Gastric carcinoma metastasis to a knee with a newly inserted prosthesis: A case report

The importance of systematic histological examination after loosening of an implant

“…12 After operation the area of tissue damage and haematoma may be a suitable breeding ground for malignant cells circulating in the blood. 8,13 Kim and Yun 7 considered this mechanism to be the probable cause of one case of metastasis to a hip implant from a carcinoma of the lung which they had described. Kim and Yun 7 and Springfield 14 have suggested that the fibrin-platelet clots in the haematoma after surgery can foster the growth of metastatic tumour cells by chemical and mechanical effects.…”

“…Once the presence of malignancy has been confirmed a total hip arthroplasty must be performed in order to allow the patient to have a painless joint for the short time for which they are likely to survive. [1][2][3]7,8 There is no direct evidence to link the material of a joint arthroplasty with neoplasia, and metastasis of a primary growth to tissue adjacent to prostheses is a rare cause of loosening. It is necessary, however, to be aware of this and to subject tissue from the side of loosening to histological examination so that the correct diagnosis is made.…”

“…[6][7][8] We present a patient in whom a metastasis from a squamous-cell carcinoma developed in the periprosthetic neosynovial tissue five years after a cemented hip replacement, which had been undertaken for revision of a painful uncemented hemiarthroplasty.…”

Revision hip arthroplasty in patients with a history of previous malignancy

“…Axial skeletal osseous metastasis as a result of this disease is uncommon and is predominantly found in the vertebral column, specifically the lumbar and sacral regions [8,9].…”

Host Reactions to Biomaterials and Their Evaluation

“…Carcino mas, reported far less frequently, have usually been restricted to situations where an implant has been placed in the lumen of an epithelium-lined organ. A distant primary tumor (gastric cancer) metastasizing to a total knee replacement has also been reported (Kolstad and Hogstorp, 1990). Illus trative reported cases are noted in Table 2; descriptions of other cases are available (Goodfellow, 1992;Jennings et al, 1988;Jacobs et al, 1992).…”