[en] Published in summary form only

[en] Two major questions are considered important in the evaluation of skeletal metastasis, namely: how to reduce the false-negative and false-positive results and, how to choose the indications for bone scintigraphy to achieve maximum yield. In this paper these questions are discussed according to our experience and an overview of the recent literature is given. In order to get a high yield of positive results, the indications for bone scintigraphy in the evaluation of malignant bone disease are: 1. a clinical suspicion of skeletal metastases, 2. breast cancer stage 3 and 4, 3. primary bone tumours in children, 4. prostatic cancer and 5. oatcell carcinoma. (orig.)

[en] Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor, which rarely occurs in bone. We present a case of ASPS in a 23-year-old man with a 2-month history of back pain. Computed tomography scanning and magnetic resonance images demonstrated a destructive process in the 12th thoracic vertebra associated with a unilateral soft tissue mass. The tumor showed evidence of hypervascularity on MRI; it obviously was enhanced on T1-weighted images after injection of Gd-GDPA, and signal voids were shown on all pulse sequences which may help to differentiate ASPS from other tumors of the vertebra. We believe that this is the first case of ASPS arising in a vertebra. (orig.)

[en] We report an osteoblastoma-like osteosarcoma in the right proximal fibula in a 22-year-old woman. Radiographs showed an irregular osteolytic lesion from the metaphysis to the epiphysis in the proximal fibula with partial destruction of cortical bone. Tissue from a biopsy indicated a typical osteoblastoma. Curettage and bone graft was performed. One year after the surgery, local recurrence occurred, and a wide excision was performed. Histological examination of the en-bloc surgical specimen revealed the tumor had permeated through the host bony trabeculae, although the nuclear atypia was not marked. Immunohistochemical expression of MIB-1 was detected in 9.0% of cells. (orig.)

[en] Highlights: • Tumor thrombus is frequently seen in the large veins draining primary pelvic osteosarcoma on cross sectional imaging studies. • Accurate detection of tumor thrombus in the large draining veins on the pre-operative imaging may impact surgical margins. • In surgically resected cohort, patients with tumor thrombus showed statistically significant lower overall survival. - Abstract: PurposeTo evaluate the frequency of tumor thrombus in the large veins draining primary pelvic osteosarcoma on early cross-sectional imaging studies and its effect on patient survival.

[en] 135 patients with histologically proven Ewing's sarcoma, treated at the Institute Gustave Roussy between 1960-1974 were reviewed in order to establish the effectiveness and the complications associated with radiotherapy. In 133 patients, a dose of at least 60 Gy for long bones, 55 Gy for flat bones and 45 Gy for vertebrae was given. 26 major complications (of which more than one occured in certain patients) were observed: 12 cases of growth retardation, loss of joint function in 7 cases, 3 fractures, 2 osteonecroses, 2 cases of delayed healing, one massive soft tissue fibrosis, 1 abdominocutaneous fistula, 2 cases of symptomatic pulmonary fibrosis with associated infection, 2 cases of radiation enteropathy, 2 of mammary hypoplasia and 1 osteosarcoma developing in an irradiated zone. These complications necessitated 12 surgical interventions, including 4 disarticulations or amputations. The incidence of complications can be related to the age of the patient and to irradiation dose

[en] The importance is evaluated of scintigraphy of the skeleton in the following conditions: a) detection of a pathological process in general, b) assessment of its extent, i.e., solitary or multiple pathological foci, c) estimate of the activity of bone reconstruction and d) evaluation of changes in the course of treatment. The problem of interpretation of the results are dealt with of radionuclide examinations of the skeleton with regard to their lack of specificity. The accumulation of osteotropic radionuclides can be influenced by an increased turnover of bone minerals as a result of collateral or whole-body response reaction, the systemic action of various humoral factors, hypercalcaemic conditions, etc. In the differential diagnosis of metastatic osteopathies it is important to take into consideration the positive character of radionuclide examinations in many non-tumorous bone and joint affections. For interpretation of the results also the possibility of depositing radionuclides in extraosseous tissues is important. (author). 2 figs., 30 refs

[en] Extraskeletal osteosarcoma (EOS) is an uncommon and usually highly aggressive mesenchymal tumor. Retroperitoneal extraskeletal osteosarma (REOS) is exceedingly rare. Due to the rare nature of the disease, both the diagnosis and the management of REOS can be challenging. We present the clinical history, CT findings, angiographic manifestations, and use of transarterial chemoembolization for treatment in a case of REOS. To our knowledge, the angiographic features of and attempt at transarterial treatment of REOS have not been reported in the literature.

[en] The osteosarcoma is the most primary malignant lesion of bone, even so it is relatively rare tumor in the jaw bones. It is derived from undifferentiated mesenchymal elements of bone, which from neoplastic osteoid and osseous tissue. It may affected primarily young adult males and more frequently mandible than maxilla. Mass, swelling and pain are the most presenting symptoms. Radiographic appearance will be sclerotic, in which bone formation is excessive; osteolytic, in which bone destruction predominates; and mixed, in which sclerotic and osteolyitc changes are intermingled. We report a case of osteosarcoma on the mandibular ramus area in a 20 years old male with a brief review of the concerned literatures.

[en] Few new compounds are available for relapsed osteosarcoma. We retrospectively evaluated the activity of gemcitabine (G) plus docetaxel (D) in patients with relapsed high-grade osteosarcoma and high-grade spindle cell sarcoma of bone (HGS). Patients receiving G 900 mg/m"2 d 1, 8; D 75 mg/m"2 d 8, every 21 days were eligible. Primary end-point: progression-free survival (PFS) at 4 months; secondary end-point: overall survival (OS) and response rate. Fifty-one patients were included, with a median age of 17 years (8–71), 26 (51 %) were pediatric patients. GD line of treatment: 2nd in 14 patients, ≥3rd in 37. 25 (49 %) patients had metastases limited to lungs, 26 (51 %) multiple sites. Histology: 40 (78 %) osteosarcoma, 11 (22 %) HGS. Eight (16 %) patients achieved surgical complete response (sCR2) after GD. Four-month PFS rate was 46 %, and significantly better for patients with ECOG 0 (ECOG 0: 54 % vs ECOG 1: 43 % vs ECOG 2: 0 %; p = 0.003), for patients undergoing metastasectomy after GD (sCR2 75 % vs no-sCR2 40 %, p = 0.02) and for osteosarcoma (osteosarcoma 56 % vs HGS 18 %; p = 0.05), with no differences according to age, line of treatment, and pattern of metastases. Forty-six cases had RECIST measurable disease: 6 (13 %) patients had a partial response (PR), 20 (43 %) had stable disease (SD) and 20 (43 %) had progressive disease (PD). The 1-year OS was 30 %: 67 % for PR, 54 % for SD and 20 % for PD (p = 0.005). GD is an active treatment for relapsed high-grade osteosarcoma, especially for ECOG 0 patients, and should be included in the therapeutic armamentarium of metastatic osteosarcoma