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[PMID]:29465573
[Au] Autor:Li X; Zhang Z; Latif M; Chen W; Cui J; Peng Z
[Ad] Endereço:Department of Radiology, the Third Hospital of Hebei Medical University.
[Ti] Título:Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report.
[So] Source:Medicine (Baltimore);97(8):e9870, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Undifferentiated high-grade pleomorphic sarcoma (UPS), originated from bone, is a rare tumor, accounting for 2% to 5% of all primary maligment bone neoplasms. Skip lesion can be found in undifferentiated high-grade pleomorphic sarcoma of bone (UPS-B). However, the direct invasion across the articular synovium to bone has not been reported previously. PATIENT CONCERNS: We report an unusual case of a 65-year-old man complained of a year history of pain, swelling, and limitation of activity in the left knee joint. At the proximal tibia, there was extensive invasion of articular synovium, which provides a direct anatomic pathway for the tumor invasion to the adjacent bone, including patella and femoral condyle. DIAGNOSES: Magnetic resonance imaging was important in defining the marrow involvement and joint invasion, including the thickening articular synovium. Subsequent pathological examination confirmed the diagnosis of UPS. INTERVENTIONS: The patient underwent an extensive resection of the knee joint, except for the patellar. OUTCOMES: After operation, routine chemotherapy was performed. Unfortunately, half a year later, soft tissue swelling of whole thigh was found. Then this patient came our hospital again. Positron emission tomography imaging showed there was recurrence of UPS with lung metastasis. A week later, this patient died. LESSONS: In contrast to frequent infiltration pathway, the articular synovium as a media for this tumor spread is rare. This study adds a better understanding of this direct invasion way to the medical literature.
[Mh] Termos MeSH primário: Neoplasias Ósseas/patologia
Histiocitoma Fibroso Maligno/patologia
Membrana Sinovial/patologia
Tíbia/patologia
[Mh] Termos MeSH secundário: Idoso
Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/cirurgia
Evolução Fatal
Neoplasias Femorais/diagnóstico por imagem
Neoplasias Femorais/patologia
Neoplasias Femorais/cirurgia
Histiocitoma Fibroso Maligno/diagnóstico por imagem
Histiocitoma Fibroso Maligno/cirurgia
Seres Humanos
Articulação do Joelho/diagnóstico por imagem
Articulação do Joelho/patologia
Articulação do Joelho/cirurgia
Neoplasias Pulmonares/secundário
Imagem por Ressonância Magnética
Masculino
Invasividade Neoplásica
Patela/diagnóstico por imagem
Patela/patologia
Patela/cirurgia
Membrana Sinovial/diagnóstico por imagem
Coxa da Perna/diagnóstico por imagem
Coxa da Perna/patologia
Tíbia/diagnóstico por imagem
Tíbia/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009870


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[PMID]:29328615
[Au] Autor:Radunovic A; Kosutic M; Vulovic M; Milev B; Janjusevic N; Ivosevic A; Krulj V
[Ti] Título:Ilizarov method as limb salvage in treatment of massive femoral defect after unsuccessful tumor arthroplasty.
[So] Source:Vojnosanit Pregl;73(8):779-82, 2016 Aug.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Surgical management of massive bone defects is very challenging in terms of estimating possibilities of saving the extremity and adequate method that can make it possible. Selection of methods is additionally limited in the presence of infection at site of defect. Case report: The female patient, diagnosed with Ewing sarcoma was treated by segmental bone resection and implantation of Kotz modular tumor endoprosthesis. After 5 years the signs of infection occured and persisted with low grade intensity. After falling, 12 years following implantation, the patient acquired periprosthetic fracture. Then endoprosthesis was removed, all along with surgical debridement of wound and application of the Ilizarov apparatus. The apparatus was applied, osteotomy of callus and the tibia performed with transport of bone segments, untill reconstruction of defect and arthrodesis of the knee was achieved. Conclusion: The Ilizarov apparatus offered us huge possibilities for management of massive bone defects with natural bone which has superior biomechanical characteristics comparing to the implant. The most frequent complication of this method is a prolonged treatment period that demands good patient selection and preparation and wide surgical experience.
