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Gasparro MA, Lee L, Vijayakumar G, Gusho CA, Colman MW, Gitelis S, Miller I, Blank AT. Rare Dedifferentiated Periosteal Chondrosarcoma with 11-Year Metastatic Relapse: A Case Report. Int J Surg Pathol 2024; 32:201-205. [PMID: 37143346 DOI: 10.1177/10668969231173379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A 50-year-old man presented for evaluation of a periscapular mass. Biopsy suggested a low-grade chondrosarcoma; however, the resected specimen revealed a grade 2 chondrosarcoma with a low-grade dedifferentiated mesenchymal component. The mass multiply recurred as chondrosarcoma without a dedifferentiated component before the patient developed lung metastases of chondrosarcoma without a dedifferentiated component 11 years after the initial diagnosis and died of disease. This is one of the first reported cases of a dedifferentiated chondrosarcoma with low-grade dedifferentiated component. While overall prognosis may be better than in typical dedifferentiated chondrosarcoma, this tumor demonstrated numerous local recurrences as well as metastasis.
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Affiliation(s)
- Matthew A Gasparro
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
| | - Linus Lee
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
| | - Gayathri Vijayakumar
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
| | - Charles A Gusho
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
| | - Matthew W Colman
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
| | - Steven Gitelis
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
| | - Ira Miller
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Alan T Blank
- Department of Orthopedic Surgery, Division of Oncology, Rush University Medical Center, Chicago, IL, USA
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2
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Alexiev BA, Vormittag-Nocito ER, Peabody TD, Samet J, Laskin WB. Clear cell chondrosarcoma: a review of clinicopathologic characteristics, differential diagnoses, and patient management. Hum Pathol 2023; 139:126-134. [PMID: 37805864 DOI: 10.1016/j.humpath.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
Clear cell chondrosarcoma (CCC), an extremely rare primary bone tumor, is currently classified by the World Health Organization as a low-grade malignant cartilaginous neoplasm. Clinically, CCC occurs primarily in males with a peak incidence in the third to fifth decades of life, and occasionally, it presents in skeletally immature patients. Unlike conventional chondrosarcoma, CCC has a predilection for the epiphysis of long bones and often displays radiologic features reminiscent of chondroblastoma. The recommended treatment is wide operative resection. CCC has a local recurrence rate of approximately 30%, and nearly 20% cases metastasize mainly to bone and lung often a decade after surgical intervention. Incomplete excision or curettage is associated with a high rate of recurrence. Histologically, the process is characterized by infiltrative lobules and sheets of round to oval cells with abundant cleared cytoplasm and well-defined cell borders associated with trabecula of osteoid and woven bone, scattered osteoclasts, and foci of conventional low-grade chondrosarcoma in about one-half of cases. Correlation with clinical and radiologic characteristics, such as epiphyseal location and young patient age, assists in establishing a correct diagnosis. Pathologic diagnosis of CCC is complicated by the low diagnostic accuracy of core needle biopsy, overlapping histologic features with other matrix-rich primary bone tumors, and a lack of a specific immunohistochemical and molecular profile. DNA methylation-based profiling classifier (sarcoma classifier) is one recent technologic advancement that may help to confirm the histopathological diagnosis of CCC or indicate the need for thorough reassessment in cases where results contradict previous conventional findings.
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Affiliation(s)
- Borislav A Alexiev
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL 60611, USA.
| | - Erica R Vormittag-Nocito
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL 60611, USA
| | - Terrance D Peabody
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Lavin Family Pavilion, Chicago, IL 60611, USA
| | - Jonathan Samet
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - William B Laskin
- Department of Pathology, Yale-New Haven Hospital, New Haven, CT 06510, USA
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3
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Bahurupe S, Phatak S, Onkar P, Ambhore AN, Trimukhe D. Chondrosarcoma of Iliac Bone Imaging Spectrum With Histopathological Correlation: A Case Report. Cureus 2023; 15:e45110. [PMID: 37842443 PMCID: PMC10569363 DOI: 10.7759/cureus.45110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Chondrosarcoma is a rare form of carcinoma that originates in the cells of cartilage, the flexible tissue that cushions the joints and gives structure to various parts of the body. This malignant tumour primarily affects adults and is most commonly found in the bones of the arms, legs, pelvis, and ribs. The severity and prognosis of chondrosarcoma can vary widely depending on factors such as tumour size, location, and grade. We are reporting a case of an 83-year-old male patient who presented with swelling over the left hip joint. A mass was detected on radiograph and ultrasound that was further characterized using contrast-enhanced CT and MRI. Imaging findings suggested chondrosarcoma. The patient was diagnosed on histopathological examination.
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Affiliation(s)
- Suchita Bahurupe
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Suresh Phatak
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Prashant Onkar
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Ashish N Ambhore
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Deepali Trimukhe
- Radiodiagnosis, N. K. P. Salve Institute of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
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4
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Zając W, Dróżdż J, Kisielewska W, Karwowska W, Dudzisz-Śledź M, Zając AE, Borkowska A, Szumera-Ciećkiewicz A, Szostakowski B, Rutkowski P, Czarnecka AM. Dedifferentiated Chondrosarcoma from Molecular Pathology to Current Treatment and Clinical Trials. Cancers (Basel) 2023; 15:3924. [PMID: 37568740 PMCID: PMC10417069 DOI: 10.3390/cancers15153924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Dedifferentiated chondrosarcoma (DDCS) is a rare subtype of chondrosarcoma, a primary cartilaginous malignant neoplasm. It accounts for up to 1-2% of all chondrosarcomas and is generally associated with one of the poorest prognoses among all chondrosarcomas with the highest risk of metastasis. The 5-year survival rates range from 7% to 24%. DDCS may develop at any age, but the average presentation age is over 50. The most common locations are the femur, pelvis humerus, scapula, rib, and tibia. The standard treatment for localised disease is surgical resection. Most patients are diagnosed in unresectable and advanced stages, and chemotherapy for localised and metastatic dedifferentiated DDCS follows protocols used for osteosarcoma.
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Affiliation(s)
- Weronika Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Julia Dróżdż
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Weronika Kisielewska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Weronika Karwowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Monika Dudzisz-Śledź
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Agnieszka E. Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Aneta Borkowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie National Research Institute of Oncology, 02-781 Warsaw, Poland (M.D.-Ś.); (A.E.Z.); (A.B.); (B.S.); (P.R.)
