Search

Complex cancer pain is a big challenge as a physician. Here we show the case of a patient diagnosed of stage IV lung cancer with bone metastasis and cancer related pain. In need of high doses of opioid and opioid rotation, the patient suffers adverse events from these drugs. The case is discussed in the interdisciplinary committee of complex cancer pain, being indicated the implantation of an intrathecal pump for continuous perfusion of morphine and ziconotide. Opioids doses are reduced and so do the adverse effects. The multidisciplinary strategy improves the coordination of every specialist physician and allows for an optimization of treatment, improving the patient's quality of life. [ABSTRACT FROM AUTHOR]

Bone metastases are one of the main causes of cancer-associated morbidity and mortality. Bone pain requires multidisciplinary and individualized management for each patient. Cryoablation and cementoplasty techniques have been described as effective and safe alternatives in the palliative treatment of refractory oncological pain to other treatments. The case of a 61-year-old woman with lung cancer with bone metastases presents left groin pain, irradiating to ipsilateral lower limb, constant at rest, which appears with the joint load causing bedridden condition without ability to control with opioids due to the appearance of toxicity with increasing dose. The case was discussed in a multidisciplinary committee, agreeing to perform cryoablation and acetabuloplasty of the injuries. The patient had a significant improvement in pain control and occasionally tolerating sitting in bed, without the appearance of adverse effects. [ABSTRACT FROM AUTHOR]

Objectives: To analyze in prostate tumor cells the effects caused by the secretome of bone cells on proliferation and on intracellular signaling pathways related to the progression of prostate cancer. Materials and methods: The effects of secreted factors present in conditioned media of pre-osteoblasts MC3T3-E1 and osteocytes MLO-Y4 on the proliferation of metastatic prostate adenocarcinoma cells PC-3 were characterized using trypan blue staining. The effects of media conditioned by MC3T3-E1 and MLOY4 cells on intracellular signaling molecules involved in the tumor progression of prostate adenocarcinoma cells PC-3 were observed by fluorescence techniques in living cells. The accumulation of intracellular calcium was studied using the fluorescent calcium indicator Fluo-4AM and the generation of cyclic AMP, and ERK 1/2 activation by Fluorescent Resonance Energy Transfer (FRET) using the EPAC and ERKNES biosensors, respectively. Results: The stimulation of PC-3 cells with conditioned media of pre-osteoblasts MC3T3-E1 and osteocytes MLO-Y4 induced an increase in PC-3 adenocarcinoma cell proliferation. Media conditioned by bone cells also caused a transient increase in intracellular calcium accumulation and generation of cyclic AMP and increased ERK 1/2 activation. Conclusions: Bone cells secrete proliferation-activating factors and signaling pathways that favor the tumor progression of prostate cancer cells, suggesting that cross-communication between these cell types may favor the development of metastatic niches of prostate cancer in the bone. [ABSTRACT FROM AUTHOR]

Chondromyxoid fibroma is a rare benign bone tumor with cartilaginous origin characterized by the association of chondroid lobes, fibrous, and myxoid areas. It represents 1% of bone tumors and 1.8% of benign bone tumors. The cardinal symptom in its identification is the presence of pain that can be several months or years of evolution, in many cases it is discovered incidentally by radiological studies. It is essential to establish a good differential diagnosis prior to any type of treatment; the main differential clinical conditions include aneurysmal bone cyst, enchondroma, giant cell tumor, fibrous dysplasia, fibromixoid chondroma, and chondroblastoma. We present the clinical case of a male patient who was diagnosed with chondromyxoid fibroma in a rare anatomical region and who also presented recurrence at the site of application of intercalar grafting with an atypical behavior. [ABSTRACT FROM AUTHOR]

