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      Bone tumours of the clavicle: Histopathological, anatomical and epidemiological analysis of 113 cases

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          Abstract

          Backround

          This retrospective study aimed to determine the frequency of bone tumours of the clavicle and their histopathological, anatomical and epidemiological characteristics in a large case series.

          Methods

          The records of 327 lesions of the clavicle collected from 1976 to 2018 in our bone tumour registry and institute of pathology were reviewed. Following data were evaluated: age, gender, side, radiological assessment, tumour location within the clavicle, and histopathological findings.

          Results

          Bone tumours were detected in 113 patients with a mean age of 40 years. The lateral third of the clavicle was most frequently involved. Analysis revealed 22 benign, 31 intermediate, and 60 malignant tumours. Eosinophilic granuloma was the most commonly found neoplasm (18.6%), followed by bone metastases (15.0%), Plasma cell myeloma (8.8%), Ewing sarcoma (8.8%), and Osteosarcoma (8.0%). 53% of the tumours were malignant. Mean age was 51 years in the malignant tumour group and 28 years in patients with a benign/intermediate lesion ( p < 0.001).

          Conclusions

          The high incidence of malignant bone tumours of the clavicle found in this study highlight the importance of biopsy to prevent delay in diagnosis and treatment of these lesions, especially in patients with increased age. We believe that the results of this study are of clinical importance and may aid the physician in the management of these rare lesions.

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          Most cited references21

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          Sarcoma classification: an update based on the 2013 World Health Organization Classification of Tumors of Soft Tissue and Bone.

          The 2013 World Health Organization Classification of Tumors of Soft Tissue and Bone incorporates changes in tumor classification, as well as new genetic insights into the pathogenesis of many different tumor types that have emerged over the 11 years since the publication of the prior volume. This article reviews changes in the classification of soft tissue and bone sarcomas as well as tumors of intermediate biologic potential in the 2013 World Health Organization volume, new molecular insights into these tumors, and associated surgical and clinical implications.
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            Epidemiology of bone tumors in Mexico City: retrospective clinicopathologic study of 566 patients at a referral institution.

            A retrospective analysis of all bone tumors accessioned at a large referral center (Instituto Nacional de Rehabilitacion) in Mexico City between 2000 and 2005 is presented. A total of 6216 biopsies and surgical resection specimens were reviewed during this period, of which 566 corresponded to bone tumors. Benign bone tumors accounted for 71.6% of cases and malignant bone tumors for 28.4%. The tumors affected men in 53.7% of cases and women in 46.3% of cases, with an average age at presentation of 25 years. The femur was the most common location of the tumors (39.9%), followed by the tibia (17.7%) and humerus (11.8%). The commonest malignant bone tumors were osteosarcoma (46.6%) and chondrosarcoma (8.7%). Of malignant bone tumors, 18.6% corresponded to metastases of carcinomas from internal organs and 8.1% were multiple myeloma. The most common benign bone tumor was osteochondroma (43.7%) followed by giant cell tumor of bone (14.6%) and enchondroma (10.1%). The age distribution showed a peak in children and adolescents comprised predominantly of benign lesions and a second peak in young adults that corresponded to malignant bone tumors (principally osteosarcoma). Malignant bone tumors most often involved the femur, vertebra, and tibia. Our results parallel the findings previously reported in the world literature and show a similar distribution and epidemiology as in other developed and underdeveloped countries. Geographic location does not appear to represent a risk factor for any particular type of bone tumor and does not affect the age distribution, location, or histopathologic type of the lesions.
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              Primary tumours and tumorous lesions of clavicle.

              Primary tumours and tumorous lesions of the clavicle are very rare, and little literature is available regarding their characteristics and outcome. We studied the clinical, radiological, and histopathological characteristics, and outcome of management of patients with primary tumours of the clavicle presenting to us from 1996-2005. Twelve cases of primary tumours of the clavicle presented during the above period. Seven patients were treated with partial or complete claviculectomy, and no reconstruction was done. These seven patients were evaluated for functional results with AMSTS scoring. Eight patients out of twelve had a primary malignant bone tumour, four of these being Ewing's sarcoma. No particular predilection of location of the tumour within the clavicle was seen. Functional and oncological results of claviculectomy were good. The distribution of types of tumours in the clavicle is quite different from long-bone tumours. No reconstruction is required following partial or total claviculectomy.
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                Author and article information

                Contributors
                Journal
                J Bone Oncol
                J Bone Oncol
                Journal of Bone Oncology
                Elsevier
                2212-1366
                2212-1374
                06 March 2019
                June 2019
                06 March 2019
                : 16
                : 100229
                Affiliations
                [a ]Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
                [b ]Department of Pediatric Orthopaedic Surgery, Children's Hospital Hamburg-Altona, Hamburg, Germany
                [c ]Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
                [d ]Pathologie Hamburg, Lademannbogen 61-63, Hamburg, Germany
                [e ]Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
                Author notes
                [* ]Corresponding author at: Department of Pediatric Orthopaedic Surgery, Children's Hospital Hamburg-Altona, Hamburg, Germany. aspiro@ 123456uke.de
                [1]

                Matthias H. Priemel and Norbert Stiel contributed equally to this work and therefore share first authorship.

                Article
                S2212-1374(19)30009-0 100229
                10.1016/j.jbo.2019.100229
                6439286
                30976505
                ca71fc1c-dd73-422b-8ab4-32df74a029e9
                © 2019 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 16 January 2019
                : 2 March 2019
                : 4 March 2019
                Categories
                Research Article

                bone tumour,clavicle,biopsy,histology
                bone tumour, clavicle, biopsy, histology

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