Tumors of the bones - a relatively rare phenomenon. Their share among the other tumor is about 1%. Bone tumors are characterized mainly for young people. The reasons they are still poorly understood. A role is given to personal injury. The bulk of bone tumors account for osteosarcoma (50-60%), Ewing's sarcoma, fibrosarcoma, and chondrosarcomas. Overall, about 30 known species of bone tumors.
In the classification of bone tumors in addition to histological forms of use: TNM and pTNM-classification. They apply to all primary malignant bone tumors except malignant lymphomas, multiple myeloma, ¬ yukstakorti Kalnoy osteo-and chondrosarcoma yukstokortikalnoy.
G-histopathological degree of malignancy. There are two or three-and four-assessment system malignancy.
R-classification (in the absence or presence of residual tumor after treatment) Classification of disease stage (stage Ia, stage Ib, IIat1 stage, stage IIb, stage III, stage IVa, stage IVb)
The clinical picture of benign and malignant tumors of bone may be similar, and include pain, swelling, and sometimes breaks for no apparent reason.
Diagnosis of bone tumors in addition to inspection, collection history and standard blood tests includes:
Using the methods of medical imaging:
magnetic resonance imaging,
X-ray computed tomography,
positron emission tomography)
morphological diagnosis of the tumor with the establishment of the type of tumor
cytology smears and smears
Radiography of mutually perpendicular projections help determine benign or malignant tumors.
Radiographic signs of malignancy:
A tumor larger
Destruction of bone
Germination of tumors in soft tissues.
Radiographic signs of purity:
Well-marked formation of small size
The thick rim of sclerosis around the tumor
The lack of germination of the tumor in the soft tissues.
Ancillary studies - CT and MRI scans, and the "T Bone helped to identify the affected step, the prevalence of the tumor and its anatomic relationship to adjacent tissues.
If you suspect a malignant tumor of the chest CT scan performed to rule out metastasis to the lung (the most frequent localization of metastases in sarcoma).
A biopsy. It is advisable, if necessary immediately to make a radical resection or amputation. Treatment of bone tumors
Surgical treatment - the main method
Benign tumors. Spend vnutriochagovoe or intracapsular excision of the tumor. Perhaps replacing the defect with bone graft
Malignant tumors. Resected within the healthy tissue (away for at least 2 cm from the visible tumor border) metastases. Single (1-2) isolated pulmonary metastases of sarcoma (especially osteo-or chondrosarcoma) are to be resected.
Adjuvant therapy of malignant tumors:
Radiation therapy. Some tumors (eg, Ewing's sarcoma) are very sensitive to radiation therapy. In other cases, radiation therapy - an auxiliary method of treatment
Treatment of bone tumors may involve surgery, chemotherapy and also radiation exposure. The choice of treatment depends on many factors. In the case of highly differentiated tumors often enough to prompt intervention. As a rule, carry out organ-saving operations. Only in certain cases provided for amputation. For some types of tumors using combined or complex treatment with chemotherapy and radiation therapy, but usually is assumed to be surgical excision of the tumor as a primary method. For certain types of tumors (Ewing's sarcoma when, for example) gives a good effect radiation therapy.
Chemotherapy is usually used in addition to surgical methods, and may precede the operation. Due to the possible impact on the reproductive system of chemotherapy and radiation therapy are usually young men offered the possibility of using sperm bank.