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christine-richard
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Musculoskeletal tumors
Soft tissue tumors
Painless lump
Benign Malignant
Soft tissue tumorsin
Orthopedic practice
Connective tissues Blood vessels
1% of adult malignancies
Clinically very similar to benign tumors
SizeLocationMobilityConsistencyMicrocirculatory status
X.RayBone scanC.T scanM.R.I
Needle Bx.Incisional Bx.Excisional Bx.
Low grade
High grade
With metastasis
I-a:Local wide resection
I-b:Wide amputation
II-a:Local radical resection
II-b:Radical amputation
?!Chemotherapy
Stopping growth
Continuous growth
Penetrating&infiltrating
Lipoma
Fibroma
Desmoid fibromatosis
Simple excision
Marginal excision
Local wide or radical
Low grade
I-a:Local wide resection
I-b:Wide amputation High gradeII-a:Local radical resection
II-b:Radical amputation
With metastasis?!
Chemotherapy
Malignant tumorsOf
Soft tissues 1% of adult malignancies
Clinically very similar to benign tumors MRI
Bx.
Needle or incisional
Never excisional
Local wide resectionLocal radical resection
Chemotherapy
Induction
Neurofibroma
Fibroma
Lipoma
Hemangioma
Desmoid fibromatosisMalignant fibrous histiocytosis
Fibrosarcoma
Synovial srcoma
Liposarcoma
Rhabdomyosarcoma
Neurofibroma
Soft&circumscribed
Rounded
Slightly tender
Skin or deeper tissues
Interstitial tissue of a periferal nerve
Solitary or Multiple
Spinal canal
Fibroma
Uncommon in extremities
Never in deep tissues
Firm,Round, painless nodule
Usually connected with a fascia or apponeurotic structure
Lipoma
Common
Almost any part
Usually subcutaneous
Soft,often large,lobulated,with thin capsule
Fat&Connective tissue
Local excision
HemangiomaBirth
CapillaryCavernous Compressible
Cosmetic Thrombosis
Limb growth
Surgery Radiotherapy
Amputation
True Neoplasia
Hamartoma
Arterovenous malformation
RecurrenceWide resection
75-90%
Desmoid fibromatosis
RareYoung adult
Hard slow growing
Musculo-apponeurotic
Trunk&shoulder
Bx.”Fibro sarcoma
No metastasis
Local recurrence
Multicentric?!
Malignant fibrous histiocytosis
Commonest in olders
Local recurrence&metastasis
Fibrosarcoma
Localized Firm Round mass
Deeper tissues Neurofibromatosis
Pseudocapsule Infiltrating
Early lung metastasis
Synovial srcoma
Solid whitish fleshy mass
Insidious , but involving
Young or middle age adult
Wide resection AMPUTATION
Liposarcoma
Common Deep tissues
Lobulated mass
Buttock&Thigh
Enormous size
Prognosis ?!!
Radical excision
Amputation
Pleomorphic&Round cell
Mixoid tissue
RecMet
Rhabdomyosarcoma
Rare
Children & young adults
Trunk Lower limbs
Rapid growth
Early metastasis lung