Editorial September- December 2021

Editorial | Volume 7 | Issue 3 | JBST Sep – Dec 2021 | Page 1 | Yogesh Panchwagh, Ashish Gulia, Ashok Shyam. DOI: 10.13107/jbst.2021.v07i03.51

Author: Dr. Yogesh Panchwagh [1], Dr. Ashish Gulia [2] & Dr. Ashok Shyam [3],[4]

[1]Orthopaedic Oncology Clinic, Pune, India.
[2]Orthopedic Oncology Services, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
[3]Indian Orthopaedic Research Group, Thane, India
[4]Sancheti Institute for Orthopaedics &Rehabilitation, Pune, India

Address of Correspondence
Dr. Yogesh Panchwagh.
Orthopaedic Oncology Clinic, 101, Vasant plot 29, Bharat Kunj
Society – 2, Erandwana, Pune – 38, India.
Email: drpanchwagh@gmail.com


Unlocking …the new normal.

The pandemic has entered its third year. Countries around the world witnessed the third wave, characterized by a rapid rise in number of cases and a dramatic fall in those numbers as well.  As the history of any pandemic goes, one would expect further reduction in severity and mortality worldwide.

One striking feature of this Covid 19 pandemic has been the quick development of vaccines and its largescale deployment in most countries of the world. Keeping the initial hesitancy and availability issues aside, there is ample evidence that the vaccines have altered the course of the pandemic which otherwise would have seen worse outcomes.

The world has realized that it is futile to expect a completely covid free world. Many have accepted the reality that humanity will coexist in future with the virus and its various mutations. The strict lockdowns and restrictions imposed in the earlier days have lost their significance particularly in the post vaccine world. As a result, the process of unlocking has already started in a few countries and probably would be the norm very soon in others.

It’s certainly a relief for certain sections of society. The now empty school corridors would again witness kids resuming uninterrupted schooling and other activities along with their peers. Patients with other life threatening diseases, including cancer would continue getting treated and operated without having to worry about interruption in care or best practices. Travel would become easier with fewer restrictions. It would be possible to expect a life reasonably similar to pre-covid world in a few months. The medical fraternity has garnered enough experience and is geared to adapt, evolve and manage challenging situations. It would continue to do so until any unforeseen catastrophic event throws the world out of gear again.

The patient care, peer interactions, research and publication in the various specialities hopefully should be back on track very soon. Unlocking, hopefully, would be the new normal this year.

Dr. Yogesh Panchwagh
Dr. Ashish Gulia
Dr. Ashok Shyam


How to Cite this article: Panchwagh Y, Gulia A, Shyam A. Editorial.|  Journal of Bone and Soft Tissue Tumors | Sep-Dec 2021; 7(3):1.

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Pathologic Fractures Secondary to Primary Non-Hodgkin’s Lymphoma of Bone: A Report of Two Cases Treated with Surgery

Case Report | Volume 7 | Issue 3 | JBST September – December 2021 | Page 16-19 | Abigail R Tud, Celestine Marie G Trinidad. DOI:0.13107/jbst.2021.v07i03.61

Author: Abigail R Tud [1], Celestine Marie G Trinidad [2]

[1] Musculoskeletal Tumor Unit, Philippine Orthopedic Center, Quezon City, Manila, Philippines.

[2] Department of Pathology, Philippine Orthopedic Center, Quezon City, Manila, Philippines.

Address of Correspondence
Dr. Abigail R Tud,
Musculoskeletal Tumor Unit, Philippine Orthopedic Center, Quezon City, Manila, Philippines.
E-mail: abitud.pocmtu@gmail.com


