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Tumor of sacrum

Valerio Nardone, Paolo Tini, Stefania Croci, Salvatore Francesco Carbone, Lucio Sebaste, Tommaso Carfagno, Giuseppe Battaglia, Pierpaolo Pastina, Giovanni Rubino, Maria Antonietta Mazzei, Luigi Pirtoli
Background: The aim of our work is to assess the potential role of texture analysis (TA), applied to computed tomography (CT) simulation scans, in relation to the development of insufficiency fractures (IFs) in patients undergoing radiation therapy (RT) for pelvic malignancies. Methods: We analyzed patients undergoing pelvic RT from Jan-2010 to Dec-2016, 31 of whom had developed IFs of the pelvis. We analyzed CT simulation scans using LifeX Software© , and in particular we selected three regions of interest (ROI): L5 body, the sacrum and both the femoral heads...
February 2018: Quantitative Imaging in Medicine and Surgery
Olivier van Wulfften Palthe, Kyung-Wook Jee, Jos A M Bramer, Francis J Hornicek, Yen-Lin E Chen, Joseph H Schwab
BACKGROUND: Effects of high-dose radiation using protons and photons on bone are relatively unexplored, but high rates of insufficiency fractures are reported, and the causes of this are incompletely understood. Imaging studies with pre- and postradiation scans can help one understand the effect of radiation on bone. QUESTIONS/PURPOSES: The purpose of this study was to assess the effects of high-dose radiation on the trabecular density of bone in the sacrum using CT-derived Hounsfield units (HU)...
March 2018: Clinical Orthopaedics and related Research
John A Abraham, Barry Kenneally, Kamil Amer, David S Geller
BACKGROUND: Navigation-assisted resection has been proposed as a useful adjunct to resection of malignant tumors in difficult anatomic sites such as the pelvis and sacrum where it is difficult to achieve tumor-free margins. Most of these studies are case reports or small case series, but these reports have been extremely promising. Very few reports, however, have documented benefits of navigation-assisted resection in series of pelvic and sacral primary tumors. Because this technology may add time and expense to the surgical procedure, it is important to determine whether navigation provides any such benefits or simply adds cost and time to an already complex procedure...
March 2018: Clinical Orthopaedics and related Research
Seddighi Afsoun, Seddighi Amir Saied, Nikouei Amir, Javadian Hamed
Giant cell tumors (GCTs) are rare, benign, and locally aggressive primary bone neoplasms. Spine is seldom affected, especially above the level of sacrum. In this report, we describe a case with GCT of the cervical vertebrae which causes collapse of the corpus. A 32-year-old female presented with gradual neck pain and abrupt paresthesia of the left hand. Computed tomography scan showed C6 vertebral collapse and magnetic resonance imaging demonstrated vertebral plana of C6 by a low signal intensity lesion on T1- and T2-weighted images...
January 2018: Asian Journal of Neurosurgery
Scott L Zuckerman, Mark H Bilsky, Ilya Laufer
BACKGROUND: Chordomas are rare, primary bone tumors that arise from the axial skeleton. Our objective was to analyze trends in radiation and surgery over time and determine location-based survival predictors for chordomas of the skull base, mobile spine, and sacrum. METHODS: A retrospective cohort study of the Surveillance Epidemiology and End Results (SEER) database from 1973-2013 was conducted. All patients had histologically confirmed chordomas. The principal outcome measure was overall survival (OS)...
February 24, 2018: World Neurosurgery
Angela R Shih, Gregory M Cote, Ivan Chebib, Edwin Choy, Thomas DeLaney, Vikram Deshpande, Francis J Hornicek, Ruoyu Miao, Joseph H Schwab, G Petur Nielsen, Yen-Lin Chen
Chordoma is a rare malignant tumor of bone with high morbidity and mortality. Recently, aggressive pediatric poorly differentiated chordoma with SMARCB1 loss has been described. This study summarizes the clinicopathologic features of poorly differentiated chordoma with SMARCB1 loss in the largest series to date. A search of records between 1990-2017 at MGH identified 19 patients with poorly differentiated chordoma. Immunohistochemical stains were evaluated. Kaplan-Meier survival statistics and log-rank (Mantel Cox) tests compared survival with other subtypes...
