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1.
Bone Joint J ; 103-B(3): 562-568, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641425

RESUMO

METHODS: A multicentre retrospective study was carried out at two tertiary sarcoma centres. A database search identified all patients with a CS treated between January 1995 and January 2018. There were 810 CSs of which 76 (9.4%) were located in the fingers, toes, metacarpals, and metatarsal bones. RESULTS: The median age of the study population was 55 years (36 to 68) with a median follow-up of 52 months (22 to 87) months. Overall, 70% of the tumours were in the hand (n = 54) and 30% in the foot (n = 22). Predictors for LR were margin (p = 0.011), anatomical location (p = 0.017), and method of surgical management (p = 0.003). Anatomical location (p = 0.026), histological grade between 1 and 3 (p = 0.004) or 2 and 3 (p = 0.016), and surgical management (p = 0.001) were significant factors for LR-free survival. Disease-specific survival was affected by histological grade (p < 0.001), but not by LR (p = 0.397). CONCLUSION: Intralesional curettage of a low-grade CS is associated with an increased risk of LR, but LR does not affect disease-specific survival. Therefore, for low-grade CSs of the hands and feet, surgical management should aim to preserve function. In grade 2 CS, our study did not show any decreased disease-specific survival after recurrence; however, we suggest a more aggressive surgical approach to these tumours to prevent local recurrence, especially in the metacarpal and metatarsal bones. In high-grade tumours, the incidence of progressive disease is high and, therefore, the treatment of the primary tumour should be aggressive where possible, and patients observed closely for the development of metastatic disease. Cite this article: Bone Joint J 2021;103-B(3):562-568.


Assuntos
Neoplasias Ósseas/cirurgia , Condrossarcoma/cirurgia , , Mãos , Adulto , Idoso , Neoplasias Ósseas/patologia , Condrossarcoma/patologia , Curetagem , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos
2.
Medicine (Baltimore) ; 100(8): e24817, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663101

RESUMO

RATIONALE: Localized chondrosarcoma of the scapula has a favorable long-term survival outcome. Therefore, recovery of shoulder function after surgery is important in middle-aged patients. Currently, three-dimensional (3-D) printing implants can be applied for personalized limb salvage surgery. PATIENT CONCERNS: A 41-year-old woman with a palpable scapular area presented with shoulder pain for 3 months, which was aggravated during shoulder exercise. DIAGNOSES: Chondrosarcoma at left scapular (Malawer S1, Enniking II B, and grade II chondrosarcoma). INTERVENTIONS: Wide excision for a localized chondrosarcoma at the infrascapular lesion was performed and the resected muscles around the scapula were repaired with a 3-D printed segmental scapula prosthesis for recovery of shoulder function. OUTCOMES: The affected shoulder achieved satisfactory function after operation using the 3-D printed segmental scapula prosthesis at 1 year 6 months after the operation. LESSONS: The 3-D printed segmental scapula prosthesis is a useful method for shoulder functional recovery in patients with scapula chondrosarcoma.


Assuntos
Neoplasias Ósseas/cirurgia , Condrossarcoma/cirurgia , Desenho de Prótese/métodos , Implantação de Prótese/métodos , Adulto , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Feminino , Humanos , Salvamento de Membro/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Impressão Tridimensional/instrumentação , Escápula/diagnóstico por imagem , Escápula/patologia , Escápula/cirurgia
3.
J Surg Oncol ; 123(2): 510-520, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33314135

RESUMO

BACKGROUND: There appears to be an association between local recurrence (LR) and risk of metastasis and death in central conventional chondrosarcoma (CCCS) of bone, but this has not been quantified in modern cohorts at a subtype level. METHODS: We identified nonmetastatic cases of CCCS (N = 180) from the Cancer Registry of Norway. We present prognostic analysis of LR accounting for immortal time bias by descriptive statistics and multivariable Cox models. RESULTS: Of 40 LR, one case demonstrated upgrading while two dedifferentiation. LR was associated with increased risk of metastasis (hazard ratio [HR] = 4.1 [confidence interval, 1.5-10.7]) and death (HR = 9.3 [5.0-17.5]) overall. LR was associated with significant increased risk of metastasis for those with a soft tissue component, axial location, malignancy grade 2, but not atypical cartilaginous tumor's, appropriately treated curettage patients, intramedullary tumors, grade 1 histology, extremity location or "Oslo low risk" group status. We found an increased risk of death for all groups except for those treated by appropriate curettage or belonging to the "Oslo low risk" group. About 50% of LR CCCS were asymptomatic and revealed by routine follow-up. CONCLUSIONS: Upgrading of LR for CCCS was a seldom event. LR was associated with significant increased risk of metastasis and death overall, but not for appropriately treated curettage patients or "Oslo low risk" status.


