Pediatric orthopedic oncology:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | The orthopedic clinics of North America
27,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIV S., S. 421 - 668 zahlr. Ill., graph. Darst. |
Internformat
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Datensatz im Suchindex
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| adam_text | PEDIATRIC ORTHOPEDIC ONCOLOGY
CONTENTS
Preface xiii
Stephen D. Heinrich and Mark T. Scarborough
Molecular Biology of Sarcomas 421
Mark C. Gebhardt
There has been an explosion of information relating to the molecular
biology of sarcomas that will soon impact the diagnosis and treatment of
patients with this type of cancer. Some of these sarcoma related findings
are reviewed for the orthopedist with an interest in oncology.
Evaluation of the Child with a Bone or Soft Tissue Neoplasm 431
G. Douglas Letson, George B. Greenfield, and Stephen D. Heinrich
The prebiopsy evaluation of a child with a musculoskeletal neoplasm is
the cornerstone for all subsequent treatment. A better understanding of
the natural history of pediatric musculoskeletal tumors and an explosion
in the development of sensitive new imaging modalities have significantly
advanced the care of the child with a musculoskeletal pathologic condi¬
tion. This article details the prebiopsy clinical and radiographic evaluation
of the child or adolescent with a musculoskeletal neoplasm.
Making the Diagnosis: Keys to a Successful Biopsy in Children with
Bone and Soft Tissue Tumors 453
Terrance D. Peabody and Michael A. Simon
A well planned and executed biopsy is critical in the management of a
child with either a bone lesion or a soft tissue mass. A biopsy is necessary
when the orthopedic surgeon, in conjunction with the radiologist, believes
that the radiographic studies or patient history indicate a progressive
process that requires intervention. Biopsies may be open (incisional or
excisional) or closed (needle or trephine). Careful attention to biopsy site
and technique is important to avoid complications that may compromise
the ability to preserve a limb.
ORTHOPEDIC CLINICS OF NORTH AMERICA
VOLUME 27 • NUMBER 3 • JULY 1996 vii
Laboratory Evaluation of Pediatric Bone and Soft Tissue Tumors 461
Randall D. Craver
This article discusses how specimens are approached and handled by
the laboratory. Basic histology is reviewed. Contributions by electron
microscopy and immunoperoxidase staining are briefly discussed. Current
uses of DNA indices, cytogenetic analysis, and new molecular diagnostic
advances are highlighted. Proper communication between the pathologist
and the orthopedist is the cornerstone for optimal use of laboratory re¬
sources.
The Staging and Surgery of Musculoskeletal Neoplasms 473
Robert E. Wolf and William F. Enneking
Musculoskeletal neoplasms have a unique natural history. These neo¬
plasms can be effectively staged using a surgical staging system that is
based on their known biologic behavior. The surgical staging system
defines progressive degrees of risk to the patient and articulates with
planned surgical procedures in regard to margins needed for tumor con¬
trol and expected outcome.
Autograft Reconstructions 483
Dempsey Springfield
This is an article describing the history of autogenous bone grafting. The
autogenous donor sites are described and surgical methods of harvesting
illustrated. Examples of the common uses are shown.
Endoprosthetic Bone Reconstruction Following Malignant Tumor Resection in
Skeletally Immature Patients 493
William G. Ward, Rong Sen Yang, and Jeffery J. Eckardt
Modular and expandable endoprosthetic reconstruction of the child s ex¬
tremity following bone tumor resection affords an opportunity for both
limb salvage and progressive limb length equalization. This article dis¬
cusses the rationale, advantages, disadvantages, and results of endopros¬
thetic bone reconstruction following tumor resections in the skeletally
immature patient. In addition to an extensive literature review, an over¬
view of the authors results with this reconstructive option in 31 patients
over the past 14 years is presented. This article will inform the reader of
the current state of the art in endoprosthetic reconstruction of the imma¬
ture patient and should allow clinicians to make more informed decisions
regarding treatment options for their patients.
Rotationplasty 503
Winfried W. Winkelmann
Today rotationplasty is well established as an acceptable procedure for
limb salvage in patients who have a malignant tumor in the femur or
tibia. The main indication is that it is the alternative to amputation.
Rotationplasty should further be used in the very young child because of
growth dependent complications that can be expected after tumor resec¬
tion and any kind of reconstruction. This article covers the classification
of the different types of rotationplasties, the operative procedure, pros¬
thetic care, and the functional results.
