Osteosarcoma-1 - Osteosarcoma Paul Duffy 1 Overview...

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12/24/11 1 Osteosarcoma Paul Duffy
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2 Overview Definition Epidemiology Pathogenesis Skeletal distribution Clinical presentation Evaluation High grade osteosarcoma Parosteal osteosarcoma Periosteal osteosarcoma High grade surface osteosarcoma
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3 Definition 2 nd most common primary bone tumor Malignant tumor of mesenchymal origin Spindle shaped cells that produce osteoid
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4 Epidemiology Any age 75% 12-25yrs Modal incidence
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5 Epidemiology Primary vs secondary Male : female Li Fraunie syndrome
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6 Pathogenesis Unknown Modal incidence correlates with rapid bone growth Radiation exposure Cancer survivors Retinoblastoma
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7 Skeletal distribution
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8 Classification
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9 Clinical Presentation Painful mass arising from bone Trauma Metastisize early in evolution 20% clinically detectable mets at dx
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10 Evaluation Suspected diagnosis by hx and physical Supported by xray
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11 Plain Xray Lytic, sclerotic or mixed Typical characteristics of malignant tumor Enneking’s 4 questions
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12 Initial Evaluation Define the extent of the disease Locally Systemically
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13 Local CT MRI +/- Angiogram
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14 CT
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15 MRI
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16 Angio
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17 Systemic Bone scan CT Chest lab
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18 Classic High Grade Osteosarc Age, sex Presentation Physical exam Blood work Plain films Site size
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19 Differential Dx Giant Cell Tumor Aneursymal Bone Cyst Ewings Osteoblastoma Metastasis Lymphoma
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20 Biopsy Principles Dx “high grade osteosarcoma” Now What??
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