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Editorial September- December 2021

December 31, 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, […]

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

December 31, 2021

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 […]

Editorial September- December 2021

December 31, 2021

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

December 31, 2021

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Editorial September- December 2021

December 31, 2021

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

December 31, 2021

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:

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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.
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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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Editorial September- December 2021

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

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