Epithelial-mesenchymal transition in osteogenic sarcoma of the neck following oral squamous cell carcinoma

Postirradiation extraosseous osteogenic sarcomas are uncommon in the head and neck, despite the extensive use of high-dose radiation. It has been described as de novo radiation-induced neoplasm. We present a 73-year-old male who had been treated by radiotherapy for gingival cancer 7 years earlier and later developed extraosseous osteogenic sarcomas (EOSs) of the neck. Microscopically, the neck mass was composed with mesenchymal malignant cells with cartilaginous and osteogenic differentiation. Immunohistochemical stain demonstrated strong positivity of tumor cells for Snail, the one of major epithelial-mesenchymal transition (EMT) inducer. The E-cadherin expression was scarce, showing inverse relationship to Snail expression. Compared with previous squamous cell carcinoma (SCC) of the gingiva, the present EOS sample revealed the remained epithelial cells on cytokeratin immunohistochemistry, suggesting the tumor arise from the cells of epithelial origin. We have also reviewed the previous 6 cases of head and neck EOSs carefully. The clinicopathologic features of the unusual lesion suggest that it is an incomplete EMT of precedent epithelial malignancy rather than de novo pathology.

Cirugía de salvación del miembro en el tratamiento de osteosarcoma de Peroné con supervivencia a los diecisiete años / Salvation surgery treatment in osteosarcoma of the fibula with seventeen years survival

El osteosarcoma es el tumor óseo primario más frecuente habiendo dos picos de incidencia, uno en torno a los 15 años (adolescentes) y otro en ancianos. Caso clínico: Paciente de 14 años con clínica de dolor en región proximal de perné. Se diagnosticó mediante estudios radiológicos y biopsia osteosarcoma localizado con infiltración de cortical y periostio y extensión hacia epífisis de peroné. Tras quimioterapia preoperatorio se realizó exéresis tumoral con márgenes de 5cm. Siguiendo criterios de Enneking (cirurgia de salvación del miembro). Completamos varios ciclos de quimioterapia postoperatoria. La paciente está libre de enfermedad a los diecisiete años. Discusión: Años atrás en el tratamiento del osteosarcoma localizado se procedía a la amputación radical por norma. Actualmente debido al avance de las técnicas quirurgicas y diagnósticas (capaces de detectar precozmente la diseminación local y a distancia del tumor) es posible efectuar otras modalidades terapéuticas que preservan el miembro hasta en terapéuticas que preservan el miembro hasta en el 90% de los pacientes. Gracias al uso de la quimioterapia la tasa de supervivencia hoy dia se aproxima al 70% en aquellos casos diagnosticados previamente a la aparición de metástasis. Actualmente en quellos casos en los cuales la enfermedad esté localizada, el tamaño tumoral sea reducido y haya una buena respuesta a la quimioterapia preoperatoria es más aconsejable optar por una cirugía de salvación del miembro haciendo una prudente resección a distancia de los márgenes de la tumoración y acompañándola de ciclos de quimioterapia combinada.

Osteosarcoma is the most frequent primary bony tumor with two picks of incidence, one around the 15 years (adolescents) and another in old people. CLINICAL CASE: Patient of 14 years with pain clinic in proximal fibula. It was diagnosed by radiological studies and biopsy of located osteosarcoma with infiltration of cortical and periostium and extension toward fibula epiphysis. After preoperatory chemotherapy she was carried out tumoral resection with margins of 5 cm. following approaches of Enneking (surgery of salvation of the member). Several cycles of chemotherapy were completed after surgery. The patient, after seventeen years, is free of illness. DISCUSSION: Traditionally in the treatment of the located osteosarcoma you proceeded to the radical amputation for norm. At the moment due to the advances of the surgical and diagnostic techniques (able to detect precociously the local and distant dissemination of the tumor) it is possible to make other therapeutic modalities that preserve the member until in 90% of the patients. Thanks to the use of the chemotherapy the rate of survival nowadays approaches to 70% in those cases diagnosed previously to the metastasis appearance. At the moment in those cases in which the illness is located, the tumoral size is reduced and have a good answer to the preoperatroy chemotherapy, it is more advisable to opt for a surgery of salvation of the limb making a wise resection at distance of the margins of the tumor and accompanying it of cycles of combined chemotherapy.