Assuntos
Neoplasias Ósseas/patologia , Condrossarcoma/patologia , Recidiva Local de Neoplasia/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/cirurgia , Condrossarcoma/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Noruega/epidemiologia , Prognóstico , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Taxa de Sobrevida , Adulto Jovem
4.
Nat Commun ; 11(1): 5023, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024108

RESUMO

Chondrosarcomas, malignant cartilaginous neoplasms, are capable of transitioning to highly aggressive, metastatic, and treatment-refractory states, resulting in significant patient mortality. Here, we aim to uncover the transcriptional program directing such tumor progression in chondrosarcomas. We conduct weighted correlation network analysis to extract a characteristic gene module underlying chondrosarcoma malignancy. Hypoxia-inducible factor-2α (HIF-2α, encoded by EPAS1) is identified as an upstream regulator that governs the malignancy gene module. HIF-2α is upregulated in high-grade chondrosarcoma biopsies and EPAS1 gene amplification is associated with poor prognosis in chondrosarcoma patients. Using tumor xenograft mouse models, we demonstrate that HIF-2α confers chondrosarcomas the capacities required for tumor growth, local invasion, and metastasis. Meanwhile, pharmacological inhibition of HIF-2α, in conjunction with the chemotherapy agents, synergistically enhances chondrosarcoma cell apoptosis and abolishes malignant signatures of chondrosarcoma in mice. We expect that our insights into the pathogenesis of chondrosarcoma will provide guidelines for the development of molecular targeted therapeutics for chondrosarcoma.


Assuntos
Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/patologia , Condrossarcoma/tratamento farmacológico , Condrossarcoma/patologia , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Fatores de Transcrição Hélice-Alça-Hélice Básicos/antagonistas & inibidores , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Benzimidazóis/administração & dosagem , Neoplasias Ósseas/genética , Linhagem Celular Tumoral , Condrossarcoma/genética , Cisplatino/administração & dosagem , Feminino , Regulação Neoplásica da Expressão Gênica , Redes Reguladoras de Genes , Humanos , Isocitrato Desidrogenase/genética , Camundongos Nus , Ensaios Antitumorais Modelo de Xenoenxerto
5.
Anticancer Res ; 40(11): 6429-6435, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33109581

RESUMO

BACKGROUND/AIM: The local control rate of chondrosarcomas treated with carbon-ion radiotherapy (CIRT) worsens as tumour size increases, possibly because of the intra-tumoural linear energy transfer (LET) distribution. This study aimed to evaluate the relationship between local recurrence and intra-tumoural LET distribution in chondrosarcomas treated with CIRT. PATIENTS AND METHODS: Thirty patients treated with CIRT for grade 2 chondrosarcoma were included. Dose-averaged LET (LETd) distribution was calculated by the treatment planning system, and the relationship between LETd distribution in the planning tumour volume (PTV) and local control was evaluated. RESULTS: The mean LETd value in PTV was similar between cases with and without recurrence. Recurrence was not observed in cases where the effective minimum LETd value exceeded 40 keV/µm. CONCLUSION: LETd distribution in PTV is associated with local control in chondrosarcomas and patients treated with ion beams of higher LETd may have an improved local control rate for unresectable chondrosarcomas.


Assuntos
Condrossarcoma/radioterapia , Radioterapia com Íons Pesados , Recidiva Local de Neoplasia/radioterapia , Doses de Radiação , Algoritmos , Condrossarcoma/patologia , Feminino , Humanos , Transferência Linear de Energia , Masculino , Método de Monte Carlo , Recidiva Local de Neoplasia/patologia , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Carga Tumoral
6.
Bull Cancer ; 107(11): 1186-1198, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33059872

RESUMO

Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed.


