bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late Results after Cement Bone Filling in Treatment of Giant Cell Tumour (GCT) - Retrospective Study
Authors: Prejbeanu R. , Crişan D. , Bălănescu A. , Haraguş H. , Deleanu B. 
Published: May 2018

Abstract
Introduction. Segmental or intralesional excision with curettage or complete resection can be one method of treatment for giant cell tumor (GCT), but the ideal filling material after curettage or resection remains controversial. The purpose of this retrospective study was to follow the latest results and complications regarding the recurrence or degradation of functional status that underwent cementation. Material and methods. We reported 24 cases with GCTs during the last 15 years. All the patients were treated by intralesional excision or segmental resection followed by acrylic cement filling with or no metal augmentation recurrence-free survival proportions were used to evaluate oncological outcomes. Other parameters including surgical complication, general condition, and radiological classification were analyzed. Results. We followed up 20 cases for at least five years postoperatory (from the 5th to the 9th year). The recurrence-free survival proportions showed that the recurrence rate in this group was for 4 patients (2 of them were at second surgery). 2 patients had degradation of implant cement fixation. Parameters including patients’ age, gender, tumor location, and radiological classification did not affect the surgeons’ treatments in cavity filling after GCT curettage. Conclusions. Cementation should be recommended because of easy usage, have long lasting better results, and the better local tumor control than other methods (ex: bone grafting). The risk of recurrence is low and is not related to the cementation and metal augmentation. The cost-benefit is also in favor of this technique.
A Tool in Differential Diagnosis of a “Cystic” Bone Lesion
Authors: Marinescu A.N. , Nicula A.I. , Iana G. 
Published: May 2018

Abstract
It is a power point program, which through a succession of steps, allows the obtaining of one shorter diagnosis, from a long list of possible ones, by choosing a character of the bone lesion. The aim of this program is to facilitate the differential diagnosis of this particular aspect of a bone lesion - the cystic, expansile osteolytic bone lesion - from a radiological point of view, but not only. The location, age, pain and other condition will be considered and will represent the first criteria in the differentiation. In this differential diagnosis, we discovered not only benign tumor lesions but also malign bone lesions or other non-tumoral conditions. We considered that this program could be easily used by the radiologist or the orthopedist in training and useful by also employing a representative photo gallery.
Imaging Diagnosis of a Proximal Tibia Tumor – Case Presentation
Authors: Turcu R. , Barbilian A. 
Published: May 2018

Abstract
Introduction. 30 years ago, the primary role of radiology in tumor pathology was predominant in establishing the diagnosis. A wide range of techniques has been developed, allowing the interventionist radiologist to apply new procedures to patients with tumor pathology. This improved both the diagnosis and the treatment of tumor lesions. Material and method. A 19-year-old male patient, accused pain and functional knee failure, and pain in the ipsilateral ankle, which started about three months before, because of a sprain. Following the clinical examination, a suspicion of a meniscal lesion associated with a lesion of the ankle ligament complex arose. The magnetic resonance imaging revealed the meniscal lesion, but changes in the proximal tibia were observed, which required computed tomography of the knee. The presence of an osseous tumor at the proximal tibia was revealed. Given the unpredictable evolution of tumors in young people, a bone scintigraphy was decided to be performed. Results. The imaging studies commonly used in assessing the patient with musculoskeletal tumor pathology are radiographs, nuclear magnetic resonance, computed tomography, bone scintigraphy. Magnetic resonance imaging is the most sensitive method of diagnosis, allowing the assessment of the extent of the tumor formation in the medullary canal, but also in the adjacent soft tissues. Conclusion. After analyzing the patient’s history, the clinical, paraclinical and imaging examination, and the differential diagnosis will be established and the optimal treatment will be decided in this case.
Bone Metastasis Secondary to Vulvar Cancer
Authors: Berceanu C. , Brătilă E. , Berceanu S. , Tetileanu A.V. , Voicu N. L. , Mehedinţu C. 
Published: May 2018

