Osteoblastoma response to chemotherapy

Article Abstract:

Osteoblastoma is a rare tumor of bone. Most osteoblastoma patients are children or young adults; in about one-third of all cases, the affected bone is a vertebra in the spinal column. Osteoblastoma is generally a benign tumor. In some cases, aggressive behavior of osteoblastoma may be attributed to confusion of this type of tumor with low-grade osteosarcoma, a malignant bone tumor. In other cases, the recurrence of osteoblastoma is a result of incomplete surgical removal. The authors report the case of an eight-year-old boy who experienced rapid and massive tumor recurrence after surgery. The boy was first seen after injuring his neck, and received aspirin treatment for neck pain over several months. His neck X-ray was initially interpreted as normal, but after review, clinicians found indications of a tumor in C2, the second vertebra down from the head in the spinal column. Biopsy revealed the lesion to be osteoblastoma, and a month later the tumor mass was removed. However, within three months, the patient developed headaches and weakness; imaging with CT scan and MRI revealed a massive destructive lesion in the region of C2. Surgery was performed, but it was impossible to remove more than half of the mass. The patient was treated with high-dose methotrexate, doxorubicin, and cisplatin. MRI revealed that the tumor had already begun to shrink after the first cycle of chemotherapy. Chemotherapy was continued for a year; the size of the tumor mass continued to shrink a little after the discontinuation of chemotherapy. The boy has been stable for 33 months now; his hearing of higher pitches is reduced as a result of cisplatin treatment, but the patient is free of pain and has no obvious impairment of heart, liver, or kidney function. Surgery is the most appropriate treatment for osteoblastoma. However, the present case illustrates that if the tumor cannot be completely removed or if the tumor behaves particularly aggressively, then chemotherapy may provide good results. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer in children, Childhood cancer, Chemotherapy, Bone cancer

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Desmoplastic fibroma of bone

Article Abstract:

Desmoplastic fibroma is a rare form of bone tumor. This tumor is benign, which means that the cells do not spread to distant parts of the body, as cancer cells are wont to do. Nevertheless, the desmoplastic fibroma is aggressive, and is likely to recur unless treatment is equally aggressive. Desmoplastic fibroma is relatively rare; only nine cases were identified among more than 9,000 bone tumors treated at the Mayo Clinic. The authors identified a further 18 cases among over 20,000 referrals. Despite the rarity of this tumor, it is important to review, since it is possible to confuse the desmoplastic fibroma with more indolent tumors and possibly use inappropriate treatment. Among the cases reviewed, treatment data were available for 19. Ten of these patients were treated with lesional curettage. In this procedure, the tumor and the affected area is scraped out of the bone. Two patients remained free of tumor for 14 and 44 years. However, the remaining eight patients experienced tumor recurrence, indicating that curettage is not a satisfactory method of treatment. In seven patients, the tumor area was cut out, along with a wide margin of apparently normal bone. Follow-up has averaged seven years in this group; there have been no recurrences. One patient of the 19 developed recurrence after a surgical resection in which wide margins were not excised. The remaining patient has received no treatment; his hip tumor has progressed slowly during 11 years, but has not progressed to the point where the removal of half the pelvis can be justified. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Fibromas, Fibroma

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Chondrosarcoma of bone in children

Article Abstract:

Chondrosarcomas are cartilaginous tumors, and chondrosarcomas of bone occur primarily in adults. The condition can occur in children, however, and in some reports in the medical literature the condition is said to have a poorer prognosis in children than in adults. But this was not supported by the current study of 47 chondrosarcomas in patients under the age of 17. Only one of the chondrosarcomas was of high grade. The low-grade histological appearance of the other tumors was reflected in the long-term follow-up of the patients for an average of eight years, during which time metastatic spread of the tumors was not observed. The treatment of chondrosarcoma is surgical, and although the prognosis is favorable, local recurrence and the necessity of further surgery is not uncommon. The difference between the outcome of chondrosarcoma in the present report and that in previous reports may be due to differences in diagnostic criteria used for defining chondrosarcoma. In the current study, the authors did not consider cases of the more malignant chondroblastic osteosarcoma, although cases of this tumor would be classified with chondrosarcoma by others. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Demographic aspects, Tumors in children, Pediatric tumors, Chondrosarcoma

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