Assuntos
Neoplasias Ósseas , Articulação Temporomandibular , Cistos Ósseos Aneurismáticos/etiologia , Cistos Ósseos Aneurismáticos/patologia , Cistos Ósseos Aneurismáticos/terapia , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Condroblastoma/complicações , Condroblastoma/diagnóstico por imagem , Condroblastoma/cirurgia , Condroma/diagnóstico por imagem , Condroma/patologia , Condroma/cirurgia , Condrossarcoma/patologia , Condrossarcoma/terapia , Diagnóstico Diferencial , Fibrossarcoma/diagnóstico por imagem , Fibrossarcoma/patologia , Fibrossarcoma/terapia , Tumor de Células Gigantes do Osso/diagnóstico por imagem , Tumor de Células Gigantes do Osso/terapia , Tumor de Células Gigantes de Bainha Tendinosa/complicações , Tumor de Células Gigantes de Bainha Tendinosa/diagnóstico por imagem , Tumor de Células Gigantes de Bainha Tendinosa/cirurgia , Hemangioma/diagnóstico por imagem , Hemangioma/terapia , Histiocitose de Células de Langerhans/patologia , Histiocitose de Células de Langerhans/cirurgia , Humanos , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/cirurgia , Mieloma Múltiplo/patologia , Osteoblastoma/diagnóstico por imagem , Osteoblastoma/patologia , Osteoblastoma/cirurgia , Osteocondroma/diagnóstico por imagem , Osteocondroma/patologia , Osteocondroma/cirurgia , Osteoma/diagnóstico por imagem , Osteoma/patologia , Osteoma Osteoide/complicações , Osteoma Osteoide/diagnóstico por imagem , Osteoma Osteoide/patologia , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/patologia , Osteossarcoma/terapia , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/patologia , Sarcoma Sinovial/diagnóstico por imagem
7.
Anticancer Res ; 40(10): 5463-5469, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988868

RESUMO

BACKGROUND/AIM: Periostin exists as an extracellular matrix protein in several carcinomas and is related to metastasis and poor prognosis. It is mainly secreted from cancer associated fibroblasts, and not from carcinoma cells. As a tumor microenvironment component, periostin usually mediates tumor cell stemness, metastasis, angiogenesis and lymphangiogenesis. This study aimed to examine the role of periostin in chondrosarcoma. MATERIALS AND METHODS: To evaluate the effect of periostin on the proliferation of chondrosarcoma cells, MTT assay was performed on SW1353 cells and periostin knockdown SW1353 cells. Migration activity was examined using Boyden chamber. RESULTS: Periostin, secreted from chondrosarcoma cells, was found to support proliferation, and maintain stemness and migration of chondrosarcoma cells. Periostin also induced proliferation and migration of lymphatic endothelial cells. CONCLUSION: Periostin plays an important role in chondrosarcoma development and disease progression.


Assuntos
Moléculas de Adesão Celular/genética , Proliferação de Células/genética , Condrossarcoma/genética , Neovascularização Patológica/genética , Linhagem Celular Tumoral , Movimento Celular/genética , Sobrevivência Celular/genética , Condrossarcoma/patologia , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Humanos , Linfangiogênese/genética , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Neovascularização Patológica/patologia , Microambiente Tumoral/genética
8.
Anticancer Res ; 40(10): 5735-5738, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988899