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5
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Abdulfatah E, Rottmann D, Morag Y, Pantanowitz L, Udager AM, Hao W, Lucas DR. Conventional Chondrosarcoma of the Rib Cage and Sternum: Clinicopathological and Molecular Analysis of 27 Patients Treated at a Single Institution. Hum Pathol 2023; 136:63-74. [PMID: 37019410 DOI: 10.1016/j.humpath.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/14/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023]
Abstract
Conventional chondrosarcoma of the chest wall is rare, accounting for 15% of cases. Our purpose was to document clinicopathological, imaging and outcome results from a novel set of chest wall chondrosarcomas, and to analyze for <I>IDH</I> mutations and novel molecular alterations. Gross and microscopic pathology, imaging and clinical charts were reviewed. Targeted next-generation sequencing was performed to identify somatic mutations and copy number alterations. The cohort consisted of 27 patients: 16 men and 11 women (mean age 51 years; range 23-76). Palpable mass was the most common presentation. Five were discovered incidentally. Among 20 tumors with complete imaging, 15 arose from a rib and 5 from the sternum. Seven rib tumors were central/intramedullary, 5 were periosteal, 2 were secondary peripheral chondrosarcomas, and one was indeterminate. Among sternal tumors, 4 were central/intramedullary and one was periosteal. Half the periosteal tumors arose from the costochondral junctional cartilage (CCJ). Periosteal chondrosarcomas were sometimes mistaken for extraskeletal masses on initial clinical or radiological examinations. Fifty-nine percent of all tumors were grade 1 and 41% were grade 2. None were dedifferentiated chondrosarcomas. Heterozygous <I>IDH1</I> mutation was detected in one tumor and heterozygous <I>RAD50</I> mutation in another. Local recurrence(s) happened in 41% and metastasis in 41%. Grade had strong association with local recurrence (25% grade 1 vs. 64% grade 2 [p=0.0447]), metastatic recurrence (19% grade 1 vs. 73% grade 2 [p=0.0058]), and survival. Although chest wall chondrosarcomas share morphologic and molecular features with other chondrosarcomas, there is a much higher incidence of periosteal chondrosarcomas. <I>IDH</I> mutant tumors are uncommon. Early diagnosis and margin-negative resection is treatment of choice since chondrosarcomas are chemo- and radioresistant.
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6
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Vijay C, Geethapriya S, Govindaraj J, Raghavan B. A Rare Charcot Neuro-Osteoarthropathy of Hip with an Uncommon Cause. Indian J Radiol Imaging 2022; 33:240-245. [PMID: 37123589 PMCID: PMC10132876 DOI: 10.1055/s-0042-1758879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AbstractNeuro-osteoarthropathy often called as Charcot joint results from decreased sensory innervations of the involved joint resulting in severely damaged and disrupted joints and involvement of adjacent soft tissues. Charcot joint is characterized by the “6Ds,” which are i) distended joints, ii) density increase, iii) debris production, iv) dislocation, v) disorganization, and vi) destruction. Hip joint involvement is very rare probably because of rich nerve supply compared with other peripheral joints. To minimize the joint deformity and loss of function, early diagnosis is of great importance in which radiological imaging plays a major role.
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Affiliation(s)
- Chandran Vijay
- Depertment of Radiology, Apollo Speciality Hospital, Padma Complex, Anna Salai, Chennai, Tamil Nadu
| | | | - Jayaraj Govindaraj
- Depertment of Radiology, Apollo Speciality Hospital, Padma Complex, Anna Salai, Chennai, Tamil Nadu
| | - Bagyam Raghavan
- Depertment of Radiology, Apollo Speciality Hospital, Padma Complex, Anna Salai, Chennai, Tamil Nadu
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7
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Alsford S, Low S, Mistry A. Chondromyxoid fibroma of the iliac bone: a brief radiological review. BMJ Case Rep 2022; 15:15/11/e251363. [PMID: 36446478 PMCID: PMC9710343 DOI: 10.1136/bcr-2022-251363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Chondromyxoid fibroma (CMF) is a rare, benign bone tumour most commonly located within the metaphyseal region of the long bones surrounding the knee joint. Here, we present an interesting case of a young woman in her early 20s with CMF of the left iliac bone and include a literature review of comparable studies with an emphasis on radiological findings and important differential diagnoses to be aware of in this atypical location.
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Affiliation(s)
- Samuel Alsford
- Radiology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Samantha Low
- Radiology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Alpesh Mistry
- Radiology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
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8
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Zhou LB, Zhang HC, Dong ZG, Wang CC. Chondrosarcoma of the toe: A case report and literature review. World J Clin Cases 2022; 10:9132-9141. [PMID: 36157642 PMCID: PMC9477028 DOI: 10.12998/wjcc.v10.i25.9132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/25/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Chondrosarcoma of the foot is a rare malignant bone tumour, and it is even rarer when it originates in a toe bone. Surgical excision is the only effective treatment. The osteolytic destruction of the tumour severely affects limb function and carries the risk of distant metastasis. Most such tumours are removed surgically to minimize local recurrence and distant metastases, maximize limb function, and prolong the patient's tumour-free survival time. The main objective of this article is to present the case of a chondrosarcoma that invaded the first phalanx of the left foot and formed a large phalangeal mass with osteolytic destruction of the distal bone.
CASE SUMMARY A 74-year-old man suffered from swelling of his left toe for six months, with pain and swelling for two months. Computed tomography and magnetic resonance imaging showed that the tumour on the first phalanx of the left foot was approximately 54.9 mm × 44.6 mm, surrounded by a significant soft tissue signal mass, with osteolytic destruction of the distal phalanx and a speckled bone-like high-density shadow within it.
CONCLUSION Chondrosarcoma occurring in a toe bone is extremely rare. In this case, extensive surgical resection of the large low-grade chondrosarcoma, which showed osteolytic destruction and invaded the distal metatarsal bone, was safe and effective.
