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Journal of Bone and Soft Tissue Tumors (JBST) is the official Journal of The Indian Musculo Skeletal Oncology Society
Tata Memorial Centre – The Journey so Far!!!
Volume 2 | Issue 2 |May- Aug 2016 | Page 3-4 | Ashish Gulia, Ajay Puri, Rajendra.A. Badwe
Authors: Ashish Gulia [1], Ajay Puri [1], Rajendra.A. Badwe [1].
[1]Orthopedic Oncology Services, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai.
Address of Correspondence
Dr. Ashish Gulia
Associate Professor, Orthopedic oncology, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai.
Email: aashishgulia@gmail.com
Tata Memorial centre, considered as “Mecca” of Oncology care in the country and sub continent, stands today at its Dodranscentennial Anniversary. Institution started as Tata Memorial Hospital, which was inaugurated on 28th February 1941 by His Excellency Sir Roger Lumley, then Governor of Mumbai. Declaring the centre open, he estimated with extraordinary prescience “…the hospital will become the spearhead of attack on cancer in this country, providing not only a center where specialized treatment can be given, but also one from which knowledge of new methods of treatment and diagnosis will go out to doctors and hospitals throughout the country…”The past 75 years stand as glowing testimony to Sir Lumley’s prophecy. A recent peer group review of the hospital has accredited it as the premier comprehensive center in India, in addition recognized it as potentially and prominently featuring in the top five cancer centers globally. The advent of TMH in chapters of the history of medicine in India can best be defined as a quantum leap. It owed its genesis to the philanthropic sentiments of the illustrious Tata family. Later on, in 1961 was passed under the guardianship of Department of Atomic Energy which remarkably aided and upheld the meteoric rise of the sterling institution. In the year 1966 Tata Memorial Hospital merged with Cancer Research Institute (the pioneer research institute), the conjoined institutes were collectively called Tata Memorial Centre (TMC). TMC exemplifies private philanthropy boosted by Government support with a mandate for Service, Education & Research in Cancer. Commencing its journey as a torchbearer, the first dedicated cancer specialty hospital in Asia, TMC today continues to maintain its excellence of being the largest cancer institute in Asia. A fledgling 80 bedded hospital spread over 15,000 sq meters with an annual budget of half a million (INR), has escalated to a lofty institution with 700+ beds, covering over 75,000 sq meters, utilizing an annual budget of 23,00 million (INR). TMC indomitably bears the responsibility of cancer care burden not only of the large Indian populace but also several parts of Asia, Middle East and Africa, catering to an annual footfall of 65,000 new cases and 450,000 follow up cases.[1] Research and education have unarguably been the essential arms of a comprehensive cancer care centre. TMC since origin has embraced the holistic model of delivering cancer care by augmenting and developing its research and education facilities as it sought to provide treatment which was affordable, innovative and particularly relevant to the needs of the country. The research wing of TMC originally established in 1952 as CRI (Cancer Research Institute) was subsequently revamped as ACTREC (Advanced Centre for Treatment Research and Education in Cancer) in 2002. ACTREC is a state of art research and training centre which has over the years focussed on the integration of basic and clinical research including evolving inspiring pathways for translational research. The academic unit of TMC imparts training in specialty and super specialty courses in oncology and is affiliated to the acclaimed Homi Bhabha National Institute, Mumbai.[1]
The noble mission of the institute was to provide comprehensive cancer care to one and all. A practice which has been resolutely followed since its inception is, that every patient who walks in is attended to and treated irrespective of their ability to pay. Over 60% of TMC’s patients receive free or highly subsidized treatment. The essence of the center however, lies in its undeviating constancy towards extending compassionate care and assuaging suffering in times of extreme distress. Patients and caregivers often refer to the hospital as a temple which bespeaks diligence and dedication of the individuals who work there. As millions stream in seeking hope, this Mecca continually labors to ensure means of cure, care and cope. Seventy five glorious years of Tata Memorial Centre have borne witness to its commitment to excellence, expertise and eminence in cancer treatment, care, research, education and awareness. As a tribute to this iconic institution we mark a yearlong celebration of its Platinum Jubilee (Dodranscentennial Anniversary) 2016.