Osteogenic Metastases Research Articles

Osteogenic and brain metastases after non-small cell lung cancer resection.

A significant number of non-small cell lung cancer (NSCLC) patients develop osteogenic metastases (OMs) and/or brain metastases (BMs) after surgery, however, routine chest computed tomography (CT) sometimes fails to diagnose these recurrences. We investigated the incidence of BMs and OMs after pulmonary resection and aimed to identify candidates who can benefit from brain magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in addition to CT. We retrospectively reviewed medical records of 1099 NSCLC patients who underwent pulmonary resection between 2002 and 2013. Clinicopathological factors associated with OM and/or BM were investigated using univariate and multivariate analyses. Postoperative recurrence occurred in 344 patients (32.6%). OMs were diagnosed in 56 patients (5.6%) with 93% within 3years. BMs were identified in 72 patients (6.6%) with 91.1% within 3years. Multivariate analysis revealed that poorly differentiated tumor and the presence of pathological nodal metastases were significantly associated with postoperative BM (p = 0.037, < 0.001), preoperative serum carcinoembryonic antigen (CEA) level of 5ng/mL or higher and the presence of pathological nodal metastases were significantly associated with OM (p = 0.034, < 0.001). The prevalence of OM and/or BM in 5years was as high as 25.9% in patients with pathological nodal metastases. We identified significant predictive factors of postoperative BM and OM. Under patient selection, the effectiveness of intensive surveillance for the modes of recurrence should be investigated with respect to earlier detection, maintenance of quality of life, and survival outcomes.

Determination Of Risk Parameters In The Detection Of Asymptomatic Bone Metastases Of Kidney And Prostate Cancer

Using multivariate analysis to identify predictive risk parameters in the diagnosis of asymptomatic osteogenic metastasis of renal and prostate cancer. The work was based on the results of observations of 105 patients with a morphologically confirmed diagnosis of malignant neoplasm registered at the Republican Specialized Scientific and Practical Center of Oncology and Radiology (RSNPMTSO and R) and the Samarkand branch. In 62 patients with kidney cancer (RP) included in the study, the mean age of patients with RP was 58.3 years. 43 patients with prostate cancer (PC) were included in the study, the average age of patients with PC was 68 years. We analyzed such parameters as age, stage of the disease, timing of detection of bone metastasis (BM), prevalence, type and size of BM, as well as additional criteria: in case of prostate cancer - the size of the primary tumor and the degree of malignancy, in case of prostate cancer - the sum of points on the Gleason scale and the prostate -specific antigen (PSA). It was revealed that the highest risk in detecting BM in RP was noted for the stage of the disease, p = 0.006. Also, a high risk was associated with the size and grade of tumor malignancy, with CR at p = 0.006 and p = 0.008, respectively. Among the listed, the highest risk in detecting BM is observed in prostate cancer for the stage of the disease (p = 0.001). In addition, an increased risk was observed for the Gleason score and PSA level (p = 0.013 and p = 0.008, respectively). Thus, during the 2-year follow-up, BM most often develops in patients with kidney cancer at stage Tv-T3a stage and with grade G III and in patients with prostate cancer - in the presence of stage III with a Gleason score of ≥ 7 and a level PSA in the range of 21-50 ng / ml.

Preoperative devascularization of a circumferential osteogenic metastasis to the upper cervical spine by direct percutaneous needle puncture: a technical note

Direct percutaneous needle puncture (DPNP) for presurgical devascularization of head and neck as well as skull base tumours is an established, yet not widespread method. We present a case of a large and highly vascularized metastasis with partial destruction of the first two cervical vertebrae and encasement of the spinal cord that was successfully treated by DPNP for preoperative devascularization after an attempted endovascular embolization had failed. The lesion was safely and effectively devascularized, which facilitated the surgical removal. The case presented illustrates the technique and furthermore demonstrates its value.

Dedifferentiation of a well-differentiated liposarcoma to a highly malignant metastatic osteosarcoma:: amplification of 12q14 at all stages and gain of 1q22–q24 associated with metastases

Well-differentiated liposarcomas (WDLPS), especially those located in the retroperitoneum, may occasionally undergo dedifferentiation. Although this process is associated with a more aggressive clinical course, dedifferentiated liposarcomas rarely produces metastases. The case reported here is rather uncommon: A retroperitoneal WDLPS gave lung metastases that were diagnosed as highly malignant osteosarcomas. We used comparative genomic hybridization (CGH), fluorescence in situ hybridization (FISH), and Southern blot analyses to characterize the copy number changes and genetic aberrations occurring at different stages of the disease. In the primary tumor, the only detectable aberration was amplification of 12q13–q14, which was present only in a fraction of the cells and revealed by FISH analysis. High-level amplification of 12q13–q14, involving CDK4, MDM2, and HMGIC, was seen both in the relapse and the metastases. The second most common change, gain or high-level amplification of 1q22–q24, was detectable by CGH only in the osteogenic metastases, as was loss of the distal 2q. FISH analyses revealed considerable heterogeneity in the samples, and the percentage of cells showing aberrations was significantly higher in the metastatic samples. In particular, increased copy numbers of 789f2, a marker for 1q21 amplification in sarcomas, was observed in more than 65% of the cells in the metastatic samples, but in less than 10% of the cells from the recurrent samples. These observations could indicate that 1q amplification, in particular, may be indicative of a more malignant phenotype and ability of metastasis in WDLPS, as has also been suggested by others.

Immunohistochemical localization of the bone morphogenetic protein-6 in salivary pleomorphic adenomas.

Salivary pleomorphic adenomas are often associated with chondroid tissue formation. We have found that bone morphogenetic proteins (BMP), especially BMP-2, may play an important role in ectopic chondrogenesis in this tumor. Bone morphogenetic protein-6 was reported to be related to the osteogenic metastasis of prostatic carcinomas. The relationship between BMP-6 expression and chondroid tissue formation is investigated. Twenty-three pleomorphic adenomas were examined immunohistochemically. The overexpression of BMP-6 was observed in 10 pleomorphic adenomas of the major salivary glands (43. 5%), and no evidence of BMP-6 expression in any of the nine pleomorphic adenomas of the palate. Bone morphogenetic protein-6 was immunolocalized in the lacuna cells of the chondroid tissue, in which type II collagen was localized. Bone morphogenetic protein-6 was expressed in inner ductal cells of the tubulo-glandular structures in the pleomorphic adenomas. This finding indicates that BMP-6 may be associated with the differentiation of inner ductal cells. Bone morphogenetic protein-6 was expressed weakly in neoplastic myoepithelial cells in the myxoid areas, which may be related to the production of extracellular matrices. Bone morphogenetic protein-6 has a role in chondroid formation, and also tubulo-glandular differentiation in pleomorphic adenomas. In conclusion, a large portion of pleomorphic adenomas of the salivary gland origin, but not of palate origin, was shown to overexpress BMP-6 protein.