• Title/Summary/Keyword: Musculoskeletal Tumors

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STAT3 is Activated in a Subset of Benign and Malignant Chondroid Tumors (양성 및 악성 연골 종양에서의 STAT3 활성화)

  • Park, Hye-Rim;Park, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.130-137
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    • 2009
  • Purpose: STAT3 is an oncogene that regulates critical cellular processes, and its constitutive activation has been demonstrated to correlate with biological and clinical features in many types of human malignancy. Materials and Methods: In this study, STAT3 activation was assessed in variable benign and malignant chondroid tumors in bone by immunohistochemistry using a monoclonal antibody specific for $tyrosine^{705}$-phosphorylated STAT3 ($pSTAT3^{tyr705}$). Results: Among conventional chondrosarcomas (n=17), three cases(50%) of grade III chondrosarcomas were pSTAT3-positive. All grade I and II chondrosarcomas were pSTAT3-negative. This pSTAT3 positivity according to the histologic grade was statistically significant (p=0.0432). Two cases(50%) of clear cell chondrosarcomas were pSTAT3-positive. Six cases (50%) among 12 benign chondroid tumors(6 enchondromas, 3 chondroblastomas, and 3 chondromyxoid fibromas) were also $pSTAT3^{tyr705}$-positive. Conclusion: In conclusion, STAT3 activation is associated with higher tumor grade in conventional chondrosarcomas. Our results suggest that STAT3 is activated in a subset of benign and malignant chondroid tumors, and may support the extension of the cancer stem cell hypothesis to include tumors of cartilaginous lineage.

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Cyclooxygenase-2 Expression in Benign and Malignant Chondroid Tumors (양성 및 악성 연골 종양의 Cyclooxygenase-2 발현)

  • Park, Hye-Rim;Min, Kwang-Seon;Park, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.105-112
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    • 2007
  • Purpose: Recent studies have shown increased levels of cyclooxygenase-2 (COX-2) in various human malignancies to include various bone and soft tissue tumors. However, little is known with regard to COX-2 expression patterns in chondroid tumors. Materials and Methods: Immunohistochemistry assays were performed for COX-2 in enchondromas (n=10), chondroblastomas (n=11), chondromyxoid fibromas (n=5), conventional chondrosarcomas (n=17), clear cell chondrosarcomas (n=7), and mesenchymal chondrosarcomas (n=6). Results: Among the benign chondroid tumors, chondroblastomas revealed characteristic strong positivity in 6 of 11 cases(54.5%). All enchondromas and chondromyxoid fibromas were negative except in one case. In conventional chondrosarcomas, three cases(17.6%) were strongly reactive with COX-2 and all positive cases represented grade III chondrosarcomas. Clear cell chondrosarcomas were found to be focally positive in two cases(28.5%), while all mesenchymal chondrosarcomas were negative. Conclusions: These findings suggest that COX-2 overexpression in conventional chondrosarcoma may represent an advanced histologic grade. Interestingly, expression of COX-2 in chondroblastomas could be an important factor for inducing peritumoral inflammatory changes in these specific tumors.

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Primary bone tumors of fibula (비골에 발생한 원발성 골 종양)

  • Park, Jang-Won;Lee, Seung-Hwan;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.112-117
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    • 2006
  • Purpose: The purpose of this study was to investigate on primary bone tumors of fibula. Materials and Methods: Patients who received operative treatment from January 1993 to December 2005 for primary bone tumors of fibula were analyzed for clinical outcomes. Results: There were 17 patients(10 males, 7 females) who were diagnosed for primary bone tumors of fibula. Osteochondroma was the most common diagnosis and others were osteosarcoma, fibrous dysplasia. The malignant bone tumors were 10.5% of all fibula tumors. There were 12 cases on proximal, 4 cases on mid shaft, and 1 cases on distal part of fibula. At the final follow up, 14 patients reported patient satisfaction of either excellent or good. Conclusion: Bone tumor of fibula doesn't need reconstruction after the resection unless it invades tibia or its site distal, which enables easy surgical resection. However, generally it is rare and accompany with vague symptoms, so careful approach to diagnosis is necessary because late diagnosis can mean the needs for amputation.