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Affiliation(s)
- Li-Bo Zhou
- Graduate School, Qinghai University, Xining 810016, Qinghai Province, China
| | - He-Cheng Zhang
- Graduate School, Qinghai University, Xining 810016, Qinghai Province, China
| | - Zai-Gang Dong
- Graduate School, Qinghai University, Xining 810016, Qinghai Province, China
| | - Chao-Chao Wang
- Department of Bone and Joint Surgery, the Affiliated Hospital of Qinghai University, Xining 810012, Qinghai Province, China
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9
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Russo S, Scotto di Carlo F, Gianfrancesco F. The Osteoclast Traces the Route to Bone Tumors and Metastases. Front Cell Dev Biol 2022; 10:886305. [PMID: 35646939 PMCID: PMC9139841 DOI: 10.3389/fcell.2022.886305] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/24/2022] [Indexed: 12/31/2022] Open
Abstract
Osteoclasts are highly specialized cells of the bone, with a unique apparatus responsible for resorption in the process of bone remodeling. They are derived from differentiation and fusion of hematopoietic precursors, committed to form mature osteoclasts in response to finely regulated stimuli produced by bone marrow–derived cells belonging to the stromal lineage. Despite a highly specific function confined to bone degradation, emerging evidence supports their relevant implication in bone tumors and metastases. In this review, we summarize the physiological role of osteoclasts and then focus our attention on their involvement in skeletal tumors, both primary and metastatic. We highlight how osteoclast-mediated bone erosion confers increased aggressiveness to primary tumors, even those with benign features. We also outline how breast and pancreas cancer cells promote osteoclastogenesis to fuel their metastatic process to the bone. Furthermore, we emphasize the role of osteoclasts in reactivating dormant cancer cells within the bone marrow niches for manifestation of overt metastases, even decades after homing of latent disseminated cells. Finally, we point out the importance of counteracting tumor progression and dissemination through pharmacological treatments based on a better understanding of molecular mechanisms underlying osteoclast lytic activity and their recruitment from cancer cells.
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10
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Bone Tumors. Radiol Clin North Am 2022; 60:221-238. [DOI: 10.1016/j.rcl.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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11
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Baba A, Kurokawa R, Kurokawa M, Ota Y, Lobo R, Srinivasan A. Imaging features of laryngeal chondrosarcomas: A case series and systematic review. J Neuroimaging 2022; 32:213-222. [PMID: 35019171 DOI: 10.1111/jon.12963] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND PURPOSE To comprehensively summarize the characteristics of radiological findings of laryngeal conventional chondrosarcomas. METHODS We included patients with pathologically proven laryngeal conventional chondrosarcomas with CT and /or MRI, including 41 cases from 31 publications recruited after a systematic review and 14 cases from our institution. Two board-certified radiologists reviewed and evaluated all the radiological images. The relationship between pathological grade and radiological findings was analyzed. RESULTS The median long diameter of the lesion was 3.1 cm (range, 1.5-8.5 cm). The most common location was the cricoid (74.5%), followed by the thyroid (12.7%), cricoid and thyroid (7.3%), and arytenoid (5.5%). All lesions showed well-defined margins. Cortical defect/expansion (98.0%), internal low density (89.6%), and calcification (95.8%) with homogeneous and scarce contrast enhancement on contrast-enhanced CT (85.3%) were frequently observed. All cases showed high signal on T2-weighted imaging, low signal on T1-weighted imaging (T1WI), and heterogeneous and mild contrast enhancement on postcontrast T1WI. No significant differences were found between the pathological grades and radiological findings. CONCLUSIONS In our summary of comprehensive CT and MRI findings of laryngeal conventional chondrosarcomas, we found that the knowledge of these radiological features may facilitate prompt diagnosis and appropriate management.
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Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Remy Lobo
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
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12
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Pennington Z, Ehresman J, Pittman PD, Ahmed AK, Lubelski D, McCarthy EF, Goodwin CR, Sciubba DM. Chondrosarcoma of the spine: a narrative review. Spine J 2021; 21:2078-2096. [PMID: 33971325 DOI: 10.1016/j.spinee.2021.04.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/19/2021] [Accepted: 04/28/2021] [Indexed: 02/03/2023]
Abstract
Chondrosarcoma is an uncommon primary bone tumor with an estimated incidence of 0.5 per 100,000 patient-years. Primary chondrosarcoma of the mobile spine and sacrum cumulatively account for less than 20% of all cases, most .commonly causing patients to present with focal pain with or without radiculopathy, or myelopathy secondary to neural element compression. Because of the rarity, patients benefit from multidisciplinary care at academic tertiary-care centers. Current standard-of-care consists of en bloc surgical resection with negative margins; for high grade lesions adjuvant focused radiation with ≥60 gray equivalents is taking an increased role in improving local control. Prognosis is dictated by lesion grade at the time of resection. Several groups have put forth survival calculators and epidemiological evidence suggests prognosis is quite good for lesions receiving R0 resection. Future efforts will be focused on identifying potential chemotherapeutic adjuvants and refining radiation treatments as a means of improving local control.
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Affiliation(s)
- Zach Pennington
- Department of Neurosurgery, Mayo Clinic, Rochester, MN USA 55905; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287.
| | - Jeff Ehresman
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287; Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ USA 85013.
| | - Patricia D Pittman
- Department of Neuropathology, Duke University School of Medicine, Durham, NC USA 27710
| | - A Karim Ahmed
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287
| | - Daniel Lubelski
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287
| | - Edward F McCarthy
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287
| | - C Rory Goodwin
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC USA 27710
| | - Daniel M Sciubba
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD USA 21287; Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, NY USA 11030.
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13
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Miwa S, Yamamoto N, Hayashi K, Takeuchi A, Igarashi K, Tada K, Yonezawa H, Morinaga S, Araki Y, Asano Y, Saito S, Okuda M, Taki J, Ikeda H, Nojima T, Tsuchiya H. A Radiological Scoring System for Differentiation between Enchondroma and Chondrosarcoma. Cancers (Basel) 2021; 13:cancers13143558. [PMID: 34298772 PMCID: PMC8304621 DOI: 10.3390/cancers13143558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Background: It is challenging to differentiate between enchondromas and atypical cartilaginous tumors (ACTs)/chondrosarcomas. Methods: To evaluate the diagnostic usefulness of radiological findings for differentiation between enchondromas and chondrosarcomas, correlations between various radiological findings and final diagnoses were investigated. Based on the correlations, a scoring system combining these findings was developed. Results: In a cohort of 81 patients, periosteal reaction on X-ray, endosteal scalloping and cortical defect on CT, extraskeletal mass, multilobular lesion, abnormal signal in adjacent tissue on MRI, and increased uptake in bone scan and thallium scan was significantly correlated with final diagnoses. Based on the correlations, a radiological scoring system combining radiological findings was developed. In another cohort of 17 patients, the sensitivity, specificity, and accuracy of the radiological score rates for differentiation between enchondromas and chondrosarcomas were 88%, 89%, and 88%, respectively. Conclusion: Comprehensive assessment combining radiological findings is recommended to differentiate between enchondromas and ACTs/chondrosarcomas. Abstract Background: It is challenging to differentiate between enchondromas and atypical cartilaginous tumors (ACTs)/chondrosarcomas. In this study, correlations between radiological findings and final diagnosis were investigated in patients with central cartilaginous tumors. Methods: To evaluate the diagnostic usefulness of radiological findings, correlations between various radiological findings and final diagnoses were investigated in a cohort of 81 patients. Furthermore, a new radiological scoring system was developed by combining radiological findings. Results: Periosteal reaction on X-ray (p = 0.025), endosteal scalloping (p = 0.010) and cortical defect (p = 0.002) on CT, extraskeletal mass (p < 0.001), multilobular lesion (p < 0.001), abnormal signal in adjacent tissue (p = 0.004) on MRI, and increased uptake in bone scan (p = 0.002) and thallium scan (p = 0.027) was significantly correlated with final diagnoses. Based on the correlations between each radiological finding and postoperative histological diagnosis, a radiological scoring system combining these findings was developed. In another cohort of 17 patients, the sensitivity, specificity, and accuracy of the radiological score rates for differentiation between enchondromas and ACTs/chondrosarcomas were 88%, 89%, and 88%, respectively (p = 0.003). Conclusion: Radiological assessment with combined radiological findings is recommended to differentiate between enchondromas and ACT/chondrosarcomas.
