Salivary gland second cancer after bone sarcoma treatment.

Purpose: Second malignant neoplasms (SMN) or second cancers may occur in 2-5 % of childhood cancer survivors within 5-25 years after diagnosis and treatment of a bone sarcoma. The most common are leukemia and breast cancer; salivary gland SMN are exceptional. To enhance the literature, we reviewed our patients with bone sarcomas and evaluated the incidence and outcome of salivary gland SMN.

Resurfaced allograft-prosthetic composite for proximal tibial reconstruction in children: intermediate-term results of an original technique.

Background: Reconstruction of the proximal part of the tibia in children with megaprostheses or standard composite devices removes the distal femoral physis, and osteoarticular allografts have a high incidence of mechanical failure. We evaluated the results of an alternative original technique for proximal tibial reconstruction after tumor resection.

Methods: Nineteen children, ranging in age from six to sixteen years, who underwent surgical resection and reconstruction with a resurfaced allograft-prosthetic composite were retrospectively reviewed at a mean follow-up time of seventy-eight months.

Difficulty distinguishing benign notochordal cell tumor from chordoma further suggests a link between them.

Background: Much discussion about benign notochordal cell tissue in vertebrae has centered on the nature of its relationship, if any, to chordoma. Often referred to as benign notochordal cell tumors (BNCTs), these lesions have unique morphological features, however, differentiating between notochordal cells in discs, BNCT, and chordoma can be difficult. They are described as radiologically distinct from chordoma, with lysis, contrast enhancement, and a soft tissue mass indicating chordoma.

Lipofibromatosis: magnetic resonance imaging features and pathological correlation in three cases.

Lipofibromatosis is a rare, benign, but infiltrative, soft tissue tumor seen in children. We present three cases of lipofibromatosis, each with different magnetic resonance imaging features and correlate this with the histological findings. The patients comprised two males and one female who presented in infancy; at birth, 5 months, and 7 months of age.

Imaging tumors of the patella.

Background: Patellar tumors are rare; only a few series have been described in the literature and radiographic diagnosis can be challenging. We reviewed all patellar tumors at one institution and reviewed the literature.

Materials And Methods: In an evaluation of the database at one institution from 1916 to 2009, 23,000 bone tumors were found.

Biopsy for suspected spondylodiscitis.

Background: Vertebral biopsy is fundamental in determining whether a spinal lesion is of infectious or neoplastic etiology. Accurate diagnosis is critical for proper medical and/or surgical treatment and consequently for the prognosis of the patient. CT-guided percutaneous spinal biopsy (CTSB) may minimize the risk of contamination and complications.

Vaginal metastasis of a Ewing Sarcoma five years after resection of the primary tumor.

A 35-year-old female presented with pain and swelling of the left wrist. A diagnosis of Ewing sarcoma was made and she underwent neoadjuvant chemotherapy and surgery. Macroscopic viable areas remained on the map of the surgical specimen; as such, she was classified as a poor responder and received high dose adjuvant chemotherapy.

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

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.

Enchondroma vs. chondrosarcoma: a simple, easy-to-use, new magnetic resonance sign.

Introduction: There is no clear radiologic or pathologic agreement on the differences between enchondroma and conventional chondrosarcoma, which has huge therapeutic consequences. Microscopically, an enchondroma is composed of "islands of intramedullary hyaline cartilage surrounded by marrow fat", and a chondrosarcoma a "diffuse cartilaginous replacement (invasion) of the marrow which leads to complete 'trapping' of host lamellar bone trabeculae." The marrow around islands of cartilage should be detectable on magnetic resonance imaging (MR).

How to read a pathology report of a bone tumor.

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.

Imaging of bone tumors for the musculoskeletal oncologic surgeon.

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.

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

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.

Molecular diagnosis in Ewing family tumors: the Rizzoli experience--222 consecutive cases in four years.

The Ewing's family of tumors (EFTs) are characterized by chimeric transcripts generated by specific chromosomal rearrangements. The most common fusions are between the EWSR1 gene on chromosome 22 and the ETS family of transcription factors; rarely, FUS (on chromosome 16) substitutes for EWSR1. The detection of specific translocations using molecular analysis is now a routine part of the pathological examination of EFT.

Severe osteolysis and soft tissue mass around total hip arthroplasty: description of four cases and review of the literature with respect to clinico-radiographic and pathologic differential diagnosis.

Periprosthetic osteolysis is a well known phenomenon caused by wear particle-induced bone resorption, particularly common and extensively reported in total hip arthroplasty. Its typical radiographic feature is a radiolucent area adjacent to an implant, sometimes associated with a soft tissue mass. Osteolytic changes may be caused by numerous other pathologic processes, including infection, metabolic disease, and neoplasia.

Sciatic nerve release following fracture or reconstructive surgery of the acetabulum. Surgical technique.

Background: Sciatic neuropathy associated with acetabular fractures can result in disabling long-term symptoms. The purpose of this retrospective study was to evaluate the effect of sciatic nerve release on sciatic neuropathy associated with acetabular fractures and reconstructive acetabular surgery.

Methods: Between 2000 and 2004, ten patients with sciatic neuropathy associated with an acetabular fracture were treated with release of the sciatic nerve from scar tissue and heterotopic bone.

Posterior stabilization at the cervicothoracic junction: a biomechanical study.

Study Design: This study biomechanically evaluated three fixation devices for stability with posterior two- and three-column injuries.

Objectives: To find an effective means of posteriorly stabilizing injuries at the cervicothoracic junction.

Summary Of Background Data: The cervicothoracic spine is complex anatomically and has been a difficult challenge in approach and stabilization of traumatic and degenerative disorders.

Intramedullary screw fixation of proximal fifth metatarsal fractures: a biomechanical study.

Intramedullary screw fixation is a popular technique for treatment of proximal fifth metatarsal fractures. The purpose of this study was to compare the fixation rigidity of a 5.5 mm partially threaded cannulated titanium screw, with presumed superior endosteal purchase, to a similar 4.