It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follo...It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.展开更多
Metastatic peritoneal sarcomatosis most commonly occurs from primary soft tissue sarcomas arising either within the abdomen or extremities. Metastatic peritoneal sarcomatosis from an osteosarcoma is extremely rare;onl...Metastatic peritoneal sarcomatosis most commonly occurs from primary soft tissue sarcomas arising either within the abdomen or extremities. Metastatic peritoneal sarcomatosis from an osteosarcoma is extremely rare;only six cases have previously been reported. We report the first case of metastatic peritoneal sarcomatosis originating from radiation-induced osteoblastic osteosarcoma in a 22-year-old woman who had previously been treated for pelvic Ewing’s sarcoma. Abdominal computed tomography, bone scintigraphy and FDG PET/CT demonstrated extensive finely nodular disseminated peritoneal lesions. Histopathologic examination of these peritoneal lesions revealed osteosarcomatosis. In summary, we describe an unusual case of metastatic peritoneal sar comatosis from secondary osteosarcoma arising in a previously irradiated pelvicEwing’s sarcoma.展开更多
Myxoinflammatory fibroblastic sarcoma(MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have ...Myxoinflammatory fibroblastic sarcoma(MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have rarely been reported. We report a case involving the distal left femur of a middle-aged man and tumoral invasion of the bone, which, to our knowledge, has been previously described only once. He was treated with distal femoral tumor resection and reconstruction with a modular prosthesis. Histopathologic diagnosis confirmed MIFS. We reviewed literature of the diagnostic imaging and bone invasion findings associated with this tumor type.展开更多
Purpose: Development of sarcoma is a known late rare negative side effect of radiotherapy. We add two cases to emphasize the need for open-end follow-up and critical evaluation to avoid misinterpretation. Patients, Me...Purpose: Development of sarcoma is a known late rare negative side effect of radiotherapy. We add two cases to emphasize the need for open-end follow-up and critical evaluation to avoid misinterpretation. Patients, Methods, and Results: Two patients developed osteosarcoma as a second malignancy in the humerus after adjuvant radiotherapy of a primary tumor not directly involving the later affected bone. The first patient had a Ewing sarcoma of the scapula at age 13 years. Though after neoadjuvant chemotherapy the resected specimen showed only fibrotic necrotic areas within clear resection margins, the study group indicated adjuvant radiotherapy in a field including the shoulder joint. At age 24 years she developed an osteosarcoma of the humeral head, which was resected and reconstructed with a proximal humerus endoprosthesis. She is alive without disease at age 32 years. The second patient presented with an osteosarcoma of the proximal humerus 29 years after irradiation for breast cancer including the shoulder joint. The sarcoma was misinterpreted as radiation-induced necrosis and the patient was treated with a reverse shoulder endoprosthesis. Pathologic examination of the resected humeral head then showed a typical osteosarcoma. Two years later the humeral reverse shoulder implant was resected and a proximal humerus tumor prosthesis implanted leaving the original glenosphere. Conclusions: In both cases radiation-induced osteosarcoma developed in bone not affected by the primary cancer. Protecting uninvolved structures must be warranted in the planning of radiotherapy. The long latency between the primary and second cancer mandates long-term—best indefinite—follow-up, as with appropriate treatment of a radiation-induced osteosarcoma good healing rates comparable to those of primary osteosarcoma can still be achieved.展开更多
骨与软组织肉瘤是一组异质性肿瘤,起源于骨骼或软组织中的不同细胞类型,根据国际肿瘤分类学委员会(International Classification of Disease for Oncology Third Edition, ICD-O3)的分类,骨与软组织肉瘤可以分为50余种亚型,其中骨肉瘤...骨与软组织肉瘤是一组异质性肿瘤,起源于骨骼或软组织中的不同细胞类型,根据国际肿瘤分类学委员会(International Classification of Disease for Oncology Third Edition, ICD-O3)的分类,骨与软组织肉瘤可以分为50余种亚型,其中骨肉瘤、软骨肉瘤和尤文肉瘤是最常见的3种原发性恶性骨肿瘤。由于骨与软组织肉瘤具有侵袭性、易转移和发展快的特点,传统治疗手段虽然可以控制疾病进展,但对于晚期或复发性患者的生存率提升仍然有限。免疫治疗以激活患者自身免疫系统为核心,通过调节免疫反应,实现对肿瘤的有针对性攻击,从而在最大程度上减少对正常组织的损害,这一治疗策略的独特性和高效性使其成为当前癌症治疗领域备受瞩目的研究热点。基于此,本综述将系统性地回顾并总结骨与软组织肉瘤免疫治疗的最新研究进展,重点关注已经在临床试验中取得成功的免疫治疗手段,并探讨其在改善患者预后、减轻治疗不良反应以及提高生存质量方面的潜在作用,以期为进一步探索免疫治疗在骨与软组织肉瘤中的应用提供参考和启示。展开更多
