Advances in musculoskeletal oncology: experience of the Lublin Orthopedic Clinic

Major milestones in the diagnosis and treatment of musculoskeletal tumors and tumor-like lesions are presented on the basis of the authors' 40 years of experience in the Lublin Orthopedic Clinic. A prompt, adequate and complex diagnosis should be established using clinical, radiological and laboratory data. The biopsy (usually trepano-biopsy) that is performed routinely can be omitted in some patients. lmmunohistochemistry tests enable adequate differential diagnosis in many cases. Great progress has also been observed in treatment methods. Burring of sclerotic bony walls in benign osteolytic lesions is a major improvement over traditional but ineffective curettage. A multidisciplinary approach using neoadjuvant chemotherapy has radically improved outcomes in the treatment of ostegenic sarcoma and Ewing's sarcoma. Progress in surgical methods is enabling limb salvage by reconstructing large bone defects with modular endoprostheses. Patients with bone metastases are routinely operated for pathological fractures, large bone destruction or spinal cord compression. The authors call for the establishment of several Musculoskeletal Oncology centers in Poland.