Pemeriksaan Penunjang

Blood picture ESR (usually elevated high) Liver function (deranged if metastasis) Alkaline phosphatase (if bony origin can be due to increased bone destruction/increased bone turnover) Ca/PO4 (some tumors or metastases can have hypercalcemia) Tumor marker (PSA if metastases from prostate) Serum protein electrophoresis (monoclonal band in myeloma)

05/02/08
Blood count
Hb Ht Leko Trombo 11.2 33 12.900 244.000

PT INR APTT Kimia klinik

Natrium Kalium

13.4 1.08 29.1

142 4.6

SGOT SGPT Ureum Kreatinin GDS

35 29 30 0.95 124

Serum electrophoresis

Radiology
Pelvic X-Ray
Soft tissue shadow Bony erosion or pressure effect Calcification

Thorax
Assess for possible metastasis

CT scan
Assess area of destruction by tumor

MRI
Detect skip lesion Extent of bone malignancy Involvement of other bone compartment or neurovascular structure Helps to plan biopsy tract and resection plan

Biopsy
Frozen section
Adequacy and check margins

Closed aspiration
Cheap, no delay, few risk

Open biopsy
More material and absolute hemostasis

 FNAB massa a/r sacrum dx

Lesi malignan jenis chondrosarcoma

Biopsy sacral
Chondrosarcoma a/r sacral