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2.1
Malignant Neoplasm of the Bone
Bone Cancer

Presentation

Occasionally binucleated cells are present. [pedorthpath.com]

Patients clinically present with night pain that may or may not be relieved with salicylates. [podiatrytoday.com]

Clinical presentation • present as a localized painful mass • with systemic symptoms such as fever, malaise, weight loss, and • an increased erythrocyte sedimentation rate. • These systemic symptoms may lead to an erroneous diagnosis of osteomyelitis. [slideshare.net]

They present between 30-60 years of age and men are more frequently affected than women. They are usually found in the metaphysis of long bones, present with pain and have a high incidence of fracture at presentation. [patient.info]

Entire Body System

  • Pain

    ADAMANTINOMA OF LONG BONES 2ND TO 3RD DECADES LOCALLY AGGRESSIVE DULL PAIN OF GRADUAL ONSET. [slideshare.net]

    Treatment focuses on the underlying malignancy and additional management of pain and prevention of fractures related to the metastases. [amboss.com]

    Clinically, patients experience pain and swelling at the site of the lesion. [podiatrytoday.com]

    Pain and swelling are the most common symptoms. [merckmanuals.com]

  • Fever

    (after osteosarcoma) medullary cavity, usually of long bones in the lower extremities  Femur most common  pelvis  upper limb  spine and ribs sacrococcygeal region SYMPTOMS Age 5-15 yrs localized pain and swelling Additional symptoms may include Fever [slideshare.net]

    Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low level of red blood cells. If you are concerned about any changes you experience, please talk with your doctor. [cancer.net]

    Other symptoms related to bone tumors may include: Fevers Night sweats Swelling around a bone Limping If you think you might have a bone tumor, see your doctor right way. [webmd.com]

    Some tumors can also cause fevers and night sweats. Many patients will not experience any symptoms, but will instead note a painless mass. Medical history and physical exam: Tell the doctor your complete medical history. [health.uconn.edu]

  • Weight Loss

    Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia, which is a low level of red blood cells. If you are concerned about any changes you experience, please talk with your doctor. [cancer.net]

    Some other symptoms can be weight loss, fatigue and or anemia. The first step in diagnosing primary bone cancer is a complete medical history and physical examination performed by a physician. [sarcomaalliance.org]

    Clinical presentation • present as a localized painful mass • with systemic symptoms such as fever, malaise, weight loss, and • an increased erythrocyte sedimentation rate. • These systemic symptoms may lead to an erroneous diagnosis of osteomyelitis. [slideshare.net]

    Other symptoms include: swelling in the affected area weakened bones that resulting in a significantly higher risk of fracture unintentional weight loss a lump in the affected area Although much less common, the patient might also experience fever, chills [medicalnewstoday.com]

  • Fatigue

    Some other symptoms can be weight loss, fatigue and or anemia. The first step in diagnosing primary bone cancer is a complete medical history and physical examination performed by a physician. [sarcomaalliance.org]

    Additional symptoms may include fatigue, fever, weight loss, anemia, and unexplained bone fractures. Many patients will not experience any symptoms, except for a painless mass. [en.wikipedia.org]

    The side effects of chemotherapy include: nausea irritability hair loss extreme fatigue Cryosurgery Cryosurgery is another treatment possibility. This treatment involves killing cancer cells by freezing them with liquid nitrogen. [healthline.com]

Musculoskeletal

  • Joint Effusion

    • Some swelling and hemorrhagic joint effusion seen some cases • Radiologically osteolytic appearance, either well circumscribed or with a wide zone of transition. Variable degrees of peripheral sclerosis may sharply demarcate the lesion. [slideshare.net]

    Large tumors may restrict range of motion,decrease musculoskeletal function,produce joint effusion and, in advances cases,result in weight loss and cachexia. A sudden fracture through destructive mass may be found. [pedorthpath.com]

  • Osteoporosis

    • Multiple myeloma may present in a variety of radiographic patterns Particularly in the spine, • it may be seen only as diffuse osteoporosis with no clearly identifiable lesion; multiple compression fractures of the vertebral bodies may also be evident [slideshare.net]

Workup

Workup Laboratory studies may include measuring serum calcium, phosphorous, and alkaline phosphatase levels to assess for possible bony metastasis. [emedicine.medscape.com]

Since not every benign tumor can be reliably diagnosed as benign on an x-ray, it is important to do a complete diagnostic workup until the dignity (benign / malignant) of the vertebral finding can be confirmed. [harms-spinesurgery.com]