February 26, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Teppei Miyakawa, Satoru Iida, Takahiro Igaki, Hiroyuki Shiobara, Ryo Matsumoto, Katsutaka Mitachi, Yoshiteru Ohata, Katsumasa Saito, Tomoya Miura, Takumi Irie, Shigeru Yamazaki
The patient was a 59-year-old man. He was admitted to our hospital because of increasing anal pain with induration of the perianal region. There were large secondary orifices with mucous discharge on the left side of the perineal resion and buttock. We diagnosed adenocarcinoma on analysis of a biopsy specimen from induration of the perianal region. Pelvic CT and MRI showed that the tumor spreaded within the pelvis, with invasion of the prostate and sacrum. We performed neoadjuvant chemoradiotherapy preoperatively...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tatsushi Shingai, Takayuki Fukuzaki, Yoshiro Ito, Tadafumi Fukata, Hiromichi Miyagaki, Hisashi Nishida, Yasuhiro Toyoda, Osamu Takayama, Setsuko Yoshioka, Shigeyuki Hojo, Yoshiichi Maeura, Hiroaki Ohigashi
A 60's male patient underwent laparoscopic left hemicolectomy with D3 lymph node dissection for transverse colon cancer. Adjuvant chemotherapy with tegafur-uracil and leucovorin was administered.Thirty -four months later, MRI scan revealed a mass with sacrum invasion.Radiation therapy(39 Gy/13 Fr)was performed followed by chemotherapy(modified oxaliplatin, leucovorin, and 5-fluorouracil plus bevacizumab).Two weeks after the completion of radiation therapy, staging laparoscopy and tissue biopsy was performed in the hard tumor, which was located at the caudal end of the incisional scar of the retroperitoneum, in front of the sacrum...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Jairo Greco Garcia, Adriano Martinez, Reynaldo Jesus Garcia Filho, Marcelo Toledo Petrilli, Dan Carai Viola
Objective: Describe the epidemiological profile of patients with primary or secondary neoplastic lesions in the pelvis who required a surgical procedure such as hemipelvectomy. Methods: This study retrospectively evaluated 69 patients located in the database of a São Paulo educational institution, subject to surgical hemipelvectomy treatment between January 1990 and December 2013. All patients had previous diagnosis of bone tumor (primary or metastatic) in the pelvis (ilium, ischium, pubis, and/or sacrum)...
January 2018: Revista Brasileira de Ortopedia
Khodamorad Jamshidi, Abolfazl Bagherifard, Alireza Mirzaei, Mehrdad Bahrabadi
There are still some debates regarding the best treatment of Giant Cell Tumor (GCT) of the sacrum. Since GCT of this location is rare, therapeutic strategies are mainly based on the treatment of GCT in other anatomic locations. The objective of this study was to evaluate the oncologic and clinical results of surgical management of sacral GCT with and without local adjuvant therapy. Medical records of 19 patients diagnosed with GCT of the sacrum, were retrospectively reviewed. Sixteen patients were treated by intralesional curettage and three patients with marginal resection...
November 2017: Archives of Bone and Joint Surgery
Prabhakar Ramachandran, Abdulrahman Tajaldeen, David Taylor, Derrick Wanigaratne, Karl Roozen, Moshi Geso
Aim: The aim of this study is to assess the use of ArcCHECK (AC) as an alternative method to replace film dosimetry for pre-treatment quality assurance (QA) of three-dimensional conformal radiation therapy, intensity-modulated radiation therapy (IMRT), and volumetric-modulated arc therapy (VMAT) stereotactic ablative radiotherapy (SABR) treatment plans. Materials and Methods: Twenty-five patients with a varied diagnosis of lung, spine, sacrum, sternum, ribs, scapula, and femur undergoing SABR were selected for this study...
October 2017: Journal of Medical Physics
Yongping Liu, Yaping Zhang, Xibao Mao, Qiufeng Qi, Ming Zhu, Changsong Zhang, Xuefeng Pan, Yang Ling
Otto Warburg observed in 1924 that cancer cells were dependent exclusively on glycolysis for the production of energy even in the presence of oxygen (the 'Warburg effect'). Consequently, cancer cells require ~19 times more glucose uptake to obtain equivalent amounts of energy as normal cells. The Warburg effect is the scientific basis for positron emission tomography (PET), which has markedly improved cancer detection. During chemotherapy, cancer cells may upregulate their expression of multi-drug resistance proteins and ultimately cause treatment failure...
December 2017: Biomedical Reports
T F E Barth, A von Witzleben, P Möller, S Scheil-Bertram
Benign notochordal tumors (BNCT) and chordomas are primary bone tumors of the spine with a predominant localization in the sacrum and clival region followed by the vertebral bodies. Besides the most common variant (NOS [not otherwise specified] with hepatoid or renal carcinoma cell-like differentiation) chordomas with chondroid, and polymorphic to anaplastic morphology are described. An unfavorable variant are pediatric chordomas with a loss of INI-1. BNCT and chordomas are characterized by the following immunohistological profile: vimentin+, cytokeratin+/-, epithelial membrane antigen (EMA)+/-, S100 protein+/-, brachyury+...
