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Mobile phones and your health
CORRESPONDENCE
201
There has been no definite treatment of choice for fibrocartilaginous mesenchymoma. Follow-up in the original small series demonstrated a propensity for recurrence, which is why Dahlin et al. 1 used the term ‘fibrocartilaginous mesenchymoma of low grade malignancy’. Further follow-up indicates that, although recurrences may occur, metastasis does not. That is one of the reasons why Bulychova et al. decided to drop the appellation ‘with low grade malignancy’.1,2 Intralesional excision has resulted in a high rate of recurrence, but to date there has been no metastasis or death related to the tumour. Bulychova et al. 2 state that the entity described by Dahlin et al. 1 is histologically distinct and that its behavior does not merit the term ‘malignant’. In our case, neither recurrence nor lung metastasis has been observed in the 5 years since surgery. Those cases treated by complete excision have not recurred.1 Hence, lesions should be treated by excision or thorough curettage followed by pasteurisation, as in the present case, which would appear to be a justifiable alternative. Masahito Hatori* Mika Watanabe† Kyoji Okada‡ Masami Hosaka* Shoichi Kokubun* Department of *Orthopaedic Surgery and †Pathology, Tohoku University School of Medicine, and ‡Department of Orthopaedic Surgery, Akita University School of Medicine, Japan Fig. 3 ( A) Well-circumscribed cartilaginous areas in the fibrous tissue ( H&E, original magnification, ´25 ). ( B) Enchondral ossification and epiphyseal growth plate-like arrangements were observed ( H&E, original magnification, ´19.3 ).
cartilage present in fibrocartilaginous mesenchymoma. In the present case, the cortical destruction clearly demonstrated by radiological examination, the existence of epiphyseal plate-like cartilage suggestive of local aggressiveness and the absence of typical woven bone led us to the diagnosis of fibrocartilaginous mesenchymoma. As for the origin of the cartilaginous portions, Mirra9 speculated that large enchondroma-like, metaphyseal nodules of cartilage are most probably derived from the growth plate where fibrous tumours abut the epiphyseal plate during growth and apparently result in the deposition of nodules of cartilage within the fibroblastic stroma of the parent tumour: fibrous dysplasia, intramedullary desmoid ( ‘aggressive’ fibromatosis), and low-grade fibrosarcoma. He thought that ‘desmoid tumour with enchondroma-like nodules’ corresponded to fibrocartilaginous mesenchymoma with low grade malignancy. Milgram10 histologically documented that the cartilaginous islands in fibrous dysplasia develop from cartilaginous columns of the epiphyseal plate that fail to ossify. The cartilaginous islands arise as developmental ‘rest’ from epiphyseal cartilage and develop pari passu with the fibrous dysplasia. Lesions high in the diaphysis indubitably arise earlier in life and remain in the site as longitudinal growth progresses. 11
1. Dahlin DC, Bertoni F, Beabout JW, Campanacci M. Fibrocartilaginous mesenchymoma with low-grade malignancy. Skeletal Radiol 1984; 12: 263– 9. 2. Bulychova IV, Unni KK, Bertoni F, Beabout JW. Fibrocartilaginous mesenchymoma of bone. Am J Surg Pathol 1993; 17: 830– 6. 3. Cozzutto C, Cornaglia-Ferraris P. Fibrocartilaginous mesenchymom a of bone. Pathol Res Pract 1991; 187: 279– 83. 4. Manabe J. Experimental studies on pasteurized autogenous bone graft. Nippon seikeigeka Gakkai Zsshi 1993; 67: 255–66. 5. McLeod RA, Dahlin DC. Hamartoma ( mesenchymoma ) of the chest wall in infancy. Radiology 1979; 131: 657– 61. 6. Unni KK. Author’s reply. Am J Surg Pathol 1995; 19: 1447– 8. 7. Ishida T, Dorfman HD. Massive chondroid differentiation in fibrous dysplasia of bone ( fibrocartilaginous dysplasia). Am J Surg Pathol 1993; 17: 924–30. 8. Bhaduri A, Deshpande RB. Fibrocartilaginous mesenchymoma versus fibrocartilaginous dysplasia: Are these a single entity? Am J Surg Pathol 1995; 19: 1447. 9. Mirra JM. Clinical, radiologic, and pathologic correlations: Fibrous tumors of bone with enchondroma-like nodules. In: Bone tumors. Philadelphia: Lea & Febiger, 1989; 674– 83. 10. Milgram JW. The origins of osteochondromas and enchondromas. A histopathologic study. Clin Orthop 1983; 174: 264– 84. 11. Sanerkin NG, Watt I. Enchondromata with annular calcification in association with fibrous dysplasia. Br J Radiol 1981; 54: 1027– 33.
