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Gersey ZC, Zenonos GA, Gardner PA. Malignant Brain and Spinal Tumors Originating from Bone or Cartilage. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:477-506. [PMID: 37452950 DOI: 10.1007/978-3-031-23705-8_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Malignant bone tumors affecting the brain and spine are a rare and exceedingly difficult-to-treat group of diseases. Most commonly consisting of chordoma and chondrosarcoma, these tumors also include giant-cell tumors and osteosarcomas. This chapter will cover the background, epidemiology, genetics, molecular biology, histopathology, radiographic features, clinical manifestations, therapeutic approaches, and clinical management of each entity.
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Affiliation(s)
- Zachary C Gersey
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Georgios A Zenonos
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Paul A Gardner
- UPMC Center for Cranial Base Surgery, 200 Lothrop Street, PUH B-400, Pittsburgh, PA, 15213, USA.
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2
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Primary osteosarcoma of the parietal bone. Skeletal Radiol 2021; 50:1729-1733. [PMID: 33604706 DOI: 10.1007/s00256-021-03726-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/16/2021] [Accepted: 01/24/2021] [Indexed: 02/02/2023]
Abstract
Osteosarcoma is the most common primary bone tumor and usually involves the long bones. Osteosarcoma of the skull, on the other hand, is relatively rare. Here, we present a 29-year-old man with a growing mass in the skull he first noticed after a fall while skateboarding. The initial clinical diagnosis was hematoma. While undergoing an evacuation surgery for a hematoma, a suspicious mass was detected which was biopsied. Histopathological evaluation showed high-grade osteosarcoma. The patient was referred to our hospital where he underwent definitive resection followed by adjuvant chemotherapy. His course was complicated by wound infection. Even though osteosarcoma of the skull is a rare finding, it should be suspected in a patient with a skull mass, and the history of prior head trauma does not exclude the diagnosis.
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Bantan NAA, Abouissa AH, Saeed M, Alwalily MH, Balkhoyour KB, Ashour KM, Hassan AA, Falemban AH, Taher MM. A unique case of multiple calvarial hemangiomas with one large symplastic hemangioma. BMC Neurol 2021; 21:29. [PMID: 33468071 PMCID: PMC7814591 DOI: 10.1186/s12883-021-02053-7] [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: 09/24/2020] [Accepted: 01/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Symplastic hemangioma is a benign superficial abnormal buildup of blood vessels, with morphological features which can mimic a pseudo malignancy. A few cases have been reported in the literature. We report here, a unique case of calvarial symplastic hemangioma, which is the first case in the calvarial region. CASE PRESENTATION A 29-year-old male patient, with a left occipital calvarial mass since childhood, that gradually increased in size with age, was associated with recurrent epileptic fits controlled by Levetiracetam (Keppra), with no history of trauma. He presented to the emergency room with a recent headache, vomiting, frequent epileptic fits and a decrease in the level of consciousness 1 day prior to admission. A CT scan showed three diploic, expansile, variable sized lytic lesions with a sunburst appearance; two that were biparietal, and one that was left occipital, which were all suggestive of calvarial hemangiomas. However, the large intracranial soft tissue content, within the hemorrhage of the occipital lesion was concerning. The patient had refused surgery over the years; however, after the last severe presentation, he finally agreed to treatment. The two adjacent, left parietal and occipital lesions were treated satisfactorily using preoperative embolization, surgical resection, and cranioplasty. Histopathology revealed cavernous hemangiomas, in addition to symplastic hemangioma (pseudo malignancy features) on top at the occipital lesion. The right parietal lesion was not within the surgical field; therefore, it was left untouched for follow-up. CONCLUSIONS Histopathology and radiology examinations confirmed the diagnosis as symplastic hemangioma, on top of a pre-existing cavernous hemangioma. To the best of our knowledge, this is the first case of a calvarial symplastic hemangioma, which we report here.
