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Musculoskeletal tumors

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Presentation on theme: "Musculoskeletal tumors"— Presentation transcript:

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

2 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

3 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.

4 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

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

6 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

7 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

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

9 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

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

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

12 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

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

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

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

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

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

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

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