Abstract
Bone metastases from a vulvar cancer are extremely rare with only few reported cases in literature. Some cases were reported, in which patients developed pathologic fractures within eight months following radical surgery for advanced vulvar carcinoma. It is unanimously recognized that metastatic vulvar cancer is a rare condition. Therefore, information on metastatic determinations and corresponding prognosis or therapeutic approaches is very low. This paper is a review on some extremely rare conditions, such as bone metastases in vulvar cancer.
Imaging Diagnosis of a Shoulder Tumor – Case Presentation
Authors: Turcu R. , Barbilian A. 
Published: May 2018

Abstract
Introduction. The most common and used molecular imaging techniques used in tumor pathology are the following: optics such as fluoroscopy, bioluminescence, and spectroscopy, radionuclides such as positron emission computed tomography, magnetic resonance with or without contrast substance, ultrasound and computed tomography. Material and method. A 39-year-old male patient accused having a shoulder tumor beginning 6 months before with a slow increase in volume without symptoms, pain, local temperature changes, and neurological phenomena. The clinical examination revealed the presence of an elastic consistency tumor, adherent to the bone but movable in soft adjacent tissues, without spontaneous and palpation pain, and local swelling. There was a slight functional embarrassment in conducting the abduction maneuver, but without limiting the amplitude of the movement. Results. Radiography of the shoulder did not reveal any significant changes. Magnetic resonance imaging of the shoulder and contrast-enhanced magnetic resonance imaging of the shoulder were performed. The evoked changes required a computed tomography of the shoulder. Conclusion. The thorough analysis of the imaging investigations and the clinical, paraclinical, and biological context of the patient will lead to the indication of the treatment and the optimal surgical time.
Personalized Surgical Planning – The Use of 3D Printing in Oncological Pathology
Authors: Liciu E. , Frumuşeanu B. , Popescu B.M. , Florea D.C. , Niculescu L. , Ulici A. 
Published: May 2018

Abstract
Introduction. Among the cases of malignant tumors, gathering 30% of them, the most frequent is the osteosarcoma. It occurs especially in children and young adults, the mean age being 14 years old. The treatment consists initially in neoadjuvant chemotherapy, followed by the surgical removal of the tumor. Due to aggressive malignant features (rapid increase in size, tendency to invade surrounding tissues, variable location), in multiple cases, the surgical treatment of osteosarcoma becomes a true challenge. Materials and methods. Nowadays, it is possible to create 3D printed models, by using CT and MRI, which are superior to the 3D graphical reconstructions. The 3D printing technique facilitates the production of these 1:1 scale printed models that faithfully embody the patient’s particular features concerning the anatomic pathology. The benefits gained from using such a modern tool allow the orthopedic surgeons to establish the measurements of a precise resection and to simulate the surgical maneuvers, as part of an elaborated modern surgical planning. Results. In this article, we presented the case of a 10-year-old patient diagnosed with femoral osteosarcoma and treated with neoadjuvant chemotherapy followed by GMRS surgical approach based on a preoperative planning involving a 3D printed model. This piece was used to provide precise information regarding the tumor, to allow preoperative measurements and a surgical simulation. Conclusion. The surgical accuracy can be increased by using a personalized preoperative planning based on a 3D printed model, leading to a lower rate of long/ short-term complications, recurrences, or metastases.
Mechanisms of Bone Metastasis of Malignancies of the Genito-Mammary Area
Authors: Bohîlțea R. , Turcan N. , Georgescu T.A. , Cîrstoiu M.M. 
Published: May 2018

Abstract
Bone metastasis is a frequent complication of advanced genito-mammary cancer patients. Skeletal involvement is particularly common in breast cancer. Bone metastases induce a wide range of symptoms, lowering the quality of life and shortening survival. The normal bone remodeling process is deeply affected in all types of metastases: osteolytic, osteoblastic, and mixed. The main mechanisms involved in bone metastatic dissemination are the expression of adhesion tumor molecules and corresponding receptors within bone marrow and bone matrix cells; local growth factors, molecular mechanisms of remodeling the hematopoietic stem cell activity, and alteration of the expression of the post-transcriptional regulatory microRNAs of the gene expression are the new theories developed from recent studies. Abnormalities in the number of copies of the 16q23 gene explain the increased risk of bone metastasis of breast cancer compared to its dissemination to the other organs; the mutual interaction between tumor cells and the bone microenvironment constitutes the element that stimulates both bone destruction and tumor development. Endothelin -1, bone morphogenic proteins, platelet-derived growth factor, Wnt proteins stimulate proliferation and osteoblastic activity. Genomic and proteomic studies underlie the development of new therapeutic agents for the treatment and prevention of bone metastases.
Malignant Neoplasms of Bone and Articular Cartilage –Hospital Burden in Romania
Authors: Mincă D.G. , Cîrstoiu C. , Furtunescu F.L. , Costea R.V. 
Published: May 2018

