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BACKGROUND: Tumor segment resection is one of the standard methods for the treatment of bone tumors. However, the reconstruction of bone defects after tumor resection faces many challenges. A growing number of researchers are focusing on 3D-printed prostheses for bone defect repair and reconstruction following bone tumor surgery. OBJECTIVE: To explore the feasibility of 3D-printed prostheses in the reconstruction of large bone defect following bone tumor surgery and to evaluate the postoperative outcomes. METHODS: Retrospective analysis of clinical data of 24 patients [19 males and 5 females, age 23.8 (6-61) years] who underwent bone tumor resection and 3D-printed prosthesis implantation in the Department of Bone Oncology, the First Affiliated Hospital of Xinjiang Medical University from December 2020 to September 2021 was conducted. There were 7 cases with distal femur tumor, 5 with pelvis tumor, 4 with proximal tibia tumor, 3 with middle femur tumor, 1 with distal tibia tumor, 1 with proximal humerus tumor, 1 with middle humerus tumor, 1 with scapula tumor, 1 with ulna tumor, and 22 cases with primary tumors (13 osteosarcoma, 4 Ewing sarcoma, 2 giant cell tumor of bone, 1 chondroblastoma, 1 chondrosarcoma, and 1 osteoblastoma), 2 metastatic carcinoma. Preoperative and postoperative imaging data were recorded and neoadjuvant chemotherapy was administered in 17 cases before surgery. The Musculoskeletal Tumour Society score was used to assess limb function before surgery and 6 months after surgery, and pain was assessed by the Visual Analog Scale, as well as the complications were recorded. RESULTS AND CONCLUSION: (1) All patients undergoing resection of the tumor segment and 3D-printed prosthesis implantation for the reconstruction of the bone defect were followed for 6-49 months, and the results showed that the length of osteotomy was (18.2 ± 7.3) cm and an average intraoperative bleeding volume was 740 (100-3 000) mL. (2) Two patients died of systemic metastasis, the remaining 22 had no pulmonary metastasis or recurrence during the followup period, and 1 patient developed aseptic loosening of the prosthesis at 25 months postoperatively. (3) The Musculoskeletal Tumour Society scores were significantly increased, while Visual Analog Scale scores were significantly decreased (P < 0.05) at 6 months postoperatively. (4) The Musculoskeletal Tumor Society score was rated excellent in all 22 patients at the final follow-up. (5) These results suggest that 3D-printed prosthesis is suitable for the reconstruction of large bone defects caused by bone tumor resection. Patients have good postoperative function and few complications. However, further investigations are needed to explore long-term follow-up results. [ABSTRACT FROM AUTHOR]

BACKGROUND: Studies have shown that osteoprotegerin/receptor activator of nuclear factor κB ligand/nuclear factor κB receptor activator (OPG/RANKL/RANK) signaling pathway has a certain correlation with the pathogenesis of giant-cell tumor. Controlling the OPG/RANKL/RANK signaling pathway to affect the interaction between osteoblasts and osteoclasts can play a certain therapeutic role in giant-cell tumor of bone. OBJECTIVE: Ton introduce the relationship between the OPG/RANKL/RANK signaling pathway and the pathogenesis of giant-cell tumor of bone, and to summarize and discuss the new advances of the OPG/RANKL/RANK signaling pathway in the pathogenesis of giant-cell tumor of bone. METHODS: PubMed, Web of Science, and WanFang databases were searched for relevant articles published from 2001 to 2019 using the keywords of “OPG/RANKL/RANK, giant cell tumor of bone, pathogenesis, signal pathway, bone metabolism" in English and Chinese, respectively. A total of 53 articles were finally included for analysis and discussion after removal of old and repeated literatures. RESULTS AND CONCLUSION: OPG inhibits the proliferation and differentiation of osteoclasts, reduces the activity of mature osteoclasts, and blocks the binding of RANKL to RANK. RANKL binds to RANK on the surface of osteoclast progenitor cells to promote the differentiation and proliferation of osteoclast progenitor cells, thus accelerating osteoclast progression. After binding to RANKL receptor, RANKL activates signal factors such as nuclear factor-κB to promote the proliferation, differentiation and activation of osteoclasts, and to regulate the transcription and expression of related genes. Therefore, the OPG/RANKL/RANK is associated with the pathogenesis of giant-cell tumor. [ABSTRACT FROM AUTHOR]