Approximately 45 percent of malignant bone tumors are seen under the age of 16 and one of the important results of growth plate sacrification in patients with immature skeletons is limb inequality.Until the early 1990...Approximately 45 percent of malignant bone tumors are seen under the age of 16 and one of the important results of growth plate sacrification in patients with immature skeletons is limb inequality.Until the early 1990s,the treatment options for these patients were rotationplasty or amputation.Multimodal approaches that combine imaging,chemotherapy,and surgical techniques have enabled the development of limb-preserving methods with satisfactory results.In order to overcome inequality problems,expandable prostheses have been developed in the 1980s.Extendable endoprosthesis replacements have been improved over the years and are now an established and safe alternative.Noninvasive prostheses appear to be advantageous compared to minimally invasive expandable prostheses that require multiple surgical procedures,but the complication rate remains high.Therefore,although expandable prostheses are not the definitive answer to the treatment of bone sarcomas in skeletally immature children,they are still a suitable interim choice until full adulthood is achieved.Due to reported high complication rates,the procedures require significant experience and are recommended for use only in specialized cancer centers.展开更多
Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the osteogenic sarcoma (osteosarcoma), a non-destructive neutron activation analysis with high resolution spectrometry of long-...Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the osteogenic sarcoma (osteosarcoma), a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides was performed. Methods: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn) mass fraction, Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fraction multiplications were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 27 patients with osteosarcoma (9 females and 18 males, 6 to 71 years old). The reliability of difference in the results between intact bone and osteosarcoma tissues was evaluated by Student’s t-test. Results: In the osteosarcoma tissue the mass fractions of Co, Cr, Fe, Sb, Se, and Zn are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, we found significantly lower values of Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as significant higher mean values of Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fractions multiplications in the osteosarcoma tissue compared to intact bone. In the osteosarcoma tissue many correlations between trace elements found in the control group were no longer evident. Conclusion: In osteosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.展开更多
BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the di...BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the diagnosis and treatment of a case of this rare disease and provide a review of the literature.CASE SUMMARY In this article,we discuss the case of a 40-year-old Hispanic female who presented with progressive thrombocytopenia and multiple hypoechoic lesions in the spleen without splenomegaly.Positron emission tomography-computed tomography showed increased activity in cervical lymph nodes,as well as multiple bone and splenic lesions with positive uptake.Two bone marrow biopsies and fine-needle aspiration of the cervical lymph node were inconclusive.Laparoscopic splenectomy was performed,and gross examination showed a 110.1 g spleen with multiple rubbery,nodular lesions within the subcapsular sinus and splenic parenchyma.The microscopic findings showed multinodular histiocyte proliferation with atypia and multilobulated nuclei,which were positive for CD163,CD4,and CD68 by immunohistochemical analysis.The final pathologic diagnosis was difficult and was found to be low-grade HS of the spleen,after consultations with two renowned hematopathology institutions.At the patient’s five-month follow-up visit,her bone marrow metastasis had progressed.She is waiting to be enrolled in a clinical trial.CONCLUSION Pathologic diagnosis of splenic HS can be challenging.Low-grade differentiation may be associated with a slow progressive disease.展开更多
Before and after general irradiation with 60Co-γ, mice were orally given Sheng Bai Solution (SBS) for one week. SBS alleviated the irradiation-induced reduction of bone marrow cell chromosome division index. The irra...Before and after general irradiation with 60Co-γ, mice were orally given Sheng Bai Solution (SBS) for one week. SBS alleviated the irradiation-induced reduction of bone marrow cell chromosome division index. The irradiation-induced decrease of marrow DNA amount, thymic and splenic fractions, and total leukocyte number were restored to some extent. SBS also helped to ameliorate general condition of patients.展开更多
