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1.
Braz J Med Biol Res ; 53(2): e8962, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32022102

RESUMO

The aims of this study were to evaluate the intra- and interobserver reproducibility of manual segmentation of bone sarcomas in magnetic resonance imaging (MRI) studies and to compare manual and semiautomatic segmentation methods. This retrospective study included twelve osteosarcoma and eight Ewing sarcoma MRI studies performed prior to any therapeutic intervention. All cases were histopathologically confirmed. Three radiologists used 3D-Slicer software to perform manual segmentation of bone sarcomas in a blinded and independent manner. One radiologist segmented manually and also performed semiautomatic segmentation with the GrowCut tool. Segmentation exercises were timed for comparison. The dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to evaluate similarity between the segmentation results and further statistical analyses were performed to compare DSC, HD, and volumetric results. Manual segmentation was reproducible with intraobserver DSC varying from 0.83 to 0.97 and HD from 3.37 to 28.73 mm. Interobserver DSC of manual segmentation showed variation from 0.73 to 0.97 and HD from 3.93 to 33.40 mm. Semiautomatic segmentation compared to manual segmentation resulted in DSCs of 0.71-0.96 and HDs of 5.38-31.54 mm. Semiautomatic segmentation required significantly less time compared to manual segmentation (P value ≤0.05). Among all situations compared, tumor volumetry did not show significant statistical differences (P value >0.05). We found excellent intra- and interobserver agreement for manual segmentation of osteosarcoma and Ewing sarcoma. There was high similarity between manual and semiautomatic segmentation, with a significant reduction of segmentation time using the semiautomatic method.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osteossarcoma/diagnóstico por imagem , Sarcoma de Ewing/diagnóstico por imagem , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imagem por Ressonância Magnética , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
2.
Bone Joint J ; 102-B(1): 64-71, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31888359

RESUMO

AIMS: The purpose of this study was to report the long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma. METHODS: A total of 35 consecutive patients treated with extendable endoprosthetic replacement of the humerus in children were included. There were 17 boys and 18 girls in the series with a median age at the time of initial surgery of nine years (interquartile range (IQR) 7 to 11). RESULTS: The median follow-up time was 10.6 years (IQR 3.9 to 20.4). The overall implant survival at ten years was 75%. Complications occurred in 13 patients (37%). Subluxation at the proximal humerus occurred in 19 patients (54%) but only six (17%) were symptomatic. Subluxation was seen more commonly in children under the age of nine years (86%) than in those aged nine years or more (33%) (p = 0.002). Implant failure occurred in nine patients (26%): the most common cause was aseptic loosening (four patients, 11%). Lengthening of the implant was carried out in 23 patients (66%). At final follow up, three patients had a limb that was shortened by 5 cm or more. The mean Musculoskeletal Tumor Society (MSTS) functional score was 79% (73% to 90%). CONCLUSION: Extendable endoprosthetic replacement is a reliable method of reconstructing humerus after excision of a bone sarcoma. Children who are less than nine years old have a high risk of subluxation. Cite this article: Bone Joint J 2020;102-B(1):64-71.


Assuntos
Neoplasias Ósseas/cirurgia , Úmero/cirurgia , Osteossarcoma/cirurgia , Membros Artificiais , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/mortalidade , Criança , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/mortalidade , Condrossarcoma/cirurgia , Feminino , Humanos , Úmero/diagnóstico por imagem , Masculino , Margens de Excisão , Metástase Neoplásica , Osteossarcoma/diagnóstico por imagem , Osteossarcoma/mortalidade , Estudos Prospectivos , Próteses e Implantes , Desenho de Prótese , Falha de Prótese , Implantação de Prótese/métodos , Implantação de Prótese/mortalidade , Amplitude de Movimento Articular/fisiologia , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/mortalidade , Sarcoma de Ewing/cirurgia , Resultado do Tratamento
3.
Urology ; 136: 241-244, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31605682

RESUMO

Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) of the kidney in children younger than 10 years of age is extremely rare. We describe here the case of a 7-year-old female patient who was diagnosed with ES/PNET. The timeframe for this case spanned from 8 months prior to diagnosis until 8 months postsurgical removal of the tumor. In addition, we summarized the cases of PNET in children younger than 10 years of age in the last decade.


