OSTEOSARCOMA Flashcards
ALSO CALLED
OSTEOGENIC SARCOMA
DEFINE
MALIGNANT TUMOUR OF MESENCHYMAL CELLS CHARACTERISED BY FORMATION OF OSTEOID / BONE BY TUMOUR CELLS.
ON BASIS OF CLINICAL SETTING
PRIMARY = COMMON ,15 TO 25 YEARS
SECONDARY = OLD AGE > 45 YEARS
CLASSIFICATION
ON BASIS OF CLINICAL SETTING
ON BASIS OF HISTOLOGY
ON BASIS OF HISTOLOGY
OSTEOBLASTIC = NEW BONE FORMATION
CHONDROBLASTIC = BASIC CELL BEING CARTILAGE
FIBROBLASTIC = BASIC CELL BEING FIBROBLASTS
OSTEOLYTIC = MOST MALIGNANT
SPREAD
LOCAL SPREAD = ARISES IN MEDULLARY CAVITY , SPREADS TO CORTEX THEN TO SOFT TISSUE , REPLACES THE MARROW CAVITY , JOINT INVOLVEMENT RARE
HEMATOGENOUS SPREAD = LUNG, BRAIN
LYMPH NODE INVOLVEMENT UNSUSUAL
AGE
15 TO 25 YEARS
SEX
MALE
SITE
AROUND KNEE: DISTAL FEMUR, PROXIMAL TIBIA
LOCATION
MEDULLARY CAVITY OF METAPHYSIS
SYMPTOM
DULL ACHING PAIN ,
SWELLING
HISTORY OF MINOR TRAUMA
SOMETIME MAY PRESENT AS PATHOLOGICAL FRACTURE
SIGN
SWELLING IN REGION OF METAPHYSIS,
SKIN OVER SWELLING SHINY WITH PROMINENT VEINS
MARGINS OF SWELLING NOT WELL DEFINED ( SUGGESTS MALIGNANCY )
MOVEMENT OF JOINT RESTRICTED
RADIOLOGICAL INVESTIGATION
X RAY
CT
MRI
BONE SCAN
X RAY AND CT OF CHEST
X RAY
SUN RAY APPEARANCE = CORTEX BREACHED AND TUMOUR GROWS INTO ADJACENT SOFT TISSUE
PERIOSTEAL REACTION = GROWING TUMOUR LIFTS UP THE PERIOSTEUM
CODMANNS TRIANGLE = TRAINGULAR AREA FORMED AT THE TUMOUR AND HOST CORTEX JUNCTION
OTHER INVESTIGATIONS
BIOPSY = OPEN BIOPSY CONFIRMS DIAGNOSIS, OR FNAC CAN ALSO BE DONE
SERUM ALKALINE PHOSPAHTASE = ELEVATED
