Displaying publications 41 - 60 of 128 in total

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  1. Singh VA, Shah SU, Yasin NF, Abdullah BJJ
    J Orthop Surg (Hong Kong), 2017 May-Aug;25(2):2309499017716256.
    PMID: 28659052 DOI: 10.1177/2309499017716256
    AIMS: Magnetic resonance guided focused ultrasound (MRgFUS) is a new modality in the management of primary and secondary bone tumors. We aimed to investigate the safety, efficacy, and feasibility of using MRgFUS for the treatment of (1) benign bone tumors with the intent of complete tumor ablation, (2) primary malignant bone tumors with the intent to assess its effectiveness in causing tumor necrosis, and (3) metastatic bone disease with the intent of pain relief.

    METHOD: Twenty-four patients with benign bone tumors, primary malignant bone tumors, and metastatic bone disease were treated with one session of MRgFUS. Contrast-enhanced (CE) magnetic resonance imaging (MRI) was carried out post-procedure to assess and quantify the area of ablation. Those with malignant primary tumors had the tumors resected 2 weeks after the treatment and the ablated areas were examined histopathologically (HPE). The other patients were followed up for 3 months to assess for the side effects and pain scores.

    RESULTS: Significant volume of ablation was noted on CE MRI after the treatment. Benign bone tumors were ablated with minimal adverse effects. Metastatic bone disease was successfully treated with significant decrease in pain scores. Ablated primary malignant tumors showed significant coagulative necrosis on MRI and the HPE showed 100% necrosis. Pain scores significantly decreased 3 months after the procedure. Only two patients had superficial skin blistering and three patients had increase in pain scores immediately after treatment.

    CONCLUSION: MRgFUS is effective, safe, and noninvasive procedure that can be an adjunct in the management of primary and metastatic bone tumors.
    Matched MeSH terms: Bone Neoplasms/pathology; Bone Neoplasms/therapy*
  2. Lim CH, Lim YH, Radzi M
    BMJ Case Rep, 2020 Mar 19;13(3).
    PMID: 32198224 DOI: 10.1136/bcr-2019-232193
    A 19-year-old girl presented to the rheumatology clinic for left knee monoarthritis for the past 4 months. She also had constitutional symptoms with significant weight loss. On physical examination, she appeared cachexic, her left knee was swollen and tender. MRI of the left knee showed a soft tissue swelling extending into the knee joint. Left knee synovial fluid showed small round cells. Histopathology results were compatible with Ewing's sarcoma. Due to the delay in seeking medical advice, she succumbed to the disease 1 week after the diagnosis was made. Soft tissue/bone tumour causes monoarthritis is not common. A careful history taking, physical examination and investigations should be done in order to identify a sinister cause of monoarthritis such as Ewing's sarcoma. Early treatment should be initiated to ensure a better outcome.
    Matched MeSH terms: Bone Neoplasms/diagnosis; Bone Neoplasms/pathology*
  3. Chan RS, Kumar G, Vijayananthan AA
    Singapore Med J, 2013 Mar;54(3):e68-71.
    PMID: 23546040
    Breast metastases are uncommon and typically spread from contralateral breast carcinomas. Breast metastases that spread from extramammary malignancies are even less common, and account for 0.5%-6.6% of all malignant breast disease. As extrapulmonary metastases from osteosarcoma are uncommon, breast metastasis from osteosarcoma is extremely rare. We report a case of breast and peritoneal metastases from a tibial osteosarcoma 18 months after diagnosis, and 9 months after surgery and adjuvant chemotherapy. Computed tomography findings of multiple calcified and noncalcified tumour deposits in the lungs, pleura, peritoneum, chest wall and both breasts are described.
    Matched MeSH terms: Bone Neoplasms/diagnosis*; Bone Neoplasms/pathology*
  4. Faisham WI, Zulmi W, Mutum SS, Shuaib IL
    Singapore Med J, 2003 Jul;44(7):362-5.
    PMID: 14620730
    The clinical presentation and behaviour of giant cell tumours of bone vary. The progression of the disease and metastases are unpredictable, but the overall prognosis is good. We describe the natural history and different clinical presentations of two cases of giant cell tumour of bone where the patients had refused the initial treatment and presented several years later with the disease.
    Matched MeSH terms: Bone Neoplasms/diagnosis; Bone Neoplasms/pathology*
  5. Dhanoa A, Yong TL, Yeap SJ, Lee IS, Singh VA
    PMID: 25324121 DOI: 10.1186/1472-6882-14-404
    Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients.
    Matched MeSH terms: Bone Neoplasms/psychology; Bone Neoplasms/therapy*
  6. Ho CC, Seong PK, Zainuddin ZM, Abdul Manaf MR, Parameswaran M, Razack AH
    Asian Pac J Cancer Prev, 2013;14(5):3289-92.
    PMID: 23803117
    INTRODUCTION: The purpose of this study was to identify clinical profiles of patients with low risk of having bone metastases, for which bone scanning could be safely eliminated.

