Search PubMed⌕ Search

Biomedical subjects

R Capanna

Publications and source records attributed to R Capanna.

At least 73 records · Page 4Linked to original sources
PubMed1989

Osteoid osteoma and osteoblastoma of the pelvis.

Benign osteoblastic tumors of the pelvis are rarely encountered in orthopedic practice. In most of the cases they involve the acetabular area, as was the case in nine of 14 cases of osteoid osteoma and osteoblastoma presented in this study. Especially with small tumors, such as osteoid osteomas, such a rare occurrence together with difficulties in the interpretation of roentgenograms can lead to mistakes and delays in diagnosis. To reduce these risks, a high grade of clinical suspicion and the use of tomograms or computed tomography (CT) scan and isotope bone scan are required. CT scan is an invaluable tool also for planning the surgical treatment in cases in which the tumor involves the acetabulum. Whereas an intracapsular excision is an adequate treatment for pelvic osteoid osteoma, pelvic osteoblastoma due to its size may need more aggressive surgery, even leading in some cases to a partial pelvic resection. The risk of recurrence is higher for osteoblastoma than for osteoid osteoma, as well as the rate of complications.

Adolescent↗
PubMed1988

The effectiveness of chemotherapy in localized malignant fibrous histiocytoma (MFH) of bone: the Rizzoli Institute experience with 66 patients treated with surgery alone or surgery + adjuvant or neoadjuvant chemotherapy.

Between January, 1974 and July, 1985 66 patients with non-metastatic malignant fibrous histiocytoma (MFH) of bone in the estremities were surgically treated with amputation (34 cases) or resection (32 cases) according to the extension of the tumor. With the exception of 3 patients, who had severe medical contraindications to the chemotherapeutic drugs, all the patients were offered, in addition to the surgery, adjuvant chemotherapy (patients treated before 1983) or neoadjuvant chemotherapy (patients treated after 1983). 33 patients accepted, while 30 wanted to be treated with surgery alone. At median follow-up of 7 years (3-14) 25 patients remained continuously disease-free and 41 relapsed (27 with metastatic disease, 1 with local recurrence and 13 with both metastases and local recurrence). The percentage of patients who remained continuously disease-free was 12.1% (4:33) in the group of patients treated with surgery alone and 63.5% (21:33) in the group treated with surgery plus adjuvant or neoadjuvant chemotherapy. Although the two groups of patients were not completely superimposable (the patients treated with surgery alone were older and more often the MFH arose in pre-existing bone lesions) these results seem to suggest the usefulness of adjuvant and neoadjuvant chemotherapy for this tumor.

Adolescent↗
PubMed1988

[Angiographic evaluation of the response of osteosarcoma to neoadjuvant chemotherapy].

Modern therapeutic osteosarcoma protocols, including both pre- and post-operative cycles of chemotherapy, have helped improving the quality of the prognosis and marking the local control of the neoplasm more reliable, with a subsequent increase in conservative surgery. Angiographic results of the chemotherapeutic response in 76 patients with primitive high-grade bone osteosarcoma are reported. The need to repeat angiographic controls under the same technical conditions is emphasized. The comparison of the above findings with data from the histological evaluation of the specimen, shows that angiography is a reliable means of evaluating the response to chemotherapy. Angiography is thus emphasized as a valid method in an early evaluation of the efficacy of chemotherapy.

Adolescent↗
PubMed1988

Neoadjuvant chemotherapy for osteosarcoma of the extremities. Good response of the primary tumor after preoperative chemotherapy with high-dose methotrexate followed by cisplatinum and adriamycin. Preliminary results.

