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1. Hugate RR, Wilkins RM, Kelly CM, Madsen W, Hinshaw I, Camozzi AB: Intraarterial chemotherapy for extremity osteosarcoma and MFH in adults. Clin Orthop Relat Res; 2008 Jun;466(6):1292-301
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  • [Title] Intraarterial chemotherapy for extremity osteosarcoma and MFH in adults.
  • The neoadjuvant treatment of osteosarcoma using intravenous agents has resulted in survival rates of 55% to 77% [3, 5, 6, 20, 22, 35].
  • We designed a neoadjuvant chemotherapy protocol using combined intraarterial and intravenous agents to treat high-grade osteosarcoma and malignant fibrous histiocytoma of bone in an attempt to improve survival.
  • We report the results of treating 53 adults (age 18-77 years) diagnosed with nonmetastatic extremity osteosarcoma or malignant fibrous histiocytoma.
  • Preoperative chemotherapy consisted of intravenous doxorubicin followed by intraarterial cisplatinum administered repetitively every 3 weeks for three to five cycles, depending on tumor response assessed by serial arteriography.
  • After resection, good responders (90% or greater necrosis) underwent treatment with the same agents and poor responders were treated with alternative agents for longer duration.
  • LEVEL OF EVIDENCE: Level III, therapeutic study.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Bone Neoplasms / drug therapy. Cisplatin / administration & dosage. Doxorubicin / administration & dosage. Histiocytoma, Malignant Fibrous / drug therapy. Osteosarcoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Arm Bones. Cohort Studies. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Infusions, Intra-Arterial. Infusions, Intravenous. Leg Bones. Male. Middle Aged. Neoadjuvant Therapy

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  • (PMID = 18437502.001).
  • [ISSN] 1528-1132
  • [Journal-full-title] Clinical orthopaedics and related research
  • [ISO-abbreviation] Clin. Orthop. Relat. Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2384032
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2. Misaki H, Yamauchi T, Arai H, Yamamoto S, Sutoh H, Yoshida A, Tsutani H, Eguchi M, Nagoshi H, Naiki H, Baba H, Ueda T, Yamakawa M: Secondary malignant fibrous histiocytoma following refractory langerhans cell histiocytosis. J Clin Exp Hematop; 2009 May;49(1):33-7
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  • [Title] Secondary malignant fibrous histiocytoma following refractory langerhans cell histiocytosis.
  • We describe a rare case of secondary malignant fibrous histiocytoma (MFH) following Langerhans cell histiocytosis (LCH).
  • A biopsy specimen from the left iliac bone revealed an infiltration of S-100 protein-positive histiocyte-like cells intermingled with eosinophils, which confirmed the diagnosis of eosinophilic granuloma, a type of LCH.
  • Although the patient was treated with prednisolone initially, the disease did not respond well and progressed gradually over time.
  • The patient subsequently received multiple courses of chemotherapy and immunosuppressive therapy with many kinds of anticancer agents for 6 years.
  • He also received radiotherapy totaling 136.8 Gy for lung tumors and osteolytic lesions of the pelvis.
  • Therefore, the patient was diagnosed with MFH.
  • Although chemotherapy was continued, the patient died of pneumonia during the neutropenic period following chemotherapy.
  • Autopsy revealed systemic invasion of MFH and dissemination of mucormycosis.
  • LCH was not detected histologically in any tissues.
  • [MeSH-major] Histiocytoma, Malignant Fibrous / diagnosis. Histiocytosis, Langerhans-Cell / diagnosis
  • [MeSH-minor] Bone Diseases. Eosinophilic Granuloma / diagnosis. Eosinophilic Granuloma / drug therapy. Eosinophilic Granuloma / radiotherapy. Fatal Outcome. Humans. Lung Diseases. Male. Neoplasms, Second Primary / diagnosis. Neoplasms, Second Primary / etiology. Pneumonia. Salvage Therapy / methods. Young Adult

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  • (PMID = 19474515.001).
  • [ISSN] 1880-9952
  • [Journal-full-title] Journal of clinical and experimental hematopathology : JCEH
  • [ISO-abbreviation] J Clin Exp Hematop
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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3. Natarajan MV, Mohanlal P, Bose JC: Limb salvage surgery complimented by customised mega prostheses for malignant fibrous histiocytomas of bone. J Orthop Surg (Hong Kong); 2007 Dec;15(3):352-6
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  • [Title] Limb salvage surgery complimented by customised mega prostheses for malignant fibrous histiocytomas of bone.
  • PURPOSE: To assess functional and oncological outcomes of patients with malignant fibrous histiocytomas of bone, after limb salvage surgery complimented by a customised prosthesis.
  • METHODS: Between May 1991 and December 2002, 15 men and 5 women (mean age, 42 years) with histologically proven malignant fibrous histiocytoma of bone underwent treatment involving limb salvage surgery complimented by a customised mega prosthesis.
  • The Kaplan-Meier 5-year survival rates of the patients treated without chemotherapy and with chemotherapy were 50% and 76%, respectively.
  • CONCLUSION: Limb salvage surgery with chemotherapy is a viable treatment option for patients with malignant fibrous histiocytoma of bone.
  • Such therapy improves quality of life and provides a useful and functional limb.
  • [MeSH-major] Bone Neoplasms / surgery. Histiocytoma, Malignant Fibrous / surgery. Limb Salvage. Prostheses and Implants
  • [MeSH-minor] Adolescent. Adult. Amputation. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Survival Rate. Treatment Outcome

