A giant cell rich osteosarcoma of the proximal ulnar bone treated by elbow arthroplasty: A case report

Cahayadi, Sigit Daru; Antoro, Aji; Swandika, B.

doi:10.1016/j.ijscr.2019.04.017

Cited by 6 publications

(12 citation statements)

References 12 publications

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“…In the past 18 years, we found more benign bone tumors than malignancy with soft tissue sarcomas predominate [1]. There were many reports on soft tissue sarcoma in forearm [7], but bone sarcoma was much more common on case reports [8,9]. The incidence of primary malignant tumors in forearm is only 18.4% (68/369) of all primary bone tumors in this series.…”

Section: Discussionmentioning

confidence: 69%

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What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

Liu

Yang

Jin

et al. 2020

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Background The forearm primary malignant bone tumor is rare and limb salvage is difficult. The purpose of this study was to analyze epidemiological characteristics of forearm primary malignant bone tumors and to explore oncological and functional results of limb salvage surgery in forearm.Methods 369 patients with primary forearm malignant bone tumors were retrospectively analyzed from 2000 to 2017. There were 266 patients with radius tumor and 46 (17.3%) of them were malignancy, while 103 patients with ulna lesion and 22 (21.4%) of them were malignant tumor. The oncological results, prognostic factors and functional results after limb salvage surgery of forearm malignancy were analyzed.Results A total of 60 patients received limb salvage surgery. Fifty-six patients followed more than 12 months or progressions within 12 months were included in final evaluation. Radius resection was performed in 38 patients and distal radius (25 patients) was most frequent. Ulna resection was performed in 18 patients and proximal ulna (13 patients) was most frequent. The surgical margin contained intracapsular resection in 3 patients, marginal resection in 8 patients and wide resection in 45 patients. The follow-up averaged 72.1 (7-192, median 62.5) months. Local recurrence occurred in 11 patients (19.6%) and distant metastasis occurred in 14 patients (25%). The 5-year recurrence free survival rates was 79.8%. Univariate analysis showed history of unplanned resection, tumor located in ulna, tumor located in proximal forearm and inadequate surgical margin were associated with recurrence. The overall 5-year and 10-year survival rates were 83.5% and 71.7%, respectively. Univariate analysis showed inadequate surgical margin, local recurrence and distant metastasis were associated with death. Forty-two patients were evaluated by MSTS score with an average of (93.0 ± 5.1) %.Conclusions The incidence of radius malignant tumor is higher than that of ulna. The distal radius and proximal ulna are most frequency involved sites. Unplanned resection, tumor located in ulna, tumor located in proximal forearm and inadequate surgical margin are risk factors for local recurrence; local recurrence and distant metastasis are independent prognostic factors of death. The oncology control and function result of limb salvage surgery was satisfactory.

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Section: Discussionmentioning

confidence: 69%

“…The prosthesis replacement is a routine and applicable method for proximal ulna. Some new methods for forearm reconstruction are proposed with different advantages and disadvantages [8,9,15]. We designed the brachioradial elbow arthroplasty between proximal radius and humeral condyle with satisfactory function.…”

Section: Discussionmentioning

confidence: 99%

What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

Liu

Yang

Jin

et al. 2020

Preprint

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“…In the forearm tumors treated in our center at the past 18 years, more benign tumors were found than malignant tumors, and more soft tissue sarcoma was found than primary bone malignant tumors ( 1 ). Many reports on soft tissue sarcoma in the forearm have been published ( 12 ), while only some case reports on bone sarcoma have been found ( 13 , 14 ). The primary malignant tumors in the forearm only occupied 18.4% (68/369) of all primary bone tumors in this study.…”

