BONE TUMORS.pptx

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1. SALALE UNIVERSITY COLLEGE OF HEALTH SCIENCE POST GRADUATE PROGRAM IN AHN. PRESENTATION ON BONE TUMORS(BENIGN&MALIGNANT) SUBMIT TO: MR. TADELE.K ( ASS’T. PROFESSOR) SUBMIT BY : YORDANOS LEMMA ( BSC, MSC STUDENT) ID N O 195 SEP 2023 FITCHE BY . yordanos L 1

2. Presentation outline Introduction Type of bone tumor Etiology Pathophysiology Epidemiology Classification Clinical Manifestation Risk factors Diagnosis Management and prevention complication Summary Reference BY yordanos L ( MSc) 2

3. O bjective of Presentation To Understand : Definition of bone tumors ,risk factors. E tiology and classification of bone tumors. Their complications & their diagnoses. The different management/treatment Options/Techniques/prevention . BY yordanos L 3

4. D efinition of Bone T umor Bone tumors develop when cells within a bone divide uncontrollably, forming a lump or mass of abnormal tissue. A bone tumor is an abnormal growth of cells within a bone. Most bone tumors are benign (not cancerous). A bone tumor may be cancerous (malignant) or noncancerous ( benign). BY yordanos L 4

5. Types of bone Tumors BY Yordanos L 5

6. Benign Bone Tumors Benign bone tumors are bone tumors that are not cancerous. Most tumors that start in our bones are benign (not cancer ). This means that benign tumors will not spread from their original site to a new location. Tumors can form in any of the bones of your skeletal system and in any part of the bone. In general, the most common bones involved are also some of the largest: the femur, tibia, humerus, pelvis, spine and ribs. By yordanos L 6

7. cont.… BY yordanos .L 7 Some types of tumors are most common in specific locations, such as the spine or near the growth plates in your hip, knee or shoulder. How common are benign bone tumors? Benign bone tumors are most common in people who are under 30 years old. A large portion of benign bone tumors are found in children while their skeletons are still growing.

8. cont.… Many benign tumors actually stop growing once a child reaches skeletal maturity, which is the term used to describe the time at which bones stop growing in length. Skeletal maturity usually happens between the ages of 14 to 16 in girls and between the ages of 16 to 19 in boys. By yordanos L 8

9. The most common types of benign bone tumors Enchondroma : This type of tumor starts in the cartilage. These tumors are found inside the bone, in the marrow space. usually appears in bones of your hands and feet . It often has no symptoms . It’s the most common type of hand tumor. By yordanos L 9

10. cont.… By yordanos L 10 Osteochondroma : is a most common tumor that grows in our spine and long bones, mostly in young adults . This type of tumor is made up of cartilage and bone and can get bigger while the skeleton is growing. These tumors grow outside the bone.

11. cont.… Osteoid osteoma : This type of tumor usually affects the long bones of the body and is more common in males. It can cause significant pain at nighttime due to hormone interaction and can be relieved with non steroidal anti-inflammatory medications (NSAIDs). Chondroblastoma : This type of tumor is usually removed because its growth affects nearby joints. It’s found in children and can cause significant pain. By yordanos L 11

12. cont.… Osteo blastoma : This type of tumor is also more common in males. Treatment is almost always surgery. Periosteal chondroma : These tumors are made up of cartilage and are located on the surface of a bone. Treatment is almost always surgery . Giant cell tumor : These tumors, though rare, grow aggressively. Females are slightly more likely to develop giant cell tumors. Treatment is almost always surgery. By yordanos L 12

13. Etiology of benign bone tumors Bone tumors form when bone cells divide and grow out of control, forming a lump or a mass of cells. We don’t know why this happens in most cases. Benign bone tumors occur most often in children whose skeletons are still growing and people up to age 30. These tumors are often strongly affected by the hormones that cause growth. Many benign tumors stop growing once a child's bones do. By yordanos L 13

14. Pathophysiology of benign bone tumors Bone tumors develop when cells within a bone divide uncontrollably, forming a lump or mass of abnormal tissue. Most bone tumors are benign (not cancerous). Benign tumors are usually not life-threatening and, in most cases, will not spread to other parts of the body. BY Yordanos L 14

15. Epidemiology of bone tumors According to the analysis of the Surveillance, Epidemiology and End Results (SEER) Cancer Statistics Review of the National Cancer Institute, it is estimated that 2,810 men and women (1,620 men and 1,190 women) will be diagnosed with and 1,490 men and women will die of cancer of the bones and joints in 2011 (1). BY Yordanos L) 15

16. Cont.… Overall, bone sarcomas account for 0.2% of all malignancies diagnosed in the United States, and the age adjusted incidence rate for all bone and joint malignancies is 0.9 per 100,000 persons per year. The overall 5-year relative survival for 2001–2007 was 66.3% and the age-adjusted death rate based on patients who died in 2004–2008 in the US, was 0.4 per 100,000 men and women per year (1). BY Yordanos L 16

17. Clinical manifestation of benign bone tumors By yordanos L 17 An obvious swelling or lump. Pain, possibly severe, that increases in intensity. It may hurt even when you’re resting. Breaks or fractures due to bones made weaker by a growing bone tumor. In most cases, these tumors have no symptoms and are incidentally discovered on an X-ray obtained for an injury.