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  • (PMID = 18162685.001).
  • [ISSN] 1022-5536
  • [Journal-full-title] Journal of orthopaedic surgery (Hong Kong)
  • [ISO-abbreviation] J Orthop Surg (Hong Kong)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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4. McTiernan A, Whelan JS: A Phase II Study of Docetaxel for the Treatment of Recurrent Osteosarcoma. Sarcoma; 2004;8(2-3):71-6
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  • [Title] A Phase II Study of Docetaxel for the Treatment of Recurrent Osteosarcoma.
  • PURPOSE: To determine the response and toxicity of docetaxel in recurrent osteosarcoma and related spindle cell tumours of bone.
  • Diagnosis was: conventional osteosarcoma, 12 patients; periosteal osteosarcoma, one patient; and malignant fibrous histiocytoma of bone, one patient.
  • Initial chemotherapy had been with doxorubicin and cisplatin in 10 patients, and multiagent regimens in four.
  • Nine had been treated with second line chemotherapy before receiving docetaxel.

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  • (PMID = 18521398.001).
  • [ISSN] 1357-714X
  • [Journal-full-title] Sarcoma
  • [ISO-abbreviation] Sarcoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2395610
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5. Mandal S, Mandal AK: Malignant fibrous histiocytoma following radiation therapy and chemotherapy for Hodgkin's lymphoma. Int J Clin Oncol; 2007 Feb;12(1):52-5
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  • [Title] Malignant fibrous histiocytoma following radiation therapy and chemotherapy for Hodgkin's lymphoma.
  • Malignant fibrous histiocytoma (MFH) originates from primitive mesenchymal cells and has the capacity for dual differentiation into histiocytes and fibroblasts.
  • MFH occurring as a secondary malignancy following radio-chemotherapy is rare and its exact incidence is not yet known.
  • Here we report a case of a 42-year-old man who developed MFH in his right knee over a period of more than 10 years after radio (44 Gy)-chemotherapy to treat Hodgkin's lymphoma.
  • After the diagnosis the patient did not return and was lost to follow-up.
  • [MeSH-major] Bone Neoplasms / etiology. Histiocytoma, Malignant Fibrous / etiology. Hodgkin Disease / therapy. Muscle Neoplasms / etiology
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Bleomycin / adverse effects. Chemotherapy, Adjuvant. Dacarbazine / adverse effects. Doxorubicin / adverse effects. Humans. Male. Mechlorethamine / adverse effects. Neoplasms, Radiation-Induced / etiology. Prednisone / adverse effects. Procarbazine / adverse effects. Radiotherapy, Adjuvant. Vinblastine / adverse effects. Vincristine / adverse effects

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  • (PMID = 17380442.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 35S93Y190K / Procarbazine; 50D9XSG0VR / Mechlorethamine; 5J49Q6B70F / Vincristine; 5V9KLZ54CY / Vinblastine; 7GR28W0FJI / Dacarbazine; 80168379AG / Doxorubicin; VB0R961HZT / Prednisone; ABVD protocol; MOPP protocol
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6. Zlowodzki M, Allen B, Schreibman KL, Vance RB, Kregor PJ: CASE REPORTS: malignant fibrous histiocytoma of bone arising in chronic osteomyelitis. Clin Orthop Relat Res; 2005 Oct;439:269-73
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  • [Title] CASE REPORTS: malignant fibrous histiocytoma of bone arising in chronic osteomyelitis.
  • This case report shows the importance of frozen section and/or permanent section pathology for diagnosis of tumorous conditions in patients with chronic osteomyelitis.
  • According to published reports, a coincidence of malignant fibrous histiocytoma of bone and post-fracture osteomyelitis has occurred in only four patients.
  • Our report details the treatment of 51-year-old man with a fracture 15 years previously and subsequent chronic osteomyelitis of the left distal femur.
  • The original treatment was open reduction and casting.
  • Fifteen years after the injury, the patient presented to the emergency room with increasing pain, erythema, swelling, and increased purulent discharge from the distal femur.
  • The left distal femur was radically resected for treatment of osteomyelitis.
  • Histologic samples of the specimen revealed malignant fibrous histiocytoma of bone.
  • One of two inguinal lymph nodes removed at that time was positive for malignant fibrous histiocytoma.
  • The patient had additional chemotherapy.
  • [MeSH-major] Bone Neoplasms / complications. Histiocytoma, Malignant Fibrous / complications. Osteomyelitis / complications
  • [MeSH-minor] Chronic Disease. Femur / pathology. Femur / surgery. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Tomography, X-Ray Computed

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  • (PMID = 16205169.001).
  • [ISSN] 0009-921X
  • [Journal-full-title] Clinical orthopaedics and related research
  • [ISO-abbreviation] Clin. Orthop. Relat. Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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7. Xiao JY, Ye ZX, Wang SL, Wang LS: [Value of imaging in the diagnosis of primary malignant fibrous histiocytoma of bone]. Zhonghua Zhong Liu Za Zhi; 2005 Jun;27(6):364-8
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  • [Title] [Value of imaging in the diagnosis of primary malignant fibrous histiocytoma of bone].
  • OBJECTIVE: To investigate the imaging feature of primary malignant fibrous histiocytoma of the bone (PBMFH) by the conventional radiography, CT and MRI, and to evaluate these different imaging methods in its diagnosis.
  • RESULTS: Though the imaging appearance of PBMFH varied in different cases, all the imaging findings of malignant bone tumors were revealed.
  • The common imaging appearance on the conventional radiography and CT were eccentric, aggressive, osteolytic destructions of various types located at the ends of extremities with extraosseous soft tissue masses, but periosteal reaction was rare.
  • CONCLUSION: Primary malignant bone fibrous histiocytoma, a rare primary malignant bone tumor, is most frequently located in the long bone.
  • Conventional radiography is still the first and main choice and is taken as an essential means of diagnosis.
  • CT and MRI are quite important in demonstrating the details and extent of the disease such as soft tissue, cortical destruction, periosteal reaction, calcification and necrosis.
  • The imaging characteristics may be of value in differentiating MFH from the other malignant bone tumors.
  • Furthermore, MRI may also be valuable in assessing the efficacy of chemotherapy and/or radiation therapy, as well as in distinguishing recurrence from postoperative or post-radiation changes.
  • [MeSH-major] Bone Neoplasms / diagnosis. Histiocytoma, Malignant Fibrous / diagnosis. Magnetic Resonance Imaging. Tomography, X-Ray Computed

