Adamantinoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Adult ; Diagnosis, Differential ; Female ; Femur ; Follow-Up Studies ; Humans ; Humerus ; Ilium ; Keratins ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Retrospective Studies ; Sarcoma, Ewing ; pathology ; Sarcoma, Synovial ; pathology ; Tibia ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the radiologic and pathologic features of primary intermediate hemangioendothelioma of the bone.

METHODSFive cases of primary intermediate hemangioendothelioma of bone encountered in the past three years were enrolled into the study. The clinical, radiologic, pathologic and immunohistochemical features of the tumors were reviewed.

RESULTSThe patients included 3 children with Kaposiform hemangioendothelioma and 2 elderly with retiform hemangioendothelioma. Four of the cases affected long bones and the remaining case affected the clavicle. One case showed multifocal involvement of the humerus. Radiologically, the tumors showed borderline to low-grade bony destruction, with various degrees of cortical defect. Intralesional or perilesional bone formation was demonstrated in 4 cases and radial spicules were seen in 1 case. The histopathologic features of primary intermediate hemangioendothelioma of bone were similar to those of soft tissue, except for the presence of reactive bone formation. Immunohistochemically, the tumor cells were positive for CD31 (5/5), CD34 (5/5), vimentin (5/5) and smooth muscle actin (3/5) but negative for cytokeratin and epithelial membrane antigen.

CONCLUSIONSPrimary intermediate hemangioendothelioma of bone is a distinct entity and similar histologic classification applies as in its soft tissue counterparts. Comparison of the biologic behavior requires long-term follow-up studies.

Actins ; metabolism ; Antigens, CD34 ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Child ; Clavicle ; pathology ; Diagnosis, Differential ; Female ; Femur ; pathology ; Hemangioendothelioma ; diagnostic imaging ; metabolism ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Humerus ; pathology ; Immunohistochemistry ; Infant ; Kasabach-Merritt Syndrome ; diagnostic imaging ; metabolism ; pathology ; Male ; Middle Aged ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Radiography ; Sarcoma, Kaposi ; diagnostic imaging ; metabolism ; pathology ; Vimentin ; metabolism

To investigate the clinical characteristics of chondroblastoma with an emphasis on lesions located in the long bone diaphysis, we reviewed the clinical data of 7 patients with histologically proven chondroblastoma treated in Tianjin Medical University Cancer Hospital and Fudan University Cancer Hospital between January 1995 and May 2009. There were two rare cases of chondroblastoma in the long bone diaphysis. One patient with a lesion in the tibial diaphysis underwent intralesional curettage and bone grafting, and the postoperative bone function was measured as excellent according to the Enneking scoring system. The patient was still alive upon follow-up at 60 months. The other patient with a lesion in the humeral diaphysis underwent resection, and the postoperative bone function was excellent at 48 months, at which there was no evidence of recurrence or metastasis. Thus, except for the distinctive site of the long bone diaphysis, which made diagnosis difficult, the patients' ages, symptoms, X-ray and CT images, treatment, and prognosis were in accordance with typical lesions in the epiphysis and metaphysis. The diagnosis of chondroblastoma in the long bone diaphysis significantly depends on histopathologic characteristics.
Adolescent ; Adult ; Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Bone Transplantation ; methods ; Chondroblastoma ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Curettage ; methods ; Diaphyses ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Humerus ; diagnostic imaging ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Tibia ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo evaluate the clinical results of ulnar osteotomy and internal fixation in treating old anterior dislocation of radial head in children.

METHODSFrom Jan.2004 to Jan.2010, 18 patients with old anterior dislocation of radial head were treated with open reduction for radial head and ulnar osteotomy and internal fixation, including 12 males and 6 females with an average age of (6.9 +/- 1.3) years (3 to 15 years). Among them, 15 cases had history of external injury, from injury to operation was for 5-65 months with an average of (24.0 +/- 5.5) months. Limitation of activity occurred in all patients including flexion and extension of elbow joint and rotation of forearm, without radial nerve injury and obviously radial head deformation.

