomach is uncommon. Only rare cases have been reported in the literature. We present here a 60-year-old female case of synchronous occurrence of gastric high-level intraepithelial neoplasia and GIST with the features of 22 similar cases and detailed information reported in the English-language literature summarized. In the present patient, epithelial neoplasia and GIST were removed en bloc by lapa...

  7. Robotic Versus Laparoscopic Gastric Resection for Primary Gastrointestinal Stromal Tumors >5 cm: A Size-Matched and Location-Matched Comparison.

    Science.gov (United States)

    de'Angelis, Nicola; Genova, Pietro; Amiot, Aurelien; Charpy, Cecile; Disabato, Mara; Belgaumkar, Ajay P; Chahrour, Ali; Legou, Francois; Azoulay, Daniel; Brunetti, Francesco

    2017-02-01

    This study compared robotic (RR) and laparoscopic resection (LR) for primary gastrointestinal stromal tumors (GISTs) of the stomach >5 cm. Twelve consecutive patients who underwent RR from 2012 to 2015 were matched for tumor size and location with 24 patients who underwent LR from 2000 to 2012. The median tumor size was 7.1 cm (range, 5.5 to 11.5). GISTs were resected by wedge resection (91.7%) or distal gastrectomy. The median RR operative time was longer than that of LR (162.5 vs. 130 min, respectively; P=0.004). Only 1 LR patient required conversion. The time to flatus and hospital stay were similar between groups. Overall, 3 patients developed minor postoperative complications that were medically treated. Mortality was nil. All resections were R0. No difference was observed in the incidence of recurrence. RR was significantly more expensive (+21.6%) than LR. RR appears to be safe and feasible for GISTs>5 cm, but is associated with longer operative times and greater costs.

  8. [Pineal region tumors in children: is gross-total resection necessary? A single-center experience].

    Science.gov (United States)

    López-Aguilar, Enrique; Garza-González, María del Carmen; Ortiz-Azpilcueta, Mariana; Sepúlveda-Vildósola, Ana Carolina; Rioscovian-Soto, Ana; de la Cruz-Yañez, Hermilo; Betanzos-Cabrera, Yadira

    2015-01-01

    Introducción: la supervivencia de los niños con tumores de la región pineal se ha incrementado en la última década; estos tienen una evolución insidiosa asociada con los desórdenes endocrinológicos y una alta morbilidad y mortalidad, sobre todo después de la resección. El objetivo es reportar la supervivencia, la morbilidad y mortalidad según el tipo de cirugía, la histología y el tratamiento en un grupo de niños con tumores de la región pineal. Métodos: estudio retrospectivo que incluyó a todos los pacientes con diagnóstico de tumor de la región pineal menores de 17 años de edad que acudieron en un periodo de 10 años a un hospital de pediatría. Se realizó una revisión histopatológica, se determinó la extensión de la resección y se estimó la supervivencia. Resultados: se incluyeron 46 pacientes, 36 de los cuales tenían expediente completo y material de patología adecuado. La resección total se realizó en 24 (66.6 %) y biopsia en 12 (33.3 %); fallecieron 23 pacientes (88 %) y fue el desequilibrio hidroelectrolítico la causa de 14 defunciones (60 %) y la progresión tumoral la causa de las 9 defunciones restantes (39.1 %). La sobrevida a 10 años de los pacientes tratados con resección total y biopsia fue del 52 y 75 %, respectivamente, con una p = 0.7; se presentaron alteraciones endocrinológicas en 13 (36.1%) pacientes de los cuales a 10 (76.9 %) se les realizó la resección de la tumoración. Conclusión: los tumores de la región pineal en niños se pueden tratar con biopsia diagnóstica seguida de tratamiento adyuvante con quimioterapia y radioterapia.

  9. A case of a sporadic malignant peripheral nerve sheath tumor of the urinary bladder with concomitant in situ urothelial carcinoma treated by transuretheral resection

    Directory of Open Access Journals (Sweden)

    Aysegul Sari

    2011-01-01

    Full Text Available Malignant peripheral nerve sheath tumor (MPNST of the urinary bladder is a very rare clinical entity. The association of such a tumor with urothelial carcinoma is even more unusual. Differential diagnosis between coexisting two distinct primary tumors and carcinosarcoma of the urinary bladder is very important as both the treatment and prognosis vary widely. Herein, we report a case of an MPNST with a concomitant in situ urothelial carcinoma in a 53-year-old man. To our knowledge, this is the first documented case of MPNST of the bladder that is treated by transuretheral resection which is in contrast with the previous reports that used cystectomy.

  10. One-stage laparoscopic resection for a large gastric gastrointestinal stromal tumor and synchronous liver metastases following preoperative imatinib therapy: A case report.

    Science.gov (United States)

    Cao, Feng; Li, Jia; Li, Ang; Fang, Yu; Li, Fei

    2013-04-01

    Laparoscopic partial gastrectomy without lymph node dissection has been accepted worldwide for the treatment of small gastric gastrointestinal stromal tumors (GISTs). However, the role of laparoscopic surgery in the treatment of large gastric GISTs remains under debate due to the risk of tumor spillage or rupture of the tumor capsule leading to peritoneal seeding. To the best of our knowledge, one-stage laparoscopic resection for a large gastric GIST and synchronous liver metastases following preoperative imatinib therapy has not been previously reported. Here, we present our initial experience of this method of treatment.

  11. CD8+ tumor-infiltrating lymphocytes predict favorable prognosis in malignant pleural mesothelioma after resection.

    Science.gov (United States)

    Yamada, Noriyuki; Oizumi, Satoshi; Kikuchi, Eiki; Shinagawa, Naofumi; Konishi-Sakakibara, Jun; Ishimine, Atsushi; Aoe, Keisuke; Gemba, Kenichi; Kishimoto, Takumi; Torigoe, Toshihiko; Nishimura, Masaharu

    2010-10-01

    Defects in human leukocyte antigen (HLA) class I expression may allow tumor cells to escape immune recognition. T cell infiltration is associated with a good prognosis in many cancers. However, the role of HLA class I expression and tumor-infiltrating lymphocytes (TILs) in malignant pleural mesothelioma (MPM) has not been fully analyzed. In the present study, we investigated the immune profiles and conducted outcome analyses of MPM patients. HLA class I expression and TILs (CD4(+), CD8(+), and NK cells) were detected by immunohistochemistry in a series of 44 MPM cases. To detect HLA class I expression, specimens were stained with the anti-pan HLA class I monoclonal antibody EMR8-5. The expression of HLA class I was positive in all patients. There was no case that showed negative HLA class I expression. The density of CD4(+) and CD8(+) TILs were strongly correlated (R = 0.76, p < 0.001). A high density of CD8(+) TILs was a significantly better prognostic factor for the survival of patients with extrapleural pneumonectomy (p < 0.05). Multivariate analysis revealed that a high density of CD8(+) TILs is an independent prognostic factor for patients who underwent extrapleural pneumonectomy. The presence of intratumoral CD8(+) T cells was correlated with an improved clinical outcome, raising the possibility that CD8(+) T cells might play a pivotal role in the antitumor immune response against MPMs. Thus, the stimulation of CD8(+) lymphocytes might be an efficacious immunotherapy for MPM patients.

  12. Gene expression disparity in giant cell tumor of bone

    Institute of Scientific and Technical Information of China (English)

    Xiaohua PAN; Shuhua YANG; Deming XIAO; Yong DAI; Lili REN

    2009-01-01

    The aim of this paper was to study the differential gene expression of giant cell tumor of bone (GCTB) by gene chip technology. Total RNA of 8 fresh GCTB specimens (Jaffe Ⅰ:6 cases, Ⅱ: 1 case, Ⅲ: 1 case; Campanacci Ⅰ:6 cases, Ⅱ:1 case, Ⅲ:1 case; Enneking Staging G0T1-2M0, 5 cases, G1T1-2M0: 2 cases, G1T2M0: 1 case) and 4 normal bony callus specimens (the control group) were extracted and purified to get mRNA and then reverse transcribed to complementary DNA, respectively. Microarray screening with a set of 8064 human cDNA genes was conducted to analyze the difference among the samples and the control. The hybridization signals were scanned. The gene expression disparity between the GCTB samples and normal bony callus was significantly different (P<0.01), and the disparity of over 5-fold was found in 47 genes in the GCTB specimens, with 25 genes up-regulated and 22 down-regulated including the extracellular matrix and transforming-related genes, oncogene and its homolog genes, cytokine and its receptor genes. Specific gene spectrum associated with GCTB can be identified by cDNA microarray, which will be the foundation of progressive etiology elucidation, diagnosis and treatment of GCTB.

  13. 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.

  14. Low infection rate after tumor hip arthroplasty for metastatic bone disease in a cohort treated with extended antibiotic prophylaxis

    DEFF Research Database (Denmark)

    Hettwer, Werner H; Horstmann, Peter Frederik; Hovgaard, Thea Bechmann;

    2015-01-01

    Background. Compared to conventional hip arthroplasty, endoprosthetic reconstruction after tumor resection is associated with a substantially increased risk of periprosthetic joint infection (PJI), with reported rates of around 10% in a recent systematic review. The optimal duration of antibiotic...

  15. 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.)

  16. 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.

  17. 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

    (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...... remained a risk factor for a CRM+ [odds ratio, 2.59 (95% confidence interval, 1.31-5.12); P = 0.006). CONCLUSIONS: In this nationwide study, resection of low rectal cancers by ELAPE did not improve short-term oncological results, when compared with conventional APE....

  18. Adjuvant treatment with tumor-targeting Salmonella typhimurium A1-R reduces recurrence and increases survival after liver metastasis resection in an orthotopic nude mouse model.

    Science.gov (United States)

    Murakami, Takashi; Hiroshima, Yukihiko; Zhao, Ming; Zhang, Yong; Chishima, Takashi; Tanaka, Kuniya; Bouvet, Michael; Endo, Itaru; Hoffman, Robert M

    2015-12-01

    Colon cancer liver metastasis is often the lethal aspect of this disease. Well-isolated metastases are candidates for surgical resection, but recurrence is common. Better adjuvant treatment is therefore needed to reduce or prevent recurrence. In the present study, HT-29 human colon cancer cells expressing red fluorescent protein (RFP) were used to establish liver metastases in nude mice. Mice with a single liver metastasis were randomized into bright-light surgery (BLS) or the combination of BLS and adjuvant treatment with tumor-targeting S. typhimurium A1-R. Residual tumor fluorescence after BLS was clearly visualized at high magnification by fluorescence imaging. Adjuvant treatment with S. typhimurium A1-R was highly effective to increase survival and disease-free survival after BLS of liver metastasis. The results suggest the future clinical potential of adjuvant S. typhimurium A1-R treatment after liver metastasis resection.

  19. Bone radiofrequency ablation combined with prophylactic internal fixation for metastatic bone tumor of the femur from hepatocellular carcinoma.

    Science.gov (United States)

    Ogura, Koichi; Miyake, Ryoko; Shiina, Shuichiro; Shinoda, Yusuke; Okuma, Tomotake; Kobayashi, Hiroshi; Goto, Takahiro; Nakamura, Kozo; Kawano, Hirotaka

    2012-08-01

    A 64-year-old man with 6-year history of hepatocellular carcinoma (HCC) was referred to us regarding bone metastasis to the right proximal femur. Although he underwent radiotherapy for pain palliation and local tumor control, the pain persisted and the tumor relapsed 3 months after the radiotherapy and he was thought to be at high risk of pathologic fracture. Given hypervascularity and large tumor size, a prophylactic internal fixation combined with adjuvant radiofrequency ablation (RFA) was proposed to reduce blood loss and prevent viable tumor cells being disseminated. His postoperative course was uneventful without requiring blood transfusion and preoperative symptoms immediately disappeared after surgery. He became capable of weight-bearing walk with a single cane and was almost asymptomatic without local progression on the plain radiographs when he died 14 months after surgery. Combination therapy of RFA and internal fixation using intramedullary nailing for metastases of the long bones from HCC seems to be a very promising technique both for sufficient pain relief and for local control of the tumor. Adjuvant RFA may become a potential option for patients with metastases of the long bones for the purpose of prevention of tumor dissemination and reduction of intraoperative blood loss.

  20. Repair of large orbito-maxillofacial defects following resection of tumors with temporalis myofascial flap and facial-cervico-pectoral flap

    Institute of Scientific and Technical Information of China (English)

    CHEN Wei-liang; LI Jin-song; YANG Zhao-hui; HUANG Zhi-quan; ZHANG Bin

    2005-01-01

    PURPOSE: To evaluate the results of facial-cervico-pectoral rotation flap (FRF) and temporalis myofascial flap (TMF) in the repair of large soft tissue defect in oral and maxillofacial regions. METHODS: Six patients with malignant orbital tumors and/or maxillofacial tumors invading the orbital regions were treated with extensive resection.The major midfacial soft tissue defects were repaired by temporalis myofascial flap and facial-cervico-pectoral rotation flap. RESULTS: All flaps were successfully transferred; the result of facial aesthetics was satisfactory in all patients.Follow-up periods varied from 9 to 20 months (mean follow up period: 13.2 months) and all of the patients were alive during the follow-up period with one recurrence. CONCLUSIONS: The TMF and the FRF are easy to harvest, have low donor site morbidity, and are compatible with the principles of oncologic resection. It is the method of choice for repairing major orbito-maxillofacial skin defects following resection of the tumors.

  1. Olecranon bone graft: revisited.

    Science.gov (United States)

    Mersa, Berkan; Ozcelik, Ismail Bulent; Kabakas, Fatih; Sacak, Bulent; Aydin, Atakan

    2010-09-01

    Autogenous bone grafts are frequently in use in the field of reconstructive upper extremity surgery. Cancellous bone grafts are applied to traumatic osseous defects, nonunions, defects after the resection of benign bone tumors, arthrodesis, and osteotomy procedures. Cancellous bone grafts do not only have benefits such as rapid revascularization, but they also have mechanical advantages. Despite the proximity to the primary surgical field, cancellous olecranon grafts have not gained the popularity they deserve in the field of reconstructive hand surgery. In this study, the properties, advantages, and technical details of harvesting cancellous olecranon grafts are discussed.

  2. Arterial reconstructions associated with the resection of malignant tumors Reconstruções arteriais associadas à ressecção de tumores malignos

    Directory of Open Access Journals (Sweden)

    Kenji Nishinari

    2006-08-01

    Full Text Available OBJECTIVE: When trunk arteries are affected by malignant neoplasia, and surgical treatment involving tumor and arterial resection is used, the vascular reconstruction must be performed immediately to avoid ischemia in the brain and large tissue masses. The objective of this study was to analyze the results obtained with the treatment of patients with malignant neoplasia who underwent tumor and vascular resection associated with arterial reconstruction. The primary patency of reconstructions, the occurrence arterial complications, and patient survival were assessed. METHODS: Thirty-six patients with cervical, abdominal, or lower limb neoplasias were followed up. These patients underwent elective operations at Hospital do Câncer A.C. Camargo, São Paulo, between September 1997 and September 2004. They were divided into 3 groups according to tumor location: Cervical (14, lower limbs (13, and Abdomen (9. Thirty-eight arterial reconstructions were performed in these 36 patients. RESULTS: There were 5 arterial complications: 2 early- and 3 late-stage. The early complications consisted of 1 symptomatic carotid occlusion with sequelae and 1 femoral graft rupture without sequelae. The late-stage complications consisted of 1 symptomatic carotid occlusion, 1 occlusion of an axillary-carotid graft, and 1 occlusion of a branch of the aortobifemoral graft, all without sequelae. There was no difference between the primary arterial patency rates. All the deaths (22 resulted from progression of neoplasic disease. CONCLUSIONS: Arterial reconstructions associated with resection of malignant neoplasia in cervical, abdominal, or lower limbs can be carried out with low rates of morbidity and mortality. There was no difference in the primary arterial patency rates among the groups studied.OBJETIVO: Quando há acometimento de artérias tronculares por neoplasias malignas e o tratamento cirúrgico é empregado para realização de ressecções tumoral e arterial, a

  3. 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.

  4. 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.

  5. 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.

  6. Tumor-derived microparticles induce bone marrow-derived cell mobilization and tumor homing: a process regulated by osteopontin.

    Science.gov (United States)

    Fremder, Ella; Munster, Michal; Aharon, Anat; Miller, Valeria; Gingis-Velitski, Svetlana; Voloshin, Tali; Alishekevitz, Dror; Bril, Rotem; Scherer, Stefan J; Loven, David; Brenner, Benjamin; Shaked, Yuval

    2014-07-15

    Acute chemotherapy can induce rapid bone-marrow derived pro-angiogenic cell (BMDC) mobilization and tumor homing, contributing to tumor regrowth. To study the contribution of tumor cells to tumor regrowth following therapy, we focused on tumor-derived microparticles (TMPs). EMT/6 murine-mammary carcinoma cells exposed to paclitaxel chemotherapy exhibited an increased number of TMPs and significantly altered their angiogenic properties. Similarly, breast cancer patients had increased levels of plasma MUC-1(+) TMPs following chemotherapy. In addition, TMPs from cells exposed to paclitaxel induced higher BMDC mobilization and colonization, but had no increased effect on angiogenesis in Matrigel plugs and tumors than TMPs from untreated cells. Since TMPs abundantly express osteopontin, a protein known to participate in BMDC trafficking, the impact of osteopontin-depleted TMPs on BMDC mobilization, colonization, and tumor angiogenesis was examined. Although EMT/6 tumors grown in mice inoculated with osteopontin-depleted TMPs had lower numbers of BMDC infiltration and microvessel density when compared with EMT/6 tumors grown in mice inoculated with wild-type TMPs, no significant difference in tumor growth was seen between the two groups. However, when BMDCs from paclitaxel-treated mice were injected into wild-type EMT/6-bearing mice, a substantial increase in tumor growth and BMDC infiltration was detected compared to osteopontin-depleted EMT/6-bearing mice injected with BMDCs from paclitaxel-treated mice. Collectively, our results suggest that osteopontin expressed by TMPs play an important role in BMDC mobilization and colonization of tumors, but is not sufficient to enhance the angiogenic activity in tumors.

