(Leukemia. An overview) Multiple Myeloma Multiple myeloma is the most common primary malignant bone tumor but is often regarded more as a bone marrow cell tumor in the bone because as a bone tumor. It is of hematopoietic origin (multiple myeloma) and usually occurs in older people. The tumor development and progression is usually multicentric and affects the bone marrow so diffuse that a bone marrow examination is diagnostically conclusive. Imaging tests show most sharply defined lytic lesions or diffuse demineralization. Rarely, the lesion may appear as sclerotic or diffuse osteopenia, especially in a vertebral body. An isolated individual Myelomläsion without systemic involvement of the bone marrow is called multiple myeloma. Certain bone lesions respond very well to radiotherapy. Osteosarcoma The osteosarcoma (osteogenic sarcoma) is a highly malignant tumor and the second most common malignant bone tumor. Osteosarcoma can occur at any age, but most often between 10 and 25 years old. It produces malignant osteoid (immature bone) from tumorous bone cells. Usually it is around the knee (the distal femur is more frequently affected than the proximal tibia) or other long bones, especially found in the metaphyseal-diaphyseal areas. Metastases show up most often in the lungs or the bones, pain and swelling are common symptoms. The findings of imaging studies vary, sclerotic and lytic pattern occur. The diagnosis is made by biopsy, by chest x-ray and CT looks for lung metastases by scintigraphy after bone metastases. Treatment consists of a combination of chemotherapy and surgical intervention. The use of adjuvant chemotherapy increases the survival rate of <20% to> 65% in 5 years. Chemotherapy usually begins before any surgical procedure. A decrease in tumor size in the X-ray image, a decreasing intensity of pain and decreased serum alkaline phosphatase exhibit a response, but the desired reaction is for> 95% of the tumor necrosis in mapping the resected specimen. After several cycles of chemotherapy (over several months) may be carried out a limb-sparing surgery, and a reconstruction of the limb. When glie dimensions conserving surgery, the tumor en bloc resection, including the entire surrounding reactive tissue and an edge of the surrounding healthy tissue. To avoid a microscopic spreading of tumor cells, the tumor may not be violated. More than 85% of patients can be treated with a limb-sparing surgery, without the long-term survival rate decreased. The continuation of chemotherapy after surgery is usually necessary. If it (about 95%) comes through the preoperative chemotherapy to almost complete tumor necrosis, the 5-year survival rate is> 90%. Among the variants of conventional osteosarcoma, which occur much less frequently, are superficial cortical lesions as the parossale osteosarcoma and periosteal osteosarcoma. Parossale osteosarcoma usually involve the posterior cortex of the distal femur and are relatively well differentiated normally. The periosteal osteosarcoma is more of a tumor of the cartilage surface that is malignant. It is often located on the midshaft of the femur and is located in the X-ray image as a solar flare. The likelihood of metastasis in periosteal osteosarcoma is much greater than in well-differentiated parosteal osteosarcoma, but slightly lower than the typical osteosarcoma. Parossale osteosarcomas require surgical en bloc resection, but no chemotherapy. In most cases, periosteal osteosarcoma are similar to conventional osteosarcoma chemotherapy and surgical en bloc resection treated. Fibrosarcoma fibrosarcoma exhibit similar characteristics as osteosarcomas, but produce fibrous tumor cells (rather than bone tumor cells), concern the same age group and face the same problems. Treatment and outcome in high-grade lesions are similar to osteosarcoma. Malignant fibrous histiocytoma Malignant fibrous histiocytoma is clinically osteosarcoma and fibrosarcoma similar, although this tumor was classified because of its different histology (no bones production of the tumor) in a group other than osteosarcoma. Malignant fibrous histiocytoma occur mostly in children and adolescents, but can occur as secondary lesions in bone infarcts and radiation fields also in older adults. Treatment and outcome are similar to conventional osteosarcoma. Chondrosarcoma chondrosarcoma tumors are malignant cartilage. They differ clinically, therapeutically and prognostically of osteosarcoma. 