BONE TUMORS

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BONE TUMORS

• Pamela Gregory-Fernandez
• RPA-C

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Benign Primary Bone Tumors

• Definition tumors that arise from cells of
  mesenchymal origin
• Bone cartilage fibrous tissue round cells
• Bone cyst fibrous lesion osteochondrome
  giant cell tumor chondroma osteoid osteoma

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Diagnosis

• 1. H P
• 2. Three age groups children young adults
  older adults gt 40 yo
• 3. How was the tumor discovered ?
• Incidental finding on x-ray
• Mass
• Pain
• Pathological fracture
• 4. BEWARE masses in the KNEE, SHOULDER, BUTTOCK

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• 5. Plain x-rays
• A. Location of the tumor in the bone
• B. Reaction of the tumor/bone complex
• 6. MRI
• A. Anatomic location and extent of tumor
• B. Soft tissue involvement
• C. Bone marrow involvement
• 7. Bone Scan
• A. Multiple lesions
• 8. CAT Scan
• 9. Special Imaging
• 10. Blood testing Multiple Myeloma
• 11. Biopsy open needle

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Problems

• 1. Pathological fracture
• 2. Deformity
• 3. Growth plate involvement
• 4. Pain
• 5. Tenderness
• 6. Neurovascular compromise
• 7. Joint motion restriction

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Treatment

• 1. Excision
• 2. Curettge and bone grafting

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Malignant Primary Bone Tumors

• Sarcoma a malignant tumor arising from cells
  of mesenchymal origin
• 1. metastasizes by the blood stream
• 2. very aggressive
• 3. poor response to radio or chemotherapy
• Examples osteosarcoma (most common)
• Fibrosarcoma Ewings sarcoma multiple myelome
  chondrosarcoma

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Clinical Features / Diagnosis

• Younger age group
• Except myeloma
• Pain
• Night
• Progressive
• Mass
• Pathological fracture
• Bone not deformed

• 1. Staging
• A. CT MRI arteriograms scans clinical
• B. Grade I II III distant mets
• C. Intra vs. Extracompartmental
• 2. Biopsy

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Treatment

• 1. Wide margin excision, may mean amputation,
  with adjunctive RT and/or chemotherapy
• 2. Limb salvage with adjunctive RT and/or
  chemotherapy
• Custom made total joints
• Large bone allografts

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Osteosarcoma

• 1. MOST COMMON
• 2. males
• 3. second decade
• 4. metaphysis
• 5. distal femur, proximal tibia, humerus
• 6. Spindle cell sarcoma
• 7. x-ray CODMANS TRIANGLE
• 8. pain
• 9. soft tissue mass

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Ewings Sarcoma

• 5-30 years old
• Second most common
• Pain of involved extremity
• May follow trauma
• FEVER, FATIGUE, MALAISE, WEIGHT LOSS
• Micromets at presentation

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Benign Tumors
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