Search PubMed⌕ Search

Biomedical subjects

J W Beabout

Publications and source records attributed to J W Beabout.

At least 19 recordsLinked to original sources
PubMed1992

Giant cell tumor of the skull.

BACKGROUND: Most giant cell tumors (GCT) occur at the ends of long bones. There is little information about GCT of the skull bones. METHODS: The authors reviewed the Mayo Clinic files, which contained 546 cases of GCT, and their own consultation files, which contained approximately 1500 cases. RESULTS: Eleven tumors occurred in the sphenoid bone with extension to the surrounding bones and structures in 8 patients. One tumor (in Paget's disease) occurred in the frontal bone, one tumor was in the occipital bone, and one tumor was in the temporal bone. There were 4 men and 11 women whose ages ranged from 8 to 78 years, with a mean of 36.5 years. Radiographic findings were not suggestive of a specific diagnosis, although the features were those of an aggressive lesion. Histologically, the tumors had features typical of GCT. However, a prominent spindle cell component was seen in five tumors. The initial treatment in all patients but one was intralesional excision that was as complete as possible. The last patient had a wide excision and had soft tissue recurrence at 1 year. This was excised and she was free of disease at 2.7 years. Three patients died, one in the immediate postoperative period and the other two at 1.6 and 4 years with progression of tumor. One patient had postoperative radiation therapy and was without evidence of disease for 2 years when he was lost to follow-up. The remaining 10 patients all had postoperative radiation therapy; 6 patients were alive without disease from 4 to 34 years. However, one of these six patients had a recurrence that was treated surgically with additional radiation. Four patients were alive with tumor from 2.1 to 26 years at the time of this report. CONCLUSIONS: GCT of the skull bones is rare but should be distinguished from giant cell reparative granuloma because of the tendency for progression. Surgical ablation (as complete as possible) and postoperative radiation therapy seem to be the treatment of choice for GCT of the skull bones.

Adolescent↗
PubMed1992

Benign giant-cell tumor of bone with pulmonary metastases: clinical findings and radiologic appearance of metastases in 13 cases.

Tumors that metastasize are considered "malignant" by definition. However, benign giant-cell tumor of bone is an exception because of the potential for histologically benign pulmonary metastases, a fact seldom emphasized in the radiologic literature. We therefore report our experience with 13 cases of pulmonary metastasis among 475 patients (prevalence, 3%) in whom benign giant-cell tumor of bone was diagnosed before 1990 at our institution. Five (38%) of the 13 primary bone tumors were located in the distal radius. Local recurrence at the site of the primary bone tumor tumor occurred in seven patients (54%) before pulmonary metastases developed. The mean interval from the diagnosis of the primary bone tumor to the onset of pulmonary metastasis was 3.8 years, with a maximum of 10.7 years. Fifty-four percent of the patients (7/13) had pulmonary metastases 3 years after diagnosis of the primary bone lesion, and 92% (12/13) had pulmonary metastases 7.5 years after diagnosis. Overall mortality rate directly due to giant-cell tumor and its metastases was 23%. On chest radiographs and CT scans, pulmonary metastases appeared as rounded, nodular opacities of homogeneous density, ranging from 0.5 cm to 8.0 cm in diameter. Peripheral regions of the lungs were involved in 85% of the cases and basilar regions in 62%. Our study shows that benign giant-cell tumor of bone can produce pulmonary metastases, that metastases most often occurred with recurrent local disease and distal radial lesions, that the prognosis was relatively favorable, and that such metastases had no distinguishing radiologic features.

Adult↗
PubMed1991

Desmoplastic fibroma of bone.

Desmoplastic fibroma is a rare primary tumor of bone that histologically and biologically mimics the extra-abdominal desmoid tumor of soft tissue. This study reviews 27 cases of desmoplastic fibroma, consisting of 9 from the Mayo Clinic files and 18 from our consultation files. There was a male predominance, and 74% of the patients were in the first 3 decades of life. The most frequent sites of involvement were the metaphysis of long bones and the mandible. Radiographically, the tumors were lucent, expansile lesions with well-defined margins. Histologically, they contained slender spindle cells and various amounts of collagen fibers. En bloc resection is the treatment of choice because a high incidence of recurrence was noticed after lesional curettage.

Adolescent↗
PubMed1991

Chondrosarcomas of the synovium.

