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High magnification micrograph of giant cells in a giant-cell tumor of bone, H&E stain. The diagnosis of giant-cell tumors is based on biopsy findings. The key histomorphologic feature is, as the name of the entity suggests, (multinucleated) giant cells with up to a hundred nuclei that have prominent nucleoli.
Therefore, the utilization of such techniques for objective tumor response should be restricted to validation purposes in specialized centers. However, such techniques can be useful in confirming complete pathological response when biopsies are obtained. Tumor markers alone cannot be used to assess response.
There is a variety of chemotherapy treatment protocols for bone tumors. The protocol with the best-reported survival in children and adults is an intra-arterial protocol where tumor response is tracked by serial arteriogram. When tumor response has reached >90% necrosis surgical intervention is planned. [16] [17]
The tumor is solid, hard, irregular ("fir-tree," "moth-eaten", or "sun-burst" appearance on X-ray examination) due to the tumor spicules of calcified bone radiating at right angles. These right angles form what is known as a Codman triangle, which is characteristic but not diagnostic of osteosarcoma. Surrounding tissues are infiltrated.
Studies that observed that bone resorption could be restored by bone marrow and spleen transplants helped prove osteoclasts' hematopoietic origin. [3] Other multinucleated giant cell formations can arise from numerous types of bacteria, diseases, and cell formations. Giant cells are also known to develop when infections are present.
These cells are arranged in short fascicles which split and merge, giving the appearance of "fish bone" known as a herringbone pattern. Poorly differentiated tumors consist in more atypical cells, pleomorphic, giant cells, multinucleated, numerous atypical mitoses and reduced collagen production.
[5] [8] Signs and symptoms vary according to tumor site, and prognosis is closely tied to the location of the primary tumor. Common sites of metastasis include the lungs, bone marrow, and bones. [9] [10] There are many classification systems for RMS and a variety of defined histological types. Embryonal rhabdomyosarcoma is the most common type ...
A bone sarcoma is a primary malignant bone tumour, a type of sarcoma that starts in the bones. [1] This is in contrast to most bone cancers that are secondary having developed as a metastasis from another cancer. Bone sarcomas are rare, and mostly affect the legs. The other type of sarcoma is a soft-tissue sarcoma.