Mobile phones and your health Sir, While there has been a large amount of discussion concerning possible effects of microwave radiation,1 the clearly proven and substantial health risks associated with driving cars while talking on mobile phones have been largely ignored. The chance of collision under these circumstances is increased by up to 400%.2
202
Pathology (2002 ), 34, April
CORRESPONDENCE
Our society has a distorted view of risk. It makes little sense to concentrate on hypothetical risks while ignoring the real but commonplace and mundane. If the public really believed that mobile phones cause brain tumours, would they still use them? Given that it is widely accepted that smoking causes lung cancer, I suppose the answer is yes. If the concern is serious, there is a simple and inexpensive way to reduce radiation dosage to the brain by about 4-fold. Simply relocate the antenna from the top of the phone to the bottom, taking it away from the brain and towards the jaw.3 Should we then start a new series of studies on the effects of microwave radiation on tumours of the jaw?
J. W. Goding Department of Pathology and Immunology, Monash Medical School, Prahran, Victoria, Australia
1. Harper CG, Lee VK. Editorial: Mobile phones and your health. Pathology 2001; 33: 269–70. 2. Redelmeier DA, Tibshirain, RJ. Association between cellular-telephone calls and motor vehicle collisions. New Engl J Med 1997: 336: 453– 8. 3. Jones D. Phones and the brain. Nature 2001; 411: 1012.
201
There has been no definite treatment of choice for fibrocartilaginous mesenchymoma. Follow-up in the original small series demonstrated a propensity for recurrence, which is why Dahlin et al. 1 used the term ‘fibrocartilaginous mesenchymoma of low grade malignancy’. Further follow-up indicates that, although recurrences may occur, metastasis does not. That is one of the reasons why Bulychova et al. decided to drop the appellation ‘with low grade malignancy’.1,2 Intralesional excision has resulted in a high rate of recurrence, but to date there has been no metastasis or death related to the tumour. Bulychova et al. 2 state that the entity described by Dahlin et al. 1 is histologically distinct and that its behavior does not merit the term ‘malignant’. In our case, neither recurrence nor lung metastasis has been observed in the 5 years since surgery. Those cases treated by complete excision have not recurred.1 Hence, lesions should be treated by excision or thorough curettage followed by pasteurisation, as in the present case, which would appear to be a justifiable alternative. Masahito Hatori* Mika Watanabe† Kyoji Okada‡ Masami Hosaka* Shoichi Kokubun* Department of *Orthopaedic Surgery and †Pathology, Tohoku University School of Medicine, and ‡Department of Orthopaedic Surgery, Akita University School of Medicine, Japan Fig. 3 ( A) Well-circumscribed cartilaginous areas in the fibrous tissue ( H&E, original magnification, ´25 ). ( B) Enchondral ossification and epiphyseal growth plate-like arrangements were observed ( H&E, original magnification, ´19.3 ).
