Osteosarcoma extraóseo en extremidad inferior

INTRODUCTION: Extraoseus osteosarcoma is a rare tumor confined in soft tissues but with histological features similar to bone osteosarcoma. CLINICAL CASE: We report the case of a young male affected extraosseous osteosarcoma. A detailed analysis of the clinical symptoms and evolution from the beginning of the process to the death of the patient, three years later, is performed. DISCUSSION: The different types of treatment and prognostic factors involving this disease are discussed CONCLUSIONS: Radical surgery followed by chemotherapy is the preferred form of treatment in extraosseus osteosarcoma.The latest advances in chemotherapy have improved the prognosis in this type of tumor

Insights on PRAME and osteosarcoma by means of gene expression profiling

Osteosarcoma (OS) is the most frequent bone tumor in children and adolescents. Tumor antigens are encoded by genes that are expressed in many types of solid tumors but are silent in normal tissues, with the exception of placenta and male germ-line cells. It has been proposed that antigen tumors are potential tumor markers. The premise of this study is that the identification of novel OS-associated transcripts will lead to a better understanding of the events involved in OS pathogenesis and biology. We analyzed the expression of a panel of seven tumor antigens in OS samples to identify possible tumor markers. After selecting the tumor antigen expressed in most samples of the panel, gene expression profiling was used to identify osteosarcoma-associated molecular alterations. A microarray was employed because of its ability to accurately produce comprehensive expression profiles. PRAME was identified as the tumor antigen expressed in most OS samples; it was detected in 68% of the cases. Microarray results showed differences in expression for genes functioning in cell signaling and adhesion as well as extracellular matrix-related genes, implying that such tumors could indeed differ in regard to distinct patterns of tumorigenesis. The hypothesis inferred in this study was gathered mostly from available data concerning other kinds of tumors. There is circumstantial evidence that PRAME expression might be related to distinct patterns of tumorigenesis. Further investigation is needed to validate the differential expression of genes belonging to tumorigenesis-related pathways in PRAME-positive and PRAME-negative tumors.

Neoplastic Ascites in Osteosarcoma A Case Report

Background Osteosarcoma is a malignant tumor of connective tissue Whose tumor cells produce bone tissue. It can be classified as osteoblastic, chondroblastic, or fibroblastic, according to the predominant histologic type of cells. Its dissemination is hematogenous; and the lungs are the most frequent site of clinically evident metastasis. Extrapulmonary metastases are rare and more frequently diagnosed at necropsy. We present a case of osteosarcoma with peritoneal dissemination that developed neoplastic ascites. Case A 46-year-old patient came to the hospital with a 4-month history of lumbar pain and weakness in the lower limbs. Computed tomography showed blastic lesions in the L3 vertebral body. Surgical resection and histologic analysis revealed a mixed osteoblastic and chondroblastic osteosarcoma. After only one session of chemotherapy, the patient presented a marked clinical worsening with extensive metastatic dissemination and occurrence of voluminous ascites. The cytologic examination of the ascitic fluid demonstrated frequent poorly differentiated tumor cells. The patient died a little more than 2 months after the diagnosis. Conclusion This case is the only report of osteosarcoma primarily focused on the vertebral column affected by peritoneal metastasis shown by cytologic examination of ascitic fluid. (Acta Cytol 2010;54:845-848)

Bone Deposition, Bone Resorption, and Osteosarcoma

Bone deposition and bone resorption are ongoing dynamic processes, constituting bone remodeling. Some bone tumors, such as osteosarcoma (OS), stimulate focal bone deposition. OS is the most common primary bone tumor in children and young adults. A complex network of genes regulates bone remodeling and alterations in its expression levels can influence the genesis and progression of bone diseases, including OS. We hypothesized that the expression profiles of bone remodeling regulator genes would be correlated with OS biology and clinical features. We used real-time PCR to evaluate the mRNA levels of the tartrate-resistant acid phosphatase (ACP5), colony stimulating factor-1 (CSF1R), bone morphogenetic protein 7 (BMP7), collagen, type XI, alpha 2 (COL11A2), and protein tyrosine phosphatases zeta 1 (PTPRZ1) genes, in 30 OS tumor samples and correlated with clinical and histological data. All genes analyzed, except CSF1R, were differentially expressed when compared with normal bone expression profiles. In our results, OS patients with high levels of COL11A2 mRNA showed worse overall (p = 0.041) and event free survival (p = 0.037). Also, a trend for better overall survival was observed in patients with samples showing higher expression of BMP7 (p =0.067). COL11A2 overexpression and BMP7 underexpression could collaborate to OS tumor growth, through its central role in bone remodeling process. (C) 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:1142-1148, 2010