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  • (PMID = 16117901.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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8. Minard-Colin V, Kalifa C, Guinebretiere JM, Brugieres L, Dubousset J, Habrand JL, Vassal G, Hartmann O: Outcome of flat bone sarcomas (other than Ewing's) in children and adolescents: a study of 25 cases. Br J Cancer; 2004 Feb 9;90(3):613-9
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  • [Title] Outcome of flat bone sarcomas (other than Ewing's) in children and adolescents: a study of 25 cases.
  • We analysed the clinical features and outcome of young patients with non-Ewing's flat bone sarcoma treated during the era of contemporary chemotherapy.
  • The characteristics and outcome of 25 patients (15 males and 10 females) with primary or radiation-related flat bone sarcoma treated in the Pediatrics Department at the Institut Gustave Roussy from 1981 to 1999 were reviewed.
  • In all, 20 patients had osteosarcoma, four chondrosarcoma and one malignant fibrous histiocytoma.
  • The age at diagnosis ranged from 2 to 23 years (median, 15 years).
  • Four patients had metastatic disease at diagnosis.
  • Radiation-associated flat bone osteosarcoma was diagnosed in 10 out of 25 cases.
  • The EFS rate of patients with second bone sarcoma was similar to that of patients with de novo flat bone sarcoma (P=0.1).
  • The aim of treatment was curative for 24 patients, 23 of whom were treated with intensive chemotherapy regimens and 19 with surgery.
  • Significant adverse prognostic factors on survival included incomplete surgical resection (P=0.001) and use of regimens without pre- and postoperative chemotherapy (P=0.007).
  • Nine of the 25 patients were treated with pre- and postoperative chemotherapy and complete surgical resection.
  • Radical surgical resection is the overriding prognostic factor for flat bone sarcomas in young patients.
  • Nevertheless, our results suggest a more favourable outcome since the advent of intensive chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / drug therapy. Bone Neoplasms / pathology. Chondrosarcoma / drug therapy. Chondrosarcoma / pathology. Histiocytoma, Benign Fibrous / drug therapy. Histiocytoma, Benign Fibrous / pathology. Neoplasms, Radiation-Induced / drug therapy. Neoplasms, Radiation-Induced / pathology. Osteosarcoma / drug therapy. Osteosarcoma / pathology
  • [MeSH-minor] Adolescent. Adult. Age of Onset. Child. Child, Preschool. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Prognosis. Treatment Outcome

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  • (PMID = 14760373.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2409588
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9. Chuman H: [Current topics in the diagnosis and treatment of malignant fibrous histiocytoma]. Gan To Kagaku Ryoho; 2003 May;30(5):626-33
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  • [Title] [Current topics in the diagnosis and treatment of malignant fibrous histiocytoma].
  • Malignant fibrous histiocytoma (MFH) is a tumor about which much remains unknown.
  • The cell origin, molecular mechanism of pleomophism and mechanism of pleomorphic change in a cell undergoing malignant change have not been elucidated.
  • MFH-like histological changes are observed in many bone and cartilage sarcomas, and some renal cell carcinomas and malignant lymphomas.
  • These changes occur in many subtypes of sarcomas such as osteogenic sarcoma, chondrosarcoma, leiomyosarcoma, rhabdomyosarcoma, and liposarcoma.
  • MFH has been regarded as one tumor classification from its special histopathological features.
  • In clinical pathological studies these tumors are divided into low-grade fibrous tumors and fibrous histiocytic tumors.
  • With the establishment of molecular biological diagnostic methods, MFH-like histological features can be seen in changes in cellular differentiation of many sarcomas.
  • Patients with MFH often have repeated recurrences before a diagnosis is made, and the tumor is partially resected.
  • The sensitivity of MFH to radiotherapy and chemotherapy is insufficient, and evidence is lacking for adjuvant treatment.
  • Rescue following initial treatment failure is extremely difficult.
  • Local control of 70% to 90% can be achieved if a correct diagnosis is made, and a curative wide resection or salvage wide resection are done early.
  • For treatment of bone and soft tissue sarcoma, a correct diagnosis and initial treatment are extremely important.
  • Many cases need to be accumulated in joint clinical studies across fields according to organ and specialty, and effective treatment method developed.
  • We need to advance the standardization of treatment for MFH, and eliminate wrong initial treatment through the active provision of information.
  • [MeSH-major] Bone Neoplasms. Histiocytoma, Benign Fibrous. Soft Tissue Neoplasms
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Prognosis. Radiotherapy, Adjuvant. Sarcoma / pathology. Sarcoma / surgery. Sarcoma / therapy. Survival Rate

