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Our case demonstrates how metastases may be present and symptomatic long before they produce sufficient osseous changes to render the lesions radiologically detectable. A case of leiomyosarcoma arising in the uterus and initially presenting as a femoral lesion is presented. It required an intensive review of the case history and of the previous pathology in order to identify the primary site in the uterus. In the literature nine cases of metastatic leiomyosarcoma presenting initially in bone are reviewed. Ten additional cases from the literature showed bone metastases as the first site of recurrence. When this is assessed together with some 14 cases of primary leiomyosarcomas reported arising in bone, one is impressed that this is an uncommon tumour in bone either as a primary or secondary. In all patients in whom a leiomyosarcoma is histologically proven in bone, all primary sites should be specifically and categorically excluded before the lesion is accepted as an osseous primary. This should include special stains for myofibrils and electron microscopy if at all possible, in order to differentiate such tumours from other sarcomas such as fibrosarcoma. This applies especially to patients with uterine lesions that have been previously treated, even if they have been regarded as benign initially. All previous pathology and in particular hysterectomy specimens should be carefully reviewed. The need to specifically identify a leiomyosarcoma as a primary lies in the different modalities of treatment used: aggressive ablative surgery for primary lesions as opposed to radiation and chemotherapy for metastatic disease. [ABSTRACT FROM AUTHOR]

A review of 839 necropsies revealed 415 cases of malignant neoplasm, 63 of which were found to have evidence of metastatic spread to the sternum. Nineteen of these metastases resulted in pathological sternal fractures. Fine detail radiography proved a quick and accurate technique for detecting these lesions post mortem. The characteristics of pathological sternal fractures were compared with traumatic sternal fractures with respect to deformity and healing. Pathological fractures of the sternum demonstrate a tendency to greater deformity and slower healing than traumatic sternal fractures. [ABSTRACT FROM PUBLISHER]

, , 472-474. The movement of the manubriosternal joint is said to be a significant factor in respiration. The incidence of fusion of the manubriosternal joint in necropsy cases has been investigated with fine detail radiography. In over 600 cases, fusion of the joint was found in 14% and partial fusion in 8%. In total, the joint was found to be abnormal in 66% of cases. There was an increase in fusion with increasing age. Little relationship was found with degenerative disc disease, and no relationship with ankylosing spondylitis. The incidence of joint abnormality suggests that hinging of the manubriosternal joint is not as significant a factor in respiration as has previously been thought. [ABSTRACT FROM PUBLISHER]

The material from a case of Tietze's disease has been examined histologically. A review of the literature on the pathology of this lesion correlated with the findings from this case indicates that there is a pathological lesion in the costal cartilage in this disease. This consists of an increased vascularity and degenerative changes with patchy loss of ground substance leading to a fibrillar appearance. Cleft formation may occur with mucoid debris which may undergo calcification. Hypertrophic changes may be present at the periphery. The aetiology still remains obscure. [ABSTRACT FROM PUBLISHER]