Objective To assess the clinical value of C-arm CT in sacral tumor embolization. Methods From 2016 through 2019. 62 patients with sacral tumors underwent interventional therapy. All patients had pathologically confirmed diagnosis of giant cell tumors (40 primary, 7 recurrent), chordomas (5), hemangiomas (2), Ewing’s sarcoma (1), and aneurysmal bone cysts (7) of the sacrum. Contrast-enhanced multi-slice CT (MSCT) was performed on all patients including C-arm CT examination (43) before interventional therapy. The image quality with and without C-arm CT were compared qualitatively. Independent sample t test was used to compare the total X-ray radiation dose and bleeding during post-operative follow-up. Results The treatment plans of 31 patients were adjusted according to C-arm CT examination. The image quality of C-arm CT was inferior to that of MSCT. All patients had varying degrees of artifacts on C-arm CT images with little influence on diagnosis. The average radiation dose in the C — arm CT group (825.3±448.0 mGy) was significantly lower (P<0.01) than that of the group without C-arm CT (1620.6±767.4 mGy). In 37 patients with preoperative arterial embolization, the follow-up surgery was successful in all patients without complications related to interventional therapy such as wound non-union. The average blood loss in C-arm CT group (1943±2131 mL) was not significantly lower (P=0.34) than that of non-C-arm CT group (2560±1648 ml). Conclusion In the interventional treatment of sacral tumors, C-arm CT can accurately determine the vascular supply for pre-operative embolization, facilitate surgery, and reduce the radiation exposure. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of complete resection of bone tumor in pelvic zone Ⅱ and reconstruction with allogeneic pelvis, modular prosthesis, and three-dimensional (3D) printing prosthesis., Methods: The clinical data of 13 patients with primary bone tumor in pelvic zone Ⅱ who underwent tumor resection and acetabular reconstruction between March 2011 and March 2022 were retrospectively analyzed. There were 4 males and 9 females with an average age of 39.0 years ranging from 16 to 59 years. There were 4 cases of giant cell tumor, 5 cases of chondrosarcoma, 2 cases of osteosarcoma, and 2 cases of Ewing sarcoma. The Enneking classification of pelvic tumors showed that 4 cases involved zone Ⅱ, 4 cases involved zone Ⅰ and zone Ⅱ, and 5 cases involved zone Ⅱ and zone Ⅲ. The disease duration ranged from 1 to 24 months, with an average of 9.5 months. The patients were followed up to observe the recurrence and metastasis of the tumor, and the imaging examination was performed to observe the status of implant in place, fracture, bone resorption, bone nonunion, and so on. The improvement of hip pain was evaluated by visual analogue scale (VAS) score before operation and at 1 week after operation, and the recovery of hip function was evaluated according to the Musculoskeletal Tumor Society (MSTS) scoring system after operation., Results: The operation time was 4-7 hours, with an average of 4.6 hours; the intraoperative blood loss ranged from 800 to 1 600 mL, with an average of 1 200.0 mL. There was no reoperation or death after operation. All patients were followed up 9-60 months (mean, 33.5 months). No tumor metastasis was found in 4 patients receiving chemotherapy during follow-up. Postoperative wound infection occurred in 1 case, and prosthesis dislocation occurred in 1 case at 1 month after prosthesis replacement. One case of giant cell tumor recurred at 12 months after operation, and the puncture biopsy showed malignant transformation of giant cell tumor, and hemipelvic amputation was performed. The postoperative hip pain significantly relieved, and the VAS score was 6.1±0.9 at 1 week after operation, which was significantly different from the preoperative score (8.2±1.3) ( t =9.699, P <0.001). At 12 months after operation, the MSTS score was 23.0±2.1, including 22.8±2.1 for patients with allogenic pelvis reconstruction and 23.3±2.3 for patients with prosthsis reconstruction. There was no significant difference in the MSTS score between the two reconstruction methods ( t =0.450, P =0.516). At last follow-up, 5 patients could walk with cane assistance and 7 patients could walk without cane assistance., Conclusion: The resection and reconstruction of primary bone tumor in pelvic zone Ⅱ can obtain satisfactory hip function, and the interface of allogeneic pelvis and 3D printing prosthesis have better bone ingrowth, which is more in line with the requirements of biomechanics and biological reconstruction. However, pelvis reconstruction is difficult, the patient's condition should be evaluated comprehensively before operation, and the long-term effectiveness needs further follow-up.