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  • (PMID = 12795093.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
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10. Goto T, Okuma T, Nakada I, Hozumi T, Kondo T: [Preoperative adjuvant therapy for primary malignant bone tumors]. Gan To Kagaku Ryoho; 2007 Nov;34(11):1750-4
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  • [Title] [Preoperative adjuvant therapy for primary malignant bone tumors].
  • In primary bone sarcomas, the efficacy of chemotherapy varies according to the histological types.
  • Prognoses are poor in patients with osteosarcoma or Ewing's sarcoma, when surgery alone is performed.
  • However, because these sarcomas are chemosensitive, their prognoses have been improved with adjuvant chemotherapy.
  • Nowadays, in highgrade bone sarcomas, especially in osteosarcoma, Ewing.s sarcoma and malignant fibrous histiocytoma of bone, adjuvant chemotherapy including neoadjuvant or preoperative chemotherapy is usually performed.
  • The purpose of the neoadjuvant chemotherapy is (I) to prevent distant metastases, (II) to reduce the size of the primary tumor and (III) to evaluate the efficacy of the chemotherapeutic agents.
  • Evaluating the efficacy of the chemotherapeutic agents in preoperative chemotherapy facilitates rational selection of postoperative chemotherapeutic agents.
  • Commonly used drugs include adriamycin, ifosfamide, cisplatin, methotrexate and vincristine in osteosarcoma, and vincristine, adriamycin, cyclophosphamide, ifosfamide, actinomycin-D and etoposide in Ewing's sarcoma.
  • In contrast, chondrosarcomas are chemoresistant, and chemotherapy is rarely performed.
  • Low-grade bone sarcomas, e. g., parosteal osteosarcoma, central low-grade osteosarcoma, are well cured only by surgical excision, and adjuvant chemotherapy is not performed for these low-grade sarcomas.
  • To enhance the efficacy of preoperative chemotherapy, various modalities have been used e. g., intraarterial infusion, caffeine-assisted chemotherapy, and local perfusion with hyperthermia.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / drug therapy
  • [MeSH-minor] Cyclophosphamide / administration & dosage. Dactinomycin / administration & dosage. Doxorubicin / administration & dosage. Drug Administration Schedule. Humans. Ifosfamide / administration & dosage. Neoadjuvant Therapy. Neoplasm Metastasis / prevention & control. Osteosarcoma / drug therapy. Osteosarcoma / surgery. Prognosis. Sarcoma, Ewing / drug therapy. Sarcoma, Ewing / surgery. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / surgery. Vincristine / administration & dosage

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  • (PMID = 18030009.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; UM20QQM95Y / Ifosfamide; VAC protocol; VACA protocol; VAIA protocol
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11. Demiralp B, Erler K, Ozturan EK, Bek D, Ozdemir T, Kurt B: An uncommon presentation of malignant fibrous histiocytoma of the calcaneus. J Am Podiatr Med Assoc; 2007 May-Jun;97(3):218-22
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  • [Title] An uncommon presentation of malignant fibrous histiocytoma of the calcaneus.
  • Malignant fibrous histiocytoma of bone is the osseous counterpart of the tumor in soft tissue.
  • It is a rare primary bone tumor, and there have been conflicting reports on its grades of malignancy.
  • We describe a primary malignant fibrous histiocytoma of the calcaneal bone in a 21-year-old man.
  • The patient underwent neoadjuvant and adjuvant chemotherapy and below-the-knee amputation, and no local recurrence or metastasis was noted after 2 years of follow-up.
  • [MeSH-major] Bone Neoplasms / pathology. Calcaneus. Histiocytoma, Malignant Fibrous / pathology

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  • (PMID = 17507531.001).
  • [ISSN] 8750-7315
  • [Journal-full-title] Journal of the American Podiatric Medical Association
  • [ISO-abbreviation] J Am Podiatr Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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12. Asavamongkolkul A, Waikakul S, Phimolsarnti R, Kiatisevi P, Wangsaturaka P: Endoprosthetic reconstruction for malignant bone and soft-tissue tumors. J Med Assoc Thai; 2007 Apr;90(4):706-17
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  • [Title] Endoprosthetic reconstruction for malignant bone and soft-tissue tumors.
  • BACKGROUND: Nowadays, the results of the management of malignant bone and soft-tissue tumors have been dramatically improved because of the advance in imaging, chemotherapy, radiation therapy, and surgical techniques.
  • Patients can have longer survival times with limb-salvage surgery.
  • Several techniques of reconstruction have been advocated and gained more popularity following malignant tumor resection by using allograft, tumor prostheses, composite allograft prosthesis, or arthrodesis.
  • OBJECTIVE: To report the preliminary results of 32 endoprosthetic reconstructions following malignant bone and soft-tissue tumor resection.
  • MATERIAL AND METHOD: Since September 1988, the authors have performed 188 limb-salvage surgical operations for the treatment of musculoskeletal tumors at Siriraj Hospital.
  • From March 1994 to July 2006, 32 endoprosthetic reconstructions were performed on 30 patients following malignant bone or soft-tissue tumor removal.
  • The diagnosis was conventional osteosarcoma in 16 patients, parosteal osteosarcoma in two patients, chondrosarcoma in two patients, leiomyosarcoma in two patients, failed allograft in two patients and one patient each of periosteal osteosarcoma, Ewing's sarcoma, Gorham's disease, synovial sarcoma, malignant fibrous histiocytoma, metastatic renal cell carcinoma, and prosthetic loosening.
  • Five proximal femurs, 17 distal femurs, 1 total femur 3 proximal tibias, 1 intercalary tibia, 4 proximal humerus and 1 distal humerus were used for reconstruction.
  • RESULTS: The mean follow-up time was 26 months (range 6-128.7).
  • CONCLUSION: Endoprosthetic reconstruction could yield satisfactory results as a wide excision and limb-salvage for patients with malignant bone and soft-tissue tumors.
  • [MeSH-major] Bone Neoplasms / surgery. Limb Salvage. Osteosarcoma / surgery. Sarcoma, Ewing / surgery. Soft Tissue Neoplasms / surgery

