-
Mayo Clinic Proceedings Nov 2007Sarcomas comprise a heterogeneous group of mesenchymal neoplasms. They can be grouped into 2 general categories, soft tissue sarcoma and primary bone sarcoma, which have... (Review)
Review
Sarcomas comprise a heterogeneous group of mesenchymal neoplasms. They can be grouped into 2 general categories, soft tissue sarcoma and primary bone sarcoma, which have different staging and treatment approaches. This review includes a discussion of both soft tissue sarcomas (malignant fibrous histiocytoma, liposarcoma, leiomyosarcoma, synovial sarcoma, dermatofibrosarcoma protuberans, angiosarcoma, Kaposi sarcoma, gastrointestinal stromal tumor, aggressive fibromatosis or desmoid tumor, rhabdomyosarcoma, and primary alveolar soft-part sarcoma) and primary bone sarcomas (osteosarcoma, Ewing sarcoma, giant cell tumor, and chondrosarcoma). The 3 most important prognostic variables are grade, size, and location of the primary tumor. The approach to a patient with a sarcoma begins with a biopsy that obtains adequate tissue for diagnosis without interfering with subsequent optimal definitive surgery. Subsequent treatment depends on the specific type of sarcoma. Because sarcomas are relatively uncommon yet comprise a wide variety of different entities, evaluation by oncology teams who have expertise in the field is recommended. Treatment and follow-up guidelines have been published by the National Comprehensive Cancer Network (www.nccn.org).
Topics: Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Chromosome Aberrations; Humans; Neoplasm Metastasis; Neoplasm Staging; Risk Factors; Sarcoma; Soft Tissue Neoplasms
PubMed: 17976362
DOI: 10.4065/82.11.1409 -
Handchirurgie, Mikrochirurgie,... Jun 2013Malignant bone tumors are very rare entities in the bones of the hand. The histologic subtypes (chondrosarcoma, osteosarcoma, Ewing-sarcoma) preferentially manifest in... (Review)
Review
Malignant bone tumors are very rare entities in the bones of the hand. The histologic subtypes (chondrosarcoma, osteosarcoma, Ewing-sarcoma) preferentially manifest in varying regions of the skeleton. Chondrosarcomas are the most frequent malignant bone tumor type in the hand. Cardinal symptoms of malignant bone tumors in the hand and in general are a new swelling and pain in the affected bones. The primary diagnostic tools are radiologic techniques (x-ray, CT, MRI) for assessment of local tumor growth and the oncologic staging. A definitive treatment of malignant bone tumors should be carried out in specialized centers, as these tumors are rare. Surgical therapy is completed by chemo- or radiotherapy, if required because of histologic subtype and local or systemic spreading. Safe margins of tumor resection should be preferred to function-preserving treatment for tumors of the hand while the preservation of functional units should be pursued whenever possible.
Topics: Biopsy; Bone Neoplasms; Bone and Bones; Chemotherapy, Adjuvant; Chondrosarcoma; Combined Modality Therapy; Diagnosis, Differential; Hand; Humans; Limb Salvage; Lymphoma; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Osteosarcoma; Prognosis; Radiotherapy, Adjuvant; Sarcoma, Ewing; Tertiary Care Centers
PubMed: 23860700
DOI: 10.1055/s-0033-1349118 -
Foot & Ankle Specialist Feb 2016Tumors of the foot and ankle are rarely encountered in the general patient population. Even among studies of tumor patients, foot and ankle neoplasms are uncommon. Given... (Review)
Review
UNLABELLED
Tumors of the foot and ankle are rarely encountered in the general patient population. Even among studies of tumor patients, foot and ankle neoplasms are uncommon. Given the weight-bearing demands of the foot and its relatively small area, even small masses are likely to be symptomatic and/or palpable to both patient and physician. Only 3% of osseous neoplasms are found in this region, while 8% of benign soft tissue tumors and 5% of malignant soft tissue tumors are localized to the foot and ankle. Despite the rarity of presentation, it is important for orthopaedic surgeons to be familiar with the diagnostic criteria and therapeutic options for these patients, as each tumor varies in its presentation, level of aggressiveness, and natural history of the disease. With appropriate diagnostic tests and treatment, patients can anticipate a reasonable chance of survival and preservation of function. In this review article, the authors survey the current literature regarding the presentation, diagnostic workup, and treatment for the most common benign and malignant tumors of the foot and ankle.
LEVELS OF EVIDENCE
Level IV: Literature Review.