RESUMO

BACKGROUND/AIM: Surgical staging is paramount to treatment of primary bone sarcomas. Often, bone scintigraphy and/or positron emission tomography-computed tomography (PET-CT) are used to exclude skeletal metastases; however, skeletal metastases in chondrosarcoma are rare. The purpose of this study was to assess the utility of these staging methods in patients with chondrosarcoma. PATIENTS AND METHODS: We reviewed 138 (87 males, 51 female) patients, mean age 54±20 years, with a chondrosarcoma, who had completed a bone scintigraphy or PET/CT as part of surgical staging. Sensitivity, specificity, and positive/negative predictive value of the scans was calculated. RESULTS: Seventeen (12%) patients had a positive bone scintigraphy or PET-CT for skeletal metastases. In cases of bone scintigraphy (n=11), 6 were benign and 5 were skeletal metastases. In cases of PET-CT, 6 were skeletal metastases, 3 were positive and 3 benign. All positive cases regarded dedifferentiated chondrosarcoma. The overall sensitivity and specificity of a bone scan or PET-CT was 100% and 93.1%; with a positive and negative predictive value of 47.1% and 100%, respectively. CONCLUSION: Skeletal metastases at presentation of chondrosarcoma are rare and associated with dedifferentiated chondrosarcoma. Bone scintigraphy or PET-CT should only be performed in cases of high grade and dedifferentiated histology.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Condrossarcoma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Cintilografia , Neoplasias Ósseas/patologia , Neoplasias Ósseas/secundário , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , Condrossarcoma/patologia , Feminino , Fluordesoxiglucose F18/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Tomografia Computadorizada por Raios X
9.
Jt Dis Relat Surg ; 31(2): 286-290, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584727

RESUMO

OBJECTIVES: This study aims to evaluate the role of elevated neutrophil-to-lymphocyte ratio (NLR) and monocyte-to- lymphocyte ratio (MLR) in differential diagnosis of enchondroma and low-grade chondrosarcoma. PATIENTS AND METHODS: One-hundred-and-one patients (44 males, 57 females; mean age 53.6±11.5 years; range, 21 to 85 years) diagnosed with enchondroma and low-grade chondrosarcoma in Ankara Oncology Training and Research Hospital between January 2010 and December 2019 were included in this retrospective study. Patients' age, gender, location and type of tumor, and pre-treatment complete blood count results were acquired. One-hundred patients (48 males, 52 females; mean age 50.9±13.6 years; range, 19 to 76 years) with complete blood count results admitted to the same center for reasons other than fracture, infection or tumors with similar age and gender to the aforementioned study group were included as healthy controls. RESULTS: Neutrophil-to-lymphocyte ratio and MLR of the study group were found to be significantly higher than the control group (p<0.001). Neutrophil-to-lymphocyte ratio and MLR held diagnostic importance with statistically significant cut-off values. Statistically significant cut-offs for NLR and MLR were ≥2.0 (sensitivity=73.3%, specificity=67%) and ≥0.2 (sensitivity=76.2%, specificity=63%), respectively. Multivariate logistic regression analysis was performed adjusting for age and gender and NLR ≥2 [odds ratio (OR)=3.1] or MLR ≥0.2 (OR=2.9) were found to be associated with approximately three-fold risk for diagnosis of enchondroma or low-grade chondrosarcoma. CONCLUSION: The NLR and MLR have diagnostic value in cartilaginous tumors such as enchondroma and low-grade chondrosarcoma. However, our results do not support utilization of NLR and MLR as diagnostic value for differentiation of enchondroma and low-grade chondrosarcoma.


Assuntos
Neoplasias Ósseas , Condroma , Condrossarcoma , Linfócitos , Monócitos , Neutrófilos , Neoplasias Ósseas/sangue , Neoplasias Ósseas/patologia , Condroma/sangue , Condroma/patologia , Condrossarcoma/sangue , Condrossarcoma/patologia , Diagnóstico Diferencial , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Reprodutibilidade dos Testes
10.
Acta Orthop Traumatol Turc ; 54(3): 234-244, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32544060