December 13, 2017: Der Pathologe
Toru Akiyama, Koichi Ogura, Tabu Gokita, Satoshi Tsukushi, Shintaro Iwata, Tomoki Nakamura, Akihiko Matsumine, Tsukasa Yonemoto, Yoshihiro Nishida, Kazuo Saita, Akira Kawai, Seiichi Matsumoto, Takehiko Yamaguchi
BACKGROUND: Chordomas are very rare primary malignant bone tumors that arise commonly from the sacrum (50-60%) and clivus (25-35%). Chordomas have a high rate of recurrence. The authors confirmed a unique histologic infiltration pattern of chordomas that resembles a skip-metastatic lesion in normal tissue around tumor, which they named "micro-skip metastasis." This study aimed to examine the correlations between the clinicopathologic features of chordomas, including micro-skip metastasis, and the clinical outcomes, including overall survival, local recurrence-free survival, and distant metastasis-free survival...
November 27, 2017: Annals of Surgical Oncology
Rajan P Patel, Clark W Sitton, Leena M Ketonen, Ping Hou, Jason M Johnson, Seferino Romo, Stephen Fletcher, Manish N Shah, Marcia Kerr, Wafik Zaky, Michael E Rytting, Soumen Khatua, David I Sandberg
PURPOSE: Nuclear medicine studies have previously been utilized to assess for blockage of cerebrospinal fluid (CSF) flow prior to intraventricular chemotherapy infusions. To assess CSF flow without nuclear medicine studies, we obtained cine phase-contrast MRI sequences that assess CSF flow from the fourth ventricle down to the sacrum. METHODS: In three clinical trials, 18 patients with recurrent malignant posterior fossa tumors underwent implantation of a ventricular access device (VAD) into the fourth ventricle, either with or without simultaneous tumor resection...
March 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Guruprasad Bettaswamy, Paurush Ambesh, Raj Kumar, Rabi Narayan Sahu, Kuntal Kanti Das, Awadhesh Kumar Jaiswal, Arun Kumar Srivastava, Sanjay Behari
Background: Primary extramedullary tumors involving multiple compartments around the spine are a technically demanding group of tumors whose extent traverses beyond the normal confines of those anatomical regions which fall in the common domain of neurosurgeons. In the following series, we present 12 patients who were diagnosed with primary spinal extramedullary tumors with multicompartmental extension, and whose surgical management was facilitated by a combined multidisciplinary approach involving surgeons of other superspecialties...
October 2017: Asian Journal of Neurosurgery
Utku Can Dölen, Uğur Koçer
Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5), anterior tibia (n=1), posterior axilla (n=1), ischium (n=1), and trochanter (n=2). The template for a bilateral flap was used on the sacrum (n=8), arm (n=1), and anterior tibia (n=1)...
January 2018: Archives of Plastic Surgery
Shlomit Yust Katz, David Cachia, Carlos Kamiya Matsuok, Adriana Olar, Brett Theeler, Marta Penas Prado, Mark R Gilbert, Terri Armstrong
BACKGROUND: Extracranial and extraspinal ependymomas are extremely rare tumors mostly published in the literature as case reports. METHODS: MD Anderson Cancer Center institutional database was screened for patients with extra CNS ependymomas over a 25 year period. RESULTS: Eight patients with extra CNS ependymoma were identified. Five cases originated in the sacrum or subcutaneous sacral area, and the other 3 cases originating in the breast, lung and adnexa of the uterus...
October 17, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Chong Zhu, Kristofor A Olson, Michael Roth, David S Geller, Richard G Gorlick, Jonathan Gill, Nadia N Laack, R L Randall
BACKGROUND: Curative therapy for ES requires both chemotherapy and local control of primary tumor. There is no universally accepted standard approach to local control modalities. This survey was conducted to determine practice patterns and factors influencing the choice to offer various local control modalities to patients with ES of the spine and pelvis. METHODS: The survey consisted of four scenarios involving a 15-year-old girl who presented with Ewing sarcoma of thoracic vertebra, sacrum, iliac wing, and acetabulum with or without neurologic compromise...
October 16, 2017: Journal of Surgical Oncology
Donguk Lee, Woo Jin Choe, So Dug Lim
Presacral ganglioneuromas are extremely rare benign tumors and fewer than 20 cases have been reported in the literature. Ganglioneuromas are difficult to be differentiated preoperatively from tumors such as schwannomas, meningiomas, and neurofibromas with imaging modalities. The retroperitoneal approach for resection of presacral ganglioneuroma was performed for gross total resection of the tumor. Recurrence and malignant transformation of these tumors is rare. Adjuvant chemotherapy or radiation therapy is not indicated because of their benign nature...
September 2017: Korean Journal of Spine
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