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BONE TUMOURS

BONE TUMOURS. 1. PRIMARY TUMOURS 2.SECONDARY TUMOURS. PRIMARY BONE TUMOURS CLASSIFICATION. BONE TUMOURS CLASSIFICATION. BONE TUMOUR CLASSIFICATION. BONE TUMOURS CLSSIFICATION. SITES OF VARIOUS BONE TUMOUR. EWING’S TUMOUR. EWING’S TUMOUR(MALIGNANT)

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BONE TUMOURS

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  1. BONE TUMOURS 1. PRIMARY TUMOURS 2.SECONDARY TUMOURS

  2. PRIMARY BONE TUMOURSCLASSIFICATION

  3. BONE TUMOURS CLASSIFICATION

  4. BONE TUMOUR CLASSIFICATION

  5. BONE TUMOURSCLSSIFICATION

  6. SITES OF VARIOUS BONE TUMOUR

  7. EWING’S TUMOUR • EWING’S TUMOUR(MALIGNANT) • DIAPHYSIS & METAPHYSIS,10- 20 YRS, MEDULLARY CAVITY-

  8. EWING’S TUMOUR MICROSCOPICALLY –SMALL ROUND CELLS,CONTAIN GLYCOGEN (PAS +ve)

  9. OSTEOSARCOMA MALIGNANT MESENCHYMALNEOPLASM IN WHICH THE NEOPLASTIC CELLS PRODUCE OSTEOID.

  10. OSTEOSARCOMA MOST COMMON PRIMARY MALIGNANT BONE TUMOUR.

  11. OSTEOSARCOMA PRIMARY (CONVENTIONAL)-ARISE de novo, SECOND DECADE, MALE PREDOMINANCE

  12. OSTEOSARCOMA SECONDARY – ARISE AS A COMPLICATION OF PAGETS DISEASE, CHRONIC OSTEOMYELITIS, RADIATION,

  13. SECONDARYOSTEOSARCOMA OSTEOCHONDROMA INFARCTS, FIBROUS DYSPLASIA - PROGNOSIS - LESS FAVOURABLE

  14. OTHER FORMS OF OSTEOSARCOMA PAROSTEAL (JUXTACORTICAL-OUTER SURFACE OF CORTEX)

  15. COVENTIONAL OSTEOSARCOMA SECOND DECADE OF LIFE MOST COMMON SITE – AROUND THE KNEE

  16. COVENTIONAL OSTEOSARCOMA PATHOGENESIS- MUTATION IN CHROMOSOME 13, IN COMMON WITH RETINOBLASTOMA LOCUS -13q14,

  17. PATHOGENESIS GERM LINE MUTATION OF RETINOBLASTOMA GENE

  18. PATHOGENESIS LOSS OF HETEROZYGOSITY AT 3p,13q, 17p & 18 q

  19. COVENTIONAL OSTEOSARCOMA OVER EXPRESSION OF MDM ONCOGENE 2 NOTED IN MANY CASES MDM2 PROTEIN BINDS TO AND INACTIVATES THE TP53 TUMOUR SUPPRESSOR GENE

  20. MORPHOLOGY OF OSTEOGENIC SARCOMA GROSS- LARGE ILL DEFINED LESION IN THE METAPHYSEAL REGION DESTROYS THE CORTEX,

  21. MORPHOLOGY OF OSTEOGENIC SARCOMA EXTENDS INWARD IN TO THE MARROW,SOFT TISSUE. INVATION OF THE EPIPHYSEAL PLATE IS NOT COMMON