Treatment

However, the choice of treatment depends upon the location, size, and stage of cancer, the patient’s age and general health, and how the tumor responds to treatment. [my.clevelandclinic.org]

The care of patients with primary malignant bone tumors requires a multidisciplinary approach to treatment. [ncbi.nlm.nih.gov]

Sometimes your doctor may recommend removing the tumor (excision) or using other treatment techniques to reduce the risk of fracture and disability. Some tumors may come back–even repeatedly–after appropriate treatment. [health.uconn.edu]

The choice of chemotherapy scheme will depend on the treatment-free interval and the initial treatment received by the patient. [link.springer.com]

The choice of treatment generally depends on the underlying primary malignancy and stage of disease. [amboss.com]

Prognosis

There remains uncertainly as to the best treatment of this disease and how to improve its prognosis. [ncbi.nlm.nih.gov]

Prognosis: • Better prognosis than conventional osteosarcoma, but still have tendency to recur and metastasize. • Medullary involvement of the bone may have poorer prognosis. • About 70% recurrence rate after excision. • Rate of metastasis has been reported [pedorthpath.com]

with neoadjuvant and adjuvant polychemotherapy (e.g., combination of methotrexate, doxorubicin, cisplatin, and ifosfamide ) Histological examination of the resected bone to evaluate the effect of neoadjuvant chemotherapy (major prognostic factor) Prognosis [amboss.com]

Every child is unique and treatment and prognosis is structured around the child's needs. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential. [childrensnational.org]

Etiology

] [19] Differential diagnosis of primary malignant bone tumors Secondary malignancies of the bone (bone metastasis) Description Definition : secondary bone tumors due to metastasis (predominantly hematogenous) of primary malignancies of other organs Etiology [amboss.com]

Consider the anatomic structures surrounding the lesion and possible etiologies for the mass. Next, palpate the lesion. Determine the size, shape, and contour. [emedicine.medscape.com]

Common benign bone tumors may be neoplastic, developmental, traumatic, infectious, or inflammatory in etiology. Some benign tumors are not true neoplasms, but rather, represent hamartomas, namely the osteochondroma. [en.wikipedia.org]

Epidemiology

Ewing sarcoma Description : : highly malignant bone tumor arising from neuroectodermal cells ; ; associated with various chromosomal translocations of the EWSR1 gene ( chromosome 22 ) Epidemiology Incidence : peak at 10–15 years Sex: ♂ > ♀ Ethnicity: [amboss.com]

Epidemiology: • Accounts for less than 1% of primary bone tumors and only 1-2% of all osteosarcomas. • Males and females are equally affected. • The peak incidence is in 2nd-3rd decades of life. [pedorthpath.com]

Osteoblastoma: Epidemiology: Usually appears between the ages of 10 and 35. Clinical features: Osteoblastoma usually is observed in long bones and posterior spine. [pedclerk.bsd.uchicago.edu]

Epidemiology Primary bone tumors are the sixth most common neoplasm occurring in children and constitute approximately 6% of all childhood malignancies. [pedsinreview.aappublications.org]

Eyre R, Feltbower RG, James PW, et al ; The epidemiology of bone cancer in 0 - 39 year olds in northern England, 1981 - BMC Cancer. 2010 Jul 610:357. [patient.info]

Pathophysiology

Raménkové blokády Raménkové blokády ... discipline: Physiology and Pathophysiology | keywords: | published on: 13.11.2011 Bradyarytmie a raménkové blokády Bradyarytmie a raménkové blokády ... discipline: Cardiology, Angiology | keywords: | published on [portal.mefanet.cz]

Prevention

Radiotherapy works by damaging the DNA inside the tumor cells, preventing them from reproducing. [medicalnewstoday.com]

Is It Possible to Prevent Bone Cancer? At this time, there are no specific methods of prevention of bone cancer. What Is the Prognosis for Bone Cancer? The outlook for patients with bone cancer is improving. [emedicinehealth.com]

Treatment focuses on the underlying malignancy and additional management of pain and prevention of fractures related to the metastases. [amboss.com]

Is it possible to prevent bone cancer? Since the exact cause of bone cancer is poorly understood, there are no lifestyle changes or habits that can prevent these uncommon cancers. [medicinenet.com]

Stabilization of long bones is often necessary to prevent pathologic fracture. Amputation is indicated only rarely, when function is lost because of pathologic fracture or extensive soft-tissue involvement that cannot be managed otherwise. [merckmanuals.com]

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2.1
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