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AAH Week 6 Notes

The document provides an overview of benign and malignant bone tumors, highlighting their characteristics, common types, and clinical manifestations. It details assessment and diagnostic findings, medical management strategies for both primary and secondary bone tumors, and outlines nursing management practices. The information emphasizes the importance of early identification and treatment to improve patient outcomes.

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7 views5 pages

AAH Week 6 Notes

The document provides an overview of benign and malignant bone tumors, highlighting their characteristics, common types, and clinical manifestations. It details assessment and diagnostic findings, medical management strategies for both primary and secondary bone tumors, and outlines nursing management practices. The information emphasizes the importance of early identification and treatment to improve patient outcomes.

Uploaded by

adericawilliams76549
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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AAH Week 6

PowerPoint Notes
Chapter 36 p. 1145-end

Benign Bone Tumors


 Are more common than malignant primary bone tumors
 Generally, are slow growing
 Well circumscribed
 Encapsulated
 Few symptoms
 Are not a cause of death
 Include:
o Osteochondroma
 Most common benign tumor
 Occurs as a large projection of the bone at the end of long
bones (knee or shoulder)
 Developing during growth, becoming a static bony mass
 Less than 1% undergo malignant transformation after
trauma
o Enchondroma
 Common tumor of the hyaline cartilage that develops in
the hand, femur, tibia, or humerus
o Bone cysts
 Expanding lesions within the bone
 Seen in young adults
 Painful
 Palpable mass of long bones, vertebrae, or flat bone
o Osteoid osteoma
 Painful tumor that occurs in children and young adults
 Neoplastic tissue
o Rhabdomyoma
o Fibroma
 Some benign tumors have the potential to become malignant
 Giant cell tumors (osteoclastomas) are benign for long periods but may
invade local tissue and cause destruction
o Occur in young adults and are soft and hemorrhagic
o Undergo malignant transformation and metastasize

Malignant Bone Tumors


 Primary malignant musculoskeletal tumors are relatively rare and arise
from connective and supportive tissue cells
 Also, from bone marrow elements
 Include:
o Osteosarcoma
 The most common and most often fatal primary malignant
bone tumor
 Appears frequently in children, adolescents, and young
adults (in bones that grow fast)
 Clinical manifestations include localized bone pain that
may be accompanied by a tender, palpable soft tissue mas
 Most common sites are the distal femur, the proximal tibia,
and the proximal humerus
o Chondrosarcoma
 Malignant tumors of the hyaline cartilage
 Second most common primary malignant bone tumors
affecting middle-aged and older adults
 Metastasis slowly or very fast
 Low-grade chondrosarcomas tend to have a much better
prognosis than those with high-grade chondrosarcomas
 Sites include the pelvis, femur, humerus, spine, scapula,
and tibia
 Metastasis to the lungs occurs in fewer than half of parents
o Ewing sarcoma
o Fibrosarcoma of soft tissue
o Rhabdomyosarcoma
Metastatic Bone Disease
 Secondary bone tumors are more common than primary bone tumors
 Arise from tissues elsewhere in the body may invade the bone and
produce localized bone destruction or overgrowth
 Most common primary sites of tumors that metastasize to bone are the
kidney, prostate, lung, breast, ovary, and thyroid
 Most frequently found in the skull, spine, pelvis, femur, and humerus
and often involve more than one bone (polyostotic)

Clinical Manifestations
 May have a wide range of associated clinical manifestations
 Weight loss
 Malaise
 Fever may be present
 With spinal metastasis, spinal cord compression may occur
 Can progress rapidly or slowly
 Neurologic deficits like progressive pain, weakness, gait abnormality,
paresthesia, paraplegia (tetraplegia), urinary retention, loss of bowel or
bladder control
 Must be identified early and treated with decompression laminectomy
to prevent permanent spinal cord injury

Assessment and Diagnostic Findings


 CT
 Myelography
 Arteriography
 MRI
 Biopsy
 Biochemical assays of the blood or urine
 PET
 Chest X-ray
 Serum ALP levels
 Hypercalcemia is also present with bone metastases from breast, lung,
or kidney cancer.
Primary Bone Tumors Medical
Management
 The goal of treatment is to destroy or remove the tumor rapidly
 Bay be accomplished by surgical excision, radiation therapy, and
chemotherapy for possible micrometastases
 Limb-sparing procedures are used
 Autograft
 Allograft

Secondary Bone Tumors Medical


Management
 With advanced bone cancer, treatment is palliative
 Therapeutic goal is to relieve the patient’s pain and discomfort while
promoting quality of life
 Patients with metastatic disease are at higher risk than other patients
from postoperative pulmonary congestion, hypoxemia, VTE, and
hemorrhage

Nursing Management
 Assess the patient’s understanding of the disease process
 How they and the family are coping
 How the patient has managed the pain
 No palpating mass
 Assess neurovascular status and range of motion of the extremity
provide baseline data for future comparisons
 Evaluate the ability to perform ADLs should be documented
 Encourage patient and family to talk about fears and concerns
 Monitor for delayed Wound Healing
 Reposition the patient at frequent intervals
 Monitor for the need for any specialty beds or mattress
 Monitor nutritional needs
 Monitor for infection
 Monitor for hypercalcemia

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