  7. APPLICATION OF TITANIUM PLATE AND Teflon PATCH IN CHEST WALL RECONSTRUCTION AFTER STERNAL TUMOR RESECTION%钛板联合Teflon补片重建胸骨肿瘤切除后胸廓

    Institute of Scientific and Technical Information of China (English)

    吴显宁; 陈名久; 喻风雷

    2011-01-01

    Objective To study the reconstruction method and effectiveness of titanium plate and Teflon patch for the chest wall after resection of sternal tumors. Methods Between October 2006 and November 2009, 4 patients with sternal tumors were treated and the thoracic cages were reconstructed. There were 2 males and 2 females, aged 30-55 years. The patients were admitted because of chest lump or pain. The sizes of palpable lump ranged from 4 cm×3 cm to 10 cm×8 cm. CT examination showed bone destruction. After sternal tumor resection, defect size ranged from 10 cm x 8 cm to 18 cm×4 cm, and titanium plate and Teflon patch were used to repair and reconstruct the chest wall defect. Results The operations of the tumor resection and reconstruction of chest wall defect were successfully performed in 4 cases. Incisions healed by first intention with no abnormal breath, subcutaneous emphysema, pneumothorax, and infection. One case failed to be followed up after 6 months; 1 case died of intracranial hemorrhage; and 2 cases were followed up 1 and 4 years respectively without tumor recurrence. The chest wall had good remodeling. No loosening and exposure of titanium plate, difficulty in breathing, chest distress, and chest pain were observed during follow-up. Conclusion Surgical resection of sternal tumors will cause large chest wall defect which can be repaired by titanium plate and Teflon patch because it had the advantages of easy operation, satisfactory remodeling, and less complication.%目的 探讨胸骨肿瘤切除术后采用钛板联合Teflon补片重建胸廓的方法及疗效.方法 2006年10月-2009年11月,收治4例胸骨肿瘤患者.男2例,女2例;年龄30~55岁.以胸部肿块、疼痛1~6个月后入院.检查见胸前区范围为4cm×3em~10cm×8cm的肿块,质硬.CT检查见骨质破坏.采用胸骨肿瘤扩大切除术,切除范围为10cm×8cm~18em×14cm,采用钛板联合Teflon补片重建胸廓.结果 患者手术均顺利完成.术后切口Ⅰ期

  8. 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.

  9. Bone marrow-derived dendritic cells pulsed with tumor lysates induce anti-tumor immunity against gastric cancer ex vivo

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To investigate whether bone marrow-derived denritic cells pulsed with tumor lysates induce immunity against gastric cancer ex vivo. METHODS: c-kit+ hematopoietic progenitor cells were magnetically isolated with a MiniMACS separator from BALB/c mice bone marrow cells. These cells were cultured with cytokines GM-CSF, IL-4, and TNFα to induce their maturation. They were analysed by morphological observation, phenotype analysis, and mixed lymphocyte reaction (MLR). Bone marrow-derived DCs (BM-DCs) were pulsed with tumor cell lysate obtained by rapid freezing and thawing at a 1:3 DC:tumor cell ratio. Finally, cytotoxic T lymphocyte (CTL) activity and interferon gamma (IFNy) secretion was evaluated ex vivo.RESULTS: c-kit+ hematopoietic progenitor cells from mice bone marrow cells cultured with cytokines for 8 d showed the character of typical mature DCs. Norphologically, observed by light microscope, these cells were large with oval or irregularly shaped nuclei and with many small dendrites. Phenotypically, FACS analysis showed that they expressed.high levels of Ia, DEC-205, CD11b, CD80 and CD86 antigen, moderate levels of CD40, and negative for F4/80. Functionally, these ceils gained the capacity to stimulate allogeneic T cells in MLR assay. However, immature DCs cultured with cytokines for 5 d did not have typical DCs phenotypic markers and could not stimulate allogeneic T cells. Ex vivo primed T cells with SGC-7901 tumor cell lysate-pulsed (TP) DCs were able to induce effective CTL activity against SGC-7901 tumor cells (E:T = 100:1, 69.55% ± 6.05% specific lysis), but not B16 tumor cells, and produced higher levels of IFNγ, when stimulated with SGC-7901 tumor cells but not when stimulated with B16 tumor cells (1575.31 ± 60.25 pg/mL in SGC-7901 group vs 164.11 ± 18.52 pg/mL in B16 group, P < 0.01).CONCLUSION: BM-derived DCs pulsed with tumor lysates can induce anti-tumor immunity specific to gastric cancer ex vivo.

  10. 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

  11. Localized experimental bone metastasis drives osteolysis and sensory hypersensitivity at distant non-tumor-bearing sites.

    Science.gov (United States)

    Abdelaziz, Dareen M; Stone, Laura S; Komarova, Svetlana V

    2015-08-01

    Patients with breast cancer metastasis to bone suffer from inadequate pain relief. Animal models provide increased understanding of cancer-induced bone and sensory alterations. The objective of this study was to investigate the measures of pain at distant non-tumor-bearing sites in animals with localized bone metastasis. Immunocompetent BALB/c mice are injected intra-tibially with murine mammary carcinoma cells (4T1) or saline, and the sensitivity to mechanical and thermal stimuli in the contralateral paw was examined. In addition to previously demonstrated development of osteolysis and hypersensitivity to mechanical and thermal stimuli in the cancer-injected tibia, these animals exhibited an increase in sensory hypersensitivity in the contralateral limb. No bone lesions were evident on radiographs of the contralateral limbs. Histomorphometry detected decreased bone volume per tissue volume and increased osteoclast number in the contralateral tibia and vertebral bones of cancer-bearing animals. Neuroplasticity was examined by immunofluorescence for calcitonin gene-related peptide (CGRP) in sensory neurons and glial fibrillary acidic protein (GFAP) in lumbar spinal cords. CGRP-immunoreactivity and GFAP-immunoreactivity were significantly elevated both ipsilateral and contralateral in tumor-bearing animals. The anti-inflammatory and osteolysis-targeting drug rapamycin reduced hypersensitivity to mechanical and cold stimuli, attenuated GFAP over-expression, and lowered osteoclast number. The osteoclast-targeting drug pamidronate reduced sensitivity to cold and protected against bone loss. Localized bone cancer drives hypersensitivity, bone remodeling, and sensory neuron plasticity at sites distant from the primary tumor area. Drugs targeting these mechanisms may be useful in the treatment of pain distant from the primary tumor site.

  12. 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)

  13. 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

  14. The cryosurgical treatment of chondroblastoma of bone: long-term oncologic and functional results.

    NARCIS (Netherlands)

    Geest, I.C.M. van der; Noort, M.P. van; Schreuder, H.W.B.; Pruszczynski, M.; Rooy, J.W.J. de; Veth, R.P.H.

    2007-01-01

    BACKGROUND: Chondroblastoma of bone is a rare tumor that occurs most often in the epiphysis or apophysis of long bones. This benign tumor sometimes shows aggressive or malignant behaviour, and rarely metastases occur. Since wide resection often leads to growth impairment, intra-lesional curettage fo

  15. Reconstruction of bone defect with autograft fibula and retained part of tibia after marginal resection of periosteal osteosarcoma: a case report.

    Science.gov (United States)

    Hu, Tongyu; Chen, Wei; Li, Jianheng; Du, Chenguang; Zhang, Yingze

    2015-06-18

    Periosteal osteosarcoma is a rare subtype of osteosarcoma. Wide surgical removal is the commonly used treatment-method algorithm. However, the limb-salvage procedure of periosteal osteosarcoma in the distal tibia is a technical challenge to orthopedic surgeons because of the scarcity of soft tissue and subcutaneous nature in the anteromedial aspect. We encountered a 16-year-old female patient with periosteal osteosarcoma in the distal half of the left tibia diagnosed preoperatively based upon the CT images and a needle biopsy. A unique identical surgical technique was applied in the case, including marginal resection of the periosteal osteosarcoma with part of the tibia retained at the same level of bone defect and reconstruction using the autologous fibula graft. A combination of cisplatin and doxorubicin was received as chemotherapy after the operation. Postoperative incisional biopsy was performed, and the hematoxylin-eosin-stained results confirmed the diagnosis of periosteal osteosarcoma. The patient was followed up for 11 years. Radiological and clinical evaluation was performed at each follow-up. The retained tibia incorporated well with the fibula autograft, and excellent limb functional recovery was achieved. The patient was free from neoplastic disease at the latest follow-up. In conclusion, young patients with periosteal osteosarcoma without intramedullary involvement can be treated by marginal resection of the lesion with part of the tibia retained at the level of bone defect and reconstructed using a long autologous fibula graft. Subsequent chemotherapy with administration of cisplatin and doxorubicin is recommended.

  16. 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

  17. 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.

  18. [Clinical perspectives of the study of RANK/RANKL/OPG system components in primary and metastatic bone tumor].

    Science.gov (United States)

    Kushlinskiĭ, N E; Timofeev, Iu S; Gershteĭn, E S; Solov'ev, Iu N

    2014-01-01

    Disbalance of bone homeostasis, associated with malfunctioning of RANK/RANKL/OPG system underlies the oncological processes such as the destruction of bone, metastasis development, tumor progression. Pathological activity of system was described in such conditions, as breast cancer, prostate cancer, multiple myeloma, squamous cell carcinoma, Hodgkin's disease, and also metastasis in bones from lung cancer and other malignant diseases. In the literature, there is evidence of involvement of RANK/RANKL/OPG system in the pathogenesis of bone tumors (osteosarcoma, giant cell tumor of bone, chondroblastoma). Experimental data show that RANKL inhibitors can play a role in reducing tumor-induced lesions of bone in multiple myeloma, breast cancer, prostate cancer and lung cancer. Also this review presents data from clinical studies of the drug efficacy targeted on RANK/RANKL/OPG system and results of authors' study of the levels of this system's components and proinflammatory cytokines in blood serum of primary bone sarcoma patients.

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

    Energy Technology Data Exchange (ETDEWEB)

    Morris, E.B. [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); St. Jude Children' s Research Hospital, Division of Cancer Survivorship, Memphis, TN (United States); Shelso, John [St. Jude Children' s Research Hospital, Department of Endocrinology, Memphis, TN (United States); Smeltzer, Matthew P.; Li, Chin-Shang [St. Jude Children' s Research Hospital, Department of Biostatistics, Memphis, TN (United States); Thomas, Nicole A.; Karimova, E.J.; Merchant, Thomas [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Gajjar, Amar [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); Kaste, Sue C. [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States)

    2008-12-15

    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.)

  20. Malignant Phyllodes Tumor Presenting in Bone, Brain, Lungs, and Lymph Nodes

    Science.gov (United States)

    Johnson, Eric D.; Gulbahce, Evin; McNally, Joseph; Buys, Saundra S.

    2016-01-01

    Introduction Phyllodes tumors (PTs) are rare fibroepithelial tumors of the breast which are classified as benign, borderline, or malignant. Malignant PTs account for tumors, and borderline tumors have potential to progress to malignant tumors. Metastatic recurrences are most commonly documented in bone and lungs. We report an extremely rare presentation of recurrent malignant PTs involving the brain, lung, lymph nodes, and bone. Case A 66-year-old female presented with a large breast mass. Biopsy identified malignant PT, treated by mastectomy. One year later she presented with acute back pain; imaging showed pathological L4 spinal compression fracture. Core biopsy confirmed PT. Staging identified additional metastases in the lymph nodes, brain, and lung. Discussion PTs are rare and fast-growing tumors that originate from periductal stromal tissues and are composed of both epithelial and stromal components. Histologically, they are classified as benign, borderline, or malignant. The prognosis of the malignant type is poorly defined, with local recurrence occurring in 10–40% and metastases in 10%. Chemotherapy and radiotherapy are generally ineffective in this tumor type. The most common metastatic sites for malignant cases are the lung and bones, but in rare instances, PTs may metastasize elsewhere. Conclusion We report a rare presentation of recurrent malignant PT presenting as pathological fracture of the lumbar spine with impingement on the spinal column, along with cerebellar, nodal, and pulmonary metastases. Only 1 similar case has been previously reported. PMID:28203179

  1. Malignant Phyllodes Tumor Presenting in Bone, Brain, Lungs, and Lymph Nodes

    Directory of Open Access Journals (Sweden)

    Eric D. Johnson

    2016-12-01

    Full Text Available Introduction: Phyllodes tumors (PTs are rare fibroepithelial tumors of the breast which are classified as benign, borderline, or malignant. Malignant PTs account for <1% of malignant breast tumors, and borderline tumors have potential to progress to malignant tumors. Metastatic recurrences are most commonly documented in bone and lungs. We report an extremely rare presentation of recurrent malignant PTs involving the brain, lung, lymph nodes, and bone. Case: A 66-year-old female presented with a large breast mass. Biopsy identified malignant PT, treated by mastectomy. One year later she presented with acute back pain; imaging showed pathological L4 spinal compression fracture. Core biopsy confirmed PT. Staging identified additional metastases in the lymph nodes, brain, and lung. Discussion: PTs are rare and fast-growing tumors that originate from periductal stromal tissues and are composed of both epithelial and stromal components. Histologically, they are classified as benign, borderline, or malignant. The prognosis of the malignant type is poorly defined, with local recurrence occurring in 10–40% and metastases in 10%. Chemotherapy and radiotherapy are generally ineffective in this tumor type. The most common metastatic sites for malignant cases are the lung and bones, but in rare instances, PTs may metastasize elsewhere. Conclusion: We report a rare presentation of recurrent malignant PT presenting as pathological fracture of the lumbar spine with impingement on the spinal column, along with cerebellar, nodal, and pulmonary metastases. Only 1 similar case has been previously reported.

  2. Surgical reconstruction strategy of high level sacral tumors after tumor resection%高位骶骨肿瘤切除后的外科重建策略

    Institute of Scientific and Technical Information of China (English)

    吴强; 邵增务; 杨述华; 王佰川; 范磊

    2013-01-01

    目的探讨高位骶骨肿瘤切除后个性化重建方案。方法回顾分析自2000年9月至2011年12月,手术治疗的高位骶骨肿瘤11例,肿瘤类型包括骨巨细胞瘤、脊索瘤、软骨肉瘤、骨肉瘤及神经源性肿瘤。所有病例中,骶椎S1均受累。根据骶骨及骶髂关节侵犯范围,选择最佳手术方案,进行个性化外科重建。结果全部11例无术中死亡病例,术中平均出血量3200 ml。10例获得8个月至6年的随访,平均24个月,术后近期并发症1例为切口皮缘坏死和伤口延迟愈合;1例术后出现排尿困难,1例脑脊液漏。患者早期功能恢复良好,神经功能障碍改善率达66.7%。局部复发2例,分别为1例骨巨细胞瘤和1例软骨肉瘤,未出现远处转移病例。随访病例均未发现钉棒松动、断裂,以及同种异体腓骨植入后骨端吸收现象。结论良好的手术计划以及个性化的切除及重建方案可以保证手术的成功性。减少术中出血、合适地保留马尾神经功能以及骨盆环的重建是手术考虑的重点。%Objective The surgery of high level sacrum is a challenge in the ifeld of bone tumor therapy because of its special anatomic structure, large quantity of hemorrhage during the operation and the difficulty in reconstruction. This study is to investigate the individual reconstruction strategy of high level sacral tumor surgery. Methods The retrospective study included 11 patients from September 2000 to December 2011. The tumor type included bone giant cell tumor, chordoma, chondrosarcoma, osteosarcoma and neurogenic tumor. In all cases, the sacral vertebrae S1 was involved. The individualized reconstruction strategy was conducted according to the invasion area of the sacrum and sacroiliac joint. Results No patients died during the operation. The average amount of bleeding was 3200 ml. 10 cases were followed up for 8 months to 6 years, 24 months in average. The recent

  3. 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.

  4. 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.

  5. 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.