[Mh] Termos MeSH primário: Neoplasias Femorais/cirurgia
Fêmur/cirurgia
Técnica de Ilizarov
Salvamento de Membro
Sarcoma de Ewing/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Feminino
Fraturas do Fêmur/diagnóstico
Seres Humanos
Fraturas Periprotéticas/diagnóstico
Implante de Prótese
Infecções Relacionadas à Prótese/diagnóstico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150419039R


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[PMID]:29305458
[Au] Autor:Stevenson JD; Kumar VS; Cribb GL; Cool P
[Ad] Endereço:Aston University Medical School, Aston Express Way, Birmingham, B4 7ET, UK.
[Ti] Título:Hemiarthroplasty proximal femoral endoprostheses following tumour reconstruction: is acetabular replacement necessary?
[So] Source:Bone Joint J;100-B(1):101-108, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Dislocation rates are reportedly lower in patients requiring proximal femoral hemiarthroplasty than for patients undergoing hip arthroplasty for neoplasia. Without acetabular replacement, pain due to acetabular wear necessitating revision surgery has been described. We aimed to determine whether wear of the native acetabulum following hemiarthroplasty necessitates revision surgery with secondary replacement of the acetabulum after proximal femoral replacement (PFR) for tumour reconstruction. PATIENTS AND METHODS: We reviewed 100 consecutive PFRs performed between January 2003 and January 2013 without acetabular resurfacing. The procedure was undertaken in 74 patients with metastases, for a primary bone tumour in 20 and for myeloma in six. There were 48 male and 52 female patients, with a mean age of 61.4 years (19 to 85) and median follow-up of two years (interquartile range (IQR) 0.5 to 3.7 years). In total, 52 patients presented with a pathological fracture and six presented with failed fixation of a previously instrumented pathological fracture. RESULTS: All patients underwent reconstruction with either a unipolar (n = 64) or bipolar (n = 36) articulation. There were no dislocations and no acetabular resurfacings. Articular wear was graded using the criteria of Baker et al from 0 to 3, where by 0 is normal; grade 1 represents a narrowing of articular cartilage and no bone erosion; grade 2 represents acetabular bone erosion and early migration; and grade 3 represents protrusio acetabuli. Of the 49 patients with radiological follow-up greater than one year, six demonstrated grade 1 acetabular wear and two demonstrated grade 2 acetabular wear. The remainder demonstrated no radiographic evidence of wear. Median medial migration was 0.3 mm (IQR -0.2 to 0.7) and superior migration was 0.3 mm (IQR -0.2 to 0.6). No relationship between unipolar bipolar articulations and wear was evident. CONCLUSION: Hemiarthroplasty PFRs for tumour reconstruction eliminate joint instability and, in the short to medium term, do not lead to native acetabular wear necessitating later acetabular resurfacing. Cite this article: 2018;100B:101-8.
[Mh] Termos MeSH primário: Acetábulo/cirurgia
Artroplastia de Quadril/métodos
Neoplasias Femorais/cirurgia
Hemiartroplastia/métodos
Prótese de Quadril
[Mh] Termos MeSH secundário: Acetábulo/diagnóstico por imagem
Adulto
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/efeitos adversos
Feminino
Neoplasias Femorais/secundário
Seguimentos
Hemiartroplastia/efeitos adversos
Luxação do Quadril/etiologia
Seres Humanos
Salvamento de Membro/métodos
Masculino
Meia-Idade
Falha de Prótese
Radiografia
Reoperação/métodos
Reoperação/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180107
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0005.R1


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[PMID]:28663406
[Au] Autor:Gupta S; Kafchinski LA; Gundle KR; Saidi K; Griffin AM; Wunder JS; Ferguson PC
[Ad] Endereço:Glasgow Royal Infirmary, 84 Castle St, Glasgow G4 0SF, UK.
