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Background: The reconstruction of the proximal humerus is possible from the resection of the tumor and the placement of a prosthesis. In some cases, they do not meet the anthropometric aspects of the patients., Objective: To determine the parameters to size the components of a humeral prosthesis and the development of a set, using design software., Method: Forty patients were selected for prostheses, radiographs and CT scans were analyzed and statistical tests were applied to the measurements., Results: The length of the tumors was 8-20 cm. The minimum length of the humerus was 28 cm and 33 cm the maximum. Correlation was observed between the humerus and the tumor and the height of the patient with p = 0.93088 and p = 0.904564, respectively; humerus diameter, p = 0.2345. The set will include three components, diameter 6-10 mm, and length of 24, 26 and 28 cm. Three modular spacers with lengths of 6, 8.5 and 13 cm. Crowns 6.5 and 8.5 cm long, 1.3 cm in diameter and 5 mm nut., Conclusion: With the development of the set, poorly calculated resections and adaptation to any humerus size can be resolved., (Copyright: © 2021 Permanyer.)

The frequency of giant cell tumors reported in the literature is very variable. Considering that our population has its own features, which distinguish it from the Anglo-Saxon and Asian populations, we think that both the frequency and the clinical characteristics of giant cell tumors in our population are different. The major aim of this paper was to determine the frequency and clinicopathological characteristics of giant cell tumors of the bone. A cross-sectional descriptive study was conducted of the cases diagnosed at our service as giant cell tumors of the bone from January to December 2013. The electronic clinical records, radiologic records and histologic slides from each case were reviewed. Giant cell tumors represented 17% of total bone tumors and 28% of benign tumors. Patients included 13 females and 18 males. The most frequent locations of giant cell tumors were: the proximal tibia, 9 cases (29%), and the distal femur, 6 cases (19%). Forty-five percent of giant cell tumors were associated with aneurysmal bone cyst (ABC) (14 cases) and one case (3%) was malignant. The frequency of giant cell tumors in this case series was intermediate, that is, higher than the one reported in Anglo-Saxon countries (usually low), but without reaching the frequency rates reported in Asian countries (high).

The Asn118Asn (rs11615) variant in the ERCC1 gene, and the Lys751Gln (rs13181) and Asp312Asn (rs1799793) variants in the ERCC2 gene have been associated with the development of varied types of cancer. The aim of the present study was to test for any association between the ERCC1 and ERCC2 gene variants and three different types of cancer in Mexican-mestizo patients. Patients and their respective controls were formed into three groups: The osteosarcoma group, with 28 patients and 97 controls; the colorectal group, with 108 patients and 119 controls; and the breast cancer group, with 71 patients and 74 controls. Genotyping was performed using TaqMan probes and quantitative polymerase chain reaction. Allele and genotype frequencies were compared using a χ 2 test. Only one SNP (rs1799793) was found to be associated with breast cancer. This is the first study analyzing the SNPs in ERCC1 and ERCC2 genes and the susceptibility to cancer in Mexican-mestizo patients with osteosarcoma, and colorectal and breast cancer.

The dedifferentiated giant-cell tumor of the bone is a very rare variant of the giant-cell tumor (GCT). We report the clinical, radiographic and histological findings of a dedifferentiated GCT in which the dedifferentiated component consisted of small round cells. We also comment on previously reported cases of dedifferentiated GCT, discuss the clinical implications of this dual histology, and analyze the information published about the coexistence of similar genetic abnormalities in GCT and small round cell tumors of the bone.

Introduction: Conservative surgery and reconstruction with an unconventional prosthesis are indicated for tumors of the humerus without neurovascular compromise, as they help preserve shoulder, elbow and hand function. The humerus is the third most frequent site of benign, aggressive, malignant and metastatic tumors that cause functional limitation or limb loss., Material: Patients with a bone tumor of the humerus without neurovascular involvement that met the inclusion criteria. Unconventional, uncemented RIMAG prosthesis with diaphyseal fit and locking bolts., Methods: 39 patients with intraarticular type I tumors according to the Malawer and Enneking classification were treated with tumor resection and reconstruction with an unconventional prosthesis and soft tissues., Results: Patients enrolled included 18 females and 21 males ages 12-72 years with tumors such as: giant cell tumors (14), osteosarcomas (7), metastasis (7), chondrosarcomas (6), Ewing's sarcomas (2), chondroblastoma (2) and aneurysmatic bone cyst (1). Twelve patients died due to systemic disease and the remaining patients survived. Surgical margins were broad, with humeral resection between 100 and 230 mm. Functional results were assessed according to the Muscoloskeletal Tumor Society score as 13 excellent, 16 good, 5 failures and 5 poor., Discussion: The resection level does not restrict the placement of this prosthesis, which permits future revisions. An appropriate result depends on the resection size and the preserved shoulder musculature and it is not limited by the size of resection, thus improving patients' disability.

