Bone Tumor 外教医学课件.pptx

Bone Tumor;Epidemiology;Age distribution is bimodal First peak: Second decade of life Osteosarcoma predominates at this age Ewing sarcoma Second peak: >60 years old Chondrosarcoma predominates Secondary osteosarcomas Paget's osteosarcoma Postradiation osteosarcoma ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;12;Gerneral principles ;;Gerneral principles ;Gerneral principles ;Gerneral principles ;;Gerneral principles ;Gerneral principles ;;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Benign tumors are staged as follows: Stage 1 lesions are intracapsular, usually asymptomatic, and frequently incidental findings. Roentgenographic features include a well-defined margin with a thick rim of reactive bone. There is no cortical destruction or expansion. ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;Gerneral principles ;High-grade lesions are designated as stage II. They are poorly differentiated with a high mitotic rate and a high cell/matrix ratio. Stages I and II lesions are subdivided according to the extent of local growth. ;Gerneral principles ;Gerneral principles ;36;37;Biopsy;Gerneral principles ;Fine needle aspiration;;;Core needle biopsy;Disadvantages Principal disadvantage pertains to the limited size of the tissue sample obtained, which has the potential to reduce accuracy and result in sampling error. ;Indications Core-needle biopsy is most often indicated for superficial or accessible deep extremity lesions that are of sufficient size to allow needle placement (>3 cm) and that do not involve major neurovascular structures. ;;Open incisional Biopsy;;Indications Many bone and less accessible deep soft tissue tumors are best approached with open biopsy (see details below for incisional versus excisional biopsy). Results Accuracy