Scribd Logo
Upload

Welcome to Scribd!

  • Osteosarcoma

    Uploaded by

    Aishwarya Gopal
    31 views23 pages
    OSTEOSARCOMA Definition Epidemiology Pathogenesis Classification Clinical presentation Evaluation Management Prognosis 2nd most common Primary Malignant bone tumour 20% of all primary bone malignancies Global incidence : 1-5 per million / year all age gps, bimodal distribution Slightly more common in males(1. :1) 70%-acquired genetic mutations Germline mutations in RB gene (1000 fold increased risk!)

    Original Description:

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    OSTEOSARCOMA Definition Epidemiology Pathogenesis Classification Clinical presentation Evaluation Management Prognosis 2nd most common Primary Malignant bone tumour 20% of all primary bone malignancies Global incidence : 1-5 per million / year all age gps, bimodal distribution Slightly more common in males(1. :1) 70%-acquired genetic mutations Germline mutations in RB gene (1000 fold increased risk!)

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    31 views23 pages

    Osteosarcoma

    Uploaded by

    Aishwarya Gopal
    OSTEOSARCOMA Definition Epidemiology Pathogenesis Classification Clinical presentation Evaluation Management Prognosis 2nd most common Primary Malignant bone tumour 20% of all primary bone malignancies Global incidence : 1-5 per million / year all age gps, bimodal distribution Slightly more common in males(1. :1) 70%-acquired genetic mutations Germline mutations in RB gene (1000 fold increased risk!)

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 23

    OSTEOSARCOMA

    Definition Epidemiology Pathogenesis Classification Skeletal distribution Clinical presentation Evaluation Management Prognosis

    Primary Malignant tumour of bone Origin : Mesenchymal cells Formation of osteoid or bone by tumour cells Site :metaphysis

    2nd most common primary malignant bone tumour 20% of all primary bone malignancies Global incidence : 1-5 per million/year All age gps, bimodal distribution Slightly more common in males(1.6 :1)

    70%-acquired genetic mutations Germline mutations in RB gene (1000 fold increased risk !) Li-Fraumeni syndrome (p53) p16, p14.

    BASED ON CLINICAL SETTING

    SITE OF ORIGIN

    HISTOLOGY

    PRIMARY
    Commoner 15-25 age No premalignant

    SECONDARY
    Older age gp Premalignant lesions : Pagets disease, fibrous dysplasia,

    lesion
    More malignant

    multiple enchondromatosis,
    Prior irradiation, Multiple osteochondromas

    SITE OF ORIGIN INTRA MEDULLARY INTRA CORTICAL

    SURFACE

    PAROSTEAL

    PERIOSTEAL

    BASED ON HISTOLOGY: Osteoblastic Chondroblastic Fibroblastic, Telangiectatic/Osteolytic Small cell Giant cell

    WORST PROGNOSIS

    Age : 15-25 Site Gross appearance Histology

    PAIN SWELLING(metaphysis) Pathological fractures Skin : shiny, prominent veins Warm & tender Margins : not well defined Movements of adj joint restricted Compression symptoms Regional LN REACTIVE METASTASIS : BLOOD : LUNGS

    RADIOLOGICAL EXAMINATION 1.Irregular destruction,new bone fmn 2.Periosteal reaction 3.Extension to the marrow or soft tissue 4.Codmans triangle 5.Sunburst Effect

    Sunburst Appearance

    Serum Alkaline Phosphatase


    No diagnostic significance

    Follow up
    Rise after initial fall :

    recurrence/metastasis

    Biopsy
    To Confirm the diagnosis

    Evaluation of spread of tumour


    Extent of involvement of affected bone
    Bone scan intramedullary spread CT,MRI- soft tissue spread

    Metastasis : MC : LUNG WHY EXTENT OF INVOLVEMENT IS IMPORTANT?


    AMPUTATION SURGERY LIMB SAVING OPERATION

    LOCAL CONTROL
    CONTROL OF MICRO & MACROMETASTASIS

    SURGICAL ABLATION AMPUTATION

    AMPUTATION

    PALLIATIVE

    DEFINITIVE

    LIMB SAVING SURGERY

    ROLE OF RADIOTHERAPY Surgically inaccessible sites Patients who refuse surgery

    ROLE OF CHEMOTHERAPY PRE AND POST OPERATIVE METHOTREXATE LEUCOVORIN CYCLOPHOSPHAMIDE CISPLATIN

    NEW CONCEPT

    PORTION OF TUMOR
    IMPLANTED INTO SARCOMA SURVIVOR REMOVED AFTER 14 DAYS + SENSITISED LYMPHOCYTES

    INFUSED INTO PATIENT,SELECTIVELY KILL THE CANCER CELLS

    Without treatment : death in 2 yrs 5 yr survival with surgery alone : 20% 5 yr survival with surgery & CT : 70 %
    WORST PROGNOSIS : TELANGIECTATIC/OSTEOLYTIC TYPE BETTER PROGNOSIS : PAROSTEAL

    - AISHWARYA. G(2K9)

    You might also like