Four-year patency of PTFE grafts after replacement of the superior vena cava and the innominate veins.

We describe a simpler alternative to treating vena cava syndrome with composite spiral vein grafts. Instead, we used 2 polytetrafluoroethylene (PTFE) grafts to replace the resected superior vena cava and innominate veins of a man with a malignant thymoma. Both grafts have remained patent more than 4 years after surgery, and the patient has continued asymptomatic and free of malignancy.

Percutaneous needle biopsy of the irradiated skeleton.

Percutaneous needle biopsy was performed in 20 patients who had radiologic abnormalities after irradiation of the skeleton. The biopsies were performed to determine the nature of the bone changes and to differentiate radiation necrosis from metastases or local tumor extension. Eleven patients had tumors, two of which were radiation-induced sarcomas; nine patients did not show evidence of tumor.

Intraarterial cis-platinum chemotherapy for patients with primary and metastatic brain tumors.

A total of 49 patients were treated using intraarterial cis-platinum infusions at a dose of 100 mg/m2. The patients were separated into three groups. There were 13 patients with metastatic tumors, 10 with recurrent malignant gliomas, and 22 patients with high-grade gliomas who received intraarterial cis-platinum as part of an adjuvant program.

Purely lytic osteosarcoma.

The radiographic features of 42 purely lytic osteosarcomas are presented. Purely lytic osteosarcoma is identified as a lytic lesion of bone with no demonstrable osteoid matrix by conventional radiographic modalities. Purely lytic osteosarcoma represented 13.

Computed tomography in liposarcoma.

Seventeen cases with proven liposarcoma were evaluated by computed tomography (CT) to assess the specificity and value of this radiographic modality. A specific diagnosis of liposarcoma could be made in only four cases (22%). Despite its relative nonspecificity, CT proved extremely useful in the clinical evaluation of this tumor and evidenced considerable superiority to other radiographic methods.

Periosteal chondroma: a radiographic spectrum.

The radiographic features of 22 cases of histologically proven periosteal chondroma are analyzed in detail. The typical tumor consisted in an area of outer cortex remodeling (scalloping) involving the metaphyseal lesion of a long bone with slightly overhanging edges and a small amount of cartilage calcified matrix adjacent to the scalloping. The presence of a visible soft tissue mass was uncommon, present in only third of the cases.

Diagnosis of eosinophilic granuloma of bone by cytology, histology, and electron microscopy of transcutaneous bone-aspiration biopsy.

The cytological, histological, and ultrastructural morphology of transcutaneous bone aspirates from five patients with eosinophilic granuloma of bone were studied. Use of this combined approach enabled us to make a definitive diagnosis of eosinophilic granuloma from a small quantity of tissue without having to resort to open biopsy. By light microscopy, eosinophilic granuloma is composed of a polymorphous infiltrate of characteristic lobulated histiocytes, eosinophils, polymorphonuclear leukocytes, and giant cells.

Computed tomography in the evaluation of small round cell tumors of bone.

The value of computed tomography (CT) in the management of 20 cases of round cell tumors of bone is reported. CT is useful in: (a) early diagnosis, particularly incomplex anatomical areas; (b) the evaluation of the extent of disease; (c) the determination of the radiation portals; (d) the evaluation of the response to therapy; and (e) the preoperative evaluation of those tumors removed surgically. In comparison with other radiographic modalities, CT was equally accurate in six and more accurate in 10 patients.

Synovial hyperemia in giant cell tumor of bone: angiographic pitfall.

Arteriography has been found useful in the clinical staging of giant cell tumors of bone in its capacity to demonstrate the presence and extent of soft tissue, extraosseous extension of the tumor. A potential source of error is the presence of hyperemic synovial tissue that may closely resemble tumor vascularity, and therefore be confused with tumor extraosseous extension. Of the 48 giant cell tumors in this series, 21 demonstrated extraosseous vascularity representing synovial hyperemia.

Computed tomography in the evaluation of osteosarcoma: experience with 25 cases.

Experience with computed tomography (CT) in 25 patients with histologically proven osteosarcoma is presented. CT was as accurate as conventional radiographic methods in determining the presence of a lesion, but it was definitely superior in defining the extent of disease, particularly intramedullary extension and soft tissue extraosseous tumor component. CT was capable of demonstrating skip metastases in one patient.

