Osman Emre AYCAN, Sami SÖKÜCÜ, Devrim ÖZER, Engin ÇETİNKAYA, Yavuz ARIKAN, Yavuz Selim KABUKÇUOĞLU

Primary bone tumors and tumor like lesions of the ulna

Objective: The aim of this study was to discuss the diagnosis and surgical management and their results according to stage of primary bone tumors at ulna and to share our experience on this exceptional location for bone tumors. Methods: We have retrospectively reviewed our clinics database and identiﬁed 23 cases (14 males and 9 females, mean age was 28.9 (range 4e77)) with primary bone tumors and tumor like lesion involvement of ulna. The patients were evaluated according to complaints, type and grade of tumor, treatment, recurrence and functional status. Results: The most common ﬁrst referral complaint was constrictive pain in 52.1% of the cases, benign tumors and tumor like lesions of the bone constituted 73.9% whereas malignant bone tumors were 26.1%, 39.1% of the lesions were located in distal end of ulna and the mean follow up was 33.8 months (range 8 e172 months). Local recurrence has unexpectedly occurred in 3 benign lesions (13.1%). Conclusion: Benign bone lesions tend to involve distal and proximal ends, malign bone lesions involve diaphysis mostly. Both benign and malignant diaphyseal lesions of the ulna have better postoperative results regarding the lesions at both ends of ulna. One should also take care of recurrences even after a decade from the primary surgery.

___

Picci P, Manfrini M, Fabbri N, et al. Atlas of Musculoskeletal Tumors and Tumorlike Lesions: The Rizzoli Case Archive. Springer Science & Business Media; 2014:5e8.

Exner GU, von Hochstetter AR, Honegger H, et al. Osseous lesions of the distal ulna: atypical locationeunusual diagnosis. Arch Orthop Trauma Surg. 2000;120(3e4):219e223.

Erschbamer M, Bode B, Buck FM, et al. A rare periosteal diaphyseal lesion of the ulna. Open Orthop J. 2012;6:8e10.

Stein A, Mogan J. Intraosseous ganglion of the distal ulna. J Hand Surg. 1987;12(6):1101e1103.

Cooney WP, Damron TA, Sim FH, et al. En bloc resection of tumors of the distal end of the ulna. J Bone Joint Surg Am. 1997;79(3):406e412.

Thirupathi RG, Vuletin JC, Wadwa R, et al. Desmoplastic ﬁbroma of the ulna. A case report. Clin Orthop Relat Res. 1983;(179):231e239.

ParkYK,RyuKN,Han CS,etal.Multifocal, metachronous giant-cell tumor ofthe ulna. A case report. J Bone Jt Surg Case Connect. 1999;81(3):409e413.

Gianoutsos MP, Marsden FW, McCarthy SW, et al. Ulnar adamantinoma: en bloc excision and ﬁbular osteoseptocutaneous free ﬂap reconstruction. J Hand Surg. 1994;19(3):495e499.

Maccauro G, Tulli A, Prezioso V, et al. Parosteal osteosarcoma of the ulna: a rare low-grade malignant neoplasm. Case report and review of the literature. J Orthop Traumatol. 2006;7(4):198e200.

Ozger H, Akgul T, Yildiz F, et al. Unusual localization of an aneurysmal bone cyst in ulnar coronoid process. Acta Orthop Traumatol Turc. 2012;46(2): 144e147.

Cooper RR. Juxtacortical Chondrosarcoma: a case report. J Bone Jt Surg Case Connect. 1965;47(3):524e528.

SchajowiczF.Juxtacorticalchondrosarcoma. JBoneJtSurgBr.1977;59(4):473e480.

Wolfe SW, Mih AD, Hotchkiss RN, et al. Wide excision of the distal ulna: a multicenter case study. J Hand Surg. 1998;23(2):222e228.

Sung HW, Kuo DP, Shu WP, et al. Giant-cell tumor of bone: analysis of two hundred and eight cases in Chinese patients. J Bone Joint Surg Am. 1982;64(5): 755e761.

Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993;(286):241e246.

Thompson JC. Netter's Concise Orthopaedic Anatomy. Elsevier Health Sciences; 2009:89.

Shapiro F, Simon S, Glimcher MJ. Hereditary multiple exostoses. Anthropometric, roentgenographic, and clinical aspects. J Bone Joint Surg. 1979;61(6): 815e824.

Bock GW, Reed MH. Forearm deformities in multiple cartilaginous exostoses. Skeletal Radiol. 1991;20(7):483e486.

Cho HS, Park IH, Han I, et al. Giant cell tumor of the femoral head and neck: result of intralesional curettage. Arch Orthop Trauma Surg. 2010;130(11): 1329e1333.

Klenke FM, Wenger DE, Inwards CY. Giant cell tumor of bone: risk factors for recurrence. Clin Orthop Relat Res. 2011;469(2):591e599.

Schwartz HS, ed. OKU, Orthopaedic Knowledge Update: Musculoskeletal Tumors 2. American Academy Of Orthopaedic Surgeons; 2007:107.