By Timothy A. Damron MD, Carol D. Morris MD MS, Paul Tornetta III MD, Thomas A. Einhorn MD
This quantity of our Orthopaedic surgical procedure necessities Series provides all of the details citizens desire in the course of orthopaedic oncology rotations and the basic uncomplicated technology wanted for board coaching, medical perform, and orthopaedic study, together with molecular and mobile biology, progress and improvement, the genetic foundation of musculoskeletal issues, biomaterials and biologic reaction to orthopaedic implants, and neoplastic problems. The e-book can simply be learn hide to hide in the course of a rotation or used for fast evaluation ahead of forums or speedy reference in medical perform. The ordinary, visually stimulating structure beneficial properties a variety of tables and considerable illustrations, together with colour plates exhibiting tumor histopathology.
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Extra resources for Oncology and Basic Science
Cancer Control 2001;8(3):221–231. Simon MA, Finn HA. Diagnostic strategy for bone and soft-tissue tumors. J Bone Joint Surg [Am] 1993;75(4):622–631. Sundaram M. Magnetic resonance imaging for solitary lesions of bone: when, why, how useful? J Orthop Sci 1999;4(5):384–396. Temple HT, Bashore CJ. Staging of bone neoplasms: an orthopedic oncologist’s perspective. Semin Musculoskelet Radiol 2000;4(1): 17–23. Wenaden AE, Szyszko TA, Saifuddin A. Imaging of periosteal reactions associated with focal lesions of bone.
Chordoma usually occurs in sacrum or base of skull. Three most common bone tumors in patients Ͼ40: metastases, metastases, metastases! Most metastases occur proximal to knees and elbows: those distal to knees and elbows are usually due to lung or renal metastases or melanoma. Common anterior spine lesions: metastases, hemangiomas of bone, Langerhans cell histiocytosis, osteomyelitis, giant cell tumor Common posterior spine lesions: aneurysmal bone cyst, osteoid osteoma, osteoblastoma Bone lesions that skip across joints to involve adjacent bones are frequently vascular: angiosarcoma and Gorham’s disease (disappearing bone disease).
Continues) A C B 19 Chapter 1 / Evaluation of Bone Tumors D E Figure 1-12 (continued) (D) Periosteal neocortical response is seen in F the posterior cortex of the distal tibia due to this aneurysmal bone cyst. (E) Onion-skinning periosteal reaction with Codman’s triangle and an associated soft tissue mass is shown in this Ewing sarcoma. (F) Endosteal expansion and erosions are seen with this low-grade chondrosarcoma. TABLE 1-7 PATTERNS OF MINERALIZATION WITHIN BONE LESIONS Radiolucent (lytic) Mineralized Calcified Ossified Description Typical Lesions Other Distinguishing Features Absence of matrix Numerous (nonspecific) Numerous Punctate rings and arcs Hyaline cartilage lesions* Enchondroma Chondrosarcoma More organized pattern of bone formation Blurring of trabeculae Osseous lesions Osteoid osteoma Osteoblastoma Osteosarcoma Lesions with marked sclerotic response Breast carcinoma metastases Prostate carcinoma metastases Lymphoma Fibrous dysplasia Geographic Permeative zone of transition Endosteal erosions Periosteal reaction Reactive peripheral bone, central nidus Scant to densely sclerotic lesions Scant to densely sclerotic lesions Permeative destructive lesions Variable sclerotic response in surrounding bone Geographic long lesion in long bone Ground glass * Immature cartilage lesions, such as chondroblastoma and periosteal chondroma, do not show the degree of mineralization characteristic of mature hyaline lesions.