Amputation Surgery and Prostheses 525
Raoul P. Rodriguez
Wide surgical margins in surgery for a bone tumor can be accomplished
either by local excision or by amputation surgery. Amputation surgery
yiii CONTENTS
has less morbidity than limb salvage surgery. Prosthetic replacement in
the lower extremity amputation should provide an artificial limb that will
be comfortable and stable for weight bearing. Retention of the anatomic
knee joint is critical for better ambulation and less energy expenditure.
Upper extremity prosthesis should be functional and cosmetically accept¬
able.
Appendices 541
Stephen D. Heinrich
Additional information relating to the first nine articles thus far is pre¬
sented.
The Evolution of Chemotherapeutic Agents for the Treatment of Pediatric
Musculoskeletal Malignancies 545
Maria C. Velez Yanguas and Raj P. Warrier
The incorporation of antineoplastic agents in the treatment of pediatric
musculoskeletal malignancies and their impact in the management and
outcome of patients with these types of malignanices are briefly reviewed.
The role of chemotherapy in the management of these tumors with special
emphasis on osteosarcoma, Ewing s sarcoma family of tumors, and rhab
domyosarcoma and undifferentiated sarcomas is discussed. Also included
are complications and side effects of the antineoplastic agents.
Current Controversies in Pediatric Radiation Oncology 551
Robert B. Marcus, Jr
Radiotherapy is commonly used in Ewing s sarcoma and pediatric soft
tissue sarcomas. In Ewing s sarcoma, radiotherapy appears to produce
survival rates similar to surgery if used to treat the primary lesion, though
the data remain subject to interpretation. When surgery is used to treat
the primary lesions, postoperative irradiation should be given if the mar¬
gins are less than wide, though the response to chemotherapy may also
influence local control. In nonrhabdomyosarcoma soft tissue sarcomas,
postoperative irradiation should be given if the margins are less than
wide, with doses of 54 Gy at 1.8 Gy per day; this provides excellent
local control.
Clinicopathologic Features and Treatment of Osteoid Osteoma and
Osteoblastoma in Children and Adolescents 559
Frank J. Frassica, Robert L. Waltrip, Paul D. Sponseller, Loralie D. Ma, and
Edward F. McCarthy, Jr
Benign bone forming tumors are common in children. Careful radio
graphic imaging is necessary to plan surgical treatment. Careful histologic
study is necessary to distinguish osteoblastoma from more aggressive
tumors. Osteoid osteoma should be considered when the child or adoles¬
cent presents with pain in an extremity or along the spine.
Osteosarcoma and Its Variants 575
Robert A. Vander Griend
Osteosarcoma is the most common primary malignant tumor of bone. The
variability of this tumor and its histologic variants in presentation, loca¬
tion, and biologic behavior has an influence on the prognosis and deter¬
mines treatment options. Despite improvements in both survival and
function due to limb salvage techniques and adjuvant chemotherapy,
osteosarcoma continues to be a major challenge for the medical and surgi¬
cal oncologist.
CONTENTS ix
Benign Cartilage Tumors 583
Mark T. Scarborough and Guy Moreau
Benign cartilaginous tumors are some of the most common lesions affect¬
ing the skeleton of children. These include exostoses, enchondromas, peri
osteal chondromas, chondromyxoid fibroma, and chondroblastoma. The
clinicopathologic features of these conditions and their treatment is dis¬
cussed.
Ewing s Sarcoma 591
Richard Vlasak and Franklin H. Sim
Ewing s sarcoma is the second most common primary malignant bone
tumor of children. Tremendous strides in the multidisciplinary treatment
of Ewing s sarcoma have been made over the past 25 years. Aggressive
chemotherapy has increased the 5 year survival rates from 10% to over
70%. The role of surgery for local control has gained importance. These
advances in the diagnosis, staging, and treatment of Ewing s sarcoma are
discussed in detail.
Unicameral and Aneurysmal Bone Cysts 605
Rodolfo Capanna, Domenico A. Campanacci, and Marco Manfrini
Unicameral and aneurysmal bone cysts are considered tumorlike condi¬
tions of unclear origin. The diagnosis of unicameral bone cysts is almost
always based on the radiographic appearance, whereas aneurysmal bone
cyst imaging may sometimes mimic a sarcomatous lesion. Several pathoge
netic hypothesis reported in literature have been described. Classifications
have been proposed to detect the activity of the cysts and to predict the
prognostic behavior. The results observed with different options of treat¬
ment have been discussed.
Langerhans Cell Histiocytosis 615
Maria C. Velez Yanguas and Raj P. Warrier
Langerhans Cell Histiocytosis, formerly known as Histiocytosis X, and its
related syndromes (i.e., eosinophilic granuloma, Hand Schuller Christian
disease, and Letterer Siwe disease) are briefly reviewed. The biology,
clinical manifestations, and treatment options of the localized, single form
and the disseminated, multisystem form are also discussed.