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Affiliation(s)
- Shinji Miwa
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
- Correspondence: ; Tel.: +81-762-652-374; Fax: +81-762-344-261
| | - Norio Yamamoto
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Katsuhiro Hayashi
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Akihiko Takeuchi
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Kentaro Igarashi
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Kaoru Tada
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Hirotaka Yonezawa
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Sei Morinaga
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Yoshihiro Araki
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Yohei Asano
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Shiro Saito
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
| | - Miho Okuda
- Department of Radiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan;
| | - Junichi Taki
- Department of Nuclear Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan;
| | - Hiroko Ikeda
- Department of Pathology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan;
| | - Takayuki Nojima
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
- Department of Pathology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan;
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-8640, Japan; (N.Y.); (K.H.); (A.T.); (K.I.); (K.T.); (H.Y.); (S.M.); (Y.A.); (Y.A.); (S.S.); (T.N.); (H.T.)
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14
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Jones HB, Murphree J, Suryavanshi JR, Osemwengie BO, Rosqvist S, Cox CT, MacKay BJ. Multifocal chondrosarcoma of the hand: Case report and review of the literature. Clin Case Rep 2021; 9:e04352. [PMID: 34136252 PMCID: PMC8190542 DOI: 10.1002/ccr3.4352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/10/2021] [Accepted: 04/28/2021] [Indexed: 11/12/2022] Open
Abstract
Few multifocal hand chondrosarcomas have been reported. To our knowledge, this report is the first to describe multifocal hand chondrosarcoma in a patient with no evidence of prior enchondroma, Ollier's disease, or Maffucci syndrome.
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Affiliation(s)
| | - Jacob Murphree
- Texas Tech University Health Sciences CenterLubbockTXUSA
| | | | | | | | - Cameron T. Cox
- Texas Tech University Health Sciences CenterLubbockTXUSA
| | - Brendan J. MacKay
- Texas Tech University Health Sciences CenterLubbockTXUSA
- University Medical CenterLubbockTXUSA
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15
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Zając AE, Kopeć S, Szostakowski B, Spałek MJ, Fiedorowicz M, Bylina E, Filipowicz P, Szumera-Ciećkiewicz A, Tysarowski A, Czarnecka AM, Rutkowski P. Chondrosarcoma-from Molecular Pathology to Novel Therapies. Cancers (Basel) 2021; 13:2390. [PMID: 34069269 PMCID: PMC8155983 DOI: 10.3390/cancers13102390] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/01/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Chondrosarcoma (CHS) is the second most common primary malignant bone sarcoma. Overall survival and prognosis of this tumor are various and often extreme, depending on histological grade and tumor subtype. CHS treatment is difficult, and surgery remains still the gold standard due to the resistance of this tumor to other therapeutic options. Considering the role of differentiation of CHS subtypes and the need to develop new treatment strategies, in this review, we introduced a multidisciplinary characterization of CHS from its pathology to therapies. We described the morphology of each subtype with the role of immunohistochemical markers in diagnostics of CHS. We also summarized the most frequently mutated genes and genome regions with altered pathways involved in the pathology of this tumor. Subsequently, we discussed imaging methods and the role of currently used therapies, including surgery and the limitations of chemo and radiotherapy. Finally, in this review, we presented novel targeted therapies, including those at ongoing clinical trials, which can be a potential future target in designing new therapeutics for patients with CHS.
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Affiliation(s)
- Agnieszka E. Zając
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Sylwia Kopeć
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Bartłomiej Szostakowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Mateusz J. Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Michał Fiedorowicz
- Small Animal Magnetic Resonance Imaging Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland;
| | - Elżbieta Bylina
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Department of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Paulina Filipowicz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Szumera-Ciećkiewicz
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
| | - Andrzej Tysarowski
- Department of Pathology and Laboratory Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
- Department of Molecular and Translational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (A.E.Z.); (S.K.); (B.S.); (M.J.S.); (E.B.); (P.F.); (P.R.)
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16
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Sharif B, Lindsay D, Saifuddin A. The role of imaging in differentiating low-grade and high-grade central chondral tumours. Eur J Radiol 2021; 137:109579. [PMID: 33578088 DOI: 10.1016/j.ejrad.2021.109579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/23/2021] [Accepted: 01/31/2021] [Indexed: 12/16/2022]
Abstract
Chondrosarcoma is a malignant cartilage matrix-producing tumour. Those arising de novo are called primary chondrosarcomas and are the second commonest primary malignant bone tumours. Numerous types of primary chondrosarcoma exist, namely conventional central (intramedullary), periosteal (juxta-cortical), clear cell, mesenchymal, and dedifferentiated. The biologic aggressiveness, prognosis and thus management of chondrosarcoma are dependent on the histological sub-type and grade. Accurate pre-operative diagnosis is therefore essential in determining management and outcome which requires a multidisciplinary approach taking into account clinical features, imaging findings and histopathology. In this review, we present the pertinent multimodality imaging features which aid in the differentiation of low-grade and high-grade conventional central chondrosarcoma.
