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Myositis ossificans (MO) is a benign bone formation in an extra-skeletal location. The most common subtype of MO, the post-traumatic, usually develops in young males after a traumatic event or sports injury.
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MO may simulate malignant bone lesions such as extra-skeletal or surface osteosarcomas, or soft tissue sarcomas such as synovial sarcoma or undifferentiated pleomorphic sarcoma. In the early phase the diagnosis of MO is challenging because imaging and histopathological findings may be non-characteristic.
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Detailed medical history as well as clinical examination, follow-up imaging studies and histological assessment are crucial for a proper diagnosis. Early and accurate differential diagnosis between MO and malignant soft tissue and bone tumours is important to maximize.
Cite this article: EFORT Open Rev 2021;6:572-583. DOI: 10.1302/2058-5241.6.210002
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In patients with metastatic or unresectable soft tissue and bone sarcoma of extremities and pelvis, survival is generally poor. The aim of the current systematic review was to analyse recent publications on treatment approaches in patients with inoperable and/or metastatic sarcoma.
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Original articles published between 1st January 2011 and 2nd May 2020, using the search terms ‘unresectable sarcoma’, ‘inoperability AND sarcoma’, ‘inoperab* AND sarcoma’, and ‘treatment AND unresectable AND sarcoma’ in PubMed, were potentially eligible. Out of the 839 initial articles (containing 274 duplicates) obtained and 23 further articles identified by cross-reference checking, 588 were screened, of which 447 articles were removed not meeting the inclusion criteria. A further 54 articles were excluded following full-text assessment, resulting in 87 articles finally being analysed.
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Of the 87 articles, 38 were retrospective (43.7%), two prospective (2.3%), six phase I or I/II trials (6.9%), 22 phase II non-randomized trials (27.6%), nine phase II randomized trials (10.3%) and eight phase III randomized trials (9.2%). Besides radio/particle therapy, isolated limb perfusion and conventional chemotherapy, novel therapeutic approaches, including immune checkpoint inhibitors and tyrosine kinase inhibitors were also identified, with partially very promising effects in advanced sarcomas.
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Management of inoperable, advanced or metastatic sarcomas of the pelvis and extremities remains challenging, with the optimal treatment to be defined individually. Besides conventional chemotherapy, some novel therapeutic approaches have promising effects in both bone and soft tissue subtypes. Considering that only a small proportion of studies were randomized, the clinical evidence currently remains moderate and thus calls for further large, randomized clinical trials.
Cite this article: EFORT Open Rev 2020;5:799-814. DOI: 10.1302/2058-5241.5.200069
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(LMNOP) 60 advise the use of the SINS for the assessment of the stability of the lesion. A number of studies have been published concerning the clinical prognostic value of the SINS in the last few years. A higher SINS score was significantly
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with both Codman triangles and the sunburst appearance. Fig. 7 Classic osteosarcoma of the femur in a child. What is in the lesion? An assessment of the matrix of a lesion can give a clue to the histological diagnosis. An osseous
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thinning, and stage 3 lesions were extended extraosseous lesions ( 26 ). After screening, the full texts of the eligible articles were read independently by the two authors, and the eligibility of each article was reassessed. Quality assessment
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younger individuals). There can be heterotopic bone formation/ossification or endochondral ossification in certain chondrosarcomas and conspicuous chondroid differentiation in some osteosarcomas. Careful assessment of the type of matrix produced by the
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2013 WHO classifications, each subgroup can be evaluated radiologically for a growth pattern. Thus, to characterize and estimate the extent of tumour growth for pre-operative assessment, magnetic resonance imaging (MRI) is the standard for evaluation
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’ deaths, and it is more common in patients with local recurrence. An assessment of the relationship between local recurrence and metastasis suggests several primary tumor treatment modalities. One method involves narrow surgical margins and no radiation
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-PET (fludeoxyglucose positron emission tomography) tracer can be administered pre-operatively for certain types of tumours and the radioactive uptake can be measured with a probe during surgery, providing a better assessment of tumour margins. 27 , 28 The use of
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assessment of any potential residual tumour. Following IE, standard practice is to perform a new MRI to assess whether there is any residual tumour apparent. In the presence of post-surgical change after IE, visualizing areas within the surgical bed that show