    MATERIALS AND METHODS: This retrospective cross sectional study looked at prostate cancer patients seen in the Urology Departments in 2 tertiary centres over the 11 year period starting from January 2000 to May 2011. Patient demographic data, levels of PSA at diagnosis, Gleason score for the biopsy core, T-staging as well as the lymph node status were recorded and analysed.

    RESULTS: 258 men were included. The mean age of those 90 men (34.9%) with bone metastasis was 69.2 ± 7.3 years. Logistic regression found that PSA level (P=0.000) at diagnosis and patient's nodal-stage (P=0.02) were the only two independent variables able to predict the probability of bone metastasis among the newly diagnosed prostate cancer patients. Among those with a low PSA level less than 20 ng/ml, and less than 10 ng/ml, bone metastasis were detected in 10.3% (12 out of 117) and 9.7% (7 out of 72), respectively. However, by combining PSA level of 10 ng/ml or lower, and nodal negative as the two criteria to predict negative bone scan, a relatively high negative predictive value of 93.8% was obtained. The probability of bone metastasis in prostate cancer can be calculated with this formula: -1.069+0.007(PSA value, ng/ml) +1.021(Nodal status, 0 or 1)=x Probability of bone metastasis=2.718 x/1+2.718 x.

    CONCLUSION: Newly diagnosed prostate cancer patients with a PSA level of 10 ng/ml or lower and negative nodes have a very low risk of bone metastasis (negative predictive value 93.8%) and therefore bone scans may not be necessary.

