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BONE CANCER

BONE CANCER. RAED ISSOU. BONE CANCER. Bone cancer is an uncommon cancer that begins in a bone. most commonly affects the long bones that make up the arms and legs 20 % of pediatric bone tumors are malignant.

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BONE CANCER

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  1. BONE CANCER RAED ISSOU

  2. BONE CANCER • Bone cancer is an uncommon cancer that begins in a bone. • most commonly affects the long bones that make up the arms and legs • 20 % of pediatric bone tumors are malignant. • 66% of adult bone tumors are malignant, most commonly mets. • The most common type of bone cancer in adults is metastatic cancer from other organs

  3. Distribution of Common Pediatric Malignancies

  4. BONE CANCER • PRIMARY : cancer arising from the bone itself. • SECONDARY : i.e. metastasis

  5. PRIMARY BONE CANCER • RISK FACTORS: • Radiotherapy & chemotherapy • Paget's disease • Family Hx : hereditary retinoblastoma

  6. Signs & symptoms • Bone pain that often is nocturnal • Swelling & tenderness near the affected area • Pathological fractures • Fatigue • Unintended weight loss • Fever • Night sweats

  7. OSTEOSARCOMA • The most common primary bone malignancy • Incidence: 2.8 per million • Age 10-25 years (the 8th most common form of childhood cancer) • M >F • The most common sites are; • Distal femur 52% • Proximal tibia 20% • Proximal humerus 9%

  8. OSTEOSARCOMA (continued) • Usually the lesions are metaphyseal • Strong genetic predisposition (chr. 13) • Metastatic spread usually is pulmonary

  9. Diagnosis • Radiological studies : • 1. X-Ray • 2. CT-scan • 3. bone scan & MRI. • Bone biopsy.

  10. X-ray findings • 1.Lesion • 2.Cortical destruction • 3.Extension to the marrow or soft tissue • 4.Codman’s triangle • 5.Sunburst Effect

  11. Sunburst Appearance

  12. TREATMENT • Surgical resection • Preoperative & postoperative chemotherapy

  13. Clinical appearance of a teenager who presented with osteosarcoma of the proximal humerus

  14. Prognosis • Aggressive tumor & The prognosis depends on the stage not the grade. • Without mets the 5-year survival is 70% • If mets present the 5- year survival is 25%

  15. Ewing’s sarcoma • Identified in 1921 by James Ewing • The second most common bone malignancy in pediatrics. • Incidence : 0.6 per million • M>F • Age 10-20 years • The usual sites are : pelvis , long bones of the limbs & ribs , but most commonly around the knee joint.

  16. Ewing’s sarcoma (continued) • Usually the lesions are diaphyseal • T(11.22). • Mets are found in 30% of cases, most commonly in the lungs & other bones & less commonly in the bone marrow.

  17. Diagnosis • Radiological studies: • 1.X-Ray • 2.CT-scan • 3.bone scan & MRI • X-ray findings : • 1.lytic medullary lesion • 2.onion skin appearance

  18. TREATMENT 1- Local radiotherapy combined with systemic chemotherapy 2- In young children amputation may be necessary due to severe compromise of bone growth

  19. Prognosis • The 5-year survival with the first approach is 50%. • The 5-year survival with the 2nd approach is 75%.

  20. THANK YOU

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