Osteosarcoma lumbar en edad pediátrica: reporte de casos y revisión de la literatura / Spinal osteosarcoma in the paediatric age group: case series and literature review

Introducción y objetivo: El tumor maligno de raquis más frecuente en la edad pediátrica es el osteosarcoma, su diagnóstico y tratamiento precoces son esenciales. El objetivo del presente trabajo es el presentar los resultados obtenidos en el tratamiento de pacientes pediátricos con osteosarcoma lumbar y realizar una revisión de la literatura. Material y métodos: Se incluyeron aquellos pacientes pediátricos intervenidos de osteosarcoma de columna móvil entre 2012 y 2014 en el mismo centro. Se analizaron datos demográficos, radiológicos (clasificaciones Enneking, WBB y Tomita) y anatomopatológicos (Broders). Todos fueron tratados mediante resección quirúrgica, asociada a distintos protocolos oncológicos (radioterapia y/o quimioterapia) según consenso del comité de tumores. El seguimiento medio fue de 62,53 meses (47-70 meses). Resultados: Se presentan un total de 3 pacientes, dos niñas de 9 y 11 años con osteosarcoma en L5 y un niño de 15 años con osteosarcoma en L4. En dos de los casos se trató inicialmente como un osteoblastoma, ya que las imágenes radiológicas y anatomopatológicas así lo apoyaban. Ninguno de los pacientes presentó recidivas locales ni metástasis tras la cirugía definitiva. Conclusiones: Los casos descritos en la literatura sobre manejo de osteosarcoma vertebral en columna móvil en la infancia son escasos, por lo que el tratamiento óptimo y pronóstico en estos pacientes es incierto. La resección en bloque mejora el control local de la enfermedad, sin demostrar que mejore la supervivencia global. La resección intralesional se asocia a mayor índice de recidivas. Un correcto diagnóstico diferencial del tumor (osteosarcoma vs. osteoblastoma) es vital para su tratamiento

Introduction and objective: Osteosarcoma is the most frequent malignant spinal tumour in the paediatric age group. Diagnosis and early treatment of this pathology is essential for a good prognosis. The aim of this study was to present the results of treatment of paediatric patients with lumbar osteosarcoma and conduct a literature review. Material and methods: All the patients with lumbar osteosarcoma who were operated between 2012 and 2014 in the same centre were included. Demographic and radiological data (Enneking, WBB and Tomita classification), as well as anatomopathological (Broders classification) variables were analysed. All the patients were treated by surgical resection associated with adjuvant therapies (chemotherapy and radiotherapy); according to consensus with the tumour committee. The average follow-up was 62.53 months (47-70 months). Results: A total of 3 patients were studied, two girls of 9 and 11, with L5 osteosarcoma, and a 15-year-old boy with L4 osteosarcoma. Two of the cases were initially treated as an osteoblastoma, supported by radiological and anatomopathological images. None of the patients had local recurrences or metastases during follow-up. Conclusions: Due to a lack of long series of cases of osteosarcoma in the mobile spine during childhood, the optimal treatment and prognosis in these patients is uncertain. Block resection improves local control of the disease, without demonstrating improvement in overall survival. Intralesional resection is associated with a higher rate of local recurrence. Oncological treatment is essential in the treatment of this pathology. A correct differential diagnosis of the tumour (osteosarcoma vs. osteoblastoma) is vital for its correct treatment

Spinal osteosarcoma in the paediatric age group: case series and literature review. / Osteosarcoma lumbar en edad pediátrica: reporte de casos y revisión de la literatura.

INTRODUCTION AND OBJECTIVE: Osteosarcoma is the most frequent malignant spinal tumour in the paediatric age group. Diagnosis and early treatment of this pathology is essential for a good prognosis. The aim of this study was to present the results of treatment of paediatric patients with lumbar osteosarcoma and conduct a literature review. MATERIAL AND METHODS: All the patients with lumbar osteosarcoma who were operated between 2012 and 2014 in the same centre were included. Demographic and radiological data (Enneking, WBB and Tomita classification), as well as anatomopathological (Broders classification) variables were analysed. All the patients were treated by surgical resection associated with adjuvant therapies (chemotherapy and radiotherapy); according to consensus with the tumour committee. The average follow-up was 62.53 months (47-70 months). RESULTS: A total of 3 patients were studied, two girls of 9 and 11, with L5 osteosarcoma, and a 15-year-old boy with L4 osteosarcoma. Two of the cases were initially treated as an osteoblastoma, supported by radiological and anatomopathological images. None of the patients had local recurrences or metastases during follow-up. CONCLUSIONS: Due to a lack of long series of cases of osteosarcoma in the mobile spine during childhood, the optimal treatment and prognosis in these patients is uncertain. Block resection improves local control of the disease, without demonstrating improvement in overall survival. Intralesional resection is associated with a higher rate of local recurrence. Oncological treatment is essential in the treatment of this pathology. A correct differential diagnosis of the tumour (osteosarcoma vs. osteoblastoma) is vital for its correct treatment.