[Ti] Título:Intercalary allograft augmented with intramedullary cement and plate fixation is a reliable solution after resection of a diaphyseal tumour.
[So] Source:Bone Joint J;99-B(7):973-978, 2017 Jul.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Intercalary allografts following resection of a primary diaphyseal tumour have high rates of complications and failures. At our institution intercalary allografts are augmented with intramedullary cement and fixed using compression plating. Our aim was to evaluate their long-term outcomes. PATIENTS AND METHODS: A total of 46 patients underwent reconstruction with an intercalary allograft between 1989 and 2014. The patients had a mean age of 32.8 years (14 to 77). The most common diagnoses were osteosarcoma (n = 16) and chondrosarcoma (n = 9). The location of the tumours was in the femur in 21, the tibia in 16 and the humerus in nine. Function was assessed using the Musculoskeletal Tumor Society (MSTS) scoring system and the Toronto Extremity Salvage Score (TESS). The survival of the graft and the overall survival were assessed using the Kaplan-Meier method. RESULTS: The median follow-up was 92 months (4 to 288). The mean MSTS 87 score was 29.1 (19 to 35), the mean MSTS 93 score was 82.2 (50 to 100) and the mean TESS score was 81.2 (43 to 100). Overall survival of the allograft was 84.8%. A total of 15 patients (33%) had a complication. Five allografts were revised for complications and one for local recurrence. CONCLUSION: Intercalary allografts augmented with intramedullary cement and compression plate fixation provide a reliable and durable method of reconstruction after the excision of a primary diaphyseal bone tumour, with high levels of function and satisfaction. Cite this article: 2017;99-B:973-8.
[Mh] Termos MeSH primário: Neoplasias Ósseas/cirurgia
Condrossarcoma/cirurgia
Neoplasias Femorais/cirurgia
Úmero/cirurgia
Osteossarcoma/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Aloenxertos
Cimentos para Ossos
Neoplasias Ósseas/tratamento farmacológico
Placas Ósseas
Condrossarcoma/tratamento farmacológico
Terapia Combinada
Diáfises
Feminino
Neoplasias Femorais/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
Osteossarcoma/tratamento farmacológico
Estudos Prospectivos
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B7.BJJ-2016-0996


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[PMID]:28403086
[Au] Autor:Zhou Y; Zhang W; Tang F; Luo Y; Min L; Zhang W; Shi R; Duan H; Tu C
[Ad] Endereço:aDepartment of Orthopedics bPrecision Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:A case report of apatinib in treating osteosarcoma with pulmonary metastases.
[So] Source:Medicine (Baltimore);96(15):e6578, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Osteosarcoma is the most common malignant bone tumor in children and adolescents. Pulmonary metastases lead to a significantly increased risk of death. Apatinib, a new potent oral small-molecule tyrosine kinase inhibitor targeting the intracellular domain of vascular endothelial growth factor receptor 2 (VEGFR-2), shows survival benefits in treating advanced or metastatic gastric adenocarcinoma, non-squamous non-small cell lung cancer and metastatic breast cancer. However, its efficacy in metastatic osteosarcoma has not been reported yet. PATIENT CONCERNS: Herein, we presented a 50-year-old man patient who visited hospital due to local bone pain in the left leg. DIAGNOSES: He was initially diagnosed with osteoblastic osteosarcoma. INTERVENTIONS: The patient suffered repeated resection surgeries but developed multiple lung metastases. Positive staining for CD31, CD34, and VEGFR-2 were detected in the tumor section. As he refused to receive chemotherapy due to concerns regarding the chemotherapy toxicities and sorafenib due to high cost, apatinib was given at a dose of 500 mg daily. OUTCOMES: Eleven months following apatinib administration, the patient achieved a partial response according to the RECIST 1.1 standard. No severe toxicity or drug-related side effect was observed during the treatment. LESSONS: Therefore, apatinib could be a new option for the treatment of metastatic osteosarcoma. Clinical trials are required to further confirm the efficacy and safety of apatinib in treating pulmonary metastases from osteosarcoma.
