Bone tumour

Bone diseases with osteoblast activity (Paget s disease, rachitis, osteomalacia, bone tumours, aseptic bone necrosis, fracture healing)... 

Figure 7.22 (c-e) The primitive intranuclear cubic membrane in cells of a human bone tumour. 

In this study, dogs with spontaneous osteosarcomas were used as a pathological animal model to examine accumulation of Re-HEDP in bone tumour lesions. As reported, owing to in vivo oxidation of rhenium, Re-HEDP is washed out faster from normal bone than from abnormal bone tumour lesions. The resulting increase in the tumour to normal bone uptake ratio is a favourable feature for a therapeutic bone agent. For this reason, the tumour to normal bone uptake ratio in the image recorded was calculated approximately... 

Hems G, Mole RH. 1966. The relative toxicities of radium 226, plutonium 239 and strontium 90 for bone tumour induction. Br J Radiol 39 719-726. 

Kowalewski K, Rodin AE. 1964. Strontium-89-induced bone tumour in the rat. Can J Surg 7 204-215. 

Mole RH. 1963. Bone tumour production in mice by strontium-90 Further experimental support for a two-event hypothesis. Br J Cancer 17(3) 524-531. 

DP MacErlean, DG Shanik and EA Martin (1978) Transcatheter embolisation of bone tumour arteriovenous malformations. Br J Radiol 606 414-419... 

Matsumine, A., Myoui, A., Kusuzaki, K., Araki, N., Seto, M., Yoshikawa, H., Uchida, A. Calcium hydroxyapatite ceramic implants in bone tumour surgery. A long-term follow-up study. J. Bone Joint Surg. Br. 86, 719-725 (2004)... 

Bone scintigraphy will show an area of increased uptake around the postero-medial aspect of the tibia within a few days of the onset of symptoms. Whilst being sensitive, it will not rule out other differential diagnoses including infection and bone tumour and involves a relatively high radiation dose. 

The triradiate cartilage and ischiopubic synchondrosis may be seen as radiolucent structures or in the older child, it may appear as an area of irregular ossification and this should not be confused with a fracture or bone tumour. Irregular areas of ossification may also be seen around the acetabulum and the iliac crest, which again are features of normal development... 

Mankin HJ, Gebhardt MC (1996) Long-term results of allograft replacement in the management of bone tumours. Clin Orthop Relat Res 324 86-97... 

These effects depend upon the nature of the radioactive material, its route of entry and concentration in a particular tissue, and due mainly to cr or p particles. Lung cancer has been observed in miners following inhalation of radon, and severe anaemia and bone tumour following ingestion of radium in luminising dial painters. 

Pagani JJ (1983) Biopsy of focal hepatic lesions. Comparison of 18 and 22 gauge needles. Radiology 147 673-675 Piccinino F etal. (1986) Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J Hepatol 2 165-173 Poe RH etal. (1984) Predicting risk of pneumothorax in needle biopsy of the lung. Chest 85 232-235 Pramesh CS et al. (2001) Core needle biopsy for bone tumours. Eur J Surg Oncol 27 668-671... 

Overall, the primary success rates of RFA in liver, kidney, lung and bone tumours range from 70% to more than 95%, depending on the tumour localization and type - assuming the above-mentioned advice has been considered. 

Thermal Ablation in Osteoid Osteomas Results of Thermal Ablation in Osteoid Osteomas 246 Thermal Ablation in Malignant Bone Tumours 246 Results of Thermal Ablation in Malignant Bone Tumours 247 Complications 248 Summary 249 References 250... 

The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1 2000. 

The major indication for thermal ablation in bone tumours is pain. Secondarily, local tumour destruction may support destruction of the tumoral matrix, which may enhance repair processes and consequently prolong the process of functional preservation. 

In this setting, thermal ablation will be mainly a symptomatic, supportive (palliative) therapy, which can also be applied in conjunction with other therapies such as resection, radiotherapy or chemotherapy. In contrast to the treatment of malignant tumours, local thermal ablation is considered the method of choice in treatment of symptomatic benign bone tumours such as osteoid osteomas. 

While primary malignant bone tumours are rare, bone metastases are a common finding among all malignancies. More than 50% of all patients with metastatic disease to the musculoskeletal system will present with symptoms - mainly pain - and will have severe constraints regarding quality of life for their remaining lifetime. 

Results of Thermal Ablation In Malignant Bone Tumours... 

It remains unclear whether the combination therapy of thermal ablation together with cemen-toplasty, for example, is superior to a single therapy (Fig. 9.3). Nevertheless, there are a few cases of painful bone tumours with a dense stroma that hinders cement injection. In cases such as these, thermal ablation may soften the tumour s stroma allowing subsequent cement instillation (Schaefer et al. 2002 Fourney et al. 2003 Hierholzer et al. 2003 Masala et al. 2003 Wenger 2003 Halpin et al. 2004 Masala et al. 2004 Halpin et al. 2005 Mont Alverne et al. 2005 Cheung et al. 2006 Brodano et al. 2007 Calmels et al. 2007 Jakobs et al. 2007). 

Table 9.2. Primary and secondary success rate of different ablation therapies in malignant bone tumours in terms of pain relief. Cryo Cryopiasty, KP kyphoplasty, OP osteoplasty, R radiation therapy, RFA radiofrequency ablation)...

Furthermore, in malignant bone tumours, when surgery and/or radiotherapy are no longer appUca-ble, these methods offer a new, very effective therapeutic option for pain management. The exact role of minimally invasive ablative therapies among the huge armamentarium of different treatment options is not fully defined therefore, additional study evidence must be obtained to appreciate the high potential of these therapies. 

Another study examined the relationship between fluoride levels and osteosarcoma, a rare malignant bone tumour, commonly occiuring in the age group of 10-24 years. This study was planned in order to analyse serum levels of fluoride in patients of osteosarcoma and fluoride content of their drinking water by comparing 10 patients of osteosarcoma and 10 healthy volxmteers (who served as control) [31 ]. 

Saifiiddin A, Burnet SJD, Mitchell R (1998) Pictorial review ultrasonography of primary bone tumors. Clin Radiol 53 239-246 Saifuddin A, Mitchell R, Burnett SJD et al (2000) Ultrasound-guided needle biopsy of primary bone tumours. J Bone Joint Surg Br 82 50-54... 

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