Myxoid chondrosarcoma-induced pathologic fracture

Jh, Walter; Peacock, Danielle L.; Powell, Alvin

doi:10.7547/87507315-84-8-411

Cited by 3 publications

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“…Patients often are restricted in their activities of daily living [ 32 ], physical activity [ 14 ], and sports activity [ 12 , 25 ], which may influence BMD because of inactivity [ 17 , 26 , 28 , 30 ]. Furthermore, in patients with chondrosarcoma, pathologic fractures occur at presentation of the disease [ 6 , 43 ] in approximately 17% to 18% [ 6 ] and it is not known whether these patients continue to experience bone events once a chondrosarcoma has been diagnosed. Unlike patients with bone tumors which are treated with chemotherapy and radiation and are known to affect bone density [ 13 , 15 , 38 ], patients with chondrosarcoma generally do not receive these adjuvant treatments.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with chondrosarcoma usually are not treated with adjuvant treatments, therefore if patients with chondrosarcoma are at risk of having low BMD develop, which to our knowledge has not been studied, this presumably would be the result of other mechanisms. Furthermore, pathologic fractures can occur at the time of presentation [ 6 , 43 ] in chondrosarcomas in approximately 17% to 18% of patients [ 7 , 36 ], but it is not known whether fracture risk is greater in patients with chondrosarcoma than in the healthy population, or whether that risk might be attributable to low BMD in patients with chondrosarcoma.…”

Section: Introductionmentioning

confidence: 99%

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Do Patients After Chondrosarcoma Treatment Have Age-appropriate Bone Mineral Density in the Long Term?

Hobusch

Tiefenboeck

Patsch

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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BackgroundIn long-term survivors of osteosarcoma and Ewing sarcoma treated with the addition of radio- and chemotherapy, low bone mineral density (BMD) and fractures have been observed, presumably resulting from these adjuvants. Because patients with chondrosarcoma usually are not treated with conventional adjuvant treatment, observation of low BMD in patients with chondrosarcoma presumably would be the result of other mechanisms. However, BMD in patients with a history of chondrosarcoma has not been well characterized.Questions/PurposesThe aim of our study was to address the following questions: (1) Do long-term survivors of chondrosarcoma have normal BMD and, if not, which factors contribute to low BMD? (2) Is there a greater risk of fracture and does the Fracture Risk Assessment Tool (FRAX®) score reflect fracture likelihood?MethodsAll known patients with a history of chondrosarcoma treated at our institution before 2006 were identified. Of 127 patients believed to be alive at the time of this study, 30 agreed to participate in this study (11 females, 19 males; mean age at surgery, 39 ± 12 years; mean followup, 12 ± 5 years). With the data available, the 30 participants were not different from the 97 nonparticipants in terms of age, sex, BMI, tumor grade, tumor location (axial versus appendicular, lower extremity versus elsewhere), and use of any treatment known to influence osteopenia (chemotherapy, lower extremity surgery). BMD was measured and history of fractures was assessed using a questionnaire. The patients´ BMD measurements in this study were sex- and age-matched with a normative sex- and age-categorized reference population reported by Kudlacek et al. Associations were tested by univariate regressions and ANOVAs of all measures of BMD and eligible oncologic and demographic factors.ResultsEighteen of 30 (60%) patients had a pathologic BMD according to the WHO dual-energy x-ray absorptiometry definition, 15 (50%) had osteopenia, and three (10%) had osteoporosis. T-scores in the study cohort were lower than reference values for the femur neck (mean difference, 0.64; 95% CI, 0.27–1.01; p < 0.0015), but not for the spine (mean difference, 0.39; 95% CI, −0.06 to 0.84; p = 0.09). Thirteen patients (45%) reported a history of fractures not distinguishing between low and high impact. The incidence of fractures was 2.8 greater than expected from a comparison with a published microcensus survey of the Austrian population. No effect of the FRAX® score on fracture risk could be identified (p = 0.057).ConclusionsLong-term survivors of chondrosarcoma appear to be at greater risk for having low BMD develop than the healthy population. Although these results are preliminary and based on a very small sampling of patients, if they can be confirmed in larger studies, BMD assessment by dual-energy x-ray absorptiometry might be considered as these patients are followed posttreatment by sarcoma care units. The reasons for low BMD still must be elucidated.Level of EvidenceLevel IV, prognostic study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Do Patients After Chondrosarcoma Treatment Have Age-appropriate Bone Mineral Density in the Long Term?

Hobusch

Tiefenboeck

Patsch

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Chondrosarcoma of small bones of the hands and feet

Ogose

Unni

Swee

et al. 1997

Cancer

135

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and feet. Histologic features and clinical charts were reviewed in all cases, and radiographs were reviewed in 111 cases. 1 Visiting Clinician at the Section of Surgical Pa-RESULTS. Seventy-five lesions involved the feet and 88 involved the hands. Bones thology, Mayo Clinic and Mayo Foundation, of the fifth finger and the calcaneus were the most common sites of involvement. Rochester, Minnesota, from the Department of Nineteen tumors were secondary. Of the 104 intramedullary lesions studied radioOrthopedic Surgery, Niigata University, Niigata, Japan.logically, 96 showed cortical destruction, 83 a soft tissue mass, and 52 a permeative lytic pattern. Histologically, soft tissue extension and permeation of preexisting 2 Section of Surgical Pathology, Mayo Clinic and bone indicated malignant disease. One hundred sixteen tumors were Grade 1, 44 Mayo Foundation, Rochester, Minnesota.were Grade 2, and 3 were Grade 3. Of the 12 patients with distant metastasis from 3 Department of Diagnostic Radiology, Mayo chondrosarcoma, 7 died of disease. Chondrosarcomas of the calcaneus and the Clinic and Mayo Foundation, Rochester, Minnetalus were more likely to metastasize. sota. CONCLUSIONS.Chondrosarcoma of small bones of the hands and feet has the

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Malign anterior knee pain

Boyle

Walton

2000

J R Soc Med

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Myxoid chondrosarcoma-induced pathologic fracture

Cited by 3 publications

References 0 publications

Do Patients After Chondrosarcoma Treatment Have Age-appropriate Bone Mineral Density in the Long Term?

Do Patients After Chondrosarcoma Treatment Have Age-appropriate Bone Mineral Density in the Long Term?

Chondrosarcoma of small bones of the hands and feet

Malign anterior knee pain

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