A Study of Bone Tumors Among Ex-service Men

Abstract

THE clinical incidence of tone sarcoma has been estimated at 1 case per 100,000 of the living population (1); accordingly, there are approximately 1,200 persons with tone sarcoma alive at any one time in the United States. With a living World War veterans' population estimated at 4,330,598, the number of cases of bone sarcoma among ex-service men is small. However, on account of the prevalence of other types of bone tumors, and the various inflammatory as well as degenerative diseases of bones, it is desirable that the differential diagnosis of the different forms of bone disease, as well as their proper treatment, be thoroughly understood. Thanks to the untiring efforts and labor of such men as Codman, Bloodgood, and Ewing, and as the result of the establishment of the Registry of Bone Sarcoma, data regarding this subject have been compiled and have been made available to the profession. The clinical, X-ray, and pathological research work done has resulted in a more scientific, a more rational as well as a more practical viewpoint regarding the classification, criteria for diagnosis, treatment, and the prognosis of bone tumors. The present study is the result of an analysis of the histories of 45 cases of bone tumor among ex-service men. Some of the patients incurred the disability during the World War, others soon after their discharge from the military service. These patients were treated in Government and civilian hospitals. There was a lack of uniformity of certain of the data in the clinical histories of these cases, so that much of the information was difficult of statistical treatment. Nevertheless, in spite of this fact, the study reveals a considerable amount of important information concerning the subject under consideration. Classification of Bone Tumors The classification and the criteria for diagnosis used in this study are those recommended by the Committee of Registry of Bone Sarcoma. A review of Table I shows that 38, or 84.5 per cent, of the total number were cases of osteogenic sarcoma; 5, or 11.1 per cent, were benign giant-cell tumors; there was one case of unclassified sarcoma (extra-periosteal), and one case of benign osteogenic tumor. The cases were also classified according to whether they were central or periosteal in origin. It was found that 2 of the bone tumors were central in origin, while 17 were periosteal in origin. In 26 cases the origin of the tumor was not recorded. Histopathology It was previously indicated that these 45 cases were under treatment in a number of Government and civilian hospitals, so that the classification of the bone tumor, the criteria for diagnosis, and the microscopic interpretation of the stained tissue specimens were varied, making it difficult to arrive at an agreement of the divergent opinion's for purposes of statistical analysis. However, in spite of these difficulties, the cases were properly classified, both according to clinical criteria and upon the basis of cell structure.