Appearance of bone metastases is the most common complication of oncological diseases. They are usually incurable, produce severe pain, decreasing the expectancy and quality of life of patients. The use of radiopharmaceuticals for bone metastatic pain palliation have shown significant advantages. Bisphosphonates are the main compounds employed for that purpose; nevertheless, their synthesis is relatively a complex process. The aim of the present work was to develop a method for the synthesis of geminal bisphosphonates, starting from the respective amino acids. A three-steps way of synthesis was stablished for the obtainment of such compounds: 1) protection of amino group of the starting amino acid, 2) phosphonation and subsequent hydrolysis of the protected amino group and 3) obtainment of sodium salt. Three different procedures for the protection of amino and hydroxyl groups of the starting amino acids were tested. The use of acylation reaction with formic acid and acetic anhydride, before phosphonation, improved practical conditions for the synthesis of respective bisphosphonates with satisfactory yields. Thus, four bisphosphonic acids, non-previously reported in consulted literature, were synthetized. They were characterized by infrared spectroscopy and NMR. [ABSTRACT FROM AUTHOR]

Chordomas are slow-growing neoplasias of the midline, representing about 1% of malignant tumorsarising from bone, and from 0.1 to 0.2% of intracranial neoplasms. Originating from embryonic notochord, they symptoms begin between the third and fifth decade of life, with an average age of 43 years. They are presented as a mass lesion in the clival region, with destruction and extension to nasopharynx. Definitive diagnosis is made by histopathological evaluation. Survival of untreated patients ranges from 28 months after onset of symptoms to 6.6 years and 3.6 years after radiation and surgery, respectively. Chemotherapy has not proved benefical, but it is usually offered to very young patients in order to reduce the tumoral mass, and to reach an older age in which radioterapy treatment is indicated. There are limitations with regard to treatment, even with current advances in imaging techniques and surgical resection. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: the osteosarcomas of the jaws are infrequently tumors. The accelerated bone growthing and the swelling with nervous sensibility alterations are suggestive of malignancy. The diagnosis is established only by the histological study and the standard treatment used is surgery with a poor survival prognosis of only 25% at five years for those cases with margins free of tumor. Clinical case: a female with an osteosarcoma of the jaw limited to the anterior left face of the maxillary and malar area without involve of the alveolar bone. A modified maxillectomy was done. Chemotherapy and radiotherapy were given after surgery. At the present, the patient is free of malignancy activity after twelve years of survival. Conclusions: no matter the systemic chemotherapy in maxillary and jaw osteosarcomas is little effective, the early diagnosis and treatment was the key in the clinical evolution of the patient presented and in who the first elected treatment was surgery. [ABSTRACT FROM AUTHOR]

In patients undergoing long bone resection for osteosarcoma the use of bone allografts is a treatment option. How do they behave functionally and what is their long term osteointegration? Material and methods: A retrospective, observational, longitudinal study was conducted to obtain clinical and radiologic data of the sample composed of a group of 15 patients with a diagnosis of limb osteosarcoma treated at our hospital with structural bone allografts. The Mankin and ISOLS (International Symposium on Limb Salvage) scales were applied to assess allograft functionality and osteointegration, respectively, from 1993 to 2006. Results: Functional results were as follows: excellent, 10 patients (66.6%); good, one patient (6.6%), and poor, 4 patients (26%). The osteointegration assessment reported excellent results in 77% of cases at 18 months and in 87% at 2 years. Surgical wound infection was reported as a complication in only 2 patients (13.3%). Conclusions: Functionality and osteointegration in patients undergoing conservative surgery with bone allografts are excellent in most cases, and this is the technique of choice for the treatment of long bone osteosarcomas. [ABSTRACT FROM AUTHOR]

We present the case of a 15-year old male with a condroblastic osteosarcoma of the proximal fibula. One year after completing adjuvant therapy, the patient suffered bilateral lung metastases. During surgical resection of a left pulmonary lesion, a tumoral thrombus was identified in the left inferior pulmonary vein. A pericardiotomy and a left auriculotomy were done in order to achieve vascular control and remove the thrombus. A tumor thrombus in pulmonary veins in patients with osteosarcoma is exceedingly rare. To our knowledge, only eight such cases have been described in the literature, and only three of those patients are alive. CT-scan may be useful in the preoperative diagnosis, however, most of these thrombi are found during surgery. They entail a poor prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bisphosphonates are strong osteoclastic inhibitor activities, being these drugs usually for treatment of múltiple myeloma and bone metastases of solid tumors like breast cáncer. The osteonecrosis of the maxillary bones was first described in 2003. The relation of these medicines and maxillary bone osteonecrosis still uncertain. The incidence of this bone necrosis was very low before biphosphonates using. Nowadays this complication reach at least 10% of patients in these therapy using. The present work mean to alert for possible complication in biphosphonates using patients, thru a literature review and a clinical case presentation. [ABSTRACT FROM AUTHOR]