Section: Discussionmentioning

confidence: 99%

What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

et al. 2022

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Background and ObjectivesAfter diagnosing a primary bone tumor involving the forearm, various excision strategies and reconstruction methods must be considered. This study explored the oncological and functional outcomes of limb salvage surgery for primary malignant bone tumors in the forearm.MethodsPatients with primary forearm bone tumors (n = 369) were retrospectively analyzed between 2000 and 2017. There were 266 patients with radial tumors, and 46 (17.3%) were malignant, whereas 103 patients had ulnar lesions and 22 (21.4%) were malignant tumors. The oncological results, prognostic factors, and functional results after limb salvage surgery of forearm malignancies were analyzed.ResultsThe follow-up averaged 72.1 (7–192, median 62.5) months. Fifty-six patients who received limb salvage surgery were included in the final evaluation. Radius resection was performed in 38 patients, and distal radius (25 patients) was most frequent. Ulnar resection was performed in 18 patients, and the proximal ulna (13 patients) was most frequent. The surgical margins obtained were intralesional in 3 patients, marginal in 8 patients and wide in 45 patients. Local recurrence occurred in 11 patients (19.6%), and distant metastasis occurred in 14 patients (25%). The 5-year recurrence-free survival rate was 79.8%. Unplanned excision, ulnar involvement, proximal forearm location and inadequate surgical margins were associated with recurrence. The overall 5-year and 10-year survival rates were 83.5 and 71.7%, respectively. Distant metastasis was a poor prognostic factor for the survival rate. Forty-two patients were evaluated by MSTS score with an average of 27.9 ± 1.5.ConclusionsThe incidence of radial malignant tumors is higher than that of ulnar lesions. The distal radius and the proximal ulna are the most frequently involved sites. Unplanned excisions, ulnar tumors, proximal forearm tumors, and inadequate surgical margin are the risk factors for local recurrence. Distant metastasis is an independent poor prognostic factor of death. The oncology control and functional results of limb salvage surgery were satisfactory.

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“…1 It usually occurs in the appendicular skeleton involving the metaphysis of long bones, most commonly the distal femur and proximal tibia of adolescent patients. [1][2][3] In long bones, the tumor is usually metaphyseal (90%), infrequently in the diaphysis (9%), or rarely in the epiphysis. 1 It may occasionally be an incidental finding, but usually presents with local pain, swelling, or pathological fracture.…”

Section: Introductionmentioning

confidence: 99%

“…1 It may occasionally be an incidental finding, but usually presents with local pain, swelling, or pathological fracture. 2 Radiologic examination shows classic lytic or blastic lesions, with periosteal reaction, and bone destruction. Histopathological examination serves as a gold standard diagnostic tool.…”

Section: Introductionmentioning

confidence: 99%

Osteosarcoma: a fluid cytologic diagnosis

Asokan

Chander

2023

Int J Res Med Sci

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Osteosarcoma is the most common malignant bone tumor characterized by the formation of disorganized immature bone or osteoid tissue from mesenchymal tumor cells. It most commonly occurs in the appendicular skeleton involving the metaphysis of long bones. It is the third most common cancer in adolescence with an annual incidence of 5.6 cases per million children under the age of 15 years. Giant cell-rich osteosarcoma (GCRO) is an exceedingly rare histological variant of conventional primary osteosarcoma. It constitutes about 1%-3% of all osteosarcomas. A 20-year-old male presented with the complaints of pain and swelling over the right knee. Examination revealed a tender 15×10×8 cm swelling palpable on the distal femur. Radiological investigations showed features suggesting right femoral osteosarcoma in the meta-epiphyseal region. A core needle biopsy from the lesion was performed and 15 ml of fluid obtained from the biopsy site was sent for cytological examination, which showed features suggestive of osteosarcoma. Biopsy showed features of osteosarcoma probably of giant cell rich type confirming the fluid cytology findings. Cell block preparation also revealed giant cell predominance. Osteosarcoma is a bone tumor found in areas of rapid bone turnover, most commonly the distal femur and proximal tibia of adolescent patients. Cytology plays a vital role in diagnosing bone tumors, being a rapid, easy, and minimally invasive outpatient department procedure. Histopathology, since it gives a complete architectural pattern of tissue, remains the gold standard diagnostic tool.

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A giant cell rich osteosarcoma of the proximal ulnar bone treated by elbow arthroplasty: A case report

Cited by 6 publications

References 12 publications

What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

Osteosarcoma: a fluid cytologic diagnosis

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