RAED ISSOU

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BONE CANCER

• RAED ISSOU

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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

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Distribution of Common Pediatric Malignancies
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BONE CANCER

• PRIMARY cancer arising from the bone itself.
• SECONDARY i.e. metastasis

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PRIMARY BONE CANCER

• RISK FACTORS
• Radiotherapy chemotherapy
• Paget's disease
• Family Hx hereditary retinoblastoma

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Signs symptoms

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

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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 gtF
• The most common sites are
• Distal femur 52
• Proximal tibia 20
• Proximal humerus 9

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OSTEOSARCOMA (continued)

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

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Diagnosis

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

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X-ray findings

• 1.Lesion
• 2.Cortical destruction
• 3.Extension to the marrow or soft tissue
• 4.Codmans triangle
• 5.Sunburst Effect

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Sunburst Appearance
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TREATMENT

• Surgical resection
• Preoperative postoperative chemotherapy

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

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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

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Ewings sarcoma

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

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Ewings 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.

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Diagnosis

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

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

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

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