RESUMO

OBJECTIVE: This study is an evaluation of the overall survival rate and factors affecting survival in patients with osteosarcoma, chondrosarcoma, or Ewing's sarcoma. This study aimed to determine the effect of factors related to the preoperative period, patient, tumor, treatment, and postoperative period on survival. METHODS: A total of 114 patients (64 male and 50 female) with osteosarcoma, chondrosarcoma, or Ewing's sarcoma treated between 2005 and 2013 were included in this study. All the patients received standard treatment and were followed up regularly. In all, 44 cases of (conventional and telangiectatic) osteosarcoma, 30 cases of Ewing's sarcoma, and 40 cases of high-grade chondrosarcoma were identified using the Bone and Soft Tissue Tumor Registry. Gender, age, tumor size and localization, pathological fractures, histopathological type, grade, surgical treatment, adjuvant treatments, relapse of the disease, and postoperative complication data were obtained from follow-up forms. The learning curve of institutional expertise was also evaluated. The patient survival rate was calculated using the Kaplan-Meier method, and log-rank statistical methods were used to compare survival rates. RESULTS: The mean length of survival of the patients was 72 months. There was a 56% 5-year survival rate, and the event-free survival rate was 53%. The survival of patients with Ewing's sarcoma whose prodromal period was less than 12 weeks was significantly higher than that of the other groups (p=0.031). The survival of patients with tumor size greater than 150 cc, with local recurrence and distant metastases was low for all groups. Survival rates were significantly lower in osteosarcoma and Ewing's sarcoma patients with stage III tumor or metastasis at diagnosis. The survival of patients with osteosarcoma diagnosed between 2010 and 2013 was significantly higher than that of the earlier group (p=0.02). CONCLUSION: Decreasing the prodromal period (early diagnosis) can improve survival by preventing the local and systemic spread of the tumor. Increase in the surgical experience is likely to have a positive effect on survival rates, especially for patients with osteosarcoma. The relapse of the disease is a poor prognostic factor for survival despite aggressive surgery and adjuvant therapies. LEVEL OF EVIDENCE: Level IV, Therapeutic study.


Assuntos
Neoplasias Ósseas , Condrossarcoma , Extremidades , Procedimentos Ortopédicos , Osteossarcoma , Ossos Pélvicos , Sarcoma de Ewing , Adolescente , Adulto , Neoplasias Ósseas/epidemiologia , Neoplasias Ósseas/patologia , Neoplasias Ósseas/cirurgia , Condrossarcoma/epidemiologia , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Terapia Combinada , Extremidades/patologia , Extremidades/cirurgia , Feminino , Humanos , Masculino , Gradação de Tumores , Estadiamento de Neoplasias , Procedimentos Ortopédicos/métodos , Procedimentos Ortopédicos/estatística & dados numéricos , Osteossarcoma/epidemiologia , Osteossarcoma/patologia , Osteossarcoma/cirurgia , Ossos Pélvicos/patologia , Ossos Pélvicos/cirurgia , Estudos Retrospectivos , Fatores de Risco , Sarcoma de Ewing/epidemiologia , Sarcoma de Ewing/patologia , Sarcoma de Ewing/cirurgia , Taxa de Sobrevida , Turquia
11.
Orthopade ; 49(11): 1006-1012, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32266431

RESUMO

This is a report of the reconstructive surgery of a patient with chondrosarcoma in the proximal radius. After extensive resection of the proximal radius that contained the tumor, the skeleton of the forearm was reconstructed by ulnar translocation. This patient was followed for 2 years, no recurrence of the tumor was found and the function of the forearm was nearly normal. This case is reported and discussed and a literature review is presented.


Assuntos
Neoplasias Ósseas/cirurgia , Condrossarcoma/secundário , Antebraço/cirurgia , Rádio (Anatomia)/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Antebraço/patologia , Humanos , Recidiva Local de Neoplasia , Radiografia , Rádio (Anatomia)/diagnóstico por imagem , Rádio (Anatomia)/patologia , Resultado do Tratamento
12.
J Surg Oncol ; 121(7): 1115-1125, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32141094

RESUMO

BACKGROUND AND OBJECTIVES: Interobserver variability in histological grading of central conventional chondrosarcoma (CCCS) limits the quality of patient information and research progression. We aim to quantify known and new prognostic variables and propose a risk stratification model. METHOD: We selected 149 cases from the Cancer Registry of Norway. Cox proportional hazard models were estimated. Based on these results a dichotomous risk classification was proposed and presented by Kaplan-Meier estimates for rates of local recurrence, metastasis, and disease-specific survival. RESULTS: The influence of axial skeletal location (Hazard ratio [HR] = 19.06), a soft tissue component ≥1 cm (HR = 13.45), and histological grade 3 (HR = 16.46) are all significant in predicting the rate of metastasis. The creation of a variable combining axial skeletal location and a soft tissue component ≥1 cm strongly predicts the risk of metastasis (HR = 14.02; P < .001) and death (HR = 2.74; P = .030) at multivariate analysis, making the histological grade insignificant. Together with metastasis at diagnosis (HR = 285.65; P < .001), this forms the basis of our proposed risk stratification, producing a small high-risk group (39 cases with 33% risk of metastasis) and a large low-risk group (103 cases with 2% risk of metastasis) without a histological grade. CONCLUSION: Axial skeletal location and a soft tissue component ≥1 cm combined divides a CCCS cohort into low- and high-risk groups without a histological grade.


