Cases reported "Osteosarcoma"

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1/96. Differential diagnosis of metastases in bone scans: chemotherapy induced bone necrosis.

    AIM: Influenced by the incorrect diagnosis of a bone metastasis caused by bone necrosis we evaluated reasons and frequency of bone necrosis in patients referred for bone scanning in follow-up of tumors. methods: Bone scans performed within two years on patients with primary bone tumors or tumors metastatic to bone were reviewed in respect to the final diagnosis bone necrosis. RESULTS: We found the cases of three young patients who presented the appearance of hot spots on bone scintigrams which were finally diagnosed as bone necrosis. In two cases the diagnosis was based on histological findings, in one case the diagnosis was made evident by follow-up. All the three patients had been treated by chemotherapy and presented no other reason for the development of bone necrosis. Enhanced tracer uptake in all sites decreased within eight weeks up to two years without therapy. CONCLUSION: Single and multiple hot spots after chemotherapy may be originated by bone necrosis but mimicry metastases.
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2/96. Osteogenic sarcoma with skeletal muscle metastases.

    Two cases of osteogenic sarcoma with skeletal muscle metastases are described. A 40-year-old woman presented with progressive swelling of both calves and a soft tissue back lump. She had been diagnosed with mandibular chondroblastic osteogenic sarcoma 6 years earlier. Radiographs showed calcified masses. MRI scans and bone scintigraphy revealed multiple soft tissue masses in both calves. Bone scintigraphy also showed uptake in the back lump, right thigh and left lung base. biopsy confirmed metastatic chondroblastic osteogenic sarcoma, which initially responded well to chemotherapy. However, the metastatic disease subsequently progressed rapidly and she died 21 months after presentation. The second case concerns a 20-year-old man who presented with a pathologic fracture of the humerus, which was found to be due to osteoblastic osteogenic sarcoma. He developed cerebral metastases 17 months later, followed by metastases at other sites. Calcified masses were subsequently seen on radiographs of the abdomen and chest. CT scans confirmed the presence of densely calcified muscle metastases in the abdominal wall, erector spinae and gluteal muscles. The patient's disease progressed rapidly and he died 30 months after presentation.
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3/96. Primary osteogenic sarcoma involving sella-sphenoid sinus--case report.

    A 38-year-old male presented with an extremely rare primary osteogenic sarcoma, unassociated with Paget's disease or late effects of radiation, involving the sella and sphenoid sinus region. Complete excision of the tumor was achieved through an extended frontobasal approach. Postoperatively, six cycles of combination chemotherapy (adriamycin, ifosphamide, and cisplatin) followed by a total of 55 Gy local radiotherapy in 33 fractions was given. Primary osteogenic sarcoma should be considered in the differential diagnosis of the central skull base tumors. Osteogenic sarcoma, in general, has a bad prognosis, and should be managed aggressively with multimodality treatment including gross total surgical resection, combination chemotherapy, and radiotherapy.
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ranking = 13.70503213174
keywords = skull, base
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4/96. Post-Paget telangiectatic osteosarcoma of the skull.

    Sarcomatous transformation is the most dreaded complication of Paget's disease. We report on a case of post-Paget telangiectatic osteosarcoma of the skull, a variant of osteogenic osteosarcoma, in a 79-year-old woman. We discuss the radiological pattern in relationship to the differential diagnosis.
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ranking = 63.525160658699
keywords = skull
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5/96. Parosteal osteosarcoma of the scapula.

    Parosteal osteosarcoma is a low-grade osteosarcoma, which occurs on the surface of the bone. We had experienced a parosteal osteosarcoma involving the flat bone, the scapula of a 21-year-old man. This is an extremely rare location for a parosteal osteosarcoma. Plain radiograph showed broad-based, well-defined radiodense lesion at the scapula. Computed tomogram demonstrated an intact cortex and absence of a medullary involvement. Tumor showed a lobulated, high-density lesion, indicating bone formation. Histologically, parosteal osteosarcoma is a well-differentiated osteosarcoma. The tumor is composed of a hypocellular proliferation of spindle cells, with minimal cytologic atypia. The bone is in the form of a well-formed bony trabeculae. Occasional cartilage is present in the form of a cap.
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6/96. Primary osteosarcoma of the skull.

    In 33 cases of primary osteosarcoma of the skull in a relatively old age group, the sex ratio and poor prognosis is the same as in osteosarcoma of long bones. However, patients in the second decade of life free of neurologic disease have a better prognosis.
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keywords = skull
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7/96. Treatment of solid tumors following allogeneic bone marrow transplantation.

    Second solid tumors are well known late complications after bone marrow transplantation. Treatment strategies are ill defined. We retrospectively evaluated treatment and outcome in a single institution. From August 1974 to July 1996, six solid tumors were observed in five of 387 patients 2 to 13 years after BMT, corresponding to a probability of developing a second solid tumor of 9% (1-17%, 95 CI) at 15 years: these comprised endometrial carcinoma, carcinoma of the thyroid gland, cervical carcinoma, sarcoma of the small intestine, osteosarcoma of the tibia and ovarian carcinoma. All five patients were treated as intensively as they would be without a history of BMT. At last follow-up four of the five patients were alive and without signs of tumor. We postulate that second solid tumors after BMT should be treated as de novo tumors. Early detection based on consequent clinical follow-up of the transplant patients might explain the relatively good outcome.
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8/96. osteosarcoma of the sella.

    Primary osteosarcoma of the skull is rare. osteosarcoma arising from the sellar region is extremely uncommon. The case of a 38-year-old man with osteosarcoma of the sella is described, and the literature is reviewed. The patient was treated with surgery followed by aggressive chemotherapy and radiotherapy. Currently he is in remission at 12 months.
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ranking = 12.70503213174
keywords = skull
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9/96. Sarcomatous transformation of the orbit in a patient with Paget's disease.

    OBJECTIVE: To report the clinical and pathologic features of sarcomatous transformation of the skull with involvement of the orbit, in Paget's disease. DESIGN: Interventional case report. PARTICIPANT: An 83-year-old woman with Paget's disease who experienced progressive proptosis of the left eye. INTERVENTION: Fine-needle aspiration biopsy of the orbital mass. RESULTS: Cytologic examination revealed round to oval malignant cells with wispy cytoplasm, consistent with the diagnosis of sarcoma. The patient died shortly after institution of orbital radiation therapy and systemic steroid therapy. CONCLUSIONS: Proptosis related to Paget's disease is uncommon, and only rarely is it a result of sarcomatous transformation. Sarcomatous transformation of the skull involving the orbit should be included in the differential diagnosis of progressive proptosis in patients with Paget's disease.
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ranking = 25.41006426348
keywords = skull
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10/96. Metastasis of osteosarcoma to the maxilla--a case report.

    Secondary osteosarcomas of the maxilla/premaxilla are extremely rare. We describe a case of a 24-year-old man with a metastasis of osteosarcoma to the premaxilla. The patient had undergone hip disarticulation followed by adria based chemotherapy for chondroblastic osteosarcoma of the proximal right femur ten years ago. The metastatic work up did not show liver or lung metastasis. The patient underwent premaxillectomy in February 1999. The histopathology revealed a chondroblatic osteosarcoma consistent with metastasis in the clinical setting. The patient was disease free at the end of five months.
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