Bone Tumors

A mass of unusual cells growing in a bone.
Most bone tumors aren't cancerous.

1. Bone Tumor Presented by : BSc Nursing 2 nd Year Royal School of Nursing

2. Table of Contents 01 Definition 02 Types of Tumor 03 E tiology 04 Risk Factors 05 Clinical Manifestation 06 Pathophysiology 07 Diagnostic Evaluation 08 Management 09 Complications 10 Prevention

3. INTRODUCTION A bone tumor refers to a lump or mass of tissue that forms when the cells divide uncontrollably. A growing tumor may replace healthy tissue with abnormal tissue. It may weaken the bone, causing it to break (fracture).

4. DEFINITION A bone tumor is an abnormal growth of cells within the bone that may be non cancerous (benign) or cancerous (malignant).

5. TYPES OF BONE TUMOR Benign Malignant Bone forming/ Osteoblastic Osteoma Osteoid Osteoma Osteoblastoma Osteosarcoma Cartilage forming Enchondroma Osteocondroma Chondroblastoma Chondrosarcoma Hemtopoietic -- Myeloma Lymphoma Unknown Giant cell tumor Malignant giant cell tumor Ewing’s Sarcoma Notochordal -- Chordoma

6. ETIOLOGY Few possible causes are genetics, radiation treatment and injuries to the bone. Osteosarcoma has been linked to radiation treatment and other anticancer drugs, especially in children. The tumour often occur when parts of the body are growing rapidly.

7. RISK FACTORS Genetic Disorders Retinoblastoma Paget Disease Radiation exposure Bone marrow transplantation Injuries

8. Clinical Manifestations Cardinal symptoms: Pain, swelling and general discomfort Limited mobility and spontaneous fracture may also be important feature. Other symptoms: Fever and night sweats Painless mass or obvious bone growth Varying degree of disability, weight loss, malaise.

9. With spinal metastasis spinal cord compression may occur. Neurologic deficit: e.g. Progressive pain, weakness, gait abnormality, paresthesia, paraplegia, urinary retention, loss of bowel and bladder control

10. PATHOPHYSIOLOGY A tumor in the bone causes the normal bone tissue to react by osteolytic response (bone destruction) or osteoblastic response (bone formation). Adjacent normal bone responds to the tumor by altering it’s normal pattern of remodeling .

11. The bone’s surface changes and the contours enlarge in the tumor area. Malignant bone tumor invade and destroy adjacent bone tissue. Benign bone tumors , in contrast, have a symmetric, controlled growth pattern and place pressure on adjacent bone tissue. Malignant bone tumors invade and weaken the structure of the bone until it can no longer withstand the stress of ordinary use; pathologic fracture commonly results.

12. Assessment and Diagnosis The differential diagnosis is based on history, physical examination and diagnostic studies. Age: It is useful information before age of 5, a malignant tumor is often metastatic neuroblastoma; between 5 and 15 years old, osteosarcoma or Ewing Sarcoma; and after 40 years, metastasis or myeloma.

13. X-rays: Can show the location, size, and shape of a bone tumor. C hest x-rays are performed to determine presence of lung metastasis. DIAGNOSTIC STUDIES

14. A Bone Scan: A test in which a small amount of radioactive material is injected into a blood vessel and through the bloodstream; in the collects in the bones and is directed by a scanner.

15. A Magnetic Resonance Imaging: Which uses a powerful magnet linked to a computer to create detailed pictures of areas inside the body without using x-rays.

16. MANAGEMENT Chemotherapy Radiation therapy Surgical therapy Targeted therapy Other treatments Nursing management

17. CHEMOTHERAPY Use of anticancer drugs to kill cancer cells. Usually received in combination. Most commonly used drugs: Doxorubicin (40-60 mg/m2) Cisplatin (75-100 mg/m2) Carboplation Ifosfamide (1.2 g/m2) Cyclophosphamide (10-15 mg/kg iv; 1-5 mg/kg oral) Methotrexate (oral/iv) Vincristine (1.4mg/m2)

18. Radiation therapy

19. Surgical Management

20. Amputation

21. Reconstructive Surgery

22. Comp lications Delayed wound healing. Nutritional deficiency. Infection Hypercalcemia 5. Muscle wasting, bone wreaking 6. Pathological fracture 7. Temporary burn to the skin and fatigue from radiation therapy

23. Prevention Individual need to be aware of their genes for any history of cancer and other risks that may influence their medical condition. Keeping a healthy and nutritious diet is vital to keep a fit body that is robust enough to combat unnecessary complications. Early diagnosis is key for effective treatment before mestasis. Consulting a doctor for screening and detection before the onset of a more damaging stage is essential.

24. Reference Brunner and Suddharth Textbook of Medical – Surgical Nursing Volume (II) 13 th Edition. Slideshare Bone Tumor

25. Thank You