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1.
BMJ Case Rep ; 16(1)2023 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-36653050

RESUMO

Laryngeal malignancy encompasses about 1% of all cancers. Chondrosarcoma in the head and neck region represents about 0.1% of head and neck malignancies. Typical presenting symptoms relate to the anatomical location of these tumours and include dysphonia, inspiratory stridor, dysphagia, odynophagia or a neck mass. Benign and malignant cartilaginous cancers of the larynx have been described, and preoperative diagnosis can be difficult. Our report highlights the surgical management of a male patient in his 50s with chondrosarcoma of the thyroid cartilage.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Neoplasias Laríngeas , Lesões do Pescoço , Fraturas da Coluna Vertebral , Humanos , Masculino , Cartilagem Tireóidea/cirurgia , Cartilagem Tireóidea/patologia , Neoplasias Laríngeas/diagnóstico , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Pescoço/patologia
2.
Ann Plast Surg ; 90(2): 151-155, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36688858

RESUMO

INTRODUCTION: Chondrosarcoma (CS) is most common primary osseous tumor of the chest wall. The aim of this study was to report results from surgical procedures and evaluate clinical factors predicting survival of patients with chest wall CSs treated in a single tertiary sarcoma center. MATERIALS AND METHODS: Fifty patients with primary CS located in the ribs and sternum were included. Details of the clinical data and oncological outcomes, including local recurrence (LR) and disease-specific survival (DSS), were collected. RESULTS: The tumor was primarily originated in the sternum in 6 patients (12.5%) and in ribs 2 to 11 in the remaining patients. Specimens were histologically graded 1 in 13 patients (26%), 2 in 28 (56%), 3 in 8 (16%), and 1 (2%) as mesenchymal grade 3 CS. R0 margins were obtained in all cases. Reconstruction was warranted in 47 (94%) cases. Local recurrence developed in 3 (6%) patients, and the median time to LR was 17 (range, 16-68) months. Eight (16%) patients developed metastasis. Increasing tumor volume was a statistically significant factor for reduction of DSS. CONCLUSIONS: Chondrosarcoma of the chest wall can be treated effectively with clear margins, resulting in lower LR rate and higher DSS than CS of the extremities and pelvis. Metastasis of the chest wall mostly occurs in high-grade tumors, and the locations of the metastases differ greatly from those observed in CS of the extremities and pelvis. Metastases are commonly extrapulmonary, indicating the need for postoperative follow-up with multiple imaging modalities to monitor recurrence and metastases.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Sarcoma , Parede Torácica , Humanos , Parede Torácica/cirurgia , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Sarcoma/cirurgia , Esterno , Costelas , Neoplasias Ósseas/cirurgia , Estudos Retrospectivos , Recidiva Local de Neoplasia/patologia
4.
Oper Neurosurg (Hagerstown) ; 24(1): 33-43, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36519877

RESUMO

BACKGROUND: Recurrent skull base chondrosarcomas (CSA) are difficult to treat, and limited data are available to help guide subsequent therapy. OBJECTIVE: To further characterize the natural history of CSA and identify treatment modalities that were most effective in prolonging progression-free (PFS) and disease-specific survival (DSS). METHODS: We conducted a single-institution retrospective review of patients with recurrent skull base CSA from 1993 to 2021. Kaplan-Meier survival analyses for PFS and DSS were completed. Univariable and multivariable Cox proportional hazards regression models were used to identify patient-related, treatment-related, and disease-related factors that predicted PFS and DSS. RESULTS: A total of 28 patients and 84 episodes of recurrence were included. One-year PFS was 70.6%, 5-year PFS was 28.9%, and 10-year DSS was 78.5%. The median time to first progression was 23.9 months (range, 2.8-282 months). In univariable Cox proportional hazards regression, male sex, higher grade histology, fourth or greater progression episode status, distal pattern of recurrence, and treatment of recurrence without surgery or with chemotherapy alone predicted worse PFS. Multivariable regression predicted shortened DSS in male patients (hazard ratio [HR] 0.16; P = .021) and higher-grade tumors (HR 0.22; P = .039). Treatment of recurrence with surgery was associated with, but did not significantly predict, improved DSS (HR 1.78; P = .11). CONCLUSION: Several patient and disease-specific factors were associated with shorter PFS and DSS in recurrent skull base chondrosarcoma. For recurrences amenable to resection, surgery is recommended for treatment of recurrent CSA. Local recurrence management without surgery results in shorter PFS and DSS.


