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  • 1
    Electronic Resource
    Electronic Resource
    Examination and evaluation of surgical margins in bone tumours (1993)
    Springer
    International orthopaedics 17 (1993), S. 93-97 
    Details
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auteurs présentent un procédé objectif d'évaluation des marges chirurgicales et du caractère radical de la chirurgie conservatrice des membres dans le traitement des tumeurs osseuses. L'examen de la région opérée par tomodensitométrie (TDM) et IRM étant généralement impossible en raison de la présence de matériel métallique implanté, ils recommandent de pratiquer l'examen TDM et IRM de la pièce opératoire et de le comparer avec les images pré-opératoires. La TDM montre mieux les modifications de l'os et particulièrement la rupture de la corticale tandis que l'IRM précise mieux l'extension extra-osseuse et intra-médullaire de la tumeur. Il est donc recommandé de combiner les deux méthodes d'examen. Une résection intralésionelle est une indication absolue, une résection marginale une indication relative de réintervention.
    Notes: Summary An objective method of evaluating surgical margins and the extent of limb-preserving surgery is described in a study of 10 malignant bone tumours. The resected specimen was imaged by computerised tomography and magnetic resonance, and the appearances compared with the preoperative images of the tumour. CT was better than MR for detecting bony changes, but MR was more satisfactory for showing the extraosseous and intramedullary outline of the tumour. These two methods should therefore be combined. Intralesional excision is an absolute indication; marginal excision a relative indication for reoperation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00183549
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  • 2
    Electronic Resource
    Electronic Resource
    Aneurysmal bone cyst (1992)
    Springer
    Archives of orthopaedic and trauma surgery 111 (1992), S. 318-322 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Authors report on the results of treatment of 52 primary and 16 secondary aneurysmal bone cysts (ABC). ABC grow rapidly; 84% of them have already destroyed more than the half of the bone width at recognition. En bloc resection is preferred when the ABC is growing superficially and eccentrically and more than half of the bone width is intact. Careful curettage and bone grafting still remains the surgical method of choice in the majority of cases, when the ABC is more destructive and affects the subchondral bone of the joints. Segmental resection is only indicated when removal of the affected bone does not influence the function of the extremity. Superselective embolization of the cyst was performed in seven cases with excellent results. This method is suggested for ABC in certain locations inaccessible to surgical intervention, e.g., the pelvis, or to avoid excessive bleeding in hypervascularized tumors. In one case, however, an incomplete rebuilding of the ABC could only be achieved by the administration of calcitonin. The 16 cases of secondary ABC were observed mostly in association with osteoblastomas, giant-cell tumors, and osteosarcomas. The incidence of the secondary ABC was 23% in the whole ABC group but not more than 2–4% among the osteosarcomas and giant-cell tumors. Secondary ABC may confuse the histological and clinical diagnoses and that, especially in cases of osteosarcoma, may have fatal consequences.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00420058
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  • 3
    Electronic Resource
    Electronic Resource
    The prognostic significance of DNA cytophotometry and proliferation index (Ki-67) in giant cell tumors of bone (1999)
    Springer
    International orthopaedics 23 (1999), S. 315-319 
    Details
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé  Les auteurs ont examiné 1’anomalie chromosomique de DNA á 1’aide de cytophotometrie de frottis; et 1’activité de proliferation par le moyen de 1’immuno- histochimie Ki-67 MIB dans 69 tumeurs de cellules géantes de 50 patients choisis accidentellement. lls ont évalué les résultats en les comparant aux données cliniques disponibles. Parmi les 46 tumeurs primaires 63% ont manifesté un caractère diploide et 37% un caractère aneuploide. On a observé une proportion de recidive significativement plus élevée (P=0.026) dans les tumeurs aneuploides (64%) que dans les tumeurs diploides (31%). Au cours des récidives on a remarquè une augmentation tant dans la proportion des tumeurs aneuploides que dans 1’indice de proliferation mais en ce dernier 1’augmentation n’était pas significative. Le caractère aneuploide ne signifie pas forcément une tendance univoque á la transformation maligne cependant dans les tumeurs aneuploides récidivantes il est nécessaire de suivre la maladie avec beaucoup de soin et comme intervention chirurgicale on conseille une excision large au lieu du curettage intralésionel.
