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Biomedical subjects

D Present

Publications and source records attributed to D Present.

At least 37 records · Page 2Linked to original sources
PubMed1989

The Istituto Rizzoli experience with small cell osteosarcoma.

Osteosarcoma has been divided into numerous varieties based on clinical, radiographic, and histologic characteristics. Small cell osteosarcoma is a distinct subtype with a histologic appearance in which the bulk of the lesion is composed of round malignant cells with minimal areas of spindle cells. Osteoid production is always present. The lesion may mimic Ewing's tumor and other lesions in which round cells are seen. We report the clinical, radiologic, and pathologic features of this tumor, as well as the clinical outcome and response to therapy.

Adolescent↗
PubMed1989

Dedifferentiated peripheral chondrosarcomas. A report of seven cases.

Peripheral dedifferentiated chondrosarcoma (CS) is an exceedingly rare variant of the highly malignant entity of dedifferentiated chondrosarcoma. Only five such cases have previously been reported. Seven cases are analyzed and evaluated for the presentation and natural history of this highly malignant lesion when it arises in a tumor that was previously an osteochondroma. Both peripheral and central dedifferentiated chondrosarcomas are high-grade malignant lesions and require wide or radical surgical margins for adequate treatment. Despite adequate resection, survival is poor; five of the seven cases presented herein died of metastatic spread of their disease. These cases of the peripheral variant of dedifferentiated chondrosarcoma occurred in patients who were younger than patients with central dedifferentiated chondrosarcomas and may be present with longer duration of symptoms because they occur in previously long-standing benign osteochondromas. As such, they may be easily overlooked clinically and radiographically. Therefore, careful histologic analysis of all cartilage lesions arising on the surface of bone is essential to prevent overlooking foci of high-grade sarcomatous dedifferentiation.

Adult↗
PubMed1989

Tumoral calcium pyrophosphate deposition disease.

A report of two patients in which a soft tissue mass, initially regarded as a malignant tumor, was shown to be the result of calcium pyrophosphate deposition disease. The first case, a woman aged 71 years, presented with a mass involving the right fifth finger. In the second case, also a woman aged 71 years, the lesion involved the tissues adjacent to the right hip. Each lesion consisted of a mass of highly cellular tissue containing deposits of calcium pyrophosphate dihydrate crystals. The clinical, radiological, and pathological features of the two cases are compared with those of seven similar cases reported in the literature.

Aged↗
PubMed1988

Giant-cell tumor of bone with pulmonary metastases. Six case reports and a review of the literature.

Giant-cell tumor of bone rarely metastasizes to the lung. In three of six cases, lesions in lung tissue were histologically benign. In 39 such cases reported in the literature, the treatments were surgical extirpation, chemotherapy, and radiation therapy. Resection was indicated to definitely diagnose the pulmonary lesions as benign giant-cell tumors. Radiation therapy and/or chemotherapy may be beneficial as adjuvant treatment, especially where the lesions are anatomically inaccessible. Some pulmonary lesions spontaneously regress even in the absence of definitive treatment.

Adult↗
PubMed1988

Dedifferentiated chondrosarcoma.

The cases of forty-six patients who had dedifferentiated chondrosarcoma were reviewed. Two groups were identified: one in which a low-grade malignant chondrosarcoma was the precursor lesion and one in which a moderate to high-grade malignant chondrosarcoma was the precursor lesion. The radiographic features of these lesions ranged from that of a cartilaginous lesion that appeared to be benign to that of a destructive osteolytic tumor in which the cartilaginous component was overshadowed by the dedifferentiated component. Only three of the forty-six patients survived for more than two years. Resection alone, even when it was wide or radical, was not successful in controlling this lethal sarcoma.

Adult↗
PubMed1988

Brown tumor of the tibia as an early manifestation of renal osteodystrophy. A case report.

A brown tumor of the tibia occurred in a 49-year-old woman on dialysis with chronic renal failure. This lesion was the first clinical or radiographic indication of bone involvement. Although serum levels of calcium and phosphorus are often well regulated by dialysis, clinical or radiologic evidence of a brown tumor may prove to be the first sign of renal osteodystrophy in patients with chronic renal failure.

Bone Neoplasms↗
PubMed1986

The correlation between the radiologic staging studies and histopathologic findings in aggressive stage 3 giant cell tumor of bone.

The histologic features of aggressive Stage 3 benign giant cell tumor of bone were correlated with their radiologic staging studies. Our series includes 24 patients treated at the University of Florida, Department of Orthopaedic Oncology, from January 1979 to July 1983. Particularly in 13 cases, results of routine specimen histologic as well as of the histologic study of macrosections containing the entire resected specimen (the tumor and surrounding bone and soft tissue) were evaluated. Surgical staging studies including plain radiographs, bone scintigrams, computerized axial tomography scans, tomography, and angiography were used to delineate the anatomic location of the lesion. Within this group of giant cell tumors, the general histologic features resemble those of the classic giant cell tumor. However, certain aggressive features best demonstrated on the macrosections, such as cortical and subchondral invasion, capsular and reactive bony zone infiltration, "digital extension" of the tumor, and neovascularity correlated well with the anatomic localization and aggressiveness found on the staging studies. Those findings emphasize the value of staging studies in the delineation of the histologic potential of these benign aggressive lesions.