    Matched MeSH terms: Bone Neoplasms/blood; Bone Neoplasms/secondary*
  7. Faisham WI, Ziyadi MG, Azman WS, Halim AS, Zulmi W, Biswal BM
    Med J Malaysia, 2012 Apr;67(2):224-5.
    PMID: 22822652 MyJurnal
    We present a series of four cases of chest wall tumor, which underwent sternum resection. The methods of resection and reconstruction chest wall defect are discussed and the final outcome highlighted.
    Matched MeSH terms: Bone Neoplasms/pathology; Bone Neoplasms/surgery*
  8. Wan-Ibrahim WI, Ashrafzadeh A, Singh VA, Hashim OH, Abdul-Rahman PS
    Electrophoresis, 2016 09;37(17-18):2328-37.
    PMID: 27062367 DOI: 10.1002/elps.201500522
    Sarcoma is a malignant tumor that originates from the bone or soft tissue. In this study, abundances of serum amyloid A (SAA) in patients with pleomorphic sarcoma (PS), chondrosarcoma (CS), and osteosarcoma (OS) were analyzed and compared with those from their respective age-matched healthy control subjects. Results obtained from our analysis by 2DE showed that the levels of SAA were markedly elevated in patients with PS and OS, which are highly metastatic, while in patients with CS, which is a less aggressive sarcoma, the increase appeared less pronounced. A similar trend of altered abundances was also observed when the levels of SAA in the subjects were estimated using Western blot, ELISA, and multiple-reaction monitoring analyses. Absolute quantification using multiple-reaction monitoring further demonstrated that the increased abundance of SAA in patients with PS, OS, and CS was mainly attributed to isoform SAA1. In view of the different degrees of tumor malignancy in PS, OS, and CS, our data suggest their apparent correlation with the levels of SAA in the patients.
    Matched MeSH terms: Bone Neoplasms/blood; Bone Neoplasms/pathology*
  9. Tan TH, Wong TH, Hassan SZ, Lee BN
    Clin Nucl Med, 2015 Nov;40(11):867-8.
    PMID: 26252329 DOI: 10.1097/RLU.0000000000000920
    A 17-year-old adolescent boy with biochemically raised 2-hour urinary metanephrine and normetanephrine as well as CT findings of retroperitoneal soft tissue mass and bony metastases was referred for further assessment. Apart from Ga DOTATATE PET/CT evaluation, pretargeted systemic radionuclide therapy assessment with I-MIBG scintigraphy showed unusual phenomenon of MIBG superscan. Postsurgically, restaging Tc-MDP bone scintigraphy showed typical bone superscan features. The MIBG superscan was better delineated on post-I-MIBG therapy images.
    Matched MeSH terms: Bone Neoplasms/radionuclide imaging*; Bone Neoplasms/secondary
  10. Ng ES, Saw A, Sengupta S, Nazarina AR, Path M
    J Orthop Surg (Hong Kong), 2002 Dec;10(2):120-8.
    PMID: 12493923
    To review cases of giant cell tumour of bone or osteoclastoma managed at the University Malaya Medical Center, University of Malaya, Kuala Lumpur, from January 1990 to December 1999.
    Matched MeSH terms: Bone Neoplasms/pathology; Bone Neoplasms/surgery*
  11. Tan LL, Ahmad K, Kareem BA, Harwant S
    Med J Malaysia, 2001 Jun;56 Suppl C:52-6.
    PMID: 11814250 MyJurnal
    An epidemiological study of 101 consecutive musculoskeletal sarcomas seen at the Institute of Radiotherapy and Oncology between 1995 and 1999 inclusive was carried out. The commonest sarcomas seen were osteosarcoma, rhabdomyosarcoma, Ewing's Sarcoma, liposarcoma, leimyosarcoma, malignant fibrous histiocytoma and chondrosarcoma; which collectively accounted for 84.2% of the group. Thirty patients (29.7%) presented with metastases. The commonest site of occurrence was lower extremity with 47.5%, followed by 34.7% in the trunk and peritoneum/axial skeleton, 9.9% in the head and neck region; and 7.90 in the upper extremity. We found no apparent relationship between race and incidence osteosarcoma and Ewing's sarcoma, as was reported by previous workers.
    Matched MeSH terms: Bone Neoplasms/epidemiology*; Bone Neoplasms/radiotherapy*
  12. Zhou D, Gopinath SCB, Mohamed Saheed MS, Siva Sangu S, Lakshmipriya T
    Int J Nanomedicine, 2020;15:10171-10181.
    PMID: 33363373 DOI: 10.2147/IJN.S284752
    Background: In recent years, nanomaterials have justified their dissemination for biosensor application towards the sensitive and selective detections of clinical biomarkers at the lower levels. MXene is a two-dimensional layered transition metal, attractive for biosensing due to its chemical, physical and electrical properties along with the biocompatibility.

    Materials and Methods: This work was focused on diagnosing osteosarcoma (OS), a common bone cancer, on MXene-modified multiple junction triangles by dielectrode sensing. Survivin protein gene is highly correlated with OS, identified on this sensing surface. Capture DNA was immobilized on MXene by using 3-glycidoxypropyltrimethoxysilane as an amine linker and duplexed by the target DNA sequence.

    Results: The limitation and sensitivity of detection were found as 1 fM with the acceptable regression co-efficient value (y=1.0037⨰ + 0.525; R2=0.978) and the current enhancement was noted when increasing the target DNA concentrations. Moreover, the control sequences of single- and triple-mismatched and noncomplementary to the target DNA sequences failed to hybridize on the capture DNA, confirming the specificity. In addition, different batches were prepared with capture probe immobilized sensing surfaces and proved the efficient reproducibility.

    Conclusion: This microgap device with Mxene-modified multiple junction triangles dielectrode surface is beneficial to quantify the survivin gene at its lower level and diagnosing OS complication levels.

    Matched MeSH terms: Bone Neoplasms/diagnosis*; Bone Neoplasms/pathology
  13. Yasin NF, Abdul Rashid ML, Ajit Singh V
    J Orthop Surg (Hong Kong), 2020 2 23;28(1):2309499019896662.
    PMID: 32077796 DOI: 10.1177/2309499019896662
    INTRODUCTION: Management of osteosarcoma has evolved considerably for the past two decades and there have been changes of practices especially pertaining to chemotherapy regime. This is a review of our cases in the past 15 years.

    METHOD: This is a retrospective survival analysis study of 128 patients treated at University Malaya Medical Centre (UMMC) from 1997 to 2011.

