Bone Tumors - PowerPoint PPT Presentation

1 / 50

About This Presentation

Title:

Bone Tumors

Description:

Number of Views:293

Avg rating:3.0/5.0

Slides: 51

Provided by: TrueFasterUser

Category:

Tags: bone | females | tumors | vulva

Transcript and Presenter's Notes

Title: Bone Tumors

1
Bone Tumors

2
????????????????????

1. ??????????????????????????????????????
(General consideration of bone tumors)
2. ??????????????????????????????????????
(Approach to diagnosis of bone tumors)
2.1 ?????????????????????????????? (Clinical
diagnosis)
2.2 ???????????????????????????? (Radiographic
diagnosis)
2.3 ???????????????????????? (Pathological
diagnosis)
3. ????????????????????????????????????????????
4. ???????????????????????
4.1 ????????????????????? (Primary bone
tumors)
4.2 ??????????????????????? (Secondary bone
tumors)
6. ????????????????????????? (Differential
diagnosis)
5. ?????????????????????????????? (Prognosis of
bone tumors)

3
???????????????????

???????? 1 ???/??????????/???????????????????????
???????????? ?????????????????????????????????????
??????????????????????????????????????????????????
??????? ??????????????????? ??????????????????????
????????????????????????????????????????
???????? 2 ???/??????????/???????????????????????
????? ???????????????????? ???????????????????????
???????? ???????????????????? ?????????????????
???????????????? ??????????????????
????????????????????????? ????????????????????????
??????????????????????????????????????
???????? 3 ???/??????????/???????????????????????
????? ??????????????????????????
???????????????????????? ???????????????????
??????????????????????????????????????
???????????????????? ?????????????????
????????????????

4
2.3 ??????????

5
????????????

1. ???????????????????????????????????????????????
?????????????????
2. ???????????????????? ?????????? ???????????
?????????????????????????????? ????????????????
????????????????????
3. ?????????????????????????????????????????????
???????????????????????????????????????????????
4. ???????????????????????????????????????????????
???????????????
5. ??????????????????????????????????
??????????????????????
6. ???????????????????????????????????????????????
????????????????????????????????

6
?????????????????????
7
History

8
Questions to be asked

1. The patients age Certain tumors are
relatively specific to particular age groups.
2. Duration of complaint Benign lesions
generally have been present for an extended
period (years). Malignant tumors usually have
been noticed for only weeks to months.
3. Rate of growth A rapidly growing mass, as in
weeks to months, is more likely to be malignant.
Growth may be difficult to assess by the patient
if it is deep seated, as can be the case with
bone. Deep lesions may be much larger than the
patient thought (tip-of-the-iceberg
phenomenon).
4. Pain associated with the mass Benign
processes are usually asymptomatic.
Osteochondromas may cause secondary symptoms
because of encroachment on surrounding
structures. Malignant lesions may cause pain.
5. History of trauma With a history of
penetrating trauma, one must rule out
osteomyelitis. With a history of blunt trauma,
healing fracture must be entertained.

9
Questions to be asked

6. Personal or family history of cancer
Adults with a history of prostate, renal, lung,
breast, or thyroid tumors are at risk for
development of metastatic bone disease.
Children with neuroblastoma are prone to bony
metastases.
Patients with retinoblastoma are at an increased
risk for osteosarcoma. Secondary osteosarcomas
and other malignancies can result from treatment
of other childhood cancers.
Family history of conditions such as LiFraumeni
syndrome must raise suspicion of any bone lesion.
Furthermore, certain benign bone tumors can run
in families (e.g., multiple hereditary
exostoses).
7. Systemic signs or symptoms Generally, no
significant findings should exist on the review
of systems with benign tumors. Fevers, chills,
night sweats, malaise, change in appetite, weight
loss, and so forth should alert the physician
that an infectious or neoplastic process may be
involved.

10
Physical Examination

11
Physical Examination

12
Physical examination should be documented

1. Skin color
2. Warmth
3. Location
4. Swelling swelling, in addition to the
primary mass effect, may reflect a more
aggressive process
5. Neurovascular examination changes may
reflect a more aggressive process
6. Joint range of motion of all joints in
proximity to the region in question, above and
below
7. Size a mass greater than 5 cm should raise
the suspicion of malignancy
8. Tenderness tenderness may reflect a more
rapidly growing process
9. Firmness malignant tumors tend to be more
firm on examination than benign processes this
applies more to soft tissue tumors than to
osseous ones
10. Lymph nodes certain sarcomas (e.g.,
rhabdomyosarcoma, synovial sarcoma, epithelioid,
and clear cell sarcomas all have increased rates
of lymph node involvement)