Assuntos
Condrossarcoma , Neoplasias da Base do Crânio , Humanos , Masculino , Neoplasias da Base do Crânio/cirurgia , Neoplasias da Base do Crânio/patologia , Intervalo Livre de Doença , Recidiva Local de Neoplasia/patologia , Condrossarcoma/cirurgia , Base do Crânio/patologia
5.
Medicine (Baltimore) ; 101(47): e31377, 2022 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-36451398

RESUMO

RATIONALE: Pulmonary blastoma is an extremely rare and highly aggressive tumor. Only a few hundred cases of pulmonary blastoma have been reported. In other cases, a definitive diagnosis is often made through surgical resection. The use of preoperative histopathological sampling in diagnosing was of limited value because of the variety of pulmonary blastoma histology. And there was no literature that the first biopsy was attempted with medical thoracoscopy for diagnosis. PATIENT CONCERNS: A 65-year-old man presented to our hospital with pleural effusion and lung mass. DIAGNOSES: The patient was initially diagnosed with dedifferentiated chondrosarcoma by medical thoracoscopic biopsy but the final diagnosis was pulmonary blastoma through bilobectomy. INTERVENTIONS: Medical thoracoscopy, and video-assisted thoracoscopic surgery (bilobectomy) followed by adjuvant chemotherapy. OUTCOMES: After surgical resection of the tumor, adjuvant chemotherapy has been performed 5 cycles at 3 weeks intervals, and there was no evidence of recurrence on follow-up computed tomography performed 4 months after surgery. LESSONS: Medical thoracoscopy is useful for the diagnosis of indeterminate pleural effusion; however, caution is needed when confirming rare malignancies, such as pulmonary blastoma. Although surgical resection is the treatment of choice, appropriate adjuvant chemotherapy to improve the prognosis may be necessary if there is pleural metastasis.


Assuntos
Condrossarcoma , Neoplasias Pulmonares , Derrame Pleural , Blastoma Pulmonar , Masculino , Humanos , Idoso , Blastoma Pulmonar/diagnóstico , Blastoma Pulmonar/cirurgia , Cirurgia Torácica Vídeoassistida , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Condrossarcoma/diagnóstico , Condrossarcoma/cirurgia
6.
Acta Orthop Traumatol Turc ; 56(6): 402-407, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36567544

RESUMO

OBJECTIVE: The purpose of this study was to investigate the results and complications in patients who had low-grade chondrosarcomas in the appendicular skeleton and were treated by intralesional curettage and cementation within the scope of 25 years of experience in a single center. METHODS: Ninety-one patients (72 female and 19 male) were retrospectively analyzed. The median at the time of surgery was 43 (17-78) years, and the median follow-up was 102 (26-288) months. All patients were treated by intralesional curettage followed by cementation with high-viscosity bone cement (polymethylmethacrylate). Complications and local recurrence rates, as well as clinical outcome scores were recorded. RESULTS: Five patients (5.49%) developed local recurrence at an average of 6.6 (6-9) months postoperatively. Four were treated with local wide excision and reconstruction with tumor prosthesis. One patient received recurettage and cementation. Two recurred patients were dedifferentiated into grade II chondrosarcomas in the last intervention. No major postoperative complication was identified in the series. Patients achieved an average Musculoskeletal Tumor Society scoring system of 92.4% (standard deviation 5.2; range 80-100) in the sixth postoperative month. Musculoskeletal Tumor Society scores in the recurrent patients decreased from an average of 90% to 75.3% after the final intervention. CONCLUSION: Intralesional curettage and cementation seem safe and reliable techniques with low recurrence and complication rates in treating low-grade chondrosarcomas of the appendicular skeleton. Clinical, radiological, and pathological evaluations are mandatory before surgical intervention, and a multidisciplinary approach is crucial. A strict follow-up regimen in the early postoperative period is needed and strongly recommended to detect local recurrence. LEVEL OF EVIDENCE: Level IV, Therapeutic Study.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Humanos , Masculino , Feminino , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/patologia , Estudos Retrospectivos , Cimentação/métodos , Condrossarcoma/cirurgia , Condrossarcoma/patologia , Curetagem/métodos , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/patologia , Resultado do Tratamento
7.
Turk J Med Sci ; 52(4): 1183-1189, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36326382

