Osteosarcoma

Question 1

Causes of Death in Children Under 20 yrs

Answer 1

1) Accidents
2) Homicides
3) Cancer
4) Suicides

Question 2

Osteosarcoma

Answer 2

Primary malignancy of the bone

Derived from primitive bone forming, mesenchyme

Question 3

Ewings’ Sarcoma

Answer 3

Derived from parasympathetic neural crest cells
“Small round blue cell” – CD99
85% have a t(11;22) EWS/FLI1 gene

Question 4

Most Common sites

Answer 4

Distal Femur
Prox Tibia
Prox Humerus

Question 5

When is an amputation considered?

Answer 5

Limb Saving Surgery (LSS) produces an inadequate margin
LSS produces a functional outcome that is worse than amputation w/ prosthesis
LSS is not able to restore active function
LSS is not able to obtain soft tissue coverage

Question 6

Four questions Limb Salvage vs. Amputation:

Answer 6

Will survival be the same?
Will the immediate and late morbidities be the same?
Will limb salvage improve function?
Will limb salvage have psychosocial (QOL) benefits?

Question 7

Limb salvage early wound healing

Answer 7

Soft tissue necrosis
Deep infection
Artery / Vein / Nerve damage
Venous thrombosis
Delay in chemotherapy

Question 8

Limb salvage late wound healing

Answer 8

Nonunion
Pathologic fracture
Aseptic loosening
Leg length discrepancy
Implant breakage

Question 9

Amputation: early wound healing

Answer 9

Inadequate wound coverage
and healing
Infection
Delay in chemotherapy

Question 10

Amputation: late wound healing

Answer 10

Stump-prostheses problems
Stump pain
Phantom limb pain
Bone overgrowth