    RESULTS: There were 80 (62.5%) male and 48 (37.5%) female patients with the median age being 15 (5-59). Majority had osteosarcoma of extremities (94.5%). More than 60% patients developed metastasis throughout the course of treatment with 39% presenting with lung metastasis. Osteoblastic osteosarcoma was the commonest subtype (65.6%). Of the 109 patients treated surgically, 84 patients (65.6%) underwent limb salvage surgery while the rest underwent amputation. Seventy-one per cent of patients completed treatment with local recurrence rate of 22.7%. The 5-year and 10-year survival rates were 56.31% (95% CI: 46.20, 65.24) and 22.33% (95% CI: 14.86, 30.76), respectively. The 5-year event-free survival was 52.94% (95% CI: 41.83, 62.87). In multivariate analysis, the independent prognostic factors were presence of metastasis and completion of treatment for both 5-year and 10-year overall survival. Good histological response was only significant for multivariate analysis at 5 years. Patients with metastasis had a hazard ratio of 20.4 at 5 years and 3.26 at 10 years.

    CONCLUSION: Overall survival rate for osteosarcoma patients at our centre was comparably higher than other centres in the region. Two independent risk factors for survival are metastatic status and completion of treatment. A standardized chemotherapy regime is essential for long-term survival.

    Matched MeSH terms: Bone Neoplasms/mortality*; Bone Neoplasms/surgery
  14. Chua HH, Tuan Sharif SE, Wan Ismail WFN, Zawawi MSF, Abdullah S
    Asian Pac J Cancer Prev, 2021 Mar 01;22(3):741-747.
    PMID: 33773537 DOI: 10.31557/APJCP.2021.22.3.741
    BACKGROUND: The receptor activator of nuclear factor kappa B ligand (RANKL) is one of the key regulators of bone remodelling in bone oncology, including osteosarcoma. We assessed RANKL immunohistochemical expression in osteosarcoma, its association, and disease-free survival with the patients' clinicopathological characteristics.

    METHODS:   One hundred osteosarcoma cases from 2003 to 2018 in Hospital Universiti Sains Malaysia were retrieved. The tissue samples were stained for RANKL, and the association with the clinicopathological characteristics was evaluated. Staining was interpreted in a semiquantitative scoring system and classified into negative and positive expressions.  Results: Eighty-two cases had a positive expression of RANKL in which 56 and 26 patients were classified as low expression and high expression, respectively. The positive expression of RANKL did not show a significant association with clinicopathological characteristics. However, Kaplan Meier survival analysis showed a significant improvement in the disease-free survival patients who underwent limb salvage surgery (LSS) than amputated patients (p-value 0.002), whereas poorer survival was observed among conventional osteosarcomas compared to non-conventional osteosarcoma (p-value 0.01).

    CONCLUSION: Limb salvage surgery had proven to improve osteosarcoma patients' survival compared to amputation, which could improve overall quality of life in osteosarcoma patients. However, our data did not show a significant association between positive RANKL immunohistochemistry with any of the clinicopathological characteristics and patients' final survival. Further studies may be acquired to understand the suitability of using RANKL immunohistochemistry as prognostication in the management of osteosarcoma patients.

    Matched MeSH terms: Bone Neoplasms/metabolism*; Bone Neoplasms/surgery
  15. Singh VA, Haseeb A, Alkubaisi AA
    Singapore Med J, 2014 Oct;55(10):539-46.
    PMID: 25631896
    INTRODUCTION: Morbidity and mortality from malignant diseases are usually the result of metastasis. The bone is the third most common site of metastasis.

    METHODS: This is a retrospective study of patients with metastatic bone disease who were referred to the Orthopaedic Department of University Malaya Medical Centre, Malaysia, between January 2004 and October 2009.

    RESULTS: A total of 151 patients (51.0% men, 49.0% women) had metastatic bone disease, with the highest incidence at the age range of 50-59 years. The commonest primary cancer was breast (23.3%), followed by lung (21.2%), prostate (9.3%), thyroid (7.3%) and renal cell carcinoma (5.3%); unknown primary cancer was 6.6%. There was long bone involvement in 52.7% of cases, axial bone in 44.5%, and both long and axial bones in 2.8%. The majority (90.1%) were symptomatic, with pain as the commonest symptom. 106 (70.2%) patients had pathological fractures. Neurological deficit was reported in 90.7% of patients, with 41.1% having extraskeletal metastases. 67.8% of the lesions were osteolytic, 24.3% were sclerotic, and 7.9%, mixed. Palliative and therapeutic interventions were undertaken for 62.0% of patients. The mean survival times were: breast 21.0; thyroid 20.7; prostate 20.3; lung 16.0; and unknown primary cancer 32.6 months.