    Notes: Abstract  We studied DNA ploidy by smear cytophotometry and proliferation activity by Ki-67 MIB immunohistochemistry in 69 primary and recurrent giant cell tumors (GCT) from 50 randomly selected patients. The obtained results were evaluated with comparisons made to the available clinical data. From the 46 primary tumors 63% showed diploidy and 37% aneuploidy. A significantly (P=0.026) higher recurrence rate (64%) was observed in aneuploid than in diploid tumors (31%). In the course of the recurrences, both the ratio of aneuploid tumors as well as the proliferation index of the tumors increased, though the degree of the latter was non-significant. Aneuploidy did not mean an unambiguous tendency towards malignant transformation; however, a close follow-up of recurrent aneuploid tumors, and wide excision of the recurrence instead of intralesional curettage are the recommended procedures. The DNA cytophotometry and proliferation index of GCTs – as compared to other histologic examinations – are of prognostic value in the evaluation of the recurrence potential of the GCTs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002640050381
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  • 4
    Electronic Resource
    Electronic Resource
    Desmoid tumours of the extremities (1988)
    Springer
    International orthopaedics 12 (1988), S. 249-253 
    Details
    ISSN: 1432-5195
    Keywords: Desmoid tumour ; Extremities
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auteurs rapportent sept cas de tumeurs desmoïdes des extrémités. Une tumeur de volume inférieur à quelques centimètres est traitée au mieux par une large excision locale. Les tumeurs plus volumineuses peuvent également être excisées en s'efforçant de ménager les vaisseaux et les nerfs puisqu'il n'y a pas de risque de transformation maligne ni de metastase. La radiothérapie peut être envisagée lorsque la tumeur est inaccessible à la chirurgie. Discussion des problèmes de diagnostic entre tumeur desmoïde et fibrosarcome.
    Notes: Summary The authors report seven cases of desmoid tumors of the extremities. A tumour less than a few centimetres in size is best removed by wide local excision. Large growths should also be excised, but efforts should be made to preserve the vessels and nerves, since malignant transformation and metastases do not occur. Irradiation therapy should be considered for tumours which are surgically inaccessible. The problems of differential diagnosis between a desmoid tumour and a fibrosarcoma are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00547171
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  • 5
    Electronic Resource
    Electronic Resource
    Aneurysmal bone cysts treated by superselective embolization (1992)
    Springer
    Skeletal radiology 21 (1992), S. 167-172 
    Details
    ISSN: 1432-2161
    Keywords: Aneurysmal bone cyst of pelvic bones ; Transcatheter embolization ; Preoperative vessel occlusion ; n-Butyl-2-cyanoacrylate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A series of 7 cases of aneurysmal bone cysts (ABC), all but 1 located in the pelvic bones, which were treated by transcatheter embolization is presented. Five embolizations were performed for primary treatment, while in 2 patients they were performed preoperatively. In all patients a definite histological diagnosis was established by open biopsy, and plain radiographs as well as computerized tomography (CT) were applied for evaluation of the results. The embolizing materials were tissue adhesive for permanent, and Gelfoam for preoperative vessel occlusions. Of 5 lesions treated for the purpose of definitive embolization, 3 (all located in the superior pubic ramus) showed complete ossification; in one, partial remineralization and progression occurred. In a further patient with a secondary ABC, partial reconstitution was recorded. Both preoperative embolizations resulted in successful en bloc resection with minimal blood loss. Transcatheter embolization is the treatment of choice for the highly vascular ABC in unfavorable anatomical locations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00242130
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  • 6
    Electronic Resource
    Electronic Resource
    Mid-foot reconstruction following involvement of five bones by giant cell tumor (2000)
    Springer
    Skeletal radiology 29 (2000), S. 664-667 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Giant cell tumor ; Multiple mid-foot bones ; Reconstructive surgery ; Radiography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on a patient who had giant cell tumor involving multiple bones of the mid-foot. The tumor originated from the navicular bone, but also destroyed the cuboid, and all cuneiform bones. This unusual presentation of giant cell tumor presented a therapeutic challenge for the surgeons. The patient was treated with en bloc resection and the bony defect replaced with a massive iliac crest graft which united within 9 months and has remained stable for 7 years without local recurrence, and with excellent function of the foot.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000274
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