• The Journal of the Korean bone and joint tumor society
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• v.12 no.2
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• pp.161-164
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• 2006

Malignant bone tumor in distal tibia is a rare condition which has been treated by amputation. Although widely accepted, limb salvage surgery in this area poses difficulties with respect to reconstruction. We present one patient with distal tibial osteosarcoma treated by performing limb salvage and reconstructing with retrograde IM nail and pasteurized bone.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.23-28
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• 1999

Between Sep. 1986 and Mar. 1996, twenty four patients with recurrent giant cell tumor of their long bones were treated and followed up for more than two years. We applied three different modalities for treatment: curettage with bone graft, curettage and packing with polymethylmethacrylate, wide excision with or without reconstruction. During the average 51.5 months after operation(24-97 months), two of three patients who underwent curettage with bone graft showed recurrence. Patients who underwent wide excision showed no recurrence. Five of fifteen patients who underwent curettage and packing with polymethylmethacrylate showed recurrence. Four of seven who showed recurrence were treated with reapplication of curettage and packing with polymethylmethacrylate. All four patients showed no recurrence, and two of them have been followed up for more than two years. We suggest that the curettage and packing with polymethylmethacrylate is an effective treatment modality of the recurrent giant cell tumor.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.74-77
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• 2013

The guidelines for the treatment of massive bone defects caused by bone resection due to tumors have changed from amputation to limb salvaging surgery. Limb salvaging surgery using endoprotheses is a well-established procedure. However, Aseptic loosening, infection, and mechanical defect remain significant problems. Among them, we experienced the case with a breakage of polyethylene lock of MUTARS$^{(R)}$ distal femur tumor Endoprostheses.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.1
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• pp.10-16
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• 2008

With the advent of effective chemotherapy and the realization of high economic cost associated with amputation, limb salvage surgery has become the standard of treatment in children with primary malignant bone tumors. Reconstruction after resection of malignant bone tumors of children has to address the leg length inequality and also has to be durable to cope with high functional demands of young patients. Expandable endoprostheses have been used in children for achieving limb length equality with substantial risk of complications. Recently, significant advances in prosthetic designs have reduced the morbidities associated with these prostheses. The purpose of this study was to review the indications, characteristics, complications and recent developments of expandable endoprostheses used for malignant bone tumors in children.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.1
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• pp.45-49
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• 2004

Chondroblastoma is a benign chondroid-forming tumor usually originating in the epiphysis. The base of metatarsal bone contains neither an epiphysis nor a secondary ossification center and so is the rare site of chondroblastoma. Here, we present a case of chondroblastoma of the base of fifth metatarsal bone in 34-year-old man. Histologically, the osteoclast-like giant cells were abundant enough to simulate a giant cell tumor. And the chondroid intercellular matrix was intermixed but scanty. However, the background mononuclear cells showed irregular and indented nuclei with longitudinal clefts and positive immunoreactivity for S-100 protein, as the evidence of chondroblasts.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.142-145
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• 2007

Gastrointestinal stromal tumor (GIST) occurring outside the gastrointestinal tract is uncommon. When GIST is found outside the gastrointestinal tract, it has greater possibility to be diagnosed with metastatic lesion from other primary focus. But it rarely occurs in extragastrointestinal tract primarily, and then even outside abdomen. We experienced one case of GIST occurred from right buttock area of 25 year-old man. We could not find out the primary focus in abdomen. The tumor was developed inside gluteus medius and minimus and extended to pelvic inner area destroying iliac bone and adjacent sacrum. Here, we report the case of GIST with terminology of extragastrointestinal stromal tumor (EGIST).

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3031-3035
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• 2012

Background: Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. Methods: The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Results: Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. Conclusion: FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

• Biomolecules & Therapeutics
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• v.24 no.1
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• pp.9-18
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• 2016

Bone matrix is properly maintained by osteoclasts and osteoblasts. In the tumor microenvironment, osteoclasts are increasingly differentiated by the various ligands and cytokines secreted from the metastasized cancer cells at the bone metastasis niche. The activated osteoclasts generate osteolytic lesions. For this reason, studies focusing on the differentiation of osteoclasts are important to reduce bone destruction by tumor metastasis. The N-myc downstream-regulated gene 2 (NDRG2) has been known to contribute to the suppression of tumor growth and metastasis, but the precise role of NDRG2 in osteoclast differentiation induced by cancer cells has not been elucidated. In this study, we demonstrate that NDRG2 expression in breast cancer cells has an inhibitory effect on osteoclast differentiation. RAW 264.7 cells, which are monocytic preosteoclast cells, treated with the conditioned media (CM) of murine breast cancer cells (4T1) expressing NDRG2 are less differentiated into the multinucleated osteoclast-like cells than those treated with the CM of 4T1-WT or 4T1-mock cells. Interestingly, 4T1 cells stably expressing NDRG2 showed a decreased mRNA and protein level of intercellular adhesion molecule 1 (ICAM1), which is known to enhance osteoclast maturation. Osteoclast differentiation was also reduced by ICAM1 knockdown in 4T1 cells. In addition, blocking the interaction between soluble ICAM1 and ICAM1 receptors significantly decreased osteoclastogenesis of RAW 264.7 cells in the tumor environment. Collectively, these results suggest that the reduction of ICAM1 expression by NDRG2 in breast cancer cells decreases osteoclast differentiation, and demonstrate that excessive bone resorption could be inhibited via ICAM1 down-regulation by NDRG2 expression.

• Archives of Reconstructive Microsurgery
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• v.16 no.2
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• pp.100-107
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• 2007

Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. But the management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle or anterior tibial vessel as living bone graft. From April 1984 to July 2005, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 14 cases, using Vascularized Fibular Graft, which occur at the distal radius. VFG with peroneal vascular pedicle was in 8 cases and anterior tibial vessel was 6 cases. Recipient artery was radial artery in all cases. Method of connection was end to end anastomosis in 11 cases, and end to side in 3 cases. An average follow-up was 6 years 6 months, average bone defect after wide segmental resection of lesion was 6.8 cm. All cases revealed good bony union in average 6.5 months, and we got the wide range of motion of wrist joint without recurrence and serious complications. Grafted bone was all alive. In functional analysis, there was good in 7 cases, fair in 4 cases and bad in 1 case. Pain was decreased in all cases but there was nearly normal joint in only 4 cases. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.162-166
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• 2007

Desmoplastic fibroma of bone is rare, involves usually long bones, and histologically resemblance to the desmoid tumor of soft tissue. It is benign, but aggressive locally. Recurrence rate is high when treated with simple curettage and bone graft. Moreover, malignant transformation of desmoplastic fibroma with recurrence has been reported very rarely, and then it make us review again whether previous tumor probably was low grade malignant tumor. We report a surgically proven case of osteosarcoma arising from desmoplastic fibroma. A 17 years old male had been treated for a desmoplastic fibroma of the proximal tibia with curettage and bone graft. But after 11 years, the patient showed recurrence accompanying malignant transformation with osteosarcoma. This is very rare case of an osteosarcoma arising in a desmoplatic fibroma of the proximal tibia.