Topics: Ankle; Bone Neoplasms; Foot Diseases; Humans; Soft Tissue Neoplasms; Weight-Bearing
PubMed: 26644034
DOI: 10.1177/1938640015620634 -
The Journal of the American Academy of... Jun 2010Osteofibrous dysplasia (OFD) is a rare, benign, fibro-osseous lesion that typically is seen within the cortex of the tibia in children. Adamantinoma (AD) is a rare,... (Review)
Review
Osteofibrous dysplasia (OFD) is a rare, benign, fibro-osseous lesion that typically is seen within the cortex of the tibia in children. Adamantinoma (AD) is a rare, low-grade malignant primary bone tumor that occurs most often in the tibia and/or fibula of adolescent persons and young adults; however, it has been reported in other long bones, as well. Immunohistochemical and ultrastructural evidence has shown that the neoplastic cell in AD derives from an epithelial lineage. More recently, published reports have described another clinical entity-differentiated or OFD-like AD-that appears to lie between OFD and AD along a spectrum of disease. Controversy exists as to whether OFD is a precursor lesion to AD or whether OFD may be a residual lesion resulting from a spontaneously regressing AD. Management of OFD varies from observation to surgical intervention, depending on the age of the patient and the extent of the lesion. Management of AD requires surgical resection with wide margins, followed by appropriate reconstruction, to minimize the risk of local recurrence or metastasis.
Topics: Adamantinoma; Bone Neoplasms; Diagnosis, Differential; Fibrous Dysplasia of Bone; Humans; Neoplasm Staging; Prognosis
PubMed: 20511441
DOI: 10.5435/00124635-201006000-00008 -
Cancer Feb 1997Malignant fibrous histiocytoma of bone, a relatively rare primary malignant neoplasm occurring in bone, is a distinct clinicopathologic entity formerly included in the...
BACKGROUND
Malignant fibrous histiocytoma of bone, a relatively rare primary malignant neoplasm occurring in bone, is a distinct clinicopathologic entity formerly included in the category of osteosarcoma or fibrosarcoma. A series of patients treated at the Mayo Clinic for malignant fibrous histiocytoma of bone was studied to determine whether the prognosis for this disease is different from that of osteosarcoma and whether treatment should be different.
METHODS
The bone tumor files of the Mayo Clinic were reviewed for examples of malignant fibrous histiocytoma of bone. Clinical records and histologic slides were reviewed for 81 patients. Roentgenograms of 13 patients were available for review.
RESULTS
Patients with malignant fibrous histiocytoma of bone ranged in age from 6 to 81 years. The region most commonly affected was the knee. Seventy-eight percent of the lesions arose de novo and 22% in preexisting conditions. Histologically, most of the tumors were classified as the storiform pleomorphic type, although other histologic subtypes were identified. The prognosis depended on the types of surgical margins involved. Patients with wide or radical margins had a better prognosis than patients in whom the margins were contaminated. Some patients who received radiation therapy alone became long term survivors.
CONCLUSIONS
The overall prognosis for patients with malignant fibrous histiocytoma was not found to be significantly different from that described for patients with osteosarcoma in recent series. However, at least in this small series, some patients with malignant fibrous histiocytoma had a good response to radiation therapy. Osteosarcoma is generally considered radioresistant.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms; Child; Female; Histiocytoma, Benign Fibrous; Humans; Male; Middle Aged; Prognosis; Radiography; Retrospective Studies; Survival Analysis; Treatment Outcome
PubMed: 9028358
DOI: No ID Found -
Oncotarget Aug 2016Osteosarcoma (OS) is a common primary malignant bone tumor with high morbidity and mortality in children and young adults. How to improve poor prognosis of OS due to... (Review)
Review
Osteosarcoma (OS) is a common primary malignant bone tumor with high morbidity and mortality in children and young adults. How to improve poor prognosis of OS due to resistance to chemotherapy remains a challenge. Recently, growing findings show activation of mammalian target of rapamycin (mTOR), is associated with OS cell growth, proliferation, metastasis. Targeting mTOR may be a promising therapeutic approach for treating OS. This review summarizes the roles of mTOR pathway in OS and present research status of mTOR inhibitors in the context of OS. In addition, we have attempted to discuss how to design a better treatment project for OS by combining mTOR inhibitor with other drugs.
Topics: Antineoplastic Agents; Apoptosis; Autophagy; Bone Neoplasms; Cell Enlargement; Cell Proliferation; Humans; Neoplasm Metastasis; Osteosarcoma; Prognosis; TOR Serine-Threonine Kinases
PubMed: 27177330
DOI: 10.18632/oncotarget.9305 -
The Journal of Bone and Joint Surgery.... Jan 1984Parosteal osteosarcoma is an uncommon malignant tumor of bone, and in a review of Mayo Clinic records we identified eleven cases of so-called dedifferentiated parosteal...
