53 (763) Fig. 4 Resected tumor specimen. Fig. 1 Lateral view of chest X-ray film showing a tumor shadow in the right anterior chest wall. Fig. 5 Micro

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Transcription:

52 (762) osteosarcoma, rib, chest wall tumor, adjuvant chemotherapy

53 (763) Fig. 4 Resected tumor specimen. Fig. 1 Lateral view of chest X-ray film showing a tumor shadow in the right anterior chest wall. Fig. 5 Microphotograph stain). of resected tumor (H-E Fig. 2 Chest CT showing the tumor with the rib destruction in the right anterior chest wall. Fig. 3 Microphotograph of biopsy specimen (H-E stain).

54 (764) Table 1 Charactaristics of primary osteosarcoma of the ribs. 40 cases from Japanese literature (1956-98).

55 (765) 1) Dahlin D C : Bone Tumors. 3rd ed, III : 226-260 Charles C, Thomas Publisher, Springfiield, 1981. 2) Burt M, Fulton M, Wessner-Dunlap S, et al : Primary Bony and Cartilaginous Sarcoma of Chest Wall : Result of Therapy. Ann Thorac Sure 54 : 226-232, 1992. 6) Abdulraman R E, White C S, Templeton P A, et al : Primary osteosarcoma of the ribs : CT findings. Skeletal Radiology 24: 127-129, 1995. 8) Lin J, Leung WT, Ho SK, et al : Quantitive evaluation of thallium-201 (TI) uptake in predicting chemotherapoietic response of osteosarcoma. Eur J Nucl Med 22 : 553-555, 1995. 9) Enneking WF : A system of staging musculoskeletal neoplasms. Clin. Orthop. 204 : 9-24, 1986. 14) Grannis FW, Wagman L D : Repair of a complex Body Wall Defect Using Polytetrafluorethylene Paches. Ann. Thorac Surg 60: 197-199, 1995. 15) Bramwell VHC, Burgers M, Sneath R, et al : A comparison of two short intensive adjuvant chemotherapy regiments in operable osteosarcoma of limbs in children and young adults ; the first study of the European osteosarcoma intergroup. J Clin Oncol 10: 1579-1591, 1992. 16) Dome J, Schwartz C : Osteosarcoma. Cancer Treat Res. 92: :215-251, 1997. 17) Bacci G, Picci P, Ruggieri P, et al : Primary chemotherapy and delayed surgery (neoadjuvant chemotherapy) for osteosarcoma of the extremites. Cancer 65: 2593-2553, 1990. 18) Link M P : The multi-institutional osteosar-

56 (766) coma study ; an update Osteosarcoma in adolescents and young adults, 261-267 G. B. Humphrey Kuluwer Academic Publishers, Boston, 1993. 21) Davis AM, Bell RS, Goodwin PJ : Prognostic factor in osteosarcoma ; a critical review. J 29) Meyers PA : Osteosarcoma of extremities ; Clin Oncol 12 : 423-431, 1994. chemotherapy experience at Memorial Sloan 22) Himelstein B. : Osteosarcoma and Other -Kettering. Osteosarcoma in adolescents and bone cancers. Curr Opin Oncol 10 : 326-333, 1998. 31 : 1013-1019, 1996. young adults, 261-267 Ed. by G B Humphrey Kluwer Academic Publishers, Boston, 1993. 30) Tsuchiya H, Yasutake H, Yokogawa A, et al : Effect of chemothrapy combined with caffeine for osteosarcoma. J Cancer Res Clin Oncol 118 : 567-569, 1992. A case of primary osteosarcoma of the rib Yoshihisa Kadota, Meinoshin Okumura, Hyung Eng Yoon, Masato Minami Shinichi Takeda, Shinichiro Miyoshi, Yoshitaka Fujii*, Hikaru Matsuda Division of general thoratic surgery, department of surgery, Osaka university graduate school of medicine Second depertoment of surgery Nagoya city university medical school Osteosarcomas commonly originate in the extremities. We report a rare case of primary osteosarcoma of the rib. A 28-year-old male patient with a right anterior chest wall mass and pain was referred to our hospital. The tumor was hard, 7 ~ 8 cm in size and fixed on the 3rd to 5th rib. Radiological examination revealed the inhomogenous tumor in the chest wall, which infiltrated the surrounding tissues and destroyed the ribs. The tumor was completely resected with a sufficient surgical margin. The tumor was histologically diagnosed as osteosarcoma. Adjuvant chemotherapy (CDDP + ADM, IFM, HD-MTX) was performed. The patient is alive without recurrence 3 years after the operation.

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