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Oncologic Results and Functional Assessment of Limb Salvage Surgery in Primary Bone Tumors Around the Shoulder Girdle (견관절 주위 원발성 골 종양에서 사지 구제술의 종양학적 결과 및 기능적 평가)

  • Lee, Sang-Hoon;Yoo, Jae-Ho;Oh, Joo-Han;Suh, Sung-Wook;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.3
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    • pp.96-105
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    • 2002
  • Purpose: The purpose of this study was to assess the oncologic results and functional outcomes of limb salvage surgery performed in patients of primary bone tumors of the shoulder girdle. Materials and Methods: Twenty-nine patients who underwent limb sparing resection for shoulder girdle neoplasm between 1982 and 2001 were analyzed. Follow up periods averaged 7 years and 1 month. Mean age of the patients was 35 (11~71) years. There were 14 males and 15 females. Primary malignant bone tumors of shoulder girdle (proximal humerus 21, scapula 3, both 1) were 23 cases; osteosarcomas 7, chondrosarcoma 14, parosteal osteosarcoma 1, hemangioendothelioma 1, and giant cell tumor of proximal humerus were 6 cases. Limb salvage surgery was performed by curettage and cementing in 7 patients, by cement molding arthroplasty in 10 patients, and by tumor prosthesis in 7 patients, by other method such as resection only, bone graft, arthrodesis in 5 patients. The Musculoskeletal Tumor Society functional rating system was used to assess functional outcomes. Results: One osteosarcoma and 2 chondrosarcoma patients died, and the survival of the salvaged limb was 88.6% at the final follow-up. There were 6 local recurrences, 2 lung metastases, 2 local recurrences and lung metastases. The functional outcome was 80%. There was statistically significant difference of functional results among the patients treated by cement filling (86%), cement molding arthroplasty and IM nailing (71%), and tumor prosthesis (83%). (p=0.034) There were three complications including 1 radial nerve palsy and 1 axillary nerve palsy, and 1 wound infection. Dislodgement of vascularized fibular graft in one patient was treated by internal fixation. Conclusion: Limb salvage surgery seems to be useful method to treat bone tumors of the shoulder girdle.

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Giant Cell Tumor of the Cervical Spine - Case Report - (경추에 발생한 거대 세포종 - 증례 보고 -)

  • An, Ki-Chan;Chung, Kyung-Chil;Kim, Yoon-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.57-62
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    • 2006
  • Giant cell tumors are potentially malignant tumors in vertebrae, affecting frequently difficult to diagnose and are often inoperable. So it will be treated using radiation because of their high recurrence rate and the mechanical compression of spinal cord, but many surgeons described tumors of the vertebra, and the affected vertebral body can be treated using radical or near to total excision, with anteroposterior vertebral fusion or instrumentation of the spine. we report a case of giant cell tumor affecting the third cervical vertebra which caused neck pain and destroyed the vertebra body had treated using radical excison with fusion of posterior arch using instrumentation of the spine together with a literature review.

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The Differentiation of Malignant and Benign Musculoskeletal Tumors by F-18 FDG PET/CT Studies - Determination of maxSUV by Analysis of ROC Curve (F-18 FDG PET/CT에서 양성과 악성 근골격 종양의 감별진단 - 수신자 판단특성곡선을 이용한 maxSUV의 절단값 결정)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Choi, Jun-Heok;Shin, Duk-Seop
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.553-560
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    • 2007
  • Purpose: We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Materials and Methods: Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. Results: There was a statistically significant difference in maxSUV between benign (n=11; maxSUV $3.4{\pm}3.2$) and malignant (n=12; maxSUV $14.8{\pm}12.2$) lesions in soft tissue tumor (p=0.001). Between benign bone tumor (n=9; maxSUV $5.4{\pm}4.0$) and malignant bone tumor (n=14; maxSUV $7.3{\pm}3.2$), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n=2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. Conclusion: The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

Tumors of the Foot and Ankle (족부 및 족관절에 발생한 종양)