La implantología ha evolucionado rápidamente en los ultimos 40 años y el empleo de biomateriales en Ia recuperación de tejidos es cada vez más frecuente. Por esta razón, es necesario conocer el proceso de reparación y Ia reacción producida entre los los tejidos huéspedes y los biomateriales a nivel histológico, ya que ello contribuirá al éxito, en el largo piazo, de los tratamiento rehabilitadores. ClInicamente, se ha podido observar Ia efectividad de diferentes compuestos, pero cuando han sido analizados histológicamente, han demostrado algunas variaciones que, muchas veces, las hacen inaceptables para la terapia odontológica. Los objetivos de esta revision es conocer Ia forma en que se produce la cicatrización ósea en torno a diferentes biomateriales y como se desarrolla Ia cicatrización ósea en rehabilitación sobre implantes con diferentes protocolos de carga. [ABSTRACT FROM AUTHOR]

Introduction: The patients with bone metastasis by prostate cancer attend frequently with bone pain. The biphosphonates preserve the bone structure and the mineralization which can repel positively in the handling of the pain. Material and methods: Controlled clinical trial in patients with secondary bone pain to metastasis by prostate carcinoma. With an average age of 74.2 years. They administered 1,600 mg of oral clodronate daily by 13 weeks evaluating with visual analogue scale (VAS), Karnofsky Index and daily requirement of analgesic in analgesic/unit (U/A), initial, monthly and final; in addition to tolerability to the medicine. Results: The basal average of 6, 8 VAS was of ± 1.68 and 4.7 end of ± 1.15, with one differentiates significant from -2.1 ± 1.37 (p = 0.00046). The basal average of Karnofsky was of 65 ± 14.33 and to the three 73 months of ± 10.59. The difference in average was 8 ± 6.324 (p = 0.0015). The basal determination of U/A per day average was of 3.826 ± 1.49 U/A and in 2.364 final state ± 1.057 U/A with -1.462 a significant difference of ± 0.684 (p = 0.00004). Conclusions: The improvement in VAS and reduction of U/A observed in this study proposes that the clodronate use can be of clinical relevance in the handling of the patient with secondary bone pain to metastasis by prostate cancer. [ABSTRACT FROM AUTHOR]

Introduction: Sinovial Sarcoma is the fourth cause commonest of sarcomas. One appears in joints, affects minors of 40 years. A rare subtype exists, that it can accompany by formation of osteoid and bone, by immunoreactive to cytokeratin vimentin. It has prognosis and behavior more favorable than the rest of sarcomas, with survival of 80% to 5 years. Objective: To present/ display a clinical case little frequents and to know the behavior neoplasia. Clinical case: Masculine of 19 years, with left shoulder tumor of 6 months of evolution, painless. The computed tomography demonstrated injury of soft parts calcified. It is put under biopsy with sinovial report of sarcoma with extensive bony formation. Intra-articular proximal humerus resection has made. Thirty months later it presents local recurrence, it was put under surgery (local resection) and it received adjuvant chemotherapy. To one year onot evidence of locoregional recurrence or metastasis. Discussion: This neoplasm is a single very rare subtype are 6 cases reported in the Literature, the prognosis and the behavior defers of the rest from sarcomas. [ABSTRACT FROM AUTHOR]

Within 5 years of experience on pediatric spine surgery. Where we analize the following diagnosis, treatment and evolution of the 28 treated patients. The most frequent pathologies are there: Congenital scoliosis, infections, bone tumors and lipomeningocele. The average in age in which the surgery was done is 10 years, the youngest patient was one month old baby and the oldest 16 years old. The period the patients were hospitalized was 10 days, including both posterior and anterior surgeries in some cases. The diagnosis of the spine pathology, in some cases it used to cause trouble, but with a detailed exploration, we could reach a probable diagnosis and the request for necessary tests and conduct a specific treatment. [ABSTRACT FROM AUTHOR]