[1] The appointment of a full time orthopaedic surgeon on the staff of Tata Memorial Centre in 1999 resulted in the establishment of a specialist orthopaedic oncology service [2]. Over the years this service has now grown to be recognised as one of the leading musculoskeletal oncology units globally. Like all other services at the centre this too functions as a “Disease Management Group”, where specialists from all disciplines involved in sarcoma care (radiology, pathology, medical oncology, radiation oncology, etc.) come together to provide multidisciplinary integrated care under one umbrella. Today the orthopaedic oncology service caters to about 2500 new musculoskeletal oncology cases per year while performing about 700 major and 1200 minor surgical procedures each year. The service has collaborated with industry to develop cost effective mechanical reconstructive options suited to the local socio economic milieu. The development of an indigenous prosthesis (TMH – NICE / RESTOR) which was recognised by the Golden Peacock award for health innovation is a proud feather in the cap of the institute. Innovative biological reconstruction techniques published in reputed peer reviewed journals are now practised in other centres globally too. Both clinical and basic research also plays a part in the units’ contribution to furthering insights in sarcoma care. The service has to its credit the only randomised trial ever conducted for surveillance in sarcomas and is part of a global consortium that has published one of the largest series of patients detailing the genomic profile of sarcomas. [3,4] Imparting training and sharing of knowledge and information has always been part of the culture of this institute and a host of young orthopaedic oncologists practising all across the country are a proud testimony in keeping with this tradition. There is a constant stream of international trainees and visitors and the service has helped in initiating and developing the limb salvage program in many resource challenged areas like Nepal, Myanmar, Palestine and Nigeria. [5] The TMC “Evidence Based Guidelines” for the management of bone and soft tissue sarcomas is a useful handbook that helps disseminate the concept of scientific and rational treatment for these challenging tumors. TMC staff and alumni have been at the forefront in establishing the Indian Musculo Skeletal Oncology Society (IMSOS), an organisation that seeks to provide a common forum for interaction and mutual collaboration between different specialists and institutes involved in the treatment of sarcomas. As the institute seeks to expand its footprint over the next decade by adding infrastructure and staff, both in Mumbai and centres across the country the orthopaedic oncology service too will need to evolve. Challenges of adopting new technology will have to be met. Yet, offering the right balance between these enhanced options while maintaining the principles of rational , cost effective medical care will necessitate “the wisdom of Solomon”.
Just as it has for the past 75 years, the institute and every individual connected with it will always strive with utmost passion to fulfil its motto of “Service – Education – Research” in a ceaseless endeavour to offer the best possible care to the patients that repose their trust in this institute.
References
1. Tata Memorial Centre. 2016. Tata Memorial Centre Platinum Jubilee – Celebrating 75 Glorious Years. Available at: http://tmcplatinumjubilee.org/tmc-platinum-jubilee.php
2. Puri A – The “ODYSSEY”: “Orthopaedic Oncology” – My journey thus far! Journal of Bone and Soft Tissue Tumors May-Aug 2015; 1(1):4-6
3. Puri A, Gulia A, Hawaldar R, Ranganathan P, Badwe RA. Does Intensity of Surveillance Affect Survival After Surgery for Sarcomas? Results of a Randomized Noninferiority Trial. ClinOrthopRelat Res. 2014 May;472(5):1568-75.
4. Ballinger ML, Goode DL, Ray-Coquard I, James PA, Mitchell G, Niedermayr E, Puri A, Schiffman JD, Dite GS, Cipponi A, Maki RG, Brohl AS, MyklebostO,Stratford EW, Lorenz S, Ahn SM, Ahn JH, Kim JE, Shanley S, Beshay V, Randall RL, Judson I, Seddon B, Campbell IG, Young MA, Sarin R, Blay JY, O’DonoghueSI,Thomas DM; International Sarcoma Kindred Study. Monogenic and polygenic determinants of sarcoma risk: an international genetic study. Lancet Oncol. 2016 Aug 4.
