Bone Neoplasms ; Diagnosis, Differential ; Humans ; Osteoblastoma/surgery*

The morbidity and mortality of prostate cancer ascend yearly, which seriously threatens the health of the male population. Bone is the main metastasis site of prostate cancer, with bone metastases and skeletal-related events (SREs) occuring in more than 70% of patients with advanced prostate cancer. Bone metastases and the resulting SREs, such as spinal cord compression and pathological fracture, seriously affect the life quality of the patients. Although the active treatments of the primary disease is important, the application of bone-modifying agents to prevent SREs cannot be overlooked. However, there is no standard treatment procedure for the bone metastasis of prostate cancer at present. According to the clinical status, the Genitourinary Oncology Committee of Chinese Anti-cancer Association formulated this consensus, which integrated clinical evidence and real world clinical practices in China and abroad, to help clinicians make more accurate diagnosis and treatment for the bone metastases of prostate cancer with multidisciplinary strategies.
Bone Neoplasms ; Bone and Bones ; Consensus ; Humans ; Male ; Prostatic Neoplasms/diagnosis* ; Spinal Cord Compression/etiology*

With the extension of survival period and the improvement of imaging technology, the incidence of bone metastasis from colorectal cancer gradually increases. Therefore, the early diagnosis and treatment of bone metastasis should not be neglected while the primary lesion was controlled.Currently, the available evidence for bone metastasis from colorectal cancer is very limited. In this article, the Chinese Society of Colorectal Cancer organized multi-disciplinary experts to integrate the relevant studies worldwide and combine with clinical practice, focused on the issues and controversies about clinical characteristics, diagnosis and treatment, and follow-up of bone metastatic patients with colorectal cancer.After discussion and voting, Chinese expert consensus on multidisciplinary treatment of bone metastasis from colorectal cancer (2020 version) was formed. This consensus could provide clinicians with more detailed multidisciplinary treatment strategies for bone metastasis from colorectal cancer.
Asian Continental Ancestry Group ; Bone Neoplasms ; pathology ; secondary ; therapy ; China ; Colonic Neoplasms ; diagnosis ; therapy ; Colorectal Neoplasms ; diagnosis ; therapy ; Consensus ; Humans ; Interdisciplinary Communication ; Patient Care Team ; Practice Guidelines as Topic ; Treatment Outcome

Fibrous dysplasia (FD) is a non-malignant bone tumor that typically behaves as a slow and indolent growing mass lesion. We report the case of a female patient presenting with headache and facial deformity and later diagnosed with polyostotic fibrous dysplasia (PFD). A 29-year-old woman visited Mealhada Primary Health Care Unit complaining of headache, nasal congestion, and hyposmia for several weeks. She also presented with facial deformity and painful swelling of the upper left orbit. X-ray imaging revealed a suspicious opacity in the left frontal sinus and a right shift of the nasal septum. Computed tomography and bone scintigraphy later confirmed a tumor involving the ethmoid and frontal bone. The patient was referred to the neurosurgery and otorhinolaryngology departments of a central hospital and the suspected diagnosis of PFD was confirmed. A watchful waiting approach with regular imaging screenings was proposed and accepted by the patient, who is now free of symptoms and more acceptant of the benign condition of her tumor. With this case, we aim to make family physicians more aware of this rare but relevant condition that can be difficult to diagnose. FD is a rare but benign tumor that occurs mainly in adolescents and young adults. Symptoms depend on the location and type of the tumor and include facial deformity, vision changes, nasal congestion, and headache. No clear guidelines exist for its treatment, and options include monitoring the progression of the tumor, in addition to medical or surgical approaches.
Adolescent ; Adult ; Bone Neoplasms ; Congenital Abnormalities ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fibrous Dysplasia of Bone ; Fibrous Dysplasia, Polyostotic* ; Frontal Bone ; Frontal Sinus ; Headache ; Humans ; Mass Screening ; Nasal Septum ; Neurosurgery ; Orbit ; Otolaryngology ; Physicians, Family ; Primary Health Care* ; Radionuclide Imaging ; Watchful Waiting ; Young Adult