[Mh] Termos MeSH primário: Antineoplásicos/uso terapêutico
Neoplasias Femorais/tratamento farmacológico
Neoplasias Pulmonares/tratamento farmacológico
Osteossarcoma/tratamento farmacológico
Piridinas/uso terapêutico
[Mh] Termos MeSH secundário: Neoplasias Femorais/patologia
Seres Humanos
Neoplasias Pulmonares/secundário
Masculino
Meia-Idade
Osteossarcoma/secundário
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Pyridines); 5S371K6132 (apatinib)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006578


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[PMID]:28385944
[Au] Autor:Henderson ER; Keeney BJ; Pala E; Funovics PT; Eward WC; Groundland JS; Ehrlichman LK; Puchner SS; Brigman BE; Ready JE; Temple HT; Ruggieri P; Windhager R; Letson GD; Hornicek FJ
[Ad] Endereço:The Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH 03756, USA.
[Ti] Título:The stability of the hip after the use of a proximal femoral endoprosthesis for oncological indications: analysis of variables relating to the patient and the surgical technique.
[So] Source:Bone Joint J;99-B(4):531-537, 2017 Apr.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Instability of the hip is the most common mode of failure after reconstruction with a proximal femoral arthroplasty (PFA) using an endoprosthesis after excision of a tumour. Small studies report improved stability with capsular repair of the hip and other techniques, but these have not been investigated in a large series of patients. The aim of this study was to evaluate variables associated with the patient and the operation that affect post-operative stability. We hypothesised an association between capsular repair and stability. PATIENTS AND METHODS: In a retrospective cohort study, we identified 527 adult patients who were treated with a PFA for tumours. Our data included demographics, the pathological diagnosis, the amount of resection of the abductor muscles, the techniques of reconstruction and the characteristics of the implant. We used regression analysis to compare patients with and without post-operative instability. RESULTS: A total of 20 patients out of 527 (4%) had instability which presented at a mean of 35 days (3 to 131) post-operatively. Capsular repair was not associated with a reduced rate of instability. Bivariate analysis showed that a posterolateral surgical approach (odds ratio (OR) 0.11, 95% confidence interval (CI) 0.02 to 0.86) and the type of implant (p = 0.046) had a significant association with reduced instability; age > 60 years predicted instability (OR 3.17, 95% CI 1.00 to 9.98). Multivariate analysis showed age > 60 years (OR 5.09, 95% CI 1.23 to 21.07), female gender (OR 1.73, 95% CI 1.04 to 2.89), a malignant primary bone tumour (OR 2.04, 95% CI 1.06 to 3.95), and benign condition (OR 5.56, 95% CI 1.35 to 22.90), but not metastatic disease or soft-tissue tumours, predicted instability, while a posterolateral approach (OR 0.09, 95% CI 0.01 to 0.53) was protective against instability. No instability occurred when a synthetic graft was used in 70 patients. CONCLUSION: Stability of the hip after PFA is influenced by variables associated with the patient, the pathology, the surgical technique and the implant. We did not find an association between capsular repair and improved stability. Extension of the tumour often dictates surgical technique; however, our results indicate that PFA using a posterolateral approach with a hemiarthroplasty and synthetic augment for soft-tissue repair confers the lowest risk of instability. Patients who are elderly, female, or with a primary benign or malignant bone tumour should be counselled about an increased risk of instability. Cite this article: 2017;99-B:531-7.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Neoplasias Femorais/cirurgia
Luxação do Quadril/etiologia
Prótese de Quadril
Instabilidade Articular/etiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/efeitos adversos
Criança
Pré-Escolar
Feminino
Neoplasias Femorais/secundário
Seguimentos
Seres Humanos
Cápsula Articular/cirurgia
Masculino
Meia-Idade
Desenho de Prótese
Estudos Retrospectivos
Fatores de Risco
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B4.BJJ-2016-0960.R1


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[PMID]:28385943
[Au] Autor:Bus MP; van de Sande MA; Taminiau AH; Dijkstra PD
[Ad] Endereço:Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
[Ti] Título:Is there still a role for osteoarticular allograft reconstruction in musculoskeletal tumour surgery? a long-term follow-up study of 38 patients and systematic review of the literature.
