肿瘤学课件 骨肉瘤.pptVIP

Case Presentation- Jesse案例介绍 Presenting Complaint:病情陈述 Acutely lame on the right rear limb. 严重右后腿破行 Jesse Signalment: 症状 9 year old MC golden retriever cross 9岁混血金毛猎犬 History: 病史 Acutely lame on the right rear limb. Usually runs 2-3 times/week. 右后肢严重破行，通常一周出现2－3次 Eating and drinking well. 饮食，饮水正常 No PU/PD, no c/s/v/d. 无烦渴，多尿 Physical Exam (Abnormalities) 5/5 lame on right pelvic limb 右骨盆肢5级破行 Problem List问题列表 Right pelvic limb lameness 右骨盆肢破行 DDs 鉴别诊断 Diagnostic Plan 诊断计划 CBC- WNL 血常规 Chemistry panel- WNL 生化 Thoracic radiographs 胸部X光 Right femoral radiographs 右后肢X光 FNA of right femoral metaphysis 右股干骨后端细针穿刺活检 Results 结果: Radiographs X光 3 view thoracic films 3张片 Results 结果: Radiographs X光 Right femur 右骨股 Results 结果: Ultrasound of the right femur 右骨股超声 Results 结果: FNA of right femoral metaphysis 右股干骨后端细针穿刺活检 Diagnosis 诊断: Osteosarcoma 骨肉瘤 Jesse Amputation of the right pelvic limb 右骨盆肢切除术 Recovered very well 恢复良好 Treated with chemotherapy- 化疗 Carboplatin and adriamycin 卡波铂和阿霉素 Still alive 11 months later 11月后依旧存活 Donovan Signalment 症状 8yo MC Rottweiler dog 8岁，去势罗威娜 Presenting Complaint 陈述 One year history intermittent lameness 间断性跛行一年病史 Progressive over previous two weeks 进程超过预计两周 Initial work-up at RDVM:初步检查 Radiographs: X光 Left humerus 左肱骨 Initial work-up at RDVM: Thoracic Radiographs - 3 view 胸腔X光－3张 Initial work-up at RDVM: Bone Biopsy 骨髓活检 Initial Therapy at RDVM Amputation of left thoracic limb 左前肢切除 Offered referral for follow-up chemotherapy 推荐继续化疗 Initial Visit to the VMTH (8/31/99) 2 weeks post amputation 切除术后2周 Referral thoracic radiographs from week before - no sign of metastasis 一周前开始X光片检查－无转移迹象 PE 1cm SQ diameter mass dorsal cervical area 子宫颈背侧团块直径1cm 0.5cm SQ mass right lateral thorax 右侧胸腔团块直径0.5cm 1 cm SQ mass medial aspect right stifle 中间右室团块直径1cm Thin BCS 3/9 Skin Mass Aspirates 皮肤团块抽吸 Right stifle, right thorax, right stifle 右室，右胸腔，右室 Plan 计划 Owner informed of likely skin met