Tumores Benignos Flashcards
Qual a predileção de envolvimento do osteoma osteoide?
Predilection for the lower extremity, with half the cases involving the femur or tibia.
Qual a população mais comumente afetada por osteoma osteoide?
Homem jovem (2a e 3a décadas de vida)
Qual é apresentação clássica do osteoma osteoide?
The typical patient with an osteoid osteoma has pain that is worse at night and is relieved by aspirin or other nonsteroidal antiinflammatory medications.
O que pode ocorrer com uma articulação ou com a coluna vertebral de um paciente com osteoma osteoide nessas localizações?
When the lesion is near a joint, swelling, stifness, and contracture may occur. When the lesion is in a vertebra, scoliosis may occur.
Qual é a aparência do osteoma osteoide no rx?
The lesion consists of a small (<1.5 cm) central radiolucent nidus with surrounding bony sclerosis.
Qual é o melhor metodo de imagem para diagnostico de osteoma osteoide?
Tomografia
Quando indicar biopsia para ostema osteoide?
Raramente
Como tratar osteoma osteoide?
Multiple treatment options are available, including medical treatment, percutaneous radiofrequency ablation, and open surgical procedures. If the patient’s symptoms are adequately controlled, and the patient is willing to undergo long-term medical management, antiinflammatory medication can be used as the definitive treatment. Patients treated in this manner usually experience spontaneous healing of the lesion within 3 to 4 years.
Most patients with lesions of the pelvis or long bones of the extremities can be treated with percutaneous radiofrequency ablation.
Qual a taxa de recorrencia do osteoma osteoide?
Menos que 10%
Como é realizada a tecnica de radiofrequencia?
This technique involves a CT-guided core needle biopsy after which a radiofrequency electrode is inserted through the cannula of the biopsy needle. The temperature at the tip is increased to 90°C for 6 minutes.
Em quais osteomas osteoides a tecnica de radiofrequencia é contra-indicada?
The procedure may not be indicated for vertebral lesions (due to risk of thermal injury to the spinal cord) or lesions of the small bones of the hands or feet (due to risk of thermal injury to the skin).
Quais são os locais mais comum de ilhas osseas/enostoses?
Almost any bone can be involved, but the pelvis and the femur are the most common sites.
Qual diagnostico diferencia deve ser feito com enostoses?
Osteopoikilosis is a rare condition consisting of multiple small bone islands throughout the skeleton. Autosomal dominant and sporadic forms of the syndrome have been identiied.
Qual é a aparencia radiografica das enostoses?
They typically are small, round or oval areas of homogeneous increased density within the cancellous bone. Radiating spicules on the periphery of the bone islands merge with the native bone creating a brushlike border.
Como tratar um paciente com enostoses?
Most patients with bone islands can be treated with observation with serial plain radiographs. As long as the lesions remain asymptomatic and do not grow, no further intervention is indicated. If a patient experiences pain, or if the lesion grows, biopsy is indicated to rule out more aggressive lesions, such as a sclerosing osteosarcoma, blastic metastasis, or sclerotic myeloma.
Qual a região mais comum de localização dos condromas?
Although any bone can be involved, the phalanges of the hand are the most common location. They are the most common tumor of the small bones of the hands and feet.
Como é o crescimento dos condromas?
They usually arise in the medullary canal, where they are referred to as “enchondromas.” Rarely, they arise on the surface of the bone, where they are referred to as “periosteal chondromas” or “juxtacortical chondromas.
Como se caracteriza a Doença de Ollier?
Multiple enchondromatosis, also known as Ollier disease, is a rare condition in which many cartilaginous tumors appear in the large and small tubular bones and in the flat bones. It is caused by failure of normal endochondral ossification.
The tumors are located in the epiphysis and the adjacent parts of the metaphysis and shat, and many bones may be afected.
Como se caracteriza a Síndrome de Mafucci?
Multiple lesions of the small bones of the hand may cause considerable disability. When associated with hemangiomas of the overlying soft tissues the disease is known as Mafucci syndrome.
Qual a porcentagem de malignização dos condromas na Doença de Ollier?
Approximately 25% of patients with Ollier disease are diagnosed with sarcomas by 40 years of age.
Qual o aspecto radiologico dos condromas?
Enchondromas are benign-appearing tumors with intralesional calcification. The calcification is irregular and has been described as “stippled,” “punctate,” or “popcorn”.
Como diferenciar radiograficamente um condroma de um condrossarcoma?
In more proximal locations (e.g., the pelvis, proximal humerus, or proximal femur), deep endosteal erosion (two thirds of the thickness of the cortex) frequently indicates a chondrosarcoma. An associated soft tissue mass is never present with an enchondroma and always indicates a chondrosarcoma.
Como tratar um paciente com condroma?
Treatment of patients with solitary enchondromas usually consists of observation with serial radiographs. If the lesion remains radiographically stable and asymptomatic, no further intervention is indicated. If a lesion grows, or if it becomes symptomatic, extended curettage usually is curative.
Como tratar um paciente com encondromatose multipla?
Treatment of patients with multiple enchondromatosis can be more diicult. Although the individual lesions usually are not treated, the more obvious deformities can be corrected by osteotomy. These patients also must be monitored indefinitely for malignant change.