Assuntos
Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/patologia , Condrossarcoma/mortalidade , Condrossarcoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Noruega/epidemiologia , Prognóstico , Modelos de Riscos Proporcionais , Sistema de Registros , Medição de Risco , Análise de Sobrevida , Adulto Jovem
13.
J Vet Diagn Invest ; 32(3): 440-443, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32188369

RESUMO

Chondrosarcomas are common tumors of the canine appendicular and axial skeleton; however, extraskeletal chondrosarcomas are very rare. Herein we report a case of extraskeletal chondrosarcoma in the tongue of a dog. Histologically, glossal skeletal muscle was infiltrated and effaced by islands of cartilage and streams of spindle-shaped cells. Retrospective analysis of 236 tongue masses submitted to the Iowa State University surgical biopsy service between 2011 and 2019 showed that the majority of submitted tongue masses are either non-neoplastic or benign, with granular cell tumors identified as the most prevalent benign neoplasms. Malignant tumors accounted for nearly 30% of all submitted masses, with malignant melanoma diagnosed most frequently.


Assuntos
Condrossarcoma/veterinária , Doenças do Cão/patologia , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/veterinária , Neoplasias da Língua/veterinária , Animais , Condrossarcoma/patologia , Cães , Masculino , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/patologia , Estudos Retrospectivos , Neoplasias da Língua/patologia
15.
Eur J Radiol ; 125: 108846, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32062570

RESUMO

PURPOSE: Distinguishing between enchondromas and low-grade (grade 1) chondrosarcomas can be challenging. The aim of this study was to investigate the role of Thallium-201 scintigraphy and Technetium-99 m pentavalent dimercaptosuccinic acid (Tc-99 m DMSA (V)) in the diagnosis and grading of chondrosarcomas. METHODS: 232 consecutive patients with pathologically proven cartilaginous tumours between the years 2000 and 2018 were evaluated. We included 197 patients (101 males and 96 females; median age 50 years; range 15-86 years) who underwent Thallium-201(n = 193) and/or Tc-99 m DMSA (V) scanning (n = 67). Increased uptake was defined as uptake greater than background. The reference standard was the histopathological assessment based on a grading system (grade 1-3). Data was analysed using multivariate modelling. RESULTS: There were 46 patients with enchondromas and 151 with chondrosarcomas. Of those, 64 (enchondroma n = 21, chondrosarcoma n = 43) underwent both Thallium-201 and Tc-99 m DMSA (V). Thallium-201 uptake had 7.92 times greater odds of grade 1 chondrosarcomas than enchondromas. Thallium-201 uptake was significantly associated with the odds of a higher grade chondrosarcoma (grade 2-3). DMSA (V) positivity was associated with 4.75 times the odds of a chondrosarcoma diagnosis over enchondroma (p = 0.024). DMSA (V) uptake revealed no association with chondrosarcoma grading. CONCLUSION: Low-grade chondrosarcomas continue to pose a diagnostic dilemma. Thallium-201 scans may identify malignancy in benign appearing tumours as well as differentiate between low-grade and high-grade chondrosarcomas in said malignancies. DMSA (V) may be useful in distinguishing between benign and malignant entities as a whole.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Compostos Radiofarmacêuticos , Ácido Dimercaptossuccínico Tecnécio Tc 99m , Radioisótopos de Tálio , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Condroma/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Cintilografia , Reprodutibilidade dos Testes , Adulto Jovem
16.
Sci Rep ; 10(1): 2155, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32034187