Chondrosarcoma of the synovium, either primary or secondary to synovial chondromatosis, is rare. Ten cases of synovial chondrosarcoma were studied (four from the Mayo Clinic files and six from the authors' consultation files). Two were considered primary. In five cases there was evidence of preexisting synovial chondromatosis, and in the remaining three, there was a suggestion of preexisting disease. Several histologic features were found that were helpful to diagnose malignancy. The most important ones were loss of the "clustering" growth pattern typical of synovial chondromatosis, myxoid change in the matrix, areas of necrosis, and spindling at the periphery of chondroid lobules. Pulmonary metastasis developed in five of nine patients; three of these patients died.

Adult↗
PubMed1991

Solitary congenital fibromatosis (infantile myofibromatosis) of bone.

Congenital fibromatosis is a rare and benign myofibroblastic tumor that may occur in either a solitary or multicentric form. The soft-tissue form of this entity is well recognized. This report analyzes the clinical and pathologic features of 14 cases of congenital fibromatosis in which the tumor existed as a solitary lesion in bone. Most of the tumors (71%) were in patients who were 2 years old or younger. All but one tumor involved the craniofacial bones. Radiographically, they were purely lucent lesions in which a sclerotic rim was visible in each skull lesion. The myofibroblastic appearance closely resembled the microscopic features seen in the soft-tissue counterpart. For appropriate surgical management, it is imperative to recognize that this tumor occurs as a solitary lesion in bone and that it is distinct from other, more aggressive fibrous lesions.

Adolescent↗
PubMed1990

Calcifying pseudoneoplasms of the neural axis.

An unusual fibrocalcifying lesion of the neural axis was identified in 14 cases. The radiographic appearance was that of a mass, which in some instances was calcified. The surrounding structures were compressed and the adjacent bone was involved. Histologically, the process was basically a granulomatous one. The granulomas were either nodular or confluent, producing a large mass with peripheral lobular configuration. Epithelioid cells and giant cells bordered the granulomas. Most of the granulomas were composed of fibrochondrocalcifying material. The lesion was particularly dangerous when located in a strategic site, such as the foramen magnum or the base of the skull. Two of the 14 patients with this pseudotumor died, and the other 12 have done well. Complete ablation, marginal or even intralesional, assures control of the lesion. The lesion is probably reactive rather than neoplastic.

Adult↗
PubMed1989

Adamantinoma of long bones. A clinicopathologic study of 85 cases.

A study of 85 adamantinomas of long bones revealed that 70 were in the tibia (11 of which also involved the fibula), six were in the femur, three were in the ulna, two were in the humerus, two were in the fibula, one was in the radius, and one arose in the soft tissue anterior to the tibia. Most patients presented with pain and swelling and were aged 10 to 30 years. The histologic appearance was that of epithelial islands in a fibrous stroma, usually with a prominent vascular pattern and a transition between the two. Twenty-six (31%) patients had recurrent local disease, 13 (15%) developed lung metastasis, and six (7%) had lymph node metastasis. Nine patients with lung metastasis had preceding recurrent local disease. Risk factors for recurrent or metastatic disease included male sex, pain, symptoms of less than 5 years' duration, and initial treatment by biopsy, curettage, excision, or resection. The only histologic feature associated with an increased recurrence rate was lack of squamous differentiation. Eleven patients died of their disease, and seven are alive with metastatic disease. Forty-one patients were still alive without disease 1 month to 47 years after treatment. Our results indicate that amputation or, when technically feasible, wide en bloc resection is the treatment of choice. All patients require long-term follow-up for evidence of local recurrence or lung metastasis.

Adolescent↗
PubMed1989

Prognostic variables in osteosarcoma: a multi-institutional study.