5. Gulia A, Wilding C, Suman MB, Puri A. OrthOncoCon-2014: Continuing education in musculoskeletal oncology. Indian J Cancer. 2015 Apr-Jun;52(2):184-5.
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Journal of Bone and Soft Tissue Tumors – Unique Status
Vol 2 | Issue 2 | May – Apr 2016 | page:1-2 | Dr Yogesh Panchwagh & Dr Ashok Shyam.
Author: Dr Yogesh Panchwagh [1] & Dr Ashok Shyam [1,2].
[1]Orthopaedic Oncology Clinic, Pune, India.
[2] Indian Orthopaedic Research Group, Thane, India
[3] 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
Journal of Bone and Soft Tissue Tumor (JBJST) enjoys a special status in being one of the unique journals exclusively dedicated to bone and soft tissue tumors. The clinical expertise and technological development has been very rapid in this field and JBST already had a demand among the clinicians involved in taking care of musculoskeletal Oncology. JBST has successfully filled this vacuum that existed and has received great support from musculoskeletal tumor surgeons and clinicians. The platform provided by JBST has been used worldwide to access articles and also to submit original research. There are other factors that further add to its uniqueness. One of the most unique point is that this is a journal that is initiated by clinicians. JBST was conceived and initiated by people who were directly involved in care of musculoskeletal tumor patients. They perceived the need of such a journal and were instrumental in moulding it in its current shape. Another unique point of JBST is that it is not a pure research journal but also a tool to educate the young trainees and practitioners. JBST has a dedicated symposium in each issue which provides a comprehensive overview of the subject along with recent updates. This is very helpful for students, trainees and practitioners of the subject. These symposium articles are written by carefully solicited authors that have years of practical experience which add to the flavour of the article. The authors are requested to add the practical tips and cases to these symposium reviews to make it much more clinically relevant rather than simply publish a theoretical review of literature. Special attention is given to students in JBST and a students corner is published in every issue which is a brief overview article on a single bone tumor. This is specially created with keeping students in mind and is co-created with help of a trainee or a student. This has received excellent response as far as student readership is concerned and we thank Dr Ashish Gulia for initiating and supporting this initiative. Oncomedia is another unique part of JBST where recent conferences, upcoming conferences and new updates regarding bone and soft tissue tumors are listed. Videos and other academic materials are also included in this section. It’s a very unique source of information to our readers and is presented in a very reader friendly manner.This particular issue is also unique as it features and is dedicated to one of the most prestigious orthopaedic oncology unit in India from Tata Memorial Hospital (TMH) in Mumbai. The guest editorial is been contributed by the TMH team and it traces the journey of the hospital from its inception till today. JBST plans to continue this feature where such units, who have contributed significantly to growth of musculoskeletal oncology will be featured. We intend to include this a regular feature in JBST. Another feature that we really wish to include is academic interview, featuring individual personalities in the field of musculoskeletal oncology. Other journals from orthopaedic research group like trauma international and International Journal of Paediatric Orthopaedics have been regularly publishing such academic interviews. Hopefully JBJST will start this feature by next year. The JBST team is always looking for making the journal better with the aim to provide the best content to its reader which is presented in the most accessible and easy format. Being focussed on the subject of bone and soft tissue tumours and created and run by focussed and expert team has helped the journal achieve a unique status already and with help of the entire fraternity it is sure to grow further. If you have any suggestions for the editorial team, please feel free to write to us.
Dr Yogesh PachwaghDr Ashok Shyam
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PVNS talus in a patient treated for chondral lesion in ipsilateral calcaneum: A case report and review of literature
Vol 3 | Issue 2 | Sep-Dec 2017 | Page 10-13 | Apurv Gabrani, Hitesh Dawar, Deepak Raina, Surbhit Rastogi
Authors: Apurv Gabrani [1], Hitesh Dawar [1], Deepak Raina [1], Surbhit Rastogi [1].