Abstract
Introduction. Cancers of bone and articular cartilage are relatively rare, and a global analysis was not performed up to present in Romania due to the lack of a national registry for these diseases. This study aimed to explore the hospital burden due to malignant neoplasm of bone and articular cartilage in Romania and the general characteristics of the hospitalized cases. Materials and methods. We used the data reported in the routine statistic system during 2012 and 2016 and we analyzed the number of cases discharged from hospitals by age group, gender, and duration of hospitalization. Results. The number of hospitalized cancers of bone and articular cartilages decreased by 17% in the last five years (2012-2016) but this decrease was higher in other/ unspecified cancers (22%) and lower in limb cancers (10%). Among the 1872 cases reported in 2016, 47% were limbs’ cancers and the rest, cancers of others/ unspecified sites. Males accounted for 62% of all cancers (58% of limbs cancers and 65% of other cancers, p=0.001, Chi2 test). Distribution by age showed that 17%, 62% and 21% of the cancers occurred in age-groups 0-14, 15-64 and 65+ respectively, but limbs cancers occurred in a significantly higher proportion in children (29% vs. 7% of other cancers, p<0.001). 16983 days of hospitalization were reported in 2016 for this pathology, with an average length of stay of 9.07 days (9.37 and 8.81 days in limbs and other cancers respectively). Conclusions. More detailed analysis of routine reported data is required for understanding the characteristics and trends of bone cancers in Romania.
Soft Tissue Sarcomas of Extremities - MRI Role in the Diagnostic Evaluation
Authors: Bratu A.M. , Sălcianu I.A. , Zaharia C. , Iana G. , Marinescu A.N. 
Published: May 2018

Abstract
Introduction. Soft tissue sarcomas (STS) are rare entities of soft tissue cancers. Their incidence is low, of only 1% of the malignant tumors. In terms of localization, most of the STS affect the extremities, and their incidence is much higher in children than in adults. Material and method. The present paper is a retrospective study that includes tumors with lower limb localizations, including the bony pelvis, over a 3-year period (2013-2016). The study group consisted of 29 patients who, following the MRI examination, were diagnosed with softtissue tumors. Of the 29 patients, 17 patients had a MRI (magnetic resonance imaging) and an anatomopathological diagnosis of leiomyosarcoma. The location of the tumor, its characteristics, and the relationship with the adjacent anatomical structures were analyzed in all cases. Results. The ages of the final group of 17 patients ranged between 28 and 84 years, with female predominance. In terms of localization, one showed a muscle tumor in the pelvis, namely left oblique muscle, other cases being located in the thigh and knee. A special importance was given to the superficial and profound location. In 5 cases, the tumor was localized in subcutaneous fatty tissue, thus superficial. In terms of the contours of the tumor, well-defined margins were present in 11 cases, and poorly defined contour in 6 cases. Regarding the size, the leiomyosarcomas in our study had dimensions between 5.2 cm and 18 cm, and their structure was inhomogeneous, with the presence of necrosis and calcifications. Necrosis was found in 14 cases, and calcifications were present in 68%, being more frequent than necrosis. Except for the necrotic areas, the contrast enhancement was intense. Conclusions. Although the diagnosis is always histopathological, the MRI plays an important role in defining a precise localization and tumor characteristics.
Reconstructive Surgery in Nose Tumors
Authors: Parasca S. V. , Iosif B.F. , Costeschi A. , Popescu O. , Roznovanu M. 
Published: May 2018

