MicroRNA expression in relation with clinical evolution of osteosarcoma.

Osteosarcoma is the most common malignant bone tumor. Early diagnosis remains a major challenge, mainly because of the lack of specific biomarkers. We performed miRNAs expression analysis through qPCR in affected and paired healthy bone derived from osteosarcoma patients. Hierarchical clustering using the top ten miRNAs with differential expression showed two main clusters. One integrated by patients with the presence of metastasis or relapse and the other without these complications. Further pathway enrichment analysis reduced to four main miRNAs, hsa-miR-486-3p, hsa-miR-355-5p, hsa-miR-34a-5p and hsa-miR-1228-3p. Afterwards, we compared patients with and without metastasis, the function enrichment analysis along with review of relevant literature, showed that hsa-miR-93-5p and hsa-miR-28-5p were associated with metastasis development. Our results support the relevance of miRNAs in the pathogenesis of osteosarcoma and contribute with evidence regarding the potential role of miRNAs as potential biomarkers. More studies are needed to define the most informative miRNAs in osteosarcoma patients.

Analysis of ERCC1 and ERCC2 gene variants in osteosarcoma, colorectal and breast cancer.

The Asn118Asn (rs11615) variant in the ERCC1 gene, and the Lys751Gln (rs13181) and Asp312Asn (rs1799793) variants in the ERCC2 gene have been associated with the development of varied types of cancer. The aim of the present study was to test for any association between the ERCC1 and ERCC2 gene variants and three different types of cancer in Mexican-mestizo patients. Patients and their respective controls were formed into three groups: The osteosarcoma group, with 28 patients and 97 controls; the colorectal group, with 108 patients and 119 controls; and the breast cancer group, with 71 patients and 74 controls. Genotyping was performed using TaqMan probes and quantitative polymerase chain reaction. Allele and genotype frequencies were compared using a χ2 test. Only one SNP (rs1799793) was found to be associated with breast cancer. This is the first study analyzing the SNPs in ERCC1 and ERCC2 genes and the susceptibility to cancer in Mexican-mestizo patients with osteosarcoma, and colorectal and breast cancer.

Dedifferentiated giant-cell tumor of bone with an undifferentiated round cell mesenchymal component.

The dedifferentiated giant-cell tumor of the bone is a very rare variant of the giant-cell tumor (GCT). We report the clinical, radiographic and histological findings of a dedifferentiated GCT in which the dedifferentiated component consisted of small round cells. We also comment on previously reported cases of dedifferentiated GCT, discuss the clinical implications of this dual histology, and analyze the information published about the coexistence of similar genetic abnormalities in GCT and small round cell tumors of the bone.

Serum tumor markers in pediatric osteosarcoma: a summary review.

Osteosarcoma is the most common primary high-grade bone tumor in both adolescents and children. Early tumor detection is key to ensuring effective treatment. Serum marker discovery and validation for pediatric osteosarcoma has accelerated in recent years, coincident with an evolving understanding of molecules and their complex interactions, and the compelling need for improved pediatric osteosarcoma outcome measures in clinical trials. This review gives a short overview of serological markers for pediatric osteosarcoma, and highlights advances in pediatric osteosarcoma-related marker research within the past year. Studies in the past year involving serum markers in patients with pediatric osteosarcoma can be assigned to one of four categories, i.e., new approaches and new markers, exploratory studies in specialized disease subsets, large cross-sectional validation studies, and longitudinal studies, with and without an intervention.Most of the studies have examined the association of a serum marker with some aspect of the natural history of pediatric osteosarcoma. As illustrated by the many studies reviewed, several serum markers are emerging that show a credible association with disease modification. The expanding pool of informative osteosarcoma-related markers is expected to impact development of therapeutics for pediatric osteosarcoma positively and, it is hoped, ultimately clinical care. Combinations of serum markers of natural immunity, thyroid hormone homeostasis, and bone tumorigenesis may be undertaken together in patients with pediatric osteosarcoma. These serum markers in combination may do better. The potential effect of an intrinsic dynamic balance of tumor angiogenesis residing within a single hormone (tri-iodothyronine) is an attractive concept for regulation of vascularization in pediatric osteosarcoma.