Prognostic impact of adenomatous polyposis coil gene expression in osteosarcoma of the extremities

Purpose: To evaluate the impact of adjuvant chemotherapy on the outcome of osteosarcoma of the extremities, and to identify prognostic factors using the expression of adenomatous polyposis coli (APC), cadherin and beta-catenin Wnt-signalling markers. Methods: The clinical, demographic, anatomic and pathological factors including a detailed analysis of the immunohistochemical expression of cadherin, B-catenin and APC were retrospectively examined in 97 patients with osteosarcoma of the extremities (metastatic and non-metastatic at diagnosis), treated with surgery and/or chemotherapy from 1985 to 2000. Results: APC immunoreactivity showed a statistically significant association with age and serum alkaline phosphatase levels (p = 0.025 and p = 0.038). When survival was the end-point of multivariate analysis, race segregated patients with poor survival as did lack of cadherin expression. For overall survival, cadherin immunoreactivity and the interaction between APC expression and response to adjuvant chemotherapy were significant (p = 0.012 and p < 0.001). No significant clinical association was evident with immunohistochemical expression of cadherin, beta-catenin. Conclusion: Lack of expression of cadherin was a significant variable to overall and disease-free survival. Significantly, positive APC immunoreactivity and adjuvant chemotherapy were associated with a favourable treatment response. Studies using newer immunohistochemical markers within the Wnt-signalling pathway may guide the development of more appropriate therapeutic targets for future individualised treatment. (C) 2010 Elsevier Ltd. All rights reserved.

Chitosan-based magnetic nanoparticles for osteosarcoma theranostic

Cancer is a well-known disease with a significant impact in society not only due to its incidence, more evident in more developed countries, but also due to the expenses related to medical treat-ments. Cancer research is considered an increasingly logical science with great potential for the development of new treatment options. Advances in nanomedicine have resulted in rapid devel-opment of nanomaterials with considerable potential in cancer diagnostics and treatment. The combination of diagnosis and treatment in a single nano-platform is named theranostic. In this PhD thesis a theranostic system for osteosarcoma was proposed, composed by a magnetic core, a polymeric coating, and a chemotherapeutic drug. The presence of a specific targeting agent, in this case a monoclonal antibody, provides high specificity to the proposed theranostic system. For the core of the proposed theranostic system, stable aqueous suspensions of superparamagnetic iron oxide nanoparticles with an average diameter of 9 nm were produced. Chitosan-based poly-meric nanoparticles with a hydrodynamic diameter around 150 nm were successfully produced. Incorporation of iron oxide nanoparticles into the polymeric ones increased their hydrodynamic diameter to at least 250 nm. A monoclonal antibody specific for a transmembranar protein (car-bonic anhydrase IX) present in solid tumors was developed by hybridoma technology. Functional hybridomas producing the desired monoclonal antibodies were obtained. The proposed theranostic system functionality was evaluated in separated parts of its components. Uncoated and coated iron oxide nanoparticles with chitosan-based polymers generated heat under the application of an external alternating magnetic field. Uncoated iron oxide nanoparticles sta-bilized with oleic acid were able to enhance contrast in magnetic resonance imaging. Drug deliv-ery studies were conducted in chitosan-based polymeric nanoparticles without and with the in-corporation of iron oxide nanoparticles, demonstrating to be an effective drug delivery platform for doxorubicin. The theranostic system proposed in this PhD thesis is very promising for cancer theranostic, demonstrating to be applicable in solid tumors such as osteosarcoma.