Profile of Gene Expression Changes During Doxorubicin Induced Apoptosis of Saos-2 / 영남의대학술지

BACKGROUND: Doxorubicin has proved to be a useful chemotherapeutic agent especially for osteogenic sarcoma. It induces cancer cell death via apoptosis. MATERIALS AND METHODS: To explore and analyze the changes of gene expression during doxorubicin induced apoptosis on human osteogenic sarcoma, Saos-2 cell, cDNA microarray was performed. After treatment with doxorubicin, total RNA was purified and expressed genes were investigated with a 17k human cDNA microarray. RESULTS: For analysis of the cDNA microarray, the genes were filtered using the sum of the median value of Cy3 and Cy5 signal intensity of greater than 800. Expression of 264 genes was changed by more than 2 fold, and the expression of 35 genes was changed more than 3 fold after treatment with doxorubicin. The genes were primarily related to cell death, cell growth and maintenance, signal transduction, cellular component, transport, and metabolism. CONCLUSION: Treatment with doxorubicin induced expressional change of many genes. Some of the genes might be related with apoptosis directly or indirectly. Further study is now needed to characterize these genes.

Osteogenic Sarcoma with Osseous, Pulmonary, and Pericardial Metastases Simultaneously Demonstrated on Bone Scintigraphy at Initial Presentation / 대한핵의학회잡지

PURPOSE: A 6-year-old boy with osteogenic sarcoma of the left humerus underwent bone scintigraphy. Tc-99m MDP was accumulated not only in the primary tumor but also in the osseous and extraosseous (pulmonary and pericardial) metastases. Osteogenic sarcoma directly produces osteoid, both in the primary and metastatic lesions. Tc-99m MDP is avidly taken up by tumor osteoid. At initial presentation, only 2% of cases have both pulmonary and osseous metastases. The patient had osseous, pulmonary, and pericardial metastases at presentation. This case presents that increased uptakes of Tc-99m MDP by the primary and metastatic tumor were demonstrated on bone scintigraphy at presentation.

Differential Sensitivity of Taxol-induced Apoptosis in U2OS and SaOS2 Osteogenic Sarcoma Cells / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Taxol (Paclitaxel) is a new generation of chemotherapeutic drug proven to be effective in the treatment of many cancers. In this study, to further demonstrate the differential effect of the tumor suppressor gene, p53, on the Taxol-induced apoptosis in osteogenic sarcoma cell lines, we used p53-defected SaOS2 cells and wild type p53-expressed U2OS cells. MATERIALS AND METHODS: The cell viability was measured by the XTT assay. To examine whether the differential expressions of p53, in U2OS and SaOS2 cells, were associated with Taxol-induced apoptosis, DNA fragmentation assays were performed on both cytosolic and genomic DNA. Since the cleavage of poly (ADP-ribose) polymerase (PARP) is primarily responsible for apoptosis, the cleavage of PARP, and the expression of cyclin B1, polo-like kinase, Bax, Bcl-xL, Bcl-2 in U2OS and SaOS2 cells were compared by Western blot analyses. RESULTS: The cell viability of the p53-defected SaOS2 cells was markedly decreased with Taxol treatment. Whereas, the cell viabilities due to 6-mercaptopurine and adriamycin were no different between the U2OS and SaOS2 cells. Treatment with Taxol induced a ladder- like pattern of DNA fragments, which is a biochemical hallmark of apoptosis, consisting of multiples of approximately 180-200 base pairs, in a dose-dependent manner in the SaOS2 cells, but insignificantly with the U2OS cells. When the cells were treated with Taxol, the 89 kDa cleavage product of PARP clearly appeared as a function of time in the SaOS2 cells, but not in the U2OS cells. The Taxol-induced apoptosis in p53 defected-osteogenic sarcoma cells was associated with the PARP cleavage as a result of the increased activity of caspase 3, and the high expressions of cyclin B1 and PLK. Bax, as a proapoptotic factor, was increased in the SaOS2cells, but the Bcl-xL and Bcl-2 were decreased when the cells were exposed to 10miceoM Taxol. CONCLUSION: From these results, it was concluded that p53-defected SaOS2 cells are much more sensitive to Taxol-induced apoptosis than p53-expressed U2OS cells.

Osteogenic Sarcoma of the Breast

Osteogenic sarcoma is a rare breast tumor. The first report of a malignant mammary neoplasm composed of bone and cartilage was that of Bonet in 1700. Meanwhile in Korea, Kim et al reported one case of osteosarcoma of the breast in 1999. A 44 year old woman visited our hospital because of a mass on her right breast. The mass was fixed on the skin and 5 5 cm in size. Following a frozen biopsy result of malignancy. A modified radical mastectomy was performed. The tumor was confirmed histologically and immunohistochemically as an osteogenic sarcoma. This study presents one case of an osteogenic sarcoma of the breast, and the report of this rare breast tumor is accompanied by a review of the literature.