cartilage present in fibrocartilaginous mesenchymoma. In the present case, the cortical destruction clearly demonstrated by radiological examination, the existence of epiphyseal plate-like cartilage suggestive of local aggressiveness and the absence of typical woven bone led us to the diagnosis of fibrocartilaginous mesenchymoma. As for the origin of the cartilaginous portions, Mirra9 speculated that large enchondroma-like, metaphyseal nodules of cartilage are most probably derived from the growth plate where fibrous tumours abut the epiphyseal plate during growth and apparently result in the deposition of nodules of cartilage within the fibroblastic stroma of the parent tumour: fibrous dysplasia, intramedullary desmoid ( ‘aggressive’ fibromatosis), and low-grade fibrosarcoma. He thought that ‘desmoid tumour with enchondroma-like nodules’ corresponded to fibrocartilaginous mesenchymoma with low grade malignancy. Milgram10 histologically documented that the cartilaginous islands in fibrous dysplasia develop from cartilaginous columns of the epiphyseal plate that fail to ossify. The cartilaginous islands arise as developmental ‘rest’ from epiphyseal cartilage and develop pari passu with the fibrous dysplasia. Lesions high in the diaphysis indubitably arise earlier in life and remain in the site as longitudinal growth progresses. 11
1. Dahlin DC, Bertoni F, Beabout JW, Campanacci M. Fibrocartilaginous mesenchymoma with low-grade malignancy. Skeletal Radiol 1984; 12: 263– 9. 2. Bulychova IV, Unni KK, Bertoni F, Beabout JW. Fibrocartilaginous mesenchymoma of bone. Am J Surg Pathol 1993; 17: 830– 6. 3. Cozzutto C, Cornaglia-Ferraris P. Fibrocartilaginous mesenchymom a of bone. Pathol Res Pract 1991; 187: 279– 83. 4. Manabe J. Experimental studies on pasteurized autogenous bone graft. Nippon seikeigeka Gakkai Zsshi 1993; 67: 255–66. 5. McLeod RA, Dahlin DC. Hamartoma ( mesenchymoma ) of the chest wall in infancy. Radiology 1979; 131: 657– 61. 6. Unni KK. Author’s reply. Am J Surg Pathol 1995; 19: 1447– 8. 7. Ishida T, Dorfman HD. Massive chondroid differentiation in fibrous dysplasia of bone ( fibrocartilaginous dysplasia). Am J Surg Pathol 1993; 17: 924–30. 8. Bhaduri A, Deshpande RB. Fibrocartilaginous mesenchymoma versus fibrocartilaginous dysplasia: Are these a single entity? Am J Surg Pathol 1995; 19: 1447. 9. Mirra JM. Clinical, radiologic, and pathologic correlations: Fibrous tumors of bone with enchondroma-like nodules. In: Bone tumors. Philadelphia: Lea & Febiger, 1989; 674– 83. 10. Milgram JW. The origins of osteochondromas and enchondromas. A histopathologic study. Clin Orthop 1983; 174: 264– 84. 11. Sanerkin NG, Watt I. Enchondromata with annular calcification in association with fibrous dysplasia. Br J Radiol 1981; 54: 1027– 33.
Mobile phones and your health Sir, While there has been a large amount of discussion concerning possible effects of microwave radiation,1 the clearly proven and substantial health risks associated with driving cars while talking on mobile phones have been largely ignored. The chance of collision under these circumstances is increased by up to 400%.2
202
Pathology (2002 ), 34, April
CORRESPONDENCE
Our society has a distorted view of risk. It makes little sense to concentrate on hypothetical risks while ignoring the real but commonplace and mundane. If the public really believed that mobile phones cause brain tumours, would they still use them? Given that it is widely accepted that smoking causes lung cancer, I suppose the answer is yes. If the concern is serious, there is a simple and inexpensive way to reduce radiation dosage to the brain by about 4-fold. Simply relocate the antenna from the top of the phone to the bottom, taking it away from the brain and towards the jaw.3 Should we then start a new series of studies on the effects of microwave radiation on tumours of the jaw?
J. W. Goding Department of Pathology and Immunology, Monash Medical School, Prahran, Victoria, Australia
1. Harper CG, Lee VK. Editorial: Mobile phones and your health. Pathology 2001; 33: 269–70. 2. Redelmeier DA, Tibshirain, RJ. Association between cellular-telephone calls and motor vehicle collisions. New Engl J Med 1997: 336: 453– 8. 3. Jones D. Phones and the brain. Nature 2001; 411: 1012.