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Sacral tumours

Daniela Jäger, Thomas F E Barth, Silke Brüderlein, Angelika Scheuerle, Beate Rinner, Adrian von Witzleben, André Lechel, Patrick Meyer, Regine Mayer-Steinacker, Alexandra von Baer, Markus Schultheiss, Christian R Wirtz, Peter Möller, Kevin Mellert
Chordomas are rare tumours of the bone arising along the spine from clivus to sacrum. We compared three chordoma cell lines of the clivus region including the newly established clivus chordoma cell line, U-CH14, with nine chordoma cell lines originating from sacral primaries by morphology, on genomic and expression levels and with patient samples from our chordoma tissue bank. Clinically, chordomas of the clivus were generally smaller in size at presentation and patients with sacral chordomas had more metastases and more often recurrent disease...
May 17, 2017: Scientific Reports
Lizz van der Heijden, P D Sander Dijkstra, Jean-Yves Blay, Hans Gelderblom
Giant cell tumour of bone (GCTB) is an intermediate locally aggressive primary bone tumour, occurring mostly at the meta-epiphysis of long bones. Overexpression of receptor activator of nuclear factor kappa-B ligand (RANKL) by mononuclear neoplastic stromal cells promotes recruitment of numerous reactive multinucleated osteoclast-like giant cells, causing lacunar bone resorption. Preferential treatment is curettage with local adjuvants such as phenol, alcohol or liquid nitrogen. The remaining cavity may be filled with bone graft or polymethylmethacrylate (PMMA) bone cement; benefits of the latter are a lower risk of recurrence, possibility of direct weight bearing and early radiographic detection of recurrences...
March 30, 2017: European Journal of Cancer
Martin J Gillies, Paul C Lyon, Feng Wu, Tom Leslie, Daniel Y Chung, Fergus Gleeson, David Cranston, Stana Bojanic
High-intensity focused ultrasound describes the use of high-intensity focused ultrasound (HIFU) to ablate tumours without requiring an incision or other invasive procedure. This technique has been trialled on a range of tumours including uterine fibroids, prostate, liver and renal cancer. We describe our experience of using HIFU to ablate sacral chordoma in four patients with advanced tumours. Patients were treated under general anaesthetic or sedation using an ultrasound-guided HIFU device. HIFU therapy was associated with a reduction in tumour volume over time in three patients for whom follow up scans were available...
December 12, 2016: British Journal of Neurosurgery
R Ghermandi, S Terzi, A Gasbarrini, S Boriani
OBJECTIVE: Aneurysmal Bone Cyst (ABC) is a cystic lesion of bone, occurring in 70% of cases as a primary lesion. Even if the metaphyseal region of long bones is more frequently involved, vertebral localization is not rare: ABC represents 15% of all primary spine and sacral tumours. Selective arterial embolization (SAE) represents the first treatment option for vertebral ABC. However, in few cases, multiple SAEs are not possible. The aim of this work is to report two cases of vertebral ABC unresponsive to SAE positively treated with Denosumab...
September 2016: European Review for Medical and Pharmacological Sciences
M Vlychou, J Teh, D Whitwell, N A Athanasou
Hibernoma is a benign adipose tumour that contains foetal brown fat cells. We report a case of hibernoma arising in the left ischium of a 65-year-old female with a past history of ovarian carcinoma. The patient presented with a relatively short history of left sacral/hip pain. Radiologically, the lesion, which was large (5 cm) and sclerotic, had been stable for a number of years. Histologically, it was composed mainly of plump cells with foamy, multivacuolated cytoplasm. These cells showed no reaction for epithelial, melanoma or leucocyte markers but expressed FABP4/aP2 and S100, indicating that they were brown fat cells...
November 2016: Skeletal Radiology
Santosh Banshelkikar, Pruthviraj Nistane
INTRODUCTION: Peripheral nerve tumours are rarely acknowledged as a cause of radiating pain in lower limbs and suspicion is almost always pointed towards lumbo-sacral causes. Schwannomas are tumours of peripheral nerve sheaths occurring anywhere along the peripheral nervous system. Often it can produce symptoms, which can be misleading in cases where obvious swelling is not present. The diagnosis may therefore be delayed by several years of emergence of symptoms. Very few such cases have been reported previously and none of them had an intrasubstance location of the tumour as in our case...
