1/44. Osteogenic sarcoma arising in an old burn scar.An osteogenic sarcoma arising in an old burn scar on the right thigh of a 70-year-old woman is described. Salient features of this rare cutaneous tumor were: a large pinkish exophytic mass, spindle and oval cells, multiple foci or osteoid formation, atypical osteoblasts and multinucleated giant cells.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/44. Periosteal osteosarcoma of the jaws: report of 2 cases.osteosarcoma (OS) occurs most often in the long bones. OS of the jaws has clinical and biologic aspects different from those of the long bones. They tend to occur at an older mean age, pain and swelling are more typical, and prognosis is more favorable. Nearly all OS shows a very prominent central intramedullary bone component. Only rarely are juxtacortical (peripheral) OS located in the jaws. There are 2 main types of juxtacortical OS, periosteal and parosteal. We present 2 cases of OS of the jaws where the clinical, radiologic, and histologic findings pointed to a diagnosis of periosteal OS. Both patients presented, in fact, with lesions located superficially on the bone surface with no marrow involvement. Both tumors were characterized by the presence of a moderately differentiated chondroblastic tumor with foci of osteoid and bone formation. Periosteal OS should be differentiated microscopically from periosteal chondrosarcoma, intramedullary OS with periosteal extension, high-grade surface OS, and parosteal OS. The clinical differential diagnosis was done, in these cases, for epulis, gingival tumors, peripheral odontogenic fibroma, peripheral ossifying fibroma, pyogenic granuloma, peripheral giant cell granuloma, and mesenchymal malignant tumors.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/44. Total spondylectomy for primary tumor of the thoracolumbar spine.STUDY DESIGN: Six patients with primary malignant tumor of the thoracolumbar spine who underwent total spondylectomy (TS) by en bloc resection were reviewed retrospectively. OBJECTIVES: To report surgical technique and preliminary results of TS and to evaluate its oncological curability. SETTING: japan. methods: Six patients were treated by TS by en bloc resection of the vertebral tumor. TS through a posterior approach was performed in three cases (T1 osteosarcoma, L1 osteosarcoma and L1 chordoma) and in the others through a single stage anterior and posterior combined approach (T6-8 recurrent giant cell tumor. L4 chordoma and L5 giant cell tumor). Surgical margins of the specimens were evaluated histologically. All patients were followed, and their status was evaluated by clinical and imaging studies. RESULTS: There were no complications related to surgery. Programmed sacrifice of nerve roots were performed in three cases for oncologic excision. A wide surgical margin was achieved in one case, a marginal one in four, and an intralesional margin in one. Five patients were alive without evidence of tumor and one was alive with disease at follow-up evaluation after 2.0-4.8 years. Local recurrence was found in one case of T1 osteosarcoma with an intralesional margin. CONCLUSIONS: These preliminary results suggested that TS is an effective procedure in control of local recurrence with acceptable complications.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
4/44. Soft-tissue osteosarcoma with prominent aneurysmatic bone cyst-like features: a case report.We describe the cytological features of a soft-tissue high-grade spindle and pleomorphic sarcoma. The smears showed hypercellularity composed of pleomorphic round and elongated cells, and a striking population of multinucleated osteoclast-type giant cells. Microscopically the tumor showed multiple patterns such as highly cellular pleomorphic, less cellular, and hyalinized areas with neoplastic cartilage and osteoid, and areas with hemorrhage and multicystic appearance with numerous osteoclastic giant cells, resembling aneurysmal bone cysts. Immunohistochemical studies showed positivity for vimentin, while chondroid tissue was positive for S-100, and osteoclastic giant cells stained positively for CD68. Due to the varied microscopic patterns, the differential diagnosis included many tumors containing osteoclastic giant cells and osteochondroid tissue.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
5/44. Aneurysmal bone cyst of the larynx presenting with hypoglottic obstruction.We report a new case of aneurysmal bone cyst of the larynx occurring in a 22-year-old man. The lesion manifested with progressive breathing discomfort and appeared as a polypoid pedunculated mass attached to the subglottic mucosa. Microscopically, it featured numerous mononuclear and multinucleated giant cells surrounding cavernous spaces filled with blood. Foci of proliferating spindle cells and mature osteoid tissue could be recognized. There was no apparent relationship with the cricoid perichondrium. Clinical follow-up was negative for local recurrence. Based on this report and a review of the literature, we conclude that aneurysmal bone cyst of the larynx is phenotypically comparable to its bone homologue; however, its microscopic recognition may be difficult, especially on small biopsy fragments. Since it can be confused with several lesions, including telangiectatic osteosarcoma, awareness of this rare appearance of aneurysmal bone cyst is important to avoid unnecessary radical surgery.