The document discusses several topics related to tumors and tumor-like conditions of the bone. It covers the diagnosis of primary and secondary bone tumors through imaging and biopsy. It also discusses the differential diagnosis and treatment principles for benign and malignant bone tumors. Specifically, it may involve local excision, wide excision with limb sparing surgery or amputation along with adjuvant chemotherapy or radiotherapy. Additionally, it provides details on several benign bone lesions such as non-ossifying fibroma, fibrous dysplasia.

1. Tumors and Tumor- like conditions of the bone

3. DIAGNOSIS 1-Presentation (a)Pain (b)Swelling (c)Local tenderness (d)Accidentally discovered during X-ray exam (e)Pathological #

4. 2-Imaging : (a) Plain X-ray: The most useful (b) CT and MRI.( extent of the lesion) (c) Radionuclide scanning with Tc-99-HDP (1)Small tumors(e.g. osteoid osteoma) (2)Skip lesions (3)Silent secondary deposits

5. 3- Biopsy: • Essential for diagnosis and planning of the treatment. • Two types: (1) Large bone needle (2) Open biopsy • The biopsy is taken after all the imaging studies have been completed.

6. Differential Diagnosis 1- Chronic osteomyelitis 2- Stress #

7. Principles of Treatment (1) Asymptomatic benign lesions No treatment needed but any doubt, exisional biopsy (2) Symptomatic benign lesion Complete local excision (3) Malignant tumor (a) Local excision (b) Wide excision with limb sparing (c) Amputation All these with adjuvant therapy (Chemotherapy OR Radiotherapy)

8. Benign Bone Lesions

12. Pathology Fibrous tissue Treatment Unnecessary Pathological # : Accordingly

13. Fibrous dysplasia

15. Clinical features : Small, single lesion ->Asymptomatic Large polyostatic -> Pain Deformity Pathological#

16. X-ray Cystic like areas Metaphysis OR Diaphysis Hazy (ground glass) appearance Bent bones (Shepherd’s crook of femur)

17. Pathology Mac. = Coarse, gritty feel Mic. = Cellular fibrous tissue + Patches of woven bone + Giant cells