Edited by K. Krishnan Unni and Carrie Y. Inwards pp. 402 Philadelphia: Lippincott, Williams & Wilkins, 2010 ISBN: 978-0781-76242-7
This beautifully illustrated book gives a thoroughly sensible view about the challenges of diagnosing bone tumours based on the massive archive available at the Mayo Clinic, numbering some 10 165 cases! The introduction points out the well known challenges and pitfalls in the diagnosis of bone tumours, reiterating the importance of multidisciplinary study and how important both the clinical and radiological features are in reaching a final diagnosis.
K. K. Unni, the senior editor, is a highly respected pathologist with a string of publications to his name dating back to 1971. This latest version of this classic text combines tips and wisdom derived from four decades. I was particularly interested to see how he dealt with well-known contentious areas of diagnosis. He emphasises the difficulty of differentiating between enchondromata and low-grade chondrosarcoma using the criteria first described by Mirra; despite all his experience the authors remain sceptical of the possibility of enchondroma becoming chondrosarcoma. Another contentious area is the link between osteofibrous dysplasia (OFD) and adamantinoma. Although some believe that OFD can turn into adamantinoma and as a result recommend that all OFD should be aggressively excised, Unni does not believe that this takes place and is happy to differentiate the two conditions. Despite ongoing concerns about its existence, MFH of bone still deserves a chapter.
This book is a safe reflection on pathology of bone tumours over the past 70 years. Whilst mention is made of immunohistochemical techniques, especially in Ewing's sarcoma, these are not extensively considered. Treatment is outlined for most conditions but reflects very much the work done at the Mayo clinic rather than cutting edge techniques available elsewhere. This book should be available in all bone tumour units for reference and will also be popular with general pathologists. It is more a reflection on what has been, rather than a statement of the current art!