Forty-nine patients with localized osteosarcoma of the extremities were treated with a new protocol of neoadjuvant chemotherapy. Preoperatively the patients received high-dose methotrexate intravenously, followed after a week by cisplatinum intra-arterially for a continuous infusion over a 72-hour period, plus adriamycin intravenously infused over an 8-hour period. In all cases the clinical and radiographic response was good and in 44 cases (89.7%) it was possible to perform conservative surgery. The histologic examination of the surgical specimen resulted in necrosis being "good" (greater than or equal to 90% of necrosis) in 41 patients (83.6%). This percentage of "good necrosis" was significantly higher than the percentage previously obtained in our Center as well as in others for preoperative treatment of this tumor. Up to now, patients with localized osteosarcoma of the extremities who showed a good histologic response to the preoperative chemotherapy have had a very good prognosis (82% of patients are continuously disease-free). These results suggest that this new regimen represents a substantial improvement in the treatment of this disease.

Adolescent↗
PubMed1988

Resection of the proximal humerus and I.O.R. modular prosthesis in the treatment of metastatic lesions.

The authors report a series of 20 patients affected with metastatic lesions of the proximal humerus (19 cases) or scapula (one case) treated by intra-or extra-articular resection of the humerus and successive reconstruction with an I.O.R. type shoulder modular prosthesis. This method is indicated for the treatment of patients with extensive destruction of the epiphysis and cortical bone and limited invasion of the surrounding soft tissues. Prosthetic implant does not contraindicate the use of postoperative radiotherapy, and the cement used to anchor the endomedullary shaft contributes to the sterilization of any metastatic microfoces present by means of an intense esothermic polymerization reaction. The results obtained were satisfactory, with regression of pain and good functional recovery of the limb. There were no postoperative complications.

Adult↗
PubMed1988

Neoadjuvant chemotherapy in the treatment of osteosarcoma of the extremities: preliminary results in 131 cases treated preoperatively with methotrexate and cisdiamminoplatinum.

The results of 131 cases of classic non-metastatic osteosarcoma of the extremities treated with preoperative chemotherapy, surgery and postoperative chemotherapy are reported. Preoperatively, the patients were given Methotrexate (MTX) intravenously (high and average doses) and Cisplatinum (CDP) intraarterially. For postoperative chemotherapy, the drugs and treatment protocols were based on the degree of necrosis observed (good, fair, poor). Conservative surgery was performed in 73% of the cases and amputation in 27%. At an average 30 month follow-up (9-48 months) 59.5% of the patients had remained disease-free, 37.5% had developed metastases, and 3% had developed local recurrence. The percentage of disease-free patients was higher for those treated with high doses of MTX (68% vs. 51%) and for those in whom preoperative chemotherapy had induced good necrosis (75% vs. 44%). Neither the age or sex of the patients, nor the site of the tumor or type of surgery performed influenced prognosis.

Antineoplastic Combined Chemotherapy Protocols↗
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↗
PubMed1987

Complications of pelvic resections.

The authors report on complications that occurred with 63 pelvic resections. There were 43 complications: 13 infections, seven cases of nerve palsy, 12 cases of vascular or visceral damage, six mechanical and five aesthetic complications. Infection and vascular and visceral damage were more frequent in anterior arch resections, neurological damage in iliac wing resections, and mechanical complications in periacetabular resections. The treatment and outcome of the complications are reported.

Adult↗
PubMed1987

A study of the bone-cement interface in upper limb prostheses not subjected to loading.

The appearance of a radiolucent band at the cement-bone interface is a frequent finding in lower limb prostheses. This is still a controversial subject, but almost certainly has a multifactorial basis. Stress related to loading may be one of the causal factors. The authors therefore studied the evolution and behaviour of this radiolucent line at the bone-cement interface in 31 upper limb prostheses not subjected to significant loading or stress. These were special prostheses designed to replace the upper humerus after the radical excision of bone tumours. The development of a radiolucent band was not significantly different from the usual conditions in which loading is present but in our cases it was nonprogressive and there was never any evidence of loosening of the prosthesis.

Adult↗
PubMed1987

Resection of the distal tibia in bone tumours.

The authors report five cases of tumour of the distal tibia treated by resection and reconstruction by autoplastic grafting and tibiotarsal arthrodesis with fixation by a Kuntscher nail or a plate. This type of surgery is indicated for the treatment of benign tumours, aggressive pseudotumours (Enneking stage 3), or for Enneking stage 1A or 2A malignant tumours. Infection was the most frequent complication (2 out of 5 cases, both of which healed after surgical cleansing). The long-term functional results were good in all cases, and there was neither pseudoarthrosis nor recurrence.