90% of chondrosarcoma are primary. Chondrosarcomas arise (for. Example, in the Ollier’s disease and in Maffucci syndrome) with other pre-existing conditions, in particular in multiple osteochondromas and in multiple Enchondromatosis. Chondrosarcoma occur mostly in older adults. They often develop in flat bones (eg. As pool, scapula), but can occur in each section of each bone and grow into the surrounding soft tissues. X-rays often show occasional calcifications. Primary chondrosarcoma offer as frequent destruction of the cortical bone and loss of normal trabecular bone structure. Secondary chondrosarcoma should be suspected if spotted calcifications occur or when an osteochondroma grows in size. The technetium bone scan is a useful screening tool. All cartilage lesions show an increased uptake in the scintigram, although chondrosarcomas have a particularly high absorption. For diagnosis, biopsy is required, which can also determine the grade of the tumor (v. A. Metastasis). Chondrosarcoma DU CANE MEDICAL IMAGING LTD / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: ‘/-/media/manual/professional/images/c0119574_chondrosarcoma_x-ray_science_photo_library_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/ – / media /manual/professional/images/c0119574_chondrosarcoma_x-ray_science_photo_library_high_de.jpg?la=de&thn=0 ‘, title:’ chondrosarcoma ‘description:’ ‘credits’ DU CANE MEDICAL IMAGING LTD / SCIENCE PHOTO LIBRARY’, hideCredits: false, hideTitle : false, hideFigure: false, hideDescription: true}; var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘image-element-panel.’). ko.applyBindings (model, panel.get (0)); Low grade chondrosarcoma (grade 1/2 or 1 degree) are often intralesionally (wide curettage) (often freezing with liquid nitrogen, argon projector, heat from methyl methacrylate, radio frequency or phenol) under addition of an adjuvant. In other tumors, there is a therapy in a total surgical resection. When the surgical resection with maintaining the function is not possible, amputation may be necessary. Because metastasis danger extreme care when performing a biopsy or surgery must prevail in order to prevent spreading of tumor cells in the soft tissue. If the tumor spread, a cure is unattainable. If it does not lead to scattering, the cure rate of tumor grade depends. Low-grade tumors have an almost complete cure rate for adequate therapy. Because these tumors have limited circulation, show chemotherapy and radiotherapy little effectiveness. Ewing’s sarcoma of the bone Ewing’s sarcoma of bone is a round cell tumor of bone disease with a peak between 10 and 25 years old. Most tumors develop in the extremities, but any bone can be affected. Ewing’s sarcoma tends to extensivem growth and sometimes affects the entire bone shaft, most commonly the diaphyseal region. Approximately 15-20% of the cases involve the metaphyseal region. Pain and swelling are common symptoms. Lytic destruction, in particular a permeatives infiltration pattern with no clear limit is the most common finding in imaging tests, but it can also cause multiple layers subperiosteal reactive new bone formation an onion-like aspect. X-rays did not reveal usually the full extent of bone involvement, and generally surrounds a large mass of soft tissue to bone affected. The MRI defines the disease extent best what can help in the treatment planning. Many other benign or malignant tumors may appear very similar so the diagnosis must be made by biopsy. Sometimes this type of tumor is mistaken for an infection. An accurate histological diagnosis can be achieved by molecular markers, including the clarification of a typical clonal chromosomal anomaly. Ewing’s sarcoma MARAZZI / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: ‘/-/media/manual/professional/images/m1340853_ewing_sarcoma_x-ray_science-photo-library-high_de.jpg?la=de&thn=0&mw=350’ imageUrl ‘ /-/media/manual/professional/images/m1340853_ewing_sarcoma_x-ray_science-photo-library-high_de.jpg?la=de&thn=0 ‘, title:’ Ewing’s sarcoma ‘description:’ u003Ca id = “v37892994 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDas Ewing’s sarcoma of the “”radial shaft “” indicates subperiosteal reactive new bone formation and a certain lytic destruction. u003c / p u003e u003c / div u003e ‘credits’ MARAZZI / SCIENCE PHOTO LIBRARY’


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