Neoplasm of bone

Benign neoplasm of bone

-           Definition

-           Classification: WHO/IARC Classification

table35-1

-           Presentation

  • Mass, Pain, Deformity, Pathologic fracture, accidental finding
  • Site, Size, color, consistence, tenderness, fixed
  • Benign neoplasm of bone
    • Screlotic border
    • No cortical involvement
    • No soft tissue extension
  • MRI
  • Biosy
    • Open
    • Core needle

-           Physical examination

-           Radiographic appearance

-           Further investigation

-           Treatment: Enneking staging for benign bone tumor

            -           Latent

            -           Active

            -           Aggressive

table35-2

 

- -       Follow up

map35-1

Malignant neoplasm of bone

-           Definition

-           Classification: WHO/IARC Classification

table36-1

-           Presentation

  • Mass, Pain, Deformity, Pathologic fracture, accidental finding
  • Site, Size, color, consistence, tenderness, fixed
    • Moth eaten, permeative
    • Cortical involvement
    • Periosteal reaction
    • Soft tissue extension
  • MRI, CT chest, chest x-ray, bone scan
  • Serum CBC, Calcium, Phosphate, Parathyroid hormone, ESR, CRP, Liver function test, BUN, Creatinine, Urinalysis, Urine Bence-Jone protein, Serum electrophoresis, PSA
  • Biosy
    • Open
    • Core needle

-           Physical examination

-           Radiographic appearance

-           Further investigation

-           Treatment: Enneking staging for Malignant bone tumor

table36-2

            -           Tumor resection

            -           Bone & soft tissue reconstruction

-           Follow up

 

map36-1

 

Metastatic bone diseases

-           Definition

-           Epidemiology

  • Breast, prostate, kidney, lung, Thyroid
  • Pain
  • Pathologic fracture
  • Bone
    • Moth eaten, permeative
    • cortical involvement
    • Periosteal reaction
    • Soft tissue extension
    • CXR
    • Bone scan
    • CT scan chest, abdomen ,pelvis
    • PET scan
    • U/S thyroid, thyroid scan
    • Biopsy
      • Open
      • Core needle
      • ESR , alkaline phosphatase
      • PSA, CEA, CA19-9, AFP,CA125
      • serum protein electrophoresis
      • serum calcium, phosphate, PTH, vitamin D

-           Presentation

-           Physical examination

-           Radiographic appearance

-           Further investigation

-           Laboratory study


-           Treatment

            -           Pain control

            -           Radiation therapy

            -           Hormone therapy

            -           Paraneoplastic syndrome

            -           Pathologic fracture

            -           Prophylactic fixation

                        -           Mirel’s scoring system

 

table37-1

 

 

 

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