To investigate the clinical efficacy of intra-arterial chemotherapy by subcutaneous implantable delivery system (SIDS) in the treatment of distal femur neoplasm. From March 2002 to December 2009, 51 patients were treated with SIDS intra-femoral artery chemotherapy, followed by customized prosthetic reconstruction, including 45 patients of osteosarcoma and 6 malignant fibrous histiocytoma in distal femur. The average follow-up period was 64 months (ranging between 24 and 116 months) to track on the efficacy of chemotherapy, which shows that 96.1 % of patients got pain relief, 70.6 % of patients had significant radiological change, and 82.4 % of paitents with medium to severe pathological variation responded to the chemotherapy. Local recurrence happened in 4 cases, 3 cases are alive with disease, 4 cases died because of pulmonary metastases and other 40 patients are free of local recurrence or distant metastasis. SIDS intra-femur artery chemotherapy can improve clinical outcome of DFN, and provide effective method for treatment of DFN when combined with customized prosthetic reconstruction.

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Since the concept of neoadjuvant chemotherapy was firstly proposed in the 1980 s, the 5-year survival rate of osteosarcoma patients has increased from less than 20% to more than 60%. 1 The implementation of neoadjuvant chemotherapy, including poly methyl methacrylate (PMMA), phenol, ethanol, or liquid nitrogen, could effectively reduce the local recurrence rate of osteosarcoma, which might provide a foundation for the development of various limb salvage operations. 2 Many clinical studies have shown that limb salvage offers greater benefits to patients than amputation. 3-6 All kinds of limb salvage techniques have their own advantages and disadvantages at present. In this study, one case of osteosarcoma extensively involving femoral disruption was treated by liquid nitrogen for cryotherapy, which achieved a good therapeutic effect.

Background: Acute lymphoblastic leukemia (ALL) is reported to be the most common malignancy in children, but is less common in adults. Though vertebral compression fractures have been reported as initial signs of ALL in children, to the best of our knowledge, there have not been any previous reports of vertebral compression fractures as an initial manifestation of ALL in elderly people. Case Presentation: Here we reported a 65-year-old man who was admitted with a 1-month history of progressive chest and back pain and worsening pain after heavy lifting. Considering the histories of osteoporosis, minor trauma and normal peripheral blood counts, it was firstly misdiagnosed as spinal osteoporotic compression fractures which were caused by low-energy injuries. The patient was definitely diagnosed as ALL after bone marrow biopsy. Conclusion: ALL must be considered in the differential diagnosis with acute vertebral compression fracture. Considering that bony lesions may precede clinical findings, knowledge of radiographic and orthopedic appearances of leukemia are important in order to initiate earlier treatment to avoid the progressive damage and improve their survival rates. we recommend bone marrow biopsy in vertebroplasty to avoid misdiagnosis.