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Sarcoma
Volume 2008, Article ID 418697, 4 pages
http://dx.doi.org/10.1155/2008/418697
Clinical Study

Primary Malignant Tumours of Bone Following Previous Malignancy

The Royal Orthopaedic Hospital Oncology Service, Royal Orthopaedioc Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK

Received 5 July 2007; Accepted 25 March 2008

Academic Editor: Jay Wunder

Copyright © 2008 J. T. Patton et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Destructive bone lesions occurring in patients who have previously had a malignancy are generally assumed to be a metastasis from that malignancy. We reviewed 60 patients with a previous history of malignancy, who presented with a solitary bone lesion that was subsequently found to be a new and different primary sarcoma of bone. These second malignancies occurred in three distinct groups of patients: (1) patients with original tumours well known to be associated with second malignancies (5%); (2) patients whose second malignancies were likely to be due to the previous treatment of their primary malignancy (40%); (3) patients in whom there was no clearly defined association between malignancies (55%). The purpose of this study is to emphasise the necessity for caution in assuming the diagnosis of a metastasis when a solitary bone lesion is identified following a prior malignancy. Inappropriate biopsy and treatment of primary bone sarcomas compromises limb salvage surgery and can affect patient mortality.