BONE TUMOUR GENERAL CONCEPT

 BONE TUMOUR

 

Definition:

Defined as abnormal growth of cells in bone tissue and its components.

 
 

Diagnosis :

Clinical Feature
Investigation

 

Clinical Feature—

History-Present , Previous, Life style

Age-  Childhood and adolescence- Benign tumour, Ewing’s sarcoma, Osteosarcoma.

            Old age- Chondrosarcoma,

 Pain -

Swelling-

Neurological symptom

Pathological fracture 

 

 



 


Investigation:

Imaging-
Laboratory Findings-
Histopathology-
 
 

 Imaging-

X-ray
USG
CT
MRI
Bone Scan(Radio nuclide Scanning)
 

Laboratory Investigation
            

CBC ESR Hb%

  PTH-------- Brown Tumour

  S. Protein electrophoresis

  Bence jone’s protein

  Acid Phosphatase--- Prostatic Cancer

  Alkaline Phosphatase—Non specific

  CRP--  

     

Histopathology- Biopsy 
Closed Biopsy-
FNAC, Trephine Needle
Open Biopsy-
Incisional
Excisional
           Typing, Grading, and Staging.
 

  Differential Diagnosis

Soft Tissue Haematoma
Myositis ossificans
Stress Fracture
Tendon Avulsion
Bone Infection
Gout
Other Bone Lesions—
Fibrous cortical defects,
Medullary Infract
Bone Islands
 
  

  

Principle Of Management

 
Multidisciplinary team approach
Best conducted in tertiary centre
Consultation and cooperation between the
Orthopaedic surgeon
Radiologist
Pathologist
Oncologist
Also be involved- physiotherapist,

  Occupational therapist, Prosthetist.

 

Methods of treatment—

Benign and asymptomatic-
Small, and can afford to temporize
Observation
Biopsy is advisable  with excision or curettage.
Benign,Symptomatic,Enlarging-
Biopsy for confirm diagnosis,
Marginal excision or curettage.
 
 Suspected Malignant Tumour
Tumour Excision-
Limb Salvage-Operation (G-II)
Amputation
Multi agent Chemotherapy
Radiotherapy
 
 

 Multi Agent chemotherapy

Reduce the size,
Prevent Metastasis seeding
Improves survival rates-(combined with surgery)
Methotraxate
Doxorubicin
Cyclophosphamide
Vincristin
Cis platinum.
  

Radiotherapy—

Adjuvent therapy before operation

Combined with adjuvant chemotherapy

Tumour in inaccessible site,

Inoperable lesion

Palliative local control

Postoperatively-Marginal or intralesional excision

Chance of post irradiation spindle cell sarcoma, Pathological fracture.

 
 
 

 

 

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