Bone marrow metastasis of colon cancer is rare. Here, we report a 56-year-old female patient who presented with pancytopenia. She was diagnosed with colon cancer accompanied by lung and axial skeleton metastasis. The bone marrow study showed metastatic carcinoma. Immunohistochemical (IHC) staining with anti-cytokeratin 7 (CK7) and anti-cytokeratin 20 (CK20) antibodies showed that the bone marrow samples were negative for CK7 and positive for CK20, consistent with metastatic colon cancer. To the best of our knowledge, there has been only one other reported case of bone marrow metastasis of colon cancer as the primary diagnosis in an adult patient in Korea. Bone and bone marrow metastases of colon cancer are regarded as uncommon. However, for proper management, bone marrows should be promptly examined in patients with solid tumors when unexplained cytopenia is noted, even if the origin of the tumor is known to be rarely metastatic to bone marrow. In addition, the use of cytokeratin IHC staining is helpful for determining the origin of metastatic carcinoma.
Adult ; Antibodies ; Bone Marrow ; Colon ; Colonic Neoplasms ; Diagnosis ; Female ; Humans ; Immunohistochemistry ; Keratins ; Korea ; Lung ; Middle Aged ; Neoplasm Metastasis ; Pancytopenia ; Skeleton

OBJECTIVES: The purposes of this study were to evaluate the clinical characteristics of temporal bone metastasis (TBM) and to determine whether the characteristics differed according to primary malignancy. METHODS: We retrospectively analyzed data on 20 patients diagnosed with TBM between January 2000 and January 2017. Demographics, the period from diagnosis of primary malignancy to TBM diagnosis, the period from TBM diagnosis to death, the type and staging of primary malignancy, otologic manifestations, and TBM sites were assessed. After the primary malignancies were divided into solid cancers and hematologic malignancies, each parameter was compared between the two groups. RESULTS: The most common primary malignancy with TBM was lung cancer (45%). The most common otologic symptoms and signs were facial palsy (30.5%) and hearing loss (30.5%). The temporal squama (23%) and the facial nerve (20%) were the most commonly involved. Most TBMs occurred late in the disease process after the primary malignancy first metastasized to other organs. Hematologic malignancies metastasized significantly more frequently to the external auditory canal and the middle ear/mastoid compared to solid cancers (P=0.001 and P=0.004, respectively). CONCLUSION: If otologic manifestations such as facial palsy and hearing loss are presented in patients at advanced stages of malignancy, TBM of primary malignancy should be suspected. In addition, hematologic malignancies tend to metastasize to the external auditory canal and the middle ear cleft more commonly than solid cancers do.
Demography ; Diagnosis ; Ear Canal ; Ear, Middle ; Facial Nerve ; Facial Paralysis ; Head and Neck Neoplasms ; Hearing Loss ; Hematologic Neoplasms ; Humans ; Leukemia ; Lung Neoplasms ; Neoplasm Metastasis ; Retrospective Studies ; Temporal Bone

BACKGROUND: This study examined the change in the trabecular bone score (TBS), areal bone mineral density (aBMD), and osteoporosis in postmenopausal women who underwent thyrotropin (TSH)-suppressive therapy for treating papillary thyroid cancer after a total thyroidectomy procedure. METHODS: We evaluated 36 postmenopausal women who received a total thyroidectomy for papillary thyroid cancer and were undergoing TSH suppressive therapy with levothyroxine. Postmenopausal women (n=94) matched for age and body mass index were recruited as healthy controls. The aBMD and TBS of the lumbar spine were compared between dual energy X-ray absorptiometry (DXA) at baseline and at follow-up after an average of 4.92 years. RESULTS: There was no significant difference in the rate of diagnoses of osteoporosis, osteopenia, or normal bone status between the 2 groups during the baseline DXA evaluation. However, the TBS was significantly lower whereas aBMD did not show significant difference at the time of baseline DXA measurement (1st DXA, 1.343±0.098 vs. 1.372±0.06317, P < 0.001; 2nd DXA, 1.342±0.095 vs. 1.370±0.062, P < 0.001). The TBS and aBMD did not differ significantly between the initial and follow-up DXA images in both groups of TSH suppressive patients and controls. CONCLUSIONS: The average value of TBS and aBMD did not significantly change during the follow-up period. The TSH suppressive therapy was revealed as not a significant factor for the progressive deterioration of bone status during long term follow-up.
Absorptiometry, Photon ; Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Osteoporosis ; Postmenopause ; Spine ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin ; Thyroxine