[1] Indian Spinal Injuries Centre, New Delhi.
Address of Correspondence
Dr . Apurv Gabrani
Ah-22, Shalimar Bagh, New Delhi-110088
Email: apurvgabrani@gmail.com
Abstract
Introduction: PVNS is a locally aggressive synovial proliferative disorder of unknown etiology and has been described in the foot and ankle in previous literature. A case of PVNS in the talus has been described in a patient treated for ipsilateral calcaneal chondral lesion.
Case Report: A 56 year old male presented with pain in his left ankle of 4 months duration. On investigation, he was found to have a well defined lytic lesion in the left calcaneum on x-ray. MRI showed a hyper intense lesion on T2WI. A needle biopsy revealed chondrogenic tumor which was managed by extended curettage. At 12 months follow up, patient presented with recent onset pain over the anterior aspect of left ankle which showed hypo density over the supero-anterior aspect of the talus and MRI showed ill defined hypo intense lesion on T2WI and hyper intense lesion on T1WI. The lesion increased in size on repeat MRI 6 weeks later. He was managed with synovectomy and debridement with core needle biopsy of talus. Histopathological examination revealed features consistent with PVNS. Patient remains asymptomatic at 1 year follow up after surgery.
Conclusion: A double primary lesion although rare, does exist and any recurrence should be viewed at with equal degree of suspicion as the primary lesion.
Keywords: Pigmented villonodular synovitis (PVNS), Talus, Calcaneum, Double Primary lesion, Chondral lesion.
References
1. Granowitz S.P., D’Antonio, j., and Mankin, H.L. The pathogenesis and long term results of PVNS. Clin Orthop 1976 ;114:335-351
2. Bakotic BW, Borkowski P. Primary soft tissue neoplasms of the foot: the clinicopathological features of 401 cases. J Foot Ankle Surg 2001; 40:29-36
3. T. Okoro, S. Isaac, R.U. Ashford, C.J. Kershaw. Pigmented villonodular synovitis of the talonavicular joint: A case report and review of the literature. The Foot 19(2009) 186-188
4. Jaffe HL, Litchtenstein L, Sutro C. Pigmented Villonodular Synovitis: bursitis and tenosynovitis. Arch Pathol 1941;31:731-65
5. Llauger J, Palmer J, Roson N. Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features. Am J Roentgenol 1999; 172(4): 1087-91
6. Dorwart R.H., Genant H.K., Johnston W.H., and Morris J.M. PVNS of synovial joints: clinical, pathological, and radiologic features. Am J Roentgenol 1984;143:877-885
7. Sharma H, Jane MJ, Reid R. Pigmented villonodular synovitis of the foot and ankle: forty years of experience from the Scottish Bone Tumor Registry. J Foot Ankle Surg 2006;45(5): 329-36
8. Carmon W.A. Pigmented villonodular synovitis. Med Clin North Am 1947; 49:26-38
9. Young JM, Hudacek AG. Experimental production of pigmented villonodular synovitis in dogs. Am J pathol 1954;30:799
10. DeBruin J.A and Rockwood C.A. PVNS: Invasion of bone involving the knee joint. South Med J 1956; 59:466-468
11. McMaster P.E. PVNS with invasion of bone. J Bone Joint Surg 1960; 42A:1170-1183
12. Rothstein A.S. Localized PVNS of the ankle. J Am Podiatr Med Assoc1981; 71:607-610
13. Chung S.M.D., Janes J.M. Diffuse PVNS of the hip joint. J Bone Joint Surg1965; 47A:293-303
14. Bravo S.M., Winalski C.S., Weissman B.N. Pigmented villonodular synovitis. Radiol Clin North Am 1996; 34:311-26
15. Lin J, Jacobson JA, Jamadar DA, Ellis JH. Pigmented villonodular synovitis and related lesions: the spectrum of imaging findings. Am J Roentgenol 1999;172:191-7
