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    Bone Tumor

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    1) Osteosarcoma and Ewing sarcoma are two primary bone cancers that commonly occur in children and adolescents between ages 10-19. 2) Osteosarcoma involves the metaphysis of long bones and presents with bone pain and swelling. Diagnosis is confirmed through x-ray, biopsy and further imaging. Treatment involves surgery along with chemotherapy and radiation. 3) Ewing sarcoma also affects bones and presents with pain and swelling. Diagnosis utilizes imaging and biopsy to identify the small, round cell tumor. Combined chemotherapy and high dose radiation to the primary tumor site is the main treatment approach.

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    Bone Tumor

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    subinj_3
    478 views32 pages
    1) Osteosarcoma and Ewing sarcoma are two primary bone cancers that commonly occur in children and adolescents between ages 10-19. 2) Osteosarcoma involves the metaphysis of long bones and presents with bone pain and swelling. Diagnosis is confirmed through x-ray, biopsy and further imaging. Treatment involves surgery along with chemotherapy and radiation. 3) Ewing sarcoma also affects bones and presents with pain and swelling. Diagnosis utilizes imaging and biopsy to identify the small, round cell tumor. Combined chemotherapy and high dose radiation to the primary tumor site is the main treatment approach.

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    1) Osteosarcoma and Ewing sarcoma are two primary bone cancers that commonly occur in children and adolescents between ages 10-19. 2) Osteosarcoma involves the metaphysis of long bones and presents with bone pain and swelling. Diagnosis is confirmed through x-ray, biopsy and further imaging. Treatment involves surgery along with chemotherapy and radiation. 3) Ewing sarcoma also affects bones and presents with pain and swelling. Diagnosis utilizes imaging and biopsy to identify the small, round cell tumor. Combined chemotherapy and high dose radiation to the primary tumor site is the main treatment approach.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    478 views32 pages

    Bone Tumor

    Uploaded by

    subinj_3
    1) Osteosarcoma and Ewing sarcoma are two primary bone cancers that commonly occur in children and adolescents between ages 10-19. 2) Osteosarcoma involves the metaphysis of long bones and presents with bone pain and swelling. Diagnosis is confirmed through x-ray, biopsy and further imaging. Treatment involves surgery along with chemotherapy and radiation. 3) Ewing sarcoma also affects bones and presents with pain and swelling. Diagnosis utilizes imaging and biopsy to identify the small, round cell tumor. Combined chemotherapy and high dose radiation to the primary tumor site is the main treatment approach.

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    of 32

    BONE TUMORS IN CHILDREN: OSTEOSARCOMA & EWING SARCOMA

    Neoplastic disease can occur from any tissue involved in bone growth. In children Primary bone cancer Metastatic bone cancer Accounts to 85% of all primary bone tumors

    TYPES: PRIMARY BONE CANCER


    Osteosarcoma Chondrosarcoma Ewing Sarcoma

    INCIDENCE
    Primary bone cancer is rare Accounts to <1 % of all cancers Osteosarcoma & ewing sarcoma occurs between ages 10 and 19 [pk 15-19 yrs]: ADOLESCENT Male : Female 2:1 Chondrosarcoma occurs mainly in older adults (over age 40).

    CAUSES: BONE CANCER


    Inherited genetic mutations Radiation Trauma

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    Some retinoblastomas, osteosarcomas, and soft tissue sarcomas may share a common etiology R R Weichselbaum M Beckett and A Diamond University of Chicago, Department of Radiation and Cellular Oncology, IL 60637. Free Powerpoint Templates

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    DNA and RNA were extracted from primary human osteosarcomas and soft tissue sarcomas obtained from patients without retinoblastoma and were analyzed by hybridization with a cDNA probe for RB mRNA; absence or alterations of the RB gene are associated with development of retinoblastoma. Most of the osteosarcomas or soft tissue sarcomas examined by us did not express detectable levels of RB mRNA, whereas normal cells and epithelial tumor cells did. One osteosarcoma expressed a 2.4-kilobase transcript in addition to a normal 4.7-kilobase species. Our data suggest that transcriptional inactivation or post-transcriptional down-regulation of the RB gene may be important in the etiology of some osteosarcomas and soft tissueTemplates sarcomas as well as Free Powerpoint Page 7 retinoblastomas.