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Affiliation(s)
| | - Ahmed H Abouissa
- Department of Radiology, Al-Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Muhammad Saeed
- Department of Radiology, Al-Noor Specialist Hospital, Makkah, Saudi Arabia
| | | | | | | | - Amal Ali Hassan
- Department of Laboratory Medicine, Division of Histopathology, Al-Noor Specialist Hospital, Makkah, Saudi Arabia.,Faculty of Medicine, Department of Pathology, Al Azhar University, Cairo, Egypt
| | - Afnan Hisham Falemban
- Department of Laboratory Medicine, Division of Histopathology, Al-Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Mohiuddin M Taher
- Department of Medical Genetics, Umm-Al-Qura University, Makkah, Saudi Arabia. .,Science and Technology Unit, Umm-Al-Qura University, Makkah, Saudi Arabia.
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Singh R, Jha K, Pant I, Satti D. Primary osteogenic sarcoma of the skull: Report of two cases with review of literature. J Postgrad Med 2019; 64:232-236. [PMID: 30264740 PMCID: PMC6198693 DOI: 10.4103/jpgm.jpgm_706_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Primary calvarial (excluding jaw) osteosarcoma is rare. We report two cases highlighting their unusual presentation and histopathologic variability – a 30-year-old female who presented with progressively increasing headache and a rapidly growing frontal swelling and a 16-year-old girl who had a rapidly growing mass in the left frontoparietal region which had recurred thrice but was otherwise asymptomatic. The lesions were osteolytic on neuroimaging and histopathological examination confirmed osteosarcoma. These two unusual cases are discussed along with a brief review of literature.
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Affiliation(s)
- R Singh
- Department of Pathology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - K Jha
- Department of Pathology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - I Pant
- Department of Pathology, Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - D Satti
- Department of Neurosurgery, Guru Teg Bahadur Hospital, New Delhi, India
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Vasquez L, Tejada V, Maza I, Mendoza R. Primary osteosarcoma of the skull in teenager. BMJ Case Rep 2019; 12:12/9/e229585. [PMID: 31527199 DOI: 10.1136/bcr-2019-229585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Osteosarcoma of the skull is a rare primary malignant bone tumour in children, representing 1-2% of all cranial tumours. We describe a case of a 17-year-old adolescent with chondroblastic osteosarcoma of the parietal-occipital bone and no distant metastases at presentation treated with neoadjuvant chemotherapy, surgery and, later, concurrent chemoradiotherapy. The patient suffered progressive disease and died 15 months after diagnosis. There are at least 15 paediatric cases of osteosarcoma of the skull described in the literature. Due to its rarity, there are no broad prospective studies on this entity, which has distinctive features when compared to other craniofacial tumours, carrying a worse prognosis. Complete surgical resection is needed for long-term survival, whereas chemotherapy and radiotherapy have still questionable indications.
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Affiliation(s)
- Liliana Vasquez
- Pediatric Oncology, Rebagliati Hospital, Lima, Peru.,Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres Facultad de Medicina Humana, La Molina, Lima, Peru
| | - Victor Tejada
- Department of Head and Neck Surgery, Rebagliati Hospital, Lima, Peru
| | - Ivan Maza
- Pediatric Oncology, Rebagliati Hospital, Lima, Peru
| | - Ronald Mendoza
- Department of Pathology, Rebagliati Hospital, Lima, Peru
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Abstract
RATIONALE Primary osteosarcomas of the skull and skull base are rare, comprising <2% of all skull tumors. Primary osteosarcomas of the skull are aggressive neoplasms composed of spindle cells producing osteoid which have poor outcome. PATIENT CONCERNS A 33-year-old woman was admitted to our hospital with a major complaint of a growing mass on her left frontal region of the skull for 10 months. Prior to the accurate diagnosis, the mass on her skull was considered to be eosinophilic granuloma. DIAGNOSES Computerized tomogram (CT) scan of skull revealed a lytic lesion causing destruction of left frontal bone with surrounding soft tissue mass. The histological examination of the lesion showed typical features of osteosarcoma. INTERVENTIONS The patient received 3 surgeries and adjuvant chemotherapy and radiotherapy for the frontal bone lesion. OUTCOMES At the last follow-up, after 4 years, the patient was free of disease both clinically and on imaging by magnetic resonance imaging (MRI) scan after 4 years. LESSONS Because osteosarcoma of skull is a rare disease, the early recognition and correct diagnosis are very important for a better prognosis. It is therefore imperative that clinicians recognize osteosarcoma early to make an accurate diagnosis and complete surgical resection followed by combined chemo-radiation is proved to be one of the most optimal treatment regimens.
