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A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis

January 10, 2021

Case Report | Volume 7 | Issue 1 | JBST January – April 2021 | Page 16-21 | Katrina Ysabel R Naraval, Daniela Kristina D. Carolino, Ma. Lilia Molina P. Jose. DOI: 10.13107/jbst.2021.v07i01.43 Author: Katrina Ysabel R Naraval[1], Daniela Kristina D. Carolino[1], Ma. Lilia Molina P. Jose[1], [2] [1]Institute of Orthopaedics and Sports Medicine, St. […]

Treatment of GCT of Distal Radius Bone with Pre-operative Denosumab Plus Replacement by Distal Ulna and Ulnocarpal Arthrodesis: A Case Report

January 10, 2021

Case Report | Volume 7 | Issue 1 | JBST January – April 2021 | Page 9-11 | Francisco de Assis Serra Baima Filho. DOI: 10.13107/jbst.2021.v07i01.42 Author: Francisco de Assis Serra Baima Filho[1] [1]Department of Orthopedics, Aldenora Bello Maranhao Institute of Oncology (IMOAB), São Luís, Brazil. Address of Correspondence Dr. Francisco de Assis Serra Baima […]

A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis

January 10, 2021

Treatment of GCT of Distal Radius Bone with Pre-operative Denosumab Plus Replacement by Distal Ulna and Ulnocarpal Arthrodesis: A Case Report

January 10, 2021

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A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis

January 10, 2021

Author: Katrina Ysabel R Naraval[1], Daniela Kristina D. Carolino[1], Ma. Lilia Molina P. Jose[1], [2]

[1]Institute of Orthopaedics and Sports Medicine, St. Luke’s Medical Center, 279 E. Rodriguez Sr. Blvd., Quezon city 1112, Philippines,
[2]Orthopaedic Oncology section, Department of Orthopaedics, The Medical City Clark, Pampanga, Philippines.

Address of Correspondence
Dr. Katrina Ysabel R Naraval,
Institute of Orthopaedics and Sports Medicine, St. Luke’s Medical Center, 279 E. Rodriguez Sr. Blvd., Quezon city 1112, Philippines.
E-mail: khayanaraval@gmail.com

Abstract

Introduction: Primary angiosarcoma of the breast is an uncommon subtype of soft-tissue sarcoma known to be aggressive and is associated with distant metastasis and poor prognosis. Solitary bone metastases occurring in these cases are even more rare with the available limited literature based from small retrospective case series.
Case Report: We present a case of a 24-year-old Filipino female previously diagnosed with primary angiosarcoma of the bilateral breasts, initially presenting with a 3-month history of the right hip pain and consulted due to a pathologic fracture of the right proximal femur. Diagnostic tests done confirmed solitary skeletal metastasis to this area, for which she underwent wide resection and application of a proximal femoral endoprosthesis. Postoperatively, the patient was able to independently ambulate, with follow-up radiographs showing stable implant fixation. Further imaging showed that lesion-free bones, however, noted development of distant recurrence manifesting with pulmonary metastases and hemorrhagic subcutaneous lesions 3 months after. Adequate tumor resection and radiotherapy are reported to successfully treat isolated skeletal metastasis in the proximal femur. The presence of the pathologic fracture before definitive treatment may have contributed to its distant recurrence, in addition to an already aggressive nature of the primary malignancy.
Conclusion: In the background of primary breast angiosarcoma, although rare, high suspicion for isolated skeletal metastasis in a symptomatic patient prevents delay in definitive management, which avoids progression to a poorer prognosis.
Keywords: Solitary bone metastasis, angiosarcoma, proximal femur, pathologic fracture.

References:

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How to Cite this article: Naraval KYR, Carolino DKD, Jose MLMP | A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis | Journal of Bone and Soft Tissue Tumors | Jan-Apr 2021; 7(1): 16-21.

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Treatment of GCT of Distal Radius Bone with Pre-operative Denosumab Plus Replacement by Distal Ulna and Ulnocarpal Arthrodesis: A Case Report

January 10, 2021

Author: Francisco de Assis Serra Baima Filho[1]

[1]Department of Orthopedics, Aldenora Bello Maranhao Institute of Oncology (IMOAB), São Luís, Brazil.

