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Malignant bone tumours of the foot.

Abstract Introduction Malignant osseous foot tumours are uncommon. Their oncological outcomes have been poorly documented in the literature so far. The aim of this study was to establish the incidence and to evaluate the oncological outcomes of such patients. Methods Our large orthopaedic oncology database was used to review 70 malignant osseous foot tumour patients. Results The age at diagnosis of malignant osseous foot tumours demonstrated a bimodal distribution peaking in the second and eighth decades of life. Overall, 55 primary malignant bone tumours of the foot (79%) were identified. The median duration from onset of symptoms to diagnosis was 52 weeks (interquartile range [IQR]: 17-104). Eight primary tumours (15%) underwent an accidental excision (ie intralesional excision of a malignant bone tumour where some of the tumour has been left behind, also known as a 'whoops procedure') prior to referral to our unit. Forty-six patients (84%) underwent surgery overall and thirteen of these developed recurrence or metastases. Seven of eight patients with a previous accidental excision underwent amputation. Fifteen osseous metastatic foot lesions were identified. The median length of foot symptoms to diagnosis was 24 weeks (IQR: 20-36 weeks). The median time to death following diagnosis of osseous foot metastases was 20.1 months (IQR: 11.3-27.8 months). Conclusions A high index of suspicion and awareness of clinical features of malignant osseous foot tumours are both essential to avoid diagnostic delays. Amputation is associated with a respectable outcome for patients who have undergone previous accidental excisions.
PMID
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Authors

Mayor MeshTerms

Foot Bones

Keywords

Bone tumour

Foot

Malignancy

Metastasis

Primary

Journal Title annals of the royal college of surgeons of england
Publication Year Start




PMID- 28853588
OWN - NLM
STAT- MEDLINE
DA  - 20170830
DCOM- 20170913
LR  - 20170913
IS  - 1478-7083 (Electronic)
IS  - 0035-8843 (Linking)
VI  - 99
IP  - 7
DP  - 2017 Sep
TI  - Malignant bone tumours of the foot.
PG  - 568-572
LID - 10.1308/rcsann.2017.0114 [doi]
AB  - Introduction Malignant osseous foot tumours are uncommon. Their oncological
      outcomes have been poorly documented in the literature so far. The aim of this
      study was to establish the incidence and to evaluate the oncological outcomes of 
      such patients. Methods Our large orthopaedic oncology database was used to review
      70 malignant osseous foot tumour patients. Results The age at diagnosis of
      malignant osseous foot tumours demonstrated a bimodal distribution peaking in the
      second and eighth decades of life. Overall, 55 primary malignant bone tumours of 
      the foot (79%) were identified. The median duration from onset of symptoms to
      diagnosis was 52 weeks (interquartile range [IQR]: 17-104). Eight primary tumours
      (15%) underwent an accidental excision (ie intralesional excision of a malignant 
      bone tumour where some of the tumour has been left behind, also known as a
      'whoops procedure') prior to referral to our unit. Forty-six patients (84%)
      underwent surgery overall and thirteen of these developed recurrence or
      metastases. Seven of eight patients with a previous accidental excision underwent
      amputation. Fifteen osseous metastatic foot lesions were identified. The median
      length of foot symptoms to diagnosis was 24 weeks (IQR: 20-36 weeks). The median 
      time to death following diagnosis of osseous foot metastases was 20.1 months
      (IQR: 11.3-27.8 months). Conclusions A high index of suspicion and awareness of
      clinical features of malignant osseous foot tumours are both essential to avoid
      diagnostic delays. Amputation is associated with a respectable outcome for
      patients who have undergone previous accidental excisions.
FAU - Yang, P
AU  - Yang P
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Evans, S
AU  - Evans S
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Bali, N
AU  - Bali N
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Ramasamy, A
AU  - Ramasamy A
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Evans, R
AU  - Evans R
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Stevenson, J
AU  - Stevenson J
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Jeys, L
AU  - Jeys L
AD  - Professor of Health and Life Sciences, Aston University , UK.
FAU - Grimer, R
AU  - Grimer R
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ann R Coll Surg Engl
JT  - Annals of the Royal College of Surgeons of England
JID - 7506860
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Neoplasms/*diagnosis/mortality/surgery
MH  - Child
MH  - Child, Preschool
MH  - Chondrosarcoma/diagnosis/mortality/surgery
MH  - Female
MH  - *Foot Bones/surgery
MH  - Humans
MH  - Infant
MH  - Male
MH  - Middle Aged
MH  - Osteosarcoma/diagnosis/mortality/surgery
MH  - Retrospective Studies
MH  - Sarcoma, Ewing/diagnosis/mortality/surgery
MH  - Young Adult
OTO - NOTNLM
OT  - Bone tumour
OT  - Foot
OT  - Malignancy
OT  - Metastasis
OT  - Primary
EDAT- 2017/08/31 06:00
MHDA- 2017/09/14 06:00
CRDT- 2017/08/31 06:00
AID - 10.1308/rcsann.2017.0114 [doi]
PST - ppublish
SO  - Ann R Coll Surg Engl. 2017 Sep;99(7):568-572. doi: 10.1308/rcsann.2017.0114.