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Affiliation(s)
- Ban Sharif
- Imaging Department, Northwick Park Hospital, United Kingdom.
| | - Daniel Lindsay
- Pathology Department, Royal National Orthopaedic Hospital, United Kingdom
| | - Asif Saifuddin
- Imaging Department, Royal National Orthopaedic Hospital, United Kingdom
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17
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Min HJ, Kim KS. Progressive Bilateral Nasal Obstruction Due to Nasopharyngeal Mass. JAMA Otolaryngol Head Neck Surg 2019; 145:971-972. [PMID: 31415072 DOI: 10.1001/jamaoto.2019.2254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
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18
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Maingi S, Padiyar B, Sharma N. Chondrosarcoma of the Nasal Septum: A Case Report. DUBAI MEDICAL JOURNAL 2019. [DOI: 10.1159/000501450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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19
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Aycan OE, Sebastiani E, Bianchi G, Gambarotti M. Coexistence of secondary chondrosarcoma and lung carcinoma metastasis in the humerus of a patient with Ollier's disease: A case report. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2019; 53:68-73. [PMID: 30522929 PMCID: PMC6424710 DOI: 10.1016/j.aott.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/19/2018] [Accepted: 10/12/2018] [Indexed: 11/26/2022]
Abstract
Tumor-to-tumor metastasis in the same bone is an extremely rare condition. Limited number of case reports exists for coincidence of benign and malign neoplasms but none for malignant to malignant metastasis. Occurrence of several individual malignancies in the same patient may eventually cause such coexistences. We report an Ollier's disease patient with malignant transformation to chondrosarcoma complicated by a pathologic fracture and eventually whose pathological examination revealed that the lesion was not only the chondrosarcoma but an accompanying metastasis from existing lung adenocarcinoma. This report includes clinical, radiological, histological diagnostic challenges in an unexpected lesion and a review of literature.
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20
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Özer D, Aycan OE, Er ST, Tanrıtanır R, Arıkan Y, Kabukçuoğlu YS. Primary Tumor and Tumor-Like Lesions of Bones of the Foot: Single-Center Experience of 166 Cases. J Foot Ankle Surg 2018; 56:1180-1187. [PMID: 29079234 DOI: 10.1053/j.jfas.2017.05.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Indexed: 02/03/2023]
Abstract
Primary bone tumors of the foot are rare lesions. The purpose of the present study was to evaluate the clinical manifestations, treatment modalities, and recurrences of various primary bone tumors of the foot from a specialized center for orthopedic oncology. Among 3681 musculoskeletal tumor cases, which were diagnosed and surgically treated in our hospital from 1983 to 2013, 166 primary tumor and tumor-like bone lesions of the foot (4.5%) were retrospectively reviewed regarding age, gender, localization, biopsy-revealed diagnosis, applied treatment modalities, follow-up period, and recurrence, if any. Of the 166 primary bone tumors of the foot, 155 (93.4%) were benign and 11 (6.6%) were malignant. The most common primary benign bone tumor was a unicameral bone cyst (57 of 155; 36.8%), and the most common malignant tumor was chondrosarcoma (7 of 11; 63.6%). The hindfoot was the most common location for both primary benign (104 of 155; 67.1%) and malignant (6 of 11; 54.5%) bone tumors of the foot. The results of our study have confirmed that the radiologic findings can be confusing owing to the structural and histopathologic features of the bones of the foot; thus, histopathologic diagnosis should be considered for foot involvement. Because the characteristics of the compartments in the foot allow for the rapid spread of malignant lesions, aggressive surgical management and wider resection are recommended to prevent recurrence and further spread.
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Affiliation(s)
- Devrim Özer
- Orthopaedic Surgeon, Orthopaedic Oncology Clinic, Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey
| | - Osman Emre Aycan
- Orthopaedic Surgeon, Siverek State Hospital, Siverek, Sanliurfa, Turkey.
| | - Sait Turgay Er
- Orthopaedic Surgeon, İSOM İstanbul Orthopaedics Center, İstanbul, Turkey
| | - Rahime Tanrıtanır
- Pathologist, Department of Pathology, Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | - Yavuz Arıkan
- Orthopaedic Surgeon, Orthopaedic Oncology Clinic, Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey
| | - Yavuz Selim Kabukçuoğlu
- Orthopaedic Surgeon, Orthopaedic Oncology Clinic, Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey
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21
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Chakrabarty S, Foderingham N, O’Hara H. Selected Disorders of the Musculoskeletal System. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Osteosarcoma of pelvic bones: imaging features. Clin Imaging 2016; 41:59-64. [PMID: 27816877 DOI: 10.1016/j.clinimag.2016.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 09/26/2016] [Accepted: 10/14/2016] [Indexed: 11/20/2022]
Abstract
The metaphyseal locations of tubular bones with osteoid mineralization in young patients are important diagnostic radiologic features of osteosarcoma. The pelvic bones are an unusual location of osteosarcoma. Although osteosarcoma occurring in pelvic bones is not common, the osteoid matrix may be a critical finding for differentiating osteosarcoma from other common pelvic bone tumors. Therefore, the possibility of osteosarcoma in pelvic bones may be considered in the presence of osteoid matrix even in the old age group.
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23
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Aycan OE, Vanel D, Righi A, Arikan Y, Manfrini M. Chondroblastoma-like osteosarcoma: a case report and review. Skeletal Radiol 2015; 44:869-73. [PMID: 25492634 DOI: 10.1007/s00256-014-2068-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 11/11/2014] [Accepted: 11/17/2014] [Indexed: 02/02/2023]
Abstract
Chondroblastoma-like osteosarcomas are extremely rare malignancies having varying clinical, radiological and histological features. Their rarity causes challenges in both diagnosis and clinical management. They are often misdiagnosed as benign lesions. Their accurate diagnosis is important because they require adequate treatment. Misdiagnosed lesions or undertreatment may result in recurrences. We report a case of chondroblastoma-like osteosarcoma arising in the left first metatarsal bone with tarsometatarsal joint involvement in a 10-year-old boy for whom surgery with an original technique was planned after a multidisciplinary diagnostic review.
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Affiliation(s)
- Osman Emre Aycan
- Department of Musculoskeletal Oncology, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy
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24
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Lee CH, Tandon A. Focal hand lesions: review and radiological approach. Insights Imaging 2014; 5:301-19. [PMID: 24838840 PMCID: PMC4035494 DOI: 10.1007/s13244-014-0334-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 04/09/2014] [Accepted: 04/15/2014] [Indexed: 12/12/2022] Open
Abstract
Focal hand lesions are commonly encountered in clinical practice and are often benign. Magnetic resonance (MR) imaging is the imaging modality of choice in evaluating these lesions as it can accurately determine the nature of the lesion, enhancement pattern and exact location in relation to surrounding tissues. However, while MR features of various soft tissue lesions in the hand have been well described, it is often still difficult to differentiate between benign and malignant lesions. We review the MR imaging features of a variety of focal hand lesions presenting at our institution and propose a classification into "benign", "intermediate grade" (histologically benign but locally aggressive with potential for recurrence) and frankly "malignant" lesions based on MR findings. This aims to narrow down differential diagnoses and helps in further management of the lesion, preoperative planning and, in cases of primary malignancy, local staging. Teaching Points • Hand lesions are often benign and MR is essential as part of the workup. • MR features of various hand lesions are well described but are often non-specific. • Certain MR features may help for the diagnosis but histological examination is usually required. • We aim to classify hand lesions based on MR features such as margin, enhancement and bony involvement. • Classifying these lesions can help narrow down differential diagnoses and aid management.
