In lung cancer patients, metastases to soft tissues (STs), including skeletal muscle, subcutaneous tissue and skin, are rarely reported. Besides, lung cancer, primary carcinomas of the kidney and ...colon are the most commonly associated with ST metastases.
To determine the prevalence, clinical-pathological features and treatment options of ST metastases originating from lung carcinoma.
A literature search was performed using the following terms: lung cancer, ST metastasis, skeletal muscle metastasis, cutaneous metastasis, subcutaneous metastasis.
Autopsy series have detected STs metastases in 0.75-9% of patients who died from metastatic lung carcinoma. Pain and the presence of a palpable mass are the most frequent clinical features. The biopsy is recommended after MRI for diagnosis. Due to the rarity of ST metastases, the differential diagnosis must be posed especially with primary ST sarcomas. The type of treatment depends on the patient's clinical status and prognosis, and includes observation, radiotherapy, chemotherapy and surgery.
In lung cancer patients, ST metastases are rare, but not exceptional. Their presence should be suspected in the presence of a palpable mass either painful or asymptomatic. Radiological and histological examinations are required for the definite diagnosis. The choice of treatment should be based on considerations related to the stage of the primary tumor and the patient's global health status.
Abstract Advances in adjuvant and neoadjuvant therapies have improved the prognosis of cancer patients leading to an increasing incidence of bone metastases and consequent long bone fractures. In the ...present study the authors consider the indications and the different surgical options of treatment of tibial pathological lesions. 13 patients (14 lesions, 6 pathological fractures), treated according to histotype and lesion localisation, were retrospectively evaluated. Using generic outcome instruments such as the Eastern Cooperative Oncology Group (ECOG) and Quality of life questionnaire of European Organization for Research and Treatment of Cancer (QLQ-C30) pain, mobility and use of analgesics were evaluated before and after surgery. In all patients, mechanical stabilisation of the osteolytic lesion was achieved. There were no pathological fractures, and no implant mechanical failure. All patients reported pain relief, with a relevant reduction in the amount of analgesics used. Surgical treatment of tibial metastases has to be decided taking into consideration the histotype, localisation of the metastases and life expectancy. The treatment has to be all-encompassing in a solitary lesion in patients with a good prognosis but less invasive in plurimetastatic patients with poor prognosis. Acquisition of good mechanical stability is crucial for a successful outcome.
Bone resection is the choice treatment of malignant bone tumors. Tumor prosthesis is one of the most common solutions of reconstruction following resection of bone tumor located to the metaphysis of ...long bones. Periprosthetic infections are a frequent complication of limb-salvage surgery which is largely due to prolonged and repeated surgeries, as well as to the immunocompromised condition of these patients due to neoplastic treatment. Furthermore, the large exposure of tissues during this type of surgery and the dissection across vascular distributions also contributes to the high risk of infection. The authors reviewed the literature discussing the incidence of infections of tumor prosthesis implanted following resection of bone tumors, taking into account the different sites of implantation. In the English literature, the highest risk of infection which led to limb amputation was observed after proximal tibia resection and this difference was considered to be due to the poor condition of soft tissue and also after pelvic resection due to huge dead space after sarcoma resection not filled by implant. Independent of the location, the management of infected prosthesis is similar. That is, after one or more attempts at debridement and antibiotic therapy, it consists of implant removal and insertion of a new implant in a one- or two-stage procedure, with a decreased risk of failure with the two-stage procedure.
The efficacy of bisphosphonate in controlling skeletally-related event in cancer patients without a great number of adverse events has resulted in a widespread use of these medications in oncology. ...Zoledronic acid and pamidronate are the most common bisphosphonates intravenously administered as a preventive treatment of bone complications encountered in multiple myeloma, as well as a palliative treatment of bone metastases in a large variety of solid tumours including breast, prostate and lung cancers. However, in recent years a relationship has been established between these drugs and a new bone injury characterised by avascular necrosis of bone that was isolated to the jaws. This paper reviews the literature concerning the discovery of this disease, its clinical, radiological and histological manifestations; its pathogenesis, with a look at the treatment and future options in preventing this complication and in treating hypercalcemia and bone lytic lesions in solid tumours.
Prosthetic joints loosening in absence of infection is the most common reason for revision surgery and is known as aseptic loosening. A significant role in the pathogenesis of implant failure ...undoubtedly played by the generation of wear debris, mainly from the load bearing joint surfaces, and the cellular reaction through the formation of tissue membrane around implants. This article analyzes histologic, immunohistochemical ad ultrastructural aspects of periprosthetic tissue membrane collected at time of surgical revision, paying attention on cell host response to different materials: metals, polyethylene and ceramics. Dimension of particles seems to be crucial in the activation of different cell population to wear debris.
The chondrocyte, the only cellular component of adult articular cartilage, plays a key role in the pathogenesis of osteoarthritis (OA). The evolution of this process is very slow: the first changes ...involve the cell-matrix morphofunctional unit known as chondron. In this study we analyzed the cartilage of 10 patients with primary osteoarthritis. The cartilage was retrieved during total knee replacement (TKR) and maxillofacial surgery procedures. All patients presented an osteoarthritis of at least grade III. The preparation of the specimens was made by taking cartilage from both well-preserved and macroscopically degenerated areas. Specimens underwent histological evaluation with conventional staining and ultrastructural analysis. Age appeared to be a high risk factor in the development of articular cartilage damages. Depth of injury was also found to be age-related as more extensive lesions were found in the elderly, either in the knee or in the mandibular condyle. Whatever the cause of possible damage, Scanning Electron Microscopy (SEM) observations showed that at the beginning most degenerative changes in articular cartilage involved the chondron unit, a concept first introduced by Benninghoff. These changes generally go through three phases. During OA progression all degenerative changes begin from the chondron, which is why it is extremely important to understand the molecular anatomy and physiology of this pericellular microenvironment and its form, function and failure in adult articular cartilage. It is also fundamental to understand the mechanism of adaptation of the cartilage and bone disruptions, given the physiological relationship between these tissues, essential to maintain normal joint structure and function.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
In recent years, the use of ceramic materials in orthopaedics and dentistry is becoming increasingly popular. However, it is important to know their biological and mechanical properties to optimize ...their use. The aim of this study is to describe a specific method to assess in vivo the effects of chronic release of ceramic materials implanted, in relation also to the type of material, pellets or powders. This was achieved by implanting ceramic powders and pellets, formed by low cohesion grains, in the patellar tendon of 48 New Zealand adult rabbits (24 with powders and 24 with pellets). The motion of the joint allowed easily and progressively the release of grains, detached from surface of the pellets and released to the joint space. Animals were sacrificed at different intervals (1, 3, 6, 12 months). Retrieved knee joints underwent X-Ray, histological and ultrastructural analysis.
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