RESUMO

BACKGROUND: Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue sarcoma. The aim of this study is to present the results of the patients we treated with the diagnosis of EMC as an oncology reference center. METHODS: Information on 13 patients diagnosed with EMC between 2006 and 2018 was retrospectively reviewed. Patients' demographic information, tumor sizes, surgical treatments, chemotherapy and radiotherapy statuses, follow-up times, recurrences, and metastases were recorded. RESULTS: Mean patient age was 53.6 ± 15 years (range: 28-73). In 8 patients, the tumor was located in the lower limbs, most commonly in the thigh (46.2%). Mean follow-up period was 52.8 ± 19.9 (24-96) months. All patients underwent wide resections and only one had a positive surgical margin. In follow-up, 5 (38.5%) patients experienced recurrence; 6 patients had lung metastasis (46.2%) and 7 patients (53.8%) died. Mean tumor size was 10.4 ± 3.2 (5-17) cm. Median survival time was 61 (50.5-71.4) months and 5-year survival rate was 51.8%. There was no significant difference between survival times according to age, gender, side, limb location, postoperative radiotherapy, recurrence, or presence of lung metastasis. The cut-off value for death obtained by ROC analysis of tumor size was 11 cm. DISCUSSION: EMC is a rare soft tissue sarcoma with high local recurrence and metastasis capacity. Tumor size and metastatic disease are poor prognostic criteria. If it is a localized disease, the first option should be wide resection.


Assuntos
Condrossarcoma , Neoplasias Pulmonares , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Condrossarcoma/cirurgia , Condrossarcoma/patologia , Neoplasias de Tecidos Moles/cirurgia , Neoplasias de Tecidos Moles/patologia , Sarcoma/patologia , Sarcoma/terapia , Neoplasias Pulmonares/cirurgia , Resultado do Tratamento
9.
Eur J Surg Oncol ; 48(11): 2299-2307, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36195471

RESUMO

Pelvic sarcomas are a rare and heterogenous group of tumors divided into two groups: soft tissue sarcomas and bone sarcomas. Soft tissue sarcomas of the pelvis include most commonly liposarcoma, leiomyosarcoma, gastrointestinal stromal tumors, malignant peripheral nerve sheath tumors, and solitary fibrous tumors. Bone sarcomas of the pelvis most commonly include osteosarcoma and chondrosarcoma. Multidisciplinary treatment at a center experienced in the treatment of sarcoma is essential. Management is dictated by histologic type and grade. Surgical resection with wide margins is the cornerstone of treatment for pelvic sarcomas, although this is often challenging due to anatomic constraints of the pelvis. Multimodal treatment is critical due to the high risk of local recurrence in the pelvis.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Osteossarcoma , Neoplasias Pélvicas , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Sarcoma/cirurgia , Sarcoma/patologia , Condrossarcoma/cirurgia , Condrossarcoma/patologia , Neoplasias de Tecidos Moles/patologia , Osteossarcoma/cirurgia , Neoplasias Pélvicas/cirurgia , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/patologia
10.
Head Neck ; 44(12): 2686-2695, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36052545

RESUMO

BACKGROUND: Chondrosarcomas of the sinonasal cavity and skull base are uncommon malignancies. We sought to provide long-term outcomes at two tertiary care centers. METHODS: Patients with chondrosarcoma treated between 2000 and 2021 were included. The primary outcomes were overall survival (OS) and disease-specific survival (DSS). RESULTS: Thirty-eight patients met inclusion criteria. Fourteen patients had sinonasal (36.8%), 7 petroclival (18.4%), and 17 other primary skull base lesions (44.7%). Twenty-eight patients (73.7%) underwent radiation with an average dose of 67.3 ± 15.1 Gy. Eighteen patients (47.4%) required revision surgery for recurrence. 1, 5, and 10-year OS were 97.3%, 93.1%, and 74.7%. DSS at 5- and 10-year survival was 95.7%. Adjuvant radiation was associated with improved OS (HR: 0.12; 95% CI: 0.02-0.75, p = 0.023). CONCLUSION: We present our experience over the last 20 years treating chondrosarcomas. Favorable survival outcomes can be achieved but recurrence requiring repeat resection is common.


