Osteosarcoma in Manitoba: review of 95 patients.

A retrospective review of all recorded cases of osteosarcoma diagnosed and treated in Manitoba from 1930 to 1977 was carried out. There were 95 patients (64 males, 31 females). The peak age was 10 to 19 years. The most common sites of osteosarcoma were the femur (38 patients), tibia (14 patients), humerus (13 patients) and pelvis (9 patients). The survival rate (excluding parosteal and periosteal types) was 28% at 2 years and 16% at 5 years. Patients who were operated upon had a somewhat better prognosis than those who had radiotherapy. Initial results of chemotherapy are encouraging. Patients with distal limb tumours had a better prognosis than those with more proximal neoplasms. Patients with tumour secondary to Paget's disease and to irradiation did poorly, those with parosteal and periosteal osteosarcoma did better. Thirteen patients had 31 thoracotomies for pulmonary metastases; their average duration of survival after this procedure was 9.3 months.

Liposarcoma: the Manitoba experience.

In a retrospective review all cases of liposarcoma recorded in the province of Manitoba from 1944 to 1978 were studied. There were 104 patients. Follow-up was obtained in all. Sites of tumour were peripheral limb in 45 patients, limb girdle in 15, retroperitoneal area in 23 and trunk and neck in 21. Fifty-seven percent of the patients were men: the disease was most commonly found in patients aged 50 to 69 years. Initial treatment was excision in 96 patients with irradiation in 26 and chemotherapy in 6. The 5- and 10-year survival rates were 60% and 49% respectively. In those who had definitive surgery the prognosis was somewhat better, while radiotherapy had little beneficial effect. Prognosis was also related to the pathologic type; well differentiated and myxoid types had a better prognosis than round cell or pleomorphic tumours. Trunk and peripheral limb tumours were associated with higher survival rates than limb girdle or retroperitoneal neoplasms. At least 37 patients had local recurrences; distant metastases occurred in at least 26, most commonly to the lungs, bones and liver. Unusual cases consisted of a patient with a multicentric tumour involving bones, a young boy with a neck liposarcoma and a woman with a breast liposarcoma.

Subperiosteal hemorrhage and cyst formation in neurofibromatosis: a case report.

A 7-year-old girl was disabled by neurofibromatosis complicated by leg hypertrophy, recurrent massive hemorrhage, and cyst formation in her right tibia. A grotesque deformity resulted in the right lower leg over a three-year period despite elevation, compression, and aspiration for various bleeding episodes. Massive areas of bone had to be resected on two separate occasions. The extreme vascularity of the region caused postoperative recurrences, but there was always some improvement. The pathologic findings consisted of true schwannomas in the periosteum. The basic problem of neurofibromatosis was the endoneural cell proliferation that was responsible for the hypertrophy, hemorrhages, and cyst formation. While there are various hemorrhagic problems in neurofibromatosis, this case demonstrates the characteristic massive hemorrhage and rapid new bone formation that follow minimal trauma, and illustrated the difficulties that are encountered in both nonoperative and operative management.