RESUMO

In the last decade, Raman Spectroscopy has demonstrated to be a label-free and non-destructive optical spectroscopy able to improve diagnostic accuracy in cancer diagnosis. This is because Raman spectroscopic measurements can reveal a deep molecular understanding of the biochemical changes in cancer tissues in comparison with non-cancer tissues. In this pilot study, we apply Raman spectroscopy imaging to the diagnosis and grading of chondrogenic tumors, including enchondroma and chondrosarcomas of increasing histologic grades. The investigation included the analysis of areas of 50×50 µm2 to approximately 200×200 µm2, respectively. Multivariate statistical analysis, based on unsupervised (Principal Analysis Components) and supervised (Linear Discriminant Analysis) methods, differentiated between the various tumor samples, between cells and extracellular matrix, and between collagen and non-collagenous components. The results dealt out basic biochemical information on tumor progression giving the possibility to grade with certainty the malignant cartilaginous tumors under investigation. The basic processes revealed by Raman Spectroscopy are the progressive degrading of collagen type-II components, the formation of calcifications and the cell proliferation in tissues ranging from enchondroma to chondrosarcomas. This study highlights that Raman spectroscopy is particularly effective when cartilaginous tumors need to be subjected to histopathological analysis.


Assuntos
Condroma/diagnóstico por imagem , Condrossarcoma/diagnóstico por imagem , Análise Espectral Raman/métodos , Adulto , Condroma/patologia , Condrossarcoma/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Análise Espectral Raman/normas
17.
Anticancer Res ; 40(2): 1035-1039, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014950

RESUMO

BACKGROUND: Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignant soft-tissue tumor and often shows extracompartmental tumoral invasion. The aim of our study was to investigate the clinical features, especially extracompartmental tumoral invasion (ETI) of EMC. PATIENTS AND METHODS: A total of 35 operative patients diagnosed with EMC were enrolled in this study from January 1980 to March 2018 in the Cancer Institute Hospital of The Japanese Foundation for Cancer Research. The operative procedure was principally wide excision. Univariate analysis assessed how clinicopathological factors (e.g. age, gender, tumor site, tumor size, histopathological grade, surgical margin, metastasis before operation, barrier invasion, local recurrence, metastasis after operation) influenced patient prognosis. We assessed how clinicopathological factors influenced ETI of EMC. RESULTS: Among 35 patients, 10 patients showed ETI. The average follow-up was 5.57 (range=0.2-20 years). The 5- and 10-year overall survival was 91.3% and 71.2%, respectively. The 5- and 10-year overall survival of patients with M0 disease was 96.1% and 73.2%, respectively, while both were 75.0% for those with M1 disease, respectively. The patients with distant metastasis at first visit tended to have a poor prognosis (p=0.07). It is notable that all of the 10 patients with ETI had distant metastasis after surgery. CONCLUSION: Patients with distant metastasis at first visit tended to have a poor prognosis. ETI of EMC induced distant metastasis after surgery. Patients with ETI of EMC should, therefore, be carefully monitored over a prolonged period.


Assuntos
Condrossarcoma/patologia , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/patologia , Adulto , Idoso , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/etiologia , Condrossarcoma/terapia , Feminino , Humanos , Estimativa de Kaplan-Meier , Imagem por Ressonância Magnética , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Metástase Neoplásica , Estadiamento de Neoplasias , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/etiologia , Neoplasias de Tecido Conjuntivo e de Tecidos Moles/terapia , Prognóstico , Fatores de Risco
18.
Artigo em Chinês | MEDLINE | ID: mdl-31954383

