The process of bone formation is called ossification
Intramembranous Ossificiation
Endochondral Ossification
Tumors in bone and
cartilage
Primary bone tumors
Benign
Osteoma
Chondroma
Rhabdomyoma
Malignant
chondrosarcoma
Osteosarcoma
Rhabdomyosarcoma
Differences
Bone forming tumors
Osteoma
Osteoblastoma
Osteoid Osteoma
Osteosarcoma
Malignant tumor of mesenchymal cells characterized by direct
formation of osteoid or bone matrix by direct formation of osteoid or
bone matrix by the tumor cells
Primary osteosarcoma
Most common malignancy in children
Males > females
mutations in retinoblastoma gene, P53
Sites
lower end femur
upper end tibia
proximal humerus
proximal femur
Skip lesions
They represent areas of an osteosarcoma that
are not connected to the primary tumor
Secondary osteosarcoma
Common in old age
Sites
flat bones > long bones
existing bone lesions
Paget’s disease of bone
Bone infarct
Chronic osteomyelitis
Metastatic bone tumors
These areas have a rich slow blood supply in their
red marrow which makes it the perfect site for the
growth of metastatic tumor cells
proximal femur
proximal humerus
Axial skeleton which includes
vertebral column, pelvis, ribs,
skull
Histology
Management
Surgery
Limb Saving Surgery
Limb sparing surgery is the procedure of removing the
cancer without removing the affected arm or leg and the
replacement with prosthetic or other bone
Complications
Infection
Prosthetic Fracture
Pathologic fracture
Amputation
Amputation is a type of surgery where a surgeon
removes part or all of a limb and replaces it with a
prosthetic device
Complications
Phantom Pain
Depression
Skin Breakdown
Consent
Capacity for consent
Make a free choice
Understand the consequences
Understand the complications and risks
Being aware of the procedure
Chemotherapy
the use of drugs to treat cancer
Types
Neo-Adjuvant Chemotherapy: administration of
antineoplastic drugs prior to surgery to shrink the
tumor size and decrease it’s vascularity.
Adjuvant Chemotherapy: the use of antineoplastic
drugs when surgery or radiation has eradicated the
primary tumor
Primary Chemotherapy: the use of
antineoplastic alone for metastic or
inoperable tumors
Complications
Nausea and vomiting
Loss of appetite
Hair loss
Mouth sores
Radiotherapy
Psychological Aspects
Emotional Reaction
Physical Examination
Look
Feel
Move
Special Tests
Thomas Test
Trendelenberg's sign
Imaging tests
X-rays
MRI
CT Scan
PET Scan
Radioisotopic
Diagnosis
Biopsy
Needle Biopsy
Open biopsy
Grading and Staging
Grading
its explains the level of aggressiveness of a tumor
based on the cytologic features of the tumor cells
mitotic activity
nuclear pleomorphism
degree of differentiation
Staging
Assessment of the spread of the malignant tumor
in the body based on clinical and radiographic
finding