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J Knee Surg 2019; 32(04): 305-314
DOI: 10.1055/s-0038-1675828
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Malignant Bone Tumors of the Knee: How to Identify and Treat

Ryan Voskuil
1   Department of Orthopaedic Surgery, University of Tennessee College of Medicine, Chattanooga, Tennessee
,
Andrea J. Evenski
2   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
Corey Montgomery
3   Department of Orthopaedic Surgery, UAMS Medical Center, Little Rock, Arkansas
,
Cynthia L. Emory
4   Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina
› Author Affiliations
Further Information

Publication History

04 July 2018

08 October 2018

Publication Date:
16 November 2018 (online)

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Abstract

Malignant bone tumors are rare conditions that may be encountered by nononcologic surgeons only a few times in their careers, but a delay in diagnosis or a misinterpretation of data can have limb and life-threatening consequences. Prior literature suggests that unplanned resection of sarcoma was associated with an increased risk of local recurrence, decreased 10-year survival, and increased amputation rate compared with planned resection. In addition to patient morbidity, missed diagnoses and unplanned excisions of malignant tumors lead to increased cost of treatment and higher likelihood of subsequent medicolegal action. According to the American Cancer Society, the 5-year survival of all combined cases of malignant bone tumors is approximately 70%. However, the survival rate of each type of malignant bone tumor varies, with multiple myeloma survival rates being much lower and lymphoma somewhat higher. These rates depend on many factors including grade, stage, and chemotherapy response. For example, the 10-year survival of localized osteosarcoma is almost 70%, yet rapidly declines to 20 to 30% in patients with metastases. This further emphasizes the elevated importance of prompt recognition and treatment of malignant bone tumors.