Diagnosis of a dedifferentiated chondrosarcoma of the pelvis by fine needle aspiration. A case report.

BACKGROUND: Dedifferentiated chondrosarcomas account for approximately 10% of all chondrosarcomas. There are few reports that describe the cytologic findings in dedifferentiated chondrosarcomas. In all these cases it was only present in the smears as a high grade sarcoma component. CASE: A 58-year-old man with a bone lesion in the right acetabular zone was admitted to the hospital. The clinical diagnosis was chondrosarcoma. A fine needle aspiration biopsy was performed. The smears of the sample had different characteristics in composition. Some slides had mostly abundant chondroid matrix with low to moderate cellularity. Other slides were cellular and contained mainly pleomorphic, spindled-shaped cells. The typical appearance of dedifferentiated chondrosarcoma was present in some slides that showed focal zones with chondroid matrix adjacent to or surrounded by pleomorphic spindled cells. The composition of the surgical specimen (slightly greater cartilaginous component than the sarcomatous one) allowed us to make a straightforward diagnosis of dedifferentiated chondrosarcoma. CONCLUSION: This is the first report that describes the presence of both components, high and low grade, by fine needle aspiration biopsy in dedifferentiated chondrosarcoma.

Hamartoma fibroso de la infancia: informe de un caso / Fibrous hamartoma of infancy: case report

Introducción: El hamartoma fibroso de la infancia es una proliferación benigna de los tejidos blandos, de presentación infrecuente; 91 % de los casos ocurre durante el primer año de edad y afecta más frecuentemente al sexo masculino. Se caracteriza por ser una lesión subcutánea de morfología característica con patrón de crecimiento organoide trifásico. Caso clínico: Lactante masculino de seis meses de edad, con tumor en la región plantar medial del pie izquierdo, el cual fue resecado completamente. En el estudio histopatológico se informó como hamartoma fibroso de la infancia. Conclusiones: Puede localizarse en cualquier sitio anatómico, aunque 5 a 10 % afecta las extremidades inferiores existen pocos casos informados en el pie. En biopsias pequeñas es importante su diagnóstico diferencial con otras lesiones fibroadiposas para el adecuado tratamiento. La resección quirúrgica amplia con márgenes libres de lesión confiere un buen pronóstico a los pacientes.

BACKGROUND: Fibrous hamartoma of infancy (FHI) is an infrequent benign proliferation of the soft tissues. Ninety one percent of cases occur during the first year of life. FHI is characterized as a subcutaneous lesion with characteristic morphology with a triphasic organoid growth pattern. CLINICAL CASE: We present the case of a 6-month-old male infant with a tumor in the medial plantar region of the left foot, which was completely withered. Histopathological study reported a fibrous hamartoma of infancy. CONCLUSIONS: Fibrous hamartoma of infancy most frequently affects males. It may be localized at any anatomic site, although 5-10% of cases affect the lower limbs. Few cases are reported in the foot. This is a lesion with a characteristic morphological pattern; however, in small biopsies, its differential diagnosis is important with other fibroadipose lesions for appropriate treatment. Ample surgical resection with lesion-free borders confers a good prognosis for these patients.

Epidemiology of bone tumors in Mexico City: retrospective clinicopathologic study of 566 patients at a referral institution.

A retrospective analysis of all bone tumors accessioned at a large referral center (Instituto Nacional de Rehabilitacion) in Mexico City between 2000 and 2005 is presented. A total of 6216 biopsies and surgical resection specimens were reviewed during this period, of which 566 corresponded to bone tumors. Benign bone tumors accounted for 71.6% of cases and malignant bone tumors for 28.4%. The tumors affected men in 53.7% of cases and women in 46.3% of cases, with an average age at presentation of 25 years. The femur was the most common location of the tumors (39.9%), followed by the tibia (17.7%) and humerus (11.8%). The commonest malignant bone tumors were osteosarcoma (46.6%) and chondrosarcoma (8.7%). Of malignant bone tumors, 18.6% corresponded to metastases of carcinomas from internal organs and 8.1% were multiple myeloma. The most common benign bone tumor was osteochondroma (43.7%) followed by giant cell tumor of bone (14.6%) and enchondroma (10.1%). The age distribution showed a peak in children and adolescents comprised predominantly of benign lesions and a second peak in young adults that corresponded to malignant bone tumors (principally osteosarcoma). Malignant bone tumors most often involved the femur, vertebra, and tibia. Our results parallel the findings previously reported in the world literature and show a similar distribution and epidemiology as in other developed and underdeveloped countries. Geographic location does not appear to represent a risk factor for any particular type of bone tumor and does not affect the age distribution, location, or histopathologic type of the lesions.