Assuntos
Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Imagem por Ressonância Magnética , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/patologia , Tumores Neuroectodérmicos Primitivos Periféricos/diagnóstico por imagem , Tumores Neuroectodérmicos Primitivos Periféricos/patologia , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/patologia , Tomografia Computadorizada por Raios X , Criança , Feminino , Humanos , Estadiamento de Neoplasias
4.
World Neurosurg ; 133: e327-e341, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31520760

RESUMO

BACKGROUND: Medical implications of 3-dimensional (3D) printing technology have evolved and are increasingly used. Surgical spine oncology involves at times complex resection using various surgical approaches and unique spinal reconstruction. As high general complication rates, including hardware failure, are reported, careful preoperative planning and optimized fixation techniques should be performed. 3D printing technology allows the improvement of preoperative planning, practice and exploration of various surgical approaches, and designing customized surgical tools and patient specific implants. OBJECTIVE: To investigate the use of 3D printing technology in complex spine surgeries. METHODS: Between 2015 and 2018, all complex spine oncological cases were evaluated and assessed for the possible benefit of use of 3D printing technology. Following high-quality imaging, a computerized integrated 3D model was created. Based on the planned procedure considering the various surgical steps, a customized 3D model was planned and printed, and in select cases a 3D custom-made implant was designed and printed in various sizes with matching trials. RESULTS: A total of 7 cases were selected for the use of a 3D printing technology. For all, a custom-made model was created. In 3 of these cases, a customized 3D-printed implant was used. Special customized intraoperative instruments were made for 2 cases, and a simulated surgical approach was performed in 5 cases. In 2 cases, pre-bent rods were made based on the model created and were used in surgery later on. CONCLUSIONS: For complex spine oncology cases, the use of 3D printing allowed better preoperative planning, simplified the operative procedure, and enabled improved reconstruction.


Assuntos
Imagem por Ressonância Magnética , Modelos Anatômicos , Impressão Tridimensional , Próteses e Implantes , Procedimentos Cirúrgicos Reconstrutivos/métodos , Neoplasias da Coluna Vertebral/cirurgia , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Transplante Ósseo , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/secundário , Carcinoma Ductal de Mama/cirurgia , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/secundário , Carcinoma de Células Renais/cirurgia , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Desenho de Equipamento , Feminino , Tumores de Células Gigantes/diagnóstico por imagem , Tumores de Células Gigantes/patologia , Tumores de Células Gigantes/cirurgia , Hemangioma/diagnóstico por imagem , Hemangioma/patologia , Hemangioma/cirurgia , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoma Osteoide/diagnóstico por imagem , Osteoma Osteoide/patologia , Osteoma Osteoide/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/secundário , Sarcoma de Ewing/cirurgia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/secundário , Cirurgia Assistida por Computador/instrumentação , Instrumentos Cirúrgicos , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/patologia , Vértebras Torácicas/cirurgia , Adulto Jovem
5.
Clin Nucl Med ; 45(2): e103-e105, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31876802

RESUMO

Primary Ewing sarcoma/primitive neuroectodermal tumor is a group of rare aggressive tumors in adults derived from neuroectoderm, and primary renal involvement is extremely rare. We describe an F-FDG PET/CT findings of a 28-year-old man who presented with left renal mass with inferior vena cava thrombus, which turned out to be primary Ewing sarcoma on histopathology specimen post left nephrectomy.


Assuntos
Neoplasias Renais/diagnóstico por imagem , Tumores Neuroectodérmicos/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoma de Ewing/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Adulto , Fluordesoxiglucose F18 , Humanos , Neoplasias Renais/complicações , Masculino , Tumores Neuroectodérmicos/complicações , Compostos Radiofarmacêuticos , Sarcoma de Ewing/complicações , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologia , Trombose Venosa/complicações
6.
Clin Nucl Med ; 45(2): e112-e114, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31876813

RESUMO

Secondary involvement of inferior vena cava is a common presentation in aggressive solid malignancies, especially arising from kidneys, adrenals, and hepatobiliary system, mostly resulting from local infiltration. Rarely, primary tumors are seen arising from vascular tissue. The Ewing family of tumors commonly arises from bone, but there is a high propensity of these tumors to originate from nonosseous sites of mesenchymal cell origin. We would herewith demonstrate a rare presentation of Ewing sarcoma, seen originating from inferior vena cava, presenting as extensive intravascular tumor thrombosis, evaluated on FDG PET/CT imaging in a 12-year-old girl.