RESULTSAll incisions obtained primary healing and no nonunion, re-dislocation of radial head and nerve injury were found. All patients were followed up from 9 to 38 months with an average of (17.0 +/- 4.5) months. Union time of fracture was from 2.3 to 3.9 months with an average of (2.8 +/- 0.5) months. Postoperative activity in flexion and extension of elbow joint and rotation of forearm improved significantly compared with preoperative. The clinical effects were evaluated according to Zhuyukui criteria, 14 patients got excellent results, 3 good, 1 fair.

CONCLUSIONUlnar osteotomy and internal fixation in treating old anterior dislocation of radial head in children can obtain satisfactory results and effectively improve the activities in flexion and extension of elbow joint and rotation of forearm and prevent re-dislocation of radial head.

Adolescent ; Bone Plates ; Child ; Child, Preschool ; Female ; Humans ; Humerus ; diagnostic imaging ; surgery ; Joint Dislocations ; surgery ; Male ; Osteotomy ; methods ; Tomography, X-Ray Computed ; Ulna ; surgery

Adult ; Aged ; Bone Transplantation ; methods ; Female ; Fracture Fixation, Intramedullary ; methods ; Humans ; Humeral Fractures ; diagnostic imaging ; surgery ; Humerus ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Young Adult

Parosteal osteosarcoma (POS) is the most common form of surface osteosarcoma. Its symptoms are insidious and its duration prior to diagnosis is considerably longer than that of other types of osteosarcoma. We report a case of POS with a growing mass but no evidence of metastasis. This tumor, which was diagnosed as calcified hematoma with benign characteristics, was incompletely resected in our hospital 21 years before the diagnosis of recurrence. The patient underwent a wide en bloc resection in our hospital and was free of symptoms, with no signs of tumor recurrence or metastasis during a 53-month follow-up.
Adult ; Bone Neoplasms ; diagnosis ; pathology ; surgery ; Diagnostic Errors ; Follow-Up Studies ; Humans ; Humerus ; Magnetic Resonance Imaging ; Male ; Neoplasm Recurrence, Local ; Osteosarcoma, Juxtacortical ; diagnosis ; pathology ; surgery ; Radiopharmaceuticals ; Technetium Tc 99m Medronate ; Tomography, Emission-Computed ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVEAfter chemotherapy was used to treat patients with malignant bone tumors in 1970s, amputation, which was the typical intervention in the 1980s, has been substituted with limb-sparing surgery. This article reported the surgical indications, operative methods, operative effects, and complications of prosthetic replacement of the proximal humerus after the resection of bone tumors.

METHODSFrom April 2004 and December 2008, prosthetic replacement was performed in 18 patients with proximal humerus tumors, including 7 patients with osteosarcoma, 5 patients with chondrosarcoma, 3 patients with giant cell tumor (GCT) of the bone, 1 patient with GCT of the bone combined with an aneurysmal bone cyst, and 1 patient with metastatic bone tumors. Using the Enneking staging system, 7 osteosarcomas and 3 chondrosarcomas were at stage Ib, and 3 GCTs and 2 chondrosarcomas were at stage Ib. The patient with metastatic bone tumors reported severe pain.

RESULTSThe follow-up ranged 5-61 months (mean, 29 months) and showed that 1 patient with osteosarcoma died 19 months after surgery. Local recurrence presented in 1 patient with GCT, 1 patient had inner infection in the area of surgery, and 2 patients had shoulder subluxation after the operation. There was no prosthetic loosening in any patient. The abduction angle of the shoulder was 8 degrees-35 degrees, and circumgyrate angle was 18 degrees-25 degrees, with flexion 35 degrees-90 degrees and extension 25 degrees-42 degrees. According to the functional score developed by the International Society of Limb Salvage, scores ranged between 18 and 29 points, with an average of 24 points.