Keywords

malignant bone tumors - osteosarcoma - lymphoma - chondrosarcoma
 

  • References

  • 1 Tedesco NS, Henshaw RM. Unplanned resection of sarcoma. J Am Acad Orthop Surg 2016; 24 (03) 150-159
    CrossrefPubMedGoogle Scholar
  • 2 Ayerza MA, Muscolo DL, Aponte-Tinao LA, Farfalli G. Effect of erroneous surgical procedures on recurrence and survival rates for patients with osteosarcoma. Clin Orthop Relat Res 2006; 452 (452) 231-235
    CrossrefPubMedGoogle Scholar
  • 3 Krych A, Odland A, Rose P. , et al. Oncologic conditions that simulate common sports injuries. J Am Acad Orthop Surg 2014; 22 (04) 223-234
    CrossrefPubMedGoogle Scholar
  • 4 Kasraeian S, Allison DC, Ahlmann ER, Fedenko AN, Menendez LR. A comparison of fine-needle aspiration, core biopsy, and surgical biopsy in the diagnosis of extremity soft tissue masses. Clin Orthop Relat Res 2010; 468 (11) 2992-3002
    CrossrefPubMedGoogle Scholar
  • 5 Mankin HJ, Mankin CJ, Simon MA. ; Members of the Musculoskeletal Tumor Society. The hazards of the biopsy, revisited. J Bone Joint Surg Am 1996; 78 (05) 656-663
    CrossrefPubMedGoogle Scholar
  • 6 Barrientos-Ruiz I, Ortiz-Cruz EJ, Serrano-Montilla J, Bernabeu-Taboada D, Pozo-Kreilinger JJ. Are biopsy tracts a concern for seeding and local recurrence in sarcomas?. Clin Orthop Relat Res 2017; 475 (02) 511-518
    CrossrefPubMedGoogle Scholar
  • 7 Messerschmitt PJ, Garcia RM, Abdul-Karim FW, Greenfield EM, Getty PJ. Osteosarcoma. J Am Acad Orthop Surg 2009; 17 (08) 515-527
    CrossrefPubMedGoogle Scholar
  • 8 Zheng YF, Lin J, Yang HL. Chondroblastic osteosarcoma secondary to fibrosarcoma: a case report and literature review. Oncol Lett 2015; 10 (06) 3573-3576
    CrossrefPubMedGoogle Scholar
  • 9 Domson GF, Shahlaee A, Reith JD, Bush CH, Gibbs CP. Infarct-associated bone sarcomas. Clin Orthop Relat Res 2009; 467 (07) 1820-1825
    CrossrefPubMedGoogle Scholar
  • 10 Maheshwari AV, Cheng EY. Ewing sarcoma family of tumors. J Am Acad Orthop Surg 2010; 18 (02) 94-107
    CrossrefPubMedGoogle Scholar
  • 11 Wurtz LD, Peabody TD, Simon MA. Delay in the diagnosis and treatment of primary bone sarcoma of the pelvis. J Bone Joint Surg Am 1999; 81 (03) 317-325
    PubMedGoogle Scholar
  • 12 Li S, Yang Q, Wang H, Wang Z, Zuo D, Cai Z, Hua Y. Prognostic significance of serum lactate dehydrogenase levels in Ewing's sarcoma: a meta-analysis. Mol Clin Oncol 2016; 5 (6): 832-838
    CrossrefPubMedGoogle Scholar
  • 13 Murphey MD, Walker EA, Wilson AJ, Kransdorf MJ, Temple HT, Gannon FH. From the archives of the AFIP: imaging of primary chondrosarcoma: radiologic-pathologic correlation. Radiographics 2003; 23 (05) 1245-1278
    CrossrefPubMedGoogle Scholar
  • 14 Gelderblom H, Hogendoorn PC, Dijkstra SD. , et al. The clinical approach towards chondrosarcoma. Oncologist 2008; 13 (03) 320-329
    CrossrefPubMedGoogle Scholar
  • 15 Lin PP, Moussallem CD, Deavers MT. Secondary chondrosarcoma. J Am Acad Orthop Surg 2010; 18 (10) 608-615
    CrossrefPubMedGoogle Scholar
  • 16 Aarons C, Potter BK, Adams SC, Pitcher Jr JD, Temple HT. Extended intralesional treatment versus resection of low-grade chondrosarcomas. Clin Orthop Relat Res 2009; 467 (08) 2105-2111
    CrossrefPubMedGoogle Scholar
  • 17 Scharschmidt TJ, Lindsey JD, Becker PS, Conrad EU. Multiple myeloma: diagnosis and orthopaedic implications. J Am Acad Orthop Surg 2011; 19 (07) 410-419
    CrossrefPubMedGoogle Scholar
  • 18 Boyle EM, Fouquet G, Guidez S. , et al. IgA kappa/IgA lambda heavy/light chain assessment in the management of patients with IgA myeloma. Cancer 2014; 120 (24) 3952-3957
    CrossrefPubMedGoogle Scholar
  • 19 Weber KL. Evaluation of the adult patient (aged > 40 years) with a destructive bone lesion. J Am Acad Orthop Surg 2010; 18 (03) 169-179
    CrossrefPubMedGoogle Scholar
  • 20 Cleven AHG, Hogendoorn PCW. Hematopoietic tumors primarily presenting in bone. Surg Pathol Clin 2017; 10 (03) 675-691
    CrossrefPubMedGoogle Scholar
  • 21 Demircay E, Hornicek Jr FJ, Mankin HJ, Degroot III H. Malignant lymphoma of bone: a review of 119 patients. Clin Orthop Relat Res 2013; 471 (08) 2684-2690
    CrossrefPubMedGoogle Scholar
  • 22 American Cancer Society. Cancer facts & figures 2017 . Available from: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html . Accessed June 1, 2018
    PubMed
  • 23 The American Cancer Society. Survival statistics for bone cancer. Available from: https://www.cancer.org/cancer/bone-cancer/detection-diagnosis-staging/survival-statistics.html . Accessed June 1, 2018
    PubMed
  • 24 Szendroi A, Dinya E, Kardos M. , et al. Prognostic factors and survival of renal clear cell carcinoma patients with bone metastases. Pathol Oncol Res 2010; 16 (01) 29-38
    CrossrefPubMedGoogle Scholar