Assuntos
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoma de Ewing/diagnóstico por imagem , Veia Cava Inferior/diagnóstico por imagem , Criança , Feminino , Fluordesoxiglucose F18 , Humanos , Compostos Radiofarmacêuticos , Veia Cava Inferior/patologia
7.
Clin Nucl Med ; 45(1): e57-e58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31524682

RESUMO

We present a case of a 19-year-old woman with Ewing sarcoma of the iliac bone in whom Ga-PSMA-HBED-CC PET/CT showed high radiotracer activity in the primary tumor. The present case documents the in vivo expression of PSMA in Ewing sarcoma family of tumors and adds on to the list of nonprostatic malignancies showing PSMA expression.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Ácido Edético/análogos & derivados , Fluordesoxiglucose F18 , Radioisótopos de Gálio , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoma de Ewing/diagnóstico por imagem , Humanos , Masculino , Adulto Jovem
9.
Tuberk Toraks ; 67(2): 146-148, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31414647

RESUMO

The Ewing's sarcoma family of tumors (ESFT) incorporates both the wellrecognized primary bone and the extraskeletal soft tissue sarcomas. Primitive neuroectodermal tumors (PNET) and ESFT have a similar neural phenotype and can be considered in the same entity. Here, we will present 28 years old patient with Ewing Sarcoma. Patient was admited chest pain. Chest radiograph showed a suspicious lesion in the left paracardiac area. Computed tomography (CT) scan and positron emission tomography (PET)/CT result were compatible with malignant tumor. The patient was underwent surgical resection as the bronchoscopic result couldn't a malignant finding and pathological finding was detected as Ewing's sarcoma. Ewing's sarcoma should be considered in patients who are very fast growing in the lungs, are properly confined and suspected of malignancy in FDG-PET/CT.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Sarcoma de Ewing/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/patologia , Masculino , Tumores Neuroectodérmicos Primitivos/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Radiografia , Sarcoma de Ewing/patologia , Tomografia Computadorizada por Raios X
10.
World Neurosurg ; 132: 303-308, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31394361

RESUMO

BACKGROUND: Primary Ewing sarcoma of the mobile spine is a rare disease. Its management requires careful surgical planning, because radical, margin-free excision is directly correlated with prognosis. Extensive bone removal in the cervical spine can lead to instability and cause postoperative iatrogenic cervical deformity. Thus, spinal instrumentation plays an important role in restoring postresection spinal stability and improving quality of life. METHODS: We present a novel technique that allows successful removal of a large Ewing sarcoma of the subaxial cervical spine, infiltrating and traversing the posterior bone elements, and extending into the paraspinal muscles. This technique involves radical en bloc resection of posteriorly located cervical tumors via multilevel pediculotomy, with terminal vertebrae pedicle screw reconstruction. RESULTS: Terminal vertebrae cervical pedicle screw reconstruction allowed wide surgical excision with satisfactory oncologic and mechanical results. CONCLUSIONS: This technique enables 1-stage total tumor resection and stabilization and may be a viable alternative to radical en bloc resection of posteriorly located epidural malignant lesions of the cervical spine in selected cases.


Assuntos
Vértebras Cervicais/cirurgia , Procedimentos Neurocirúrgicos/métodos , Parafusos Pediculares , Procedimentos Cirúrgicos Reconstrutivos/métodos , Sarcoma de Ewing/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Adolescente , Vértebras Cervicais/diagnóstico por imagem , Humanos , Masculino , Osteotomia/métodos , Sarcoma de Ewing/complicações , Sarcoma de Ewing/diagnóstico por imagem , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/etiologia , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/diagnóstico por imagem
11.
Clin Nucl Med ; 44(8): 666-668, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274619

RESUMO

Extraskeletal Ewing sarcoma is rare. The common locations of extraskeletal Ewing sarcoma include the paravertebral region, lower extremities, and chest wall. Primary pulmonary Ewing sarcoma is extremely rare. Because Ewing sarcoma is sensitive to specialized chemotherapy regimens, accurate diagnosis is therefore critical. The diagnosis of pulmonary Ewing sarcoma can be challenging and need immunohistochemical and cytogenetic analyses. Imaging findings of pulmonary Ewing sarcoma have been rarely reported. This report describes a case of primary pulmonary Ewing sarcoma with immunohistochemical, cytogenetic, CT, and FDG PET/CT findings.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Sarcoma de Ewing/diagnóstico por imagem , Adulto , Fluordesoxiglucose F18 , Humanos , Masculino , Compostos Radiofarmacêuticos
13.
Nucl Med Commun ; 40(8): 827-834, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31107830

