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Oncologie Curs 3

Oncologie Curs 3

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Published by Lorena Igna

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Categories:Types, Research
Published by: Lorena Igna on Feb 09, 2011
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03/27/2014

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4.

TUMORILE OSOASE
4.1.Clasificare A.Osteosarcom B.Familia tumorilor Ewing C.Condrosarcom D.Histiocitom fibros malign E.Alte: fibrosarcom, limfom, hemangiopericitom 90% osteosarcom i sarcom Ewing

4.2.Defini ii 4.2.1.Osteosarcomul:tu malign , cu celule fuziforme,cu provenien din esut mezenchimal, celulele tumorale produc intens esut osteoid sau osos 4.2.2.Sarcom Ewing: tu.malign cu celule mici,rotunde, albastre, cu provenien incert (neural ?) Familia tumorilor Ewing: s.Ewing tipic,s.Ewing atipic, PPNET

4.3.Tabloul clinic -durere: progresiv -tumefac ie local , cu sensibilitate, circula ie venoas accentuat , c ldur local , impoten a func ional -fenomene generale: febr , paloare, sc dere în greutate -semne legate de metastaze:tuse Localiz ri predominante: Osteosarcom. 80% membre (predominant m.inf) S.Ewing:53% membre, 47% axial

4.4.Diagnostic
4.4.1.Imagistic 1.Osteosarcom: distruc ii osoase, formare de os nou, ridicarea periostului 2.S.Ewing:distruc ii osoase, lamela ia periostului

4.4.2.Histologie 1.Osteosarcom:celule fuziforme, producere intens de os i esut osteoid 2.Sarcom Ewing:abunden de celule mici, rotunde, albastre (Vimentin+NSE±) 4.4.3.Investiga ii pentru standardizare 4.5.Diagnostic diferen ial:osteomielit , tu.benigne PPNET, neuroblastom

4.6.Tratament
4.6.1.Osteosarcom ‡ chimioterapie:DOXO, MTX, IFO, CIS, CARBO, ETO ‡Chirurgie

4.6.2.Ewing ‡chimioterapie:VCR, ADR, CYC,ACT-D, IFO,ETO ‡chirurgie ‡Radioterapie

4.7.Evolu ie, prognostic

5.TUMORA WILMS
5.1.Generalit i -deriv din metanefros -inciden maxim la 1-4 ani (63%), 10% bilaterale -delec ia 11 p.13, asocieri malformative frecvente

5.2.Tablou clinic
-dureri abdominale -tu.abdominal :dezvoltare anterioar ,în ax craniocaudal, contact lombar -HTA -hematurie -subfebrilit i

5.3.Diagnostic
5.3.1.Imagistic :US, CT abdominal 5.3.2.Histologie:asociere a trei componente celulare ‡Blastematoas ‡Epitelial (tip glomerulo-tubular) ‡Mezenchimal (mu chi, os, cartilagiu) 5.3.3.Alte investiga ii:pt.gradul de extensie i dg.diferen ial

5.4.Dg.diferen ial
-afec iuni renale netumorale:hidronefroz -tumori renale benigne:chiste, teratoame -tumori renale maligne:adenocarcinom, tumori rabdoide, sarcom cu celule clare -tumori extrarenale:neuroblastom, limfom

5.5.Tratament
-chimioterapie:VCR, ADR, ACT-D, CARBO, IFO ‡preoperatiorie ‡postoperatorie -chirurgie -radioterapie

5.6.Evolu ie, prognostic

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