  6. Dialkyl bisphosphonate platinum(II) complex as a potential drug for metastatic bone tumor.

    Science.gov (United States)

    Nakatake, Hidetoshi; Ekimoto, Hisao; Aso, Mariko; Ogawa, Atsushi; Yamaguchi, Asami; Suemune, Hiroshi

    2011-01-01

    Bisphosphonates have high affinity for hydroxyapatite (HA), which is abundantly present in bone. Also, platinum complexes are known that have a wide spectrum of antitumor activities. The conjugate of bisphosphonate and a platinum complex might have HA affinity and antitumor activity, and become a drug for metastatic bone tumor. In this study, the authors synthesized platinum complexes that had dialkyl bisphosphonic acid as a ligand, and evaluated the possibility of the synthesized complexes as a drug for metastatic bone tumor. The synthesized dialkyl bisphosphonate platinum(II) complex was characterized, and its stability in an aqueous solution was also confirmed. The synthesized platinum complex showed higher HA affinity than other platinum complexes such as cisplatin and carboplatin in an experiment of adsorption to HA. In vitro, the platinum complex showed tumor growth inhibitory effect stronger than or equal to cisplatin, which is the most commonly used antitumor agent. Moreover, the platinum complex showed a bone absorption inhibitory effect on the osteoclast. These results suggest potential of dialkyl bisphosphonate platinum(II) complexes as a drug for metastatic bone tumor.

  7. 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.

  8. Disseminated mast cell tumor infiltrating the sphenoid bone and causing blindness in a dog.

    Science.gov (United States)

    Beltran, Elsa; de Stefani, Alberta; Stewart, Jennifer; De Risio, Luisa; Johnson, Victoria

    2010-05-01

    Mast cell tumors are found in most organs and tissues with variable biologic behavior in dogs. This case illustrates the clinical and magnetic resonance imaging (MRI) findings in a dog with disseminated mast cell tumor infiltrating the sphenoid bones. A 6-year-old male neutered Greyhound presented with a 3-day history of acute onset of blindness. General physical examination was normal. Neurological examination revealed mildly disorientated mental status, absent menace response in both eyes, bilaterally decreased vestibulo-oculocephalic reflexes and absent direct and consensual pupillary light reflex in both eyes. An electroretinogram indicated normal retinal function in both eyes. A lesion involving the middle and rostral cranial fossa was suspected. Hematology and serum biochemistry were normal except decreased urea (1.2 mmol/L). MRI of the head revealed heterogeneous signal intensity of the sphenoid bones on T2-weighted images and loss of their normal internal architecture. Cerebrospinal fluid analysis was normal. Abdominal ultrasound revealed hepatosplenomegaly and mesenteric lymphadenopathy. Fine needle aspirates were taken from the jejunal lymph nodes and the spleen. Results were consistent with disseminated mast cell tumor. The owner declined any treatment and the dog was euthanatized. Postmortem examination confirmed disseminated mast cell tumor affecting multiple organs, including the sphenoid bones. To our knowledge, this is the first case describing MRI features of disseminated mast cell tumor affecting the sphenoid bones and causing acute onset of blindness in a dog.

  9. 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.

  10. Differential diagnosis of cystic bone tumors in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Refior, H.J.; Stuerz, H.

    1982-09-01

    Skeletal changes leading to a suspicion of the presence of a tumour frequently occur in childhood with the roentgenological manifestation of a cyst. X-ray morphology can differ depending upon the localisation and the course. In childhood, however such findings are mainly classified as tumour-like bone lesions. This group comprises, inter alia, the juvenile bone cyst, the aneurysmatic bone cyst and fibrous dysplasia. However, it is necessary to exclude by differential diagnosis - even though the main age of manifestation is after completion of growth - genuine bone tumours with cystic phenomena, such as the giant cell tumour, chondroma or chondroblastoma. Verification of the diagnosis can be effected via radiologic-diagnostic methods such as tomography and angiography as well as computerized tomography. The use of scintigraphy of the skeleton can likewise be indicated. Numerous laboratory parameters can be used in individual cases to exclude certain diagnoses. Taking these aspects into consideration, the article reviews differential diagnosis of the most frequent skeletal affections in childhood. Great emphasis is given to the ranking and importance of the individual diagnostic methods.

  11. A prospective study of tumor suppressor gene methylation as a prognostic biomarker in surgically-resected stage I-IIIA non-small cell lung cancers

    Science.gov (United States)

    Drilon, Alexander; Sugita, Hirofumi; Sima, Camelia S.; Zauderer, Marjorie; Rudin, Charles M.; Kris, Mark G.; Rusch, Valerie W.; Azzoli, Christopher G.

    2014-01-01

    Introduction While retrospective analyses support an association between early tumor recurrence and tumor suppressor gene (TSG) promoter methylation in early-stage non-small cell lung cancers (NSCLCs), few studies have investigated this question prospectively. Methods Primary tumor tissue from patients with resected pathologic stage I-IIIA NSCLCs was collected at the time of surgery and analyzed for promoter methylation via methylation-specific reverse-transcriptase polymerase chain reaction (MethyLight). The primary objective was to determine an association between promoter methylation of 10 individual TSGs (CDKN2A, CDH13, RASSF1, APC, MGMT, GSTP1, DAPK1, WIF1, SOCS3, and ADAMTS8) and recurrence-free survival (RFS), with the secondary objectives of determining association with overall survival (OS), and relation to clinical or pathologic features. Results 107 patients had sufficient tumor tissue for successful promoter methylation analysis. Majority of patients were former/current smokers (88%) with lung adenocarcinoma (78%) and pathologic stage I disease (66%). Median follow-up was 4 years. When controlled for pathologic stage, promoter methylation of the individual genes CDKN2A, CDH13, RASSF1, APC, MGMT, GSTP1, DAPK1, WIF1, and ADAMTS8 was not associated with RFS. Promoter methylation of the same genes was not associated with OS except for DAPK1 which was associated with improved OS (p=0.03). The total number of genes with methylated promoters did not correlate with RFS (p=0.89) or OS (p=0.55). Conclusions Contrary to data established by previous retrospective series, TSG promoter methylation (CDKN2A, CDH13, RASSF1,APC, MGMT, GSTP1, DAPK1, WIF1, and ADAMTS8) was not prognostic for early tumor recurrence in this prospective study of resected NSCLCs. PMID:25122424

  12. Low-temperature Plasma Resection of Epiglottis Tumor Under Visual Laryngoscope%可视喉镜下低温等离子治疗会厌肿物

    Institute of Scientific and Technical Information of China (English)

    梁好勇; 安艳军; 柴康; 张孟丽; 王慎祥; 孙云霞; 高志杰

    2016-01-01

    目的 探讨可视喉镜下低温等离子治疗会厌肿物的效果. 方法 2014年8月~2015年3月18例较大会厌肿物在全麻插管可视喉镜下进行低温等离子切除,助手把持可视喉镜,暴露病变部位,术者一手持喉钳提起肿物,另一手持低温等离子刀头行会厌肿物切除. 结果 18例均顺利完成手术,术中病变暴露完全,会厌创面周围黏膜轻微水肿,无肿物残留. 18例术后随访2~6个月,平均4个月,除1例仍诉咽喉部异物感外,其余17例未诉其他不适. 1例神经鞘膜瘤术后5个月复发,行再次手术,仍在随访中. 结论 可视喉镜下低温等离子切除会厌肿物操作简单方便,病变切除彻底,手术安全,是一种理想的手术方法.%Objective To explore the effects of low-temperature plasma resection under laryngoscope for epiglottis tumor. Methods Eighteen cases of large epiglottis tumor underwent low-temperature plasma resection under visual laryngoscope with general anesthesia and intubation from August 2014 to March 2015.The laryngoscope was held by an assistant to expose lesions, and the operator lifted the tumor with laryngeal forceps by one hand and performed low-temperature plasma resection of epiglottis tumor by another hand. Results All the eighteen cases were successfully operated.Intraoperatively, lesions were completely exposed, and slight mucosal edema was found around the surgical wound.No residual tumor was found.The eighteen cases were followed up for 2-6 months (average, 4 months).Except for one case of throat foreign body sensation complained of, the remaining 17 cases didn' t complain of other discomforts.One case of nerve sheath tumor relapsed after five months, which was given a secondary surgery and was still in follow-up. Conclusion Epiglottis tumor resection by low-temperature plasma under visual laryngoscope has advantages of simple performance, thorough resection, and good safety, being an ideal surgical method.

  13. 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.

  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.

  15. Giant Cell Tumor of the Temporal Bone with Direct Invasion into the Middle Ear and Skull Base: A Case Report

    Directory of Open Access Journals (Sweden)

    Takashi Iizuka

    2012-01-01

    Full Text Available Giant cell tumor (GCT is classified as a benign bone tumor, and it is frequently identified at the epiphysis of long bones and relatively rare in the temporal bone. For orthopedists expert at recognizing bone and soft tissue tumors, the diagnosis of GCT is relatively easy; however, since head and neck surgeons experience few cases of GCT, it may be difficult to diagnose when it occurs in the temporal bone. A 32-year-old man complained of left hearing loss, aural fullness, and tinnitus. Examination of the ear revealed a bulging tumor. Audiologic examination demonstrated conductive hearing loss of the left ear. Computer tomograph of the temporal bone showed a soft-tissue-density specification indicating bone destruction at the left temporal bone. The tumor invaded the skull base. Imaging examinations using magnetic resonance imaging revealed a nonhomogenous isosignal intensity area on T1 at the left temporal bone. After intravenous gadolinium, the mass showed unequal enhancement. This patient subsequently underwent surgery to remove the lesion using transmastoid and middle fossa approach. Pathological examinations from specimens of the tumor revealed characteristic of GCT. No clinical or radiological evidence of tumor recurrence was detected for 4 years.

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

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    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.

  17. 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

  18. Rectal Carcinoma with Heterotopic Bone: Report of a Case

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    Yuichi Nagao

    2010-09-01

    Full Text Available Heterotopic bone is rarely present in malignant tumors of the gastrointestinal tract. We herein report a case of rectal adenocarcinoma with heterotopic bone. A 46-year-old Japanese male presented to our hospital with abdominal distension and constipation. Colonoscopic examination showed an ulcerated polypoid tumor of the rectum which nearly obstructed the rectal lumen. Abdominal computed tomography showed a tumor of the rectum with calcified deposits. Low anterior resection with lateral lymph node dissection was performed under the tentative diagnosis of rectal cancer. Histological examination of the resected specimen showed mucinous carcinoma of the rectum with heterotopic bone. One of the metastatic lymph nodes dissected also showed heterotopic bone. In the present report, we describe this rare tumor and briefly review the pertinent literature regarding rectal cancer with heterotopic bone.

  19. Thermodynamic considerations of acrylic cement implant at the site of giant cell tumors of the bone.

    Science.gov (United States)

    Krishnan, E C; Nelson, C; Neff, J R

    1986-01-01

    A discussion of the thermodynamic aspects of a relatively new treatment method for giant cell tumors of the bone is presented in this paper. The advantages of implanting methylmethacrylate acrylic bone cement into a curetted tumor site are briefly discussed and placed in perspective relative to more prevalent surgical treatments. As the bone cement self-heats while curing, the possibility of heat necrosis in the bone exists. However, the damage due to heat may be beneficial in reducing the rate of tumor recurrence. A thermodynamic consideration of the treatment situation appears to be warranted. After a general introduction and a brief literature review, the theoretical thermodynamic equations are developed. Once the basic equations for the heat transfer from the cement or the bone are derived, there is then a discussion of the various characteristics of bone and methylmethacrylate crucial to the analysis, such as, thermal conductivity, specific heat, density, and heat generation parameters. Finally, in order to reduce the theory to a form which may be used practically, the equations derived are written in terms of finite-difference equations, which approximate them numerically. Different equations are written for each type of heat transfer condition encountered in the cement-bone system as spacial variances in material and geometry occur. The equations derived may be used to model the system allowing one to predict the time-dependent temperature distribution in bone during the curing of acrylic cement. Using computer techniques to reduce the equations obtained from this analysis, and knowing the temperature at which adjacent cells die, a zone of necrosis may be mapped surrounding the acrylic impact.

  20. Osteoradionecrosois of the temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Thornley, G.D.; Gullane, P.J.; Ruby, R.R.; Heeneman, H.

    1979-10-01

    Six cases of osteoradionecrosis of the temporal bone are described. Persistent symptoms of otitis externa refractory to local treatment measures should alert the physician to the possibility of underlying osteoradionecrosis. Treatment of superficial parotidectomy and partial temporal bone resection with preservation of the facial nerve is indicated if local aggressive conservative measures fail to control the disease. Benign mixed tumors of the parotid gland should be treated surgically with avoidance of radiotherapy.

  1. Application of USS screw rods system in the reconstruction of the stability of the lumbar sacrum after resection of sacrum tumor%骶骨肿瘤切除后腰骶关节稳定性重建中 USS钉棒系统的应用

    Institute of Scientific and Technical Information of China (English)

    颉强; 王臻; 王岭; 郭征; 刘继中; 戴先文

    2002-01-01

    Objective To introduce one operation method applied with USS (universal spine system) screw rods system for the reconstruction of the stability of the lumbar sacrum after resection of sacrum tumor and discuss indications and feasibility of the operation method.Methods 5 patients with sacrum tumor had accepted the clinical treatment of USS.Resect the sacrum tumor,insert pedicle screw into the normal pedicles (L3 or L4 or L5)above the region of laminectomy routinely,fix lower screw in the iliac plane,put metal rods,plant bone and put transverse links. Results There was no recurrence of sacrum tumor by MRI examination after 1~ 12 months follow up.The preoperative pain of lumbar- sacrum joint and roots of the spinal nerves relieved significantly.The patients turned to normal weight loading and movement.There were no fractures of the screw and rods and motion of the screw.X- ray examination hasn't found increase of screw passage,pelvic decrease, and L5 sinking.Conclusion The operation method applied with USS screw- rods system for the reconstruction of the stability of the lumbar- sacrum can reduce postoperative pain,promote early postoperative activity,and prevent pathologic fracture and paraplegia.

  2. Tumor-Host Interaction in Breast Cancer Bone Metastasis

    Science.gov (United States)

    2006-01-01

    immortalized osteoblasts. REPORTABLE OUTCOMES • Thesis , entitled “PDGF expression by breast cancer cells, and its role in regulating osteolytic...investigation of microenvironmental regulation of genes, including (MMP-11 and cathepsin K) in breast cancer that may impact the progression of bone...C, Fan D, O’Brian CA, et al. Modulation of doxorubicin sensitivity and level of p-glycoprotein expression in human colon carcinoma cells by ectopic

  3. 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.

  4. Development of Composite Scaffolds for Load Bearing Segmental Bone Defects

    Science.gov (United States)

    2013-07-01

    composite scaffolds designed to serve as bone regenerative therapies . We analyzed the benefits and drawbacks of different composite scaffold...related to fractures, sport and blast injuries. Diseases include bone cancer (osteosarcoma), tumor resection and reconstruction, osteoporosis ...selection for the scaffold has a direct impact on the biological and physical properties of the construct, there are some factors contributing to the

  5. Transarticular invasion of the sacroiliac joints by malignant pelvic bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hwang Woo; Huh, Jin Do; Kim, Seong Min; Cho, Young Duk [College of Medicine, Kosin Univ., Pusan (Korea, Republic of); Cho, Kil Ho [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)

    2002-03-01

    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 cm{sup 2} vs. 69.6 cm{sup 2}. 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

  6. Two Cases of Sarcoma Arising in Giant Cell Tumor of Bone Treated with Denosumab

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    Cory Julian Broehm

    2015-01-01

    Full Text Available Giant cell tumor (GCT of bone is a generally benign, but often locally aggressive, neoplasm of bone, with a propensity for recurrence. Sarcomatous transformation is rare and typically occurs with a history of recurrences and radiation treatment. Denosumab, an inhibitor of the RANK ligand involved in bone resorption in GCT, is increasingly used in treatment of recurrent or unresectable giant cell tumor of bone. We report two cases of sarcomatous transformation of GCT to osteosarcoma in patients receiving denosumab. One was a 59-year-old male with a 12-year history of GCT and multiple recurrences taking denosumab for 2.5 years. The second case was in a 56-year-old male with a seven-year history of GCT taking denosumab for six months. Review of the literature shows one case report of malignant transformation of GCT in a patient being treated with denosumab. As the use of denosumab for treatment of GCT will likely increase, larger, controlled studies are needed to ascertain whether denosumab may play a role in malignant transformation of giant cell tumor of bone.

  7. Diffusion-weighted Magnetic Resonance Imaging in the Diagnosis of Bone Tumors: Preliminary Results

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    Yeliz Pekcevik

    2013-01-01

    Full Text Available Objective: The study aims to determine whether apparent diffusion coefficient (ADC can help differentiate benign and malignant bone tumors. Materials and Methods: From January 2012 to February 2013, we prospectively included 26 patients. Of these 15 patients were male and 11 were female; ranging in age from 8 to 76 years (mean age, 34.5 years. Diffusion-weighted magnetic resonance (MR imaging was obtained with a single-shot echo-planar imaging sequence using a 1.5T MR scanner. We grouped malignant lesions as primary, secondary, and primary tumor with chondroid matrix. The minimum ADC was measured in the tumors and mean minimum ADC values were selected for statistical analysis. ADC values were compared between malignant and benign tumors using the Mann-Whitney U-test and receiver operating curve analysis were done to determine optimal cut-off values. Results: The mean ADC values from the area with lowest ADC values of benign and malignant tumors were 1.99 ± 0.57 × 10−3 mm 2 /s and 1.02 ± 1.0 × 10−3 mm 2 /s, respectively. The mean minimum ADC values of benign and malignant tumors were statistically different (P = 0.029. With cut-off value of 1.37 (10−3 mm 2 /s, sensitivity was 77.8% and specificity was 82.4%, for distinguishing benign and malignant lesion. Benign and secondary malignant tumors showed statistically significant difference (P = 0.002. There was some overlap in ADC values between benign and malignant tumors. The mean minimum ADC values of benign and malignant chondroid tumors were high. Giant cell tumor, non-ossifying fibroma and fibrous dysplasia showed lower ADC values. Conclusion: Although there is some overlap, ADC values of benign and malignant bone tumors seem to be different. Further studies with larger patient groups are needed to find an optimal cut-off ADC value.

