bone tumours

bone tumours

1. malignant bone tumours uncommon before puberty

2. male>female

   • osteogenic sarcoma
     • more common
   • Ewing sarcoma
     • seen more freq in younger kids

3. clinical features

   • limbs commonest site
   • characteristic sx
     • persistent localised bone pain
       • indication for early x-ray
       • precedes detection of a mass
   • pts otherwise well @ diag

4. Ix

   • 1st plain Xray
     • then MRI & bone scan
     • shows destruction & variable periosteal new bone formation
     • substantial soft tissue mass
       • in Ewing sarcoma
   • chest CT
     • to assess for lung mets
   • bone marrow sampling
     • exclude marrow involvement

5. Mx

   • in both tumours
     • combo chemo
       • then surgery
         • amputation avoided where possible
           • using en bloc resection of tumours w/ endoprosthetic resection
   • Ewing sarcoma
     • radiotherapy also used
       • manage local disease, esp when surgical resection impossible/incomplete e.g. in pelvis, axial skeleton