Seven patients with a giant-cell tumor involving the distal end of the radius were treated with en bloc resection and reconstruction with a free vascularized fibular graft. Two patients with stage 2 disease of Enneking's surgical staging and grade 2 of Campanacci's radiographic grading system were reconstructed with an articular fibular head graft. Five patients with stage 3 and grade 3 disease underwent wrist arthrodesis using fibular shaft transfer. There was radiographic evidence of bone union at the host-graft junctions in all cases. No local recurrence was seen in any of the patients at the most recent follow-up examinations. There were six good and one excellent functional results. Wrist arthroplasty using a vascularized fibula head graft is the best procedure for a stage 2 or grade 2 giant-cell tumor of the distal end of the radius. In cases of stage 3 or grade 3 disease, wrist arthrodesis using a vascularized fibular shaft graft is indicated.

Both spontaneous (SOS) and 4‐hydroxyaminoquinoline 1‐oxide (4‐HAQO)‐induced osteosarcomas (COS) could be serially transplanted in the subcutaneous back space of syngeneic F344 rats, the success rate becoming 100% within 5 passage generations. Transplanted tumors demonstrated rapid growth and displayed high potential for metastasis to the lung in later generations. Tbus, a 100% lung metastasis rate was observed for SOS after the 20th and for COS after the 14th generation. The histological features of the primary SOS and COS were retained during serial transfer. These model systems should be useful for investigation of the biology of this very important tumor type.

A quantitative analysis was undertaken to investigate the width and area of survival of flow-through venous flaps in 20 ears of 10 rabbits. The 3.0- x 3.0-cm flap models, which included one flow-through vein, were prepared with additional circulation from the graft bed and surrounding tissue excluded, as far as possible. The flaps were divided as follows: Group A--composite grafts (n = 10), and Group B--flow-through venous flaps (n = 10). All flaps in Group A became necrotic and all those in Group B showed partial survival along the flow-through vein. The average survival width was 1.10 +/- 0.48 cm, and the survival rate was 44 +/- 19.3 percent. Microangiograms revealed patency of the flow-through vein in all flaps of Group B. Histologically, there tended to be progressively more fibrous tissue in the area further away from the flow-through vein. The model is useful to investigate the width and area of survival in flow-through venous flaps.

Recent studies have advocated the genotypic and phenotypic delineation of a novel Ewing's sarcoma histologic variant showing epithelial features defined as "adamantinoma-like Ewing's sarcoma". We described an 18-year-old girl with a primary small round-cell sarcoma of the right tibia showing polyphenotypic differentiation with epithelioid features. The neoplastic cells had mainly round or oval nuclei with fine chromatin with a portion of epithelial arrangements. The immunohistochemical analysis showed the epithelial markers of cytokeratin 5/6/18, AE1/AE3, and cytokeratin high molecular weight were stained especially in the foci with epithelioid features, as well as MIC2, S100, and NSE. The diagnosis of the lesion was confirmed as Ewing's sarcoma by the presence of the EWS-FLI1 fusion transcript, and could be defined as the so-called "adamantinoma-like Ewing's sarcoma". After wide excision and high-dose chemotherapy with peripheral blood stem cell transfusion, the patient has been well and continuously event-free for 3 years since the initial diagnosis.

No abstract