April 2015: Journal of Orthopaedic Case Reports
T Kaneko, D Rokunohe, N Takiyoshi, S Minakawa, H Nakano, D Sawamura
We present the case of a 68-year-old woman who developed a painful subcutaneous tumour in the sacral region. Histological examinations revealed a characteristic zonal pattern with a central zone of liquefactive necrosis, surrounded by proliferated atypical fibroblasts and prominent vessels, indicating ischaemic fasciitis. We demonstrate that the characteristic features of ischaemic fasciitis revealed by ultrasonography are strongly associated with those revealed by pathological findings. We thus believe that ultrasonography is a valid tool for making an accurate diagnosis of ischaemic fasciitis...
July 2016: Clinical and Experimental Dermatology
M C Parry, M Laitinen, J Albergo, L Jeys, S Carter, C L Gaston, V Sumathi, R J Grimer
AIMS: Osteosarcoma of the pelvis is a particularly difficult tumour to treat as it often presents late, may be of considerable size and/or associated with metastases when it presents, and is frequently chondroid in origin and resistant to chemotherapy. The aim of this study was to review our experience of managing this group of patients and to identify features predictive of a poor outcome. PATIENTS AND METHODS: Between 1983 and 2014, 121 patients, (74 females and 47 males) were treated at a single hospital: 74 (61...
April 2016: Bone & Joint Journal
Jayanth Kumar Bangalore Chikkanna, Surendra Gopal, Deepak Sampath
Schwannomas are common, benign, slow growing tumours of peripheral nerve sheath arising from the schwann cells of the neuroectoderm. They do not transverse the nerve but remain within the sheath on top of the nerve. They rarely present in the sciatic nerve. Sciatic schwannomas may mimic symptoms of herniated disc, usually with radiation of pain to buttocks and thigh region with inability to walk for long distances and sometimes may present with claudication. In the absence of low back pain and with a normal Lumbo-Sacral MRI study, causes intrinsic to sciatic nerve needs to be thought off, which often delays the diagnosis...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
Uwe Scheuermann, Fabian Bartsch, Boris Jansen-Winkeln, Hauke Lang, Werner Kneist
INTRODUCTION: This report describes for the first time a case of a transsacral rectocele after combined abdominotranssacral tumour resection. Furthermore, we demonstrate a method for laparoscopic defect repair. PRESENTATION OF CASE: A 44-year-old Caucasian female presented to our hospital with strange gurgling sounds and a painless subdermal swelling in her lower back after resection of a presacral neurinoma two years earlier. Magnetic resonance imaging (MRI) showed a huge rectocele through a sacral defect extending into the subcutaneous tissue...
2016: International Journal of Surgery Case Reports
M P Henrichs, L Beck, G Gosheger, A Streitbuerger, M Koehler, W Heindel, J Hardes, V Vieth
PURPOSE: The sacrum is a rare but unfavourable location for Aneurysmal Bone Cysts (ABCs), surgical procedures aiming to achieve local tumour control can be mutilating. Aim of this study was to evaluate whether selective arterial embolisation (AE) of ABC of the sacrum is an effective treatment and might be an alternative to surgical treatment options. MATERIALS AND METHODS: Between 2007 and 2011 six patients (mean age 13.7 years, range 8 - 18 years) with an ABC of the sacrum were treated by AE...
January 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
C Ruosi, G Colella, S L Di Donato, F Granata, M G Di Salvatore, F Fazioli
INTRODUCTION: Sacral chordoma is a rare low-to-intermediate grade malignant tumour. The mainstay of treatment is still surgery with en bloc and wide resection margins, which can grant the best chances of a long-term control or cure of this disease. The first aim of this paper is to collect data about survival, time to local recurrence and metastasis among patients affected by sacral chordoma and primarily treated with surgery. The second aim is to analyze the influence of level resection, tumor volume and surgical margins on local recurrence...
November 2015: European Spine Journal
Shelby J Bennett, Gregory L Katzman, Raymond P Roos, Amar S Mehta, Saad Ali
Cauda equina syndrome refers to dysfunction of the cauda equina, the collection of ventral and dorsal lumbar, sacral and coccygeal nerve roots that surround the filum terminale. This most commonly occurs as a result of compression by a herniated lumbosacral disc. However, the syndrome may also complicate metastatic cancer or a primary neoplasm within or infiltrating the spinal canal. An accurate and timely diagnosis is critical to avoid irreversible loss of neurological function. The clinician and radiologist must therefore be aware of the many possible causes to guide timely management...