16. Berger. I, Ehemann. V, Helmchen. B, Penzel. R, Weckauf. H. Comparative analysis of cell populations involved in the proliferative and inflammatory process in localized and diffuse pigmented villonodular synovitis: Histopathol 2004 Jul;19-3:687-92
17. Lewis R.W. Roentgen diagnosis of PVNS and synovial SA of the knee joint. Radiology1947; 49:26-38
18. Ho C.F. Chiou H.J., Chou Y.H. Peritendinous lesions. The role of high resolution ultrasonography. J. Clin. Imaging 2003;27:239-250
19. Ugai K., Morimoto K. Magnetic resonance imaging of pigmented villonodular synovitis in subtalar joint. Report of a case: Clin Orthop 1992;283:281-4
20. Myers B.W, Masi A.T. Pigmented villonodular synovitis and tenosynovitis: a clinical epidemiological study of 166 cases and literature review. Medicine(Baltimore)1980;59(3):223-38
21. Al-Nakshabandi N.A., Ryan A.G., Choudur H.: Pigmented villonodular synovitis. Clin Radiol 2004;59:414-20
22. Babinas I., De silva U., Grimer R.J. Pigmented villonodular synovitis of the foot and ankle: a 12 year experience from a tertiary orthopedic oncology unit. J Foot Ankle Surg. 2004;43(6):407-11
23. Segler C.P. Irradiation as an adjunctive treatment of diffuse pigmented villonodular synovitis of the foot and ankle prior to tumor surgical excision. Med Hypothesis 2003;61:229-230
24. Byers P.D., Cotton R.E., Deacon O.W., Lowy M., Newmau P.H., Sissons H.A., Thomson A.D.: The diagnosis and treatment of pigmented villonodular synovitis. J Bone Joint Surg1968; 50:290.
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Primary Intraosseous Schwannoma
Vol 3 | Issue 2 | Sep-Dec 2017 | Page 14-15| Asawari Ambekar, Chitralekha Soman.
Authors: Asawari Ambekar [1], Chitralekha Soman [1].
[1] Department of Histopathology, Mumbai Reference Laboratory, SRL Limited, Mumbai, Maharashtra, India
Address of Correspondence
Dr. Asawari Ambekar,
Reserve Bank of India Soc number 2 B 5 Gavand Path Thane West 400602
E-mail: asawariaa61@gmail.com
Abstract
Schwannomas are benign tumors arising from the peripheral nerve sheath. Neurogenic tumors of bone are extremely uncommon and they compose less than 1% of all benign tumors [1]. We present a case of intraosseous schwannoma in a 15 year old girl who presented with pain and pathological fracture of tibia. The radiology revealed an expansile and lytic lesion in the diaphysis. Histopathology confirmed the diagnosis of intraosseous schwannoma. The tumor cells were immunoreactive for S100protein. We present this case as tibial schwannoma is extremely rare and its diaphyseal location in the bone is virtually unknown.
Keywords: Schwannoma, tibia, diaphysis
References
1. Mark JM, Natalie C., Donald K.Schwannoma: A case report.The Foot and Ankle Online Journal 2009
2. Rosai, J., Ackerman, L. V. 1. &Rosai, J. (2004). Rosai and Ackerman’s surgical pathology (9th ed.). St. Louis, Mo. : London: Mosby
3. Fletcher, CDM. Bridge, JA. Hogendoorn, P., Mertens, F.WHO Classification of Tumours of Soft Tissue and Bone. Fourth Edition.2002
4. Ryan MI, Kevin BJ, Nathan L, Joseph AB.Intraosseous neurilemmoma involving the distal tibia and fibula: A case report.The Iowa Orthopaedic Journal.
5. K. Krishnan Unni Carrie Y. Inwards.Dahlin’s Bone Tumors, 6e.GENERAL ASPECTS AND DATA ON 10,165 CASES.
6. Chelsea P,Hamad G, Shweta B. Vikram Dogra.Schwannoma of the Tibial Nerve.Journal of Diagnostic Medical Sonography.2010
7. Manasa AM. Intraosseous Schwannoma of the Maxilla Mimicking a Periapical Lesion: A Diagnostic Challenge. Journal of Clinical and Diagnostic Research. 2015.