Abstract
Introduction. Cutaneous malignancies localized on the nasal pyramid are one of the most frequent non-melanocytic skin cancers with a great psychosocial impact. A predominant pathology of the elderly is distinguished by slow development, with a tendency to ulceration and addressability to medical services in advanced local stages. Reconstruction after oncologic intervention is diverse, locoregional flaps, grafting, and simple direct sutures can be made, the case per se dictating the appropriate attitude. The variables to be considered are location, size of the remaining defect and quality of potential donor areas. The following are also taken into account: reduction of morbidity, increasing quality of life, patient’s psychological impact. Materials and methods. 7 cases of basocellular carcinoma of the nose addressed between 2017- 2018 are described throughout an observational analysis based in the Emergency Hospital for Plastic Reconstructive Surgery and Burncare in Bucharest, referred to by various reconstructive methods, depending on the particularities encountered. Locoregional flaps-bilobed, nasogenian, frontal, dorsal nasal - as well as full-thickness skin grafts and simple direct sutures were performed. Results. Carcinoma excision was complete and safety margins were confirmed histopathologically. Evolution of postoperative patients was favorable without complications. Conclusion. There are numerous surgical options for repairing nose defects. Oncological radicality and satisfactory aesthetic and functional outcome are the main objectives in choosing the method. The aims of reconstructive surgery are functionality of the nose, aesthetic appearance with finer scars, preserving the aesthetic subunits of the nose, but also the relationship with the neighboring structures.
Multidisciplinary Approach in the Treatment of Malignant Bone Tumors
Authors: Marinca L. , Pop D. , Moraru O. , Stoica I.C. 
Published: May 2018

Abstract
Introduction. There are two types of tumor lesions at bone level: primary tumors and bone metastasis. These lesions cause a decrease in the structural strength of the bone that may lead to fracture. The goal of the orthopedic treatment is to resect the tumor, alleviate symptomatology, and restore the function of the limb. The orthopedic treatment consists of two phases: tumor resection and limb reconstruction. Treatment of such lesions implies extensive preoperative investigations to determine the local and general extent of the tumor and procedures aimed to facilitate resection. Case presentation. We present the case of a 58-year-old male, diagnosed with clear cell renal carcinoma three years before and treated by nephrectomy. Two months after surgery, the patient started reporting moderate pain in the hip, which gradually intensified. He was first seen in Foişor Hospital in December 2018 when a pathologic bone fracture in the trochanteric region of the right femur was discovered at the radiologic exam. This was supposed to be a bone metastasis from the previously operated renal cell carcinoma. The MRI investigation showed the presence of a large, polylobed bone tumor with an inhomogeneous structure, sized 80/ 72/ 82 mm extending in the adjacent soft tissue. Bone scintigraphy of entire skeleton revealed no other lesions and abdominal MRI exam revealed neither the recurrence of the tumor or the presence of abdominal metastasis. Significant vascularization of the tumor, from branches of the deep femoral artery, was evidenced on the Angio Computer Tomography. Due to the known profuse bleeding of such lesions, an angiography with embolization was also performed. Embolization was done with PVA particles, with a lack of post-embolization load. The Angio Computer Tomography scan performed at three weeks after embolization showed a reduction in size of the tumor. In March 2018 patient underwent bone resection and reconstruction with a G.M.R.S. tumor prosthesis. Resection was performed in a complex team involving also two vascular surgeons. The pathology exam confirmed it was a renal cell carcinoma bone metastasis. Results. At one week after the surgical procedure, the operative wound was healing, the patient had no pain, and he was gradually regaining ambulation. Conclusion. Surgical treatment of such neoplastic pathology is difficult and involves a multidisciplinary approach consisting of disciplines such as oncology, orthopedics, vascular surgery, and pathology. It also implies a significant contribution from radiology and interventional radiology.
Long-Term Follow-Up in Tumoral Arthroplasty
Authors: Iacobescu G. , Ene R. , Cursaru A. , Anghelescu D. , Cîrstoiu C. 
Published: May 2018

