骨肿瘤-双语.pptVIP

Bone Tumors General Principles Definition Benign and malignant abnormal growths found in bone Or arises from the tissues of bone including cartilage、fibrous tissue、blood vessel、marrow and fat Include primary、secondary or metastatic tumors Classification China Classification(1983) Benign、intermediate、malignant tumor Giant cell tumor arises from histiocyte Based on clinical situation、pathology and radiologic characteristics Incidence Sex Male female osteosarcoma is more often observed on males than female, while GCT often on female Morbility Benign malignant Age osteosarcoma---children, teenagers GCT----adult Predilection site Metaphysis [mi’tafisis]（干骺端） of long bone Typical Locations Synovial Cell Tumor Osteosarcoma Osteoclastic (lytic)（破骨性） Osteogenic Parosteal Osteosarcoma (juxtacortical) Chondrosarcoma Fibrosarcoma Hemangiosarcoma i:’ ‘ Myeloma /Metastatic Clinical Finding Pain Tenderness connect with tumor growth velocity and malignancy degree Mass Swelling Benign stiff with no tenderness Malignant swelling, euangiotic Impaired Function Compression Pathological Fracture Primary tumors cause osteolysis, bone breakdown, which weakens bone and leads to bone fractures Diagnostic Tests X-Ray Some tumor produce osteoclastic resorption, which show low density area Benign tumors show sharp margins separating from normal bones Benign tumors could also show thin cortical end plate (capsule) around an intraosseous area, from which cancellous or cortical bone has been lost, sometimes referred to as a “geographic lesion” There is no clear line of demarcation between abnormal and normal bone in malignant tumors Periosteal reactive new bone formation results when the tumor destroys cortex and may take the form of a Codmans triangle, onion-skinning, or a sunburst pattern. It is usually a sign of malignancy CT scan evaluation of extent of tumor invasion into bone, soft tissues, neurovascular structures MRI determine extent of t