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  • Tumors Algorithm Massoud

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    Karamany
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    Tumors can be suspected based on x-ray findings including location (bone affected), content (osteogenic, chondrogenic, fibrous), and delineation (destruction, periosteal reaction). Further evaluation with CT and MRI of the whole limb may be needed if still suspect. Benign tumors may be treated with conservative methods like curettage while malignant tumors require a biopsy to guide further treatment such as chemotherapy, radiation therapy, or surgical resection depending on factors like metastasis and margins.

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    Tumors algorithms

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    Tumors_algorithm_Massoud

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    Tumors can be suspected based on x-ray findings including location (bone affected), content (osteogenic, chondrogenic, fibrous), and delineation (destruction, periosteal reaction). Further evaluation with CT and MRI of the whole limb may be needed if still suspect. Benign tumors may be treated with conservative methods like curettage while malignant tumors require a biopsy to guide further treatment such as chemotherapy, radiation therapy, or surgical resection depending on factors like metastasis and margins.

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    © All Rights Reserved
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    3 views3 pages

    Tumors Algorithm Massoud

    Uploaded by

    Karamany
    Tumors can be suspected based on x-ray findings including location (bone affected), content (osteogenic, chondrogenic, fibrous), and delineation (destruction, periosteal reaction). Further evaluation with CT and MRI of the whole limb may be needed if still suspect. Benign tumors may be treated with conservative methods like curettage while malignant tumors require a biopsy to guide further treatment such as chemotherapy, radiation therapy, or surgical resection depending on factors like metastasis and margins.

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    © All Rights Reserved
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    of 3

    Tumors algorithm

    Cap.Dr.Mahmoud Massoud, MD.

    Suspect tumors

    X ray
    A age

    <30 (a.e.i.o.u) ABC/Ewing/infection/ost.sac/UBC

    >30(MACRO) mets/adult lymphoma/ch.sarc/Round cell MM/ost.sarc

    B bone

    Which bone(sacrum chordoma/ hand chondroma/.....

    Which part

    Epiphysis (E=GC2)GCT ‫كبير‬/ch.blastoma‫طفل‬

    Central Eccentric
    Metaphysis (SEF) SBC/enchondroma/FD Ost.sar/ ch.sar
    Diaphysis (...)Ewing/MM/leukemia/lymphoma O.o/NoF/admantinoma
    C content matrix

    Osteogenic (flafy cotton)

    Chondrogenic (calcification)

    Fibrous ( ground glass)

    D delineation
    Detruction Periost.reaction
    Benign=Geographic benign=sclerotic
    Malignant = Malignant =
    Moth eaten/permeative Lamillated(onion beel)
    Speculated(sun burst)
    E extent

    Soft tissue infiltrates / BM/joint/ vasularity


    CT & MRI whole limb if still suspect & preop.
    Benign
    Latent
    Conserve/simple currtage
    Active
    Extended currtage

    Malignant Bone scan


    Single focus (do biopsy) Multiple foci (mets work up)
    Biopsy (guided us or CT) Mets work up....
    CT chest/abd/pelvis
    Tumor markers
    Fecal occult blood
    LN

    Mets
    Fixation according Mirel criteria
    Radio ttt palliative
    Chemottt
    Hormonal ttt

    Chemottt Radiottt Surgical resection


    REMO .....‫نقط‬ IM WRA
    Rabdomyosarc ....ewing/lymphoma/MM *Intra lesional
    Ewing Soft tissue sarcoma (intracaps) =benign
    Myloma Mets *Marginal (till pseudocaps)
    Ost.sar low grade maligant
    (Ch.sar/parosteal ost.s)
    *Wide ( +3 cm safty margin)
    High grade malignant
    (Ost.sar/Ewing )
    Limb salvage procedure ‫بشرط‬
    Not involving vasularity
    Adequate coverage skin/soft
    tissue
    *Radical/ Amputation

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