This is a report of a multi-institutional study of all patients with osteosarcoma who were seen at 13 comprehensive cancer centers from July 1, 1977, to December 31, 1982. Follow-up extended to 9 years; a minimum of 3 years was obtained for greater than 90% of the patients. All patients with osteosarcoma were considered, but only those with tissue confirmation who had had at least part of their first course of treatment at one of the 13 institutions were included. There were 543 patients. In a search for prognostic indicators, 38 patient characteristics, three treatment categories, and an institutional variable were studied. A combination of nine of these constituted the best indicator of survival. They were morphology (two parts), site of primary cancer (two parts), spread of tumor, grade and size of tumor, duration of symptoms, weight loss of greater than 4.5 kg (10 lb), swelling at primary site, and lytic appearance. Unexpectedly, treatment was not one of the indicators of survival. A prognostic score was developed in which the coefficients were obtained from the Cox regression (step-down) method. Each patient had a score (S) and an observed survival time that together provided the expected risk of death for that patient. Although this was not a randomized study, treatments were compared before and after adjusting for characteristics identified as prognostic. Three treatments differed little: surgery alone, surgery plus chemotherapy and/or radiotherapy, and chemotherapy and/or radiotherapy followed in 1-4 months by surgery. Patients with amputations and those with resections had similar death rates, but the observed progression rates differed widely. However, when the rates were adjusted for prognostic characteristics, the difference disappeared. Complete surgery (if osteosarcoma existed within surgical margins) was no better than incomplete surgery (if osteosarcoma existed beyond surgical margins) with respect to death but, as would be expected, complete surgery was much better with respect to disease progression.

Follow-Up Studies↗
PubMed1988

Aneurysmal bone cyst: clinicopathologic features and treatment of ten cases involving the hand.

Ten cases of aneurysmal bone cyst in the hand were identified among 208 such lesions in our institutional files. The patients (six women and four men) had a mean age of 27.3 years. Two patients had open physes. Seven lesions were in the metacarpals. Radiographic examination showed that in all cases the lesion was both expansile and completely lucent. There were no recurrences in the three patients treated by complete excision and bone grafting. Curettage and bone grafting in seven cases was associated with four recurrences. Three of these four local recurrences were treated successfully with curettage procedures. Treatment of aneurysmal bone cysts of the small bones of the hand requires either thorough exteriorization, curettage, and bone grafting or excision and bone grafting.

Adolescent↗
PubMed1988

Intraosseous ganglion cysts.

An illustrative case report of intraosseous ganglion cyst is presented. Intraosseous ganglion cysts are uncommon, juxta-articular, and benign. They are thought to arise from an intramedullary metaplastic event. Intraosseous ganglia are most common in middle-aged patients. They usually involve the tibia but also are located in other skeletal sites. The lesion is typically epiphyseal and appears benign. It is successfully treated with curettage and bone graft if it is symptomatic or progressively increasing in size. It is important to avoid extensive surgical procedures. Recurrence is unlikely.

Bone Cysts↗
PubMed1987

Chondroblastoma of the skull and facial bones.

A series of 30 chondroblastomas was reviewed: 21 had occurred in the lateral part of the temporal bone, 6 in the mandible, 1 in the parietal bone, and 2 in the region that included the temporal bone and mandible. Of the 30 patients in the series, 20 were males and 9 were females; the sex of 1 patient was not stated. The ages of 29 patients ranged from 2 years 11 months to 70 years (mean, 43.5 years). Radiologic findings were not suggestive of a specific diagnosis, although the lesions appeared to be benign. Histologically, most tumors were classic chondroblastomas. However, some showed aneurysmal bone cyst-like areas and nodules of epithelioid cells without chondroid differentiation. Conservative reexcisions were usually curative. Approximately half of the patients had recurrence after curettage.

Chondroblastoma↗
PubMed1987

Liposarcoma of the soft tissues.

A case report presents a liposarcoma of the extremities and an overall review of this disease entity. Past and present histologic classifications of liposarcoma are discussed, as are the clinical behavior and treatment options in relation to the surgical stage of the tumor. The importance of a well-planned biopsy site is stressed.

Adult↗
PubMed1987

Periosteal osteosarcoma.

Periosteal osteosarcoma is a surface lesion without evidence of medullary involvement. This report extends the Mayo Clinic series of periosteal osteosarcoma cases from 11 to 22 cases. In a review of demographic information from our 22 cases and from 30 additional cases, referred only for pathologic diagnosis, the average age at the time of diagnosis in our series was 20.5 years. The proximal tibia was the most frequent site of tumor. Men and women were affected in approximately equal numbers. Limb pain and swelling were common complaints, as were findings of limb mass and tenderness. Excision of a tumor demands at least wide margins. When surgical margins were less than wide, there were higher rates of local tumor recurrence and tumor metastasis. A relatively high rate of tumor recurrence and metastasis occurred with femoral lesions despite wide excisional margins, suggesting that femoral lesions may need more aggressive surgical treatment.

Adolescent↗