Abstract

Background: Primary lymphoma of bone (PLB) is a rare condition accounting for <2% of lymphomas among adults. Diagnosis is confirmed through clinical features, radiologic findings, and immunohistochemical studies. Treatment consists primarily of chemotherapy and radiotherapy. A lack of consensus remains, however, regarding the role of surgery on prognosis. Interventions with potential to improve quality of life therefore warrant further investigation. The authors report two cases of PLB treated with surgery, with favorable outcomes.
Case Presentation 1: A 21-year-old female presented with the left knee pain unaccompanied by constitutional symptoms. Imaging studies showed an isolated pathologic fracture of the left proximal tibia. Histopathology showed an atypical proliferation of large round cells, which stained diffusely and strongly positive for CD20. 90% of the cells also stained positive for the proliferation marker Ki-67. These findings were consistent with a high-grade B-Cell non-Hodgkin’s lymphoma (NHL). The tibial lesion was managed with direct fracture reduction and knee arthrodesis. Six cycles of chemotherapy were completed. Current Musculoskeletal Tumor Society (MSTS) score is 28/30, without evidence of recurrence 3 years post-surgery.
Case Presentation 2: A 69-year-old male sustained a pathologic subtrochanteric fracture after falling on his left hip. Diagnostic imaging revealed no other osseous lesions. Biopsy specimens showed a proliferation of atypical lymphoid cells, and on immunohistochemistry, these were diffusely and strongly positive for lymphocyte common antigen (CD45) and CD20. This was consistent with a high-grade B-Cell NHL. After proximal femoral nailing was performed, no further treatment was given. The patient is currently 2 years post-surgery with MSTS score of 28/30, and no signs of recurrence or metastases.

Conclusion: Current approach to treatment of PLB is multi-modal, but guidelines for surgical intervention are unavailable. Few reports have been made on outcomes after surgery. Pathologic fracture fixation is an option among select patients, affording satisfactory functional outcomes while minimizing morbidity.

Keywords: Knee resection arthrodesis, Non-Hodgkin’s lymphoma of bone, pathologic fracture, primary lymphoma of bone.


References:

1. Scoccianti G, Rigacci L, Puccini B, Campanacci DA, Simontacchi G, Bosi A, et al. Primary lymphoma of bone: outcome and role of surgery. Int Orthop 2013;37:2437-42.
2. Tsoucalas G, Papaioannou TG, Mainta I, Thomaidis V, Fiska A. A rare case of a non-Hodgkin’s lymphoma presented as a single bone lesion. Biomed J Sci Tech Res 2018;3:1-3.
3. Singh T, Satheesh CT, Lakshmaiah KC, Suresh TM, Babu GK, Lokanatha D, et al. Primary bone lymphoma: A report of two cases and review of the literature. J Can Res Ther 2010;6:296-8.
4. Coley BL, Higginbotham NL, Groesbeck HP. Primary reticulum cell sarcoma of bone; summary of 37 cases. Radiology 1950;55:641-58.
5. Jacobs AJ, Michels R, Stein J, Levin AS. Socioeconomic and demographic factors contributing to outcomes in patients with primary lymphoma of bone. J Bone Oncol 2015;4:32-6.
6. Jawad MU. Primary lymphoma of bone in adult patients. Cancer 2010;116:871-9.
7. Kitsoulis P, Vlychou M, Papoudou-Bai A, Karatzias G, Charchanti A, Agnantis NJ, et al. Primary lymphomas of bone. Anticancer Res 2006;26:325-38.
8. Mavrogenis AF, Angelini A, Pala E, Zinzani P, Ruggieri P. The role of surgery for haematologic neoplasms of bone. Acta Orthop Belg 2012;78:382-92.
9. Messina C, Christie D, Zucca E, Gospodarowicz M, Ferreri AJ. Primary and secondary bone lymphomas. Cancer Treatment Rev 2015;41:235-46.
10. Bhagavathi S, Fu K. Primary lymphoma of bone: Areview. Semin Diagn Pathol 2014;31:48-52.
11. Bhagavathi S, Micale MA, Les K, Wilson JD, Wiggins ML, Fu K. Primary bone diffuse large B-cell lymphoma. Am J Surg Pathol 2009;33:1463-9.

 


How to Cite this article: Tud AR, Trinidad CMG | Pathologic fractures secondary to primary non-Hodgkin’s lymphoma of bone: A report of two cases treated with surgery. | Journal of Bone and Soft Tissue Tumors | Sep-Dec 2021; 7(3): 16-19.

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AI in Logistics and Supply Chain Management Market Report 2026

AI in logistics

Weighing this many data points while accounting for the many variables involved is nearly impossible for human cognitive functions. AI can assess demand in future supply chains and simulate anomaly events that could disrupt operations. If logistics and supply chains are to support these business process transformations, AI adoption becomes essential. Underpinning a large portion of businesses’ operations are robust logistics and supply chain transformations, which ensure the swift movement of goods and services globally.

best dealer management systems: Features, integrations, and top fit for your business

The technology enables cleaner transportation options through route optimization that cuts fuel consumption. McKinsey reports that dynamic optimization of routing https://power-at-work.com/lifts-streamlining-logistics-in-high-rise-construction-projects/ and freight contracting reduces both costs and environmental impact. AI provides data analytics for sustainable production, eco-friendly logistics, and greener supply chain practices.