  8. Survival Analyses for Patients With Surgically Resected Pancreatic Neuroendocrine Tumors by World Health Organization 2010 Grading Classifications and American Joint Committee on Cancer 2010 Staging Systems.

    Science.gov (United States)

    Yang, Min; Ke, Neng-wen; Zeng, Lin; Zhang, Yi; Tan, Chun-lu; Zhang, Hao; Mai, Gang; Tian, Bo-le; Liu, Xu-bao

    2015-12-01

    In 2010, World Health Organization (WHO) reclassified pancreatic neuroendocrine tumors (p-NETs) into 4 main groups: neuroendocrine tumor G1 (NET G1), neuroendocrine tumor G2 (NET G2), neuroendocrine carcinoma G3 (NEC G3), mixed adeno and neuroendocrine carcinoma (MANEC). Clinical value of these newly updated WHO grading criteria has not been rigorously validated. The authors aimed to evaluate the clinical consistency of the new 2010 grading classifications by WHO and the 2010 tumor-node metastasis staging systems by American Joint Committee on Cancer (AJCC) on survivals for patients with surgically resected p-NETs. Moreover, the authors would validate the prognostic value of both criteria for p-NETs.The authors retrospectively collected the clinicopathologic data of 120 eligible patients who were all surgically treated and histopathologically diagnosed as p-NETs from January 2004 to February 2014 in our single institution. The new WHO criteria were assigned to 4 stratified groups with a respective distribution of 62, 35, 17, and 6 patients. Patients with NET G1 or NET G2 obtained a statistically better survival compared with those with NEC G3 or MANEC (P systems were respectively defined in 61, 36, 12, and 11 patients for each stage. Differences of survivals of stage I with stage III and IV were significant (P systems were both significant in univariate and multivariate analysis (P systems could consistently reflect the clinical outcome of patients with surgically resected p-NETs. Meanwhile, both criteria could be independent predictors for survival analysis of p-NETs.

  9. CT-MR image data fusion for computer assisted navigated neurosurgery of temporal bone tumors

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    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

  10. Palliative resection of the primary tumor is associated with improved overall survival in incurable stage IV colorectal cancer: A nationwide population-based propensity-score adjusted study in the Netherlands.

    Science.gov (United States)

    't Lam-Boer, Jorine; Van der Geest, Lydia G; Verhoef, Cees; Elferink, Marloes E; Koopman, Miriam; de Wilt, Johannes H

    2016-11-01

    As the value of palliative primary tumor resection in stage IV colorectal cancer (CRC) is still under debate, the purpose of this population-based study was to investigate if palliative primary tumor resection as the initial treatment after diagnosis was associated with improved overall survival. All patients with stage IV colorectal adenocarcinoma (2008-2011) were selected from the Netherlands Cancer Registry, and patients undergoing treatment with curative intent (i.e., metastasectomy, radiofrequency ablation and/or hyperthermic intraperitoneal chemotherapy), or best supportive care were excluded. After propensity score matching, a multivariable Cox proportional hazard model was performed to determine the association between treatment strategy and mortality. From a total group of 10,371 patients with stage IV CRC, 2,746 patients (26%) underwent an elective palliative resection of the primary tumor, whether or not followed by systemic therapy, and 3,345 patients (32%) were initially treated with palliative systemic therapy. After propensity score matching, median overall survival in these groups was 17.2 months (95% CI 16.3-18.1) and 11.5 months (95% CI 11.0-12.0), respectively. In Cox regression analysis, primary tumor resection was significantly associated with improved overall survival (hazard ratio of death = 0.44 [95% CI 0.35-0.55], p population-based study shows an overall survival benefit for patients with incurable stage IV CRC who underwent primary tumor resection as the initial treatment after diagnosis, compared to patients who started systemic therapy with the primary tumor in situ. This result is an argument in favor of resection of the primary tumor, even when patients have little to no symptoms.

  11. Investigation of Maxillary Preprosthetic Situations after Oral Tumor Treatment

    Institute of Scientific and Technical Information of China (English)

    CAO Yingguang(曹颖光); SUN Guohong(孙国洪); Thomas Weischer

    2004-01-01

    In order to investigate the maxillary preprosthetic situation after oral tumor treatmentand/or reconstructive surgery, based on the review of case history and the clinical records 47 cases were analyzed after oral tumor treatment and/or reconstruction, including residual maxillary bone,intermaxillary relationships, defection of maxilla and oral situation after radiation therapy. The results showed that the residual maxillary bone was useful for implantation in the front alveolar bone and zygoma area. The maxillary preprosthetic situation after tumor treatment and/or reconstructive surgery was difficult due to maxillary resection, intermaxillary relationships, unsuitable soft and hard tissue transfer and the irradiation. It is suggested that the maxillary preprosthetic situation after oral tumor treatment is getting worse not only due to maxillary resection and/or irradiation, but surprisingly also due to mandibular resection and/or irradiation.

  12. Myelopotentiating effect of curcumin in tumor-bearing host: Role of bone marrow resident macrophages

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    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

  13. [Glomus tumors of the temporal bone: a report of 6 cases].

    Science.gov (United States)

    Arruda, W O; Teive, H A; Torres, L F; Ramina, R; Parolim, M K; Maniglia, J J; Barrionuevo, C E

    1989-03-01

    The authors review the clinical, radiological and pathological features of 6 cases of glomus tumors of the temporal bone. Out of the 6 patients, 5 were female; age was distributed between 22 and 76 years (mean 48 years). The main clinical features were hypoacusia, tinnitus and otoscopic findings suggestive of the diagnosis. In one case was noted the concomitant presence of a neurinoma of the VIII cranial nerve with a ipsilateral glomus tumor, and in another case there was a concomitancy of carotid body tumor with temporal glomus jugularis tumor. Metastases were not observed in any case. Tumoral lesions were successfully ressected employing microsurgical techniques and a multidisciplinary staff involving neurosurgeons, head and neck surgeons and otolaryngologists. Radioteraphy was not employed, neither pre-operative embolization. Some aspects related to the nosology, embriology, pathophysiology, diagnosis and treatment of this interesting type of neoplasms are discussed.

  14. Incidental detection of gastrointestinal stromal tumor by Tc-99m MDP bone scan.

    Science.gov (United States)

    Shepherd, Timothy M; Idakoji, Ibrahim A; Pampaloni, Miguel H

    2012-02-01

    This case demonstrates extraosseous 99m-technetium methylene diphosphonate (Tc-99m MDP) accumulation from a gastrointestinal stromal tumor. A 75-year-old woman underwent a temporal bone CT for conductive hearing loss that showed sclerosis in the right occipital condyle. Follow-up Tc-99m MDP bone scan for osseous metastases instead showed a mass-like extraosseous accumulation of Tc-99m MDP in the anterior left upper quadrant. Differential diagnoses included gastric cancer, lymphoma, metastatic melanoma, systemic hypercalcemia, or heterotopic mesenteric ossification. Contrast CT showed a well-circumscribed mass arising from the stomach, and subsequent pathology confirmed gastrointestinal stromal tumor. These tumors rarely can contain osteoclast-like giant cells and should be considered for extraosseous Tc-99m MDP accumulation.

  15. Total Humeral Endoprosthetic Replacement following Excision of Malignant Bone Tumors

    Directory of Open Access Journals (Sweden)

    Suhel Kotwal

    2016-01-01

    Full Text Available Humerus is a common site for malignant tumors. Advances in adjuvant therapies and reconstructive methods provide salvage of the upper limb with improved outcomes. Reports of limb salvage with total humeral replacement in extensive humeral tumors are sparse. We undertook a retrospective study of 20 patients who underwent total humeral endoprosthetic replacement as limb salvage following excision of extensile malignant tumor from 1990 to 2011. With an average followup of 42.9, functional and oncological outcomes were analyzed. Ten patients were still alive at the time of review. Mean estimated blood loss was 1131 mL and duration of surgery was 314 minutes. Deep infection was encountered in one patient requiring debridement while mechanical loosening of ulnar component was identified in one patient. Subluxation of prosthetic humeral head was noted in 3 patients. Mean active shoulder abduction was 12.5° and active flexion was 15°. Incompetence of abduction mechanism was the major determinant of poor active functional outcome. Mean elbow flexion was 103.5° with 30.5° flexion contracture in 10 patients with good and useful hand function. Average MSTS score was 71.5%. Total humeral replacement is a reliable treatment option in restoring mechanical stability and reasonable functional results without compromising patient survival, with low complication rate.

  16. A novel 3-D mineralized tumor model to study breast cancer bone metastasis.

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    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. 经后路360°全椎体切除重建术治疗胸椎肿瘤%Posterior 360° Total Vertebral Resection and Reconstruction in Treatment of Thoracic Tumor

    Institute of Scientific and Technical Information of China (English)

    熊怀风; 刘建军; 李大廉

    2014-01-01

    Objective To explore the issue of posterior vertebral body resection operation of 360°ef icacy and method of treatment of thoracic tumor. Methods 5 patients with thoracic vertebrae tumor of posterior total vertebral resection and reconstruction. Four cases in our hospital 3 cases of single segment of thoracic vertebra,2 cases of double segments adjacent vertebral body,using Harm and titanium mesh and bone graft and pedicle screw internal fixation system reconstruction. Results fol ow-up 3 months to 3.5 years,average 27 months.Al the 5 patients until stable fixation,postoperative short-term and long-term vertebral height loss,al eviate the pain of chest and back and lower extremity nerve compression symptoms of varying degrees of. Conclusion posterior thoracic 360° vertebral resection can significantly improve the neurological function,lower thoracic vertebrae tumor local recurrence rate,improve the ef ect of operation. Harm titanium mesh and bone graft combined with pedicle screw fixation can ef ectively improve the stability of the spine and column,also can reduce the frequency of operation,wound complications.%目的:探讨后路一期手术360°椎体全切治疗胸椎肿瘤的疗效及方法。方法5例胸椎骨肿瘤患者实施后路全脊椎切除重建术。本院4例中3例为单节段胸椎,2例为双节段相邻椎体,均采用Harm钛网植骨椎弓根钉内固定系统重建。结果随访3个月~3.5年,平均27个月。5例患者均等到稳定固定,术后近期和远期椎体高度无丢失,胸背部疼痛和下肢神经压迫症状均有不同程度的缓解。结论胸椎后路360°椎体全切能显著改善脊髓神经功能,明显降低胸椎骨肿瘤局部复发率,提高手术疗效。 Harm钛网植骨联合椎弓根钉固定能有效提高脊柱的前后柱的稳定性,同时可减少手术创伤的次数、减少并发症。

  18. LAPTM4B allele *2 is a marker of poor prognosis following hepatic tumor resection for hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Hua Yang

    Full Text Available BACKGROUND: Lysosomal protein transmembrane 4 beta (LAPTM4B is a gene related to hepatocellular carcinoma that has two alleles designated LAPTM4B*1 and LAPTM4B*2. This study aimed to investigate the correlation of LAPTM4B genotype with prognosis and clinicopathologic features in patients who have undergone resection for hepatocellular carcinoma (HCC. METHODOLOGY/PRINCIPAL FINDINGS: The LAPTM4B genotype was analyzed by PCR in 68 patients who had undergone curative hepatic resection for hepatocellular carcinoma. The correlation of LAPTM4B genotype with clinicopathologic parameters was assessed with the Chi-squared test. Differences in patient survival were determined by the Kaplan-Meier method. Multivariate analysis of prognostic factors was carried out with Cox regression analysis. Patients with LAPTM4B *2 had both significantly shorter overall survival (OS and shorter disease-free survival (DFS (both P<0.001. Multivariate analysis showed that LAPTM4B genotype is an independent prognostic factor for OS and DFS (both P<0.001. CONCLUSIONS/SIGNIFICANCE: Allele *2 of LAPTM4B is a risk factor associated with poor prognosis in patients with resected HCC. LAPTM4B status may be useful preoperatively as an adjunct in evaluation of the operability of HCC.

  19. Uncommon bone tumors of the skull: Ewing's sarcoma and Triton's tumor; Tumores osseos raros da calota craniana: sarcoma de Ewing e tumor de Triton

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    Rosa, Ana Claudia Ferreira; Carvalho, Claudio Sobral de [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Dept. de Radiologia; Machado, Marcio Martins [Sao Paulo Univ., SP (Brazil). Faculdade de Medicina. Dept. de Radiologia; Figueiredo, Marco Antonio Junqueira; Albertotti, Cesar Jose [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Servico de Tomografia Computadorizada e Ressonancia Magnetica; Cerri, Giovanni Guido [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Centro de Diagnostico]. E-mail: giovanni.cerri@hcnet.usp.br

    2002-04-01

    Ewing's sarcoma and Triton's tumor are two uncommon bone tumors of the skull that have nonspecific clinical and imaging features. However, imaging methods are important in the detection of the lesions during the diagnostic investigation in order to evaluate the extent of the bone lesions, involvement of the soft tissues and brain, and to determine the presence of local recurrence and metastases. The confirmatory diagnosis relies on histological studies and immunohistochemistry. The authors report two cases of patients with these tumors and present the radiological findings. (author)

  20. Cabozantinib Resolves Bone Scans in Tumor-Naïve Mice Harboring Skeletal Injuries

    Directory of Open Access Journals (Sweden)

    Michael G. Doran

    2014-10-01

    Full Text Available The receptor tyrosine kinase inhibitor cabozantinib (XL184, BMS-907351 Cometriq has displayed impressive clinical activity against several indications, culminating in its recent approval for medullary thyroid cancer. Among malignancies with tropism for the bone (prostate, breast, one striking feature of early clinical reports about this drug has been the rapid and complete resolution of bone scans, a phenomenon almost never observed even among therapies already shown to confer survival benefit. In castration-resistant prostate cancer, not all conventional response indicators change as dramatically posttreatment, raising the possibility that cabozantinib may impair the ability of bone-seeking radionuclides to integrate within the remodeling bone. To test this hypothesis, we surgically induced bone remodeling via physical insult in non–tumor-bearing mice and performed 18F-sodium fluoride (18F-NaF positron emission tomographic (PET and technetium 99m–methylene diphosphonate (99mTc-MDP single-photon emission computed tomographic (SPECT scans pre- and posttreatment with cabozantinib and related inhibitors. A consistent reduction in the accumulation of either radiotracer at the site of bone remodeling was observed in animals treated with cabozantinib. Given that cabozantinib is known to inhibit several receptor tyrosine kinases, we drugged animals with various permutations of more selective inhibitors to attempt to refine the molecular basis of bone scan resolution. Neither the vascular endothelial growth factor receptor (VEGFR inhibitor axitinib, the MET inhibitor crizotinib, nor the combination was capable of inhibiting 18F-NaF accumulation at known bioactive doses. In summary, although the mechanism by which cabozantinib suppresses radionuclide incorporation into foci undergoing bone remodeling remains unknown, that this phenomenon occurs in tumor-naïve models indicates that caution should be exercised in interpreting the clinical significance

  1. SOFT TISSUE RECONSTRUCTION AFTER RESECTION OF MUSCULOSKELETAL TUMORS%软组织重建在骨与软组织肿瘤外科治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    姬涛; 王天兵; 郭卫

    2012-01-01

    bone tumors and 38 soft tissue tumors. One stage reconstruction of soft tissue was performed after tumor resection in 75 cases; reconstruction of soft tissue was performed after debridement in 7 cases of wound dehiscence; and two stage reconstruction of soft tissue was performed after debridement and vacuum sealing drainage placement in 8 cases of infected wounds. The gastrocnemiums flap was used in 40 cases, the latissimus dorsi myocutaneous flap in 6 cases, rectus abdominis myocutaneous flap in 4 cases, gluteus maximus musculocutaneous flap in 1 case, pectoral is major muscle flap in 1 case, cross-abdominal flap in 1 case, local transfer flap in 27 cases, pedicled flaps in 5 cases, and skin grafts in 5 cases. The size of the flap ranged from 6.5 cm×4.5 cm to 21,0 cm× 9.0 cm. Results Eighty-seven flaps survived, and incisions healed by first intention in 81 cases. In 6 cases of healing by second intention, 2 had partial flap necrosis, which was cured by dressing change; 3 had delayed healing; 1 had mild infection, which was cured after conservative treatment. Wound of donor site healed primarily, and the grafted skin survived. Seventy-three patients were followed up 10-102 months (mean, 36.1 months). Local tumor recurrence was observed in 6 patients, who received second resection at 2-27 months (mean, 8.2 months) after operation. Thirteen patients dead of primary disease at 6-34 months (mean, 19.2 months) after operation. Conclusion The defects caused by resection of musculoskeletal tumor require soft tissue reconstructions. Optimal reconstruction can enhance wound closure, decrease incidence of wound complication, preserve limb function.