Angiography in giant-cell bone tumors.

Angiography was performed on 48 patients with giant-cell bone tumors. Sixty-four per cent were hypervascular; 25% were hypo- or moderately vascular; and 10% were avascular. Findings were similar in the 45 benign and 3 malignant tumors.

Metastatic osteogenic sarcoma to the brain.

The radiographic appearances of intracranial metastases from primary osteogenic sarcomas in three patients are presented. In two patients, the diagnosis of metastatic disease could be made on conventional roentgenograms of the skull since mineralization of tumor osteoid could be seen within the brain parenchyma. This had a similar appearance to the primary bone tumor.

The value of percutaneous needle biopsy in the management of primary bone tumors.

Thirty-four suspected primary bone neoplasms were evaluated by needle biopsy at M. D. Anderson Hospital and Tumor Institute between September 1976 and February 1978.

Computed tomography in the evaluation of post-nephrectomy patients.

Twenty-one CT examinations were performed in 19 patients who had undergone previous nephrectomy for renal carcinoma or retroperitoneal malignancy. Nine patients were free of disease and 10 had recurrence. Findings of recurrent disease included masses in the vacant renal fossa, inability to visualize the inferior vena cava or aorta, and ipsilateral psoas muscle thickening.

Arterial occlusion of pelvic bone tumors.

Arterial occlusion of the internal iliac artery was successful in the relief of pain due to primary and secondary neoplasms of the bony pelvis in 8 of 9 patients. These included 3 giant cell tumors, 1 aneurysmal bone cyst, 1 recurrent chondrosarcoma, 3 metastatic renal cell carcinoma and 1 metastatic clear cell sarcoma. Calcification of the margin of the lesion occurred in 3 of 4 primary neoplasms after infarction.

Osteogenic sarcoma after the age of 50: a radiographic evaluation.

Twenty-four cases of primary osteosarcoma in individuals over the age of 50 are described. This represents 6% of all osteosarcomas and 80% of osteosarcomas occurring over the age of 50 at this institution. Radiographically, features were similar to osteosarcoma in younger individuals.

Computed tomography in the evaluation of musculoskeletal neoplasms.

In a study of 62 musculoskeletal neoplasms, computed tomography contributed little to establishing tissue diagnosis. Its primary value lay in the assessment of intraosseous and/or extraosseous extent of disease. CT also established the presence or absence of disease in a small number of cases with clinically questionable findings.

Case report: computed tomography of cystadenoma of the pancreas.

Cystadenoma is an unusual pancreatic tumor characterized by large-sized polycystic components. It is located totally within the pancreas and may cause retroperitoneal collateral venous return. These characteristics can be easily visualized by computed tomography, thus making it a very effective modality in the differential diagnosis of pancreatic lesions.

The radiographic spectrum of periosteal osteosarcoma.

Fifteen cases of a recently described variety of osteosarcoma, periosteal osteosarcoma, were studied to define their radiographic characteristics. All the lesions were limited to the cortex that was always thickened but without invasion of the medulla cavity. The tumors presented as non-homogeneous masses of spiculated osteoid matrix progressively denser from the periphery to their cortical base.

Percutaneous needle biopsy of bone in the cancer patient.

Needle biopsy of skeletal lesions is easily accomplished by the percutaneous technique. Although this approach has been utilized for many years, the frequency has definitely increased of the 91 cases performed at M. D.

Calcification within metastatic pulmonary nodules from synovial sarcoma.

A case of calcified metastatic lung deposits from synovial sarcoma of the leg is reported. Calcification within metastatic lung nodules from synovial sarcoma has not been previously reported. The differential diagnoses of calcified lung metastases are presented.

Ultrasonography in tumors arising from the spine and bony pelvis.

Gray scale ultrasonography is a useful tool in evaluating pelvic and abdominal soft tissue masses that may be associated with bone neoplasms. Four patients are described: two with giant cell tumors, one with Ewing's sarcoma, and one with a sacrococcygeal teratoma. Ultrasound is especially helpful in assessing the extent of disease, treatment planning, and in following the results of therapy.