Musculoskeletal tumors AIDS Soft tissue tumors Genetics BENIGN Malignant Sarcoma 5700/Yr. USA

Soft tissue tumors Benign Malignant Painless lump in Orthopedic practice Connective tissues Blood vessels Clinically very similar to benign tumors 1% of adult malignancies Benign Malignant Painless lump

Painless mass Malignant Benign 5 Cm. Size Location Mobility Consistency Microcirculatory status X.Ray Bone scan C.T scan M.R.I Needle Bx. Incisional Bx. Excisional Bx. 5 Cm.

Surgical staging Benign Malignant Latent Intracompartmental I A Active I-a:Local wide resection Latent Intracompartmental Low grade I I-b:Wide amputation A Active II-a:Local radical resection High grade II Aggressive II-b:Radical amputation Extracompartmental ?! Chemotherapy B With metastasis III

Penetrating&infiltrating Latent Stopping growth Lipoma Simple excision Active Continuous growth Fibroma Marginal excision Aggressive Penetrating&infiltrating Desmoid fibromatosis Local wide or radical

High grade Low grade With metastasis ?! Chemotherapy I-a:Local wide resection II-a:Local radical resection High grade Low grade I-b:Wide amputation II-b:Radical amputation With metastasis ?! Chemotherapy

1% of adult malignancies Induction Malignant tumors Of Soft tissues Never excisional Chemotherapy Needle or incisional Bx. 1% of adult malignancies Clinically very similar to benign tumors MRI Local wide resection Local radical resection

eg. Rhabdomyosarcoma Neurofibroma Liposarcoma Fibroma Synovial srcoma Lipoma Fibrosarcoma Hemangioma Malignant fibrous histiocytosis Desmoid fibromatosis

Interstitial tissue of a Neurofibroma Soft&circumscribed Rounded Slightly tender Skin or deeper tissues Interstitial tissue of a periferal nerve Solitary or Multiple Spinal canal

Firm,Round, painless nodule Fibroma Uncommon in extremities Never in deep tissues Firm,Round, painless nodule Usually connected with a fascia or apponeurotic structure

Fat&Connective tissue Lipoma Common Almost any part Usually subcutaneous Soft,often large,lobulated,with thin capsule Fat&Connective tissue Local excision

Arterovenous malformation 75-90% Hemangioma 7 Yr. True Neoplasia Birth Cavernous Capillary Compressible Hamartoma Cosmetic Thrombosis Arterovenous malformation Limb growth Recurrence Head & Neck Wide resection Surgery Radiotherapy Amputation

Desmoid fibromatosis Young adult Rare Hard slow growing Musculo-apponeurotic Trunk&shoulder Bx.”Fibro sarcoma No metastasis Local recurrence Multicentric?!

Malignant fibrous histiocytosis Local recurrence&metastasis Commonest in olders Local recurrence&metastasis

Fibrosarcoma Localized Firm Round mass Deeper tissues Neurofibromatosis Pseudocapsule Infiltrating Early lung metastasis

Lung Lymph node Synovial srcoma Solid whitish fleshy mass Insidious , but involving Young or middle age adult Wide resection AMPUTATION

Pleomorphic&Round cell Liposarcoma Rec Met Common Deep tissues Lobulated mass Buttock&Thigh Enormous size Prognosis ?!! Mixoid tissue Radical excision Pleomorphic&Round cell Amputation

Children & young adults Rhabdomyosarcoma Rare Children & young adults Trunk Lower limbs Rapid growth Early metastasis lung