Suspected Bone Tumors Research Articles

Imaging of bone tumors using a monoclonal antibody raised against human osteosarcoma.

The radiolabeled monoclonal antibody 791T/36 raised against a human osteosarcoma was injected into 20 patients with known or suspected bone tumors. Gamma camera images were acquired at 48 or 72 hours after injection, and assessed for antibody localization. Positive images were obtained in all five osteosarcomas and four other primary malignant sarcomas. Two of the four other primary bone tumors gave positive images. Three patients with trauma had negative images as did one patient with Paget's disease. Two patients with suppurative disease gave positive images. The antibody localized in the majority of malignant sarcomas tested. In one tumor where tissue was available, a tumor:non-tumor ratio of 2.8:1 was measured. Repeat imaging was performed in five patients. Immunoscintigraphy using the monoclonal antibody 791T/36 has shown tumor localization in patients with bone and soft tissue sarcomas.

Three-phase Skeletal Scintlgraphy for Suspected Bone Tumors

The advantage of using three-phase skeletal scintigraphy rather than merely conventional delayed imaging in the investigation of suspected bone tumors is illustrated by two cases in which this procedure provided greater information on the site and extent of the lesion than other single modalities.

The role of the radiologist in the management of the child with a suspected bone tumor.

The radiologist's most important task in evaluating lesions of the skeleton is to recognize with a great degree of certainty the post-traumatic and the self-limiting and healing tumorous conditions which require neither biopsy nor other surgical treatment. The group of lesions that will need biopsy ranges from those that cannot be absolutely classified in the above group to frankly malignant-appearing tumors. The radiologic differential diagnosis of malignant tumors is of lesser importance because this will be performed by the pathologist. Examples are illustrated and discussed. The importance of consultation among surgeon, radiologists, and pathologist is emphasized, particularly to avoid the possibility of misinterpreting immature callus formation as ostegenic sarcoma.

Hematogenous Osteomyelitis in Recent 5 Years

In recent 5 years, 44 cases of hematogenous osteomyelitis were experienced in our clinic. The femurs were involved in 16 cases. Next, in order of frequency were 14 tibiae, 8 arms, 3 iliac bones and others.No pyogenic organisms could be cultured in 15 cases, and among the remaining 29 cases staphylococcus were cultured in 23 (79.3%).According to the clinical courses, physical signs, laboratory tests and X-ray findings, 7 cases were suspected bone tumors, and the diagnosis could be confirmed after surgery.

Bone Tumors.

The introductory chapter of this text emphasizes that shadows in roentgenograms afford no fixed formula for clinical diagnosis but must be correlated with tissue examination before any treatment of a suspected bone tumor is attempted. The author classifies tumors of the bone as derivatives of (1) cartilage cells or cartilage forming connective tissues, (2) osteoblastic connective tissues, (3) nonosteoblastic connective tissues, (4) mesenchymal connective tissues (Ewing's tumor), (5) hematopoietic tissues, (6) nerve tissues, (7) vascular tissues, (8) fat cells, (9) notochordal tissues, and (10) adamantine tissues. The chapters on the bone tumors describe the clinical features, pathology, radiograms, therapy, and prognosis of (1) osteochondroma, (2) solitary enchondroma, (3) benign chondroblastoma, (4) chondromyxoid fibroma, (5) osteoid osteoma, (6) osteogenic fibroma, (7) nonosteogenic fibroma, (8) giant cell tumor, (9) vascular tumors, (10) nerve tumors, (11) chondrosarcoma, (12) osteogenic sarcoma, (13) fibrosarcoma, (14) Ewing's tumor, (15) multiple myeloma, (16) hematopoietic tissue tumors, (17)

Sources of Error in Radiological Interpretation in Tumors of Bone

THE diagnosis of tumors of bone remains one of the most difficult problems confronting surgeons, radiologists, and pathologists, and this in spite of intensive study of the subject by large numbers of clinicians and research workers. The literature on every aspect of this problem is extensive, and great advances have been made in the diagnosis of these lesions. From the Bone Registry of the American College of Surgeons has come a workable classification of tumors of bone which has done much to bring order out of the chaos of confusing and clinically impractical terminology previously existing (Table I). Kolodny (1), in his masterly review of the material of the Bone Registry up to 1927, evolved a classification of primary malignant newgrowths of bone which is clear, concise, and very practical. His classification is as follows: (A) Osteogenic sarcoma (B) Ewing's sarcoma (C) Myeloma (D) Unclassified sarcoma The groups are arranged in the order of frequency of the various types of primary bone neoplasms. Osteogenic sarcoma is by far the most common of malignant bone tumors, accounting for about 80 per cent of all cases. Ewing's sarcoma has been variously quoted as comprising from 7 to 15 per cent of cases, while myeloma is responsible for about 3 per cent of hemangioendotheliomas and angiosarcomas of bone, which Kolodny carries in the unclassified group, and rare tumors, as is also the periosteal fibrosarcoma. There is no better illustration in the field of medicine of the need of close correlation of clinical and laboratory data than in the diagnosis of bone tumors. It is very hazardous to express an opinion on roentgenographs of bone lesions without having at least an accurate abstract of the clinical history, and any discrepancy between the two calls for a careful review of all the findings. With regard to the roentgenographs themselves, no effort should be spared to obtain as good visualization of the tumor as possible. Films should be made in at least two directions if the lesion is in a long bone, and stereoscopic views if the lesion involves the trunk or skull. In these cases patients should be closely questioned as to the presence of symptoms in other parts of the body, and roentgenographs made of any area of which they complain. In certain cases it will be necessary to make films of the entire skeleton to show multiple primary lesions or the presence of metastases. In all cases of suspected primary malignant newgrowth of bone, chest films should be made to discover possible metastases, because of the fact that the chest is the commonest site of secondary involvement in malignant bone tumors. The essential point in the radiological investigation of cases of suspected bone tumor is to determine whether the patient has or has not primary malignant disease of bone. This may well be approached by the following stages: First: Has the patient a tumor of bone? Second: Is the tumor benign or malignant? If malignant, is it primary or secondary?