Address of Correspondence
Dr. Francisco de Assis Serra Baima Filho,
Department of Orthopedics, Aldenora Bello Maranhao Institute of Oncology (IMOAB), São Luís, Brazil.
E-mail: assisbaima@gmail.com

Introduction: Giant-cell tumor (GCT) of bone is a benign tumor, however locally aggressive with a tendency for local recurrence and potential for metastasis. The distal radio is the third most frequent location, after the distal femur and proximal tibia. In Campanacci grade Grade III tumors, multiple reconstruction techniques after resection of the distal radius have been described, such as bone graft plus wrist arthrodesis. The use of the drug denosumab in the pre-operative period helps a surgery with less comorbidity, and limb preservation and reduces the chance of function loss. The objective is to report a case of a patient who underwent treatment of Campanacci grade Grade III distal radius bone GCT, with pre-operative denosumab application and resection surgery, replacement by bone graft (distal ulna), and ulnocarpal arthrodesis.
Methodology: Quantitative, descriptive, retrospective study by analyzing the medical record of a case report, plus literature study.
Conclusion: The use of pre-operative denosumab favors surgery with less comorbidity, ; however, more studies are needed in order to define the ideal dosage. Ulnar translocation with ulnar carpal arthrodesis has also proved to be a successful technique and further studies are needed to evaluate its effectiveness.
Keywords: Giant -cell tumors of bone (MeSH ID: D018212), denosumab (MeSH ID: D000069448), arthrodesis (MeSH ID: D001174), case report (MeSH ID: D002363).

Reference:
1. Qi DW, Wang P, Ye ZM, Yu XC, Hu YC, Zhang GC, et al. Clinical and radiographic results of reconstruction with fibular autograft for distal radius giant cell tumor. Orthop Surg 2016;8:196-204.
2. Yang YF, Wang JW, Huang P, Xu ZH. Distal radius reconstruction with vascularized proximal fibular autograft after en-bloc resection of recurrent giant cell tumor. BMC Musculoskelet Disord 2016;17:1-6.
3. Barik S, Jain A, Ahmad S, Singh V. Functional outcome in giant cell tumor of distal radius treated with excision and fibular arthroplasty: A case series. Eur J Orthop Surg Traumatol 2020;30:1109-17.
4. Meena DK. Re: Wrist fusion through centralisation of the ulna for recurrent giant cell tumour of the distal radius. J Orthop Surg 2016;24:280.
5. McCarthy CL, Gibbons CL, Bradley KM, Hassan AB, Giele H, Athanasou NA. Giant cell tumour of the distal radius/ulna: Response to pre-operative treatment with short-term denosumab. Clin Sarcoma Res 2017;7:1-11.
6. Gulia A, Puri A, Prajapati A, Kurisunkal V. Outcomes of short segment distal radius resections and wrist fusion with iliac crest bone grafting for giant cell tumor. J Clin Orthop Trauma 2019;10:1033-7.
7. Bianchi G, Sambri A, Marini E, Piana R, Campanacci DA, Donati DM. Wrist arthrodesis and osteoarticular reconstruction in giant cell tumor of the distal radius. J Hand Surg Am 2020;2020:1-6.

How to Cite this article: de Assis Serra Baima Filho F. | Treatment of GCT of Distal Radius Bone with Pre-operative Denosumab Plus Replacement by Distal Ulna and Ulnocarpal Arthrodesis: A Case Report | Journal of Bone and Soft Tissue Tumors | Jan-Apr 2021; 7(1): 9-11.

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A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis

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Treatment of GCT of Distal Radius Bone with Pre-operative Denosumab Plus Replacement by Distal Ulna and Ulnocarpal Arthrodesis: A Case Report

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A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis

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Treatment of GCT of Distal Radius Bone with Pre-operative Denosumab Plus Replacement by Distal Ulna and Ulnocarpal Arthrodesis: A Case Report

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A Case Report of Solitary Bone Metastasis from Primary Angiosarcoma of the Bilateral Breasts – A Rare Diagnosis

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Treatment of GCT of Distal Radius Bone with Pre-operative Denosumab Plus Replacement by Distal Ulna and Ulnocarpal Arthrodesis: A Case Report

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