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Affiliation(s)
| | - Qi Liang
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
| | - Yu Liu
- Department of Neurosurgery
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Gonzalez ME, Raghavan P, Cho B, Muttikkal TJE, Rehm PK. Primary osteogenic osteosarcoma of the ethmoid sinus in an adolescent: case report. J Radiol Case Rep 2016; 10:1-9. [PMID: 27200156 DOI: 10.3941/jrcr.v10i2.2298] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Osteosarcomas of the craniofacial bones account for fewer than 10% of all osteosarcomas. Primary osteosarcomas of the nasal cavity and paranasal sinus are rare (0.5-8.1% of the osteosarcomas occur in this location). Because of the rarity of this presentation, we report a case of osteogenic osteosarcoma arising de novo from the ethmoid bone in a 13 year old male who presented with discharge from the right eye and headaches. We describe the imaging features of this rare tumor and provide a brief review of the literature.
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Affiliation(s)
- Marta E Gonzalez
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
| | - Prashant Raghavan
- Department of Radiology and Medical Imaging, University of Maryland Medical Center, Baltimore, MD, USA
| | - Benjamin Cho
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | | | - Patrice K Rehm
- Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA
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Hadley C, Gressot LV, Patel AJ, Wang LL, Flores RJ, Whitehead WE, Luerssen TG, Jea A, Bollo RJ. Osteosarcoma of the cranial vault and skull base in pediatric patients. J Neurosurg Pediatr 2014; 13:380-7. [PMID: 24483254 DOI: 10.3171/2013.12.peds13359] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cranial osteosarcoma is very rare in children, rendering the development of optimal treatment algorithms challenging. The authors present 3 cases of pediatric cranial osteosarcoma: a primary calvarial tumor, a cranial metastasis, and a primary osteosarcoma of the cranial base. A review of the literature demonstrates significant variation in the management of cranial osteosarcomas and the outcome for patients with these tumors. This series and literature review is presented to improve the understanding of pediatric cranial osteosarcoma and to reinforce the importance of maximal resection in optimizing outcome.
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Affiliation(s)
- Caroline Hadley
- Department of Neurosurgery, Baylor College of Medicine and Division of Pediatric Neurosurgery, Texas Children's Hospital
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Chang CS, Bergeron L, Liao CC, Liao HT, Chang CN, Kuo-Ting Chen P, Chen YR. Craniofacial reconstruction of primary osteogenic sarcoma of the skull. J Plast Reconstr Aesthet Surg 2010; 63:1265-8. [DOI: 10.1016/j.bjps.2009.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2008] [Revised: 07/16/2009] [Accepted: 07/23/2009] [Indexed: 11/29/2022]
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SATO H, HAYASHI N, YAMAMOTO H, NAGAI S, OHMORI K, KANAMORI M, ENDO S. Synchronous Multifocal Osteosarcoma Involving the Skull Presenting With Intracranial Hemorrhage -Case Report-. Neurol Med Chir (Tokyo) 2010; 50:407-9. [DOI: 10.2176/nmc.50.407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hikari SATO
- Department of Neurosurgery, Faculty of Medicine, University of Toyama
| | - Nakamasa HAYASHI
- Department of Neurosurgery, Faculty of Medicine, University of Toyama
| | | | - Shoichi NAGAI
- Department of Neurosurgery, Faculty of Medicine, University of Toyama
| | - Kazuo OHMORI
- Department of Orthopedics, Faculty of Medicine, University of Toyama
| | - Masahiko KANAMORI
- Department of Orthopedics, Faculty of Medicine, University of Toyama
| | - Shunro ENDO
- Department of Neurosurgery, Faculty of Medicine, University of Toyama
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Abstract
Primary osteogenic sarcoma of the skull is an exceedingly rare condition. An adult male patient is described, who had a painless swelling in the right forehead that had rapidly enlarged in the previous 6 months. Radiological investigations showed a large destructive mass lesion involving the right side of the frontal bone with extension into the frontal sinus, causing marked extradural compression of brain parenchyma. Histopathological examination confirmed the lesion to be primary osteogenic sarcoma.
