NEOPLASMA

OBJECTIVES:
1. To explain biocellular activity and pathology of
bone tumor
2. To understand the clinical and prevalence of bone
tumor
3. To assess bone tumor based on multidiciplin
4. Should be able early detection of bone tumor
5. To explain the principle and moran of bone
tumor management
 NEOPLASMA

BENIGN MALIGNANT
BONE TUMOR BONE TUMOR
NEOPLASMA ETIOLOGY

1. GENETIC
2. RADIATION
3. CHEMISTRY
4. TRAUMA
5. CHRONIC LYMPHEDEMA
6. INFECTION
 BONE TUMOR BASED ON AGE
AGE : 1 - 5 AGE : 6 - 18 AGE : 19 - 40 AGE: > 40

OSTEOMIELITIS Simple bone cyst Ewing sarcoma Metastasis

Metastatic neuro- Aneurysmal bone cyst Giant cell tumor Multiple myeloma
blastoma
Metastatic neuro- Nonossifying fibroma Osteosarcoma Fibrosarcoma
blastoma
Eosinophilic granu- Ewing sarcoma Malignant fibrous
loma histiocytoma
Simple bone cyst Osteomyelitis Chordoma

Osteosarcoma
Enchondroma
Chondroblastoma
Chondromyxoid-
fibroma
Osteoblastoma
Fibrous dysplasia
Osteofibrous
dysplasia
 BONE TUMOR
Asal Jaringan Benign/Jinak
1. Kartilago • Khondroblastoma
(umur 8 sampai maturitas,
jarang, lokasi di epifisis)
Khondromixoid fibroma
(adolescent, eccentric, metafisis,
tibia)
• Enkhondroma
(dewasa muda, jari, dan
metakarpal, speckled
calcification)
• Osteokhondroma
(Anak-anak atau teneeger,
cartilaginous cap on bony
stalk)
Malignant/Ganas
• Khondrosarcoma
(>40, lokasi pusat metafisis,
kalsifikasi
• Fibrosarcoma/ malignant
fibrous histiocytoma
(dewasa tua, metafisis,litik)
• Osteosarcoma
(dekade kedua, metafisis, tulang
panjang, mixed blastic dan lityc
area)
• Osteosarcoma sekunder
(asal peny. Paget atau irradiasi
tulang)
Catatan: asal tulang, kartilago, dan
jaringan fibrosa
 BONE TUMOR

Asal Benign/Jinak Malignant/Ganas

Jaringan
2. Tulang Osteoid osteoma
(anank-anak-anak dan
teneeger, nyeri di
malam hari dan
dengan dosis kecil
NSAIDs)
Osteoblastoma
(anak-anak, dewasa
muda, jarang, tulang
belakang)
 BONE TUMOR

Asal Benign/Jinak Malignant/Ganas

Jaringan
3. Elemen • Eosinophilic granuloma • Ewing sarcoma
sumsum (anak-anak muda, “hole in (dekade kedua, dapat
tulang/bo bone”) distimulasi oleh
ne marrow OSTEOMIELITIS, litic)
• Leukemia
(anak-anak muda, anggota
gerak, tulang belakang)
• Multiple myeloma atau
plasmacytoma
(umur > 40, tulang belakang
dan pelvis)
 BONE TUMOR

Asal Benign/Jinak Malignant/Ganas

Jaringan
4. Jaringan • Nonossifying fibroma
fibrosa (anak-anak dan teneeger,
metaphysis eccentric)
• Fibrous dysplasia
(umur 6 sampai maturitas,
diaphyseal, bony
deformity, limb
shortening)
 BONE TUMOR

Asal Benign/Jinak Malignant/Ganas

Jaringan
5. Tissue of • Aneurysmal bone cyst
uncer-tain (anak-anak dan teneeger,
origin metafisis, expansile)
• Giant cell tumor
(dewasa muda, epifisis dan
metafisis, eccentric dan
lytic)
• Simple bone cyst
(anak-anak dan teneeger,
metafisis, lytic)
 SYMPTOM AND SIGN OF BONE TUMOR

1. IDENTIFICATION OF SYMPTOM AND SYMPTOM:

Deep aching pain, pathologic fracture (osteoid osteoma) or
keluhan benjolan.
2. AGE PATIENT > 40: Metastasis tumor (paru-paru, payudara,
prostat, tiroid, and kidney
3. TUMOR IDENTIFICATION: Pain, location, mobilization,
ROM decreasing, limping, body weight decreasing, and
adenopathy.
4. RADIOGRAPHS DESCRIPTION:
Circumcribed/uncircumscribed, periostela elevation, Codman
triangle, calcification/blastic or lytic, eccentric/central
 HOW TO DIFFERENTIATE BENIGN
AND MALIGNANT BONE TUMOR

BENIGN MALIGNANT INTERMEDIATE

SLOW SPEED UP LOCAL INVASSIVE

CAPSULLATED INFILTRATIF A LITTLE BIT

METASTASIS

GOOD PROGNOSIS HEMATOGEN/LYMPH BASAL CELL

OGEN CARCINOMA

BAD PROGNOSIS
 BONE TUMOR DIAGNOSIS

1. BONE TUMOR COMPLAINT

2. PHYSICAL EXAMINATION: LOOK, FEEL,
AND MOVE
3. INVESTIGATION: RADIOGRAPHS AND
LABORATORIES DATA, FNAB (Fine Needle
Aspiration Biaopsy)
EARLY DETECTION
OF BONE TUMOR
 POPULASI

RISK
FACTOR
EARLY
DETECTION

BENIGN MALIGNANT

OBSEVATION HOSPITAL
Armis - 2010
 History

Physic. Add. Exam:

Tumor suspected
Exam. lab,& X-ray
Refer

Expert/Hosp.
(oncologic team)
History, physical BIOPSI
exam., lab. & X-
ASPIRASI
ray reevaluation

DIAGNOSIS

BENIGNA MALIGNA Second. tumor

Additional
Examination

THERAPY
Primary
tumor
Observation
Surgery
Non-surgery:
oDrugs
Armis 2004
oChemotherapy
oTerapi radiasi