Giant Cell Tumor (tumor gigantocellularis, osteoclastoma) - epidemiology, diagnosis, treatment.

The author presents the epidemiology, classification, clinical features and strategies of treatment of Giant Cell Tumor. Giant Cell Tumor of Bone accounts for 4-8% of primary bone tumors. It is most commonly seen in women aged 20 to 40 years. The most common sites are the distal femur and proximal tibia, distal radius, and proximal humerus. Increasing pain at the tumor site is the most common presenting symptom. Three types of GCT can be distinguished radiographically according to the Cappanacci or Enneking classification. The mainstay of treatment is total mechanical removal with curettage. The recurrence rate is high (12-50%) during the first 2-3 years after surgery, regardless of pre-operative tumor stage. 5-7% cases of giant cell tumor produce malignant recurrences, usually after five to more than 10 years after surgery.

Low Grade Chondrosarcoma - Epidemiology, Diagnosis, Treatment.

The article describes epidemiology, clinical features and treatment strategy of chondrosarcoma with special regard to diagnostic and therapeutic difficulties in low grade chondrosarcomas. Chondrosarcomas account for 3.5-9% of primary bone tumors and approximately 30% of primary bone malignancies. They occur in the 4th to 7th decade of life, slightly more commonly in men. The most common locations are the pelvis, ribs, proximal femur and proximal humerus. Gradually increasing pain is the most common presenting symptom. Diagnosis must be based on clinical, radiological (conventional radiology, computed tomography, magnetic resonance imaging) and histopathological features. Treatment of the tumor is based on complete removal according to the principles of oncological asepsis. Lung metastases may develop and are associated with a markedly poorer prognosis.

Radionegative Low Grade Chondrosarcoma in Distal Third of Femur. Case Study.

We present the case of a 43-year-old patient with a radionegative tumor of the distal third of the femur. Work-up following a knee injury without any abnormalities on x-ray was extended to include an MRI study, which revealed an osteolytic lesion in the distal third of the femur. Extended work-up including an open biopsy identified a low-grade chondrosarcoma. Considering the patient's clinical status and the diagnostic findings, tumour resection and placement of a resection knee endoprosthesis appeared to be the best solution. The clinical outcome was good.

Osteoid Osteoma - Diagnostic and Therapeutic Difficulties. A. Single-centre Experience.

BACKGROUND: Osteoid osteoma is a primary, benign bone tumour. The characteristic clinical symptom is nocturnal pain at the tumour site that decreases or resolves completely with salicylates and non-steroidal antiinflammatory drugs (NSAIDs). The typical radiological features include a radiolucent area with an osteosclerotic rim. An unusual location or absence of visible abnormalities on conventional radiographs may pose a diagnostic challenge. MATERIAL AND METHODS: We report our clinical experience with osteoid osteoma in 15 patients, with special regard to diagnostic and therapeutic difficulties in two cases. RESULTS: All patients reported the characteristic pattern of nocturnal pain that was reduced or resolved after administration of aspirin or NSAIDs. A typical radiological appearance of osteoid osteoma was observed in 13 patients, with radiological studies showing no changes in two patients, who required extended imaging workup to establish the diagnosis. CONCLUSIONS: 1. Osteoid osteoma may be a diagnostic and therapeutic problem. 2. Lack of visible abnormalities on conventional radiographs in the presence of typical clinical symptoms does not rule out osteoid osteoma. 3. Bone scintigraphy and magnetic resonance imaging are helpful methods in the imaging of radiologically silent pathological lesions.

Custom made tumor-prosthesis as a primary treatment for giant cell tumor of femur--case report.

The article presents the case of a 41-year-old patient with a tumor of the distal third of left femur. Following extended radiological diagnostic work-up, MR, and an open biopsy, the diagnosis of a giant cell tumor was made. In view of the patient's clinical status, diagnostic work-up, and considerable tumor size, the decision was made to resect the tumour and use a primary custom-made endoprosthesis. A good clinical outcome was achieved. Even with the extended diagnostic work-up, the determination of tumor malignancy still posed a diagnostic problem.

The effect of prophylactic doses of nadroparin and therapeutic doses of betamethasone on skin flap survival in rats.

Application of pedicle flaps is of great importance in orthopaedics and reconstructive surgery. It has been postulated that anticoagulants or anti-inflammatory treatments may have advantageous effect on pedicle flap survival. The aim of this study was to investigate whether: 1. low-molecular-weight heparin given at prophylactic doses or 2. steroids given at therapeutic doses improve survival of dorsal pedicle flap in rats. Thirty four animals divided into three groups were used for the experiments: Group I (N=12) was treated with low-molecular-weight heparin (nadroparin, 40 IU per kilogram of body mass/day). Group II (N=12) received single injection of betamethasone (intramuscularly, 0.1 mg per kilogram of body mass). Group III (N=10) received sterile saline (0.9% NaCl) subcutaneously as placebo. All animals were housed individually in an environmentally controlled room. After seven days from the operation, 51.7% of the dorsal flaps survived in group I and 48.3% in the group II. These results were comparable to those in the control animals. Our results indicate that neither low dose heparin (nadroparin) used at prophylactic doses nor steroids used at therapeutic doses had any effect on dorsal pedicle flap survival in rats.