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  • (PMID = 17487125.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Thailand
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13. Weber K, Damron TA, Frassica FJ, Sim FH: Malignant bone tumors. Instr Course Lect; 2008;57:673-88
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  • [Title] Malignant bone tumors.
  • Malignant bone tumors represent a small percentage of cancers nationwide and also are much less common than malignant soft-tissue tumors.
  • The rarity of the condition makes it imperative that orthopaedic surgeons in nononcologic practices are able to recognize the symptoms that suggest a possible bony malignancy to avoid inappropriate or delayed treatment.
  • The most common primary malignant bone tumors, osteosarcoma and Ewing's sarcoma, occur in childhood.
  • The primary symptom of a patient with a malignant bone tumor is pain, which often occurs at rest or at night.
  • Patients with a likely malignancy require thorough staging to determine the extent of disease and a well-planned biopsy for accurate diagnosis.
  • Knowledge of specific tumor characteristics and treatment options for osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, chordoma, and adamantinoma is important.
  • Patients with osteosarcoma and resectable Ewing's sarcoma are treated with chemotherapy followed by surgical resection.
  • Secondary sarcomas can occur in previously benign bone lesions and require aggressive treatment.
  • Specific techniques are available for the resection of malignant bone tumors from the upper extremities, lower extremities, pelvis, and spine.
  • The care of patients with primary malignant bone tumors requires a multidisciplinary approach to treatment.
  • [MeSH-major] Bone Neoplasms. Orthopedic Procedures / methods

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  • (PMID = 18399615.001).
  • [ISSN] 0065-6895
  • [Journal-full-title] Instructional course lectures
  • [ISO-abbreviation] Instr Course Lect
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 42
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14. Delépine F, Delépine G, Belarbi L, Markowska B, Alkallaf S, Cornille H, Delépine N: [Diagnosis and treatment of malignant bone fibrohistiocytoma]. Ann Med Interne (Paris); 2001 Nov;152(7):437-45
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  • [Title] [Diagnosis and treatment of malignant bone fibrohistiocytoma].
  • [Transliterated title] Diagnostic et traitement des histiocytofibromes malins de l'os.
  • Malignant fibrous histiocytoma (MFH) and giant cells sarcoma arise from fibrous tissue and histiocytic cells evenly distributed in all age group, except children much less common than osteosarcoma and chondrosarcoma.
  • Outcome was historically better than those of osteosarcoma but hangs on the grading of tumors; low grade sarcoma have a regional evolution while high grade malignant histiocytofibroma are threatened with metastases.
  • Therapy must be adapted to the histological grading and the extent of the illness.
  • Low grade localized MFH are best treated by wide resection.
  • High grade MFH are preferentially treated by a comprehensive multidisciplinary approach with preoperative chemotherapy including high dose methotrexate, wide resection and postoperative chemotherapy.
  • With such a treatment, nearly 80% of patients seen with localized tumor of the limb can be cured and keep a functional limb.
  • [MeSH-major] Bone Neoplasms / diagnosis. Histiocytoma, Benign Fibrous / diagnosis. Osteosarcoma / diagnosis
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Diagnosis, Differential. Female. Humans. Limb Salvage. Male. Middle Aged

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  • (PMID = 11965084.001).
  • [ISSN] 0003-410X
  • [Journal-full-title] Annales de médecine interne
  • [ISO-abbreviation] Ann Med Interne (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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15. Domson GF, Shahlaee A, Reith JD, Bush CH, Gibbs CP: Infarct-associated bone sarcomas. Clin Orthop Relat Res; 2009 Jul;467(7):1820-5
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  • [Title] Infarct-associated bone sarcomas.
  • Sarcoma associated with bone infarct is a rare condition sparsely reported in the literature.
  • Sixty percent of cases arise about the knee and most are malignant fibrous histiocytomas.
  • Treatment was limb salvage in seven patients, amputation in six, and biopsy alone in two.
  • Two patients received chemotherapy and both were continuously disease-free at last followup.
  • When we combined our 15 patients with the 52 previously reported in the literature, 38 of the 67 (57%) died of their disease at an average of 19.2 months after diagnosis; 21 patients (31%) were continuously disease-free for 24 months.
  • Of 13 patients who received chemotherapy, eight (62%) were continuously disease-free at 24 months compared with 24% (13 of 54) of those who did not receive chemotherapy.
  • Overall, prognosis for these patients is poor, but survival in patients without metastatic disease at diagnosis approaches that of other bone sarcomas.
  • There is a trend suggesting adjuvant chemotherapy combined with appropriate surgery may improve patient outcomes.
  • LEVEL OF EVIDENCE: Level IV, therapeutic study.
  • [MeSH-major] Bone Neoplasms / complications. Histiocytoma, Malignant Fibrous / complications. Infarction / complications. Sarcoma / complications

