My Orthopaedic Surgeon

J Orthop Surg (Hong Kong). 2005 Apr;13(1):58-63 Leow AM, Halim AS, Wan Z. Reconstructive Sciences Department, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
PURPOSE: To review the role of free tissue transfer in reconstructive surgery following resection of high-grade soft-tissue sarcomas of the lower limb.
CONCLUSION: Tissue transfer allows early adjuvant therapy facilitating the multimodal approach for the high-grade soft-tissue sarcomas of the lower extremity.

J Bone Joint Surg Br. 1983 May;65(3):299-307
Sarcoma complicating Paget's disease of bone. A clinicopathological study of 62 cases.Schajowicz F, Santini Araujo E, Berenstein M. Out of 21 900 cases filed at the Latin-American Registry of Bone Pathology between April 1940 and July 1981, there were 987 with Paget's disease (4.51 per cent); 62 of these (6.28 per cent) were complicated by sarcoma and two were associated with giant-cell tumours of bone (osteoclastoma) without signs of malignancy. There was a slight predominance of men and the ages ranged from 45 to 87 years, with an average of 66 years. The most frequent sites were the femur (23 cases), the humerus (nine), the pelvis (10), and the tibia (nine). The low incidence of vertebral involvement (five cases) is noteworthy and is in sharp contrast to uncomplicated Paget's disease. The most common tumour type was osteosarcoma (39 cases), followed by fibrosarcoma (15 cases); other varieties (chondrosarcoma, malignant fibrous histiocytoma and reticulum-cell sarcoma) were much rarer. Most of the sarcomata occurred when the Paget's disease was polyostotic. Tumours often developed simultaneously, or at short time intervals, in the same or different bones; these bones had, in all cases, been affected by Paget's disease. The histological features of the osteosarcomata were characteristic, with large numbers of osteoclast giant cells, alternating with atypical osteoblasts, thus exaggerating the anarchic remodelling process of Paget's disease. The neighbouring areas of the pagetic bone showed an increased number of osteoclasts. These facts suggest a possible pathogenetic relationship between sarcoma and Paget's disease; the possibility of both processes having a viral aetiology is discussed.

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Subcutaneous sarcoma. A population-based study of 129 patients. J Bone Joint Surg Br. 1991 Jul;73(4):662-7
Rydholm A, Gustafson P, Rööser B, Willén H, Berg NO. University Hospital, Lund, Sweden. We reviewed 129 patients with subcutaneous sarcoma diagnosed from 1964 to the end of 1985 in a population-based series of sarcoma cases from southern Sweden. The annual incidence was 0.4 per 100,000, comprising 32% of all soft-tissue sarcomas of the extremities or the trunk wall. Compared to deep-seated sarcomas, subcutaneous tumours were half the size at diagnosis, more common in the lower leg and foot, more often malignant fibrous histiocytoma, and of a lower grade of malignancy. None of the low-grade and only 7% of the high-grade tumours recurred locally after wide local excision without radiotherapy. The cumulative five-year survival for all 129 patients was 80%. Multivariate analysis identified only high grade of malignancy and the size of the tumour (greater than 5 cm) as independent prognostic factors. We conclude that systemic or local adjuvant therapy is not generally indicated for subcutaneous sarcoma because of the good prognosis and low local recurrence rate after wide excision.

Links to Bone Tumor subjects in Wheeless Textbook of Orthopaedics Benign Osteoid osteoma; Osteoblastoma; Osteoma; Osteochondroma; Enchondroma; Periosteal chondroma; Chondroblastoma; Chondromyxoid fibroma; Osteochondroma; Nonossifying fibroma; Desmoplastic fibroma; Fibrous Dysplasia; Eosinophilic granuloma; Aneurysmal bone cyst; Hemangioma; Simple bone cyst; Giant Cell Tumor; Chordoma; Adamantinoma Malignant Classic osteosarcoma; Parosteal osteosarcoma; Periosteal osteosarcoma; Chondrosarcoma; Fibrosarcoma of bone; Malignant fibrous histiocytoma (IIb); Ewing's sarcoma; Reticulum cell sarcoma; Angiosarcoma; Multiple Myeloma:

Links to Soft Tissue Tumor subject covered in Wheeless Textbook of Orthopaedics Benign Myositis ossificans; Synovial Chondromatosis; Fibroma; Desmoplastic Fibroma; Fibromatosis; PVS; Hemangioma; Lipoma; Neurolemmoma; Neurofibroma; Neuroblastoma Malignant Extraosseous chondrosarcoma; Fibrosarcoma; Malignant fibrous histiocytoma; Synovial sarcoma; Angiosarcoma; Liposarcoma; Neurosarcoma; Rhabdomyosarcoma; Malignant Melanoma; Squamous Cell Carcinoma; GCT of Tendon Sheath; Epithelioid Sarcoma

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