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Objective:To analyze the clinical characteristics of bone tumors in children, so as to improve the understanding and diagnosis of bone tumors in children.Methods:The clinical data of bone tumors in children hospitalized in the Affiliated Hospital of Zunyi Medical University from January 2009 to December 2018 were collected, with the age ≤ 14 years old.All children′s gender, age, tumor type, location, number of lesions and first symptoms were counted, and the clinical characteristics of bone tumors in children in this area were analyzed.Results:Totally 548 children with bone tumor were collected, with 344 males and 204 females, and the ratio of males to females was 1.69∶1.00, with 462 single cases and 86 multiple cases.Among the multiple cases (86 cases), 82 cases (95.35%) were benign bone tumors.The total number of cases increased with age.The age of different tumors has its own characteristics.Tibia was the most common tumor location (223 in total), followed by femur (177 in total) and humerus (82 in total). According to the classification of tumor nature, there were 478 cases (87.22%) of benign bone tumors, 43 cases (7.85%) of intermediate bone tumors and 27 cases (4.93%) of malignant bone tumors.The incidence of benign bone tumors was significantly higher than that of intermediate and malignant bone tumors, with statistically significant differences ( χ2=72.604, P<0.05). Among the benign bone tumors (478 cases), osteochondroma was the most common (265 cases), accounting for 55.44%; among the intermediate bone tumors (43 cases), aneurysmal bone cyst was the most common (20 cases), occupying 46.51%; among the malignant bone tumors(27 cases), osteosarcoma was the most common (16 cases), accounting for 59.26%.Among the initial symptoms, 268 cases were local masses, and 166 cases were pain, which were significantly higher than that of 79 without symptoms, with 28 lameness, 4 deformity and 3 dysfunction, and the differences were statistically significant( χ2=71.422, P<0.05). Conclusions:The majority of bone tumors patients in children were male, and the incidence increased with age.Benign and solitary are common, and the multiple cases were mainly benign.The most common locations are tibia and femur.The initial symptoms were mainly local mass and pain.Most importantly, the clinical characteristics of different tumors are slightly different.
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Among bone tumours of head neck region, benign tumours of bone are common, while malignant tumours are very rare. These benign tumours constitute about 75% of all bone tumours. Most of these bone tumours present clinically with pain, swelling and symptoms of compression of vascular and neural structures. Surgery is not required for these bone tumours unless patient experiences any discomfort as diagnosis is made on plain radiographs. Only 2% of all benign tumours may undergo malignancy[1]. Fibrous dysplasia (FD) is a less common skeletal developmental anomaly of the bone, which is often misdiagnosed as malignant bone tumour. It manifests as defect in osteoblastic differentiation and maturation and affects a single bone or may involve multiple bones2. Osteosarcoma is a malignant mesenchymal tumour, predominantly affecting the long bones and occasionally seen affecting the maxillofacial region. It accounts for 15–35% of all primary bone tumours and 4–8% of sarcomas of jaw[4]. In osteosarcoma, males are more commonly affected than females. The aim of this article is to represent a rare case of bone tumour of the upper jaw in 10-year-old boy, which was initially suspected as osteosarcoma and later confirmed as FD.
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Objective To explore the imaging radiological and clinicopathological characteristics of benign fibrous histiocytoma (BFH) of bone, in order to improve the imaging diagnostic accuracy of the disease Methods Radiological and clinical data of 16 patients with BFH confirmedbypathology were retrospectively analyzed , and relevant literatures were reviewed. Results The X-ray findings of 14 BFHpatients were osteolytic lesion , expansive destruction of bone,without soft tissue involvement, 10 with residual apophysis,9 with osteosclerosis marginal; CT was performed on 2 patients. Expansive destruction of bone and soft tissue densities were seen inside the loops , 1 case remarkable enhancement of the lesion. MRI was performed on 9 patients and 5 cases showed long T1 and T2 signal intensity; 1case showed equal T1 and long T2 signal intensity in cystic part and equal T1 and T2 signal intensity in the solid part. One patient had pathological fracture, and the surrounding soft tissue invaded, showing equal T1 and long T2 signal intensity. Two lesions located at spinous process of cervical vertebra , showing long T1 short T2 and equal T1 and T2 signal intensity. Linear low signal separation shadow in T1 and T2 could be seen in 6 cases. Long T1 and short T2 sclerotic ring were seen in 4 cases. Solid part of tumor and linear separator were obviously enhanced. Conclusions The radiological findings of benign fibrous histioeytoma of bone indicate some characteristics. The combination with X-ray , CT and MRI examination is helpful to improve the diagnostic accuracy of the disease before operation.
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We evaluated functional outcomes for patients who underwent surgery for resection and endoprosthesis replacement for primary tumours around the knee. We used the Musculoskeletal Tumour Society Scoring System (MSTS) for functional evaluations to compare differences between distal femur (DF) and proximal tibia (PT) placements. The study sample included 34 cases of distal femur and 20 cases of proximal tibia endoprosthesis replacement. Primary tumours were classified as follows: 33 osteosarcoma, 20 stage III giant cell tumour (GCT) and one case of mesenchymal chondrosarcoma. The mean MSTS score for both DF and PT endoprosthesis together was 21.13 (70.43%), and The MSTS scores for DF was 21.94 (73.13%) and PT was 19.75 (65.83%) Infection developed in 7 cases and 5 of which were PT endoprosthesis cases. Three deep infections required early, two-stage revision and resulted in poor MSTS scores. We conclude that endoprosthesis replacement for primary bone tumours had early good to excellent functional outcome. There were no differences in functional outcomes when comparing distal femur endoprostheses with proximal tibia endoprostheses.
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Objective To make a summary of the clinical application and cooperation of piezosurgery in jaw bone tumour operation. Methods 64 patients with jaw bone tumour were selected since 2007 and were divided into the piezosurgery group and the routine group, they used piezosurgery and routine osteotome respectively. Feelings during operation, operation time, hemorrhage, postoperative reaction and complication were observed and compared. Results Discomfort and hemorrhage during operation was lighter, but operation was longer in the piezosurgery group compared with the routine group. Complications such as postoperative infection, hemorrhage and nerve damage did not occurred. Conclusions Application of piezosurgery in jaw bone tumor operation can increase comfort degree and reduce hemorrhage, it requires proficiency in operation procedures and master key aspects of nursing, so that can cooperate well.
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Objective To evaluate the efficacy of zoledronic acid combined with radiotherapy for metastatic bone tumours. Methods Eighty patients with metastatic bone tumour by meta were randomly derided into two groups study group(n=40), and the eantrol group (n=40). The study group received 4 mg zoledronic acid infusion for 15 minutes combined with radiotherapy (DT 30Gy/10f/2w) ,control group was only treated with radiotherapy. The primary effective parameters were pain scores, quality of life, KPS scores and pain relief rates. The vital signs, bi-ochemical and hematological parameters were determined. Results The overall response rates of study group and control group were 97.5% and 72.5% ,respectively(P<0.05). The overall response rate of movement capacity im-provement was 87.5 % in the study group and 65.0% in the control group(P<0.05). There was statistical signifi-cance of QOL and KPS in two groups (P<0.01). An adverse event of mild systemic skeletal pain was recorded after pamidronate infusion and completely reversed after 8 hours. Conclusion Zoledronic acid combined with radiothera-py is effective and safe for treating malignant tumour with mestastatic bone tumours. It is a better way to treat meta-static bone tumors at present.