Objective To discuss the clinical effect and adverse reaction of resection of tumor segment and custom tumor type artificial joint replacement in treatment of giant cell of bone tumor of long bones of limbs in Campanacci' s level III patients. Methods Twenty-nine patients with giant cell tumor of bone in large joints of limbs were diagnosed by objective biopsy and treated by tumor segment resection and custom artificial joint replacement between January in 2004 to January in 2014 at Yunnan Province Cancer Hospital. There were 14 male and 15 female patients, aged from 19 to 85(39.66 on average). The location of tumor in patients was: proximal humerus in 6 cases, the upper segment of femur in 5 cases and the lower segment of femur in 15 cases, the proximal tibia with 6 cases. The Campanacci' s Level was III. We resected the pathological bone and soft tissue out of the tumor boundary in treatment, and truncated bone on surface at 3 to 5 cm to the edge of tumor, and installed artificial prosthesis for reconstruction of the function of human joint. The prosthesis and the interface of host bone were fxied by bone cement fixed technique. The medial head of gastrocnemius muscle transposition was used to repair the soft tissue of proximal tibial of patients underwent the poximal tibial tumor resection. MSTS limb salvage scoring system was used to evaluate the function of patients after treatment. Results The followed up time was 1 to 83 months(36.62 months on average) in 29 patients. I period healing of the operation incision was in 28 patients had, and sinus was formed at the tip of the drainage tube was found in one patient, and the wound were healed after Debridement. The MSTS score in patients was 12 to 27, 23.10 on average. The limb function were excellent in 16 patients, good in 11 patients, moderate in 1 patient and poor in 1 patient, the rate of excellent-good is 93.10%. All cases had no local recurrence, but one was died of lung cancer with metastasis after 2 years. Conclusions The resection of tumor segment and custom artificial joint replacement can be used as limb salvage treatment for giant cell tumor of bone in Campanacci's level III patients. The correct selection of indication, designing individualized prosthesis, good intraoperative fixation and appropriate soft tissue reconstruction can prevent complications and achieve good clinical efficacy. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the effect of computer-aided navigation (CAN) technique in the resection margin control of tenosynovial giant cell tumor (TGCT) involving the temporomandibular joint and skull base. METHODS: CAN technique was used to assist the resection of TGCT in TMJ and skull base, as well as immediate reconstruction of the skull base. Postoperative CT scanning was taken to evaluate the effect of the operation. RESULTS: Postoperative CT scanning showed a complete resection of the tumor, with a fine reconstruction of the removed skull base region. Postoperative follow-up of 6 months showed no signs of recurrence. CONCLUSIONS: The application of CAN technique can help to control the surgical margins of lesions in TMJ and skull base region. It can help to mark the tumor boundaries, protect vital structures as well as facilitate the reconstruction process during the surgical procedure. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100), Scientific Research Foundation of Ministry of Education or Returned Overseas Chinese Scholars and Program for Innovative Research Team of Shanghai Municipal Education Commission. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to determine the characteristic computed tomography (CT) findings of diffuse type giant cell tumour of the temporomandibular joint (TMJ). METHODS: Eight subjects with diffuse type giant cell tumour of the TMJ were examined with contrasted CT scans. All lesions were histopathologically confirmed through surgery. CT appearances of the lesions were reviewed. RESULTS: Among the 8 subjects, 8 (100%) demonstrated soft tissue swelling and further enhancement, 6 (75%) demonstrated entire or focal areas of noncontrast hyperdensity, 6 (75%) had widening of the joint spaces. Bony changes of the mandibular condyles were found in 7 (87.5%) subjects. Bony changes of articular surfaces and intracranial extensions were found in 6 (75%) subjects respectively. CONCLUSION: Based on the CT findings, diffuse type giant cell tumour of the TMJ is characterized by hyperdensity soft tissue swelling and further enhancement, bony destruction of the mandibular condyles and skull base, and intracranial extension. [ABSTRACT FROM AUTHOR]