Objective: To assess the functional efficacy of the RIMAG unconventional hip prosthesis in cancer and non-cancer patients., Material and Methods: Functional analysis of 38 patients with RIMAG arthroplasty, using the Musculoskeletal Tumor Society Scoring System and including the following: functionality versus histologic diagnosis (5 malignancies, 3 metastases, 14 giant cell tumors (GCT), 8 with other benign tumors, and 8 had no tumor), age (40.4 +/- 19.1 years), sex (24 females, 14 males), postoperative follow-up (34.7 +/- 31.3 months). Analysis of intraoperative, immediate and late complications, time to weight bearing, gait and work or social reintegration were also assessed., Results: Global mean of ideal functionality was 65.6 +/- 23.2%. Age was negatively correlated with the functionality rate (r = -0.507, p = 0.001); significant difference with the histologic diagnosis: malignant tumors 54.8, metastasis 58.6, giant cell tumor 25.6, other benign tumors 34.2, non-tumor causes 56.6 (p = 0.001). When functionality means were adjusted for age with a covariance analysis, better percentages were found for benign tumors (79.2 +/- 6.8%) and giant cell tumors (76.4 +/- 6.3%), less functionality for non-tumor causes (45.7 +/- 7.6%), and intermediate percentages for malignant tumors and metastasis (p = 0.03). Intraoperative complications occurred in 4 cases (28.6%), immediate in 3 (7.8%), late in 15 (39.4%); 62.5% of patients started immediate weight bearing, 92.1% resumed their usual activities after surgery., Conclusions: The reconstruction of the proximal femur with RIMAG is a safe and reliable treatment option, with complication rates below the ones reported in the literature. Satisfactory results were obtained, with high functional rates for benign tumors, and low rates in older patients, malignant tumors and metastasis.

Giant cell tumor (GCT) is an aggressive benign neoplasia that accounts for 5% of primary bone tumors and 20% of all benign bone tumors. It appears almost exclusively after skeletal maturation, between 20 and 40 years of age, and is predominant among females. We report the case of a 39 year-old male patient who in 1988 sustained a left hip fracture in a pathological area. On July 20, 1988 he underwent excisional biopsy and curettage; on January 13, 1989 broad resection and arthrodesis of the left hip were performed with a cobra plate. The histopathologic diagnosis was GCT. On October 2, 1990 the cobra plate was removed due to fatigue. The patient was referred to our service with a floating hip joint and left knee anchylosis. On February 11, 1991 he underwent unconventional hip arthroplasty with a long stem up to the femoral supracondylar area. On February 2, 1995 the implant was removed due to fatigue. On February 16, 1995 an unconventional prosthesis with a long stem was re-implanted for knee arthrodesis. Final shortening was 10 cm. On November 17, 2010 he had radiographic signs of acetabular loosening and fatigue of the arthrodesis stem. On March 17, 2011 the unconventional prosthesis was removed, en-bloc resection of the distal femur was performed, and acetabular and femoral components were put in place. He is currently painless, walks with crutches and has 5.5 cm of shortening. The proximal femur is an infrequent site for GCT. Controlling the neoplasia and limb preservation are the major challenges that orthopedic surgeons and patients face. There are only a few published papers on revision of unconventional arthroplasty. There are no cases published on unconventional hip arthroplasty with ipsilateral knee arthrodesis.

Introduction: Chondrosarcoma is a malignant tumor of chondroid matrix-producing cells; based on its frequency, it is the second most common malignant bone tumor (10-20%) and responds poorly to chemo- and radiotherapy. It is infrequent in the pelvis. It has a rapid growth potential. The indicated treatment is broad resection with tumor-free margins. Pelvic reconstruction after resection is controversial. The current management of musculoskeletal neoplasias has a two-fold purpose. First of all, controlling the neoplasia by means of surgeries with cancer-free margins and, second, performing procedures for the reconstruction of the involved segment achieving limb preservation with maximum functionality., Objective: Intrapelvic reconstruction with the proximal third of the ipsilateral femur in a patient with a chondrosarcoma in Enneking-Dunham's zone II. And placement of an unconventional femur prosthesis., Clinical Case: We present herein the case of a 58 year-old male, with a lytic lesion of the right acetabulum. The patient completed the diagnostic protocol, and the biopsy result was dedifferentiated chondrosarcoma., Conclusion: The purpose of the surgical technique is to use the proximal third of the femur as a novel reconstruction alternative with massive autograft for tumor lesions located in Enneking-Dunham zone II.

