Benign Orthopaedic Neoplasms
-
Upload
farry-doank -
Category
Documents
-
view
238 -
download
2
description
Transcript of Benign Orthopaedic Neoplasms
Benign Neoplasms of Musculoskeletal Tissues
dr. Farry
OSTEOMA
Osteoma
• Rare benign tumor that may appear on the surface of the skull or tibia
• X-ray well-demarcated area of radio-opaque
• No treatment is required unless the lesion presses on soft tissue
OSTEOCHONDROMA(OSTEOCARTILAGINOUS EXOSTOSIS)
Osteochondroma(Osteocartilaginous Exostosis)
• Abnormal growth direction and remodeling of bone and cartilage in the metaphyseal long bones of young children
• Most common– Distal femur– Proximal tibia– Proximal humerus
Osteochondroma(Osteocartilaginous Exostosis)
• Consists of normal bone capped with normal cartilage with its own epiphyseal plate
• Growth of the tumor persists until the growth of nearby epiphyseal plate ceases
• Types– Pedunculated (stalked) type
• Long with narrow base
– Sessile type• Short with broad base
Osteochondroma(Osteocartilaginous Exostosis)
• Symptoms– Painless lump– May interfere nearby
soft tissue/joint function
• Indication of excision– Cosmetic purpose– Interfering normal
function of the limb
OSTEOID OSTEOMA
Osteoid Osteoma
• A benign bone tumor that arises from osteoblasts
• Consists of small, round, uncalcified nidus which is surrounded by reactive bone
• Does not grow in size and tend to be <1cm
Osteoid Osteoma
• Incidence– Children/young adults– Boys > girls– Most common in femur
and tibia
• Symptoms– Dull pain that increases at
night
• X-ray– Radiolucent nidus
surrounded with radioopaque reactive bone
Osteoid Osteoma
• Treatment– Surgical excision of the
nidus and narrow margin of surrounding bone
– Percutaneous overdrilling, cauterization, laser coagulation, or crytherapy of the nidus
ENCHONDROMA
Enchondroma• A cartilage cyst within a bone
marrow which develops from local abnormal growth of chondrocyte from epiphyseal plate
• Most common in tubular bones of the hands and feet (metacarpal/metatarsal, phalanx)
• 2% will become chondrosarcoma
• Multiple enchondroma Ollier disease (enchondromatosis)
Enchondroma
• As the lesion grows bone is slowly absorbed from inner cortex and periosteal reactive bone deposited on the outer cortex the lesion expanded with thin cortex may become pathological fracture
• Symptoms– Painless lump– Pathological fracture pain
• X-ray– Lytic lesion with thin cortex
Enchondroma
• Treatment– Curretage with packing
of cancellous bone grafts at the residual cavity
NONOSSIFYING FIBROMA
Nonossifying Fibroma• A fibrous bone lesion that is usually
asymptomatic and discovered as an incidental finding on x-ray
• The most common benign bone tumor in children and adolescents
• Most common in long bones of lower limb
• Consists of collagen rich connective tissue, fibroblasts, histiocytes and osteoclasts which originates from epiphyseal plate
• Still not clear whether it is a true neoplasm or a developmental disorder of growing bone
Nonossifying Fibroma
• X-ray– Well marginated
radiolucent lesion, with a distinct multilocular appearance
• Self-limiting disease no treatment needed
Thank You