Pediatric Osteomyelitis Masquerading as Skeletal Neoplasia 625
R. Baxter Willis and Richard Rozencwaig
Osteomyelitis has many forms of presentation in the pediatric age group.
From neonatal osteomyelitis, with a paucity of clinical symptoms and
signs, to the more typical acute hematogenous form or even the subacute
or chronic presentations, a high index of suspicion is needed to institute
appropriate investigations and treatment.
Orthopedic Manifestations of Acute Pediatric Leukemia 635
Daniel J. Gallagher, Dennis J. Phillips, and Stephen D. Heinrich
The variety and distribution of skeletal lesions in children with acute
lymphoblastic leukemia is rarely seen in other diseases. Skeletal radio
graphic changes that can occur in a child with acute leukemia include
diffuse osteopenia, metaphyseal bands, periosteal new bone formation,
geographic osteolysis, osteosclerosis, mixed osteolysis and sclerosis, and
permeative destruction. It is important for orthopedic surgeons to recog¬
nize the skeletal manifestations of acute leukemia of childhood because
X CONTENTS
the physician who initially evaluates the child will often be an orthopedic
surgeon, and a delay in diagnosis has an adverse affect on survival.
Benign Soft Tissue Lesions in Children 645
John T. Smith and Suzanne M. Yandow
This article is a review of the common benign soft tissue lesions of the
spine and extremities. Reviewed are the pathophysiology, natural history,
appropriate work up, and treatment options. A recommendation is given
to consider the diagnosis as possible malignancy and approach such le¬
sions with caution.
Pediatric Soft Tissue Sarcomas 655
Ernest U. Conrad III, Letitia Bradford, and Howard A. Chansky
Pediatric soft tissue sarcomas represent a relatively common problem in
pediatric oncology. The evaluation of these lesions has contributed signifi¬
cantly to the understanding of the molecular basis of sarcomas, and the
adjuvant treatment of these tumors has resulted in improved local control
and significant improvements in long term survival. The essence of suc¬
cessful treatment involves preoperative imaging, followed by needle bi¬
opsy, preoperative neoadjuvant chemotherapy, and well documented sur¬
gical resection. Indications for radiation therapy and the adequacy of
surgical margins remain areas of further investigation. The identification
and treatment of well defined histologic and molecular subtypes will allow
further improvements in treatment decisions and clinical results.
Index 665
Subscription Information Inside back cover
CONTENTS xi
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| spelling | Pediatric orthopedic oncology Stephen D. Heinrich ... guest ed. Philadelphia [u.a.] Saunders 1996 XIV S., S. 421 - 668 zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier The orthopedic clinics of North America 27,3 Knochenkrebs (DE-588)4031331-1 gnd rswk-swf Chondrosarkom (DE-588)4221165-7 gnd rswk-swf Kind (DE-588)4030550-8 gnd rswk-swf Weichteilsarkom (DE-588)4189415-7 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Knochenkrebs (DE-588)4031331-1 s Kind (DE-588)4030550-8 s DE-604 Chondrosarkom (DE-588)4221165-7 s Weichteilsarkom (DE-588)4189415-7 s Heinrich, Stephen D. Sonstige oth The orthopedic clinics of North America 27,3 (DE-604)BV000001089 27,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007260500&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Pediatric orthopedic oncology The orthopedic clinics of North America Knochenkrebs (DE-588)4031331-1 gnd Chondrosarkom (DE-588)4221165-7 gnd Kind (DE-588)4030550-8 gnd Weichteilsarkom (DE-588)4189415-7 gnd |
| subject_GND | (DE-588)4031331-1 (DE-588)4221165-7 (DE-588)4030550-8 (DE-588)4189415-7 (DE-588)4143413-4 |
| title | Pediatric orthopedic oncology |
| title_auth | Pediatric orthopedic oncology |
| title_exact_search | Pediatric orthopedic oncology |
| title_full | Pediatric orthopedic oncology Stephen D. Heinrich ... guest ed. |
| title_fullStr | Pediatric orthopedic oncology Stephen D. Heinrich ... guest ed. |
| title_full_unstemmed | Pediatric orthopedic oncology Stephen D. Heinrich ... guest ed. |
| title_short | Pediatric orthopedic oncology |
| title_sort | pediatric orthopedic oncology |
| topic | Knochenkrebs (DE-588)4031331-1 gnd Chondrosarkom (DE-588)4221165-7 gnd Kind (DE-588)4030550-8 gnd Weichteilsarkom (DE-588)4189415-7 gnd |
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