  2. Bone marrow CFU-GM and human tumor xenograft efficacy of three antitumor nucleoside analogs.

    Science.gov (United States)

    Bagley, Rebecca G; Roth, Stephanie; Kurtzberg, Leslie S; Rouleau, Cecile; Yao, Min; Crawford, Jennifer; Krumbholz, Roy; Lovett, Dennis; Schmid, Steven; Teicher, Beverly A

    2009-05-01

    Nucleoside analogs are rationally designed anticancer agents that disrupt DNA and RNA synthesis. Fludarabine and cladribine have important roles in the treatment of hematologic malignancies. Clofarabine is a next generation nucleoside analog which is under clinical investigation. The bone marrow toxicity, tumor cell cytotoxicity and human tumor xenograft activity of fludarabine, cladribine and clofarabine were compared. Mouse and human bone marrow were subjected to colony forming (CFU-GM) assays over a 5-log concentration range in culture. NCI-60 cell line screening data were compared. In vivo, a range of clofarabine doses was compared with fludarabine for efficacy in several human tumor xenografts. The IC90 concentrations for fludarabine and cladribine for mouse CFU-GM were >30 and 0.93 microM, and for human CFU-GM were 8 and 0.11 microM, giving mouse to human differentials of >3.8- and 8.5-fold. Clofarabine produced IC90s of 1.7 microM in mouse and 0.51 microM in human CFU-GM, thus a 3.3-fold differential between species. In the NCI-60 cell line screen, fludarabine and cladribine showed selective cytotoxicity toward leukemia cell lines while for clofarabine there was no apparent selectivity based upon origin of the tumor cells. In vivo, clofarabine produced a dose-dependent increase in tumor growth delay in the RL lymphoma, the RPMI-8226 multiple myeloma, and HT-29 colon carcinoma models. The PC3 prostate carcinoma was equally responsive to clofarabine and fludarabine. Bringing together bone marrow toxicity data, tumor cell line cytotoxicity data, and human tumor xenograft efficacy provides valuable information for the translation of preclinical findings to the clinic.

  3. Workshop Report on the European Bone Sarcoma Networking Meeting: Integration of Clinical Trials with Tumor Biology.

    Science.gov (United States)

    Thomas, David M; Wilhelm, Miriam; Cleton-Jansen, Anne-Marie; Dirksen, Uta; Entz-Werlé, Natacha; Gelderblom, Hans; Hassan, Bass; Jürgens, Heribert; Koster, Jan; Kovar, Heinrich; Lankester, Arjan C; Lewis, Ian J; Myklebost, Ola; Nathrath, Michaela H M; Picci, Piero; Whelan, Jeremy S; Hogendoorn, Pancras C W; Bielack, Stefan S

    2011-09-01

    A key workshop was held in The Netherlands in June 2011, hosted by several European bone sarcoma networks and with a broad range of stakeholders from Europe and Australia. The purpose of the meeting was to identify the strengths and weaknesses in current clinical trials for bone sarcomas and to make recommendations as to how to accelerate progress in this field. Two areas of particular interest were discussed. First, all participants agreed upon the importance of tumor biology to understanding clinical responses for all types of bone sarcoma. Various barriers to biobanking tumor and germline specimens were canvassed and are outlined in this paper. Second, there was consideration of the particular challenges of dealing with adolescent and young adult cancers, exemplified by bone sarcomas. Participants recommended greater engagement of both pediatric and adult sarcoma trial organizations to address this issue. Specific opportunities were identified to develop biological sub-studies within osteosarcoma, focused on understanding germ line risk and pharmacogenomics defining toxicity and biological responses. In Ewing sarcoma, it was harder to define opportunities for biological insights. There was agreement that the results for insulin-like growth factor pathway inhibition in Ewing family tumors were disappointing, but represented a clear indication of the need for companion biologic studies to develop predictive biomarkers. The meeting ended with broad commitment to working together to make progress in this rare but important subgroup of cancers.

  4. Frontal bone hemangioma in an 8-year-old female: A common tumor in a rare location

    Directory of Open Access Journals (Sweden)

    Abhimanyu Sharma

    2016-01-01

    Full Text Available Intraosseous hemangioma is a rare bone tumor accounting for 0.7%–1.0% of all bone tumors. In the skull, frontal bone is the commonly involved bone. An 8-year-old female presented to our outpatient department with complaints of pain and swelling over forehead for 4 months. X-ray revealed a lytic expansile lesion involving frontal bone with sunburst pattern of bony spicules radiating to periphery of the lesion. Magnetic resonance imaging revealed the presence of a well-circumscribed lesion with both intra as well as extracranial components. Histopathology revealed a vascular tumor consisting of both small (capillary and large (cavernous sized vessels. A diagnosis of mixed type of hemangioma of the frontal bone was given. Recognition of hemangioma on radiology and confirmation by histopathology is essential for proper management as it might be confused clinically with other locally aggressive/malignant lesions.

  5. 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.

  6. Megaendoprosthesis in the treatment of bone tumors in the knee and hip region

    Directory of Open Access Journals (Sweden)

    Barjaktarović Radoslav

    2011-01-01

    Full Text Available Background/Aim. For almost two decades extremity amputation has not been the only viable option for patients with from bone cancer in the region of the hip and knee. Remarkable advances in implant technology, surgical reconstructive technique and adoption of new chemotherapy protocols provide a new option for surgeons who diagnose and treat bone tumors. Megaendoprosthesis has become widely accepted alternative in limb salvage surgery of the extremities. The aim of this study was to present an outcome of the treatment of bone tumors in the knee and hip region by the use of custom made megaendoprothesis. Methods. In the period 2006-2008 we adopted new clinical practice protocols for preoperative management in candidates for tumor megaprostheses of the hip and knee including: surgical tumor staging, histopathological verification, determinants of anatomical-mechanical defect, status of soft tissues, CT evaluation of the referent measures of pelvis, femur and tibia necessary for creation of custom made endoprosthesis and surgery plan, as well as modern, less invasive surgical approach. The patients were monitored during ≥ 24 months after the surgery for detecting possible complications. Results. All procedures were performed without complications during and immediately after the surgery. During the follow-up period not less than 24 months we failed to record any significant complications. Conclusion. Custom made megaendoprosthesis are the method of choice in the treatment of bone tumors in the region of the hip and knee at the Orthopedics and Traumatology Clinic, Military Medical Academy, Belgrade. The greatest challenge - ensuring longevity of a prosthesis can be achieved not only by prevention of common complications of arthroplasty procedures but, certainly, with the introduction of new methods for preoperative planning - computer-assisted technique of measuring referent sizes and software solutions for the selection and design of custom

  7. Surgical treatment and outcomes of temporal bone chondroblastoma.

    Science.gov (United States)

    Moon, In Seok; Kim, Jin; Lee, Ho-Ki; Lee, Won-Sang

    2008-12-01

    Chondroblastoma is an uncommon primary benign bone tumor that usually arises in the epiphyses of the long bones. Temporal bone chondroblastoma is a rare primary bone tumor that affects the floor of the middle cranial fossa and temporomandibular joint (TMJ). The biological nature of temporal bone chondroblastoma is occasionally aggressive because of local invasion and is known to have a high recurrence after curettage. Therefore, complete resection is recommended. However, the literature provides little information regarding long-term surgical outcomes and complications after surgical resection. The authors have retrospectively analyzed four cases of temporal bone chondroblastoma that had been completely excised by a single surgeon with an eventual long-term follow-up. A single surgeon operated on four patients, two males and two females, with a mean age of 34 years, at the Department of Otorhinolaryngology, Severance Hospital. In all cases, the tumor involved the middle cranial fossa dura and the mandibular fossa with variable degree of infiltration. All patients have had no tumor recurrence to date (mean follow-up period of 5 years). Complete surgical resection of the temporal bone chondroblastoma is the gold standard for treatment. Precise preoperative image evaluation of tumor extension and proper management of the dura mater and temporomandibular joint (TMJ) are the major important features in complete surgical removal that minimize complications in temporal bone chondroblastoma treatment.

  8. 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.

  9. 内镜治疗胃胃肠间质瘤的可行性%Feasibility of endoscopic resection for gastric gastrointestinal stromal tumor

    Institute of Scientific and Technical Information of China (English)

    姚礼庆; 钟芸诗; 何梦江

    2012-01-01

    In recent years,with the development of digestive endoscopy,endoscopic submucosal dissection (ESD) and its derived techniques including endoscopic submucosal excavation (ESE),submucosal tunnelling endoscopic resection (STER) and laparoscopic endoscopic combined surgery(LECS),can cure most of the gastric gastrointestinal stromal tumor (GIST).This article reviews the indication, method and evaluation of endoscopic resection for gastric GIST.%近年来,随着消化内镜技术的发展,以内镜黏膜下剥离术(ESD)及其衍生技术包括内镜黏膜下挖除术(ESE)、内镜下全层切除技术(EFR)、内镜经隧道肿瘤切除术(STER)和腹腔镜内镜联合手术(LECS)等的内镜切除技术可治疗绝大多数的胃GIST.本文就内镜治疗胃GIST的指征、方法和疗效评价进行评述.

  10. 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.

  11. RABL6A Promotes Oxaliplatin Resistance in Tumor Cells and Is a New Marker of Survival for Resected Pancreatic Ductal Adenocarcinoma Patients.

    Science.gov (United States)

    Muniz, Viviane P; Askeland, Ryan W; Zhang, Xuefeng; Reed, Sara M; Tompkins, Van S; Hagen, Jussara; McDowell, Bradley D; Button, Anna; Smith, Brian J; Weydert, Jamie A; Mezhir, James J; Quelle, Dawn E

    2013-07-01

    Pancreatic ductal adenocarcinoma (PDAC) is characterized by early recurrence following pancreatectomy, rapid progression, and chemoresistance. Novel prognostic and predictive biomarkers are urgently needed to both stratify patients for clinical trials and select patients for adjuvant therapy regimens. This study sought to determine the biological significance of RABL6A (RAB, member RAS oncogene family-like protein 6 isoform A), a novel pancreatic protein, in PDAC. Analyses of RABL6A protein expression in PDAC specimens from 73 patients who underwent pancreatic resection showed that RABL6A levels are altered in 74% of tumors relative to adjacent benign ductal epithelium. Undetectable RABL6A expression, found in 7% (5/73) of patients, correlated with improved overall survival (range 41 to 118 months with 3/5 patients still living), while patients with RABL6A expression had a worse outcome (range 3.3 to 100 months, median survival 20.3 months) (P = 0.0134). In agreement with those findings, RABL6A expression was increased in pancreatic cancer cell lines compared to normal pancreatic epithelial cells, and its knockdown inhibited pancreatic cancer cell proliferation and induced apoptosis. Moreover, RABL6A depletion selectively sensitized cells to oxaliplatin-induced arrest and death. This work reveals that RABL6A promotes the proliferation, survival, and oxaliplatin resistance of PDAC cells, whereas its loss is associated with extended survival in patients with resected PDAC. Such data suggest RABL6A is a novel biomarker of PDAC and potential target for anticancer therapy.

  12. Automated segmentation of tumors on bone scans using anatomy-specific thresholding

    Science.gov (United States)

    Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Lu, Peiyun; Ramakrishna, Bharath; Gjertson, David; Poon, Cheryce; Auerbach, Martin; Goldin, Jonathan; Brown, Matthew S.

    2012-03-01

    Quantification of overall tumor area on bone scans may be a potential biomarker for treatment response assessment and has, to date, not been investigated. Segmentation of bone metastases on bone scans is a fundamental step for this response marker. In this paper, we propose a fully automated computerized method for the segmentation of bone metastases on bone scans, taking into account characteristics of different anatomic regions. A scan is first segmented into anatomic regions via an atlas-based segmentation procedure, which involves non-rigidly registering a labeled atlas scan to the patient scan. Next, an intensity normalization method is applied to account for varying levels of radiotracer dosing levels and scan timing. Lastly, lesions are segmented via anatomic regionspecific intensity thresholding. Thresholds are chosen by receiver operating characteristic (ROC) curve analysis against manual contouring by board certified nuclear medicine physicians. A leave-one-out cross validation of our method on a set of 39 bone scans with metastases marked by 2 board-certified nuclear medicine physicians yielded a median sensitivity of 95.5%, and specificity of 93.9%. Our method was compared with a global intensity thresholding method. The results show a comparable sensitivity and significantly improved overall specificity, with a p-value of 0.0069.

  13. Gene transfection in primary stem-like cells of giant cell tumor of bone.

    Science.gov (United States)

    Singh, Shalini; Mak, Isabella; Power, Patricia; Cunningham, Melissa; Cunnigham, Melissa; Turcotte, Robert; Ghert, Michelle

    2010-01-01

    The neoplastic stem-like stromal cell of giant cell tumor of bone (GCT) survives for multiple passages in primary culture with a stable phenotype, and exhibits multipotent characteristics. The pathophysiology of this tumor has been studied through the primary culture of these cells. However, successful gene transfer of these cells has not been reported to date. In this short report, we describe the development of the first reported technique that results in efficient gene transfection in primary stem-like cells of GCT.

  14. [Giant cell tumor of the 4th metacarpal bone of the left hand. Apropos of a case].

    Science.gov (United States)

    Kamel, E J; Pinto, J A; Potenza, L; Michelena, A; Perez Signini, F; Fuenmayor, A

    1983-01-01

    He is a 46 year old patient that consults on a tumor that deforms the back of his left hand. The X-ray examination shows a bone osteolytic tumor with complete dis appearance of the 4th metacarpal. Surgical removal of the tumor was practiced with immediate reconstruction of the 4th metacarpal by an oseo-iliac graft. Anatomopathological examination. It is an ovoid tumor 6.5 long and irregular surface.

  15. Reconstruction of the extensor mechanism after major knee resection.

    Science.gov (United States)

    Mavrogenis, Andreas F; Angelini, Andrea; Pala, Elisa; Sakellariou, Vasileios I; Ruggieri, Pietro; Papagelopoulos, Panayiotis J

    2012-05-01

    In periarticular knee resections, the relative lack of soft tissue coverage and need to reattach the extensor mechanism after en bloc resection of the tibial tuberosity with the tumor specimen complicate reconstructions and decrease postoperative function and stability of the knee joint. Distal femoral reconstructions are less problematic; muscular attachments are relatively few, neurovascular structures are not immediately adjacent to bone, and the knee extensor mechanism is usually not compromised from bone tumors. In the proximal tibia, the close proximity of the neurovascular structures in the popliteal fossa and peroneal nerve at the lateral aspect of the leg make reconstruction more difficult. Poor function is mostly related to unreliable options for knee extensor mechanism reattachment and poor soft tissue coverage. Successful and reliable attachment of the soft tissues has been a significant advance that improved functional outcomes.This article describes techniques for the reconstruction of the extensor mechanism of the knee after proximal tibia resections. Combined reconstruction techniques using direct reattachment of the patellar tendon with synthetic materials to megaprosthetic or allograft reconstructions for immediate stability, augmentation with autologous bone graft or substitutes at the attachment site, and coverage with the medial gastrocnemius muscle flap and supplementary flaps for long-term stability of the reattachment are currently considered the gold standard.

