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Orthopaedic Implant-Associated Rhabdomyosarcoma
Danielle E Brown1, Carla Saoud, Cristina R Antonescu
1From the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY (Brown, Bartlett, and Morris), the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY (Saoud and Antonescu), and the Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY (Wexler).
Orthopaedic metallic implants are rarely associated with soft-tissue sarcoma, specifically high-grade sclerosing rhabdomyosarcoma. Genetic analysis revealed no significant differences between implant-associated and non-implant-associated tumors.
Area of Science:
- Orthopaedic surgery
- Oncology
- Genetics
Background:
- Metallic implants are common in orthopaedic surgery.
- Carcinogenic properties of implants are suspected but rarely documented.
- This study investigates soft-tissue sarcomas adjacent to orthopaedic implants.
Purpose of the Study:
- To identify and characterize soft-tissue sarcomas arising adjacent to orthopaedic implants.
- To compare genetic profiles of implant-associated sarcomas with non-implant-associated sarcomas.
- To raise physician awareness of this rare diagnosis.
Main Methods:
- Retrospective review of soft-tissue sarcomas treated at an institution.
- Identification of tumors adjacent to orthopaedic implants.
- Collection of clinical, therapeutic, and outcome data.
- Genetic testing of implant-associated and control tumors.
Main Results:
- Four cases of high-grade sclerosing rhabdomyosarcoma adjacent to implants were identified.
- Median time from implant placement to diagnosis was 19 years.
- All tumors exhibited a MYOD1 mutation; no significant genetic differences were found compared to control tumors.
- Outcomes varied, with some patients achieving disease-free status and others succumbing to metastatic disease.
Conclusions:
- No genetic distinctions were found between implant-associated and non-implant-associated rhabdomyosarcomas.
- The role of metallic implants in tumorigenesis requires further investigation.
- Clinicians should consider implant-associated sarcoma in patients with new masses near long-standing orthopaedic implants.