Parosteal osteosarcoma is an uncommon malignant tumor of bone, and in a review of Mayo Clinic records we identified eleven cases of so-called dedifferentiated parosteal osteosarcoma. Ten of the eleven patients had had a long history of treatment for multiple recurrences of the tumor as a low-grade parosteal osteosarcoma and then for a definite recurrence as a high-grade undifferentiated osteosarcoma. The prognosis in this group of patients was similar to that in patients with conventional osteosarcoma.
Topics: Adolescent; Adult; Bone Neoplasms; Female; Femoral Neoplasms; Humans; Male; Neoplasm Recurrence, Local; Osteosarcoma; Periosteum
PubMed: 6581170
DOI: No ID Found -
Anticancer Research Jun 2021The delayed initiation of treatment is not associated with good clinical outcomes in patients with malignancies. However, few previous studies have examined prognostic...
BACKGROUND/AIM
The delayed initiation of treatment is not associated with good clinical outcomes in patients with malignancies. However, few previous studies have examined prognostic factors, including the delayed initiation of treatment, in malignant bone tumors.
PATIENTS AND METHODS
One hundred and one patients with malignant bone tumors were enrolled. Univariate and multivariate analyses were performed to identify factors predicting metastasis, including factors that delay the initiation of treatment.
RESULTS
The multivariate analysis revealed that high-grade bone malignancy (p<0.01), a >30-day delay in referral to a specialized hospital by a general practitioner (p=0.03), and large tumor size (>77 mm) (p=0.04), were independently associated with metastasis of malignant bone tumors.
CONCLUSION
When general practitioners notice a patient with a >77 mm bone tumor, early referral to a specialized hospital within one month might be essential for preventing metastasis.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Neoplasms; Child; Humans; Middle Aged; Neoplasm Grading; Neoplasm Metastasis; Osteosarcoma; Prognosis; Referral and Consultation; Survival Analysis; Time-to-Treatment; Young Adult
PubMed: 34083290
DOI: 10.21873/anticanres.15081 -
Critical Reviews in Oncology/hematology Feb 2014The mechanisms underlying malignant cell metastasis to secondary sites such as bone are complex and no doubt multifactorial. Members of the small integrin-binding ligand... (Review)
Review
The mechanisms underlying malignant cell metastasis to secondary sites such as bone are complex and no doubt multifactorial. Members of the small integrin-binding ligand N-linked glycoproteins (SIBLINGs) family, particularly bone sialoprotein (BSP) and osteopontin (OPN), exhibit multiple activities known to promote malignant cell proliferation, detachment, invasion, and metastasis of several osteotropic cancers. The expression level of BSP and OPN is elevated in a variety of human cancers, particularly those that metastasize preferentially to the skeleton. Recent studies suggest that the "osteomimicry" of malignant cells is not only conferred by transmembrane receptors bound by BSP and OPN, but includes the "switch" in gene expression repertoire typically expressed in cells of skeletal lineage. Understanding the role of BSP and OPN in tumor progression, altered pathophysiology of bone microenvironment, and tumor metastasis to bone will likely result in development of better diagnostic approaches and therapeutic regimens for osteotropic malignant diseases.
Topics: Animals; Bone Neoplasms; Bone and Bones; Gene Expression Regulation, Neoplastic; Humans; Integrin-Binding Sialoprotein; Neoplasm Metastasis; Osteopontin
PubMed: 24071501
DOI: 10.1016/j.critrevonc.2013.08.013 -
Oral Oncology Oct 2001Currently, it has been established that osteosarcoma (OS) of bone is not a stereotyped disease, and several varieties have been identified by clinical findings,... (Review)
Review
Currently, it has been established that osteosarcoma (OS) of bone is not a stereotyped disease, and several varieties have been identified by clinical findings, radiographic and histopathologic appearances. Generally, it is the most common primary malignant bone neoplasm that accounts for at least 30% of all primary tumours of bone. In the jaw bones, OS accounts for about 4% of all the primary malignant neoplasms. In the general skeleton, the highest incidence is observed in the second decade of life; the neoplasm is said to be unusual before the age of 5 years and very rare after age 50 years. The aetiology and precise pathogenesis of this disease remain unknown. A diagnosis of clinically and radiologically suspicious OS requires meticulous histologic examination. However, histologic diagnosis may also be difficult since the different varieties of OS may have different morphological patterns in different sample sites. Currently, the two therapeutic modalities used in the primary treatment of OS include radical surgery and cytotoxic chemotherapy. In the general skeleton, the use of surgery alone results in a 90% rate of recurrence of OS. Notably, the advent of adjuvant and neoadjuvant cytotoxic chemotherapy as an adjunct to radical surgery has greatly improved the prognosis of many cases of OS of the jaw bones.
Topics: Humans; Jaw Neoplasms; Osteosarcoma; Prognosis
PubMed: 11564573
DOI: 10.1016/s1368-8375(00)00129-9