Abstract
Introduction. Efficient management of a segmental resection or major osteolysis in the distal femur secondary to a tumor formation remains a controversial problem. Available options include the use of a modular or customized megaprosthetic implant. Modularity allows versatility for reconstruction and avoids the delay required to make a customized implant. Hypothesis and type of study. Performing a clinical and radiological retrospective study that aims to evaluate long-term efficiency in the use of megaprostheses in segmental distal femur resections. Elaboration of patient selection criteria for modular prosthesis. Materials and methods. We followed retrospectively 33 patients for 5 years from the time of the first surgery. We evaluated the implant stability, the late complications rate, and the long-term functional recovery of patients with distal femoral tumors who underwent segmental resections and subsequently reconstructive arthroplasty. Results. Thirty of the 33 patients maintained a mobile knee joint. An intermediate staging was performed at 30 months, which determined tumor recurrence in 2 patients, aseptic degradation of the components in 3 of them, and septic degradation in two of the evaluated cases. Because a tumoral recurrence occurred on the 45th month, the need for amputation of the prosthetic limb was imposed. The degradation of the polyethylene component (in 5 cases) was observed in the 5-year assessment. The functional results were excellent with the Musculoskeletal Tumor Society Score of 88% and a Toronto Extremity Severity Scale Score of 94%. Conclusions. Patients with distal femoral bone tumors undergoing modular reconstruction prosthetic arthroplasty have excellent functional results with retaining the affected limb and knee mobility. There was a close correlation between correctly applying the selection criteria for patients undergoing prosthesis intervention and functional recovery results.
Tumor with Aggregate Cells at the Level of Radial Distance Pipe - Treatment and Evolution
Authors: Tarniţa D.N. , Grecu D.C. , Tenovici M.C. , Văduva R.C. , Tudora A.D. , Grecu A. , Petrovici I.L. , Căpitănescu B. 
Published: May 2018

Abstract
A 20-year-old patient presented to the emergency service with radial distal epiphysis after a minor trauma. The radiological examination indicated a fracture at the radial distal epiphysis on the background of a tumor that occupied the radial epiphysis in its entirety, with cortical burglary in some places. When consulting the oncologist, a surgical intervention for biopsy material harvesting was performed. The anatomopathological exam showed: multiple fragments microscopically representing a tumor proliferation consisting of two cell populations, mononuclear cells, densely cellular and strobe pattern; areas of infarction, haemorrhage areas, rare intratumoral osteoid formation zones; appearance of giant cell tumor. The immunohistochemical examination confirmed the anatomopathological diagnosis adding, therefore, the aggressive character and the local relapse. The oncologist decided that it did not require oncology treatment but only orthopedic treatment. Orthopedic treatment required repeated surgery at intervals of about 5 months apart, caused by tumor recurrence. The first intervention consisted of 1/ 3 distal radius resection and replacement with a graft harvested from the peroneum. Tumor recurrence after 5 months required extirpation of tumor tissue and filling of caries caused in the graft with a fluid bone substitute. Recurrence after another 5 months required removal of the graft that was invaded by the tumor and cubitusmetacarpal arthrodesis fixed with a screw plate. Currently, the patient is undergoing complementary oncology treatment finally initiated by a medical oncologist.
Pelvic Chondrosarcoma - Therapeutic Options (Literature Review)
Authors: Popescu R. , Cuculici Șt. , Cristea Șt. 
Published: May 2018

Abstract
Chondrosarcoma is a mesenchymal malignant tumor (primary or secondary) which is characterized by a cartilaginous mass formed out of neoplastic cells. It is one of the most frequent malignant bone tumors (after multiple myeloma and osteosarcoma), affecting more males than females (Ratio M:F=2:1). It appears with predilection in the pelvis and long bones - mainly the proximal portion of the humerus and femur. It is a unique primary bone tumor through its chemotherapy and radiotherapy resistance, the only effective treatment being the surgical one. As far as the pelvis is concerned, it is important to determine the location, the dimension, and the relation with the nearby structures of the tumor, in order to establish if it is possible to do a complete excision of the tumor and adapt the subsequent reconstruction of the pelvis. In the excisions of the pelvic chondrosarcoma, the choices are conservatory surgery (limb saving) and the radical surgery (conventional pelvic resection). The oncological resection is the primary goal, but the functional result and the patient’s quality of life are also very important.