  • The report, authored by Kearney and presented by Penske Logistics for the Council of Supply Chain Management Professionals, identifies five structural forces that continue to reshape the macro environment.
  • Resiliency of pharmaceutical supply chains has turned into a board level issue.
  • Companies must implement controlled data versioning, comply with privacy regulations, and balance cost with accuracy while protecting against malicious data manipulation that could skew AI performance.
  • AI-driven supply chain planning integrates machine learning, real-time data analytics, and external risk monitoring to anticipate disruptions before they materialize.

Top 11 AIaaS to Enhance Business Efficiency

The AI logistics pharma platforms are re-inventing the flow of pharmaceutical products across the global networks. The smart logistics pharma industry solutions are designed with AI that helps in optimizing routes, carrier selection, warehouse operation, and real-time monitoring of cold chains. AI will play a role in pharmaceutical inventory management in 2026 based on autonomous inventory optimization. AI will keep recalibrating reorder points, safety stock and allocation strategies on multi-echelon networks.

Terminal operating systems: Modules, features, and top providers

  • AI models help businesses analyze existing routing and track route optimization.
  • Companies using AI-based demand forecasting lower inventory holding costs while improving order fulfillment rates.
  • This makes the last mile busier than ever and ripe for a technology disruption.
  • Artificial intelligence in turn is quickly becoming a strategic enabler in the worlds of logistics, inventory control and the overall coordination of a supply chain.
  • Each category addresses distinct operational challenges and highlights significant opportunities.

Early adopters of warehouse automation achieve fulfillment accuracy rates exceeding 99.5%. The Tariff Chaos post covers how trade volatility is actually accelerating AI adoption in logistics by making manual decision-making too slow and too costly. That creates a compliance-meets-operations use case that teams should understand. Logistics ranks among the top three industries for AI ROI potential, averaging 190% returns on AI investments. The 35% adoption rate means early movers capture disproportionate competitive advantage.

AI in logistics

How artificial intelligence is transforming logistics

A digital twin is an imaginary replica of the physical supply chain, which responds to real-time processes, assets, and flows. Digital twins can be used to enable pharmaceutical firms to simulate situations, analyze the risks, and test their decisions before deploying them in the real world, all using AI. The AI inventory management pharma solutions are changing the manner in which businesses maintain balance between stock and working capital efficiency.

This system is now being expanded to mid-tier suppliers and transportation rate negotiations. Research shows up to 90% of routine logistics manager tasks are automatable (e.g., via tools like predictive analytics), while mechanics and technicians face low automation risk. The shift reduces clerical roles but boosts demand for data analysts, AI supervisors, and decision-makers.

Data sharing is both a technical and governance challenge — see our logistics AI governance guide for approaches to multi-party AI accountability. AI success has become an operating model challenge, not simply a tool to be implemented where available. Organizations that master integration, change management, and outcome measurement will pull ahead, while those waiting for better technology or lower prices will fall further behind.

Dynamic route optimization

  • Prolifics helps enterprises operationalize real-time intelligence by modernizing data pipelines, enabling AI-ready architectures, and embedding intelligence directly into operational workflows.
  • The technology becomes increasingly accurate in future load-to-carrier matchings as it learns from millions of performed transactions each day.
  • The greatest returns begin in back-office workflows and visibility enhancements, with expanding potential in warehouses, sorting, and last-mile delivery.
  • Collectively, these six categories enable logistics firms to target cost reductions between 10% and 25% percent across operational pools such as selling, general, and administrative (SG&A), last-mile delivery, sorting, and warehouse management.
  • This paper examines how AI-driven sustainment can transform logistics operations in the Indo-Pacific, aligning with the Army’s multi-domain operations (MDO) doctrine and ensuring combat effectiveness in a highly contested theater.

In 2026, labor shortages and surging e-commerce demand are accelerating adoption, with facilities reporting 25–30% reductions in labor costs and fulfillment rates up to three times faster than traditional methods. Autonomous systems and AI integration allow warehouses to maintain near-perfect accuracy while scaling operations efficiently across thousands of facilities. Companies are restructuring supplier networks, adopting just-in-case (JIC) inventory models, and implementing AI-driven forecasting to anticipate and mitigate disruptions. The objective is to maintain operational continuity while balancing cost efficiency with risk https://ulstergrandprix.net/meet-the-sponsors-ifs-logistics/ management.

