Radiographic Enchondroma Surveillance: Assessing Clinical Outcomes and Costs Effectiveness.
In conclusion, enchondroma growth was a rare event and typically occurred at two years follow-up in our series. Given the low risk for malignant transformation, we propose surveillance with plain radiographic follow-up for stable enchondromas every 3-6 months for the first year and then annually for at least three years of total follow-up. The most significant costs savings can be made by limiting MRI imaging in the absence of clinical or radiographic concern. Additional studies are needed to determine the long-term risk of growth or declaration of chondrosarcoma.Level of Evidence: IV. PMID: 31413693 [PubMed - in process]
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ConclusionsChondral lesions in the shoulder have low risk of malignant transformation and are rarely responsible for shoulder symptoms. We recommend patients be referred to a dedicated BTU for surveillance if there are any concerning features, but to proceed with management for any alternative diagnosis.
Chest computed tomography demonstrated a suspected primary tumor in the upper sternal body of a 48 ‐year‐old woman who presented with sternal pain. After being diagnosed with chondrosarcoma, she underwent sternal resection. Subsequent chest wall reconstruction was performed after careful planning using a bone cement block made of polypropylene mesh and polymethylmethacrylate. The block was fi xed to the manubrium and ribs using the SternaLock System. She was discharged following an uneventful postoperative recovery, and is currently undergoing follow‐up.
ConclusionBoth procedures offer a good primary stabilization with excellent pain reduction and good return to life. Limited information on long-term survivors is known. Therefore, the theoretical advantage of a biological solution needs to be checked in the long-term f/u for consistency.
Conclusions: The proposed nomogram is a reliable and robust tool for accurate prognostic prediction in patients with extremity soft tissue LMS. Introduction Soft tissue leiomyosarcoma (LMS) is an aggressive sarcoma, which originates from smooth muscle cells (1). Soft tissue LMS accounts for about 5–10% of all soft tissue sarcomas (2). It occurs in different sites, including the retroperitoneum, intraabdominal sites, and extremities (3). Extremity LMS comprised about 10–15% of extremity sarcomas, with a preference for the lower limb (4–6). Extremity LMS tends to have a better prognosis than uterine...
CONCLUSION: Surgical treatment of primary malignant tumors of the proximal fibula is problematic. In appropriate indications, Malawer type 1 resection should be the treatment of choice due to lower local recurrence rates and higher MSTS scores. PMID: 30885105 [PubMed - in process]
AbstractWe herein report a rare case of mesenchymal hamartoma of the chest wall in a 10-year-old girl. She complained of chest pain and was diagnosed with a large chest wall tumor originating from the left fourth rib. Malignancy such as osteosarcoma or chondrosarcoma could not be ruled out with imaging studies. Therefore, we performed a core needle biopsy assisted by thoracoscopy, which revealed no malignancy. Therefore, extended resection with chest wall reconstruction was unnecessary, and thoracoscopy-assisted tumor excision with only the removal of the involved fourth rib was performed without chest wall reconstruction....
A 20 year old man suffered severe right knee pain, especially when his right foot touched ground. The MRI findings suggested periosteal osteosarcoma, which led to a staging FDG PET/CT. The images showed not only a hypermetabolic right knee lesion but also focally elevated activity in select muscles, which was attributed to altered biomechanics. The resected lesion was pathologically proven as periosteal chondrosarcoma instead of periosteal osteosarcoma. In a follow-up period of 4 years after the surgery, there was no recurrent disease, nor any abnormality in the muscles which showed focal FDG activity on the initial FDG PET/CT.
DiscussionWidening of the PDL space is an important finding associated with malignant disease and may occur with sarcomas and non-Hodgkin lymphoma. 2,5 Widening of the PDL space was identified in nearly half the osteosarcoma cases reported by Fernandes et al.2 The combination of PDL widening, sclerotic bone pattern with bone formation, and higher incidence of osteosarcoma compared with chondrosarcoma can be used to identify osteosarcoma cases radiographically.
This study may help guide surgeons to avoid overtreatment with additional osteosynthe sis after curettage and bone cement filling of intramedullary lesions of the distal femur. Meta-epiphyseal lesions will need additional osteosynthesis rarely, contrary to diaphyseal lesions with considerable cortical thinning.