Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.
Bone Neoplasms ; pathology ; secondary ; surgery ; Endometrial Neoplasms ; complications ; pathology ; surgery ; Female ; Humans ; Middle Aged

Adenocarcinoma ; pathology ; secondary ; surgery ; Adult ; Bone Marrow Neoplasms ; diagnosis ; secondary ; Female ; Humans ; Postoperative Period ; Stomach Neoplasms ; pathology ; surgery

Follicular carcinoma of the thyroid rarely manifests itself as a distant metastatic lesion, and, when present, is usually found in flat bones. A soft tissue metastasis is extremely rare, and synchronous metastases to the bone and soft tissue is not reported in the literature so far. We report such a case of a 42-yr-old male, who presented with a goiter, scalp and forearm soft tissue swellings, and, fine needle aspiration cytology of all these swellings revealed a follicular neoplasm. A wide excision of the forearm swelling was carried out and the histopathology was consistent with features of metastatic follicular carcinoma of the thyroid. The main stay of treatment is surgical resection of the primary tumor. The various modalities of treatment of metastasis is discussed with a review of literature.
Adenocarcinoma, Follicular/*pathology/surgery ; Adult ; Bone Neoplasms/pathology/*secondary/surgery ; Human ; Male ; Soft Tissue Neoplasms/pathology/*secondary/surgery ; Thyroid Neoplasms/*pathology/surgery ; Treatment Outcome

Aged ; Carcinoma, Renal Cell ; secondary ; surgery ; Female ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Nephrectomy ; Parietal Bone ; Skull Neoplasms ; secondary ; surgery

Bone Neoplasms ; diagnostic imaging ; pathology ; secondary ; surgery ; Chondrosarcoma ; diagnostic imaging ; pathology ; secondary ; surgery ; Fingers ; Humans ; Male ; Middle Aged ; Osteochondroma ; pathology ; Radiography

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; pathology ; therapy ; Catheter Ablation ; Humans ; Lung Neoplasms ; secondary ; surgery ; Neoplasm Recurrence, Local ; Osteosarcoma ; pathology ; secondary ; therapy ; Salvage Therapy

OBJECTIVETo improve the life quality of cancer patients with metastasis to long bone and to select suitable surgical treatment.

METHODSFifty two patients with metastasis 27 men and 25 women, were treated from 1990 to 1999. Their average age was 56.8 years (33 - 74). In 16 patients with multiple lesions, underwent surgery at bone shaft (29 patients) and bone epiphysis (26). Thirty patients were treated for pathologic fracture and the rest for impending fracture. Operations included limb-salvage (51 patients) and amputation (4) Limb salvage consisted of intralesional curettage (3 patients), intramedullary nailing reconstruction (29), endoprosthesis (18), and temporary spacer (1). 21 patients accepted postoperative chemotherapy or radiotherapy.

RESULTSFollow-up of 52 patients for a mean of 28.2 months (2 - 122 months) showed pain relief (41 patients), (75%) and full or part weight-bearing stability (36) 69%. Local tumor recurrence occurred in 11 patients.

CONCLUSIONSSurgical treatment can effectively improve the life quality of patients with metastasis to long bone. The metastatic lesions should be resected with wide or radical margin for the patients with kidney, breast, prostate and thyroid cancer.

Adult ; Aged ; Bone Neoplasms ; pathology ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Limb Salvage ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo retrospectively review the experience with different surgical procedures for periacetabular metastasis.

METHODSThe data of 43 patients with periacetabular metastasis between July 2000 and July 2007 was reviewed. There were 21 patients with primary malignant tumors at the beginning, and 10 patients diagnosed metastasis by preoperative biopsy. The other 12 patients presented skeletal involved as initial manifestations of metastasis prior to the pathological diagnosis of the primary tumor. Twelve patients had solitary metastasis, and the others had multiple bone metastasis. The surgical procedure included curettage (35 cases) and en-blot excision (8 cases). The techniques of reconstruction of acetabular defect included total hip replacement (THR) with cemented components or titanium acetabular reconstruction cup (12 cases), THR with partial pelvis replacement with Candal Hook (16 cases), THR with Steinmann pins and cement augmented or titanium cup reconstruction (7 cases), and modular hemipelvic prosthesis reconstruction (8 cases).

