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Bone Tumor, Primary Malignant

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Primary malignant bone tumors are rare (<1% of all tumors). In >40, rule out more common metastatic disease (breast, lung, prostate, thyroid, kidney).

  • Osteogenic sarcomas arise ...

DIAGNOSIS

HISTORY

  • Pain with weightbearing, at rest and at night; often dull or aching; swelling, tenderness; systemic symptoms of weight loss and fever; failure of symptoms to resolve after a 2 to 3 we...

TREATMENT

MEDICATION

  • Neoadjuvant chemotherapy treats micrometastatic disease, allows time for ordering replacement prosthesis and bone graft, and for in vivo assessment of response to chemotherapy. (Ad...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • CBC for myelosuppression

  • Serial ECGs when doxorubicin is being used; granulocyte colony-stimulating factor (G-CSF) is often used to minimize neut...

REFERENCES

1
Eyre R, Feltbower RG, Mubwandarikwa E, et al. Epidemiology of bone tumours in children and young adults. Pediatr Blood Cancer.  2009;53(6):941–952. {L-End} [View Abstract on OvidMedl...

ADDITIONAL READING

  • Arndt CA, Rose PS, Folpe AL, et al. Common musculoskeletal tumors of childhood and adolescence. Mayo Clin Proc.  2012;87(5):475–487.

  • Gorlick R, Janeway K, Lessnick S, et al. Chi...

CODES

ICD10

  • C41.9 Malignant neoplasm of bone and articular cartilage, unsp

  • C40.90 Malig neoplasm of unsp bones and artic cartlg of unsp limb

  • C41.0 Malignant neoplasm of bones of skull and face

  • C41.2 Malig...

CLINICAL PEARLS

  • Literature consistently recommends bone tumor biopsies should ideally be performed at the same institution that can provide comprehensive definitive treatment using a multispecialty ap...

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