Oncology

Orthopaedic Oncology Program Approach

The Musculoskeletal Oncology Service was established in 1980 by Dr. Jeffrey J. Eckardt, M.D. This service manages all bone and soft-tissue tumors, benign and malignant, primary, recurrent and metastatic as well as tumor-like conditions of bone. UCLA has been a pioneer in the development of limb-sparing surgical strategies for both malignant bone and soft-tissue sarcomas. It has one of the largest series of metal implants (endoprostheses) for bone tumors and resections for soft-tissue sarcomas.

All cases are reviewed and discussed by a Multidisciplinary Musculoskeletal Tumor Board. This review board was conceived in 1991 and it was the first interdisciplinary panel focusing on a specific topic at UCLA. Diagnoses are confirmed and neoadjuvant treatments using chemotherapy and or radiation therapy are considered and discussed. All radiographic studies are reviewed and the locations of tumors are precisely defined prior treatment. Surgical biopsies are reviewed by pathology as are all the surgical specimens after definitive surgical procedures. Additional adjuvant treatments are recommended if thought to be in the patient's best interest. The goal in dealing with malignant bone and soft tissue-tumors of the musculoskeletal system is to save both the life and limb, while maximizing the function of the limb. CT-guided needle biopsies are preferred for diagnosis and can usually be done the day of the consultation, under sedation if necessary. Infants, children, adolescents, and adults are all eligible for evaluation and treatment. Tumors involving the hand and the spine are routinely managed along with members of the Hand and Spine services. Surgical resections are done by orthopaedic oncologists and when indicated by a multidisciplinary team that could include surgical oncologists, vascular surgeons, neurosurgeons, thoracic surgeons, urologists and plastic surgeons.

Members of this multidisciplinary tumor board include five orthopaedic oncologists, chairman Dr. Francis J. Hornicek, Dr. Jeffrey J. Eckardt, Dr. Nicholas Bernthal, and Dr. Susan Bukata, as well two surgical oncologists, two pathologists specializing in bone and soft-tissue tumors, three musculoskeletal radiologists, a radiation oncologist, a thoracic surgical oncologist and three medical and one pediatric oncologist.
 

Comprehensive treatment is available for conditions in: 

Malignant bone tumors 

• Adamantinoma
• Angiosarcoma of bone
• Chondrosarcoma
• Chordoma
• Ewing's sarcoma
• Hemangioendothelioma
• Lymphoma of bone
• Malignant fibrohistiocytoma (MFH)
• Myeloma
• Osteosarcoma
• Treatment-associated sarcomas
• All metastatic tumor to bone including but not limited to breast, lung, kidney prostate, thyroid, colon and melanoma 

Malignant soft-tissue tumors: soft-tissue sarcomas

• Angiosarcoma of soft tissues
• Dermatofibrosarcoma protuberans
• Epithelioid sarcoma
• Liposarcoma
• Malignant tumors of peripheral nerves (MPNST)
• (MFH) Malignant fibrohistiocytoma
• Rhabdomyosarcoma 
• Synovial sarcoma 

Benign bone tumors

• Bone-forming tumors: osteoma, osteoid osteoma and osteoblastoma
• Cartilage tumors: chondroblastoma, periosteal chondroma, osteochondroma, enchondroma and chondromyxoid fibroma
• Diaphyseal sclerosis
• Fibrous tumors and conditions: metaphyseal fibrous cortical defect, non-ossifying fibroma, fibrous dysphasia and osteofibrous dysphasia
• Giant cell tumor of bone
• Hemangioma of bone
• Tumor-like conditions of bone: aneurysmal bone cysts, unicameral bone cysts and Langerhans cell granulomatosis

Benign soft-tissue tumors

• Giant cell tumor of tendon sheath
• Hemangiomas; superficial, deep, intramuscular and intra-articular
• Lipomas; superficial, deep, intra-muscular and inter-muscular
• Myxoma
• Pigmented villonodular synovitis (PVNS) of nodular and diffuse forms
• Synovial chondromatosis
• Schwannomas and neuromas of peripheral nerves
• Tumeral calcinosis

Surgical procedures

• Amputations at all levels and when necessary for, malignant-bone and soft-tissue sarcomas, osteomylitis, trauma, necrotizing fasciitis and failed joint reconstructions
• Excision and/or curettage and bone grafting of benign tumors of bone and tumor-like conditions of bone.
  Free tissue transfers
• Limb-sparing surgery; endoprosthetic reconstructions of the humerus, femur and tibia
• Resection arthroplasty to include scapulectomy and internal hemipelvectomy
• Wide and radical resections for extremity soft-tissue sarcomas

Physicians

Bernthal, Nicholas MD
Assistant Professor of Orthopaedic Surgery
Chief of Musculoskeletal Oncology Service

Bukata, Susan MD
Associate Professor of Orthopaedic Surgery

Crawford, Brooke M. MD
Assistant Professor of Orthopaedic Surgery

Eckardt, Jeffrey J. MD
Distinguished Professor of Orthopaedic Surgery
Helga and Walter Oppenheimer Chair of Musculoskeletal Oncology

Hornicek, Francis J. MD, PhD
Chair, Department of Orthopaedic Surgery
Professor of Orthopaedic Surgery

Affiliated Physicians

Eilber, Fritz MD
Department of Surgical Oncology

Eilber, Fred MD
Department of Surgical Oncology

Federman, Noah MD
Department of Surgical Oncology

Physician Assistant

Margaret Regan-Rainey, PA
Physician Assistant

Contact Us

Voice: (310) 319-3818 or (310) 319-3816
Fax:(310) 319-3817

On-line appointment request form

Travel resources

Locations

Santa Monica
UCLA Orthopaedic Surgery
1250 16th Street, Suite 2100
Santa Monica, CA 90404