[So] Source:Bone Joint J;99-B(4):522-530, 2017 Apr.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To assess complications and failure mechanisms of osteoarticular allograft reconstructions for primary bone tumours. PATIENTS AND METHODS: We retrospectively evaluated 38 patients (28 men, 74%) who were treated at our institution with osteoarticular allograft reconstruction between 1989 and 2010. Median age was 19 years (interquartile range 14 to 32). Median follow-up was 19.5 years (95% confidence interval (CI) 13.0 to 26.1) when 26 patients (68%) were alive. In addition, we systematically searched the literature for clinical studies on osteoarticular allografts, finding 31 studies suitable for analysis. Results of papers that reported on one site exclusively were pooled for comparison. RESULTS: A total of 20 patients (53%) experienced graft failure, including 15 due to mechanical complications (39%) and three (9%) due to infection. In the systematic review, 514 reconstructions were analysed (distal femur, n = 184, 36%; proximal tibia, n = 136, 26%; distal radius, n = 99, 19%; proximal humerus, n = 95, 18%). Overall rates of failure, fracture and infection were 27%, 20%, and 10% respectively. With the distal femur as the reference, fractures were more common in the humerus (odds ratio (OR) 4.1, 95% CI 2.2 to 7.7) and tibia (OR 2.2, 95% CI 1.3 to 4.4); infections occurred more often in the tibia (OR 2.2, 95% CI 1.3 to 4.4) and less often in the radius (OR 0.1, 95% CI 0.0 to 0.8). CONCLUSION: Osteoarticular allograft reconstructions are associated with high rates of mechanical complications. Although comparative studies with alternative techniques are scarce, the risk of mechanical failure in our opinion does not justify routine employment of osteoarticular allografts for reconstruction of large joints after tumour resection. Cite this article: 2017;99-B:522-30.
[Mh] Termos MeSH primário: Neoplasias Ósseas/cirurgia
Transplante Ósseo/métodos
Cartilagem/transplante
[Mh] Termos MeSH secundário: Adolescente
Adulto
Neoplasias Ósseas/diagnóstico por imagem
Transplante Ósseo/efeitos adversos
Feminino
Neoplasias Femorais/diagnóstico por imagem
Neoplasias Femorais/cirurgia
Seguimentos
Rejeição de Enxerto
Seres Humanos
Úmero/diagnóstico por imagem
Úmero/cirurgia
Estimativa de Kaplan-Meier
Masculino
Osteossarcoma/diagnóstico por imagem
Osteossarcoma/cirurgia
Radiografia
Reoperação/estatística & dados numéricos
Estudos Retrospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B4.BJJ-2016-0443.R2


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[PMID]:28377548
[Au] Autor:Aldashash F; Elraie M
[Ad] Endereço:Dr. Fahad Aldashash, King Saud St. 40501, Riyadh 11551, Saudi Arabia, f.a.dashash@gmail.com, ORCID: http://orcid. org/0000-0002-6190-0788.
[Ti] Título:Solitary osteochondroma of the proximal femur causing sciatic nerve compression.
[So] Source:Ann Saudi Med;37(2):166-169, 2017 Mar-Apr.