  • Shin, Kyoo-Ho;Park, Hong-Jun;Kim, Jong-Min;Hahn, Soo-Bong;Kang, Eung-Shick
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.69-76
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    • 2000
  • Purpose : Tumors of the foot and ankle are uncommon compared with those arising in the other sites, and the malignant tumors are rare. We analyzed the data of patients who have been diagnosed as having a tumor of the foot and ankle. Materials and Methods : Between 1989 and 1998, we treated 72 patients and analyzed on their clinical characteristics retrospectively. Results : Fifty-three cases were benign. Included are 30 cases of soft tissue tumor and 23 cases of bone tumor. Malignant tumor was in 19 cases (26%), including 17 cases of soft tissue tumor, one cases of metastatic tumor. The most common benign tumor was fibroma in soft tissue and osteochondroma in bone. Malignant melanoma was the most common malignant tumor of the foot (7 cases). The predilection site for benign tumors was around toes while for the malignant tumor mostly arises in the heel. Among 19 malignant tumors, local recurrence developed in 3 cases and the distant metastasis occurred in 8 cases. Conclusion : The ratio of malignant tumor and metastasis was high. Therefore, when we faced with a tumor of the foot and ankle, the histopathologic confirmation is essential through biopsy before the definite initial treatment.

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Femur Fractures Associated with Benign Bone Tumors in Children (양성 골종양을 동반한 소아 대퇴골의 병적 골절)

  • Jung, Sung-Taek;Kim, Byung-Soo;Moon, Eun-Sun;Lee, Keun-Bae;Seo, Hyoung-Yeon
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.111-117
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    • 2005
  • Purpose: We evaluate the results of treatment of pathologic femur fractures secondary to bone tumors in children. Materials and Methods: Between January 1995 and June 2004, 18 patients(20 cases) were evaluated. Their mean age of the first episode of fracture was 10.2 years and mean follow-up period is 42.5 months. Primary bone tumors, the location of fracture, time to union and complications were evauated. Results: Fractures occurred at proximal portion in 14 cases, shaft 3 cases and distal portion 3 cases. The bone tumors causing pathologic fracture were fibrous dysplasia(9 c ases), simple bone cyst(4 cases), aneurysmal bone cyst(4 cases), nonossifying fibroma(2 cases) and eosinophilic granuloma(1 case). In the treatment for fractures, cast was in 11 cases, internal fixation 8 cases and external fixation in 1 case. In the treatment for tumors, observation was in 11 cases, curettage & bone graft in 8 cases and resection in 1 case. In polyostotic fibrous dysplasia, all cases were treated by cast initially but deformity developed in all cases. Fracture prevention and deformity correction were obtained with intramedullary nailing. Conclusion: Adequate choice of treatment of bone tumor and fracture will result in good prognosis.

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Clinical Analysis of Metastatic Tumors of Bone - Survivorship Analysis after Bony Metastasis - (전이성 골종양에 대한 임상적 분석 - 골전이 후의 생존분석 -)

  • Kim, Kyung-Je;Kang, Ho-Seong;Kim, Yon-Il;Shin, Byung-Joon
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.133-138
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    • 2001
  • Purpose : To analyze the clinical behaviors and survivorship of metastatic bone tumors. Materials and Methods : One hundred and ninty-eight metastatic bone tumors had been diagnosed from January 1982 to December 1998. Age and sex distribution, primary cancer types. metastatic sites, duration from diagnosed of primary tumors to bony metastases and survivorship were analysed. Results : Mean age was 57(24~86) years old. Lung(32.3%) and breast(16.2%) cancers were two most common primary foci. The spines was the most common site of metastases especially lumbar region(38%). Survivorship analysis was done in one hundred and fifteen patients who had been followed up. The mean survival period was 15.3 months. The survivorship of hepatoma(7.1 Mons), lung(8.72 Mons) and renal cell(4.8 Mons)cancers was relatively shorter and breast cancer(54.1 Mons) longest. Conclusion : The mean age of metastatic bone tumors of this study was older than the past reports. The axial skeletons especially spine was predominant metastatic site. The survivorship of metastatic bone tumor decreased sharply as time goes by, so early diagnosis is clue for longer survival after bony metastases.

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Primary Non-Hodgkin's Lymphomas of The Axilla and Arm - A Case Report - (액와부와 상완부에 발생한 원발성 비 호지킨 림프종 - 1예 보고 -)

  • Seo, Moo-Sam;Park, Han-Seong;Song, Moo-Ho;Park, Hyung-Taek;Lee, Gun-Shik
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.157-161
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    • 2001
  • Nearly a quarter of cases of non-Hodgkin's lymphoma present with extranodal, but rarely involve the soft tissue. The authors experienced one case of non-Hodgkin's lymphoma presenting as voluminous subcutaneous tissue tumors in the left axilla and arm.

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