Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Sadoghi, P.
Primary osteosarcoma over the age of 60: A series of seven cases and review of the literature.
[ Diplomarbeit/Master Thesis ] Graz Medical University; 2008. pp.53.
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- Autor*innen der Med Uni Graz:
- Sadoghi Patrick
- Betreuer*innen:
- Leithner Andreas
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- Abstract:
- Introduction: Osteosarcomas are the most common malignant bone tumors with an incidence of 4-5/1 000 000. Although Campanacci only describes one peak of incidence which arises in adolescence, Kyoji et al. and Huvos et al. report that there is a second peak of primary osteosarcomas in the sixth and seventh decade of life. The aim of this retrospective study was an analysis of osteosarcoma patients over the age of 60 treated at our department. Materials and methods: Sixtyfour patients (40 male, 24 female) with a mean age of 29 years (from 7 to 82) were treated for primary osteosarcomas from February 1998 to October 2008. One female and one male patient were excluded because their osteosarcomas developed after irradiation for a separate primary malignancy. At time of diagnosis seven patients (two male and five female) were over 60 years of age. Five patients of these suffered from osseous osteosarcomas and two patients of these from extra- osseous osteosarcomas. Results: At the time of analysis two of these seven patients had died 8 and 101 months after diagnosis. The remaining five patients were alive at a follow- up of 3, 18, 21, 29 and 112 months. Three out of seven sarcomas were radiologically or histologically primarily misdiagnosed but only one was mistreated by intramedullary nailing at a trauma center. Discussion: In a complete review of six studies of Campanacci (1682 pat.) [2], Huvos (1095 pat.) [3], Dahlin (600 pat.) [14], Coventry (430 pat.) [13], Stark (249 pat.) [16], and the present study (62 pat.), including 4132 primary osseous osteosarcomas, we found no evidence for a second peak of primary osteosarcomas in the older ages. Okada et al. report clinical or radiological misdiagnosis in terms of osteosarcomas in the age over 50 in more than 23%. Jeon et al. in more than 39% in the age over 40. Our data show misdiagnoses of osteosarcoma patients treated at our department in three out of seven cases over the age of 60. Misdiagnoses were a juvenile cyst, a fibrous dysplasia and a simple fracture each diagnosed at a local trauma center. The simple fracture was the only mistreated case of this series by intramedullary nailing. The possibility of primary osteosarcomas in the older age and the high rate of misdiagnoses should increase our vigilance to this tumor.