  22. OSTEOSARCOMA-X RAY 1.CODMANS TRIANGLE 2. SUN RAY APPEARANCE

  23. OSTEOSARCOMA-X RAY

  24. OSTEOSARCOMA-GROSS

  25. MICROSCOPY HALLMARK IS FORMATION OF OSTEOID BY MALIGNANT MESENCHYMAL CELLS.

  26. MICROSCOPY PRIMITIVE BONY TRABECULAE HUGGED BY A RIM OF MALIGNANT OSTEOBLASTS. CARTILAGE MAY BE PRESENT.

  27. MICROSCOPY MALIGNANT CELLS MAY BE UNIFORM OR PLEOMORPHIC BIZARRE HYPERCHROMATIC NUCLEI, FREQUENT MITOSES.

  28. MICROSCOPY GIANT CELLS RESEMBLING OSTEOCLASTS MAY BE PRESENT.

  29. OSTEOSARCOMA

  30. CLINICAL FEATURES OF OSTEOSARCOMA PROGRESSIVELY ENLARGING PAINFUL MASS. X RAY – STRONGLY SUGGEST

  31. CLINICAL FEATURES OF OSTEOSARCOMA X RAY LUNG – EARLY METASTASIS TO LUNG. 20% CASES DETECTABLE METASTASIS AT THE TIME OF DIAGNOSIS

  32. PROGNOSIS OF OSTEOSARCOMA ADVANCED SURGICAL TECHNIQUE COMBINED WITH RADIOTHERAPY, CHEMOTHERAPY HAVE GREATLY IMPROVED THE PROGNOSIS.

  33. PROGNOSIS OF SECONDARY OSTEOSARCOMA SECONDARY OSTEOSARCOMA OCCUR IN AN OLDER AGE GROUP DEVELOP IN SETTING OF PAGET’S DISEASE PREVIOUS RADIATION RARELY IN PATIENT’S WITH

  34. PROGNOSIS OF SECONDARY OSTEOSARCOMA FIBROUS DYSPLASIA BONE INFARCTS CHRONIC OSTEOMYELITIS HIGHLY AGGRESSIVE,RESPOND LESS FAVOURABLY TO CURRENT THERAPIES

  35. GIANT CELL TUMOUR OF THE BONE COMMON TUMOUR 20% OF ALL BENIGN TUMOURS OF THE BONE

  36. GIANT CELL TUMOUR OF THE BONE OSTEOCLASTOMA. LARGE NUMBER OF OSTEOCLAST LIKE GIANT CELLS ADMIXED WITH MONONUCLEAR NEOPLASTIC CELLS.

  37. GIANT CELL TUMOUR OF THE BONE SITES – EPIPHYSIS OF LONG BONES AROUND KNEE, PROXIMAL HUMEROUS & DISTAL RADIUS.

  38. GIANT CELL TUMOUR 20 – 40 yrs F >M HISTOGENESIS –NOT KNOWN

  39. GIANT CELL TUMOUR MOST PROBABLY FROM REACTIVE CELL POPULATION DERIVED FROM MACROPHAGES. MONONUCLEAR CELLS ARE NEOPLASTIC

  40. MORPHOLOGY RADIOLUCENT LESIONS INVOLVING THE END OF LONG BONES. LESS COMMONLY SACRUM.

  41. OSTEOCLASTOMA-X RAY

  42. OSTEOCLASTOMA-X RAY

  43. MORPHOLOGY SOLITARY INVOLVE THE EPIPHYSIS LONG STANDING TUMOURS ERODE THE CORTEX DARK BROWN CYSTIC?

  44. OSTEOCLASTOMA-GROSS

  45. MICROSCOPIC FEATURES 1.MULTINUCLEATED GIANT CELL RESEMBLING OSTEOCLASTS DERIVED FROM FUSION OF MONOCYTE- REACTIVE.

  46. MICROSCOPIC FEATURES 2.PROLIFERATING NEOPLASTIC COMPONENT OF THE TUMOUR IS ROUND TO SPINDLE SHAPED MONONUCLEAR CELLS HAVING BENIGN FEATURES.

  47. OSTEOCLASTOMA

  48. GIANT CELL TUMOUR RARE OCCATIONS MALIGNANCY MAY DEVELOP MONONUCLEAR CELLS BECOME ANAPLASTIC.

  49. CLINICAL FEATURES LOCAL PAIN – MAY BE MISTAKEN FOR ARTHRITIS. BIOPSY & X RAY ESTABLISHES THE DIAGNOSIS.

  50. CLINICAL FEATURES RECURRENCES ARE COMMON AFTER SIMPLE CURETTAGE. SARCOMATOUS TRANSFORMASTION IS RARE.

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