RESUMO

Objective: To discuss the treatment, pathological subtypes and recurrence of sinonasal chondrosarcoma, and to identify the prognostic factors. Methods: Between January 1994 and May 2018, 47 patients with sinonasal chondrosarcoma who were treated in Eye, Ear, Nose and Throat Hospital, Shanghai Medwal College, Fudan University were retrospectively reviewed, including 19 males and 28 females, aging from 7 months to 71 years old, with a median age of 38 years old. The clinical symptoms, location of tumor, surgical method, pathological subtype, recurrence and prognosis were collected and analyzed. Kaplan-Meier method was used to calculate the disease-specific survival rate, disease-free survival rate and draw survival curve. Log Rank was used to analyze the prognostic factors. Cox regression was used for multivariate analysis. Results: Except for one patient who gave up treatment after tumor biopsy, other 46 patients underwent radical resection, including 31 cases of endoscopic resection and 15 cases of extranasal approach resection. Thirty-nine patients were diagnosed as conventional intramedullary chondrosarcoma with pathological grade Ⅰ of 24 cases and grade Ⅱ of 15 cases. Six cases were diagnosed as mesenchymal chondrosarcoma while 2 cases were diagnosed as myxoid chondrosarcoma. During an average follow-up period of 56.1 months (17-156 months), 23 patients had recurrence (54.8%, 23/42), among whom 9 patients had re-operations and 5 patients died. Thirty-seven patients survived, including 25 patients survived without tumors. In addition, 5 patients were lost to follow-up, including the patient who gave up treatment after tumor biopsy. Five-year overall survival rate and disease-free survival rate was 84.7% and 34.3%, respectively. Multivariate analysis showed that invasion of skull base was an independent risk factor affecting disease-free survival rate (95% confidence interval: 1.089-5.825, P=0.031). Conclusions: Radical resection is the primary treatment for sinonasal chondrosarcoma. The most common pathological subtype is conventional intramedullary chondrosarcoma. Sinonasal chondrosarcoma has a high local recurrence rate. The long-term prognosis is well after complete excision of the lesion. The most important cause of death is uncontrollable local disease and invasion of adjacent key structures.


Assuntos
Condrossarcoma/patologia , Condrossarcoma/terapia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos , Adulto Jovem
19.
Head Neck Pathol ; 14(1): 83-96, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31950468

RESUMO

Clinically, radiologically, and pathologically, chondroid neoplasms of the skull can be diagnostically challenging due to overlapping features in each of these domains. Compounding the problem for the pathologist, there is also significant morphologic, immunophenotypic, and molecular genetic overlap between benign and malignant cartilaginous lesions, and the majority of these lesions are encountered quite rarely in routine surgical pathology practice. Each of these factors contribute to the diagnostic difficulty posed by these lesions, highlighting the importance of radiologic-pathologic correlation in the diagnosis. This review is intended to provide an update for surgical pathologists on some of the most commonly encountered chondroid neoplasms in the skull, and includes the following lesions: chondromyxoid fibroma, synovial chondromatosis, chondrosarcoma and variants, and chordoma and variants. For each of these lesions, the differential diagnosis and useful ancillary tests will be discussed in the context of a broad range of additional primary and secondary lesions.


Assuntos
Condromatose Sinovial/patologia , Condrossarcoma/patologia , Cordoma/patologia , Fibroma/patologia , Neoplasias Cranianas/patologia , Humanos
20.
J Surg Oncol ; 121(4): 638-644, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31989655

RESUMO

BACKGROUND: Conventional primary pelvic chondrosarcoma often presents as a low- or intermediate-grade tumor in older patients. Although this is the most common variant of pelvic chondrosarcoma, studies examining treatment outcomes are lacking. The purpose of this study was to evaluate patients with these tumors to determine their outcomes of treatment. METHODS: Seventy-three patients (grade I [n = 19, 26%] and grade II [n = 54, 74%]) were reviewed including 55 (75%) males and 18 (25%) females, with a mean age of 51 (range, 17-81) years and follow-up of 9 ± 5 years. RESULTS: The 10-year disease-specific survival was 71%. Grade II disease (hazard ratio [HR], 6.74; P = .04) and age ≥50 years (HR, 3.97; P = .02) was associated with death due to disease. The 10-year local recurrence- and metastatic-free survival were 79% and 72%. Of the patients with a local recurrence (n = 11), 7 (64%) recurred at a higher histological grade. Patient age ≥50 years was associated with local recurrence (HR, 10.03; P = .02) and metastatic disease (HR, 4.20; P = .02). CONCLUSION: Advancing patient age was an independent risk factor for worse survival and disease recurrence. Tumors often recurred locally at a higher grade and as such wide local excision remains the treatment of choice for these tumors.


Assuntos
Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/cirurgia , Condrossarcoma/mortalidade , Condrossarcoma/cirurgia , Ossos Pélvicos/cirurgia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/patologia , Condrossarcoma/patologia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Ossos Pélvicos/patologia , Modelos de Riscos Proporcionais , Procedimentos Cirúrgicos Reconstrutivos , Resultado do Tratamento , Adulto Jovem
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