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Affiliation(s)
- F Haque
- Department of Radiodiagnosis, Jawahar Lal Nehru Medical College, Aligarh Muslim University, Aligarh, India.
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Watanabe T, Fuse T, Umezu M, Yamamoto M, Demura K, Niwa Y. Radiation-Induced Osteosarcoma 16 Years After Surgery and Radiation for Glioma-Case Report-. Neurol Med Chir (Tokyo) 2006; 46:51-4. [PMID: 16434828 DOI: 10.2176/nmc.46.51] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 35-year-old man developed osteosarcoma of the left parietal and occipital bones 16 years after radiotherapy for glioma in the right occipital lobe. Radiotherapy of the primary neoplasm used 50 Gy administered to a localized field through two lateral ports. The secondary neoplasm arose contralateral to the primary lesion but within the irradiated field. The tumor had a multilocular cyst with considerable intracranial extension, and symptoms of elevated intracranial pressure were prominent early in the course. After a short-lived initial remission following surgical intervention and chemotherapy, the patient deteriorated because of tumor recurrence and died 18 months after the diagnosis. Radiation-induced osteosarcoma is a well-known but rare complication of radiotherapy for brain neoplasms with a poor prognosis.
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Affiliation(s)
- Takayuki Watanabe
- Department of Neurosurgery, National Hospital Organization Shizuoka Medical Center, Japan
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Abstract
A case of low-grade central osteosarcoma of the skull in a 36-year-old male is described. A 10cm mass of the left temporo-occipital bone, which was incidentally found 6 years previously on the occasion of a head trauma, was osteolytic and osteoplastic, affecting soft tissues and the subdural space. The patient was treated with intralesional curettage. Histologically, the tumor was characterized by spindle cell proliferation with woven and lamellar bone formation, resembling fibrous dysplasia, parosteal osteosarcoma, low-grade fibrosarcoma, or desmoplastic fibroma. The spindle cells were fairly uniform with mild atypia and low-mitotic activity (3 per 50 high power fields), and cellularity varied from low to high. Clinicians and pathologists should be aware of this type of low-grade osteosarcoma of the skull and distinguish it from its mimics, including fibrous dysplasia, parosteal osteosarcoma, and low-grade fibrosarcoma. Careful microscopic correlation with radiographic findings is the clue to the correct diagnosis.
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Affiliation(s)
- Masaharu Fukunaga
- Department of Pathology, The Jikei Daisan Hospital, 4-11-1, Izumihoncho, Komaeshi, Tokyo 201-8601, Japan.
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Abe K, Kosuda S, Kusano S, Shima K. Detection of Recurrent Skull Osteosarcoma by Skull Single Photon Emission Computed Tomography Using Tc-99m Methylene Diphosphonate. Clin Nucl Med 2004; 29:72-3. [PMID: 14688610 DOI: 10.1097/01.rlu.0000102766.99886.e9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Katsumi Abe
- Department of Radiology, National Defense Medical College, Tokorozawa, Japan
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