Introduction: Benign fibrous histiocytoma is a rare tumor with very stringent radiologic and histopathologic criteria. It accounts for approximately 1% of all the benign bone tumors. It may be located in both the soft tissues and bone. Its usual location is the shaft, the epiphyseal end of the long bones, the pelvis and the ribs. The age range of presentation is very broad, from 5 to 75 years; it occurs more frequently in young adults. It is rare in children., Case: Female, 27 year-old patient who presented at 10 years of age with a tumor in the right proximal femur, which was diagnosed as benign fibrous histiocytoma. She underwent surgical en bloc resection and unconventional arthroplasty with a RIMAG prosthesis. She did fine, had no alterations of implant instability and bone quality. She is developing properly, with symmetry of the extremities and appropriate mobility., Discussion: There are only a few articles addressing subtotal and total hip arthroplasty in pediatric ages. There are reports in adolescents ranging from infection to loosening, periprosthetic fracture, revision and, generally speaking, implant failure. However, we did not see this type of complications in this case, and the patient received appropriate management.

Background: Fibrous hamartoma of infancy (FHI) is an infrequent benign proliferation of the soft tissues. Ninety one percent of cases occur during the first year of life. FHI is characterized as a subcutaneous lesion with characteristic morphology with a triphasic organoid growth pattern., Clinical Case: We present the case of a 6-month-old male infant with a tumor in the medial plantar region of the left foot, which was completely withered. Histopathological study reported a fibrous hamartoma of infancy., Conclusions: Fibrous hamartoma of infancy most frequently affects males. It may be localized at any anatomic site, although 5-10% of cases affect the lower limbs. Few cases are reported in the foot. This is a lesion with a characteristic morphological pattern; however, in small biopsies, its differential diagnosis is important with other fibroadipose lesions for appropriate treatment. Ample surgical resection with lesion-free borders confers a good prognosis for these patients.

The purpose of this paper is to present the orthopedic-oncologic and functional outcomes of internal partial hemipelvectomy for a secondary giant pelvic chondrosarcoma in a patient with multiple hereditary osteochondromatosis.

Design: Report of cases., Objective: Review of the cases in a period of 10 years with bone and soft tumors in foot and ankle, to knowing epidemilogical, clinic and patologic anatomy parameters to describe the behavior., Materials and Methods: Review of 166 cases from 1991 to 2000 and been analyze with descriptive statistic, association measurment for inside stratum, with odds ratio, hipótesis test with chi square for qualitative date and t to Student for quantitative date., Results: 166 patients within 2 years to 78 years old, 81 with bone tumors and 79 with soft tumors, mostly benign, the most frequent was in the soft tissue ganglion and oseal benign exostosis in bone, 6 different malignant tumors, the principal affected zone were the toes, as a difference to literature, the most affected age group was 10 to 20 years followed to the 30 to 40 years old, we report 42 different patological diagnostics results to soft tissue and osseous tissue., Conclusion: clinical features is not a useful parameter to differentiate between malign or benign tumors and does not allow to establish the biological behavior, we propose the diagnostic algorithm that includes the intentional clinical probe, comparative X-ray in three projections with soft technique, in suspicion to malignant lesion may require CT scan, MRI, osseous scan and finally biopsy which will improve the final outcome.

Background: Low grade fibromyxoid sarcoma, first described in 1987, is a rare sarcoma characterized by a bland and deceptively benign histologic appearance but with aggressive behavior., Case: A 51-year-old female presented with a history of a recurrent and slowly growing mass in the left foot. Fine needle aspiration biopsy showed an abundant myxoid background with occasional thick bands of collagen. Tumor cells present in the myxoid background were spindle shaped, with focally mild or a light degree of nuclear enlargement, hyperchromasia and pleomorphism, Conclusion: Low grade fibromyxoid sarcoma has particular cytologic features. Besides a careful cytologic evaluation of all the components, clinical and radiographic correlation is necessary to make the correct diagnosis.