February 2016: Practical Neurology
Bo Wang, Peidong Sun, Xianbiao Xie, Weidong Wu, Jian Tu, Jun Ouyang, Jingnan Shen
PURPOSE: Our aim was to introduce a novel combined hemipelvic endoprosthesis for pelvic reconstruction after Enneking type I/II/IV resection and to evaluate the biomechanical properties of the endoprosthesis using finite element analysis. METHODS: A three-dimensional finite element model of the postoperative pelvis was developed based on computed tomography (CT) images of the patient with the best post-operative limb function. A force of 400 N was applied along the longitudinal axis of the normal and post-operative pelvis for two positions: standing on two feet and sitting...
November 2015: International Orthopaedics
Saurabh Rohatgi, Nikhil H Ramaiya, Jyothi P Jagannathan, Stephanie A Howard, Atul B Shinagare, Katherine M Krajewski
Chordomas are rare malignant bone tumours with a predilection for the axial skeleton, especially the sacrum and skull base. Median survival in patients with metastatic disease is usually dismal. Treatment is challenging due to the propensity for local recurrence, metastatic disease as well as lack of clear consensus regarding the optimal management. Our case report highlights two cases of sacral chordoma with locally recurrent and widespread metastatic disease, stable on molecular targeted therapy.
June 2015: Eurasian Journal of Medicine
Stephen Chu-Sung Hu, Chi-Ling Lin
Desmoplastic fibroblastoma (collagenous fibroma) is a rare and recently recognised benign tumour. Most desmoplastic fibroblastomas arise in the subcutaneous tissue or skeletal muscle. Involvement of the dermis is extremely rare. We describe an unusual case of dermal desmoplastic fibroblastoma presenting as a large sacral mass in a 16-year-old male. An awareness of this entity is necessary to avoid confusion with other benign and malignant soft tissue neoplasms.
June 26, 2015: Australasian Journal of Dermatology
Varun Sharma Tandra, Krishna Mohan Reddy Kotha, Moorthy Gadisetti Venkata Satyanarayana, Kali Varaprasad Vadlamani, Vyjayanthi Yerravalli
Giant cell tumour (GCT) is an uncommon primary bone tumour, and its multicentric presentation is exceedingly rare. We report a case of a 45-year-old female who presented to us with GCT of left distal radius. On the skeletal survey, osteolytic lesion was noted in her right sacral ala. Biopsy confirmed both lesions as GCT. Pulmonary metastasis was also present. Resection-reconstruction arthroplasty for distal radius and thorough curettage and bone grafting of the sacral lesion were done. Multicentric GCT involving distal radius and sacrum with primary sacral involvement is not reported so far to our knowledge...
2015: Case Reports in Oncological Medicine
Karthik Kailash Kannan, Rajkumar Jayachandran Sundarapandian, Vignesh Jayabalan Surulivel
Ewing's sarcoma is a primary malignancy of the bone affecting individuals in the second decade of life. Primary sarcomas of the spine are rare and the occurrence of Primary Ewing's sarcoma in the spine is very rare. Ewing's sarcoma occurring in the spine is divided into two types, Ewing's sarcoma of sacral spine which are very aggressive with poor prognosis and Ewing's sarcoma of the non sacral spine which is an extremely rare occurrence. Patient may present with neurological deficit when the tumour extends into the spinal canal causing spinal cord compression...
March 2015: Journal of Clinical and Diagnostic Research: JCDR
C Xie, N Whalley, K Adasonla, R Grimer, L Jeys
The purpose of this study was to evaluate the long-term outcome of patients with a sacral chordoma and the surgical management of locally recurrent disease. Between October 1990 and August 2013 we operated on 54 consecutive patients with a sacral chordoma. There were 34 men and 20 women with a mean age of 60 years (25 to 86). The mean maximum diameter of the tumour was 9.3 cm (3 to 20). The mean follow-up was 7.8 years (2 months to 23.4 years). The disease-specific survival was 82% at five years, 57% at ten years and 45% at 15 years...
May 2015: Bone & Joint Journal
Ranjit Kumar Baruah, Hemjit Das, Russel Haque
PURPOSE: To report a case of solitary sacral osteochondroma without neurological symptoms and describe the en bloc excision of the tumour, as well as review the literature on osteochondroma involving the sacrum. METHODS: HASH(0x4225b48) SUMMARY OF THE BACKGROUND DATA: although osteochondromas are among the most common benign tumours of the bone, they uncommonly involve the spine. Its occurence in the sacrum is rare, accounting for only 0.5 % of the osteochondromas involving spine...
May 2015: European Spine Journal
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