Osteosarcoma of the ilium

BACKGROUND: Iliosacral resection of pelvic malignant tumors and subsequent reconstruction have tested the ingenuity of orthopedic oncologists because of the difficulty of oncological wide resection and the complex biomechanics of the sacroiliac joint render reconstruction challenging. This study compared the functional and surgical outcomes of a biological reconstruction technique with the lack of reconstruction following iliosacral resection. METHODS: Twenty-six consecutive cases with malignant iliac tumors involving the sacrum were retrospectively reviewed...

OBJECTIVE: To investigate the value of computer-aided design (CAD) in defining the resection boundary, reconstructing the pelvis and hip in patients with pelvis tumors. METHODS: Between November 2006 and April 2009, 5 cases of pelvis tumors were treated surgically using CAD technology. There were 3 males and 2 females with an average age of 36.4 years (range, 24-62 years). The cause was osteosarcoma, giant cell tumor of bone, and angiosarcoma in 1 case, respectively, and chondrosarcoma in 2 cases...

OBJECTIVE: To study the clinical manifestations, radiologic findings, pathologic diagnosis and differential diagnosis of primary osteosarcoma in elderly patients. METHODS: Twelve cases of primary osteosarcoma occurring in patients older than 60 years were encountered during the period from 1985 to 2010. The clinical manifestations, radiologic features and pathologic findings were studied and the follow-up data were analyzed. RESULTS: The sites of involvement included long bones (number = 7), ilium (number = 1), craniofacial bones (number = 2) and soft tissue (number = 2)...

PURPOSE OF REVIEW: This paper will discuss reconstruction of the mandible with autogenous nonvascularized bone grafting. New developments in this area will be investigated by reviewing the most recent literature on this topic as compared with other techniques currently employed. With the advances of vascularized free flap reconstruction it is important to investigate the indication for nonvascularized techniques. RECENT FINDINGS: Replacement of a portion of the mandibular bone is a common procedure for patients undergoing ablative cancer surgery or for infection as well as temporomandibular joint replacement secondary to disease or trauma...

Primary sternal osteosarcoma is rare and has a poor prognosis. Here, we describe the case of a 44-year-old man with sternal osteosarcoma. He underwent subtotal sternectomy with partial resection of the bilateral ribs and left clavicle. Sternal reconstruction was performed with an iliac bone allograft, which was fixed by polyester suture. The patient had a normal postoperative course, followed by adjuvant chemotherapy. The allograft healed with correct integration, and have been no signs of recurrence and absorption during 14 years of follow-up...

En bloc resection of iliosacral sarcomas is a surgical challenge. There are substantial risks of inadequate margins, local recurrence, and nerve root loss when pelvic sarcomas involve sacral root canals and foramina. The decancellation technique uses principles similar to transpedicle decancellation in spinal deformity correction to perform the sacral osteotomy in iliosacral tumor resection. The technique aims at improving sacral margins and minimizing loss of neural function. We performed a decancellation osteotomy in five patients with sarcomas requiring difficult oblique or sagittal sacral osteotomies and selective root sacrifice...

The recurrence of osteosarcoma is rare. Local recurrence occurs in 4-10% of patients following effective treatment. So far, recurrences as late as 15 years have been reported in the literature. We report a unique case of local recurrence of intramedullary osteosarcoma 17 years from initial diagnosis and treatment. Regular long-term follow-up of patients with this diagnosis is crucial to ensure early detection and treatment of potential recurrences.

Low back pain is one of the main reasons for doctor's appointment, and the motive of consultation of General Practitioners in 56% of cases. More than 85% of the patients who present to primary care physicians have low back pain that cannot reliably be attributed to a specific cause. In a minority of cases low back pain can be caused by a specific disorder, such as cancer. The authors describe a case of a 59-year-old woman with prolonged evolution low back pain which turned out to be a high grade osteossarcoma of the iliac bone...

BACKGROUND: Recently, the navigation system has been introduced to orthopedic oncology. It can apply MRI and/or CT images to intraoperative visualization. We performed navigation-assisted limb salvage surgeries on patients with a malignant bone tumor of the metaphysis of the long bone or the iliac bone while preserving the adjacent joint. METHODS: When preoperative chemotherapy was estimated to be effective by imaging studies and the residual remaining epiphysis was expected to be more than 1 cm long after tumor resection with 1-2 cm of surgical margin, joint-preserving surgery was performed under navigation guidance...

Because of loss of function and chronic pain total calcanectomy is a serious impairment for the patient. There are few reports concerning replacement procedures using ribs [Brenner P, Zwipp H, Rammelt S. Vascularized double barrel ribs combined with free serratus anterior muscle transfer for homologous restoration of the hindfoot after calcanectomy. J Trauma-Injury Infect Crit Care 2000;49(2):331-5; Lin CH, Wei FC, Levin LS, Su JI. Free composite serratus anterior and rib flaps for tibial composite bone and soft-tissue defect...