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Affiliation(s)
- Chau Hung Lee
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore
| | - Ankit Tandon
- Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore
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25
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Dyrstad SW, Fowler AM, Jokerst CE, Baker JC, Hillen TJ, Menias C. Abdominal and pelvic tumors with musculoskeletal histology. Curr Probl Diagn Radiol 2014; 43:68-79. [PMID: 24629660 DOI: 10.1067/j.cpradiol.2013.11.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This article is a case-based review of the broad spectrum of tumors with musculoskeletal histology that can arise in the abdomen or pelvis and involve the soft tissues, muscle, and bone. In this article, pathology-proven cases are presented with a focus on radiographic, computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography findings. The imaging features that differentiate tumors with musculoskeletal histology from more common abdominal tumors are discussed. Representative cases include malignant fibrous histiocytoma, chondrosarcoma, Ewing sarcoma, hemangiopericytoma, desmoplastic fibroma, neurofibrosarcoma, osteosarcoma, intimal sarcoma, liposarcoma, leiomyosarcoma, synovial sarcoma, teratoma, and chordoma. A variety of tumors with musculoskeletal histology can arise in the abdomen and pelvis. In some cases, unique imaging characteristics allow a confident diagnosis, whereas other cases have a more nonspecific appearance. Recognition of imaging features that suggest a musculoskeletal tumor including direct extension from a bone or neural foramen, the presence of cartilaginous or osseous matrix, or macroscopic fat would allow the radiologist to suggest the proper diagnosis. Recognizing imaging characteristics of tumors with musculoskeletal histology is important clinically as management and prognosis differ from that of more common abdominal tumors.
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Affiliation(s)
| | - Amy M Fowler
- Mallinckrodt Institute of Radiology, St. Louis, MO
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26
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Zhang I, Zaorsky NG, Abraham JA, Tuluc M, Curry JM, Bar-Ad V. Chondrosarcoma of the hyoid bone: Case report and review of current management options. Head Neck 2014; 36:E65-72. [DOI: 10.1002/hed.23373] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Revised: 02/02/2013] [Accepted: 04/23/2013] [Indexed: 12/29/2022] Open
Affiliation(s)
- Isabella Zhang
- Department of Radiation Oncology Kimmel Cancer Center; Thomas Jefferson University; Philadelphia Pennsylvania
| | - Nicholas G. Zaorsky
- Department of Radiation Oncology Kimmel Cancer Center; Thomas Jefferson University; Philadelphia Pennsylvania
| | - John A. Abraham
- Rothman Institute and Department Orthopedic Surgery; Thomas Jefferson University, Philadelphia Pennsylvania
| | - Madalina Tuluc
- Department of Pathology; Thomas Jefferson University Hospital; Philadelphia Pennsylvania
| | - Joseph M. Curry
- Department of Otolaryngology; Thomas Jefferson University Hospital; Philadelphia Pennsylvania
| | - Voichita Bar-Ad
- Department of Radiation Oncology Kimmel Cancer Center; Thomas Jefferson University; Philadelphia Pennsylvania
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27
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Abstract
Heterotopic ossification is a benign process of mature laminar bone formation in the soft tissues. A synonymous term used to describe this pathology in muscle is myositis ossificans. The pathogenesis is unclear, but is likely multifactorial. The basic pathology is thought to be ectopic production of osseous tissue as part of a repair process in response to tissue injury. This report describes a case of heterotopic ossification of the quadratus lumborum muscle as an incidental finding. This case highlights that treatment is based on symptoms and conservative management might be appropriate for the asymptomatic patient.
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Affiliation(s)
- Brie Alport
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - David Horne
- Medical Imaging, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Brent Burbridge
- Medical Imaging, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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28
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Selected Disorders of the Musculoskeletal System. Fam Med 2014. [DOI: 10.1007/978-1-4939-0779-3_121-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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An unusual cause of precordial chest pain. Case Rep Pulmonol 2013; 2013:342096. [PMID: 23424704 PMCID: PMC3574655 DOI: 10.1155/2013/342096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Accepted: 10/01/2012] [Indexed: 11/29/2022] Open
Abstract
Extraskeletal chondrosarcoma in anterior mediastinum is very rare. A 45-year-old male patient was admitted to the hospital with precordial chest pain. A large and well-shaped mass in the anterior mediastinum was seen radiologically, and there was a clearly compression of the heart by the mass. The lesion was totally resected, and extraskeletal mediastinal chondrosarcoma was histopathologically diagnosed. We aimed to present and discuss the radiologic, clinic, and histopathologic features of unusual presentation of extraskeletal chondrosarcoma in a case.
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30
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Abstract
BACKGROUND Distinguishing grade 1 chondrosarcoma from grade 2 chondrosarcoma is critical both for planning the surgical procedure and for predicting the outcome. We aimed to review the preoperative radiographic and histologic findings, and to evaluate the reliability of preoperative grading. METHODS We retrospectively reviewed the medical records of 17 patients diagnosed with central chondrosarcoma at our institution between 1996 and 2011. In these cases, we compared the preoperative and postoperative histologic grades, and evaluated the reliability of the preoperative histologic grading. We also assessed the preoperative radiographic findings obtained using plain radiography, computed tomography (CT), and magnetic resonance imaging (MRI). RESULTS Preoperative histologic grade was 1 in 12 patients, 2 in 4 patients, and 3 in 1 patient. However, 6 of the 12 cases classified as grade 1 before surgery were re-classified as grade 2 postoperatively. In the radiographic evaluation, grade 1 was suspected by the presence of a ring-and-arc pattern of calcification on plain radiography and CT and entrapped fat and ring-and-arc enhancement on MRI. Grades 2 and 3 were suspected by the absence of calcification and the presence of cortical penetration and endosteal scalloping on plain radiography and CT, as well as soft-tissue mass formation on MRI. CONCLUSION Although the combination of radiographic interpretation and histologic findings may improve the accuracy of preoperative grading in chondrosarcoma, the establishment of a standard evaluation system with the histologic and radiographic findings and/or the development of new biologic markers are necessary for preoperative discrimination of low-grade chondrosarcoma from high-grade chondrosarcoma.