  16. 骶骨肿瘤切除术辅助氩氦刀的临床疗效分析%An analysis of clinical effects of surgical resection of sacral tumors adjuvant with Cryo-Hit

    Institute of Scientific and Technical Information of China (English)

    彭智恒; 王吉兴; 江建明; 瞿东滨; 鲁凯伍; 蒋晖; 王海明; 陈建庭

    2014-01-01

    Objective To evaluate the clinical effects of surgical resection of sacral tumors adjuvant with Cryo-Hit. Methods From January 2007 to December 2012, the clinical data of 15 consecutive patients with sacral tumors who were treated with resection adjuvant with Cryo-Hit and were followed up were retrospectively analyzed. There were 9 males and 6 females, whose average age was 51.3 years old ( range;38-78 years ). There were 12 cases of chordomas, 1 case of giant cell tumor of bone, 1 case of ifbromatosis in the sacroiliac region and 1 case of metastatic tumor in the sacrum, which were conifrmed by the postoperative pathology. Tumors were found in S2 ( n=8 ) and below S3 ( n=6 ). Recurrence was noticed in the buttock in 1 case. The course ranged from 2 months to 9 years. Sacrococcygeal pain occurred in 90%of all the patients, sciatica in 6 patients, and bladder and ( or ) rectal dysfunction in varying degrees in 12 patients. All the patients received surgical resection of sacral tumors adjuvant with Cryo-Hit. A combination of anterior and posterior approaches was adopted in 14 patients. In the anterior approach isolation and exposure of tumors was performed under laparoscope, and in the posterior approach Cryo-Hit was used to freeze and completely resect tumors. Palliative posterior surgery was performed alone on 1 patient with metastatic tumor in the sacrum, due to the poor body condition. Results The mean operation time was 315 min, and the mean blood loss was 1065 ml. The mean drainage lfow was 635 ml, and the mean postoperative hospital stay was 19.2 days. All the patients were followed up for an average period of 26 months ( range;5-48 months ). There were 14 patients alive, and the total survival rate was 93.3%. The bilateral nerve roots in S2 and above were successfully spared in all the patients, and no motor or sensory disturbances of lower limbs were noticed. The Visual Analogue Scale ( VAS ) scores were ( 6.80±1.52 ) points and ( 2.33±0.90 ) points

  17. Aesthetic considerations and treatment of parotid tumor resection%腮腺肿瘤切除术的美容考虑与处理

    Institute of Scientific and Technical Information of China (English)

    蒋榕林; 李军; 沈宁; 董皓

    2012-01-01

    Objective To investigate the small incision in clinical use of a benign tumor resection and aesthetic treatment. Methods Select the 32 cases of parotid gland under paragraph benign tumor patients with tumor diameter less than 2cm,use of mandibular incision,anatomy of the marginal mandibular branch and buccal branch of facial nerve,retain the parotid duct.operation resection of parotid tumor and regional parotid gland,use the parotid gland tissue flap transfer to repair tissue defects of mandibular posterior region. Results In 32 patients the wound healing well,follow-up 2 years after surgery,no recurrence of patients and gustatory sweating syndrome patients,the scar short and local depression is not obvious.no permanent facial paralysis cases. Conclusion Occur in the parotid gland under section and diameter less than 2cm benign tumor, resection of the tumor through a small incision,use the parotid gland tissue flap transfer to repair tissue defects of mandibular posterior region,reduce the surgical trauma and complications.to improve local tissue depression,get a satisfactory aesthetic effect.%目的:探讨小切口在腮腺良性肿瘤切除术中的临床应用、美学处理及利用腮腺残端组织修复组织缺损的方法.方法:选择肿瘤直径< 2cm,发生在腮腺下极良性肿瘤患者32例,采用下颌升支后缘切口,解剖面神经下颌缘支及下颊支,保留腮腺导管,行腮腺肿瘤及区域性腮腺切除术,用腮腺残端组织瓣转移修复下颌后区组织缺损.结果:32例患者术后伤口愈合良好,随访2年,无术后复发及味觉出汗综合征患者,瘢痕短,局部凹陷不明显,无永久性面瘫发生.结论:针对发生在腮腺下极且直径< 2cm的良性肿瘤,经小切口切除肿瘤,用腮腺残端组织转移修复缺损的手术方式,减少了手术创伤及并发症,改善局部组织凹陷,获得满意的手术效果和美学效果.

  18. Characterization and Clinical Implication of Th1/Th2/Th17 Cytokines Produced from Three-Dimensionally Cultured Tumor Tissues Resected from Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Anna Kiyomi

    2015-08-01

    Full Text Available OBJECTIVES: Several cytokines secreted from breast cancer tissues are suggested to be related to disease prognosis. We examined Th1/Th2/Th17 cytokines produced from three-dimensionally cultured breast cancer tissues and related them with patient clinical profiles. METHODS: 21 tumor tissues and 9 normal tissues surgically resected from breast cancer patients were cultured in thermoreversible gelatin polymer–containing medium. Tissue growth and Th1/Th2/Th17 cytokine concentrations in the culture medium were analyzed and were related with hormone receptor expressions and patient clinical profiles. RESULTS: IL-6 and IL-10 were expressed highly in culture medium of both cancer and normal tissues. However, IFN-γ, TNF-α, IL-2, and IL-17A were not detected in the supernatant of the three-dimensionally cultured normal mammary gland and are seemed to be specific to breast cancer tissues. The growth abilities of hormone receptor–negative cancer tissues were significantly higher than those of receptor-positive tissues (P = 0.0383. Cancer tissues of stage ≥IIB patients expressed significantly higher TNF-α levels as compared with those of patients with stage tumor tissues resected from breast cancer patients can grow in the three-dimensional thermoreversible gelatin polymer culture system and produce Th1/Th2/Th17 cytokines. Hormone receptor–positive cancer tissues showed less growth ability. TNF-α is suggested to be a biomarker for the cancer stage.

  19. Inflammation and tumors of the temporal bone; Entzuendungen und Tumoren des Schlaefenbeins

    Energy Technology Data Exchange (ETDEWEB)

    Burian, M. [Universitaetsklinik fuer Hals-, Nasen- und Ohrenkrankheiten, Allgemeines Krankenhaus, Wien (Austria)

    1997-12-01

    The term `inflammation of the middle ear` covers a couple of deseases which range from the acute otitis media to the middle ear cholesteatoma. However, a clear characterization of a certain pathology is essential for any further treatment. Therefore this article presents a short overview about the different types of infections and their clinical manifestation. The tumors of the temporal bone show a great variety in their incidence. Even if tumors like the acoustic neurinoma or the paraganglioma are compareable common, the chondroblastoma of the temporal bone is absolutely rare. In spite of these differences the individual temporal bone neoplasias are shortly mentioned herein. (orig.) [Deutsch] Der Begriff Mittelohrentzuendung umfasst ein weites Spektrum von Krankheiten welches von der akuten Mittelohrentzuendung bis hin zum Cholesteatom reicht. Es soll in diesem Artikel eine kurze Uebersicht ueber die verschiedenen Entzuendungen gegeben werden, wobei vor allem auf eine klare Begriffsdefinition der einzelnen Entzuendungsformen und deren klinisches Erscheinungsbild geachtet wurde. Bei den Tumoren des Schlaefenbeins ist ein grosser Unterschied in der Inzidenz der einzelnen Tumoren gegeben. Waehrend Neubildungen wie das Akustikusneurinom oder das Paragangliom vergleichsweise haeufig im klinischen Alltag zu sehen sind, stellen Veraenderungen wie das Chondroblastom eine Raritaet dar. Trotz dieses Unterschieds im Vorkommen der verschiedenen Tumoren, wurde versucht, einen kurzen Gesamtueberblick ueber die Tumore des Mittel- und Innenohres zu geben. (orig.)

  20. 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.

  1. Diagnostic guidelines and treatment of benign bone tumors; Diagnostisch-therapeutisches Vorgehen bei gutartigen Knochentumoren

    Energy Technology Data Exchange (ETDEWEB)

    Dominkus, M.; Krepler, P.; Schwameis, E.; Kotz, R. [Vienna Univ. (Austria). Orthopaedische Klinik

    2001-07-01

    The indications of surgical treatment of benigne bone tumours are strongly related to the clinical behaviour, the patient's complaints and the activity in Tc-bone scan. Some lesions - like the nonossifying fibroma - that can safely be diagnosed by conventional X-rays may not be treated surgically - as long as the patients are free of pain, and there is no risk of pathologic fracture. In case of clinically relevant lesions, activity in Tc-bone scan, or a risk of fracture, biopsy and curettage combined with autologous or homologous bone grafting is indicated. Some aggressive tumors, like the giant cell tumor, have to be treated more aggressively by curettage with adjuvant measures (Phenole) or by marginal excision. (orig.) [German] Die Indikation zur operativen Sanierung benigner Knochentumoren richtet sich nach ihrem klinischen Verhalten, dem Beschwerdebild des Patienten, und der Aktivitaet im Knochenscan. Generell koennen klinisch stumme Laesionen wie das NOF beobachtet werden, waehrend Laesionen die entweder klinische Beschwerden verursachen, im Knochenscan speichern, oder aufgrund ihrer Ausdehnung eine Frakturgefahr darstellen, entsprechend den angegebenen Richtlinien abgeklaert und behandelt werden sollen. (orig.)

  2. 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.

  3. 累及骶髂关节原始神经外胚瘤的整块切除与骨盆环重建术一例报道并文献复习%En bloc resection of primitive neuroectodermal tumor involving the sacroiliac joint and reconstruction of the pelvic ring: a case report and literature review

    Institute of Scientific and Technical Information of China (English)

    于秀淳; 徐明; 许宋锋; 付志厚; 袁冶

    2012-01-01

    Objective To investigate the possibility of clinical application of en bloc resection of primitive neuroectodermal tumor (PNET) involving the sacroiliac joint and reconstruction of the pelvic ring. Methods 1 female patient with PNET involving the sacroiliac joint was treated in our hospital in February 2009. She underwent 2 cycles of preoperative chemotherapy and 1 cycle of radiotherapy as the diagnosis was made by preoperative puncture. And then she received en bloc resection and reconstruction of the pelvic ring under general anesthesia. Postoperatively she accepted 10 cycles of chemotherapy. Results No recurrence and metastasis was found during the postoperative follow-up of 36 months, and she recovered to normal now. Conclusions It is particularly challenging to treat the patients with malignant bone tumors involving the sacroiliac joint because of the complicated anatomy of tumors and some other problems. However, it is possible to perform en bloc resection of tumors as long as the comprehensive methods such as preoperative chemotherapy, radiotherapy and so on are used and the therapy procedure of malignant bone tumors is strictly followed.%@@ 骶骨和骨盆环处恶性肿瘤的保肢治疗具有相当高起,局部皮温升高.L5~S3棘突左侧压痛、叩击痛的挑战性,该部位解剖毗邻关系复杂、存在重要脏阳性,无放射痛,鞍区及双下肢感觉无异常,双下器和神经血管等常使手术难以达到恶性骨肿瘤的外肢肌力V级.肛门收缩正常.左侧"4字"试验阳科边界[1] .恶性肿瘤一旦侵及骶髂关节,手术过程性,双侧膝腱、右跟腱反射正常,左侧跟腱反射消中需要将肿瘤组织包括骶髂关节一并切除,同时重失.

  4. Diagnosis and treatment for primary bone tumor of the talus%距骨原发肿瘤的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    杨发军; 刘巍峰; 牛晓辉; 丁易

    2011-01-01

    Objective To analyze the clinical feature, surgical treatment and prognosis of primary bone tumor of the talus.Methods From January 1993 to December 2008, 21 patients of primary bone tumor and tumor-like lesion in the talus were retrospectively analyzed.The feature of bone tumor of the talus was analyzed from clinical, imaging and pathological aspects.All patients underwent surgical treatment.During postoperative follow-up, the function of patients was evaluated according to the criteria of musculoskeletal tumor society (MSTS).Results In all 21 patients,there were chondroblastoma (10 cases), giant cell tumor of bone (7 cases), osteoid osteoma (1 case), aneurysmal bone cysts (1 case), simple bone cysts (1 case), and osteofibrous dysplasia (1 case).Among 10 patients with chondroblastoma,the mean age was 22 years old (range; 10-35years).All 10 patients were performed curettage.1 patient was performed curettage and filled with bone cement.9 patients were performed curettage and bone grafting.No recurrence appeared among 9 patients with complete follow-up.The follow-up lasted for 15-87 months, and the median follow-up was 36 months.The function score (MSTS) was all 30.The mean age of onset of 7 patients with giant cell tumor of bone was 24 years old (range; 20-33years).Through image text, all cases suffered osteolytic damage.No calcification existed in ground substance.4 patients were primary cases and conducted curettage.3 cases relapsed.2 cases were performed astragalectomy and fusion of calcaneus and tibia.1 patient was applied crus amputation.3 patients had complete followup, and 2 patients were primary cases.Postoperatively, no recurrence happened within 10 and 32 months respectively.Recurrence happened in 1 case.No recurrence happened in follow-up lasting for 36 months.The function scores were respectively 26, 29 and 24.For other four patients with diagnosis, 1 patient with osteoid osteoma received lesion resection and bone grafting and 3 patients received

  5. Radionuclide bone scanning in neuroblastoma: skeletal metastases and primary tumor localization of /sup 99m/Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Podrasky, A.E.; Stark, D.D.; Hattner, R.S.; Gooding, C.A.; Moss, A.A.

    1983-09-01

    Of 42 radionuclide bone scans in 35 children with neuroblastoma, 21 were abnormal for the presence of skeletal metastases. Of the 21 abnormal scans, 16 were corroborated by positive bone-marrow biopsy or clinical data. The false-negative and false-positive rates for bone scanning were 4.8% and 9.5%, respectively. Calcification of the primary tumor was seen on pretreatment computed tomographic (CT) scans in 24 (89%) of 27 cases, while only 13 (48%) of 27 were detectable by plain radiographs. Uptake of /sup 99m/Tc methylene diphosphate /sup 99m/Tc-MDP) by the primary tumor occurred in 20 of 27 cases, but correlation between tumor uptake and calcification was not statistically significant. All children with markedly elevated urinary vanillylmandelic acid exhibited primary tumor uptake. Survival was not affected independently by primary tumor uptake.

  6. Tumor Size on Abdominal MRI Versus Pathologic Specimen in Resected Pancreatic Adenocarcinoma: Implications for Radiation Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Hall, William A., E-mail: whall4@emory.edu [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Mikell, John L. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Mittal, Pardeep [Department of Radiology, Emory University, Atlanta, Georgia (United States); Colbert, Lauren [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Prabhu, Roshan S. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Kooby, David A. [Department of Surgery, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Nickleach, Dana [Biostatistics and Bioinformatics Shared Resource, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hanley, Krisztina [Department of Pathology, Emory University, Atlanta, Georgia (United States); Sarmiento, Juan M. [Department of Surgery, Emory University, Atlanta, Georgia (United States); Ali, Arif N.; Landry, Jerome C. [Department of Radiation Oncology, Emory University, Atlanta, Georgia (United States); Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2013-05-01

    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

  7. Primary diaphyseal osteosarcoma in long bones: Imaging features and tumor characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Cheng-Sheng, E-mail: wangchsh2011@hotmail.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai 200025 (China); Yin, Qi-Hua, E-mail: 843003910@qq.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai 200025 (China); Liao, Jin-Sheng, E-mail: liaojinsheng850929@163.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai 200025 (China); Lou, Jiang-Hua, E-mail: loujianghua1985@163.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai 200025 (China); Ding, Xiao-Yi, E-mail: dxyrj@hotmail.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai 200025 (China); Zhu, Yan-Bo, E-mail: zhuyanbo11@hotmail.com [Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197, Ruijin 2nd Road, Shanghai 200025 (China); Chen, Ke-Min, E-mail: chenkemin1@hotmail.com [Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai 200025 (China)

    2012-11-15

    Objective: This study aims to assess retrospectively the imaging features of diaphyseal osteosarcoma and compare its characteristics with that of metaphyseal osteosarcoma. Materials and methods: Eighteen pathologically confirmed diaphyseal osteosarcomas were reviewed. Images of X-ray (n = 18), CT (n = 12) and MRI (n = 15) were evaluated by two radiologists. Differences among common radiologic findings of X-ray, CT and MRI, and between diaphyseal osteosarcomas and metaphyseal osteosarcomas in terms of tumor characteristics were compared. Results: The common imaging features of diaphyseal osteosarcoma were bone destruction, lamellar periosteal reaction with/without Codman triangle, massive soft tissue mass/swelling, neoplastic bone and/or calcification. CT and MRI had a higher detection rate in detecting bone destruction (P = 0.001) as compared with that of X-ray. X-ray and CT resulted in a higher percentage in detecting periosteal reaction (P = 0.018) and neoplastic bone and/or calcification (P = 0.043) as compared with that of MRI. There was no difference (P = 0.179) in detecting soft tissue mass among three imaging modalities. When comparing metaphyseal osteosarcoma to diaphyseal osteosarcoma, the latter had the following characteristics: a higher age of onset (P = 0.022), a larger extent of tumor (P = 0.018), a more osteolytic radiographic pattern (P = 0.043). Conclusion: As compared with metaphyseal osteosarcoma, diaphysial osteosarcoma is a special location of osteosarcoma with a lower incidence, a higher age of onset, a larger extent of tumor, a more osteolytic radiographic pattern. The osteoblastic and mixed types are diagnosed easily, but the osteolytic lesion should be differentiated from Ewing sarcoma. X-ray, CT and MRI can show imaging features from different aspects with different detection rates.

  8. THE USE OF THE SADDLE PROSTHESIS FOR RECONSTRUCTION OF THE HIP-JOINT AFTER TUMOR RESECTION OF THE PELVIS

    NARCIS (Netherlands)

    VANDERLEI, B; HOEKSTRA, HJ; VETH, RPH; HAM, SJ; OLDHOFF, J; KOOPS, HS

    1992-01-01

    Reconstruction of the hip joint by a saddle prosthesis after excision of a malignant pelvic tumor is a relatively new method, which thus far has been mainly used for revision of infected hip arthroplasties. One patient with a metastatic cystosarcoma phyllodes and one patient with a chondrosarcoma of

  9. [A case of crossed aphasia with echolalia after the resection of tumor in the right medial frontal lobe].

