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Bone tumors

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Bone tumors

  1. 1. Bone tumors
  2. 2. Classification 1. Primary 2. Metastatic -3rd common site of hematogenous metastasis  Liver >Lungs > Bone
  3. 3. Primary Bone tumors  Osseous tumors  Non Osseous Tumors
  4. 4. Osseous tumors
  5. 5. Benign Malignant Bone forming/osteoblastic Osteoma Osteod osteoma Osteoblastoima Osteosarcoma Cartilage forming Enchondroma Osteochondroma Chondroblastoma Chondrosarcoma Hematopoietic Myeloma Lymphoma Unknown Giant Cell tumor Malignant GCT Ewing’s sarcoma Notochordal Chordoma
  6. 6. Non Osseous Tumors
  7. 7. Vascular Hemangioma Hemangio endothelioma Pericytoma Fibrogenic Non ossifying fibroma Fibrosarcoma Neurogenic Neurilemmoma Shwannoma MPNST Lipogenic Lipoma Liposarcoma Histiocytic Fiberous histiocytoma Malignant Fibrous Histiocytoma
  8. 8.  Gardner syndrome, also known as familial colorectal polyposis,[1] is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon.[2] The extracolonic tumors may include osteomas of the skull, thyroid cancer, epidermoid cysts, fibromas and sebaceous cysts,[3] as well as the occurrence of desmoid tumors in approximately 15% of affected individuals.
  9. 9. Osteosarcoma  MC primary tumor of bone  Tumor cells can produce osteiod – tumor ostiod / tumor bone  Malignancy of mesenchyme  Two types 1. Central / medullary 2. Surface / parosteal / Perosteal  Pathogenesis 1. Primary 2. Secondary
  10. 10. Pathogenesis  Genetic  Constitutional factors  Environmental Factors
  11. 11. Genetic  RB gene mutation – 1000 times more risk  13q14  Homozygous mutation in RB locus  Mutation in p53 gene  Over expression of MDM2
  12. 12. Constitutional factors  10- 20 yrs – maximum Bone growth  Males more risk – inc osteoblastic activity  Inc risk in paget’s disease  Metaphysis - osteogenesis
  13. 13. Pathogenesis  Metaphysis  Medullary cavity  Perisoteal eleation – codmann’s triangle  Xray – metaphyseal radio dense lesion with codmann’s triangle  Sunburst / sunray appearance
  14. 14. Gross  Fleshy tumor  Expands laterally
  15. 15. Microscopy  Tumor cells– very in shape –giant cells- spindle ,oval polgonal cells  Osteiod – not rimmed by osteoblast  But surrounded by tumor cells  Varients – 1. Chondroblastic 2. Fibroblastic 3. Small cell 4. telangectactic
  16. 16. Chondroblastic osteosarcoma  Mandible can be involved
  17. 17. Fibroblastic Osteosarcoma
  18. 18. Small cell osteosarcoma
  19. 19. Telangectatic
  20. 20. T/t  Limb salvaged surgery
  21. 21. Extra skeletal osteosarcoma  Mediastinum  Breast  retroperitonim
  22. 22. Surface Osteosarcoma 1. Parosteal / Juxta cortical Osteosarcoma 2. Periosteal osteosarcoma
  23. 23. Ewing’s sarcoma  Highly malignant small round cell tumor  More in females  5 – 20 yrs  Cell of origin – Primitive Neurectodermal cells
  24. 24. Variants of ES 1. Classic / Skeletal ES 2. Soft tissue Ewing’s sarcoma 3. PNET

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