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31
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Gheno R, Cepparo JM, Rosca CE, Cotten A. Musculoskeletal disorders in the elderly. J Clin Imaging Sci 2012; 2:39. [PMID: 22919553 PMCID: PMC3424705 DOI: 10.4103/2156-7514.99151] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 05/03/2012] [Indexed: 11/21/2022] Open
Abstract
Musculoskeletal disorders are among the most common problems affecting the elderly. The resulting loss of mobility and physical independence can be particularly devastating in this population. The aim of this article is to present some of the most frequent musculoskeletal disorders of the elderly, such as fractures, osteoporosis, osteoarthritis, microcrystal disorders, infections, and tumors.
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Affiliation(s)
- Ramon Gheno
- Department of Musculoskeletal Radiology, Centre Hospitalier Régional Universitaire de Lille, Hôpital Roger Salengro, Lille, France
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Mavrogenis AF, Gambarotti M, Angelini A, Palmerini E, Staals EL, Ruggieri P, Papagelopoulos PJ. Chondrosarcomas revisited. Orthopedics 2012; 35:e379-90. [PMID: 22385450 DOI: 10.3928/01477447-20120222-30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Chondrosarcomas are malignant bone tumors with pure hyaline cartilage differentiation; myxoid changes, calcification, or ossification may be present. Several subtypes of chondrosarcomas exist. Behavior patterns vary, ranging from slow-growing nonmetastasizing lesions to aggressive metastasizing sarcomas. Symptoms are usually mild, with duration ranging from several months to years, and usually consist of persistent, dull, aching pain or palpable masses. Radiographic findings include bone expansion with cortical thickening, radiolucent areas with variably distributed punctate or ring-like matrix calcifications, cortical erosion or destruction, endosteal scalloping, and scant or absent periosteal reaction; extension into the soft tissue may be present. Histological differential diagnosis from benign cartilaginous lesions can be achieved by increased cellularity, enlarged plump nuclei, binucleated cells, hyperchromatic nuclear pleomorphism, and permeation of cortical or medullary bone. Atypia is usually mild to moderate; necrosis and mitoses can be seen, particularly in high-grade lesions. Adequate surgery is the mainstay of treatment. High-grade and pelvic chondrosarcomas are best managed with wide resection. Because of the low metastatic potential and low local recurrence rate noted with intralesional surgery, low-grade chondrosarcomas can be treated with curettage (with or without treatment of the defect cavity) with a local adjuvant, such as phenol or cryotherapy. Adjuvant chemotherapy may be considered for mesenchymal and dedifferentiated chondrosarcomas. Radiation therapy can be considered after incomplete resection or if resection is not feasible or would cause unacceptable morbidity.
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Affiliation(s)
- Andreas F Mavrogenis
- First Department of Orthopaedics, ATTIKON University Hospital, Athens University Medical School, 41 Ventouri St, 15562 Holargos, Athens, Greece.
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Krajarng A, Nakamura Y, Suksamrarn S, Watanapokasin R. α-Mangostin induces apoptosis in human chondrosarcoma cells through downregulation of ERK/JNK and Akt signaling pathway. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2011; 59:5746-5754. [PMID: 21446759 DOI: 10.1021/jf200620n] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Chondrosarcoma is a malignant primary bone tumor that is resistant to chemotherapy and radiation therapy. α-Mangostin, a component of Garcinia mangostana Linn, is a xanthone derivative shown to have antioxidant and antitumor properties. This study is the first to investigate anticancer effects of α-mangostin in the human chondrosarcoma cell line SW1353. We showed that α-mangostin inhibited cell proliferation of SW1353 cells in a time- and dose-dependent manner by using the trypan blue exclusion method. Hoechst 33342 nuclear staining and nucleosomal DNA-gel electrophoresis revealed that α-mangostin could induce nuclear condensation and fragmentation, typically seen in apoptosis. Flow cytometry using Annexin V/PI double staining assessed apoptosis, necrosis and viability. α-Mangostin activated caspase-3, -8, -9 expression, decreased Bcl-2 and increased Bax. This promotes mitochondrial dysfunction, leading to the release of cytochrome c from the mitochondria to the cytoplasm. In addition, total and phosphorylated ERK and JNK were downregulated in α-mangostin-treated SW1353 cells but no changes in p38. α-Mangostin also decreased phosphorylated Akt without altering total Akt. These results suggest that α-mangostin inhinbited cell proliferation and induced apoptosis through downregulation of ERK, JNK and Akt signaling pathway in human chondrosarcoma SW1353 cells.
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Affiliation(s)
- Aungkana Krajarng
- Department of Biochemistry, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
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Peyrode C, Gouin F, Vidal A, Auzeloux P, Besse S, Dauplat MM, Askienazy S, Heymann D, Chezal JM, Redini F, Miot-Noirault E. A"Proteoglycan targeting strategy" for the scintigraphic imaging and monitoring of the swarm rat chondrosarcoma orthotopic model. Sarcoma 2011; 2011:691608. [PMID: 21331335 PMCID: PMC3038667 DOI: 10.1155/2011/691608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 12/24/2010] [Accepted: 01/04/2011] [Indexed: 11/27/2022] Open
Abstract
Our lab developed (99m)Tc-NTP 15-5 radiotracer as targeting proteoglycans (PGs) for the scintigraphic imaging of joint. This paper reports preclinical results of (99m)Tc-NTP 15-5 imaging of an orthotopic model of Swarm rat chondrosarcoma (SRC). (99m)Tc-NTP 15-5 imaging of SRC-bearing and sham-operated animals was performed and quantified at regular intervals after surgery and compared to bone scintigraphy and tumoural volume. Tumours were characterized by histology and PG assay. SRC exhibited a significant (99m)Tc-NTP 15-5 uptake at very early stage after implant (with tumour/muscle ratio of 1.61 ± 0.14), whereas no measurable tumour was evidenced. As tumour grew, mean tumour/muscle ratio was increased by 2.4, between the early and late stage of pathology. Bone scintigraphy failed to image chondrosarcoma, even at the later stage of study. (99m)Tc-NTP 15-5 imaging provided a suitable set of quantitative criteria for the in vivo characterization of chondrosarcoma behaviour in bone environment, useful for achieving a greater understanding of the pathology.