Fibrous hamartoma of infancy. Case report.

BACKGROUND: Fibrous hamartoma of infancy (FHI) is an infrequent benign proliferation of the soft tissues. Ninety one percent of cases occur during the first year of life. FHI is characterized as a subcutaneous lesion with characteristic morphology with a triphasic organoid growth pattern. CLINICAL CASE: We present the case of a 6-month-old male infant with a tumor in the medial plantar region of the left foot, which was completely withered. Histopathological study reported a fibrous hamartoma of infancy. CONCLUSIONS: Fibrous hamartoma of infancy most frequently affects males. It may be localized at any anatomic site, although 5-10% of cases affect the lower limbs. Few cases are reported in the foot. This is a lesion with a characteristic morphological pattern; however, in small biopsies, its differential diagnosis is important with other fibroadipose lesions for appropriate treatment. Ample surgical resection with lesion-free borders confers a good prognosis for these patients.

[Partial internal hemipelvectomy for a secondary giant pelvic chondrosarcoma. A case report]. / Hemipelvectomía parcial interna por condrosarcoma secundario gigante de pelvis. Reporte de caso.

The purpose of this paper is to present the orthopedic-oncologic and functional outcomes of internal partial hemipelvectomy for a secondary giant pelvic chondrosarcoma in a patient with multiple hereditary osteochondromatosis.

[Epidemiology of bone and soft-part tumors of the foot and knee]. / Epidemiología de tumores óseos y partes blandas del pie y tobillo.

DESIGN: Report of cases. OBJECTIVE: Review of the cases in a period of 10 years with bone and soft tumors in foot and ankle, to knowing epidemilogical, clinic and patologic anatomy parameters to describe the behavior. MATERIALS AND METHODS: Review of 166 cases from 1991 to 2000 and been analyze with descriptive statistic, association measurment for inside stratum, with odds ratio, hipótesis test with chi square for qualitative date and t to Student for quantitative date. RESULTS: 166 patients within 2 years to 78 years old, 81 with bone tumors and 79 with soft tumors, mostly benign, the most frequent was in the soft tissue ganglion and oseal benign exostosis in bone, 6 different malignant tumors, the principal affected zone were the toes, as a difference to literature, the most affected age group was 10 to 20 years followed to the 30 to 40 years old, we report 42 different patological diagnostics results to soft tissue and osseous tissue. CONCLUSION: clinical features is not a useful parameter to differentiate between malign or benign tumors and does not allow to establish the biological behavior, we propose the diagnostic algorithm that includes the intentional clinical probe, comparative X-ray in three projections with soft technique, in suspicion to malignant lesion may require CT scan, MRI, osseous scan and finally biopsy which will improve the final outcome.

Fine needle aspiration cytology of low grade fibromyxoid sarcoma. Report of a case with histologic correlation.

BACKGROUND: Low grade fibromyxoid sarcoma, first described in 1987, is a rare sarcoma characterized by a bland and deceptively benign histologic appearance but with aggressive behavior. CASE: A 51-year-old female presented with a history of a recurrent and slowly growing mass in the left foot. Fine needle aspiration biopsy showed an abundant myxoid background with occasional thick bands of collagen. Tumor cells present in the myxoid background were spindle shaped, with focally mild or a light degree of nuclear enlargement, hyperchromasia and pleomorphism CONCLUSION: Low grade fibromyxoid sarcoma has particular cytologic features. Besides a careful cytologic evaluation of all the components, clinical and radiographic correlation is necessary to make the correct diagnosis.