RESUMO

OBJECTIVES: Ewing sarcoma breakpoint region 1 (EWSR1) translocation-negative tumors represent a minor portion of small round cell tumors consistent with Ewing sarcoma morphology. The purpose of this study was to differentiate EWSR1 translocation-positive tumors from EWSR1 translocation-negative tumors using PET-computed tomography features. MATERIALS AND METHODS: In this retrospective study 27, Ewing sarcoma patients (December 2011 to November 2016) were divided into two groups, EWSR1 translocation-positive and EWSR1 translocation-negative based on cytogenetic analysis. Pretreatment standardized uptake value maximum (SUVmax) and Hounsfield Units (HU) were measured in the primary tumor in the axial slice with the largest tumor diameter.The associations between SUVmax, HU and the presence of EWSR1 translocation were evaluated. Receiver operating characteristic curve analysis was used to determine cut-off levels of SUVmax and HU suggestive of EWSR1-negative tumors. RESULTS: Twenty-one patients were classified as EWSR1-positive and six as EWSR1-negative. Eighteen had SUVmax and 21 had HU measurements. EWSR1-negative tumors had significantly higher SUVmax values (P = 0.003) and significantly lower HU values (P = 0.008). Receiver operating characteristic curve analysis showed that SUVmax had diagnostic ability to discriminate between EWSR1-negative and EWSR1-positive tumors (area under the curve = 0.964, P = 0.006). A SUVmax of at least 10 had a sensitivity of 100% and specificity of 85.7% for EWSR1-negative tumors. HU had lower diagnostic ability than SUVmax (area under the curve = 0.881, P = 0.012). A HU up to 57 had a sensitivity of 81.3% and specificity of 80.0% for EWSR1-negative tumors. CONCLUSION: Higher SUVmax and lower HU may differentiate between EWSR1-positive and EWSR1-negative tumors. This may reflect EWSR1-negative tumor aggressiveness.


Assuntos
Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Proteína EWS de Ligação a RNA/genética , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/genética , Translocação Genética , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Adulto Jovem
14.
Med Oncol ; 36(7): 58, 2019 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-31104192

RESUMO

Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/PNET) is an aggressive bone tumor. Bone marrow aspiration and biopsy (BMAB) has been recognized as the gold standard for assessing bone marrow status. While the latest guideline suggests the need to omit bone marrow aspiration in patients with no findings on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) based on one retrospective report, there is no study using 18F-FDG PET/computed tomography (CT). We retrospectively reviewed 26 consecutive, previously untreated, ES/PNET patients. We compare the results of bone marrow aspiration and biopsy (BMAB) and those of 18F-FDG PET/CT in ES/PNET patients. All of the 21 patients without metastases on 18F-FDG PET/CT had negative BMAB. The sensitivity of bone marrow involvement in bone metastases positive patients on 18F-FDG PET/CT was 75% (3/4), and the specificity was 100% (22/22). In addition to the metastatic findings on 18F-FDG PET/CT, tumor diameter, lactate dehydrogenase level at diagnosis, and the presence or absence of bone metastasis were factors related to bone marrow involvement. It may be a reasonable option to omit BMAB in ES/PNET patients with no distant metastasis based on 18F-FDG PET/CT findings.


Assuntos
Medula Óssea/diagnóstico por imagem , Neoplasias Ósseas/secundário , Tumores Neuroectodérmicos Primitivos Periféricos/diagnóstico por imagem , Sarcoma de Ewing/diagnóstico por imagem , Adolescente , Adulto , Biópsia por Agulha , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/patologia , Criança , Feminino , Fluordesoxiglucose F18 , Humanos , Masculino , Pessoa de Meia-Idade , Tumores Neuroectodérmicos Primitivos Periféricos/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Sarcoma de Ewing/patologia , Adulto Jovem
15.
J Clin Neurosci ; 66: 280-284, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31113698

RESUMO

Spinal intradural Ewing sarcoma (ES) of the cervical region is not common. Few cases have been reported and optimal management remain poorly defined. We described a case of a young woman with extensive primary leptomeningeal spinal ES and conducted a review of the literature.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/cirurgia , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Feminino , Humanos
16.
Dev Period Med ; 23(1): 39-44, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30954980