8. Kaihu Li et al.Giant intraosseous Schwannoma of the calcaneusInt J ClinExp Med 2016.
9. S.A. Lacerda et al.Intraosseous Schwannoma of Mandibular Symphysis: Case Report.Braz Dent J 2006.
10. Suzuki et al.Association between intraosseous schwannoma occurrence and the position of the intraosseous nutrient vessel: A case report.ONCOLOGY LETTERS.2016
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Adamantinoma; An update
Vol 3 | Issue 2 | Sep-Dec 2017 | Page 16-19 | Ashish Gulia, Pankaj Kumar Panda.
Authors: Ashish Gulia [1], Pankaj Kumar Panda [1].
[1] Surgical Oncology (Orthopedic Oncology), 93, Ground Floor, Main Building, Bone & Soft tissue Services (Disease Management Group), Tata Memorial Hospital, Mumbai – 400012, India.
Address of Correspondence
Dr. Ashish Gulia,
Surgical Oncology (Orthopedic Oncology), 93, Ground Floor, Main Building, Bone & Soft tissue Services (Disease Management Group), Tata Memorial Hospital, Mumbai – 400012, India.
Email: aashishgulia@gmail.com
Abstract
Adamantinoma is a rare, malignant biphasic tumor with varied morphological patterns.Adamantinoma mostly occurs in the second to fifth decade and is slightly more common in men than women.The onset is insidious, and its course shows a slow, progressive character.Radiography is the initial and most reliable imaging modality for adamantinoma of bones because of the tumor’s classic location and appearance on a plain radiograph.Present management modalitieswhich includeen blocresection (mostly intercalary resection) with limb salvage and limb reconstruction. Chemotherapy and radiotherapy have no established role. Amputation does not improve survival but may be advisable in cases with local recurrence and in cases with few large, recurrent lesions where en bloc resection is not possible.
Keywords: Adamantinoma, malignant biphasic tumor, management.
References
1. Dahlin DC. Bone Tumors: General Aspects and Data on 6221 Cases. 3rded. Springfield, IL: Charles C Thomas; 1978. p. 296.
2. Kahn LB. Adamantinoma, osteofibrous dysplasia and differentiated adamantinoma. Skeletal Radiol 2003;32(5):245-258.
3. Fisher B. Primary adamantinoma of the tibia. Z Pathol 1913;12:422-441.
4. Van Rijn R, Bras J, Schaap G, van den Berg H, Maas M. Adamantinoma in childhood: Report of six cases and review of the literature. PediatrRadiol 2006;36(10):1068-1074.
5. Czerniak B, Rojas-Corona RR, Dorfman HD. Morphologic diversity of long bone adamantinoma. The concept of differentiated (regressing) adamantinoma and its relationship to osteofibrous dysplasia. Cancer 1989;64(11):2319-2334.
6. Mirra JM. Adamantinoma and fibrous dysplasia. InBone tumors 1sted. Mirra JM, editor. Philadelphia,PA: Lea &Febiger; 1989. p. 1203-1231.
7. Springfield DS, Rosenberg AE, Mankin HJ, Mindell ER. Relationship between osteofibrous dysplasia and adamantinoma. ClinOrthopRelat Res 1994;309:234-244.
8. Moon NF, Mori H. Adamantinoma of the appendicular skeleton-updated. ClinOrthopRelat Res 1986;204:215-237.
9. Lederer H, Sinclair AJ. Malignant synovioma simulating “adamantinoma of the tibia”. J PatholBacteriol 1954;67(1):163-168.
10. Van der Woude HJ, Hazelbag HM, Bloem JL, Taminiau AH, Hogendoorn PC. MRI of adamantinoma of long bones in correlation with histopathology. AJR Am J Roentgenol 2004;183(6):1737-1744.