[Is] ISSN:0975-4466
[Cp] País de publicação:Saudi Arabia
[La] Idioma:eng
[Ab] Resumo:Osteochondromas (OC) are the most common benign tumors of the bones. They are most frequently found near the knee joint and are typically asymptomatic. The presence of OC near the hip joint is rare. In addition, OC is an extremely uncommon cause of sciatica. We present a rare case of OC of the proximal femur. The patient presented with left hip pain and manifestations of sciatic nerve compression. Surgical excision was performed. The diagnosis was confirmed postoperatively by histopathology. SIMILAR CASES PUBLISHED: 1.
[Mh] Termos MeSH primário: Neoplasias Ósseas/complicações
Neoplasias Femorais/complicações
Síndromes de Compressão Nervosa/etiologia
Osteocondroma/complicações
[Mh] Termos MeSH secundário: Adulto
Neoplasias Ósseas/patologia
Neoplasias Ósseas/cirurgia
Feminino
Neoplasias Femorais/patologia
Neoplasias Femorais/cirurgia
Articulação do Quadril/patologia
Seres Humanos
Osteocondroma/patologia
Osteocondroma/cirurgia
Dor/etiologia
Nervo Isquiático/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE
[do] DOI:10.5144/0256-4947.2017.166


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[PMID]:28324746
[Au] Autor:Palmerini E; Chawla NS; Ferrari S; Sudan M; Picci P; Marchesi E; Leopardi MP; Syed I; Sankhala KK; Parthasarathy P; Mendanha WE; Pierini M; Paioli A; Chawla SP
[Ad] Endereço:Istituto Ortopedico Rizzoli, Bologna, Italy. Electronic address: emanuela.palmerini@ior.it.
[Ti] Título:Denosumab in advanced/unresectable giant-cell tumour of bone (GCTB): For how long?
[So] Source:Eur J Cancer;76:118-124, 2017 May.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Giant-cell tumours of bone (GCTB) are RANK/RANK-ligand (RANKL) positive, aggressive and progressive osteolytic tumours. Denosumab, a RANKL inhibitor, was FDA-approved for adults and skeletally mature adolescents with unresectable GCTB or when surgical resection is likely to result in severe morbidity. Data on long-term toxicity and activity of denosumab monthly 'GCTB-schedule' (120 mg per 12/year, 1440 mg total dose/year) are lacking. METHODS: Patients with GCTB receiving denosumab, 120 mg on days 1, 8, 15, 29 and every 4 weeks thereafter, from 2006 to 2015 treated in two centres were included. Long-term toxicity was evaluated. RESULTS: Ninety-seven patients were identified. 43 patients underwent resection of the tumour with a median time on denosumab treatment of 12 months (range 6-45 months). Fifty-four patients had unresectable GCTB's (male/female 23/31, median age 35 years [range: 13-76 years], 26% presented with lung metastases, 31% had primary tumor located to the spine, 63% were relapsed after previous surgery) with a median time on denosumab of 54 months (9-115 months). In the unresectable GCTB group, tumour control and clinical benefits were observed in all patients undergoing denosumab, whereas 40% of patients discontinuing denosumab had tumour progression after a median of 8 months (range 7-15 months). ADVERSE EVENTS: Overall, six (6%) patients developed osteonecrosis of jaw (ONJ): 1/43 (2%) in the resectable group, 5/54 (9%) in the unresectable group, with a 5-year ONJ-free survival of 92% (95% CI 84-100). Only patients with prolonged treatment experienced mild peripheral neuropathy (6/54, 11%), skin rash (5/54, 9%), hypophosphataemia (2/54, 4%) and atypical femoral fracture (2/54, 4%). CONCLUSIONS: Prolonged treatment with denosumab has sustained activity in GCTB, with a mild toxicity profile. The dose-dependent toxicity observed recommends a careful and strict monitoring of patients who need prolonged treatment. Decreased dose-intensity schedules should be further explored in unresectable GCTB.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/administração & dosagem
Neoplasias Ósseas/tratamento farmacológico
Denosumab/administração & dosagem
Tumor de Células Gigantes do Osso/tratamento farmacológico