Background The multilineage differentiation potential ability of bone marrow stromal cells(BMSCs) showed great potential in tissue engineering, while vascular endothelial growth factor 165(VEGF165) promotes vasculogen...Background The multilineage differentiation potential ability of bone marrow stromal cells(BMSCs) showed great potential in tissue engineering, while vascular endothelial growth factor 165(VEGF165) promotes vasculogenesis and further promotes tissue regeneration. This study aimed to assess the ability of rat BMSCs expressing human VEGF A165(hVEGF165) to promote tissue repair in rat model of radiation-induced injury.Methods Rat BMSCs were isolated from the tibia. Plasmid DNA expressing hVEGF165 was stably transfected into BMSCs using liposomes. The right hindlimb muscle of 40 rats was irradiated using a 60 Co γ source(total dose 30 Gy). The animals were divided into four groups(n=10): not injected with BMSCs(control; group 1) or intramuscularly injected two times(once in 2 weeks) with pcDNATM3.1-transfected BMSCs(group 2), untransfected BMSCs(group 3), or hVEGF165-transfected BMSCs(group 4). Angiography was performed 1 week after the last injection of BMSCs; samples of the hindlimb muscle were subjected to transmission electron microscopy, ultrastructural analysis, reverse transcription-PCR(RT-PCR), Western blotting, and immunohistochemistry.Results Rat BMSCs with multipotent differentiation capacity were isolated. hVEGF165-transfected BMSCs overexpressed hVEGF165 mRNA and protein. Injection of BMSCs(groups 2–4) increased the average vessel number, density, diameter, and cross-sectional area; mRNA expression of the myogenic markers including myoblast determination protein, myogenin, and α-smooth muscle actin; and CD31 protein expression; and promoted the repair of blood vessels and myofibers after radiation-induced injury compared to group 1; each of these parameters and hVEGF165 mRNA or protein expression were markedly improved in rats injected with hVEGF165-transfected BMSCs compared to groups 2 and 3.Conclusions BMSCs expressing hVEGF165 enhanced the repair of radiation-induced tissue injury by promoting vasculogenesis and muscle fiber regeneration. BMSCs expressing hVEGF165 may have potential clinical applications.展开更多
文摘It is important for surgeons performing sarcoma surgery to know that bone resection and tumor prosthesis applications in soft tissue sarcomas(STS)have unique features in terms of indication,surgical approach and follow-up,in terms of the management of these cases.Some STS are associated with bone and major neurovascular structures.Bone-associated STS are generally relatively large and relatively deep-seated.Additionally,the tendency for metastasis is high.In some cases,the decision about which structures to resect is difficult.These cases are often accompanied by poor oncological and surgical outcomes.Management of cases should be done by a multidisciplinary team in advanced centers specialized in this field.The surgical team must have sufficient knowledge and experience in the field of limb-sparing surgery.Preoperative evaluation and especially good planning of bone and soft tissue reconstruction are vital.
文摘Metastatic peritoneal sarcomatosis most commonly occurs from primary soft tissue sarcomas arising either within the abdomen or extremities. Metastatic peritoneal sarcomatosis from an osteosarcoma is extremely rare;only six cases have previously been reported. We report the first case of metastatic peritoneal sarcomatosis originating from radiation-induced osteoblastic osteosarcoma in a 22-year-old woman who had previously been treated for pelvic Ewing’s sarcoma. Abdominal computed tomography, bone scintigraphy and FDG PET/CT demonstrated extensive finely nodular disseminated peritoneal lesions. Histopathologic examination of these peritoneal lesions revealed osteosarcomatosis. In summary, we describe an unusual case of metastatic peritoneal sar comatosis from secondary osteosarcoma arising in a previously irradiated pelvicEwing’s sarcoma.
文摘Myxoinflammatory fibroblastic sarcoma(MIFS) is a rare low-grade, malignant soft tissue tumor that is usually observed in the extremities of adult patients. Magnetic resonance imaging findings for this tumor type have rarely been reported. We report a case involving the distal left femur of a middle-aged man and tumoral invasion of the bone, which, to our knowledge, has been previously described only once. He was treated with distal femoral tumor resection and reconstruction with a modular prosthesis. Histopathologic diagnosis confirmed MIFS. We reviewed literature of the diagnostic imaging and bone invasion findings associated with this tumor type.