Assuntos
Condrossarcoma , Neoplasias da Base do Crânio , Humanos , Neoplasias da Base do Crânio/cirurgia , Resultado do Tratamento , Condrossarcoma/cirurgia , Base do Crânio/patologia , Radioterapia Adjuvante , Estudos Retrospectivos
11.
JBJS Case Connect ; 12(3)2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-36099358

RESUMO

CASE: A 45-year-old woman had a grade II chondrosarcoma (T2N0M0G2) located at the spinous processes and laminas of T3-6 with the tumor extension into the spinal canal at T3-4. To perform en bloc tumor resection, we released or disarticulated bilateral costovertebral ligaments from T3-6 and cut the bilateral pedicles at T3-5 all from posteriorly. Then, we completed en bloc resection without violating the tumor capsule. CONCLUSION: Our novel procedure, bilateral osteotomy of pedicles for en bloc resection successfully allowed for en bloc tumor resection involving the posterior elements with wide surgical margins.


Assuntos
Condrossarcoma , Neoplasias da Coluna Vertebral , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Osteotomia/métodos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral/cirurgia , Corpo Vertebral
12.
J Surg Oncol ; 126(8): 1533-1542, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35962783

RESUMO

BACKGROUNDS AND OBJECTIVES: This investigation described clinicopathological features and outcomes of extraskeletal myxoid chondrosarcoma (EMC) patients. METHODS: EMC patients were identified from the United States Sarcoma Collaborative database between 2000 and 2016. Overall survival (OS) and recurrence-free survival (RFS) were calculated, and prognostic factors were analyzed. RESULTS: Sixty individuals with a mean age of 55 years were included, and 65.0% (n = 39) were male. 73.3% (n = 44) had a primary tumor. A total of 41.6% (n = 25) developed tumor relapse following resection. The locoregional recurrence rate was 30.0% (n = 18/60), and mean follow-up was 42.7 months. The 5-year OS was 71.0%, while the 5-year RFS was 41.4%. On multivariate analysis for all EMC, chemotherapy (hazard ratio [HR], 6.054; 95% confidence interval [CI], 1.33-27.7; p = 0.020) and radiation (HR, 5.07, 95% CI, 1.3-20.1; p = 0.021) were independently predictive of a worse RFS. Among patients with primary EMC only, the 5-year OS was 85.3%, with a 30.0% (n = 12) locoregional recurrence rate, though no significant prognostic factors were identified. CONCLUSIONS: Long-term survival with EMC is probable, however there exists a high incidence of locoregional recurrence. While chemotherapy and radiation were associated with a worse RFS, these findings were likely confounded by recurrent disease as significance was lost in the primary EMC-only subset.


Assuntos
Condrossarcoma , Neoplasias de Tecido Conjuntivo e de Tecidos Moles , Sarcoma , Neoplasias de Tecidos Moles , Humanos , Masculino , Estados Unidos/epidemiologia , Pessoa de Meia-Idade , Feminino , Condrossarcoma/cirurgia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/terapia , Sarcoma/cirurgia , Sarcoma/patologia
13.
BMC Musculoskelet Disord ; 23(1): 758, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941682