    CONCLUSION: In our study, breast and lung cancers were the commonest primary cancers in metastatic bone disease. Most patients had more than one site of involvement, pain at presentation and pathological fractures. Surgery is beneficial to relieve pain and improve function and neurology. Duration of survival depends on the type of primary cancer and whether systemic metastasis is present.
    Matched MeSH terms: Bone Neoplasms/epidemiology*; Bone Neoplasms/secondary*
  16. Wong SK, Mohamad NV, Giaze TR, Chin KY, Mohamed N, Ima-Nirwana S
    Int J Mol Sci, 2019 May 27;20(10).
    PMID: 31137764 DOI: 10.3390/ijms20102587
    Patients with advanced prostate cancer often develop bone metastases, leading to bone pain, skeletal fracture, and increased mortality. Bone provides a hospitable microenvironment to tumor cells. The disease manifestation is driven by the interaction between invading tumor cells, bone-forming osteoblasts, and bone-resorbing osteoclasts. The increased level of osteoclast-activating factor (parathyroid hormone-related peptide, PTHrP) is believed to induce bone resorption by upregulating receptor activator of nuclear factor-kappa B ligand (RANKL) and the release of various growth factors into the bone microenvironment to enhance cancer cell growth. However, the underlying molecular mechanisms remain poorly understood. This review outlines the possible molecular mechanisms involved in governing bone metastases driven by prostate cancer, which further provide the basis in searching for new molecular targets for the development of potential therapy.
    Matched MeSH terms: Bone Neoplasms/metabolism*; Bone Neoplasms/secondary
  17. Choong C, Chan H, Azuhairy A, Hau MA, Zulkiflee O
    Malays Orthop J, 2014 Jul;8(2):55-8.
    PMID: 25279096 DOI: 10.5704/MOJ.1407.006
    Conventional chondrosarcomas rarely metastasize and it is extremely unusual to see multicentric- behaviour in malignant cartilage tumour. We report a 40 year old lady with presentation of two non-contiguous metachronous foci of low to intermediate grade of chondrosarcoma over left pelvic bone and right scalp respectively in the absence of pulmonary or visceral metastasis.
    Matched MeSH terms: Bone Neoplasms
  18. Ezat SW, Syed Junid SM, Noraziani K, Zafar A, Saperi S, Nur AM, et al.
    Asian Pac J Cancer Prev, 2013;14(5):3357-62.
    PMID: 23803129
    The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient health- related quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.
    Matched MeSH terms: Bone Neoplasms/economics*; Bone Neoplasms/secondary*; Bone Neoplasms/therapy
  19. Noorizan Y, Asma A
    Med J Malaysia, 2010 Jun;65(2):162-4.
    PMID: 23756808 MyJurnal
    Temporal bone carcinoma may masquerade as an infective process causing late diagnosis. A delay in treatment as a result of missed diagnosis would carry a poor prognosis as the disease progresses to an advanced stage. We present a lady with history of chronic otorrhea, who developed left sided otalgia associated with hearing loss in her sixth decade. She underwent surgery which revealed left mastoiditis and cholesteatoma. After a year, she had a mass in her left ear and pus discharge which was initially treated as an infection. The biopsy of the mass was proven to be squamous cell carcinoma. High index of suspicion is necessary when encountering patients presenting with a mass in the ear canal with prior history of chronic otorrhea or cholesteatoma. Proper tissue biopsy is crucial. Early referral to tertiary centre is required for further management of the patient.
    Matched MeSH terms: Bone Neoplasms
  20. Dhanoa A, Singh VA, Shanmugam R, Rajendram R
    World J Surg Oncol, 2010;8:96.
    PMID: 21059231 DOI: 10.1186/1477-7819-8-96
    We describe an unusual case of osteosarcoma in a Jehovah's Witness patient who underwent chemotherapy and major surgery without the need for blood transfusion. This 16-year-old girl presented with osteosarcoma of the right proximal tibia requiring proximal tibia resection, followed by endoprosthesis replacement. She was successfully treated with neoadjuvant chemotherapy and surgery with the support of haematinics, granulocyte colony-stimulating factor, recombinant erythropoietin and intraoperative normovolaemic haemodilution. This case illustrates the importance of maintaining effective, open communication and exploring acceptable therapeutic alternative in the management of these patients, whilst still respecting their beliefs.
    Matched MeSH terms: Bone Neoplasms/diagnosis; Bone Neoplasms/drug therapy; Bone Neoplasms/surgery*
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