Intraosseous meningioma mimicking osteosarcoma

Background Predominantly intraosseous meningiomas are rare entities that include true primary intraosseous meningiomas (PIM), as well as meningiomas that may show extensive bone involvement, such as en plaque meningiomas. Different hypotheses have been proposed to decipher the origin of PIMs, such as ectopic arachnoid cap cell entrapment during birth or after trauma. Surgical resection is the treatment of choice of such lesions. Case presentation We present a case of a 65-year-old man with an enlarging mass in the parieto-occipital region that grew slowly and progressively over 13 years, following head trauma during a motor vehicle accident. One year prior to presentation, he started experiencing daily holocranial headaches and blurry vision. CT and MRI studies revealed a permeative midline calvarial lesion measuring 14 cm in greatest dimension with extensive periosteal reaction, extension into the subcutaneous soft tissues, subjacent dural thickening and intracranial extension with invasion of the superior sagittal sinus. The favored pre-operative clinical diagnosis was osteosarcoma. The abnormal calvarium was excised and histopathological examination confirmed the diagnosis of a predominantly intraosseous calvarial meningioma, WHO grade I. Conclusions The present case highlights the importance of histopathologic diagnosis in guiding therapeutic decisions and reiterates the necessity of considering PIM or meningiomas with extensive intraosseous component in the differential diagnosis of calvarial masses, even when imaging suggests a neoplasm with aggressive behavior, such as osteosarcoma.

Osteosarcoma of the Clavicle in an Adolescent Child.

Clavicle is an unusual site for any primary bone tumour, including osteogenic sarcoma. Although a rare site of affection, most clavicular tumours tend to be malignant. We present a case report of osteosarcoma of the clavicle in a twelve-year-old male child who presented with a huge swelling of the left clavicle for the last six months.

[Lung metastasis due to limb osteogenic and soft tissue sarcoma in the hospitalized patients at Al-Zahra hospital in Isfahan between 1995 and 2008]

Soft tissue sarcoma is a relatively rare disease from mesenchymal cells . Lung metastases occur in many of the patients with limb sarcoma . The aim of this study was the evaluation of lung metastasis due to limb osteogenic and soft tissue sarcoma in the hospitalized patients at Al-Zahra hospital in Isfahan between 1995 and 2008. This descriptive cross sectional study was done on the hospitalized patients at Al-Zahra hospital in Isfahan between 1995 and 2008. Lung metastases were evaluated by lung CT scan. The data were collected from the patients' dossier and their laboratory file. We used chi-square, fisher and T test, and SPSS software [v. 11] for analyzing the collected data. We evaluated 65 patients with limb sarcoma. Lung metastases were detected in 43.3% of the patients with osteogenic sarcoma and 11.4% of the patients with soft tissue sarcoma [p=0.005]. There were no relations between occurance of lung metastases and genders, the size of the primary tumor, the side of the stricken limb, and recurrence of the tumor. The incidence of lung metastasis in the patients with osteogenic sarcoma is more than the patients with soft tissue sarcoma. In view of the fact that the incidence of lung metastasis in the patients with osteogenic sarcoma is high, we suggest that these patients be evaluated for lung metastasis

Reporte de primer caso de transplante oseo en paraguay / Report bone transplant first case in paraguay

El osteosarcoma es un tumor maligno primario del esqueleto apendicular que se caracteriza por la formaciòn directa de hueso o tejido osteoide por las cèlulas tumorales.

