From the Guidelines
The most recent and highest quality study recommends that all patients with a suspected primary malignant bone tumor should be referred to a bone sarcoma reference center or an institution belonging to a specialized bone sarcoma network before biopsy 1.
Diagnosis and Treatment
The diagnosis of bone sarcomas is frequently difficult to recognize as malignant by clinicians, radiologists, and pathologists.
- The medical history should focus on symptoms such as duration, intensity, and timing of complaints, for example night pain or fracture.
- Conventional radiographs in two planes should always be the first investigation.
- When the diagnosis of malignancy cannot be excluded with certainty on radiographs, the next imaging step is magnetic resonance imaging (MRI) of the whole compartment with adjacent joints.
- The biopsy of a suspected primary malignant bone tumor should be carried out at the reference center by the surgeon who is to carry out the definitive tumor resection or a radiologist member of the team.
Types of Bone Sarcomas
- Osteosarcoma is the most common primary malignant bone tumor, with a higher incidence in adolescents and a second peak in the seventh and eighth decades of life.
- Ewing sarcoma is the second most common primary malignant bone tumor in children and adolescents, but can occur in adults.
- Other types of bone sarcomas include chondrosarcoma, chordoma, and giant cell tumor of bone.
Treatment Strategies
- Treatment strategies for bone sarcomas include chemotherapy, surgery, and radiation therapy.
- The choice of treatment depends on the type and stage of the tumor, as well as the patient's overall health.
- Referral to a specialized bone sarcoma center is crucial for optimal diagnosis and treatment 1. It's essential to prioritize the patient's morbidity, mortality, and quality of life when making treatment decisions.
- A multidisciplinary approach, including orthopedic surgeons, medical oncologists, radiation oncologists, and pathologists, is necessary for the management of bone sarcomas.
- The patient's treatment plan should be individualized based on their specific needs and circumstances 1.
From the Research
Saos Information
- The term "Saos" is not explicitly defined in the provided studies, however, it can be related to "OSAS" which stands for Obstructive Sleep Apnea and Hypopnea Syndrome, as mentioned in the study 2.
- OSAS is a highly prevalent disease with serious consequences for the patients' lives, and its treatment is mandatory for the improvement of the quality of life, as well as the life expectancy of the affected individuals.
- The most frequent treatments provided by dentistry for OSAS are mandibular advancement devices (MAD) and orthognathic surgery with maxillomandibular advancement (MMA), as stated in the study 2.
Treatment Options
- MADs are a solid treatment option for primary snoring and mild or moderate OSAS, according to the study 2.
- Patients with severe apnea who are non-adherent to CPAP may also be treated with MADs, as mentioned in the study 2.
- Maxillomandibular advancement surgery is a safe and very effective treatment option for OSAS, as stated in the study 2.