A Case Report of Extraosseous Osteogenic Sarcoma / 대한정형외과학회잡지

Ex.traosseous osteogenic sarcoma is exceedingly rare although bone formation occurs commonly in different reactive processes or neoplasms. Most of this tumors occurred in the lower extremities of middle aged people. The overall prognosis is grave and local recurrence following simple local excision possibly contributes to the poor prognosis. An agressive surgical approach including major amputation is recommended as the primary form of treatment. We have experienced a case of extraosseous osteogenic sarcoma of left gluteal region at the site of therapeutic irradiation for cervical carcinoma 16 years previously.

THE METHODS OF MULTIMODALITY IN THE TREATMENT OF 65 CASES OF OSTEOGENIC SARCOMA OF BONE (ANALYSIS REPORT) / 西安交通大学学报(医学版)

Oseteogenic sarcoma is a kind of malignanttumor of bone, it can occur at any age, teenagersare mose commonly involved. The conventionaltreatment of osteogenic sarcoma was high amputa-tion. Although the primary focuses were removedtotaliy, the subclinical minor focuses could not becontrolled effectively. Therefore. the prognosiswas very poor, the five-year survival rate was on-ly about 20 percent. With the rapid development inchemotherapy and orthopedical surgery tech-niques, multimodality therapy of osteogenic sarco-ma were carried out in 65 cases from 1982 to 1988in our hospital. Curative effect has been satisfac-torily improved. The fivc-year survival rate hasbeen raised to 67. 92%. The methods of multi-modality therapy were as follows: ①Peroperationand postoperation chemotherapy with p?liod ofbody. ②Local arteries were perfused with Nitero-gen mustard (HN_2). ③Inactivation of tumor celland replantation. ④Inactivation of tumor cells invivo. ⑤Amputation.

Clinical Observation on the Primary Bone Tumors / 대한정형외과학회잡지

A total of 189 cases of primary bone tumors reviewed and analysed clinically and pathologically at the Department of Orthopedic Surgery, Presbyterian Hospital, Taegu, Korea during the 15 years period from july, 1964 to june, 1979. The results were obtained as follows: 1. In 189 cases of primary bone tumors, 87 cases (46%) were benign and 102 cases (54%) were malignant. 2. Osteochondroma was the most common benign bone tumor (31.0%) and followed by simple bone cyst (14.9%), enchondroma (14.9%) and giant cell tumor (13.8%). 3. Osteosarcoma was the most common primary malignant bone tumor (45.0%) and followed by fibrosarcoma (17.7%) and chondrosarcoma (12.8%). 4. 22 cases were solitary and 5 cases were multiple Iesions of osteochondroma. The knee joint area was the most common site of osteochondroma (59.2%) and peak incidence was in the second decade. 5. Simple bone cyst was 13 cases. The sex distribution of simple bone cyst showed 5.5 times of the male predominence. The knee joint area was the most common site of simple bone cyst (76.9%) and its peak incidence was in the first and second decade (61.5%). Seven of 13 cases of simple bone cyst were seen pathological fracture and three of its cases were recurred. 6. In 13 cases of enchondroma, 6 cases were solitary and 7 cases were multiple lesions. The common site was phalanges of the hand and its peak incidence was in the second and third decade of life. 7. Giant cell tumor was 16 cases and to be divided into pathologically Grade 1 & 11 12 cases (75%) and Grade III 4 cases (25%). The sex distribution of giant cell tumor was 8 males and 8 females. The average age of giant cell tumor was 36.1 years with the peak incidence in the third and forth decade of life. 8. The average age of osteogenic sarcoma was 23.1 years with the peak incidence in the second decade of life. The sex distribution of osteogenic sarcoma was 25 males (54.3%) and 21 females (45.7%). The common sites of osteogenic sarcoma were distal femur and proximal tibia and proximal humerus in 41 cases (89.1%). 9. The average age of fibrosarcoma was 28.1 years with the peak incidence in the second and third decade of life. The sex distribution of fibrosarcoma was 12 males (66.6%) and 6 females (33.3%). The common site of fibrosarcoma were femur and tibia in 9 cases (50%). 10. Chondrosarcoma were 13 cases. The sex distribution of chondrosarcoma showed 5.5 times of the male predominence. The knee joint area was the most common site of chondrosarcoma (46.1%) and its peak incidence was in the third and forth decade of life.