RESUMO

OBJECTIVE: Background: Patients with Ewing sarcoma have a dismal outcome. Maintenance treatment with trofosfamide has been proposed as an effective regimen for some paediatric malignancies. Aim: We sought to evaluate the schedule of trofosfamide for patients with high-risk primary bone Ewing sarcoma. PATIENTS AND METHODS: Materials and methods: Fifteen patients with primary bone Ewing sarcoma received treatment with trofosfamide (150 mg/m2 p.o. days 1-10) every 28 days. All patients had standard tumour imaging and laboratory evaluation. All toxicities were documented. RESULTS: Results: A total of 90 cycles (median 5 cycles/patient) were administered. A complete response was maintained in nine patients, while six patients had disease progression during treatment. Median time to progression was 1.9 months (range 1.8 to 4.6). Eleven patients (73.3%) are alive including nine with no evidence of disease with a median follow-up of 3.9 years (range 1.4 to 7.6). All patients with active disease at the start of the trofosfamide treatment died. There were no significant toxicities. CONCLUSION: Conclusions: Treatment with trofosfamide is well-tolerated and could have a role to maintain response in patients with primary bone Ewing sarcoma. Further studies are needed to better define the use of this regimen in the upfront management of those patients.


Assuntos
Neoplasias Ósseas/tratamento farmacológico , Ciclofosfamida/análogos & derivados , Sarcoma de Ewing/tratamento farmacológico , Adolescente , Antineoplásicos Alquilantes/efeitos adversos , Antineoplásicos Alquilantes/uso terapêutico , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/diagnóstico por imagem , Criança , Pré-Escolar , Ciclofosfamida/efeitos adversos , Ciclofosfamida/uso terapêutico , Feminino , Humanos , Masculino , Sarcoma de Ewing/diagnóstico , Sarcoma de Ewing/diagnóstico por imagem , Resultado do Tratamento , Adulto Jovem
17.
Molecules ; 24(6)2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-30893786

RESUMO

BACKGROUND: Improved outcome prediction is vital for the delivery of risk-adjusted, appropriate and effective care to paediatric patients with Ewing sarcoma-the second most common paediatric malignant bone tumour. Fourier transform infrared (FTIR) spectroscopy of tissues allows the bulk biochemical content of a biological sample to be probed and makes possible the study and diagnosis of disease. METHODS: In this retrospective study, FTIR spectra of sections of biopsy-obtained bone tissue were recorded. Twenty-seven patients (between 5 and 20 years of age) with newly diagnosed Ewing sarcoma of bone were included in this study. The prognostic value of FTIR spectra obtained from Ewing sarcoma (ES) tumours before and after neoadjuvant chemotherapy were analysed in combination with various data-reduction and machine learning approaches. RESULTS: Random forest and linear discriminant analysis supervised learning models were able to correctly predict patient mortality in 92% of cases using leave-one-out cross-validation. The best performing model for predicting patient relapse was a linear Support Vector Machine trained on the observed spectral changes as a result of chemotherapy treatment, which achieved 92% accuracy. CONCLUSION: FTIR spectra of tumour biopsy samples may predict treatment outcome in paediatric Ewing sarcoma patients with greater than 92% accuracy.


Assuntos
Aprendizado de Máquina , Espectrofotometria Infravermelho , Adolescente , Adulto , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/tratamento farmacológico , Criança , Pré-Escolar , Humanos , Terapia Neoadjuvante , Prognóstico , Estudos Retrospectivos , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/tratamento farmacológico , Espectroscopia de Infravermelho com Transformada de Fourier , Resultado do Tratamento , Adulto Jovem
18.
Cir. plást. ibero-latinoam ; 45(1): 67-72, ene.-mar. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182680