The incidence of primary malignant bone tumors is low, and clinical cognition is insufficient. The establishment of diagnostic criteria is of great significance for prognosis of tumors. National Comprehensive Cancer Network (NCCN) regularly publishes "Clinical Practice Guidelines for Bone Tumors" to summarize the latest treatment progress of bone tumors. In the latest version of the guidelines released in November 2020, surgery is the main treatment for chondrosarcoma, chordoma, and giant cell tumor of bone, which can be combined with radiotherapy or targeted therapy. Ewing's sarcoma and osteosarcoma are treated by surgery combined with chemotherapy. Immunotherapy can be used to treat high-grade undifferentiated pleomorphic sarcoma. For recurrent tumors, surgery combined with radiotherapy, chemotherapy, and/or targeted therapy can be used for control. The guidelines provide a reference for the standard treatment of bone tumors.

Primary salivary duct carcinoma (SDC) featured with giant cell tumor (GCT) is a extremely rare, relatively new understanding lesion and its histogenesis has not been fully defined. This paper reported a case of SDC associated with GCT, its clinical, histopathologic features and histological origin were discussed in combination with literature review. [ABSTRACT FROM AUTHOR]

Giant cell reparative granuloma (GCRG) is a type of non-neoplastic lesion that can be rarely found in clinical practices. Due to the lack of specificity in symptoms, signs and auxiliary examinations, it is likely to be misdiagnosed, and thereby affecting the treatment and prognosis. In July 2018, a GCRG patient who was described with "4 years of hearing loss in the left ear, accompanied by 2 months of preauricular swelling" as the first symptom was admitted in our hospital. Both the HRCT and MRI scans for the temporal bone suggested the presence of tumor at the left lateral skull base, but the nature still needed further examination. Intraoperatively, the tumor was completely removed and repaired locally. Pathological examination confirmed the symptoms as GCRG. Immunohistochemistry showed the expression of CD68 and CD163 in the tumor cells. Postoperatively, the patient recovered well without complications, and had the stitches removed before being discharged on schedule.