RESUMO

OBJECTIVES: To evaluate the oncologic and functional results of scapular reconstruction after partial or total scapulectomy for chondrosarcoma. MATERIALS AND METHODS: Twenty-one patients with chondrosarcoma who underwent partial or total scapulectomy between January 2005 and July 2019 were reviewed retrospectively. RESULTS: At a mean follow-up of 62.6 months (range, 13-123 months), four patients developed local recurrence, and three developed distant metastases, one of which developed both recurrence and metastasis. The overall survival rate of patients at 5 years was 84.6%, the disease-free survival rate was 69.3%, and the complication rate was 19% (4/21). The 1993 American Musculoskeletal Tumor Society (MSTS93) scores of patients in the partial scapulectomy group, total scapulectomy + humeral suspension group and prosthetic reconstruction group were 26.50 ± 1.38, 19.00 ± 2.58, and 21.38 ± 2.62, respectively. There was a statistically significant difference between the partial scapulectomy group and the total scapulectomy + humeral suspension or prosthetic reconstruction group ( P = 0.006 and 0.0336, respectively). The range of motion of the shoulder joint for forward flexion was 80.83° ± 11.14°, 51.25° ± 21.36°, and 52.50° ± 11.02°, respectively. The p-values for the comparison between the partial scapulectomy group and the total scapulectomy + humeral suspension or prosthetic reconstruction group were 0.0493 and 0.0174, respectively. And the range of motion of abduction was 75.00° ± 10.49°, 32.50° ± 11.90°, 41.88° ± 11.63°, respectively. Patients in the partial scapulectomy group had significantly better postoperative shoulder abduction function than the total scapulectomy + humeral suspension or prosthetic reconstruction group (P = 0.0035 and 0.0304, respectively). There was no significant difference in MSTS93 scores and flexion and abduction function of the shoulder joint in the upper extremity after total scapulectomy with humeral suspension or prosthetic reconstruction (P > 0.05). CONCLUSIONS: Surgical treatment of chondrosarcoma of the scapula can achieve a satisfactory prognosis and shoulder function. Total scapulectomy followed by prosthetic reconstruction or humeral suspension are both feasible treatments.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Articulação do Ombro , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Seguimentos , Humanos , Amplitude de Movimento Articular , Estudos Retrospectivos , Escápula/patologia , Escápula/cirurgia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/patologia , Articulação do Ombro/cirurgia
14.
PLoS One ; 17(7): e0268215, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35901087

RESUMO

INTRODUCTION: Chondrosarcoma, although relatively uncommon, represents a significant percentage of primary osseous tumors. Nonetheless, there are few large-cohort, longitudinal studies of long-term survival and treatment outcomes of chondrosarcoma patients and none using the National Cancer Database (NCDB). METHODS: Chondrosarcoma patients were identified from the 2004-2015 NCDB datasets and divided on three primary tumor sites: appendicular, axial, and other. Demographic, treatment, and long-term survival data were determined for each group. Multivariate Cox analysis and Kaplan-Meier survival curves were generated to assess long-term survival over time for each. RESULTS: In total, 5,329 chondrosarcoma patients were identified, of which 2,686 were appendicular and 1,616 were axial. Survival was higher among the appendicular cohort than axial at 1-year, 5-year, and 10-year (89.52%, 75.76%, and 65.24%, respectively). Multivariate Cox analysis identified patients in the appendicular cohort to have significantly greater likelihood of death with increasing age category, distant metastases at presentation, and male sex (p<0.001 for each). Best outcomes for seen for those undergoing surgical treatment (p<0.001). Patients in the axial cohort were with increased likelihood of death with increasing age category and distant metastases (p<0.001), while surgical treatment with or without radiation were associated with a significant decrease (p<0.001). Kaplan-Meier survival analysis showed worst survival for the axial cohort (p<0.001) and patients with distant metastases at presentation (p<0.001). Survival was not significantly different between older (2004-2007) and more recent years (2012-2016) (p = 0.742). CONCLUSIONS: For both appendicular and axial chondrosarcomas, surgical treatment remains the mainstay of treatment due to its continued superiority for the long-term survival of patients, although advancements in survival over the last decade have been insignificant. Presence of distant metastases and axial involvement are significant, poor prognostic factors perhaps because of difficulty in surgical excision or extent of disease.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/cirurgia , Condrossarcoma/radioterapia , Condrossarcoma/cirurgia , Bases de Dados Factuais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Resultado do Tratamento
15.
J Neurooncol ; 159(3): 581-590, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35882753