Bone marrow necrosis (BMN) is a pathologic state which is derived from various disease entities. Most commonly, it is accompanied by hematologic malignancies such as acute leukemia. The patients with marrow necrosis are generally known to have dismal prognoses but variations exist according to early diagnosis. Here we report a case of BMN in an acute lymphoblastic leukemia patient with Philadelphia chromosome at presentation.
Bone Marrow* ; Early Diagnosis ; Hematologic Neoplasms ; Humans ; Leukemia ; Necrosis* ; Philadelphia Chromosome* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis

BACKGROUND: Intraosseous lipoma is a very rare lesion that constitutes no more than 0.1% of all bone tumors. We analyzed 21 cases of intraosseous lipoma at a single institution for clinical and radiographic characteristics. METHODS: A retrospective study was performed on 21 pathologically confirmed intraosseous lipomas treated in our hospital from 2000 to 2017. Simple X-ray and magnetic resonance imaging findings and medical records were reviewed. Patients' age, sex, and clinical symptoms were investigated. From the radiographic images, the site of the lesion, calcification, bony expansion, and stage of the lesion were evaluated. Correlations between the degree of involution and clinical symptoms were analyzed. RESULTS: The mean age of patients was 50 years (range, 20 to 67 years), and there were 13 males and eight females. The mean lesion size was 6.1 cm (range, 2.5 to 13.6 cm). The most common anatomical site of the lesion was the femur (seven cases), and three cases occurred in flat bones such as the ilium and scapula. Visual analogue scale score for pain was 3 to 6 in 15 patients. There were no complaints of functional limitation. There was no correlation between the degree of degeneration and clinical symptoms (p = 1.000). Curettage was performed as a surgical treatment in 20 patients, and bone graft was performed using a bone chip. Excision was performed in one patient. Pain was resolved in seven of 11 patients with a complaint of preoperative pain; intermittent pain remained in four cases. There was no local recurrence or malignant change during the follow-up. CONCLUSIONS: There was no correlation between the degree of degeneration and clinical symptoms. Pain was the most common clinical symptom, but it was rarely accompanied by functional limitation. However, it is important to distinguish it from other pain-inducing disorders. The incidence of intraosseous lipomas is low, and detection based on various imaging findings can be difficult. Clear understanding of the radiographic findings and symptoms of intraosseous lipoma is helpful for diagnosis and differentiation.
Bone Neoplasms ; Curettage ; Diagnosis ; Female ; Femur ; Follow-Up Studies ; Humans ; Ilium ; Incidence ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Scapula ; Transplants

BACKGROUND: Lung cancer is the leading cause of cancer-related deaths, patients with non-small cell lung cancer (NSCLC) usually have distant metastases, such as bone metastasis, brain metastasis, and lung metastasis. The purpose of this study was to explore the risk factors for bone metastasis in NSCLC patients. METHODS: A total of 176 cases of NSCLC were selected from May 2009 to May 2011, and patients were divided into two groups, namely the bone metastasis group and non-bone metastasis group. The general clinicopathological data of the two groups and analyzing the independent risk factors of bone metastasis were compared. RESULTS: In the general clinicopathological data of NSCLC patients. The thrombus or not and tumor-node-metastasis (TNM) stage were closely related to the occurrence of bone metastasis, and were statistically significant (all P<0.01). Prothrombin time, activated partial thromboplastin time, Fibrinogen, thrombin time, blood platelet, D-Dimer and alkaline phosphatase have significantly difference between the two groups (all P<0.05). Logistic regression analysis showed that fibrinogen, activated partial thromboplast in time, alkaline phosphatase, T4 phase, N3 phase and d-dimer were independent risk factors for bone metastasis in NSCLC patients. CONCLUSIONS Fibrinogen, alkaline phosphatase, T3, N2 stage and D-Dimer is the independent risk factors of bone metastases in patients with NSCLC.
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Aged ; Bone Neoplasms ; diagnosis ; secondary ; Carcinoma, Non-Small-Cell Lung ; pathology ; therapy ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Risk Factors