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The term Tumour is usually applied to an abnormal growth of tissue which may be benign or malignant.
The musculoskeletal system may develop tumours , either as a primary from this system itself or as a secondary from
a distant primary location.
Secondary bone tumours ( Metastatic deposits) are commoner than primary bone tumours.
Primary bone tumours may be begin or malignant.
Osteochondroma is the commonest benign tumour of the bone , where as Multiple Myeloma is highly malignant
tumour affecting adults above 40 years of age.
Classification
Various classifications have been proposed for bone tumours like Dahlins classification, Mercers
classification , Tureks classification etc.
These classifications are mainly based on the recognisation of the dominant tissue in the various lesions.
# Marginal excision
3.Origin- Few cells from the growth plate start Pathology- The typical feature is the formation of a
growing centrifugally as a separate lump of the nidus , less than 1 cm in diameter , usually in the
bone. Eventually the tumour gets left behind and cortex of the long bone, the tibia being the
comes to lie at the metaphysis. commonest site.
4. Site- Any bone that develops in cartilage involved. Clinical features- The only symptom is a severe ill
Fast growing ends of long bone and the crest of the localised deep boring pain , worst at night. The
ilium are the commonest site. pain is eased by aspirin or its derivatives.
8. Treatment
Usually it requires no treatment , but complete
surgical excision is indicated if:-
# If the tumour is large and obstructing the joint
movements.
# Painful bursitis
# Fracture of the bony stack
# Malignant change ( 1-2%)
# Pressure on the neighbouring vessels and nerves.
etc.
Giant Cell Tumour
Giant cell tumour is a benign , locally aggressive lesion Treatment:-
arising from the epiphysis. 1. Slow-growing benign lesion- curettage and stripping
of the cavity with burrs and gouses, swabbing with
Sex- more common in female than the males. hydrogen peroxide or with liquid nitrogen then the
Age- Seen commonly in age group of 20- 40 years cavity packed with bone chips.
after epiphyseal fusion. 2. More aggressive tumours, recurrent lesions- Excision
Bones affected- the lower end of femur, upper end of of the tumour followed by bone grafting or custom
tibia, the lower end of radius. made prosthesis.
Types:- Benign GTC
Intermediate GTC
Malignant t GTC
Clinical Features:-
Radiology
- An eccentrically osteolytic lesion near the epiphysis.
-The cortex is thin and sometimes ballooned .
-No periosteal new bone formation (unless there is
pathological fracture)
-Soap- bubble appearance due to ridging of the
surrounding bone
-No calcification within the tumour
-The cortex may be disrupted at places.
-The tumour usually does not enter the adjacent joint