Bone Tumors part 2

Bone Tumours II

Dr. Wahby Ghalib FJMC, CABO, MRCS

Giant cell tumour

= osteoclastoma Benign but locally aggressive Histology : abundant multinucleated giant cells

Age : 20-40 yr Site : around the knee distal radius Metaphyseal-epiphyseal


XR : soap – bubble appearanceRx : curettage + tumouricidalHi recurrence rateMalignant potential : 5%

Osteosarcoma

Commonest primary malignant bone tumour in child

Highly malignant Histology : malignant cells producing osteoid 10% metastasis at presentation


C/F
Age : 10 -25 yr Pain : constant & more at night Swelling Pathologic # : rarely

XR
Metaphyseal lesionUsually around the kneeOsteolytic & osteoblastic areasSoft tissue invasion  sun-ray appearancePeriosteal elevation  Codman`s triangle


Rx
CT + surgery 5 yr survival : 60 %

Ewing sarcoma

Highly malignant Histology : small round cells 25 % metastasis at presentation


C/F
Age 10 -25 yr Pain Swelling Generalized illness & fever Pathologic # rare



XR
Diaphyseal lesionTibia & fibula more commonNew bone formation  multiple layers onion – peel appearance

Rx
CT + surgery 5 yr survival : 60 %

Chondrosarcoma

Slowly growing Primary or secondary to preexisting lesion


C/F
Age 40 -50 yr


XR
Lytic lesion + flecks of calcification


Rx
Surgery Radio- & chemoresistant 5 yr survival 60 %

Objectives :

Stressing the importance of the bone tumours as being a significant source of mortality and morbidity. Training the students to acquire the basic skills of XR interpretation in case of bone tumours.

Objectives :

Emphasizing the general outlines of treatment including the medical and surgical lines. Emphasizing the significance of classifying the bone tumours and the tumour-like conditions. Stressing the importance of the tumour-like conditions and the sequellae of misdiagnosis.