It addresses the challenges posed when communications are denied, disrupted, intermittent, or limited, allowing units to continue operations without relying on central servers. Artificial intelligence is involved at the mission planning stage to create a route that bypasses Russian air defense zones. The Ministry of Defence explained that the neural network onboard the drones also helps distinguish decoys from combat equipment. The algorithm compares object geometry, surface characteristics and engine heat signatures to improve target identification and ensure effective use of the system.

AI in logistics

Because these areas yield fast results, businesses concentrate on risk management, freight optimization, and workflow automation. Despite shippers’ growing expectations that their LSP partners offer AI capabilities, AI adoption among LSPs still lags significantly. (See Exhibit 2.) About 40% report deploying AI beyond pilots, yet only one in ten have embedded AI into core operations at scale. Only 13% report measurable value—such as improvements in unit costs, service levels, or margins—from embedding AI into daily operations.

AI in logistics

AI in logistics involves analyzing vast amounts of data to optimize operations and reduce inefficiencies. The Corporate Sustainability Reporting Directive requires Scope 3 emissions reporting across logistics chains. AI-assisted emissions calculation must comply with European Sustainability Reporting Standards (ESRS) methodology and survive external audit. Logistics firms handling goods for CSRD-reporting customers face indirect compliance pressure even if they are below direct CSRD thresholds. The World Economic Forum’s 2025 Supply Chain Governance Report found that 78% of logistics companies lack contractual clarity on AI accountability in multi-party operations.

Analysis of X-ray Patterns in Infection and Tumor

Cases Series | Volume 7 | Issue 2 | JBST May – August  2021 | Page 5-8 | Dominic Puthoor. DOI:10.13107/jbst.2021.v07i02.47

Author: Dominic Puthoor[1]

[1]Department of Orthopaedic Oncologist, Amala Institute of Medical Sciences, Thrissur, Kerala, India.

Address of Correspondence
Dr. Dominic Puthoori,
Department of Orthopaedic Oncologist, Amala Institute of Medical Sciences, Thrissur, Kerala, India.
E-mail: dkputhur@gmail.com


Abstract

Introduction: In diagnosis of bone tumor, X-ray is as important, if not more important than pathology report. However, X-ray had specific disadvantage. Tumor mimics especially infection can have same appearance as tumor in the X-ray. In this article, author analyzes the different patterns of X-ray changes common to tumor and infection and points outs that X-ray depicts the aggressiveness of the condition rather than a specific diagnosis.

Keywords: X-ray, Bone tumor, Tumor mimics.


References:
1. Mandal AK, Chaudhary S. Text Book of Pathology. Synapse Books. 1st ed. New Delhi, India: Avichal Publishing Company; 2010. p. 51, 113.
2. Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran Pathological Basis of Diseases. Amsterdam, Netherlands: Elsevier; 2010. p. 1205-35.
3. Enneking WF, Bertoni F, The staging system for benign and malignant tumours of the musculoskeletal system. In: Nadarajan M, editors. Article Written in Principles of Orthopedic Oncology; 1997. p. 112-20.
4. Shimose S, Sugita T, Kubo T, Matsuo T, Nobuto H, Ochi M. Differential diagnosis between osteomyelitis and bone tumors. Acta Radiol 2008;49:928-33.
5. Stacy GS, Kapur A. Mimics of bone and soft tissue neoplasms. Radiol Clin North Am 2011;49:1261-86.
6. Dorman HD, Czerniak B. Bone Tumors. 1st ed. United States: Mosby; 1998. p. 22.
7. Puthur D. X-ray patterns common to infection and tumours. Kerala J Orthop 2014;27:73-7.
8. Malawer MM, Sugarbaker PH. Musculoskeletal Cancer Surgery: Treatment of Sarcomas and Allied Diseases. Berlin, Germany: Springer; 2001. p. 59, 60.
9. Sutton D. Text Book of Radiology and Imaging. 7th ed. United Kingdom: Churchill Livingstone; 2003. p. 1153-60.
10. Miwa S, Otsuka T. Practical use of imaging technique for management of bone and soft tissue tumors. J Orthop Sci 2017;22:391-400.


How to Cite this article: Puthoor D | Analysis of X-ray patterns in infection and tumor. | Journal of Bone and Soft Tissue Tumors | May-August 2021; 7(2): 5-8.