RESUMO

Introducción y Objetivo: La patología tumoral primaria de pared torácica es una entidad poco frecuente en niños. El tratamiento quirúrgico comúnmente involucra la resección de la pared torácica, pudiendo dejar grandes defectos que requieren reconstrucción compleja. Estos pueden incluir la reconstrucción de tejidos blandos y esqueléticos con materiales aloplásticos y colgajos regionales. Presentamos nuestra experiencia en reconstrucción torácica secundaria a tumores primarios de pared torácica en población pediátrica. Material y Método: Describimos 2 casos clínicos de pacientes pediátricos con tumores de pared torácica manejados multidisciplinariamente con resección amplia, cobertura con malla y colgajo miocutáneo de latissimus dorsi. Resultados: El colgajo de latissimus dorsi fue una buena alternativa en estos 2 casos para la cobertura de la reconstrucción esquelética en niños. Conclusiones: El abordaje multidisciplinario de estas patologías es fundamental dada la necesidad de realizar grandes ablaciones torácicas


Background and Objective: Primary tumor of the thoracic wall is a rare entity in children. Surgical treatment commonly involves resection of the chest wall, potentially leaving large defects that can require complex reconstruction. These may include skeletal and soft tissue reconstruction with alloplastic materials and regional flaps. We report our experience in thoracic wall reconstruction after extensive resection due to primary wall tumors resection in children. Methods: We present 2 cases of pediatric patients with thoracic wall tumor who were managed multidisciplinary with wide resection and reconstructed with mesh coverage and latissimus dorsi myocutaneous flap. Results: The latissimus dorsi flap was a good alternative for coverage of skeletal reconstruction in the presented cases. Conclusions: Multidisciplinary management of these pathologies is fundamental given the need to perform large thoracic ablations


Assuntos
Humanos , Masculino , Recém-Nascido , Parede Torácica/cirurgia , Retalhos Cirúrgicos/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Neoplasias Primárias Múltiplas/secundário , Fibrossarcoma/diagnóstico , Biópsia , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/cirurgia
19.
BMJ Case Rep ; 12(2)2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30796079

RESUMO

Ewing sarcoma is a lesion of bone, described in small round cell neoplasm. This tumour resembles primitive neuroectodermal tumour both clinically and histologically. Major difference between these two is that the former arises in the bone and the later in soft tissue. It appears most frequently in males at the age range of of 5-25 years, 80% of which occurs within first two decades of life. Males are more commonly affected than females. Present paper reported with a case report of male patient with 24-year-old showing Ewing's sarcoma of right maxilla.


Assuntos
Neoplasias Ósseas/patologia , Maxila/patologia , Neoplasias Maxilares/patologia , Sarcoma de Ewing/patologia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Humanos , Imagem por Ressonância Magnética , Masculino , Maxila/cirurgia , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/cirurgia , Osteotomia de Le Fort , Procedimentos Cirúrgicos Reconstrutivos , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
20.
Pediatr Blood Cancer ; 66(6): e27653, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30724024

RESUMO

BACKGROUND: Ewing sarcoma (ES) is the second most common bone tumor in adolescents and children. Staging workup for ES includes imaging and bone marrow biopsy (BMB). The effective role of BMB is now under discussion. PROCEDURE: A monoinstitutional retrospective analysis reviewed clinical charts, imaging, and histology of patients with diagnosis of ES treated at the Rizzoli Institute between 1998 and 2017. RESULTS: The cohort included 504 cases of ES of bone; 137 (27%) had metastases at diagnosis, while the remaining 367 had localized disease. Twelve patients had a positive BMB (2.4%). Eleven had distant metastases detected at initial workup staging with imaging assessment: six patients presented with bone metastases, five with both bone and lung metastases. Only one patient with ES of the foot (second metatarsus) was found to have bone marrow involvement with negative imaging evaluation (0.3%). CONCLUSIONS: On the basis of our data, we suggest reconsidering the effective role of BMB in initial staging workup for patients with ES with no signs of metastases by modern imaging techniques. In metastatic disease, the assessment of the bone marrow status may remain useful to identify a group of patients at very high risk who could benefit from different treatment strategies.


Assuntos
Neoplasias da Medula Óssea/secundário , Medula Óssea/patologia , Neoplasias Ósseas/secundário , Neoplasias Pulmonares/secundário , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Sarcoma de Ewing/patologia , Adolescente , Adulto , Medula Óssea/cirurgia , Neoplasias da Medula Óssea/diagnóstico por imagem , Neoplasias da Medula Óssea/cirurgia , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Criança , Pré-Escolar , Feminino , Seguimentos , Doenças do Pé , Humanos , Lactente , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Masculino , Prognóstico , Estudos Retrospectivos , Sarcoma de Ewing/diagnóstico por imagem , Sarcoma de Ewing/cirurgia , Adulto Jovem
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