文摘Purpose: Development of sarcoma is a known late rare negative side effect of radiotherapy. We add two cases to emphasize the need for open-end follow-up and critical evaluation to avoid misinterpretation. Patients, Methods, and Results: Two patients developed osteosarcoma as a second malignancy in the humerus after adjuvant radiotherapy of a primary tumor not directly involving the later affected bone. The first patient had a Ewing sarcoma of the scapula at age 13 years. Though after neoadjuvant chemotherapy the resected specimen showed only fibrotic necrotic areas within clear resection margins, the study group indicated adjuvant radiotherapy in a field including the shoulder joint. At age 24 years she developed an osteosarcoma of the humeral head, which was resected and reconstructed with a proximal humerus endoprosthesis. She is alive without disease at age 32 years. The second patient presented with an osteosarcoma of the proximal humerus 29 years after irradiation for breast cancer including the shoulder joint. The sarcoma was misinterpreted as radiation-induced necrosis and the patient was treated with a reverse shoulder endoprosthesis. Pathologic examination of the resected humeral head then showed a typical osteosarcoma. Two years later the humeral reverse shoulder implant was resected and a proximal humerus tumor prosthesis implanted leaving the original glenosphere. Conclusions: In both cases radiation-induced osteosarcoma developed in bone not affected by the primary cancer. Protecting uninvolved structures must be warranted in the planning of radiotherapy. The long latency between the primary and second cancer mandates long-term—best indefinite—follow-up, as with appropriate treatment of a radiation-induced osteosarcoma good healing rates comparable to those of primary osteosarcoma can still be achieved.
文摘骨与软组织肉瘤是一组异质性肿瘤,起源于骨骼或软组织中的不同细胞类型,根据国际肿瘤分类学委员会(International Classification of Disease for Oncology Third Edition, ICD-O3)的分类,骨与软组织肉瘤可以分为50余种亚型,其中骨肉瘤、软骨肉瘤和尤文肉瘤是最常见的3种原发性恶性骨肿瘤。由于骨与软组织肉瘤具有侵袭性、易转移和发展快的特点,传统治疗手段虽然可以控制疾病进展,但对于晚期或复发性患者的生存率提升仍然有限。免疫治疗以激活患者自身免疫系统为核心,通过调节免疫反应,实现对肿瘤的有针对性攻击,从而在最大程度上减少对正常组织的损害,这一治疗策略的独特性和高效性使其成为当前癌症治疗领域备受瞩目的研究热点。基于此,本综述将系统性地回顾并总结骨与软组织肉瘤免疫治疗的最新研究进展,重点关注已经在临床试验中取得成功的免疫治疗手段,并探讨其在改善患者预后、减轻治疗不良反应以及提高生存质量方面的潜在作用,以期为进一步探索免疫治疗在骨与软组织肉瘤中的应用提供参考和启示。
文摘Approximately 45 percent of malignant bone tumors are seen under the age of 16 and one of the important results of growth plate sacrification in patients with immature skeletons is limb inequality.Until the early 1990s,the treatment options for these patients were rotationplasty or amputation.Multimodal approaches that combine imaging,chemotherapy,and surgical techniques have enabled the development of limb-preserving methods with satisfactory results.In order to overcome inequality problems,expandable prostheses have been developed in the 1980s.Extendable endoprosthesis replacements have been improved over the years and are now an established and safe alternative.Noninvasive prostheses appear to be advantageous compared to minimally invasive expandable prostheses that require multiple surgical procedures,but the complication rate remains high.Therefore,although expandable prostheses are not the definitive answer to the treatment of bone sarcomas in skeletally immature children,they are still a suitable interim choice until full adulthood is achieved.Due to reported high complication rates,the procedures require significant experience and are recommended for use only in specialized cancer centers.
文摘Objectives: To clarify the role of trace elements in the etiology and the pathogenesis of the osteogenic sarcoma (osteosarcoma), a non-destructive neutron activation analysis with high resolution spectrometry of long-lived radionuclides was performed. Methods: The silver (Ag), cobalt (Co), chromium (Cr), iron (Fe), mercury (Hg), rubidium (Rb), antimony (Sb), selenium (Se), and zinc (Zn) mass fraction, Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fraction multiplications were estimated in normal bone samples from 27 patients with intact bone (12 females and 15 males, aged from 16 to 49 years), who had died from various non bone related causes, mainly unexpected from trauma, and in tumor samples, obtained from open biopsies or after operation of 27 patients with osteosarcoma (9 females and 18 males, 6 to 71 years old). The reliability of difference in the results between intact bone and osteosarcoma tissues was evaluated by Student’s t-test. Results: In the osteosarcoma tissue the mass fractions of Co, Cr, Fe, Sb, Se, and Zn are significantly higher while the mass fraction of Rb is lower than in normal bone tissues. Moreover, we found significantly lower values of Rb/Co, Rb/Fe, Rb/Se, and Rb/Zn mass fraction ratios as well as significant higher mean values of Co × Zn, Fe × Zn, Sb × Zn, Se × Zn, Co × Se, and Fe × Se mass fractions multiplications in the osteosarcoma tissue compared to intact bone. In the osteosarcoma tissue many correlations between trace elements found in the control group were no longer evident. Conclusion: In osteosarcoma transformed bone tissues the trace element homeostasis is significantly disturbed.