    Science.gov (United States)

    Endo, K; Suzuki, K; Yamadori, A; Kumabe, T; Seki, K; Fujii, T

    2001-03-01

    We report a right-handed woman, who developed a non-fluent aphasia after resection of astrocytoma (grade III) in the right medial frontal lobe. On admission to the rehabilitation department, neurological examination revealed mild left hemiparesis, hyperreflexia on the left side and grasp reflex on the left hand. Neuropsychologically she showed general inattention, non-fluent aphasia, acalculia, constructional disability, and mild buccofacial apraxia. No other apraxia, unilateral spatial neglect or extinction phenomena were observed. An MRI demonstrated resected areas in the right superior frontal gyrus, subcortical region in the right middle frontal gyrus, anterior part of the cingulate gyrus, a part of supplementary motor area. Surrounding area in the right frontal lobe showed diffuse signal change. She demonstrated non-fluent aprosodic speech with word finding difficulty. No phonemic paraphasia, or anarthria was observed. Auditory comprehension was fair with some difficulty in comprehending complex commands. Naming was good, but verbal fluency tests for a category or phonemic cuing was severely impaired. She could repeat words but not sentences. Reading comprehension was disturbed by semantic paralexia and writing words was poor for both Kana (syllabogram) and Kanji(logogram) characters. A significant feature of her speech was mitigated echolalia. In both free conversation and examination setting, she often repeated phrases spoken to her which she used to start her speech. In addition, she repeated words spoken to others which were totally irrelevant to her conversation. She was aware of her echoing, which always embarrassed her. She described her echolalic tendency as a great nuisance. However, once echoing being forbidden, she could not initiate her speech and made incorrect responses after long delay. Thus, her compulsive echolalia helped to start her speech. Only four patients with crossed aphasia demonstrated echolalia in the literature. They showed severe

  10. 肩胛带骨肿瘤的外科治疗结果及评价%Surgical treatment of bone tumors of the shoulder girdle

    Institute of Scientific and Technical Information of China (English)

    郭卫; 杨毅; 姬涛

    2008-01-01

    Objective To evaluate the surgical procedures and both oncological and functional outcome in patients with bone tumors of the shoulder girdle.Methods Seventy-one patients including 61.pts with malignant tumor and 10 pts with giant cell tumors of the shoulder girdle treated in our department from July 1998 to July 2006 were studied retrospectively.According to the location,there were 15 pts with scapula tumor and 56 pts with proximal humeral tumor.Forty-two male pts and 29 female pts were included in this study with an average age of 36.5 years old ranging from 11.to 62 years old.Surgical procedures:forequarter amputation in 10 pts;Scapulectomy in 3 pts;Scapulectomy and artificial scapular replacement in 3pts;partial scapulectomy and proximal humerus resection with prosthetic reconstruction in 8 pts;proximal humerus resection and prosthesis replacement in 47 pts.Results Due to adequate soft tissue was preserved,the mean functional score was 28 for the pts with giant cell tumor according to MSTS functional scoring system,compared with the functional score 23 for the pts with malignant tumor because the deltoid muscle insertion was resected in the latter group.Among the thirty-seven patients with osteosarcoma,local recurrence occurred in four cases(10.8%),lung metastasis in five and bone metastasis in two.The seven patients died of disease.One patient iagnosed of malignancy in giant cell tumor died after distal metastasis.thtee patients with Ewing sarcoma died of the disease.No recurrence Wag observed in both five humeral chondrosarcoma and five scapular chondrosarcoma.Conclusion Tumot resection and proximal humeral prostbesis replacement is the optimal method for the sarcoma of shoulder girdle in term of preservation of elbow and hand function.Preservation of abductor insertion is necessary for good abduction function.The metastatic rate of proximal humeral osteosarcoma was lower than that of lower extremities.also the prognosis of oncological outcome

  11. Wide resection and knee joint reconstruction for malignant tumors of the proximal tibia%胫骨上端恶性骨肿瘤广泛切除与重建

    Institute of Scientific and Technical Information of China (English)

    杨志平; 杨强; 李昕; 李振峰; 李建民

    2011-01-01

    bone tumors of proximal tibia,27 males and 18 females,28 years in average (range, 12 -62 years). The tumors,including 25 osteosarcomas,7 malignant giant cell tumors,6 chondrosarcomas,3 malignant fibrous histiocytomas,3 fibrosarcomas and 1 lymphoma were treated with wide resection which performed through anteromedial incision in 30 cases and anterolateral incision in 15. The superior tibiofibuiar joints were involved and the proximal tibia resected en bloc in 13. Two knee joints were involved and extraarticuler resection were performed. Partial tumorous bone was devitalized and replanted in 5 cases and the anterior tibial vessels were ligated in 28. The involved knee joints were reconstructed with domestic-made prostheses and soft tissue coverage was improved by medial or lateral gastrocnemius flap and sagittal split anterior tibial muscle flap in some patients which tibia was removed longer. Neoadjuvant chemotherapy were performed to the patients with osteosarcoma and malignant fibrous histiocytoma. [ Result] With an average follow-up of 4.6 years ( range,8 months -9 years ),local recurrences occurred in four cases and lung metastases in six cases. One patients with malignant fibrous histiocytoma of proximal tibia had metastasis to L* after 6 years postoperatively and was treated with total en bloc spondylectomy. The complications related to the prostheses included peri-prosthetic infection in 3, prosthetic dis-location in 3, prosthesis loosening in 2, peri-prosthesis fracturein 1 and prosthetic fracture in 1. The average range of motion were 92 degrees (50 - 120 degrees) with the 4.4 degrees (0 - 20 degrees) of average extension lag. According to the Musculoskeletal Tumor Society ( MSTS ) Scoring system, the average functional score was 76.7%. [ Conclusion ] Wide resection and reconstruction for malignant tumor of proximal tib-la I- highly demanding. To achieve the goal of Limb salvage and _■■?." function, il is necessary to employ standard reseolion lech

  12. TU-B-210-01: MRg HIFU - Bone and Soft Tissue Tumor Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Ghanouni, P. [Stanford University (United States)

    2015-06-15

    MR guided focused ultrasound (MRgFUS), or alternatively high-intensity focused ultrasound (MRgHIFU), is approved for thermal ablative treatment of uterine fibroids and pain palliation in bone metastases. Ablation of malignant tumors is under active investigation in sites such as breast, prostate, brain, liver, kidney, pancreas, and soft tissue. Hyperthermia therapy with MRgFUS is also feasible, and may be used in conjunction with radiotherapy and for local targeted drug delivery. MRI allows in situ target definition and provides continuous temperature monitoring and subsequent thermal dose mapping during HIFU. Although MRgHIFU can be very precise, treatment of mobile organs is challenging and advanced techniques are required because of artifacts in MR temperature mapping, the need for intercostal firing, and need for gated HIFU or tracking of the lesion in real time. The first invited talk, “MR guided Focused Ultrasound Treatment of Tumors in Bone and Soft Tissue”, will summarize the treatment protocol and review results from treatment of bone tumors. In addition, efforts to extend this technology to treat both benign and malignant soft tissue tumors of the extremities will be presented. The second invited talk, “MRI guided High Intensity Focused Ultrasound – Advanced Approaches for Ablation and Hyperthermia”, will provide an overview of techniques that are in or near clinical trials for thermal ablation and hyperthermia, with an emphasis of applications in abdominal organs and breast, including methods for MRTI and tracking targets in moving organs. Learning Objectives: Learn background on devices and techniques for MR guided HIFU for cancer therapy Understand issues and current status of clinical MRg HIFU Understand strategies for compensating for organ movement during MRgHIFU Understand strategies for strategies for delivering hyperthermia with MRgHIFU CM - research collaboration with Philips.

  13. Intravenous chemotherapy combined with intravesical chemotherapy to treat T1G3 bladder urothelial carcinoma after transurethral resection of bladder tumor: results of a retrospective study

    Directory of Open Access Journals (Sweden)

    Zhang Y

    2016-01-01

    Full Text Available Yu Zhang,1,* Linguo Xie,1,* Tao Chen,1,* Wanqin Xie,2 Zhouliang Wu,1 Hao Xu,1 Chen Xing,1 Nan Sha,1 Zhonghua Shen,1 Yunkai Qie,1 Xiaoteng Liu,1 Hailong Hu,1 Changli Wu1 1Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin, 2Key Laboratory of Genetics and Birth Health of Hunan Province, The Family Planning Research Institute of Hunan Province, Changsha, People’s Republic of China *These authors contributed equally to this work Objective: The management of stage 1 and grade 3 (T1G3 bladder cancer continues to be controversial. Although the transurethral resection of bladder tumor (TURBT followed by intravesical chemotherapy is a conservative strategy for treatment of T1G3 bladder cancer, a relatively high risk of tumor recurrence and progression remains regarding the therapy. This study aimed to compare the efficacy of intravenous chemotherapy combined with intravesical chemotherapy versus intravesical chemotherapy alone for T1G3 bladder cancer after TURBT surgery. Methods: We retrospectively reviewed the cases of 457 patients who were newly diagnosed with T1G3 bladder urothelial carcinoma between January 2009 and March 2014. After TURBT, 281 patients received intravesical chemotherapy alone, whereas 176 patients underwent intravesical chemotherapy in combination with intravenous chemotherapy. Tumor recurrence and progression were monitored periodically by urine cytology and cystoscopy in follow-up. Recurrence-free survival and progression-free survival of the two chemotherapy strategies following TURBT were analyzed. Univariable and multivariable Cox hazards analyses were performed to predict the prognostic factors for tumor recurrence and progression. Results: The tumor recurrence rate was 36.7% for patients who received intravesical chemotherapy alone after TURBT, compared with 19.9% for patients who received intravenous chemotherapy combined with intravesical chemotherapy after

  14. 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.

  15. 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.

  16. 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

  17. 3D打印组配式骨盆假体重建骨盆肿瘤切除后骨缺损%Reconstruction with 3D-printed modular pelvic endoprostheses after pelvic tumor resection

    Institute of Scientific and Technical Information of China (English)

    郭卫; 王毅飞; 张熠丹; 姬涛

    2016-01-01

    目的 探讨骨盆肿瘤切除后理想的骨盆环及髋关节功能重建方法,验证3D打印技术用于骨盆重建的可行性.方法 2013年9月至2015年12月,共有35例患者接受骨盆肿瘤切除、3D打印组配式骨盆假体重建手术.根据En-neking骨盆外科分区方法确定切除及重建部位:Ⅰ区3例、Ⅱ+Ⅲ区12例、Ⅰ+Ⅱ区5例、Ⅰ+Ⅱ+Ⅲ区2例、Ⅰ+Ⅱ+Ⅳ区10例、Ⅰ+Ⅱ+Ⅲ+Ⅳ区3例.重建方法:3例应用3D打印髂骨假体,12例使用3D打印标准半骨盆假体,20例使用3D打印钉-棒半骨盆假体.结果 35例患者均为整块切除.肿瘤切除边界达到广泛切除15例,边缘切除14例,囊内切除6例,肿瘤切除边界满意率为82.9%(29/35).术后均获得随访,随访时间6~30个月,平均20.5个月.无瘤生存25例,带瘤生存5例,余5例因肿瘤转移而死亡.采用MSTS-93量表进行功能评价,30例存活患者末次随访时功能评分为9~26分,平均19.1分.3例应用髂骨假体重建者功能评分为20~25分,平均22.7分;12例应用标准半骨盆假体重建者为15~26分,平均19.8分;15例应用钉-棒半骨盆假体重建者为9~25分,平均17.7分.术后并发症包括7例切口延迟愈合及2例髋关节脱位,无一例发生深部感染.结论 应用3D打印技术制造骨盆假体有利于假体与截骨面的精确匹配及骨长入.短期随访结果证实应用3D打印组配式骨盆假体重建骨盆肿瘤切除后骨缺损的安全性高,不增加额外并发症,并可获得良好的功能状态.%Objective To investigate the ideal reconstruction methods after pelvic tumor resection and to assess the feasibility of three-dimensional (3D) printing technology for pelvic reconstruction,we performed a retrospective study of patients with pelvic tumors who received tumor resection and reconstruction using 3D-printed pelvic endoprostheses.Methods Thirty-five patients received tumor resection and functional reconstruction with 3D-printed pelvic endoprostheses

  18. 3D打印技术在股骨远端骨肿瘤的应用%Application of 3D Printing Technology in the Treatment of Distal Femur Bone Tumor

    Institute of Scientific and Technical Information of China (English)

    马立敏; 张余; 周烨; 周霞; 夏虹; 蓝国波

    2013-01-01

    Objective:To investigate the application of individual digital resection plate in the treatment of bone tumor. Methods:Twenty-three patients with bone tumor by spiral CT scanner and MRI. The data was reconstructed by 3D imaging reconstruction workstation. The operation was simulated and the individual resection plate was designed on the virtual 3D model according to the surgical procedure. With the rapid prototyping technology, the individual resection plate was produced to guide the reduction of the bone tumor. Results:The average follow-up times were 48 months. No local recurrence, endoprostheses infection, loosening and fracture happened. Average scoring was 21 points according to Enneking system. Conclusion:Individual digital reduction plate is helpful in accurate reduction of bone tumor and can also save the operation time.%  目的:探讨个体化数字导板在股骨远端骨肿瘤的应用。方法:23例股骨远端患者,术前行64排螺旋CT扫描和MRI3.0T扫描,进行三维重建和股骨模型上模拟手术并设计复位导板,通过快速成型技术制作实体导板,术中引导骨肿瘤截骨。术后对手术效果进行评价。结果:平均随访48个月,无局部复发,无假体周围感染、松动及断裂事件发生。术后6个月以上进行功能评分,优16例,良5例,中2例,Enneking得分平均21分。结论:个体化数字导板应用于股骨远端骨肿瘤,可以明确骨折的复位位置,有利于骨折的精确复位,并且减少了手术的操作时间,达到更佳手术效果。

  19. MicroRNAs and Osteolytic Bone Metastasis: The Roles of MicroRNAs in Tumor-Induced Osteoclast Differentiation

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    Tadayoshi Kagiya

    2015-08-01

    Full Text Available Osteolytic bone metastasis frequently occurs in the later stages of breast, lung, and several other cancers. Osteoclasts, the only cells that resorb bone, are hijacked by tumor cells, which break down bone remodeling systems. As a result, osteolysis occurs and may cause patients to suffer bone fractures, pain, and hypercalcemia. It is important to understand the mechanism of bone metastasis to establish new cancer therapies. MicroRNAs are small, noncoding RNAs that are involved in various biological processes, including cellular differentiation, proliferation, apoptosis, and tumorigenesis. MicroRNAs have significant clinical potential, including their use as new therapeutic targets and disease-specific biomarkers. Recent studies have revealed that microRNAs are involved in osteoclast differentiation and osteolytic bone metastasis. In this review focusing on microRNAs, the author discusses the roles of microRNAs in osteoclastogenesis and osteolytic bone metastasis.

  20. 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.

  1. Transdifferentiation of Small Cell Carcinoma of the Urinary Bladder from Urothelial Carcinoma after Transurethral Resection of a Bladder Tumor, Intravesical Bacillus Calmette-Guerin Instillation, and Chemotherapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Kento Morozumi

    2016-11-01

    Full Text Available A 73-year-old male underwent transurethral resection of a bladder tumor in August 2010 and April 2011. Pathological examination revealed urothelial carcinoma. After the surgery, chemotherapy and intravesical Bacillus Calmette-Guerin instillation were performed. In September 2014, he once again underwent transurethral resection of the bladder tumor for recurrence, and was again diagnosed with urothelial carcinoma, pT2, by pathological examination. After neoadjuvant chemotherapy, radical cystectomy for tumor recurrence was performed. Pathological examination at this time revealed small cell carcinoma, pT3N0. It is rare for urothelial carcinoma to change to small cell carcinoma, and the mechanism and cause of this change are still unknown. In this case report, we discuss what causes small cell carcinoma of the urinary bladder and review the literature regarding its origin.

  2. Chondrosarcoma of the hand: is a wide surgical resection necessary?

    Science.gov (United States)

    Mittermayer, Florian; Dominkus, Martin; Krepler, Petra; Schwameis, Eva; Sluga, Maria; Toma, Cyril; Lang, Susanna; Grampp, Stephan; Kotz, Rainer

    2004-07-01

    Chondrosarcomas of the hand are rare and generally treated with surgical resection. Thirteen patients with Grade 1 chondrosarcoma of the small bones of the hand were followed up for a mean of 99.8 months (range, 26-293 months). In eight patients (Group 1) curettage and reconstruction with cancellous bone was done and in five patients (Group 2) a wide resection was done. No patient experienced relapse in Group 2. In Group 1 one patient had a local relapse 18 months after intralesional resection. Using the Musculoskeletal Tumor Society score for evaluation, the clinical results showed an average of 98% and 95% of the normal function in Groups 1 and 2, respectively. None of the patients had evidence of systemic spread of the disease. With a relapse rate of 12.5% and no distant metastases after curettage, intralesional resection is the preferred method of treatment in Grade 1 chondrosarcoma of the hand, allowing the patient to avoid amputation and major loss of function.

  3. Investigation on tumor hypoxia in resectable primary prostate cancer as demonstrated by {sup 18}F-FAZA PET/CT utilizing multimodality fusion techniques

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Parra, Rita [University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI (United States); University of Milan Bicocca, Department of Nuclear Medicine, Monza (Italy); Wood, David [University of Michigan, Urology Department, Ann Arbor, MI (United States); Shah, Rajal B.; Siddiqui, Javed [University of Michigan, Pathology Department, Ann Arbor, MI (United States); Hussain, Hero; Meyer, Charles [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Park, Hyunjin [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Gachon University of Medicine and Science, Department of Biomedical Engineering, Incheon (Korea, Republic of); Desmond, Timothy; Piert, Morand [University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI (United States)

    2011-10-15

    As hypoxia is believed to play an important role in the development and progression of prostate cancer, we evaluated whether {sup 18}F-labeled fluoroazomycin arabinoside ({sup 18}F-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 {sup 18}F-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 1{alpha} (HIF-1{alpha}). 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 {sup 18}F-FAZA, MRI, and histological 3-D image information. None of these lesions was found to be positive for CAIX or visualized by {sup 18}F-FAZA PET/CT while IHC for HIF-1{alpha} showed variable staining of tumor tissues. Accordingly, no correlation was found between {sup 18}F-FAZA uptake and Gleason scores. Our data based on {sup 18}F-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-1{alpha} may be independent of tissue hypoxia in primary prostate cancer. (orig.)