11. Unni KK. Dahlin’s Bone Tumors: General Aspects and Data on 11,087 Cases. 5thed. Philadelphia, Pa: Lippincott-Raven; 1996. p. 333-342.
12. Hazelbag HM, Taminiau AHM, Fleuren GJ, Hogendoorn PC. Adamantinoma of the long bones. A clinicopathological study of thirty-two patients with emphasis on histologic subtype, precursor lesion, and biological behavior. J Bone Joint Surg Am 1994;76:1482-1499.
13. Weiss SW, Dorfman HD. Adamantinoma of long bone. An analysis of nine new cases with emphasis on metastasizing lesions and fibrous dysplasia-like changes. Hum Pathol 1977;8(2):141-153.
14. Bridge JA, Dembinski A, DeBoer J, Travis J, Neff JR. Clonal chromosomal abnormalities in osteofibrous dysplasia. Implications for histopathogenesis and its relationship with adamantinoma. Cancer 1994;73(6):1746-1752.
15. Ueda Y, Blasius S, Edel G, Wuisman P, Böcker W, Roessner A. Osteofibrous dysplasia of long bones-A reactive process to adamantinomatous tissue. J Cancer Res ClinOncol 1992;118(2):152-156.
16. Hazelbag HM, Fleuren GJ, vdBroek LJ, Taminiau AH, Hogendoorn PC. Adamantinoma of the long bones: Keratin subclass immunoreactivity pattern with reference to its histogenesis. Am J SurgPathol 1993;17(12):1225-1233.
17. Kanamori M, Antonescu CR, Scott M, Bridge RS Jr, Neff JR, Spanier SS, et al. Extra copies of chromosomes 7, 8, 12, 19, and 21 are recurrent in adamantinoma. J MolDiagn 2001;3(1):16-21.
18. Keeney GL, Unni KK, Beabout JW, Pritchard DJ. Adamantinoma of long bones. A clinicopathologic study of 85 cases. Cancer 1989;64(3):730-7.
19. Qureshi AA, Shott S, Mallin BA, Gitelis S. Current trends in the management of adamantinoma of long bones. An international study. J Bone Joint Surg Am 2000;82-A(8):1122-1131.
20. Bovée JV, van den Broek LJ, de Boer WI, Hogendoorn PC. Expression of growth factors and their receptors in adamantinoma of long bones and the implication for its histogenesis. J Pathol 1998;184(1):24-30.
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Giant Cell Tumor Symposium Part 2
Vol 3 | Issue 2 | Sep-Dec 2017 | page:1 | Dr. Mandip Shah.
Author: Mandip Shah [1].
[1] Sparsh Orthopedic Oncology Clinic. Medicare Building 9th Floor, , B/H Town Hall, Ashram Road, 380006 – Ahmedabad., India.
Address of Correspondence
Dr. Mandip Shah
Sparsh Orthopedic Oncology Clinic. Medicare Building 9th Floor, , B/H Town Hall, Ashram Road, 380006 – Ahmedabad., India
Email: mandipshah@gmail.com
Giant Cell Tumor Symposium Part 2
We are back with the second part of the Giant Cell Tumor Symposium for Journal of Bone and Soft Tissue Tumors.
Two very important aspects are covered in this part. First is the histopathological concepts regarding GCT. There is lot of new knowledge that is available in recent years and that has significantly impacted the diagnosis, management and prognosis of GCT. Histopathological assessment play a major role in terms of determining the behaviour of GCT. Current understanding of molecular pathogenesis of GCTB particularly RANK on osteoclast-like GCs and RANKL on stromal cells and development of newer agents such as denosumab and INF-α has tremendously impacted management of patients with GCTB. This aspect is elaborated in the first article. The second article builds on these concepts and describes how this is used for adjuvent therapy for GCTB. Authors of both the authors have taken tremendous effort to make both these articles good and current. Also these two now conclude the GCT Symposium and cover all aspect of GCTB
Please write to us regarding your suggestions and opinions
Regards
Dr. Mandip Shah
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