Transarticular invasion of iliopelvic sarcomas into the sacrum: Radiological analysis of 47 cases

Ozaki, Toshifumi; Lindner, Norbert; Hillmann, Axel; Link, Thomas M.; Winkelmann, Winfried

doi:10.3109/17453679708996181

Cited by 19 publications

(35 citation statements)

References 9 publications

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“…However, transarticular spread of tumor cells to the opposite side of the joint is uncommon except in the sacroiliac joint (Abdelwahab et al 1991, Ozaki et al 1997b, Drnovsek et al 1999. The characteristics of hip joint in ltration by sarcoma of the pelvis or femur is poorly understood and the literature is limited.…”

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confidence: 99%

Infiltration of sarcomas into the hip joint: Comparison of CT, MRI and histologic findings in 67 cases

Ozaki

Putzke

Bürger

et al. 2002

Acta Orthopaedica Scandinavica

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confidence: 99%

Infiltration of sarcomas into the hip joint: Comparison of CT, MRI and histologic findings in 67 cases

Ozaki

Putzke

Bürger

et al. 2002

Acta Orthopaedica Scandinavica

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“…A pelvic sarcoma is a particularly difficult surgical problem when the posterior ilium is involved [4,16,17,20]. Unlike sarcomas of the extremities that rarely cross nearby joints, posterior iliac tumors frequently infiltrate the sacroiliac joint probably owing to relative joint immobility, increased local vascularity, and the large size of most pelvic lesions [1,4,9,11,19,20]. Despite difficulties caused by peritumoral edema, marrow signal changes, and unevenness of sacroiliac joint plane, interpretation of MR images in iliosacral lesions has a sensitivity of 100% and specificity of 92% [20].…”

Section: Discussionmentioning

confidence: 98%

Decancellation Sacral Osteotomy in Iliosacral Tumor Resection: A Technique for Precise Sacral Margins

Farid

2010

Clinical Orthopaedics &Amp; Related Research

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En bloc resection of iliosacral sarcomas is a surgical challenge. There are substantial risks of inadequate margins, local recurrence, and nerve root loss when pelvic sarcomas involve sacral root canals and foramina. The decancellation technique uses principles similar to transpedicle decancellation in spinal deformity correction to perform the sacral osteotomy in iliosacral tumor resection. The technique aims at improving sacral margins and minimizing loss of neural function. We performed a decancellation osteotomy in five patients with sarcomas requiring difficult oblique or sagittal sacral osteotomies and selective root sacrifice. Through laminectomy and without anterior exposure, a precise full-thickness osteotomy of the sacrum was performed without major technique-related morbidities or complications. This was followed by formal pelvic resection and reconstruction. Surgical margins were adequate in all patients and all tumor-free nerve roots were preserved.

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“…Abnormal signal changes on MRI can not only clearly reveal the location, size and range of bone tumors abutting the sacroiliac joint but also show the destruction of the cortex and invasion of the contralateral bone via different structures. According to the literature, the sensitivity and specificity of MRI were 100% and 92% respectively if a strict definition of transarticular invasion was used [2,4] . In this study, 33 of 128 patients with primary tumors abutting the sacroiliac joint In our study, the incidence of transarticular invasion was highest in Group 1(conventional osteosarcoma (51.7%) and Ewing's sarcoma (43.8%)), but was low in Group 2(central chondrosarcoma (11.4%) and chordoma (7.7%)).…”

Section: Discussionmentioning

confidence: 99%

“…Sacral or iliac tumors with minimum length less than 2 cm from the tumor margin to the ipsilateral sacroiliac joint surface was defined as bone tumors abutting the sacroiliac joint [4] . The transarticular invasion was defined as sacral/iliac tumor invaded to the contralateral bone of the sacroiliac joint to cause bone destruction [1][2][3][4] . The MRI images were reviewed by 2 radiologists specializing in bone tumor and the final diagnosis was reached a consensus.…”

Section: Imaging Evaluationmentioning

confidence: 99%

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Transarticular invasion of primary bone tumors abutting the sacroiliac joint: an MRI study in 128 patients

Ding¹,

Yin²,

Zhang³

et al. 2020

Preprint

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Background: To investigate magnetic resonance imaging (MRI) manifestation of transarticular invasion of primary bone tumors abutting the sacroiliac joint. Methods: We conducted a retrospective analysis of MRI data in 128 patients from January 2004 to December 2015. The diagnosis confirmed by surgical findings and pathological examination. The tumors of 87 patients located in the ilium and 41 patients in the sacrum. Tumors were divided into high-grade (Group 1), low-grade (Group 2) malignant tumor group and intermediate tumor group (Group 3). Transarticular invasion routes included 3 types: across ligament (Type 1), across articular cartilage (Type 2) and across periarticular tissue (Type 3). Results : Transarticular invasion were observed in 33 patients (25.8%): Group 1 (22 patients) included 15 patients (51.7%) with conventional osteosarcoma and 7 patients (43.8%) with Ewing's sarcoma; Group 2(5 patients) included 4 patients (11.4%) with central chondrosarcoma and 1 patient (7.7%) with chordoma; Group 3(6 patients) included 4 patients (20.0%) with giant cell tumor of bone, 1 patient (16.7%) with chondroblastoma and 1 patient (11.1%) with aneurysmal bone cyst. The difference of transarticular invasion incidence was not significant statistically between primary iliac and sacral tumors ( P > 0.05). The differences were significant statistically between group 2 and group 1, group 3 and group 1, respectively ( P < 0.01). Significant differences were observed among different invasion types ( P < 0.01): type 1(31 times), type 2(15 times) and type 3(5 times). Conclusions: MRI is sensitive and useful to evaluate transarticular invasion of primary bone tumors abutting the sacroiliac joint.

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Transarticular invasion of iliopelvic sarcomas into the sacrum: Radiological analysis of 47 cases

Cited by 19 publications

References 9 publications

Infiltration of sarcomas into the hip joint: Comparison of CT, MRI and histologic findings in 67 cases

Infiltration of sarcomas into the hip joint: Comparison of CT, MRI and histologic findings in 67 cases

Decancellation Sacral Osteotomy in Iliosacral Tumor Resection: A Technique for Precise Sacral Margins

Transarticular invasion of primary bone tumors abutting the sacroiliac joint: an MRI study in 128 patients

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