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  • (PMID = 19229663.001).
  • [ISSN] 1528-1132
  • [Journal-full-title] Clinical orthopaedics and related research
  • [ISO-abbreviation] Clin. Orthop. Relat. Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2690751
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16. Wang J, Chen A, Luo Y: [Surgical management of limb salvage for osteogenic malignant tumors around knees]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2006 Oct;20(10):975-7
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  • [Title] [Surgical management of limb salvage for osteogenic malignant tumors around knees].
  • OBJECTIVE: To probe a satisfactory surgical management of the limb salvage for osteogenic malignant tumors around the knees.
  • METHODS: From January 1989 to December 2001, 42 patients (19 males and 18 females, aged 12-46) with osteogenic malignant tumors around the knees underwent surgical management of the limb salvage, including prosthesis replacement, allogenous bone grafting, and bone cement with adriamycin filled.
  • Based on the pathological examination, osteosarcoma was found in 11 patients, synoviosarcoma in 4 patients, malignant fibrous histiocytoma in 3 patients, and giant cell tumor of the bone in 19 patients.
  • All the patients underwent neoadjuvant chemotherapy for 1-2 courses before operation except the patients with giant cell tumor of the bone.
  • The patients underwent prosthesis replacement, allogenous bone grafting, bone cement with adriamycin filled, and postoperative chemotherapy.
  • By the Enneking evaluating system, the patients were assessed on their reconstructed limb functions after the reconstructive operation for the musculoskeletal malignant tumors.
  • Two patients had amputation of the limb for the rejection of the allogenous bone graft and the formation of the fistula.
  • CONCLUSION: Making an early diagnosis, recognizing the operative indication, choosing the operative method, and performing the preoperative and postoperative chemotherapy and/or radiotherapy are the keys to achieving an ideal limb-salvage surgery for osteogenic malignant tumors around the knees.
  • [MeSH-minor] Adolescent. Adult. Child. Female. Follow-Up Studies. Giant Cell Tumor of Bone / surgery. Humans. Male. Middle Aged. Prosthesis Implantation. Reconstructive Surgical Procedures. Soft Tissue Neoplasms / surgery

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  • (PMID = 17140066.001).
  • [ISSN] 1002-1892
  • [Journal-full-title] Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery
  • [ISO-abbreviation] Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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17. Staals EL, Bacchini P, Bertoni F: Dedifferentiated central chondrosarcoma. Cancer; 2006 Jun 15;106(12):2682-91
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  • METHODS: In this retrospective study, the clinical, radiographic, and histologic features and the treatments in 123 patients from the Rizzoli Institute were reviewed in an attempt to define which factors may be related to outcome in patients with dedifferentiated central chondrosarcoma.
  • Radiographically, a soft tissue mass was present in 87% of patients, and a bimorphic pattern was appreciated in 53% of patients.
  • In most patients, the dedifferentiated component showed the features of an osteosarcoma (92 patients), followed by fibrosarcoma (19 patients), and malignant fibrous histiocytoma (9 patients).
  • For 101 patients, surgery was a component of their definitive management.
  • In 25 patients, surgery was combined with chemotherapy.
  • CONCLUSIONS: Metastatic disease at diagnosis, malignant fibrous histiocytoma dedifferentiation, and a high percentage of dedifferentiated component were related to poorer outcomes.
  • There was no statistical evidence of any beneficial effect from adjuvant chemotherapy.
  • [MeSH-major] Bone Neoplasms / pathology. Bone Neoplasms / radiography. Chondrosarcoma / pathology. Chondrosarcoma / radiography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cell Differentiation. Combined Modality Therapy. Drug Therapy. Female. Femur / pathology. Histiocytoma, Malignant Fibrous / pathology. Histiocytoma, Malignant Fibrous / radiography. Histiocytoma, Malignant Fibrous / therapy. Humans. Humerus / pathology. Male. Middle Aged. Neoplasm Metastasis. Pelvis / pathology. Prognosis. Retrospective Studies. Survival Analysis. Survival Rate. Tomography, X-Ray Computed. Treatment Outcome

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  • [Copyright] Copyright 2006 American Cancer Society.
  • (PMID = 16691621.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Oya N, Aoki J, Shinozaki T, Watanabe H, Takagishi K, Endo K: Preliminary study of proton magnetic resonance spectroscopy in bone and soft tissue tumors: an unassigned signal at 2.0-2.1 ppm may be a possible indicator of malignant neuroectodermal tumor. Radiat Med; 2000 May-Jun;18(3):193-8
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  • [Title] Preliminary study of proton magnetic resonance spectroscopy in bone and soft tissue tumors: an unassigned signal at 2.0-2.1 ppm may be a possible indicator of malignant neuroectodermal tumor.
  • PURPOSE: To evaluate the utility of proton magnetic resonance spectroscopy in bone and soft tissue tumors, especially whether or not the N-acetyl aspartate signal (NAA) could be recognized in neurogenic tumors.
  • MATERIALS AND METHODS: Forty-nine proton magnetic resonance spectroscopy studies were performed in 60 bone and soft tissue tumors.
  • RESULTS: An unassigned signal at about 2.0-2.1 ppm was recognized in six of 47 lesions: clear cell sarcoma (2/2), Ewing sarcoma (1/1), malignant fibrous histiocytoma (1/3), malignant schwannoma (1/1), and mucoepidermoid carcinoma (1/1).
  • Neuroblastoma (1/1), primitive neuroectodermal tumor (1/1), and malignant melanoma (1/1) after chemotherapy or radiotherapy did not show this signal.
  • CONCLUSIONS: The assigned signal at about 2.0-2.1 ppm was detected in a small percentage of bone and soft tissue tumors and could be suggestive of an untreated malignant tumor of neuroectodermal origin.
  • [MeSH-major] Aspartic Acid / analogs & derivatives. Bone Neoplasms / diagnosis. Magnetic Resonance Spectroscopy. Neuroectodermal Tumors / diagnosis. Soft Tissue Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Child, Preschool. Diagnosis, Differential. Female. Humans. Infant. Male. Middle Aged