Metastatic osteosarcoma of the maxilla

We present a case of successfully treated primary osteosarcoma [OS] of the tibia with an isolated maxillary metastasis, which is an extremely rare entity. Once histopathologically proved, a total maxillectomy with adjuvant chemo-radiation was carried out. Local recurrence and distant metastasis have been negative for the past year. Surgery is the gold standard of treatment in operable cases. Adjuvant treatment is required to prevent local recurrence and distant metastases. Amulti-modality therapeutic approach is essential in treating these patients

Frecuencia y distribución de metástasis pulmonar por sarcoma óseo en el Instituto Nacional de Cancerología: periodo 1986-1996 / Frequency and distribution of pulmonary metastases induced by bone sarcoma in the Instituto Nacional de Cancerologia: period 1986-1996

Antecedentes. Los sarcomas óseos son poco frecuentes, pero inducen hasta 80 por ciento de metástasis pulmonar. En población mexicana esta información se desconoce, por lo que describimos su frecuencia en el Instituto Nacional de Cancerología. Métodos. Se revisaron los expedientes de pacientes con sarcoma, registrados entre 1986-1996. Se recabo información demográfica, la histología del tumor y el tiempo de desarrollo de la metástasis. Resultados. Se incluyeron en el estudio 173 casos. De éstos, 74 (43 por ciento) desarrollaron metástasis pulmonar; 102 (60 por ciento) fueron hombres y 71 (40 por ciento) mujeres. Se observó una mediana de edad de 21 años. Se registraron 120 (70 por ciento) casos con diagnóstico de osteosarcoma, 54 (45 por ciento) de los cuales presentaron metástasis; 35 (20 por ciento) casos de condrosarcoma, en 10 (29 por ciento) de los cuales se confirmó metástasis a pulmón y 18 (10 por ciento) casos con sarcoma de Ewing, 10 (56 por ciento) de éstos con metástasis. Considerando la fecha de ingreso, se observaron medianas de tiempo de desarrollo de metástasis pulmonar de hasta 15 meses. A 50 meses, en los pacientes con sarcoma de Ewing, se calculó una supervivencia del 60 por ciento, significativamente menor a la observada en los otros grupos (p=0.0368). Los pacientes con osteosarcoma y metástasis presentaron una supervivencia del 70 por ciento a 50 meses, significativamente menor a la registrada de los osteosarcomas sin metástasis (p=0.0319). Conclusiones. Se encontró una frecuencia del 43 por ciento de metástasis pulmonar. El osteosarcoma y el sarcoma de Ewing fueron los principales inductores de este tipo de metástasis y los grupos en los que se registraron los menores tiempos de supervivencia en presencia o no de metástasis, respectivamente

Retroperitoneal extraosseous osteosarcoma. A case report and review of literature.

Extraosseous osteogenic sarcoma is a rare and highly malignant neoplasm. A 57 year old male patient presented with a mass in the abdomen involving the left lumber region. The ultrasound and computerized tomography (CT) scan showed a large mass arising from upper pole of the left kidney. Left radical nephrectomy was performed in April 1995. Histopathology report revealed a high grade extraosseous osteogenic sarcoma. Patient was disease free for 23 months. Although the prognosis is grave, aggressive surgical treatment with adjuvant therapy helps in prolonging the survival.

La deshidrogenasa láctica como factor pronóstico del desarrollo de enfermedad metastásica pulmonar en pacientes con osteosarcoma / Lactic dehydrogenase as a prognostic factor for the development of pulmonary metastasic disease in patients with osteosarcoma

La sobrevida de los pacientes con osteosarcoma ha mejorado con el empleo de la quimioterapia; sin embargo, el pronóstico es malo en aquéllos que desarrollan metástasis en los primeros 12 meses. Se revisa el rol de la hidrogenasa láctica como indicador. Se estudiaron en forma retrospectiva a 18 pacientes con osteosarcoma en dos grupos: grupo A con niveles normales de deshidrogenasa láctica y grupo B con niveles elevados. Se realizó un análisis univariado de porcentajes para establecer la frecuencia de elevación de la enzima y el desarrollo de metástasis. De los 18 pacientes estudiados 10 (99 por ciento) presentaban niveles elevados al diagnóstico, de los cuales 9 (90 por ciento) desarrollan metástasis en los primeros 12 meses. La diferencia fue significativa con un intervalo de confianza del 95 por ciento y una razón de momios de 15 cuando existió deshidrogenasa elevada. El valor de la deshidrogenasa láctica como pronóstico de sobrevida está limitado si se pretende considerar como un dato de valor único aislado. El volumen tumoral, la variedad histológica y la edad del paciente influyen, pero es de utilidad para predecir enfermedad metastásica pulmonar temprana.