RESULTSAll the patients received successful operations. The average score for preoperative pain of 7.2 was assessed. Forty-one patients (95.4%) were evaluated for relief of pain and resumption of walking, and the pain score improved to 3.5 after surgery. The average functional score was 24.5 postoperatively. Six of 32 patients had local recurrence. Fourteen patients died of diseases. The average blood loss during the operation was 1600 ml in 43 patients and the bleeding exceeded 3000 ml was in 3 patients with renal carcinomas. Major complications included two superficial wound infections, one multiple organ failure and two dislocations.

CONCLUSIONSAlthough surgery will not typically cure patients of their metastatic disease, surgery that is well planned and well executed can help many people by relieving their suffering and improving their quality of life.

Acetabulum ; pathology ; Adult ; Aged ; Bone Neoplasms ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo investigate the efficacy of surgical treatment of sternal tumors and repairing methods of the chest wall defects.

METHODSFifteen patients with sternal tumors were diagnosed and underwent resection of the sternal tumors according to the en-bolck principle and repair of the chest wall defects using various materials from January 1968 to December 2010 in our hospital.

RESULTSOf 6 patients with sternal manubrim tumors, one patient had reconstruction only with steel wire, other 5 patients healed completely after repair with soft materials. Of 7 patients with sternal body tumors, one patient recovered quickly without reconstruction because he had only partial resection; four patients had chest wall repair with soft materials, but they breathed hardly; and two patients had chest wall reconstruction with rigid materials. One patient had ventilatory support, another patient recovered quickly. Ventilatory support was needed in two patients treated by subtotal sternectomy because they had chest wall repair with soft materials.

CONCLUSIONSIn surgical treatment of sternal tumors by manubrim sternetomy, the chest wall defects can be constructed with soft materials. After resection of sternal body tumors and subtotal sternectomy, the thoracic wall defects need to be reconstructed with rigid materials.

Adenocarcinoma ; secondary ; surgery ; Adult ; Aged ; Bone Neoplasms ; pathology ; surgery ; Chondrosarcoma ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Sternum ; pathology ; surgery ; Thoracic Surgical Procedures ; methods ; Thoracic Wall ; pathology ; surgery

OBJECTIVETo improve the understanding of thymic neuroendocrine carcinoma (TNC) by retrospective analysis of the clinical data of 21 cases.

METHODSThe clinical data of 21 patients with TNC treated in the Peking Union Medical College Hospital from 1998 to 2010 were retrospectively analyzed.

RESULTSThere were 12 males and 9 females, with onset age ranging from 13 to 67 years and the mean age of 43 years. The clinical manifestation was diverse, in which the malaise of chest and back accounted for 57.1% (12/21), Cushing's syndrome 33.3% (7/21), multiple endocrine neoplasia type 1 accounted for 4.8% (1/21), pharyngeal malaise 4.8%, superior vena cava syndrome 4.8% (1/21) and asymptomatic patients accounted for 4.8% (1/21). Eighteen of them demonstrated metastasis, in which 13 had metastasis to lymph nodes and local vascular invasion, 9 to lung or pleura, 5 to bone, 1 to liver and 1 was recurred in situ. Twenty of them were treated by surgical resection. Eleven of them received radiotherapy and 9 chemotherapy after surgery. One patient was too severe to endure surgery, and was a treated by chemotherapy only.

CONCLUSIONTNC is rare, and its clinical features are complex, with a high level of malignancy. The first choice of treatment is resection. Adjuvant radiotherapy and/or chemotherapy may be applied in patients with metastasis.

Adolescent ; Adrenocorticotropic Hormone ; metabolism ; Adult ; Aged ; Bone Neoplasms ; secondary ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; secondary ; surgery ; therapy ; Chemotherapy, Adjuvant ; Cushing Syndrome ; metabolism ; pathology ; surgery ; therapy ; Female ; Humans ; Hydrocortisone ; metabolism ; Immunohistochemistry ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Multiple Endocrine Neoplasia Type 1 ; metabolism ; pathology ; surgery ; therapy ; Radiotherapy, Adjuvant ; Retrospective Studies ; Thymectomy ; Thymus Neoplasms ; metabolism ; pathology ; surgery ; therapy ; Young Adult