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  • (PMID = 10972550.001).
  • [ISSN] 0288-2043
  • [Journal-full-title] Radiation medicine
  • [ISO-abbreviation] Radiat Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 30KYC7MIAI / Aspartic Acid; 997-55-7 / N-acetylaspartate
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19. Nakamura T, Kusuzaki K, Seto M, Matsumine A, Uchida A: Case report: recurrence of soft tissue MFH in bone due to minute intravenous tumor emboli detected by MRI. Oncol Rep; 2003 Nov-Dec;10(6):1957-60
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  • [Title] Case report: recurrence of soft tissue MFH in bone due to minute intravenous tumor emboli detected by MRI.
  • We recently encountered a case with local recurrence of malignant fibrous histiocytoma (MFH) in the bone after wide resection, caused by minute intravenous tumor emboli which were retrospectively detected in MR imaging.
  • The tumor was diagnosed to be MFH, therefore a wide resection was performed; although the tumor was closely attached to the periosteum, it was not difficult to dissect the tumor subperiosteally from the cortex of the femur.
  • The patient received postoperative brachytherapy, but no chemotherapy.
  • Such intravenous tumor emboli have recently been implicated in the development of regional bone metastasis near the site of the primary lesion in cases of malignant soft tissue tumors.
  • It is therefore emphasized that MR images should be carefully reviewed for the presence of such intravenous tumor emboli before surgery in cases of high-grade malignant sarcomas.
  • As at the time of writing, our patient remains alive and disease-free, with no evidence of any local recurrence or distant metastasis after wide tumor resection for the recurrent tumor.
  • [MeSH-major] Bone Neoplasms / diagnosis. Bone Neoplasms / secondary. Histiocytoma, Benign Fibrous / diagnosis. Histiocytoma, Benign Fibrous / metabolism. Magnetic Resonance Imaging / methods. Recurrence. Soft Tissue Neoplasms / diagnosis. Soft Tissue Neoplasms / metabolism

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  • (PMID = 14534725.001).
  • [ISSN] 1021-335X
  • [Journal-full-title] Oncology reports
  • [ISO-abbreviation] Oncol. Rep.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
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20. Daw NC, Mahmoud HH, Meyer WH, Jenkins JJ, Kaste SC, Poquette CA, Kun LE, Pratt CB, Rao BN: Bone sarcomas of the head and neck in children: the St Jude Children's Research Hospital experience. Cancer; 2000 May 1;88(9):2172-80
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  • [Title] Bone sarcomas of the head and neck in children: the St Jude Children's Research Hospital experience.
  • BACKGROUND: Bone sarcomas of the head and neck are difficult to resect.
  • METHODS: The records of the 28 patients with bone sarcomas originating in the head and neck treated at St. Jude Children's Research Hospital between March 1962 and January 1998 were reviewed.
  • RESULTS: There were 10 males and 18 females (median age, 12.6 years) each with a single sarcoma: osteosarcoma (18), Ewing sarcoma (7), malignant fibrous histiocytoma (MFH) (2), and fibrosarcoma (1).
  • All but one patient with Ewing sarcoma had localized disease at the time of diagnosis.
  • All patients underwent surgery: complete resection, 8; gross total resection, 4; incomplete resection, 14; and biopsy only, 2; 22 also received chemotherapy.
  • Radiotherapy was given to all patients with Ewing sarcoma and to four patients with primary osteosarcoma.
  • Twelve patients survived a median of 8.4 years after diagnosis, 14 died of disease, and 2 died of unrelated causes.
  • Local disease progression was evident in 12 patients (9 with osteosarcoma, 2 with MFH, and 1 with Ewing sarcoma) who died of disease, 9 of whom had the initial treatment of biopsy alone or incomplete resection.
  • Patients with osteosarcoma who had the initial treatment of incomplete resection or biopsy alone were more likely to experience local failure (P = 0.001) and had poorer survival (P = 0.014) than those who underwent complete or gross total resection.
  • CONCLUSIONS: Bone sarcomas of the head and neck are rare among children and most often are localized at the time of diagnosis.
  • Although aggressive surgery is essential for the cure of osteosarcoma, its necessity in the treatment of Ewing sarcomas remains controversial.
  • [MeSH-major] Sarcoma / surgery. Skull Neoplasms / surgery
  • [MeSH-minor] Adolescent. Adult. Cause of Death. Chemotherapy, Adjuvant. Child. Child, Preschool. Disease Progression. Female. Fibrosarcoma / surgery. Histiocytoma, Benign Fibrous / surgery. Hospitals, Pediatric. Humans. Infant. Male. Mandibular Neoplasms / surgery. Maxillary Neoplasms / surgery. Neoplasm Recurrence, Local / pathology. Osteosarcoma / surgery. Radiotherapy, Adjuvant. Retrospective Studies. Sarcoma, Ewing / surgery. Survival Rate. Tennessee. Treatment Outcome