Neoplasias Pulmonares/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/epidemiologia
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia
Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/patologia
Estudos de Coortes
Progressão da Doença
Relação Dose-Resposta a Droga
Feminino
Neoplasias Femorais/tratamento farmacológico
Neoplasias Femorais/patologia
Tumor de Células Gigantes do Osso/diagnóstico por imagem
Tumor de Células Gigantes do Osso/secundário
Seres Humanos
Ísquio
Neoplasias Pulmonares/diagnóstico por imagem
Neoplasias Pulmonares/secundário
Masculino
Meia-Idade
Rádio (Anatomia)/diagnóstico por imagem
Estudos Retrospectivos
Sacro
Neoplasias Cranianas/tratamento farmacológico
Neoplasias Cranianas/patologia
Neoplasias da Coluna Vertebral/tratamento farmacológico
Neoplasias da Coluna Vertebral/patologia
Tíbia
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 4EQZ6YO2HI (Denosumab)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE


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[PMID]:28300344
[Au] Autor:Zhang Y; Li JZ; Lu XC; Zhang Y; Zhang HS; Shi HL; Lei Z; Feng G; Fu WP
[Ad] Endereço:Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
[Ti] Título:Intramedullary Nailing Combined with Bone Grafting for Benign Lesions of the Proximal Femur.
[So] Source:Orthop Surg;9(1):97-102, 2017 Feb.
[Is] ISSN:1757-7861
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the effectiveness of intramedullary nailing for benign lesions of the proximal femur. METHOD: A retrospective analysis was carried out on 68 cases of benign lesions in the proximal femur at our hospital from April 2002 to April 2013 (38 men and 30 women). Mean age at surgery was 35.5 years (range, 22-56 years). The cases were divided into two groups: curettage of the lesion with bone grafting only as the grafting group (32 cases) and internal fixation after removal of the lesion as the fixation group (36 cases). For the grafting group, lesions were scraped out, deactivated and washed thoroughly with normal saline, then the allogeneic bone was implanted. For the fixation group, after the lesions were scraped, the intramedullary nails were implanted, and allogeneic bone was implanted into the scraped cavity with compaction. RESULTS: Pathological examination showed that 24 out of 68 cases (35.3%) had simple bone cysts (suffered from pathological fracture in 2 cases); 21 (30.9%) fibrous dysplasia; 18 (26.5%) aneurysmal bone cysts; 3 (4.4%) chondroblastoma, 2 (2.9%) out of which were combined with aneurysmal bone cysts. All patients were followed up for 12-96 months (56 months for mean). In the grafting group, 4 patients had postoperative complications (1 pathological bone fractures and 3 deep vein thrombosis), but only 1 patient of the fixation group (deep vein thrombosis) (P < 0.05). The average bedridden time after surgery was 11.4 ± 7.6 days for the grafting group, and for the other group was 7.5 ± 5.4 days ( P < 0.05). CONCLUSION: Both treatments are effective for benign lesions in the proximal femur, but the fixation group facilitated the functional recovery of patients and reduced postoperative complications.
[Mh] Termos MeSH primário: Doenças Ósseas/cirurgia
Transplante Ósseo/métodos
Fêmur/cirurgia
Fixação Intramedular de Fraturas/métodos
[Mh] Termos MeSH secundário: Adulto
Cistos Ósseos/diagnóstico por imagem
Cistos Ósseos/cirurgia
Doenças Ósseas/diagnóstico por imagem
Transplante Ósseo/efeitos adversos
Curetagem/métodos
Feminino
Neoplasias Femorais/diagnóstico por imagem
Neoplasias Femorais/cirurgia
Fêmur/diagnóstico por imagem
Seguimentos
Fixação Intramedular de Fraturas/efeitos adversos
Seres Humanos
Imagem por Ressonância Magnética/métodos
Masculino
Meia-Idade
Recuperação de Função Fisiológica
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE
[do] DOI:10.1111/os.12311



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