Nuestra experiencia en el tratamiento quirúrgico de las metástasis pulmonares / Our experience in surgical treatment of lung metastasis

Se describe la experiencia del Departamento de Tórax del Instituto de Enfermedades Neoplásicas (INEN) en el tratamiento quirúrgico de las metástasis pulmonares en el lapso comprendido entre 1966 y 1994. Se han revisado las historias clínicas de 77 pacientes, la mayor parte de los cuales presentó metástasis pulmonar de sarcoma osteogénico. Otras metástasis estuvieron dadas por cáncer de testículo, de riñón, de mama, etc. En sarcoma osteogénico se obtuvo una sobrevida de 40 por ciento a 5 años post resección de las metástasis; 67 por ciento a 4 años en cáncer de testículo y 88 por ciento a 3 años en cáncer de riñón. La morbilidad operatoria fue mínima, no habiéndose presentado ningún caso de mortalidad postoperatoria en esta serie. Se revisan los criterios para la selección de los pacientes candidatos a ser sometidos a la resección de metástasis y la literatura respectiva

Deletion of Rb1 gene in late osteosarcoma from survivor of unilateral retinoblastoma: a case report

It has been well known that the survivors of retinoblastoma are prone to have osteosarcoma. But the secondary tumor usually occurs in bilateral, hereditary type of retinoblastoma. We report one case of osteosarcoma in a survivor of unilateral, sporadic retinoblastoma. A fourteen year old male presented with a painfully swollen distal forearm of 2 month duration. He had enucleated his left eye 10 years ago due to retinoblastoma with no other adjuvant therapy. We managed him with our conventional protocol and identified deletion of Rb gene from his pathological specimen by using the PCR-RFLP method. This result is unusual for unilateral nonhereditable retinoblastoma and may suggest gene level change even in sporadic cases. And Rb gene study may be helpful for unilateral, sporadic retinoblastoma patient in detecting the possibility of late osteosarcoma.

Bilateral spontaneous pneumothoraces in osteogenic sarcoma and extragonadal germ cell tumour.

Bilateral spontaneous pneumothoraces are uncommon complications of metastatic pulmonary disease especially antedating frank metastases or developing as a complication of chemotherapy. It is seen more often in osteogenic sarcoma and uncommon in extra gonadal germ cell tumour. It may correct spontaneously or need tube drainage.

Telangiectatic osteosarcoma: a case report

Telangiectatic osteosarcoma is a rare and special variant of osteogenic sarcoma with distinct radiologic, gross and microscopic features. This tumor is predominantly lytic, destructive tumor without sclerosis on roentgenogram, and is soft and cystic on gross examination. Histologically aneurysmally dilated spaces lined or traversed by stromal cells producing osteoid are noted. This report concerns a case of telangiectatic osteosarcoma occurring in a 7 years old boy. He presented with pathologic fracture of the right distal tibia, followed by a purely lytic lesion on X-ray examination. This lesion recurred five times during a span of one year. Microscopic features of the biopsy specimen was difficult to differentiate from aneurysmal bone cyst because of prominant blood-filled cyst formation. It was finally identified as osteosarcoma from the below-knee amputation specimen through the close examination for anaplastic osteoid-producing stromal cells in the septa that separate the blood cysts.

Tumor de células gigantes: um problema difícil, reporte de um caso / Giant cell tumor: a difficult problem, report of a case

Se reporta sobre un caso de tumor de células gigantes de tibia distal que si bien se pudo tratar satisfactoriamente desde el punto de vista ortopédico se complicó con metástasis pulmonares demostradas en biopsia