基金supported (in whole or part) by HCA Healthcare and/or an HCA Healthcare affiliated entity
文摘BACKGROUND Histiocytic sarcoma(HS)of the spleen is reported to be a rare and lethal disease.The clinicopathological features of splenic HS have not been well described.The objective of this paper is to describe the diagnosis and treatment of a case of this rare disease and provide a review of the literature.CASE SUMMARY In this article,we discuss the case of a 40-year-old Hispanic female who presented with progressive thrombocytopenia and multiple hypoechoic lesions in the spleen without splenomegaly.Positron emission tomography-computed tomography showed increased activity in cervical lymph nodes,as well as multiple bone and splenic lesions with positive uptake.Two bone marrow biopsies and fine-needle aspiration of the cervical lymph node were inconclusive.Laparoscopic splenectomy was performed,and gross examination showed a 110.1 g spleen with multiple rubbery,nodular lesions within the subcapsular sinus and splenic parenchyma.The microscopic findings showed multinodular histiocyte proliferation with atypia and multilobulated nuclei,which were positive for CD163,CD4,and CD68 by immunohistochemical analysis.The final pathologic diagnosis was difficult and was found to be low-grade HS of the spleen,after consultations with two renowned hematopathology institutions.At the patient’s five-month follow-up visit,her bone marrow metastasis had progressed.She is waiting to be enrolled in a clinical trial.CONCLUSION Pathologic diagnosis of splenic HS can be challenging.Low-grade differentiation may be associated with a slow progressive disease.
文摘Before and after general irradiation with 60Co-γ, mice were orally given Sheng Bai Solution (SBS) for one week. SBS alleviated the irradiation-induced reduction of bone marrow cell chromosome division index. The irradiation-induced decrease of marrow DNA amount, thymic and splenic fractions, and total leukocyte number were restored to some extent. SBS also helped to ameliorate general condition of patients.
基金This study Was supported by a grant from the National Natural Science Foundation of Hainan Province （No. 30635）.
文摘Background The multilineage differentiation potential ability of bone marrow stromal cells(BMSCs) showed great potential in tissue engineering, while vascular endothelial growth factor 165(VEGF165) promotes vasculogenesis and further promotes tissue regeneration. This study aimed to assess the ability of rat BMSCs expressing human VEGF A165(hVEGF165) to promote tissue repair in rat model of radiation-induced injury.Methods Rat BMSCs were isolated from the tibia. Plasmid DNA expressing hVEGF165 was stably transfected into BMSCs using liposomes. The right hindlimb muscle of 40 rats was irradiated using a 60 Co γ source(total dose 30 Gy). The animals were divided into four groups(n=10): not injected with BMSCs(control; group 1) or intramuscularly injected two times(once in 2 weeks) with pcDNATM3.1-transfected BMSCs(group 2), untransfected BMSCs(group 3), or hVEGF165-transfected BMSCs(group 4). Angiography was performed 1 week after the last injection of BMSCs; samples of the hindlimb muscle were subjected to transmission electron microscopy, ultrastructural analysis, reverse transcription-PCR(RT-PCR), Western blotting, and immunohistochemistry.Results Rat BMSCs with multipotent differentiation capacity were isolated. hVEGF165-transfected BMSCs overexpressed hVEGF165 mRNA and protein. Injection of BMSCs(groups 2–4) increased the average vessel number, density, diameter, and cross-sectional area; mRNA expression of the myogenic markers including myoblast determination protein, myogenin, and α-smooth muscle actin; and CD31 protein expression; and promoted the repair of blood vessels and myofibers after radiation-induced injury compared to group 1; each of these parameters and hVEGF165 mRNA or protein expression were markedly improved in rats injected with hVEGF165-transfected BMSCs compared to groups 2 and 3.Conclusions BMSCs expressing hVEGF165 enhanced the repair of radiation-induced tissue injury by promoting vasculogenesis and muscle fiber regeneration. BMSCs expressing hVEGF165 may have potential clinical applications.
