Safety Concern between Autologous Fat Graft, Mesenchymal Stem Cell and Osteosarcoma Recurrence

Abstract

BackgroundOsteosarcoma is the most common malignant primary bone tumour in young adult treated by neo adjuvant chemotherapy, surgical tumor removal and adjuvant multidrug chemotherapy. For correction of soft tissue defect consecutive to surgery and/or tumor treatment, autologous fat graft has been proposed in plastic and reconstructive surgery.Principal FindingsWe report here a case of a late local recurrence of osteosarcoma which occurred 13 years after the initial pathology and 18 months after a lipofilling procedure. Because such recurrence was highly unexpected, we investigated the possible relationship of tumor growth with fat injections and with mesenchymal stem/stromal cell like cells which are largely found in fatty tissue. Results obtained in osteosarcoma pre-clinical models show that fat grafts or progenitor cells promoted tumor growth.SignificanceThese observations and results raise the question of whether autologous fat grafting is a safe reconstructive procedure in a known post neoplasic context.

The contribution of immune infiltrates and the local microenvironment in the pathogenesis of osteosarcoma

“…Therefore, dialogs between these cells are possible [13]. In 2010, Perrot et al reported a case of a late local recurrence of osteosarcoma occurring more than 10 years after the initial pathology and 18 months after a "lipofilling" procedure [38]. In complement of this observation, the co-injection of purified mesenchymal stem cells promoted the osteosarcoma development in a murine model, then underlying a functional interaction between osteosarcoma cells and mesenchymal stem cells.…”

“…Several studies have confirmed that mesenchymal stem cells promote the proliferation of osteosarcoma cells both in vitro and in vivo [38,[46][47][48][49]. Mesenchymal stem cells, the low differentiated precursor of various cell-types including osteoblast [16], in contrast to differentiated osteoblasts appear unable to communicate with osteosarcoma cells through the establishment of functional gap junctions [50].…”

Do Mesenchymal Stromal Cells Influence Microscopic Residual or Metastatic Osteosarcoma in a Murine Model?

“…Previous investigators have shown that MSCs promote both primary and metastatic tumor growth when coinjected in the presence of established primary osteosarcoma or concurrently with osteosarcoma cell lines [3,24,28,29]. This effect of MSCs has been shown with other tumor types as well [4,14,20].…”

Osteosarcoma: From Molecular Biology to Mesenchymal Stem Cells

“…Perrot et al [95] raised concern of osteosarcoma recurrence after autologous fat grafting, reporting a case of late recurrent osteosarcoma 13 years after the use of a lipoilling procedure. Following this they utilised a pre-clinical murine model of osteosarcoma to show that injection of fat grafts and MSCs promoted tumour growth.…”