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/44. De novo malignant transformation of giant cell tumor of bone.Two cases of malignant lesions are reported, both of which arose secondary to an originally benign giant cell tumor (GCT) of bone. The first case was a typical benign GCT, which occurred in the left proximal tibia of a 31-year-old woman. The tumor was treated by curettage and bone grafting. However, it recurred twice during 15 years of follow-up. The second recurrence showed that the lesion histologically had turned into malignant fibrous histiocytoma. The second case also started as an initially benign GCT that arose in the left distal femur of a 41-year-old man. The patient underwent curettage and bone grafting. The lesion recurred 13 years postoperatively. The histological appearance of the recurrent tumor showed it to be an osteogenic sarcoma. In both patients, radiation and never been given. Malignant transformation has rarely been reported in patients with GCT of bone who have not received radiation treatment.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
7/44. Multicentric telangiectatic osteosarcoma.A rare case of multicentric telangiectatic osteosarcoma in a 29-year-old woman is described. A plain X-ray showed a pure osteolytic lesion of the navicular, cuboid and I, II, III cuneiform bones. On magnetic resonance images, a T1-weighted image showed heterogeneous low signal intensity. A T2-weighted image showed heterogeneous high signal change with multicentric cystic foci and fluid-fluid levels. Histologically, the lesion showed typical telangiectatic osteosarcoma with numerous atypical giant cells.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/44. Extraskeletal osteosarcoma arising in the buttock.Extraskeletal osteosarcoma is a rare sarcoma that accounts for about 1% of malignant soft tissue tumours. We report an very unusual case of a small-size extraskeletal osteosarcoma arising in the superficial subcutaneous region of the buttock. The patient was a 55 year-old female. She incidentally noticed a small nodule in the right trochanteric region. It was removed under local anesthesia at a private clinic. An additional wide excision was performed at our hospital. There was an 8 mm? 10 mm mass in the subcutaneous tissue. No invasion of the underlying fascia was observed. Microscopic examination of the removed tumour showed bizarre-looking spindle and giant cells with lace-like osteoid. The tumour was diagnosed as extraskeletal osteosarcoma. Chemotherapy with Rosen T-20 was administered to the patient. The patient has survived without recurrence or metastasis for 4 years since the primary surgery. Its superficial location, very small size, wide excision, and chemotherapy were thought to contribute to her long survival.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/44. Coexistence of primary bone tumours: report of 4 cases of collision tumours.OBJECTIVE: To report, in 4 patients, the occurrence of 2 different primary tumours in proximity in the same bone. Three patients had osteosarcomas, and 1 had a giant cell tumour; all had coincident metaphyseal fibrous defect. methods: Four patients (2 women, 1 man and 1 boy; 18, 25, 24 and 10 years of age, respectively) presented with progressive pain in the knee and distal thigh. All were studied by radiography, magnetic resonance imaging was done in 3 patients, and diagnostic open biopsy was performed for all. RESULTS: Radiologic studies demonstrated tumours in the distal end of the femur in all 4 patients. biopsy tissue showed a metaphyseal fibrous defect in all, with coexistence of an associated giant cell tumour in 1 patient and an osteosarcoma in each of the others. In all cases, the metaphyseal fibrous defect was penetrated by the adjacent tumour. CONCLUSIONS: Despite the relative prevalence of metaphyseal fibrous defect, giant cell tumour and osteosarcomas in the distal end of the femur and their occurrence in approximately the same age group, their association has rarely been reported. As both giant cell tumours and osteosarcomas are usually diagnosed late in their clinical course, they may outgrow and destroy any evidence of pre-existing metaphyseal fibrous defect. The rate of destruction is also influenced by the distance between the 2 lesions--the shorter the distance, the earlier the destruction.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
10/44. Malignancy in giant cell tumor.Malignant giant cell tumor is a confusing term that in the past has been used to describe different types of giant cell-rich tumors. We try to clarify this term in this report. We consider two types of malignancy in giant cell tumor of bone: "primary" when it arises in juxtaposition to a benign giant cell tumor and 'secondary' when it arises at the site of a previously treated giant cell tumor. Here we present a case of primary malignancy in giant cell tumor that was initially not recognized as a malignancy. On radiography and histology of frozen sections the lesion had the appearance of a conventional giant cell tumor of bone. After curettage, the permanent histology slides showed areas of highly malignant osteosarcoma juxtaposed to areas of benign giant cell tumor. The patient was treated with chemotherapy and wide resection of the tumor.- - - - - - - - - - ranking = 12keywords = giant (Clic here for more details about this article) |
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