RESUMO

PURPOSE: Pre-surgical diagnosis of skull base chondrosarcoma (SBC) is often challenging due to the resemblance to chordoma. The goal of this study was to develop an optimal method for predicting SBC diagnosis. METHODS: This retrospective study included patients with histologically diagnosed SBC and skull base chordoma. Their clinical and radiologic features were compared, and the predictive factors of SBC were examined. RESULTS: Forty-one patients with SBC and 41 with chordoma were included. Most SBCs exhibited hypointensity (25, 64.1%) or isointensity (12, 30.8%) on T1-weighted images, and hyperintensity (34, 87.1%) or mixed intensity (5, 12.8%) on T2-weighted images. MRI contrast enhancement was usually avid or fair (89.7%) with "arabesque"-like pattern (41.0%). The lateral/paramidline location was more common in SBC than in chordoma (85.4% vs. 9.8%; P < 0.01), while midline SBCs (14.6%) were also possible. Multivariate analysis demonstrated that higher apparent diffusion coefficient (ADC) value (unit odds ratio 1.01; 95% confidence interval 1.00-1.02; P < 0.01) was associated with an SBC diagnosis. An ADC value of ≥ 1750 × 10-6 mm2/s demonstrated a strong association with an SBC diagnosis (odds ratio 5.89 × 102; 95% confidence interval 51.0-6.80 × 103; P < 0.01) and yielded a sensitivity of 93.9%, specificity of 97.4%, positive predictive value of 96.9%, and negative predictive value of 95.0%. CONCLUSION: The ADC-based method is helpful in distinguishing SBC from chordoma and readily applicable in clinical practice. The prediction accuracy increases when other characteristics of SBC, such as non-midline location and arabesque-like enhancement, are considered together.


Assuntos
Condrossarcoma , Cordoma , Neoplasias da Base do Crânio , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Cordoma/diagnóstico por imagem , Cordoma/patologia , Cordoma/cirurgia , Humanos , Imageamento por Ressonância Magnética/métodos , Estudos Retrospectivos , Base do Crânio , Neoplasias da Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/patologia
16.
Jt Dis Relat Surg ; 33(2): 440-448, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35852206

RESUMO

OBJECTIVES: The aim of this study was to identify the demographic characteristics of chondrosarcoma (CS) and prognostic factors affecting survival. PATIENTS AND METHODS: A total of 87 patients (45 males, 42 females; median age: 51.3 years; range, 19 to 77 years) with CS treated in our clinic between January 2007 and June 2020 were retrospectively analyzed. Demographic characteristics, whether it was primary/secondary, tumor location, histopathological features, tumor grade and stage, clinical follow-up period, surgical treatment methods, use of radiotherapy and chemotherapy, and the presence of local recurrence and metastasis in the postoperative period were recorded. The relationship of these factors with prognosis was analyzed and survival rates were compared. RESULTS: Histological subtype, tumor grade, pathological stage and presence of metastasis were defined as independent predictors in both overall survival and disease-free survival analysis of CS. Overall and disease-free five-year and 10-year survival rates were found to be the highest in the clear cell chondrosarcoma group. While mortality increased in the first five years in the patient groups with histological Grade 2 and 3, all groups were followed in a balanced manner over time. The mortality rate in the group with metastatic disease (M2) was approximately four times higher than the other groups at 10-year follow-up. According to the surgical margins, we found that the five-year survival rates of the R1 (marginal resection) and R2 (residual tumor) groups were similar, with the highest rate being in the R0 (wide resection) group with 78.3%. In multivariate analysis, only grade and stage had a significant association with disease-specific survival. Surgical resection combined with adjuvant radiotherapy was found to increase survival in both overall and disease-free survival of patients with dedifferentiated chondrosarcoma compared to other treatments. CONCLUSION: Histological subtype, grade, stage and presence of metastasis were the independent prognostic factors for survival in CS. However, marginal resection was a risk factor for local recurrence (LR), but there was no significant difference in overall survival in patients with or without LR. Although it is not significant, radiotherapy could increase survival in dedifferentiated CS variants.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Adulto , Idoso , Neoplasias Ósseas/cirurgia , Condrossarcoma/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos , Adulto Jovem
17.
Eur J Surg Oncol ; 48(8): 1730-1738, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35690562