Histiocitoma fibroso benigno tratado por medio de esterilización ósea e injerto de médula ósea autóloga / Benign fibrous hystiocitoma treated by steriliation, reimplantation and bone marrow. Case report

Se presenta el caso de un paciente de 12 años de edad el cual cursa con una lesión ósea en fémur distal izquierdo, diagnosticado como histiocitoma fibroso benigno de comportamiento agresivo. El tratamiento se realiza mediante resección segmentaria de la lesión ósea. El segmento se sometió a esterilización en autoclave a 125 ºC por 15 minutos. Posteriormente se aplicó sobre el injerto de médula ósea y se reimplantó en su sitio estabilizándose con clavo centromedular bloqueado de Colchero. Se vigila la evolución clínica y radiográfica del paciente, encontrándose integración del hueso esterilizado al resto del fémur así como la funcionalidad de la extremidad realizando marcha y apoyo a los 3 meses y se revisa los antecedentes bibliográficos.

Trasplante de médula ósea autóloga. experiencia en el tratamiento de lesiones de origen tumoral y pseudotumoral para estimulación de neoformación ósea / Autologous bone marrow trasplantation. Experience in treatment for tumoral and pseudotumoral lesions as a stimulation procedure for bone formation

El presente trabajo reporta la experiencia y resultados con el uso de médula ósea autóloga aplicada como injerto por vía percutánea o en contacto directo con injertos óseos autólogos y homólogos, en el tratamiento de lesiones tumorales y pseudotumorales, así como en grandes resecciones por tumores y su reconstrucción con injertos, alargamiento y retardos de consolidación. Esta técnica y procedimientos incluye a 94 pacientes, tratados de enero de 1993 a diciembre de 1996, con edades de 5 a 42 años, con una media de 17.35 años. En el Servicio de Tumores del Instituto Nacional de Ortopedia se ha realizado 136 aplicaciones de médula ósea en un lapso de 4 años así como su seguimiento, obteniendo buenos y excelentes resultados. Se ha observado la neoformación de hueso, puentes y curación de los retardos de consolidación. Durante su control clínico y radiológico se observaron los primeros hallazgos a las primeras 7 semanas y 3 meses. Entre los cuatro y seis meses se observa la radiolucidez de la neoformación casi completa. La médula ósea como gran potencial osteogénico, derivados de la célula madre (stem cell), proporciona células inductoras de osteoblastos. El injerto aplicado en un sitio diferente a su medio por vía percutánea induce la neoformación ósea. Su toma y aplicación percutánea permite que sea un procedimiento fácil, de corta duración, sin complicaciones, evitando los riesgos de grandes tomas de injerto óseo

Tratamiento de los tumores óseos mediante resección en bloque y colocación de clavo Colchero especial con espaciador metálico / Treatment of bone tumors by en-bloq resection and application of special Colchero rod and a metallic spacer

En el Instituto Nacional de Ortopedia de la Ciudad de México, se evaluó el seguimiento de 16 pacientes comprendiendo el periodo entre el 1o. de marzo de 1990 al 1o. de octubre de 1996. Pacientes sometidos a resección en bloque, con magnitudes mayores de 15 cm, en mienbros inferiores y con diagnósticos de: 9 osteosarcomas, 3 tumores de células gigantes, 2 histiocitomas fibrosos malignos y 2 condrosarcomas. Fue utilizada la clasificación de Enneking, etapificando a 11 como II-B, 2 como III y 3 como lesiones agresivo-benignas. Manejadas con resección en bloque y realizando 11 resecciones intraarticulares, 4 extraarticulares y una segmentaria. Todos utilizaron espacidor de acero 316 LVM y clavo bloqueado especial. Diez pacientes fueron sometidos a quimioterapia neoadyuvante. Cinco pacientes desarrollaron recidiva y cuatro murieron por metástasis pulmonar, nueve viven sin actividad tumoral, otros dos fallecieron de causas no relacionadas a su patología. Se han realizado procedimientos secundarios para reconstrucción como injertos óseos autólogos y homólogos, así como injertos óseos autólogos y homólogos, así como injertos óseos autólogos y homólogos, así como injertos de médula ósea autólogos (utilizados en nuestro servicio desde 1992), en otros dos pacientes se realizó alargamiento óseo y artrodesis femoroperonel a dos más