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Affiliation(s)
- Caroline Peyrode
- INSERM (UMR 990) Université d'Auvergne, rue Montalembert, BP 184, 63005 Clermont-Ferrand Cédex, France
| | - François Gouin
- INSERM (UMR S957), Université de Nantes, 44035 Nantes, France
| | - Aurélien Vidal
- INSERM (UMR 990) Université d'Auvergne, rue Montalembert, BP 184, 63005 Clermont-Ferrand Cédex, France
| | - Philippe Auzeloux
- INSERM (UMR 990) Université d'Auvergne, rue Montalembert, BP 184, 63005 Clermont-Ferrand Cédex, France
| | - Sophie Besse
- INSERM (UMR 990) Université d'Auvergne, rue Montalembert, BP 184, 63005 Clermont-Ferrand Cédex, France
| | | | | | | | - Jean-Michel Chezal
- INSERM (UMR 990) Université d'Auvergne, rue Montalembert, BP 184, 63005 Clermont-Ferrand Cédex, France
| | | | - Elisabeth Miot-Noirault
- INSERM (UMR 990) Université d'Auvergne, rue Montalembert, BP 184, 63005 Clermont-Ferrand Cédex, France
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Cintra FF, Etchebehere M, Gonçalves JCB, Cassone AE, Amstalden EMI. Analysis of angiogenic factors and cyclooxygenase-2 expression in cartilaginous tumors- clinical and histological correlation. Clinics (Sao Paulo) 2011; 66:1591-6. [PMID: 22179165 PMCID: PMC3164410 DOI: 10.1590/s1807-59322011000900015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Accepted: 06/01/2011] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES To study the role of angiogenesis and cyclooxygenase-2 expression in cartilaginous tumors and correlate these factors with prognosis. INTRODUCTION For chondrosarcoma, the histological grade is the current standard for predicting tumor outcome. However, a low-grade chondrosarcoma can follow an aggressive course-as monitored by sequential imaging techniques-even when it is histologically indistinguishable from an enchondroma. Therefore, additional tools are needed to help identify the biological potential of these tumors. The degree of angiogenesis that is induced by the tumor could assist in this task. Angiogenesis can be quantified by measuring the expression of vascular endothelial growth factor and CD34, and cyclooxygenase-2 can induce angiogenesis by stimulating the production of proangiogenic factors. METHODS In total, 21 enchondromas and 58 conventional chondrosarcomas were studied by examining the clinical and histopathological findings in conjunction with the immunostaining markers of angiogenesis and cyclooxygenase- 2 expression. RESULTS The significant variables that were associated with poor outcome were 1) higher-grade chondrosarcomas, 2) tumors that developed in flat bones, and 3) over-expression of CD34 (with a median count that was higher than 5.9 vessels in 5 high power fields). Moreover, CD34 expression (measured using the Chalkley method) revealed significantly higher microvessel density in flat bone chondrosarcomas. DISCUSSION Previous studies have shown a positive correlation between Chalkley microvessel density and histological grade; however, in our sample, we found that the former is predictive of the outcome. Chondrosarcomas in flat bones have been shown to correlate with a poor prognosis. We also found that CD34 microvessel density values were significantly higher in flat-bone chondrosarcomas. This could explain-at least in part-the more aggressive biological course that is taken by these tumors. CONCLUSIONS These results provide evidence that CD34 microvessel density in chondrosarcomas can be helpful in predicting patient outcome and may add to our understanding of chondrosarcoma pathogenesis.
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Miot-Noirault E, Gouin F, Vidal A, Rapp M, Maublant J, Askienazy S, Chezal JM, Heymann D, Redini F, Moins N. First preclinical imaging of primary cartilage neoplasm and its local recurrence using 99mTc-NTP 15-5 radiotracer. J Nucl Med 2009; 50:1541-7. [PMID: 19690026 DOI: 10.2967/jnumed.108.056721] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED This study on a rat model of grade II chondrosarcoma aimed to determine whether the radiotracer N-(triethylammonium)-3-propyl-[15]ane-N5 radiolabeled with (99m)Tc ((99m)Tc-NTP 15-5), which binds to cartilage proteoglycans, has pathophysiologic validity for in vivo imaging of cartilage tumoral tissue. METHODS We used 2 experimental approaches with the Swarm chondrosarcoma rat model: that is, a primary paratibial location and local recurrence after intralesional curettage. (99m)Tc-NTP 15-5 scintigraphy and (99m)Tc-hydroxymethylenediphosphonate ((99m)Tc-HMDP) scanning were performed at regular intervals during 50 d after tumor implantation in a paratibial location (primary model; n = 12 animals) and after intralesional curettage in a femoral condyle location (recurrence model; n = 9 animals). For each animal, positive scans were analyzed at each time point using the target-to-background ratio (TBR), with the target region of interest delineated over the tumor and the background region of interest over muscle. In each model, the TBR time course was followed against primary tumoral growth or recurrence. Tumor volume was monitored for 2 mo by measuring the 2 perpendicular diameters. At study end, animals were sacrificed for histopathologic analysis. RESULTS For both models, (99m)Tc-NTP 15-5 scans showed tracer accumulation at the site of implantation or curettage. For the primary tumor model, the mean TBR was 1.6 +/- 0.14 by day 4 after implantation and increased over time as the disease progressed, with a mean TBR of 4.25 +/- 0.25 on day 45. For the recurrence model, mean TBR was 3.27 +/- 0.24 by day 4 after curettage and increased with recurrence, with a mean value of 5.25 +/- 0.49 on day 50. (99m)Tc-HMDP bone scans were negative for both models throughout the study; at a later stage of the study, an area of (99m)Tc-HMDP accumulation was seen in the diaphysis of the bone adjacent to the tumor and was attributed to remodeling. CONCLUSION These experimental results in 2 preclinical models of grade II chondrosarcoma bring forward data in favor of (99m)Tc-NTP 15-5 radiotracer for imaging primary growth of chondrosarcoma and its local recurrence after surgery.
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Abstract
There is a diversity of modalities available for the imaging of soft tissue and skeletal sarcomas. However, conventional radiography remains the first line imaging modality in the diagnostic work-up, as it provides superior spatial resolution for the evaluation of bone trabecular detail. This article focuses on the advanced imaging modalities of computer tomography, magnetic resonance imaging, and positron emission tomography in the evaluation of sarcomas.
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Affiliation(s)
- Dalia Fadul
- The Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD 21287, USA
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