CONCLUSIONSThe prosthesis replacement for the patients with bone tumors in the proximal humerus is an appropriate procedure with satisfactory therapeutic outcomes; however, many complications should be noted and long-term therapeutic effect needs further investigations.

Adolescent ; Adult ; Arthroplasty, Replacement ; Bone Neoplasms ; diagnostic imaging ; pathology ; surgery ; Chondrosarcoma ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Giant Cell Tumor of Bone ; diagnostic imaging ; pathology ; surgery ; Humans ; Humerus ; Lung Neoplasms ; secondary ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Osteosarcoma ; diagnostic imaging ; pathology ; secondary ; surgery ; Prosthesis Implantation ; Radiography ; Range of Motion, Articular ; Young Adult

OBJECTIVETo study the clinicopathologic and radiologic features of dedifferentiated chondrosarcoma, focusing on its diagnosis and differential diagnosis.

METHODClinical, radiological and pathologic findings of 14 cases of dedifferentiated chondrosarcoma (including biopsy and surgical specimens) were analyzed by hematoxylin and eosin stained sections and immunohistochemistry.

RESULTSThe mean age of patients was 52 years. The male-to-female ratio was 9:5. The most common sites of involvement were pelvis, femur and humerus, similar to the conventional chondrosarcoma. Radiologically, they were malignant tumors with dimorphic pattern. Grossly, central chondrosarcomas were more common than those of the peripheral. An essential histological feature of dedifferentiated chondrosarcoma was an abrupt interface between the low-grade cartilaginous tumor and high-grade anaplastic sarcoma. The most common dedifferentiated components were osteosarcoma, malignant fibrous histocytoma and fibrosarcoma. False negative diagnosis and erroneous diagnosis were frequent when only one-time biopsy was available.

CONCLUSIONSDedifferentiated chondrosarcoma is a rare subtype of chondrosarcoma with poor prognosis, which has different features of clinical manifestation, imaging features and pathological characteristics, compared to conventional chondrosarcoma and chondroblastic osteosarcoma.

Adult ; Aged ; Bone Neoplasms ; diagnostic imaging ; drug therapy ; pathology ; surgery ; Cell Differentiation ; Chondrosarcoma ; diagnostic imaging ; drug therapy ; pathology ; surgery ; Chondrosarcoma, Mesenchymal ; pathology ; Diagnosis, Differential ; Female ; Femoral Neoplasms ; diagnostic imaging ; drug therapy ; pathology ; surgery ; Follow-Up Studies ; Humans ; Humerus ; pathology ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Osteosarcoma ; pathology ; Pelvic Bones ; pathology ; Radiography ; Vimentin ; metabolism ; Young Adult

Age estimation by the measurement method is to get the data such as the length, width, thickness, area of the ossification center, transverse diameter of the metaphysis, transverse diameter of osteoepiphysis, width of the epiphyseal line and the ratio between the diaph and the epiphyseal, by measuring the different bones of human in different ages with the radiological technology and to explore the relationship between these data and the life age by statistics. According to the relationships the personal life age may be estimated. In this article the measurement methods above mentioned and its application in age estimation were reviewed.
Age Determination by Skeleton/methods* ; Bone Development/physiology* ; Cervical Vertebrae/diagnostic imaging* ; Female ; Femur/diagnostic imaging* ; Forensic Anthropology/methods* ; Hand Bones/diagnostic imaging* ; Humans ; Humerus/diagnostic imaging* ; Male ; Retrospective Studies ; X-Ray Film

Albendazole ; therapeutic use ; Anthelmintics ; therapeutic use ; Bone Diseases, Infectious ; diagnostic imaging ; pathology ; therapy ; Bone Plates ; Curettage ; Echinococcosis ; diagnostic imaging ; drug therapy ; pathology ; Humans ; Humerus ; parasitology ; surgery ; Male ; Middle Aged ; Radiography