外科学精品教学（重庆医科大学）（参考翻译）07.Bone Tumor（2017）teaching.pptVIP

Radiotherapy is contraindicated 禁忌 because of the increased risk of sarcomatous change 肉瘤样变. * Thanks for your attention * Codman’s triangle * * Sunburst * Osteosarcoma MRI is the best test to measure the extent of the tumor both within the bone and in the soft tissue and to determine the relationship of the tumor to nearby anatomical structures. * * Osteosarcoma A bone scan should be obtained 获得 to look for skeletal metastases 骨转移, and roentgenograms and CT scans of the chest should be done to search for pulmonary metastases. * * Osteosarcoma The most important prognostic factor at the time of diagnosis is the extent of the disease. Approximately 15% of patients with osteosarcoma have detectable pulmonary metastases at the time of diagnosis. * Osteosarcoma The next most important prognostic feature is the grade of the lesion. * Osteosarcoma The treatment of high-grade osteosarcoma consists of neoadjuvant chemotherapy, wide or radical surgery (resection or amputation), and adjuvant chemotherapy. Pulmonary metastases likewise 同样地 are resected 切除 if possible after neoadjuvant chemotherapy. * Osteosarcoma About 50% of patients with high-grade osteosarcoma have some type of relapse 复发 after the initial treatment. About 10% of patients have local recurrence after wide resection or wide amputation. * * 13 months after operation Ewing Sarcoma Ewing sarcoma is the fourth most common primary malignancy of bone, but it is the second most common (behind osteosarcoma) in patients younger than 30 years of age the most common in patients is younger than 10 years of age. * Ewing Sarcoma Ewing sarcoma has been reported to occur in a wide age range of patients from infants to the elderly, but most occur in patients between the ages of 5 and 25 years. The most common locations include the metaphyses of long bones (often with extension into the diaphysis 骨干) and the flat bones 扁骨 of the shoulder 肩 and pelvic girdles 骨盆带. * Ewing Sarcoma Pain is an almost un