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Malignant Transformation of Monostotic Fibrous Dysplasia after Surgery: A Case Report

Case Report | Volume 7 | Issue 2 | JBST May- August 2021 | Page 1-4 | Abigail R. Tud, Cesar D. Dimayuga.

DOI:10.13107/jbst.2021.v07i02.46

Author: Abigail R. Tud[1], Cesar D. Dimayuga[1]

[1]Department of Orthopedics, The Medical City, Ortigas Avenue, Pasig City, Philippines 1605.

Address of Correspondence
Dr. Abigail R. Tud,
Musculoskeletal Tumor Unit, Philippine Orthopedic Center, Banawe corner Maria Clara Streets, Santa Mesa Heights, Quezon City, Metro Manila, Philippines 1114.
E-mail: abitud@gmail.com

 


Abstract

Introduction: Fibrous dysplasia (FD) is a benign lesion characterized by replacement of normal bone with abnormal connective tissue. It occurs in monostotic or polyostotic forms, with a rare but proven potential for malignant transformation. Symptoms of acute pain, rapid swelling, or an enlarging mass should increase suspicion for possible sarcomatous change. Complete surgical resection is the mainstay of treatment, and chemotherapy is recommended to improve survival.
Case Report: A 52-year-old male presented with a painful, enlarging mass on the right proximal thigh 2 years after undergoing plate fixation of the distal femur for a pathologic fracture secondary to monostotic FD. Diagnostic imaging revealed signs of recurrence, and core needle biopsy revealed aggressive features suggestive of malignant transformation. Following surgical resection and chemotherapy, the outcome has been uneventful without evidence of recurrence or metastasis at 4-year post-operation.
Conclusion: Malignant transformation in monostotic FD is rare. Symptom exacerbation should increase the suspicion for sarcomatous change and prompt the need for diagnostic imaging as well as histologic confirmation.
Keywords: Fibrosarcoma, fibrous dysplasia, malignant transformation, secondary sarcoma.


References:
1. Picci P, Sieberova G, Alberghini M, Balladelli A, Vanel D, Hogendoorn PC, et al. Late sarcoma development after curettage and bone grafting of benign bone tumors. Eur J Radiol 2011;77:19-25.
2. Muthusamy S, Conway SA, Subhaeong TY, Temple HT. Locally aggressive fibrous dysplasia mimicking malignancy: A report of four cases and review of the literature. Clin Orthop Relat Res 2015;473:742-50.
3. Qu N, Yao W, Cui X, Zhang H. Malignant transformation in monostotic fibrous dysplasia: Clinical features, imaging features, outcomes in 10 patients, and review. Medicine (Baltimore) 2015;94:e369.
4. Mardekian SK, Tuluc M. Malignant sarcomatous transformation of fibrous dysplasia. Head Neck Pathol 2015;9:100-3.
5. Riddle ND, Bui MM. Fibrous dysplasia. Arch Pathol Lab Med 2013;137:8-21.
6. Ruggieri P, Sim FH, Bond JR, Unni KK. Malignancies in fibrous dysplasia. Cancer 1994;73:1411-24.
7. Chapurlat RD, Gensburger D, Jimenez-Andrade JM, Ghilardi JR, Kelly M, Mantyh P. Pathophysiology and medical treatment of pain in fibrous dysplasia of bone. Orphanet J Rare Dis 2012;7:S3.
8. Doqanavsarqil B, Argin M, Kececi B, Sezak M, Sanli UA, Oztop F. Secondary osteosarcoma arising in fibrous dysplasia, case report. Arch Orthop Trauma Surg 2009;129:439-44.
9. Stanton RP, Ippolito E, Springfield D, Lindaman L, Wientroub S, Leet A. The surgical management of fibrous dysplasia of bone. Orphanet J Rare Dis 2012;7 Suppl 1:S1.
10. Hatano H, Morita T, Arllzumi T, Kawashima H, Ogose A. Malignant transformation of fibrous dysplasia: A case report. Oncol Lett 2014;8:384-6.
11. National Comprehensive Cancer Network (NCCN). Bone Cancer, NCCN Guidelines; 2013. Available from: http://www.nccn.org. [Last accessed on 2016 Mar 16].


How to Cite this article: Tud AR, Dimayuga CD| Malignant Transformation of Monostotic Fibrous Dysplasia after Surgery: A Case Report | Journal of Bone and Soft Tissue Tumors | May-Aug 2021; 7(2): 1-4.

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