UNLABELLED: Risk factors to explain the poor survival of patients with osteosarcoma of the pelvis are poorly understood. Therefore, we attempted to identify factors affecting survival and development of local recurrence and metastasis. We retrospectively reviewed 43 patients who had high-grade pelvic tumors and were treated surgically. Twenty lesions were chondroblastic, 10 fibroblastic, 11 osteoblastic, and one each was giant cell-rich and small cell osteosarcomas. At a median of 3.5 years (range, 0...

The presence of large and massive segmental defects of the diaphyseal bone following tumor resection is a significant problem for orthopedic surgeons. Double or folded free vascularized fibula graft (FVFG) is used in massive femur defects and is considered to be a reliable reconstructive procedure. However, folded or double fibula grafts cannot prevent stress fractures. Here, a novel surgical procedure for bridging of massive femur defects using double FVFG and hydroxyapatite with autogenous bone grafts to prevent stress fractures is reported...

We report our early experience with a new peri-acetabular reconstruction endoprosthesis used for pelvic reconstruction after tumour resection. The outcome of 21 patients who underwent limb salvage following type II pelvic resection and reconstruction using the peri-acetabular reconstruction prosthesis between 2000 and 2006 was retrospectively reviewed. This prosthesis was designed to use the remaining part of the ilium to support a horizontally placed acetabular component secured with internal fixation and bone cement...

INTRODUCTION: In this report we present our experience in "post war" environment in our institution. Any king of pelvic surgery is challenging and impacts significantly on limb and visceral function. Any surgeon has to ask a question "is heroic surgery justifiable". We aim to asses functional, oncologic and surgical outcomes following pelvis tumor resections. MATERIALS AND METHODS: Between 1998-2005, 7 patients (mean age 48.2 years) underwent pelvic tumor resections...

BACKGROUND: Parosteal osteosarcoma is a rare type of osteosarcoma with distinct characteristics. Clinical outcome of 21 patients was analyzed to assess the predictive relevance of surgical margin, intramedullary tumor extension and histologic grade. METHODS: There were 5 mens and 16 womens with an average age of 26 years. Average follow-up was 9.1 years (range 2.5-22.1). Most common sites were distal femur (15) and proximal humerus (2). No patient presented with metastasis...

The lesion Nora described in 1983 as a bizarre parosteal osteochondromatous proliferation (BPOP) is a member of a group of osteocartilaginous surface lesions. BPOP is infrequent but new cases are regularly reported. We report two new cases with an unusual localization (ilion and distal humerus) and unusual size (9 cm for the iliac lesion). In light of these cases and reports in the literature, the main differential diagnoses of BPOP are exostosis and parosteal osteosarcoma.

Periacetabular resections for primary bone sarcoma and metastatic disease require reconstruction to restore weight-bearing along anatomic axes. We designed a modular hemipelvic prosthetic system to reconstruct the pelvis and evaluated the early clinical outcome of the prosthesis using 3-year survival rate, local recurrence rate, Musculoskeletal Tumor Society (MSTS) 93 function score, and complications. We retrospectively reviewed 28 patients who had pelvic tumor resections and reconstructions using the new hemipelvic prostheses between 2001 and 2005...

A 16-year old female presented painful masses in the lumbar region 5 years after the initial diagnosis of a localized osteosarcoma of the tibia. Abdominal X-ray revealed calcified masses. A bone scan confirmed an increased uptake in the renal areas. An ultrasound-guided fine needle biopsy confirmed the diagnosis of metastases. The procedure was complicated by subcapsular hemorrhage and gross hematuria. Renal metastases from osteosarcoma are usually asymptomatic and invisible on abdominal X-rays. The diagnosis is generally established by radionuclide bone scan or abdominal CT-scan...

Osteosarcoma is a rare malignancy of largely unknown etiology. Although there is no consistent evidence for an association between fluoridation and cancer, some concerns remain about osteosarcoma. As part of the design of a collaborative study, bone samples were collected to allow for an evaluation of the association between osteosarcoma risk and individual fluoride exposure measured by levels of fluoride in bone. In this report, we provide the results of pilot experiments to consider issues that arose during the study design and to assess the reliability of the bone assays...

BACKGROUND: Although hemipelvectomy has been the standard treatment for malignant tumors of the pelvis, limb salvage surgery is now the treatment of choice, even for patients with advanced tumors. For these patients, pelvic reconstruction is needed to maintain the stability of the pelvis and the spinal column and to allow ambulation. In this report, the authors' experiences with pelvic ring reconstruction are described. METHODS: Pelvic ring reconstruction with free double-barreled vascularized fibular grafts was performed after resection of malignant pelvic tumors in five patients...