Parosteal osteosarcoma with myocardial metastasis 13 years after follow-up

PURPOSE: To report the case of a woman with a diagnosis of grade II (low grade) parosteal osteosarcoma with the occurrence of myocardial metastasis 13 years after resection, and to present a review of the existing literature on the subject. METHODS: Description of the case and review of the literature. CONCLUSION: The review leads to the conclusion that the occurrence of metastasis from parosteal osteosarcoma can occur in up to 38% of the cases, in spite of its relatively low aggressiveness. However, myocardial metastasis of a parosteal osteosarcoma is an event that was not found in the literature.

Estudios de quimioprevención en: 1) Modelo NMU de carcinogénesis de páncreas de rata. 2) Osteosarcoma inducido por NMU

El cáncer es una enfermedad común de causa de muerte en el mundo entero. Si bien el éxito en el tratamiento de casi todas las formas de esta enfermedad depende de su diagnóstico temprano seguido de resección quirúrgica, los enfoques en investigación sobre compuestos inhibitorios de la carcinogénesis podrían ser aplicados a implementar estrategias de quimioprevención poblacionales. Se sabe que el carcinoma de páncreas exocrino ocupa el cuarto lugar como causa de muerte en el hombre en los Estados Unidos. Se presupone que su incidencia es similar en nuestro país. La causa del cáncer de páncreas es desconocido en la mayoría de los casos. Los estudios epidemiológicos si bien no dan datos certeros tienden a señalar que componentes de la dieta son factores de riesgo en la génesis del cáncer de páncreas (Rogers y Longnecker, 1988). Se conoce que el cáncer de páncreas es clínicamente silencioso y sólo manifiesta síntomas tardíamente, cuando ya se ha producido la invasión y metástasis (Pour, 1991). De ahí que haya interés por desarrollar modelos multifactoriales que puedan aportar datos para comprender las causas y el mecanismo de desarrollo del cáncer en el hombre. Trabajos realizados en el laboratorio del Programa Centro de Biología Celular y Desarrollo (CEBYD-CONICET), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Director Dr. Benito Monis, han permitido establecer que la nitrosometilurea (NMU) induce la proliferación de poblaciones celulares exocrinas del páncreas de rata con la formación de estructuras nodulares atípicas, múltiples, de crecimiento expansivo que aumenta en número y tamaño con la edad, a los que identificaron con la sigla FACH (Focal Acinar Cell Hyperplasia). Este proceso hiperplásico es primariamente del epitelio acinar, aunque se han observado con notable menor frecuencia la aparición de estructuras ductulares neoformadas y aislados focos microscópicos de células con apariencia de hepatocitos (transdiferenciación o metaplasia hepatocítica). Los nódulos son con mayor frecuencia acidófilos aunque pueden observarse focos basófilos. Estos últimos son de dimensión microscópica. Excepcionalmente se han encontrado lesiones cancerosas en páncreas en el numeroso grupo de ratas inyectadas con NMU y estudiadas luego de la muerte natural en el laboratorio, por lo cual se infiere que las lesiones proliferativas que el NMU induce en páncreas de rata no posee tendencia a la transformación maligna. Este es el concepto central en las investigaciones sobre carcinogénesis pancreática en curso en el laboratorio CEBYD y sobre el cual proponemos el presente plan de trabajo. Además, hemos aislado células de un osteosarcoma inducido en la rata por la NMU (en curso) que han sido mantenidas tanto "in vivo" como "in vitro" para su caracterización y para el estudio de agentes inhibitorios de la carcinogénesis. El propósito del presente plan de trabajo es probar posibles agentes quimioterapéuticos en ambos modelos experimentales desarrollados en nuestro laboratorio.

Resultados a largo plazo en el tratamiento del osteosarcoma: experiencia de 20 años

Hem analitzat de manera retrospectiva una sèrie de 58 pacients diagnosticats d’un osteosarcoma no metastàsic a l’Hospital Universitari La Fe de València entre els anys 1985 i 2005. La supervivència global obtinguda als 5 i 10 anys va ser del 57 i del 50 % respectivament. Hem identificat com a factors pronòstic independents la grandària tumoral i la localització axial. Un 50% dels pacients van morir com a conseqüència d’una recidiva sistèmica malgrat haver estat tractats, la majoria, amb cirurgia amb conservació de membre i quimioteràpia tant pre com postoperatòria. El rescat quirúrgic de la recidiva proporciona supervivències prolongades d’una manera significativa.