    Etiology of Osteosarcoma Fuchs, Bruno MD*,**; Pritchard, Douglas J. MD* Several chemical agents such as beryllium, viruses such as FBJ, subsequently found to contain the sarconcogene, and radiation were shown to be potent inducers of osteosarcoma. Paget's disease, electrical burn, or trauma all are thought to be other factors that may contribute to the pathogenesis.

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    More recently, patients with hereditary diseases such as Rothmund-Thomson syndrome, Bloom syndrome, and LiFraumeni syndrome were found to have an increased risk of having osteosarcoma develop.

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    During the past few years, the molecular analysis brought a wealth of new information with numerous genes that were associated with osteosarcoma and its clinical disease progression. They can be categorized into self-sufficiency in growth signals, insensitivity to growth inhibitory signals, evasion of apoptosis, limitless replicative potential, sustained angiogenesis, and tissue evasion and metastasis. Although the understanding of these processes in osteosarcoma still is incomplete, it may have the potential to significantly affect the patient care in the future.

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    SYMPTOMS
    Bone fracture, especially fracture from slight injury (trauma) Bone pain Occasionally a mass and swelling can be

    felt at the tumor site


    Some benign tumors have no symptoms
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    DIAGNOSTIC MEASURES
    Patients personal and family, medical history. Physical examination and Laboratory and other diagnostic tests These tests may include the following X-rays A bone scan A CT or CAT

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    MRI PET scan An angiogram Biopsy Blood tests e.g : alkaline phosphatase.

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    TREATMENT

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    Surgery Chemotherapy Radiation therapy Cryosurgery

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    GOAL: to provide the adolescent with a functional extremity. May involve amputation of the affected limp or limb salvage procedure Resection surgery is performed unless there is extensive involvement of soft tissue or neuromuscular muscle The primary bone tumor is removed & the diseased bone is replaced with an internal prosthesis.
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    Involves metaphyseal ends of long bones like femur,humerus, tibia ,pelvis, jaw, phalanges. It may also occur in other locations

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    The metaphysis is the wider portion of a long bone adjacent to the epiphyseal plate- are responsible

    for growth in the length of the bone. Has rich blood supply It is this part of the bone that grows during childhood; as it

    grows, it ossifies near the diaphysis and the epiphyses.

    PATHOPHYSIOLOGY
    Etiological factors Tumor from bone producing mesenchymal cell Tumor extends beyond the bone & into a soft tissue mass that encircle the bone Tumor cells may spread into the blood stream & produce metastasis

    CLINICAL MANIFESTATIONS
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    Pain at the site of tumor Localised swelling and warmth Limitation of movements, limp Tenderness

    Erythema
    Metastasis
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    DIAGNOSIS
    Suspected : unexplained bone pain in association with a palpable mass. X-rays CT scan - the magnitude of the medullary involvement CT scan of chest - metastases

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    TREATMENT
    Optimal Treatment Surgery Radical surgical resection Amputation Chemotherapy: in combination or singly before and after surgery -high dose methotrexate with citrovorum rescue, adriamycin, actinomycin D, cyclophosphamide, cisplatin etc

    PROGNOSIS

    50-60% survival

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    EWING SARCOMA/ PRIMITIVE NEURO ECTODERMAL TUMOR


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    Ewing tumor characteristically occur in childhood and adolescents [4-20 yrs] Involving either long bones of extremities (most often femur) or flat bones of head and trunk- femur, tibia, ulna, humerus, vertebrae, pelvis, scapula, ribs, skull
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    MANIFESTATIONS
    Painful swelling with constitutional symptoms like fever and malaise

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    DIAGNOSIS
    X ray showing mottled, lytic, onion skin pattern must be confirmed by surgical bone biopsy showing round cell tumor.

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    -CT scan to define the magnitude of the tumor


    -Chest X ray -CT scan and radio nuclide bone scan -Bone marrow biopsy
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    TREATMENT Powerpoint Templates


    TREATMENT OF CHOICE: High dose irradiation of the primary tumor site & combination of chemotherapy employing vincristine, cyclophosphamide, dactinomycin and doxorubicin.

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    PROGNOSIS
    With metastasis , survival is 5-15%. Without metastasis it is around 60%.

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