  4. 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

  5. Gamma probe-assisted brain tumor microsurgical resection: a new technique Ressecção microcirúrgica de tumor cerebral assistida por detector gama: uma nova técnica

    Directory of Open Access Journals (Sweden)

    Osvaldo Vilela Filho

    2002-12-01

    Full Text Available OBJECTIVES: The pioneering performance of gamma probe-assisted surgery (GPAS for brain tumors, aiming not only an improvement of tumor detection, but mainly assurance of its complete removal and the study of the usual distribution of the 99mTc-MIBI in the brain SPECT of normal individuals. METHOD: Patient's informed consent and demonstration of the tumor by the preoperative MIBI SPECT were the inclusion criteria adopted for GPAS, which was performed in one patient with a right parietal lobe metastatic tumor. The radiotracer (99mTc-MIBI was injected in a peripheral vein 5 hours before the operation. A tumor to-normal tissue count ratio equal to or greater than 2/1 was considered indicative of tumor. MIBI SPECT was performed in five normal individuals in a pilot study. RESULTS: The gamma probe greatly facilitated intraoperative tumor detection (tumor to-normal brain count ratio was 5/1 and indicated a small piece of residual tumor after what was thought to be a complete tumor removal, allowing its resection, which, otherwise, would have been left behind. Postoperative CT confirmed complete tumor resection. The MIBI SPECT in normal individuals showed an increased uptake by the hypophisis, choroid plexus, skull, scalp and salivary glands and absence of uptake by the normal brain tissue. There were no complications. CONCLUSION: GPAS proved to be, in this single case, a safe and reliable technique to improve brain tumor detection and to confirm the presence or absence of residual tumor.OBJETIVOS: A realização pioneira de cirurgia assistida por detector gama (CADG para tumores cerebrais, objetivando-se não apenas a identificação do tumor, mas, sobretudo, assegurar-se quanto à sua completa ressecção e estudar a distribuição usual do 99mTc-MIBI no SPECT cerebral de indivíduos normais. MÉTODO: O consentimento informado do paciente e a demonstração do tumor pelo SPECT pré-operatório com MIBI foram os critérios de inclusão adotados para a

  6. Endoscopically assisted resection of a scapular osteochondroma causing snapping scapula syndrome

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    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.

  7. Extracapsular wide resection of a femoral neck osteosarcoma and its reconstruction using a pasteurized autograft-prosthesis composite: A case report.

    Science.gov (United States)

    Yasuda, Taketoshi; Hori, Takeshi; Suzuki, Kayo; Hachinoda, Jun; Matsushita, Isao; Ito, Yoshiaki; Kanamori, Masahiko; Kimura, Tomoatsu

    2013-10-01

    The requirement for an extracapsular resection is indicated for malignant bone tumors that have disseminated intracapsularly. Extracapsular resections are often performed for malignant tumors arising from the knee joint, but there are relatively few studies that have described an extracapsular resection of a tumor arising from the hip joint. The present study describes a case of extracapsular wide resection of the hip joint using rotational acetabular osteotomy. The patient was a 17-year-old female and the diagnosis was an osteoblastic osteosarcoma with a pathological fracture of the femoral neck. The joint was reconstructed using an allograft-implant composite graft and total hip arthroplasty. Although the patient presented a slight Trendelenburg gait, no recurrence or metastases were identified during a follow-up period of 3 years. The clinical features and surgical procedure of the case are described.

  8. Preparation and bio-distribution of bone tumor therapeutic radiopharmaceutical 153Sm-TTHMP

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    TTHMP (triethylenetetraaminehexamethylenephosphonic acid) was labeled with 153Sm. The labeling condition, stability, mole ratio of 153Sm to TTHMP, rabbit bone imaging and bio-distribution of 153Sm-TTHMP in mice were investigated. The results showed that weak basic media and high concentration ligands were favorable to form 153Sm-TTHMP; labeling compounds were stable at pH 7 in 7 days. The results also indicated that the chemical mole ratio of 153Sm-TTHMP is n(153Sm)﹕n(TTHMP) = 1﹕1 and skeleton uptake of 153Sm-TTHMP is high((13.96(3.51)%/g at 1h post injection and (13.54(2.98)%/g at 48h post injection), while the non-target tissue uptake is relatively low, so 153Sm-TTHMP is a promising bone tumor therapeutic agent.

  9. Resection of Ethmoidal Sinus Tumors Invading Anterior Skull Base%侵犯前颅底的筛窦肿瘤切除

    Institute of Scientific and Technical Information of China (English)

    沈志森; 谢光天; 李幼珍; 龚晓放; 成立新

    2000-01-01

    目的:探讨侵犯前颅底筛窦肿瘤的手术方式及前颅底重建的方法.方法:对1994~1998年间的4例侵犯前颅底的筛窦肿瘤采用额骨硬脑膜外进路颅面联合手术,分别用带蒂额骨膜瓣或帽状腱膜瓣及颅骨内板结合耳脑胶重建前颅底.结果:4例创口一期愈合,均未见脑脊液鼻漏及脑膜脑膨出,1例术后出现一过性尿崩症,1例术后视力提高,术后随访半年至5年,4例均存活.结论:额骨硬脑膜外入路颅面联合手术是切除侵犯前颅底筛窦肿瘤的有效方法,带蒂额骨膜瓣或帽状腱膜瓣与颅骨内板结合重建前颅底可有效地防止脑脊液鼻漏及脑膜脑膨出.%Objective:The surgical method of ethmoidal sinus tumors invading anterior skull base and it'a rehibilitation arestudied. Methods:4 cases of patients with ethmoidal sinus neoplasms were operated of frontal bone. The anterior skull basewas rehibilitated with the flaps of frontal bone and membrane,caplike tendinous membrane, interior plate of skull boneand ECear-beadadhesive respectively. Results:There were no complication of cerebrospinal rhinorrhea and meningo-encephalocele in 4Cases. The temporary diabetes iuspidus took place in one case during 12 days postoperatively. There was enhancement of theeyesight in 1 Case. All these patients were alive after followed-up for 0.5~5 years. Conelusion:the combined intracranial facialresection by the way of frontal bone is the effective therapeutic methed of the ethmoidal sinus tumors invading anterior skullbase. The flaps of frontal bone membrane, Caplike tendinous membrane, interior plate of skull bone and ECadhesive are better materials for the reparation of anterior skull bese.

  10. Reconstrução tridimensional da face nos tumores avançados com invasão da fossa craniana anterior Tridimensional facial reconstruction following major resection of tumors involving the anterior cranial fossa

    Directory of Open Access Journals (Sweden)

    Mario Sergio Lomba Galvão

    2004-04-01

    Full Text Available OBJETIVO: Analisar as indicações cirúrgicas e o seguimento pós operatório, ressaltando as complicações e efetividade da abordagem multidisciplinar, para os tumores avançados da base do crânio. MÉTODO: Análise retrospectiva de 46 prontuários de pacientes submetidos à ressecção de tumores invadindo a fossa craniana anterior e reconstruídos com retalhos microcirúrgicos, operados entre março de 1990 e julho de 2002. Todos os pacientes foram operados pelo núcleo de cirurgia de base do crânio do INCA. RESULTADOS: As estruturas mais envolvidas na ressecção foram por ordem: a órbita (76,5%, seio maxilar (76,5%, seio esfenoidal (63,8%, paredes da cavidade nasal (59,5% e palato (42,5%. A dura-máter estava acometida em 32,6% dos casos. A reconstrução microcirúrgica utilizando os retalhos do músculo reto abdominal foi empregada em 93,5 % dos casos. A taxa de sucesso dos transplantes livres foi de 97,8%. As complicações ocorreram em 58,6% dos pacientes e as mais freqüentes foram: infecções locais (21,7%, fístulas liquóricas (15,2%, meningite (6,5% e hematoma (6,5%. CONCLUSÕES: A reconstrução com técnica microcirúrgica permite que se realizem ressecções alargadas destes tumores com limites seguros e índices de complicações aceitáveis, permitindo a estes pacientes uma melhoria da qualidade de vida e da sobrevida, com baixo índice de recidiva.BACKGROUND: The analysis of the surgical indications and the follow-up, stressing the surgical complications and efficiency of a team approach for the advanced tumors involving the anterior skull base are the purpose of the present study. METHODS: The authors present a retrospective evaluation of 46 patients who underwent resections of advanced tumors involving the anterior skull base, which were reconstructed with free flaps from May, 1990 to July, 2002. Those patients have been treated by the skull base surgical team of INCA. RESULTS: The commonest resected structures were

  11. CT and MRI of jejunal patches after oropharyngeal tumor resections; CT und MRT von Duenndarminterponaten nach oropharyngealen Tumorresektionen

    Energy Technology Data Exchange (ETDEWEB)

    Nasel, C. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Glaser, C. [Universitaetsklinik fuer Mund-, Kiefer- und Gesichtschirurgie, Wien (Austria); Krestan, C. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Millesi, W. [Universitaetsklinik fuer Mund-, Kiefer- und Gesichtschirurgie, Wien (Austria); Breitenseher, M. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Steiner, E. [Universitaetsklinik fuer Radiodiagnostik, Wien (Austria)

    1996-03-01

    Computed tomography (CT; n=30) and magnetic resonance imaging (MRI; n=13) were used for follow-up examinations in patients who had an operative reconstruction with a jejunal patch. Three parts of a patch were differentiated with both imaging modalities: the region of the anastomosis, the mesenterial fatty tissue and the interstinal wall. The morphology of the patches correlated with clinical findings in the following cases. The patches were identified satisfactorily by CT and MRI. The appearance of patches without complications was influenced by a variable degree of fibrosis and by persistent intestinal folds. Recurrent tumors only infiltrated the margins of the patches. Destructive alterations in the patches were always less severe than those in the original orofacial soft tissue. Postoperative follow-up examinations with CT and MRI are particularly important when tumor recurrences spread under a patch, since these tumors are invisible in the clinical examinations. CT was advantageous in demonstrating osseous alterations and showed less loss of image quality in patients for whom the implantation of multiple metallic hardware during the operation had been necessary. (orig./MG) [Deutsch] Mittels Computertomographie (CT) (n=30) und Magnetresonanztomographie (MRT) (n=13) wurden im Rahmen der postoperativen Tumornachsorge Patienten mit Duenndarminterponaten untersucht. An den Interponaten wurden folgende Anteile unterschieden: Die Anastomosenregion, das Mesenterium und die Darmwand. Die Morphologie dieser Anteile wurde mit dem klinischen Befund korreliert. Die Ergebnisse zeigen eine zufriedenstellende Abgrenzbarkeit der einzelnen Anteile der Transplantate mit beiden tomographischen Methoden. Die morphologische Heterogenitaet der als komplikationslos eingestuften Transplantate zeigte sich v.a. in einer unterschiedlichen Auspraegung postoperativer Veraenderungen, wie Fibrosierung oder der Persistenz des intestinalen Faltenreliefs. Lokale Tumorrezidive infiltrieren die

  12. 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.

  13. Late bone metastasis from an apparently benign oncocytic follicular thyroid tumor

    Science.gov (United States)

    Boronat, Mauro; Cabrera, Juan J; Perera, Carmen; Isla, Concepción; Nóvoa, Francisco J

    2013-01-01

    A man underwent total thyroidectomy for goiter when he was 62 years old. The pathology report informed on a 5.5 cm oncocytic follicular adenoma and a 3.5 mm papillary microcarcinoma. Due to the papillary tumor, he was treated with ablative radioiodine therapy and suppressive doses of levothyroxine. After uneventful follow-up for 9 years, increased levels of serum thyroglobulin were detected. Further imaging studies including a whole body scan (WBS) after an empirical dose of 200 mCi 131I were negative. Two years later, a 99mTc SestaMIBI WBS and a 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography showed a well-delimited focal uptake in the right femur. A bone biopsy of the lesion demonstrated metastasis of follicular thyroid carcinoma. Retrospective histological reexamination of available material from the primary oncocytic thyroid tumor failed to reveal definitive traits of malignancy. Learning points Oncocytic follicular thyroid tumors are a relatively uncommon variant of follicular thyroid neoplasms mostly composed of distinctive large oxyphilic cells (Hürthle cells).Criteria for the distinction between benign and malignant oncocytic neoplasms are not different from those used in the diagnosis of ordinary follicular tumors.Some cases of apparently benign oncocytic neoplasms have been found to develop malignant behavior.Search to rule out vascular and capsular invasion should be particularly exhaustive in histological assessment of oncocytic thyroid tumors.Even so, long-term surveillance remains appropriate for patients with large apparently benign oncocytic tumors. PMID:24616777

  14. Outcome Evaluation of Oligometastatic Patients Treated with Surgical Resection Followed by Hypofractionated Stereotactic Radiosurgery (HSRS) on the Tumor Bed, for Single, Large Brain Metastases

    Science.gov (United States)

    Pessina, Federico; Navarria, Pierina; Cozzi, Luca; Ascolese, Anna Maria; Maggi, Giulia; Riva, Marco; Masci, Giovanna; D’Agostino, Giuseppe; Finocchiaro, Giovanna; Santoro, Armando; Bello, Lorenzo; Scorsetti, Marta

    2016-01-01

    Purpose The aim of this study was to evaluate the benefit of a combined treatment, surgery followed by adjuvant hypofractionated stereotactic radiosurgery (HSRS) on the tumor bed, in oligometastatic patients with single, large brain metastasis (BM). Methods and Materials Fom January 2011 to March 2015, 69 patients underwent complete surgical resection followed by HSRS with a total dose of 30Gy in 3 daily fractions. Clinical outcome was evaluated by neurological examination and MRI 2 months after radiotherapy and then every 3 months. Local progression was defined as radiographic increase of the enhancing abnormality in the irradiated volume, and brain distant progression as the presence of new brain metastases or leptomeningeal enhancement outside the irradiated volume. Surgical morbidity and radiation-therapy toxicity, local control (LC), brain distant progression (BDP), and overall survival (OS) were evaluated. Results The median preoperative volume and maximum diameter of BM was 18.5cm3 (range 4.1–64.2cm3) and 3.6cm (range 2.1-5-4cm); the median CTV was 29.0cm3 (range 4.1–203.1cm3) and median PTV was 55.2cm3 (range 17.2–282.9cm3). The median follow-up time was 24 months (range 4–33 months). The 1-and 2-year LC in site of treatment was 100%; the median, 1-and 2-year BDP was 11.9 months, 19.6% and 33.0%; the median, 1-and 2-year OS was 24 months (range 4–33 months), 91.3% and 73.0%. No severe postoperative morbidity or radiation therapy toxicity occurred in our series. Conclusions Multimodal approach, surgery followed by HSRS, can be an effective treatment option for selected patients with single, large brain metastases from different solid tumors. PMID:27348860

  15. Predictive and prognostic value of preoperative serum tumor markers is EGFR mutation-specific in resectable non-small-cell lung cancer

    Science.gov (United States)

    Jiang, Richeng; Wang, Xinyue; Li, Kai

    2016-01-01

    Background The predictive and prognostic value of carcinoembryonic antigen (CEA), cytokeratin-19 fragments (Cyfra21-1), squamous cell carcinoma antigen (SCCA) and neuron-specific enolase (NSE) has been investigated in non-small-cell lung cancer (NSCLC) patients. However, few studies have directly focused on the association between these markers and epidermal growth factor receptor (EGFR) mutation status or mutation subtypes. Patients and methods We retrospectively analyzed 1016 patients with stage I-IIIA NSCLC who underwent complete resection between 2008 and 2012. Correlations between serum tumor marker levels and EGFR mutations and survival parameters were analyzed and prognostic factors were identified. Results Cyfra21-1 levels (P = 0.032 for disease-free survival [DFS]; P < 0.001 for overall survival [OS]) and clinical stage were identified as independent predictive and prognostic factors in EGFR-mutated adenocarcinoma patients. CEA levels (P < 0.001 for DFS; P = 0.002 for OS) and clinical stage were independently predictive and prognostic in EGFR wild-type adenocarcinoma patients. Further stratification analysis revealed that in EGFR exon 19 deletion adenocarcinomas, elevated Cyfra21-1 was an independent prognostic factor (P = 0.002). Within the Leu858Arg substitution subgroup, increased CEA (P = 0.005) and clinical stage were predictive factors of DFS, while elevated CEA (P = 0.005) and Cyfra21-1 (P = 0.027) were independent prognostic factors. Conclusion Cyfra21-1 and CEA exhibit different predictive and prognostic values between EGFR-mutated and wild-type adenocarcinomas, as well as between EGFR mutatio