Bone tumors Pazourek L Ondrek Rozkydal Z Classification

Bone tumors Pazourek L. , Ondrůšek Š. , Rozkydal, Z.

Classification n Malignant – Primary bone tumors n Osteosarcoma, chondrosarcoma, Ewing sarcoma … n Myeloma, solitary plasmocytoma … – Secondary bone tumors (bone metastasis) n Breast n carcinom, renal carcinoma, prostate, lung … Benign n Osteoma, n osteoid osteoma, osteblastoma … Tumor like lesions n Juvenile bone cyst, aneurysma bone cyst …

Prevalence of primary bone tumors

$Symptoms n Pain n Swelling n Impaired function n Pathological fracture n General symptoms$

Symptoms n Pain n Swelling n Impaired function n Pathological fracture n General symptoms (fever, weaknes, cachexia …)

Diagnostics History n X-ray n CT / MRI n Scintigraphy of the skeleton n Chest X-ray, CT of the lungs n Ultrasonography of the abdomen n Biopsy (histology) n n Other imaging methods (PET, angiography, laboratory tests. Genetic examination …

X-ray finding in malignant bone tumors – Aggressive lesions – Periostal reaction – Erosions of cortex – Endostal irregularities

Irregularities

Periostal reaction (spikes)

Codman´s triangle

Onion-like periostosis

Osteolytic patches

Erosions of the cortex

Expansion of the tumor

Age 1. decade: Ewing. SA, OSA n 2. -3. decade: OSA, Ewing. SA n 3. -4. decade: osteoclastoma, parostal OSA, Chondrosarcoma … n 5. decade …. : Myeloma, secondary bone tumors, chondrosarcoma … n

Staging of muscuiloskeletal tumors (Enneking) Grade – biological aggressivity n Local finding (Site) n Metastases n

n n n I Low grade A Intracompartmental B Extracompartmental II High grade A Intracompatmental B Extracompartmental III Metastatic A Intracompatmental B Extracompartmental G 1 -2 T 1 T 2 M 0 G 3 T 1 T 2 M 0 G 1 -3 T 1 G 1 -3 T 2 M 1

Therapy n Local therapy – surgery – radiotherapy – Others (embolisation, RFA …) n Systemic therapy – chemotherapy – Hormonal therapy – bisphonates – Biological treatment …