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  • (PMID = 10813731.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-21765; United States / NCI NIH HHS / CA / CA-23099
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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21. Ludwig K: [Musculoskeletal lymphomas]. Radiologe; 2002 Dec;42(12):988-92
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  • Primary lymphomas of bone or skeletal muscle are rare entities.
  • The most frequent among these diseases are primary non-Hodgkin's lymphomas of bone.
  • They account for 3-5% of all bone tumors and 5% of all primary extranodal non-Hodgkin's lymphomas.
  • Primary manifestations of Hodgkin's disease in bone or skeletal muscle are rarities.
  • Primary non-Hodgkin's lymphomas of bone can be found in any patient age.
  • The radiographic appearance of these entities resembles other aggressive bone tumors.
  • Their differential diagnosis includes -- depending on the patient's age -- Ewing's sarcoma,malignant fibrous histiocytoma,metastases of small cell tumors and osteomyelitis.Further differential diagnoses are the peripheral primitive neuroectodermal tumor (PNET), osteosarcoma, eosinophilic granuloma and fibrosarcoma.
  • Treatment of primary non-Hodgkin's lymphomas uses combinations of chemotherapy and radiation therapy.
  • Operative treatment is reserved for the treatment of complications.
  • [MeSH-major] Bone Neoplasms / diagnosis. Hodgkin Disease / diagnosis. Lymphoma, Non-Hodgkin / diagnosis. Magnetic Resonance Imaging. Muscle Neoplasms / diagnosis. Tomography, X-Ray Computed
  • [MeSH-minor] Bone and Bones / pathology. Humans. Muscle, Skeletal / pathology. Neoplasm Staging. Prognosis. Sensitivity and Specificity

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  • (PMID = 12486552.001).
  • [ISSN] 0033-832X
  • [Journal-full-title] Der Radiologe
  • [ISO-abbreviation] Radiologe
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 0
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22. Merimsky O, Kollender Y, Issakov J, Bickels J, Flusser G, Gutman M, Lev-Chelouche D, Inbar M, Meller I: Multiple primary malignancies in association with soft tissue sarcomas. Cancer; 2001 Apr 1;91(7):1363-71
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  • [Title] Multiple primary malignancies in association with soft tissue sarcomas.
  • BACKGROUND: Modern cancer treatment has increased the survival of patients with various malignancies substantially.
  • One of the late sequelae of successful treatment is the development of a second malignant tumor.
  • However, in many cases of second primary tumors, exposure to chemotherapy or radiation therapy is not evident, and it should be postulated that the putative mechanism for the development of the second tumor is different.
  • In the current series, the association between soft tissue sarcoma (STS) in adults and the development of other primary malignancies was studied.
  • METHODS: A retrospective search of the data files of 610 patients with STS or bone sarcomas who were treated at the study institution between January 1995 and December 1999 was performed.
  • All files regarding patients with STS who developed a second malignant tumor were retrieved for analysis.
  • RESULTS: Of 375 patients with STS, 28 (7.5%) developed other malignant neoplasms either before or after the diagnosis of STS.
  • Only three patients were treated with chemotherapy for their sarcoma.
  • Radiation therapy was administered to five patients as an adjuvant to surgery for the first tumor.
  • The second tumor types mainly included STS and renal cell carcinoma.
  • The time interval between the diagnosis of the STS and the second malignancy was 0 (for synchronous tumors) to 21 years.
  • Three patients developed a third primary tumor within 3 years after the diagnosis of the second tumor.
  • The median overall survival for the 14 patients in this group from the time of diagnosis of the first tumor was > 102 months.
  • This is especially true in patients with primary malignant fibrous histiocytoma who demonstrate a risk for developing a renal cell carcinoma.
  • [MeSH-major] Neoplasms, Multiple Primary. Sarcoma. Soft Tissue Neoplasms
  • [MeSH-minor] Adolescent. Adult. Aged. Bone Neoplasms / therapy. Humans. Middle Aged. Neoplasms, Second Primary. Retrospective Studies

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  • [Copyright] Copyright 2001 American Cancer Society.
  • (PMID = 11283938.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Mardinger O, Givol N, Talmi YP, Taicher S: Osteosarcoma of the jaw. The Chaim Sheba Medical Center experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod; 2001 Apr;91(4):445-51
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  • Each patient had a histopathologically established diagnosis of osteosarcoma of the jaw.
  • Records were reviewed for epidemiologic data, treatment modalities, and survival.
  • Histopathologic types included chondroblastic, osteoblastic, fibroblastic, and malignant fibrous histiocytoma-like.
  • Adjuvant therapy included postoperative radiation (5 patients), postoperative chemotherapy (2 patients), and preoperative chemotherapy and postoperative radiation (1 patient).
  • Because of differences in tumor characteristics, the introduction of chemotherapy did not dramatically alter the prognosis of osteosarcoma of the jaw.
  • Early diagnosis and radical surgery are the keys to high survival rates.
  • [MeSH-minor] Adolescent. Adult. Aged. Bone Neoplasms / pathology. Chemotherapy, Adjuvant. Child. Disease-Free Survival. Female. Growth Plate / pathology. Humans. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Recurrence, Local. Prognosis. Radiotherapy, Adjuvant

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  • (PMID = 11312461.001).
  • [ISSN] 1079-2104
  • [Journal-full-title] Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics
  • [ISO-abbreviation] Oral Surg Oral Med Oral Pathol Oral Radiol Endod
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 90
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24. Inaba H, Khan RB, Laningham FH, Crews KR, Pui CH, Daw NC: Clinical and radiological characteristics of methotrexate-induced acute encephalopathy in pediatric patients with cancer. Ann Oncol; 2008 Jan;19(1):178-84
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  • BACKGROUND: Little information is available about the diagnosis and management of acute methotrexate (MTX)-induced encephalopathy.
  • RESULTS: Six of 754 (0.8%) patients with leukemia or lymphoma and 2 of 44 (4.5%) with bone sarcoma experienced acute encephalopathy within 2 weeks (median, 7.5 days) after receiving high-dose i.v. and/or intrathecal MTX.

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  • (PMID = 17947226.001).
  • [ISSN] 1569-8041
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA021765; United States / NCI NIH HHS / CA / CA023099
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 27Y3KJK423 / Aminophylline; YL5FZ2Y5U1 / Methotrexate
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