Adolescent↗
PubMed1987

[CT evaluation of sacrococcygeal chordoma].

From June 1985 to September 1986, eight patients affected by sacrococcygeal chordoma were examined by means of conventional radiography and tomography first, and then by high-resolution CT. All patients underwent surgery and an histologic examination of the surgical specimen was carried out. CT always allowed to detect the sacro-coccygeal neoplasm, which looked like a solid non-homogeneous mass; in 50% of cases coarse calcifications were found. CT made it possible to evaluate the growing side of the tumor, its relation with the adjacent anatomical structures-especially the longitudinal extension and the involvement of the sacral hiatus; these findings proved to be very useful in order to choose the most appropriate surgical technique. CT findings also suggested the nature of the tumor but rarely allowed a definitive diagnosis. CT is, at any rate, mandatory in order to evaluate the real extent of the tumor and to plan surgery.

Adult↗
PubMed1987

Neoadjuvant chemotherapy for osteosarcoma of the extremity.

Eighty-five patients with nonmetastatic, high-grade osteosarcoma of an extremity received intravenous methotrexate and intraarterial cisplatinum and then a definitive surgical resection. The preliminary results suggest that preoperative chemotherapy with a delayed surgical resection is as safe as immediate surgery. More patients are candidates for limb salvage after chemotherapy. The tumor response to the preoperative chemotherapy also has prognostic value. Reducing the postoperative chemotherapy can be dangerous. A high dose methotrexate may not be necessary.

Adolescent↗
PubMed1987

[Radiographic pictures of foot localizations of Ewing's sarcoma].

Ewing's Sarcoma (ES) is the most frequent malignant bone tumor of the foot. The radiological picture is characterized, in 14 patients, by a pure osteolytic lesion (9 cases) or by a mixed one (5 cases); the interruption of the cortical bone and swelling of the soft tissues were always present; the periostal reaction was occasional. The radiological aspects cannot be considered typical of the ES and it is suggested that biopsies should always be performed in the presence of a structural alteration of the bone.

Adolescent↗
PubMed1986

Osteoid osteoma and osteoblastoma of the talus. A report of 40 cases.

Forty patients with osteoid osteoma or osteoblastoma of the talus are presented. Clinical and radiographic findings, histologic features, and therapy of these lesions are discussed. The body of the talus was involved in two patients, all other lesions being located in the neck of the bone. Subperiosteal lesions accounted for 75% of cases, and medullary lesions for 25%. Thirty of the 40 lesions were paraarticular. Five radiographic appearances in the talus are discussed: subperiosteal target lesions of the neck (54%); medullary lesions of the neck (20%); subperiosteal radiolucent lesions of the neck (13%); medullary lesions of the body (5%); and exostotic osteoid osteoma of the talar neck (3%).

Adult↗
PubMed1986

Epiphyseal involvement in unicameral bone cysts.

Twelve patients are reported in whom a unicameral bone cyst was found to involve the epiphysis or apophysis across an open growth plate. Nine patients showed pathologic fracture. In four patients a growth disturbance was found. A varying amount of varus angulation was present in most cases. No patient had functional impairment.

Bone Cysts↗
PubMed1986

Sacral osteoid osteoma and osteoblastoma: a report of 13 cases.

The authors present 13 cases (nine males and four females) of osteoid osteoma and osteoblastoma of the sacrum. All patients were less than 20 years old. Clinical and radiographic findings, histological features, and therapy of these rare lesions are discussed. Surgical excision with a posterior approach is considered the treatment of choice, except for tumors localized in the body of S-1, which require an anterior approach. The prognosis is good, even when the neoplasm has been incompletely removed. Nevertheless, a marginal or wide resection is the recommended surgical treatment. Radiotherapy is necessary only for inoperable tumors.

Adolescent↗