Infarct-associated bone sarcomas.
Sarcoma associated with bone infarct is a rare condition sparsely reported in the literature. Sixty percent of cases arise about the knee and most are malignant fibrous histiocytomas. We report 15 patients; 12 of 15 presented with a tumor around the knee. Treatment was limb salvage in seven patients, amputation in six, and biopsy alone in two. For patients without metastatic disease at presentation, the 2-year disease-free survival rate was 63% (seven of 11). Two patients received chemotherapy and both were continuously disease-free at last followup. When we combined our 15 patients with the 52 previously reported in the literature, 38 of the 67 (57%) died of their disease at an average of 19.2 months after diagnosis; 21 patients (31%) were continuously disease-free for 24 months. Of 13 patients who received chemotherapy, eight (62%) were continuously disease-free at 24 months compared with 24% (13 of 54) of those who did not receive chemotherapy. Overall, prognosis for these patients is poor, but survival in patients without metastatic disease at diagnosis approaches that of other bone sarcomas. There is a trend suggesting adjuvant chemotherapy combined with appropriate surgery may improve patient outcomes.


METHODS
Level IV, therapeutic study.
Domson
Gregory F
GF
Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, 3450 Hull Road, Gainesville, FL 32607, USA.
Shahlaee
Amir
A
Reith
John D
JD
Bush
Charles H
CH
Gibbs
C Parker
CP
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001706:Biopsy; D001859:Bone Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D051677:Histiocytoma, Malignant Fibrous / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007238:Infarction / Q000150:complications* / Q000473:pathology / Q000601:surgery; D023821:Limb Salvage; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011859:Radiography; D012189:Retrospective Studies; D012509:Sarcoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology