Surgical treatment options for benign lytic lesions of the proximal femur include curettage, and bone grafting of the resulting defect with or without internal fixation. Most of these studies recommended either autogenous or allogenic bone graft.
What are the treatment options for benign lytic lesions of the femur?
Surgical treatment options for benign lytic lesions of the proximal femur include curettage, and bone grafting of the resulting defect with or without internal fixation. Most of these studies recommended either autogenous or allogenic bone graft. Local adjuvants may be used to control local recurrence of the aggressive lesions [1, 2, 4–8].
How to treat lytic lesions of bone?
Treatment Of Lytic Bone Lesions. It is necessary to prevent further deterioration of bone, alleviate pain and prevent fractures. In majority of cases medications are given to reduce the incidence of osteoporosis. Modern medicines are now available especially in case of cancer causing lytic lesions of bone.
What are the treatment options for osteolytic lesions of the hip?
Treatment of osteolytic lesions usually involves medications that control further loss of bone tissue and radiation therapy to alleviate pain and other accompanying symptoms.
Why are MRI and bone scans performed preoperatively for lytic bone lesions?
MRI and bone scans can be adversely affected by biopsy and postoperative changes in the tissue; hence they are generally obtained preoperatively. Important imaging features of certain different lytic bone lesions bear mentioning: Fibrous dysplasia: FD is a common benign lesion with no age predilection.
What causes femoral fractures?
What is intramedullary nailing?
Can proximal femoral metastases cause fracture?
About this website
Can lytic lesions be treated?
Typically, the most effective treatment for lytic lesions involves treatment of the underlying condition and supportive treatment for the bone. For example, common treatments for multiple myeloma may include : Chemotherapy: This treatment involves the use of certain drugs to kill rapidly dividing cancer cells.
What causes lytic lesions on the femur?
Myeloma bone disease can cause the bones to become thinner and weaker (osteoporosis), and it can make holes appear in the bone (lytic lesions).
Are lytic lesions always cancer?
They are benign, asymptomatic tumors with a well-defined sclerotic margin. They are usually juxtacortical in location and typically occur in the metaphysis of long bones, and are most common in the under 30 age group.
Do lytic bone lesions cause pain?
Multiple myeloma can cause osteolytic lesions, or soft spots in the bone, that appear as holes on an X-ray. These osteolytic lesions are painful. They can increase the risk of painful breaks or fractures.
What is the treatment for bone lesions?
Malignant lesions always require treatment. Malignant lesions are usually treated with surgery to remove the tumor, but they may also require other forms of treatment, such as chemotherapy or radiation therapy.
Can you biopsy a lytic lesion?
We conclude that ultrasonically guided fine-needle aspiration biopsy is a useful technique to obtain a pathological diagnosis in cases of lytic bone lesions that can be visualized with this imaging technique.
Which cancers cause lytic bone lesions?
Other types that can cause bone lesions include:Breast cancer.Kidney cancer.Lung cancer.Prostate cancer.Thyroid cancer.
How do you know if a bone lesion is cancerous?
In addition to pain, some cancerous bone lesions can cause stiffness, swelling, or tenderness in the affected area. The pain may come and go and may be worse or better at night. Not all people will experience these symptoms but may instead notice a painless mass somewhere on their body.
What does lytic lesion mean in medical terms?
(LIH-tik LEE-zhun) Destruction of an area of bone due to a disease process, such as cancer.
Where does myeloma spread to first?
At first, the cells reproduce in the bone marrow of the spine. From there, they enter the bloodstream and travel to bone marrow in other parts of the body. They collect in the bone marrow and the hard, outer part of the bones. As this progression happens, the plasma cells can cause multiple tumors.
Is a lesion the same as a Tumour?
A lesion describes any area of damaged tissue. All tumors are lesions, but not all lesions are tumors. Other brain lesions can be caused by stroke, injury, encephalitis and arteriovenous malformation.
Can a CT scan tell if a tumor is benign?
Cysts that appear uniform after examination by ultrasound or a computerized tomography (CT) scan are almost always benign and should simply be observed. If the cyst has solid components, it may be benign or malignant and should have further evaluation.
Are Lytic Lesions on CT Scans Always Cancer? Worried.
My mom who is an 11 year Stage 3 breast cancer survivor had an xray done for shoulder pain at the ER which was clear. A CT scan was ordered of the neck/chest/abdomen/pelvis because of her history and the results are suspicious for malignancy.
Are lytic lesions always a sign of cancer? | Zocdoc Answers
Question. Is a lytic lesion necessarily a sign of cancer? If not, what are the chances that any one lytic lesion is cancerous? A family member was recently having a bone x-ray, and the doctor located something she called a lytic lesion, but she couldn't explain what this has to do with cancer.
Lytic lesions in the femoral neck: Importance of location and ...
Proximal femoral metastases can lead to pathologic fracture. The goals of this study were to improve guidelines for assessing pathologic hip fracture risk by quantifying the effect of location of femoral neck metastases on hip strength under single-limb stance loading and to evaluate the effectiveness of a proposed minimally invasive surgical repair technique for restoring hip strength.
Prominent Symptoms Of Lytic Bone Lesions: Causes & Treatment
Lytic bone lesion is a term used when the bone becomes extremely weak by a disease. Three characteristic symptoms are moderate to severe bone pain, pathologic fracture and high level of calcium in blood.
What Is a Lytic Lesion? - Reference.com
WebMD describes lytic lesions as weak areas of the bone. Also called osteolytic lesions, these lesions occur when multiple myeloma afflicts the body. Registered nurse Karen Raymaakers also notes that myeloma cells release chemicals that lead to bone breakdown. Dr. Sheeba Thomas at Everyday Health further explains that lytic lesions occur with other forms of cancer, including breast cancer ...
Abstract
Thirty-five patients with a benign lesion of the femoral neck or trochanter were treated and seen in followup at the authors' institution from 1988 to 1991. Sixteen men and 19 women between the ages of 18 and 54 years (average, 27 years) were seen at an average followup of 3 years 6 months (range, 2-5 years).
MATERIALS AND METHODS
Seventy-three patients with benign bone lesions of the femoral neck and trochanter were surgically treated at the authors' institution from 1988 to 1991. Small lesions that can be treated with simple bone grafting, pinning, or palliative methods were excluded from this series.
RESULTS
Of the 35 patients, 16 were women and 19 were men. The average age of the patients was 27 years (range, 18-54 years). The pathologic diagnoses were 8 aneurysmal bone cysts (Fig 2); 14 monostotic fibrous dysplasias (Fig 3); 11 simple bone cysts (Fig 4); and 2 giant cell tumors.
DISCUSSION
The upper third of the femur is 1 of the most common sites of benign tumor involvement. The specific anatomic location makes the management of these lesions unique. Most of the lesions are small and silent. They need close observation or palliative treatment, especially in children.
What causes femoral fractures?
... Pathological femoral fractures can result from various underlying diseases, such as infection, metabolic bone diseases, or bone tumors. Among bone tumors, metastatic disease is the most frequent malignant neoplasm of the bone, ranging from 25-85%, and usually originating from the prostate, breast, lung, kidney, or thyroid [5] [6] [7] [8]. The femur is the second most common metastasis site following the vertebra [9,10], with high susceptibility of progression to pathological fractures because the femur is a long, high load-bearing bone [11,12]. ...
What is intramedullary nailing?
Background: Antegrade intramedullary nailing is indicated for treating metastatic pathological femoral shaft fractures. Although good functional outcomes could be obtained from internal fixation, postoperative adverse events have been reported in patients with pathological fractures and non-pathological fractures. Not only adverse events but also their consequences including, readmission and reoperation, need to be considered. Few studies have assessed the risk of postoperative adverse events, reoperation, and readmission without comparison. Therefore, this study aimed to compare the risk of in-hospital adverse events and consequences after discharge between patients with metastatic pathological and non-pathological femoral fractures undergoing intramedullary nailing. Methods: We conducted a retrospective study by extracting records from the Hospital Information System database. We accessed patients with pathological metastatic pathological and non-pathological femoral shaft fractures undergoing intramedullary nailing by the International Classification of Diseases code; from June 2006 to 2020. We then tracked the in-hospital medical and surgical adverse events postoperatively, along with the consequences after discharge. The in-hospital adverse events risk between the two groups of patients were analyzed and compared by multivariate logistic regression analysis. Results: Included patients consisted of 48 in pathological groups and 185 in non-pathological groups. Significantly higher rates of surgical and medical adverse events in patients with pathological fractures compared to patients with non-pathological fractures were observed. After adjusting for potential confounding factors in multivariate regression analysis, patients with pathological fractures had higher odds of both adverse surgical (adjusted OR 2.43, 95% CI 1.15 - 5.13) and medical adverse events (adjusted OR 2.81, 95% CI 1.13 - 7.03). Conclusions: Patients with metastatic pathological femoral shaft fractures undergoing intramedullary nailing were more likely to experience postoperative adverse events than patients with non-pathological fractures.
Can proximal femoral metastases cause fracture?
Proximal femoral metastases can lead to pathologic fracture. The goals of this study were to improve guidelines for assessing pathologic hip fracture risk by quantifying the effect of location of femoral neck metastases on hip strength under single-limb stance loading and to evaluate the effectiveness of a proposed minimally invasive surgical repair technique for restoring hip strength. Twelve matched pairs of human cadaveric proximal femora were used to create a total of 564 finite element models before and after introduction and repair of simulated lytic defects, modeled as spherical voids, at various locations within the femoral neck. Defect site greatly affected hip strength (p < 0.001). Defects in the inferomedial aspect of the neck and in the dense trabecular bone near the base of the femoral head had the greatest effect, with hip strengths 23% to 72% and 43% to 64% that of the intact strength, respectively, for 20-mm diameter defects. Even so, the proposed percutaneous repair technique restored static strength of femora with defects at all of the studied locations. These findings may lead to a reduction in the number of patients who suffer a preventable pathologic fracture, a decreased likelihood of unnecessary surgery, and a less invasive prophylactic surgical procedure.
Abstract
Benign bone tumors and tumor-like conditions are commonly located in the proximal femur. The main indications for surgical treatment are lesions with impending or actual pathological fractures, or with aggressive or recurrent lesions.
Background
Benign bone tumors and tumor-like conditions are commonly located in the proximal femur [ 1] with high risk of pathological fracture [ 2 ]. It has been reported that destruction of more than 54% of the bone cortex by tumor carries a high risk for pathological fracture [ 3 ].
Methods
Between 1996 and 2015, 27 patients (22 females and 5 males) with benign lytic lesions of the proximal femur, underwent surgical treatment with curettage followed by implantation of synthetic bone graft (Table 1 ).
Results
The mean operative time was 143 min (range, 80–245 min). At the last follow-up, all patients had regained normal unrestricted activity without pain at the operation site.
Discussion
In our study, we reported the outcomes for the patients with benign lytic lesions of the proximal femur who underwent surgical treatment by curettage followed by implantation of a synthetic bone graft.
Conclusion
We concluded that the treatment of benign lytic lesions of the proximal femur either primary or recurrent using synthetic bone graft is a safe and effective method, and the addition of internal fixation should be carefully planned.
Author information
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
What causes femoral fractures?
... Pathological femoral fractures can result from various underlying diseases, such as infection, metabolic bone diseases, or bone tumors. Among bone tumors, metastatic disease is the most frequent malignant neoplasm of the bone, ranging from 25-85%, and usually originating from the prostate, breast, lung, kidney, or thyroid [5] [6] [7] [8]. The femur is the second most common metastasis site following the vertebra [9,10], with high susceptibility of progression to pathological fractures because the femur is a long, high load-bearing bone [11,12]. ...
What is intramedullary nailing?
Background: Antegrade intramedullary nailing is indicated for treating metastatic pathological femoral shaft fractures. Although good functional outcomes could be obtained from internal fixation, postoperative adverse events have been reported in patients with pathological fractures and non-pathological fractures. Not only adverse events but also their consequences including, readmission and reoperation, need to be considered. Few studies have assessed the risk of postoperative adverse events, reoperation, and readmission without comparison. Therefore, this study aimed to compare the risk of in-hospital adverse events and consequences after discharge between patients with metastatic pathological and non-pathological femoral fractures undergoing intramedullary nailing. Methods: We conducted a retrospective study by extracting records from the Hospital Information System database. We accessed patients with pathological metastatic pathological and non-pathological femoral shaft fractures undergoing intramedullary nailing by the International Classification of Diseases code; from June 2006 to 2020. We then tracked the in-hospital medical and surgical adverse events postoperatively, along with the consequences after discharge. The in-hospital adverse events risk between the two groups of patients were analyzed and compared by multivariate logistic regression analysis. Results: Included patients consisted of 48 in pathological groups and 185 in non-pathological groups. Significantly higher rates of surgical and medical adverse events in patients with pathological fractures compared to patients with non-pathological fractures were observed. After adjusting for potential confounding factors in multivariate regression analysis, patients with pathological fractures had higher odds of both adverse surgical (adjusted OR 2.43, 95% CI 1.15 - 5.13) and medical adverse events (adjusted OR 2.81, 95% CI 1.13 - 7.03). Conclusions: Patients with metastatic pathological femoral shaft fractures undergoing intramedullary nailing were more likely to experience postoperative adverse events than patients with non-pathological fractures.
Can proximal femoral metastases cause fracture?
Proximal femoral metastases can lead to pathologic fracture. The goals of this study were to improve guidelines for assessing pathologic hip fracture risk by quantifying the effect of location of femoral neck metastases on hip strength under single-limb stance loading and to evaluate the effectiveness of a proposed minimally invasive surgical repair technique for restoring hip strength. Twelve matched pairs of human cadaveric proximal femora were used to create a total of 564 finite element models before and after introduction and repair of simulated lytic defects, modeled as spherical voids, at various locations within the femoral neck. Defect site greatly affected hip strength (p < 0.001). Defects in the inferomedial aspect of the neck and in the dense trabecular bone near the base of the femoral head had the greatest effect, with hip strengths 23% to 72% and 43% to 64% that of the intact strength, respectively, for 20-mm diameter defects. Even so, the proposed percutaneous repair technique restored static strength of femora with defects at all of the studied locations. These findings may lead to a reduction in the number of patients who suffer a preventable pathologic fracture, a decreased likelihood of unnecessary surgery, and a less invasive prophylactic surgical procedure.