Primary malignant bone tumors are rare (<1% of all tumors). Patients >40 years; rule out more common metastatic disease (breast, lung, prostate, colon, kidney, thyroid).
In chil...
Pain with weight-bearing, at rest, and at night; often dull or aching; swelling, tenderness
Clinical course without expected recovery for common sports injury
Fracture with minor trauma...
Neoadjuvant chemotherapy treats micrometastatic disease and allows time for ordering replacement prosthesis and bone graft and for in vivo assessment of response to chemotherapy. (...
CBC for myelosuppression
Serial ECGs when doxorubicin is being used; granulocyte colony-stimulating factor (G-CSF) is often used to minimize neut...
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...
Bone tumor biopsies should ideally be performed at the same institution that can provide comprehensive definitive treatment using a multispecialty approach.
Have a high index of suspici...
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FIGURE 16-3. Anteroposterior radiograph of a 62-year-old patient's distal femur. The patient had pain for 4 weeks before sustaining a nondisplaced fracture through a lesion in her distal lateral femur. Its appearance on the plain radiograph is suggestive of a metastatic lesion. No other lesions were found and a biopsy was done. The lesion proved to be a primary malignant fibrohistiocytoma of bone. She had a limb salvage resection after preoperative chemotherapy.
FIGURE 16-3. Anteroposterior radiograph of a 62-year-old patient's distal femur. The patient had pain for 4 weeks before sustaining a nond...
Figure 58.1. A destructive bone-forming lesion of the distal femoral metaphysis. Notice the destruction of the medial femoral condyle, the new bone formation in the region of bone destruction, and the elevation of the periosteum. These features are characteristic of osteosarcomas.
Figure 58.1. A destructive bone-forming lesion of the distal femoral metaphysis. Notice the destruction of the medial femoral condyle, the...
Osteosarcoma. (A) The distal femur contains a dense osteoblastic malignant tumor that extends through the cortex into the soft tissue and the epiphysis. (B) A photomicrograph reveals pleomorphic malignant cells, tumor giant cells, and mitoses. The tumor produces woven bone that is focally calcified.
Osteosarcoma. (A) The distal femur contains a dense osteoblastic malignant tumor that extends through the cortex into the soft tissue and t...
Ewing sarcoma. The tumor shows small, round cells, with glycogen-filled clear cytoplasm.