Objective: To explore the risk factors of giant cell tumor on extremities for patients with postoperative recurrence., Methods: The literature reports published before June 2014 were searched in the electronic databases of CBM, CNKI, PUBNED, MEDLINE and EMBASE. Meta-analysis was performed by software Review Manager (Version 5.3). The odds ratios (OR) of gender, age, tumor site, Campanacci Classification, pathological fracture, selection of treatment and soft tissue invasion were analyzed with heterogeneity test. Publication bias were tested by funnel plot and fail-safe number.Sensitivity analysis was performed to assess the stability., Results: A total of 15 case-control studies were identified. Age, location and type of surgery were associated with tumor recurrence. The combined OR (95%CI) was 1.83 (1.04-3.24) P = 0.04 for aged <20 years, 0.52(0.31-0.86) P = 0.01 for aged >40 years, 1.60 (1.06-2.42) P = 0.02 for distal radius, 0.35 (0.14-0.90) P = 0.03 for proximal humerus, 3.64 (1.88-7.04) P = 0.0001 for curettage,0.56 (0.35-0.91) P = 0.02 for curettage with PMMA, 1.79 (1.11-2.88) P = 0.02 for curettage with bone graft and adjuvant and 0.29 (0.12-0.66) P = 0.003 for resection respectively. There were not significant relationship between tumor recurrence and gender, tumor location (distal femur, proximal femur, distal tibia, proximal tibia), Jaffe staging, Campanacci classification,Enneking classification, pathological fracture, soft tissue invasion, extensive curettage, curettage with bone graft, curettage with polymethylmethacrylate and adjuvant (P > 0.05)., Conclusion: Youth (aged <20 years), distal radius, curettage and curettage with bone graft and adjuvant are the risk factors for recurrence of giant cell tumor.However, advanced age (aged >40 years), proximal tibia, curettage with PMMA and resection appear to have lower risks for tumor recurrence.

Objective: To evaluate the effect of bone cement filling on articular cartilage injury after curettage of giant cell tumor around the knee., Methods: Fifty-three patients with giant cell tumor who accorded with the inclusion criteria were treated between January 2000 and December 2011, and the clinical data were retrospectively analyzed. There were 30 males and 23 females, aged 16-69 years (mean, 34.2 years). The lesion located at the distal femur in 28 cases and at the proximal tibia in 25 cases. According to Campanacci grade, there were 6 patients at grade I, 38 at grade II, and 9 at grade III. Of 53 patients, 42 underwent curettage followed by bone cement filling, and 11 received curettage followed by bone grafts in the subchondral bony area and bone cement filling. Two groups were divided according to whether secondary osteoarthritis occurred or not during postoperative follow-up. The gender, age, lesion site, the subchondral residual bone thickness, tumor cross section, preoperative Campanacci grade, subchondral bone graft, and Enneking function score were compared between 2 groups, and multivariate logistic regression analysis was done., Results: All incisions healed by first intention. The average follow-up time was 65 months (range, 23-158 months). Of 53 cases, 37 (69.8%) had no osteoarthritis, and 16 (30.2%) had secondary osteoarthritis. Three cases (5.7%) recurred during the follow-up period. Univariate logistic regression analysis showed no significant difference in gender, age, lesion site, and Campanacci grade between 2 groups (P > 0.1); difference was significant in the subchondral residual bone thickness, tumor cross section, Enneking function score, and subchondral bone graft (P < 0.1). The multivariate logistic regression analysis showed that the decreased subchondral residual bone thickness, the increased tumor cross section, and no subchondral bone graft are the risk factors of postoperative secondary osteoarthritis (P < 0.05)., Conclusion: Curettage of giant cell tumor around the knee followed by bone cement filling can increase the damage of cartilage, and subchondral bone graft can delay or reduce cartilage injury.

Giant cell tumor (GCT) is rare and it mainly occurred in male patients. A man of 65 years-old with progressive dyspnea has a 4 cm x 4 cm x 3 cm tumor mass under the right vocal fold originated from right-thyroid cartilage and the parapharyngeal space. The right false vocal was involved in the computed tomography (CT) imaging and laryngoscope. Microscopically, the tumors had an expansile, infiltrative growth and consisted of numerous multinucleated osteoclast-like giant cells within a cellular stroma composed of plump and oval mononuclear cells. The patient underwent partial laryngectomy and has been followed up for 6 months without recurrence or metastasis.

Primary salivary duct carcinoma(SDC) featured with giant cell tumor(GCT) is a extremely rare, relatively new understanding lesion and its histogenesis has not been fully defined. This paper reported a case of SDC associated with GCT, its clinical, histopathologic features and histological origin were discussed in combination with literature review.