RESUMO

BACKGROUND: Periosteal chondrosarcomas are among the rarest types of chondrosarcomas dealt with in few small series of cases. In this study, we aimed to present our experience with this chondrosarcoma, seek for prognostic factors for OS and DFS and survey the status of IDH1 and IDH2. RESULTS: 55 periosteal chondrosarcomas were retrospectively identified. Median age was 37 years, there was a male predominance (62%). The great majority of cases involved the metaphysis of long bones of the extremities. The median size of the tumors was 7.5 cm. Thirty patients underwent to subtotal surgical resection, 22 to tangential resection and the remaining 3 to amputation. The margins, reported in 54 cases, were wide/radical in 38 patients (70.4%), marginal in 9 (16.7%) and intralesional in 7 (12.9%). Histologically, 23 (42%) were grade 1; 27 (49%), grade 2; 3 (5%), grade 3 and 2 (4%) were dedifferentiated. A third of cases in which mutational analysis was feasible harbored heterozygous mutations in codon 132 of IDH1. Fifty-four cases were included for follow-up (median, 137 months). Four patients had local recurrences and six patients developed metastasis to the lungs. All patients that developed metastasis died of disease, two died of unrelated causes and 46 were alive without disease. OS and DFS was not found to be statistically associated with clinical and pathological parameters considered. CONCLUSIONS: periosteal chondrosarcomas exhibit a low-grade behavior that can be adequately treated with marginal excisions. Clinical and morphologic parameters do not seem to predict their outcome.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Adulto , Neoplasias Ósseas/genética , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Condrossarcoma/genética , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/patologia , Encaminhamento e Consulta , Estudos Retrospectivos , Sobrevivência
18.
Oncology (Williston Park) ; 36(6): 375-377, 2022 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-35723941

RESUMO

A man, aged 21 years, presented with a 4-month history of progressive swelling of the right testicle. Ultrasound revealed a heterogenous solid mass in the right testicle suspicious for malignancy. Further work-up included CT scans, which identified a 2-cm retroperitoneal lymph node; there was no evidence of thoracic metastases. Serum tumor markers revealed a mildly elevated α-fetoprotein (AFP) and normal lactate dehydrogenase (LDH) and human chorionic gonadotropin (hCG). The patient underwent right radical inguinal orchiectomy. Pathology evaluation demonstrated 1% teratoma with extensive secondary somatic-type malignant components of embryonal rhabdomyosarcoma and chondrosarcoma. No lymphovascular invasion was identified. Repeat tumor markers showed normal AFP, LDH, and hCG. Follow-up short-interval CT scans confirmed a dominant 2-cm interaortocaval lymph node with no evidence of distant metastases. The patient underwent retroperitoneal lymph node dissection, which revealed 1 of 24 lymph nodes positive for similar somatic-type malignancy composed of rhabdomyosarcoma and chondrosarcoma as well as undifferentiated spindle cell sarcoma with extranodal extension. Immunohistochemistry revealed that tumor cells were positive for myogenin and desmin and negative for SALL4.


Assuntos
Condrossarcoma , Neoplasias Embrionárias de Células Germinativas , Neoplasias Testiculares , Condrossarcoma/cirurgia , Humanos , Excisão de Linfonodo , Masculino , Neoplasias Embrionárias de Células Germinativas/cirurgia , Orquiectomia , Neoplasias Testiculares/cirurgia , alfa-Fetoproteínas
20.
Artigo em Inglês | MEDLINE | ID: mdl-35652753

RESUMO

Carinal re-resection for tumour recurrence is rarely performed due to increased difficulty in airway reconstruction. We reported a successful case of carinal resection and reconstruction for recurrent chondrosarcoma after previous distal tracheal resection. Due to the technical complexity of the reconstruction and the poor respiratory reserve of the patient, the veno-venous extracorporeal membrane oxygenation support was used.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Oxigenação por Membrana Extracorpórea , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/cirurgia , Humanos , Recidiva Local de Neoplasia , Traqueia/diagnóstico por imagem , Traqueia/cirurgia
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