Adolescent↗
PubMed1986

Aneurysmal bone cysts of the pelvis.

Twenty-three cases of pelvic aneurysmal bone cysts treated at the Istituto Ortopedico Rizzoli were reviewed after a mean follow-up of 7 years. Eighteen cysts involved the anterior arch, four extended into the iliac wing and the anterior arch, and one invaded the entire hemipelvis. The acetabulum was involved in 56.5% of the cases. Fourteen patients were treated with surgery (curettage 11; resection 3), and five with radiation therapy; two patients had both modalities; two additional patients refused any treatment after biopsy. The overall recurrence rate was 13% (one case after curettage, one after radiation therapy, and one after combined treatment). Significant complications affected the final functional result in four of seven patients who received radiation therapy, while only one minor complication was seen in the surgical group.

Adolescent↗
PubMed1986

Benign fibrous histiocytoma of bone.

The cases of seven patients who had a lytic lesion that was histologically similar to a metaphyseal fibrous defect (non-ossifying fibroma) of bone were studied. The patients all were adults and had pain without a fracture. These features were considered distinctive for the lesion, which has the same histological appearance as benign fibrous histiocytoma of soft tissue. The lesion is a benign tumor with fibroblastic and histiocytic differentiation. This picture may be seen in foci in other lesions of bone (aneurysmal bone cyst, fibrous dysplasia, and giant-cell tumor). Ten cases of giant-cell tumor of bone that had a large component of the same foci were also reviewed. It should be emphasized that these areas are secondary reactive tissue rather than the true neoplastic tissue of benign fibrous histiocytoma.

Adult↗
PubMed1986

Osteosarcoma of the mandible arising in fibrous dysplasia. A case report.

A Grade 3 chondroblastic osteosarcoma is reported in the mandible of a 37-year-old man with longstanding polyostotic fibrous dysplasia. There was also a history of multiple endocrine disturbances including hyperthyroidism, pituitary adenoma, and acromegaly. Malignant transformation of fibrous dysplasia is very rare and occurs most often when the lesion is polyostotic in distribution. The patient received preoperative radiation therapy followed immediately by marginal excision, i.e., left hemimandibulectomy. Forty-two months after initial presentation of the osteosarcoma of the mandible, he is alive with no evidence of disease.

Acromegaly↗
PubMed1985

Malignant fibrous histiocytoma of soft tissue. An analysis of 78 cases located and deeply seated in the extremities.

Seventy-eight cases of malignant fibrous histiocytoma (MFH) of soft tissues are reported. All tumors were deeply located in the extremities. An analysis is presented with regard to sex, age, site, macro- and microscopic features. The staging was assessed according to Enneking's classification (IB, one case; IIA, 25 cases; IIB, 42 cases; III, 10 cases). The recurrence rate after surgical treatment was high (37.5%) with significant differences after inadequate surgery (70%), wide excision (38%), or amputation (0%). Adjunctive radiotherapy rarely was effective in preventing local recurrence. The overall 5-year survival rate was 36%. The prognosis was worse in (1) tumors larger than 5 cm in diameter, (2) tumors that recurred early (less than 1 year) after surgery, and (3) tumors that had inadequate surgical treatment (intralesional or marginal excision).

Actuarial Analysis↗
PubMed1985

The meaning of radiolucencies in parosteal osteosarcoma.

Parosteal osteosarcoma with either intralesional radiolucencies or extralesional clefts within the tumor was identified in eighteen patients. In each patient, both high-quality radiographs and whole macrosections of the lesions were available for correlative study of the radiolucencies. The intralesional radiolucencies were characterized as either deep or peripheral. Study of the macrosections showed that most of the peripheral lucent areas were comprised of low-grade malignant cartilaginous or fibrous tissue that was mixed with fat and bone trabeculae. The majority (67 per cent) of the high-grade dedifferentiated areas of tumor, however, corresponded to the deep radiolucencies. We think that the presence of a deep radiolucent area on a computed tomographic scan or other preoperative radiographic staging studies must create suspicion that a high-grade (grade-II) dedifferentiated region exists within an otherwise low-grade parosteal osteosarcoma.

Adolescent↗
PubMed1985

Giant-cell tumor of bone with pulmonary metastases.

We reviewed the cases of seven patients with histologically benign primary giant-cell tumor of bone and histologically proved metastases to the lung. All seven had a Stage-3, aggressive, benign lesion with interruption of the cortex and soft-tissue extension. The main histological features of the primary lesion were identical to those of the pulmonary metastases. In only one of the seven patients were the metastases detected simultaneously with the primary lesion. All seven patients were treated by surgical resection of the lung nodules and chemotherapy. Of the seven patients, four were alive and free of disease after an average follow-up of nine years; two were receiving chemotherapy; and one, who had had immunosuppression for an allograft transplant, died less than one year after the discovery of the pulmonary lesions. Based on this small series, we concluded that patients with a Stage-3 giant-cell tumor of bone may be at risk for pulmonary spread of the disease. This lesion, with its benign histological picture even in lung lesions, has a favorable prognosis when treated with pulmonary resection of the nodules. However, the role for chemotherapy after pulmonary surgery is still unclear.

Adolescent↗