18. Risk Factors Children whose skeletons are still growing and people up to age 30. These tumors are often strongly affected by the hormones that cause growth. Many benign tumors stop growing once a child's bones do. BY Yordanos L 18

19. Diagnosis of benign bone tumors Imaging and tests : obtain X-rays. Different types of tumors exhibit different characteristics on X-ray. Some dissolve bone or make a hole in the bone. Some cause extra formation of bone. Some can result in a mixture of these findings. Some tumors have characteristic findings on X-rays. In other cases, it may be hard to tell what kind of tumor is involved. By yordanos L 19

20. cont .… You may need more imaging studies to further evaluate some tumors. These may include MRI (magnetic resonance imaging) or CT (computed tomography). You may also require blood and or urine tests . If these tests are not adequate to diagnose your tumor, you may require a biopsy. A biopsy involves removing a sample of tissue from the tumor. The tissue sample is examined under a microscope. There are two basic methods of doing a biopsy. By yordanos L 20

21. cont.… There are two basic methods of doing a biopsy . Needle biopsy : The doctor inserts a needle into the tumor to remove some tissue. This may be done while you are under local anesthesia. Or a radiologist may do it, using an X-ray machine or MRI scanner to help direct the needle to the tumor. By yordanos L 21

22. cont.… Open biopsy : The doctor uses surgery to remove tissue. This is generally done through a small incision while you are under general anesthesia in an operating room. BY yordanos L) 22

23. Management In many cases, benign tumors just need to be watched. Some can be treated effectively with medication. Some benign tumors will disappear over time; this is particularly true for some benign tumors that occur in children. By yordanos L 23

24. cont.… Some times removing the tumor (excision) or using other treatment techniques to reduce the risk of fracture and disability. Some tumors may come back–even repeatedly–after appropriate treatment. BY Yordanos L) 24

25. Non-pharmacological aspect J ust need to be watched Some benign tumors will disappear over time; this is particularly true for some benign tumors that occur in children . BY Yordanos L 25

26. P revention Don't use tobacco. ... Eat a healthy diet. ... Maintain a healthy weight and be physically active. ... Protect yourself from the sun. ... Get vaccinated. ... Eating citrus fruits such as lemons, limes, grapefruits and oranges has been associated with a lower risk of cancer in some studies. Avoid risky behaviors. ... Get regular medical care. By yordanos L 26

27. Malignant Bone Tumors Bone cancer is when unusual cells grow out of control in our bone. It destroys normal bone tissue. It may start in our bone or spread there from other parts of our body (called metastasis)& Bone cancer is rare . Malignant tumors can spread cancer cells throughout the body (metastasize ). BY yordanos L 27

28. cont.… • This happens via the blood or lymphatic system. Cancer that begins in bone (primary bone cancer) is different from cancer that begins somewhere else in the body and spreads to bone (secondary bone cancer). By yordanos L) 28

29. T ypes of malignant bone tumors Depend on the origins A , primary bone cancer(malignancy) & B , secondary bone cancer(malignancy) A, Primary bone cancer(malignancy) : Cancer that begins in bone . BY yordanos .L 29

30. The four most common types of primary bone cancer are : Multiple Myeloma : the most common primary bone cancer, is a malignant tumor of bone marrow. It affects approximately 20 people per million people each year Most cases are seen in patients aged 50 to 70 years old. Any bone can be involved. Osteosarcoma is the second most common bone cancer. It occurs in two or three new people per million people each year. By yordanos L 30

31. Cont.… Most cases occur in teenagers. Most tumors occur around the knee. Other common locations include the hip and shoulder. Ewing's sarcoma: most commonly occurs between age 5 and 20. The most common locations are the upper and lower leg, pelvis, upper arm and ribs. Chondrosarcoma : occurs most commonly in patients 40 to 70 years of age. Most cases occur around the hip and pelvis or shoulder. BY yordanos L 31

32. B , secondary bone cancer(malignancy) Cancer in our bones usually started else where in our body. For example, if lung cancer has spread to our bones, that's secondary bone cancer. Any cancer that moves from one part of our body to another is called metastatic cancer. Cancers that commonly spread to bone include: Breast cancer, Prostate cancer ,Lung cancer BY yordanos L 32

33. Etiology of malignant bone tumors The causes of malignant bone tumors aren't known. A few possible causes are genetics, radiation treatment, and injuries to the bones. Osteosarcoma has been linked to radiation treatment (particularly high doses of radiation) and other anticancer drugs, especially in children. However , a direct cause hasn't been identified. By yordanos L 33

34. Pathophysiology of malignant bone tumors Osteosarcomas arise from mesenchyme cells and are characterized by areas of abnormal bone growth . The various genetic, epigenetic, and environmental factors that drive mesenchyme stem cells to differentiate into bone precursor cells also play a role in the development of osteosarcoma. By yordanos L 34

35. E pidemologe of malignant bone tumor Overall, bone sarcomas account for 0.2% of all malignancies, and the adjusted incidence rate for all bone and joint malignancies is 0.9 per 100,000 persons per year, while the 5-year overall survival rate is 67.9%. Osteosarcoma is not a common cancer. Each year, about 1,000 new cases of osteosarcoma are diagnosed in the United States. About half of these are in children and teens. Most osteosarcomas occur in children, teens, and young adults between the ages of 10 and 30.8 octo 2020 BY yordanos L 35

36. Clinical manifestation of malignant bone tumors symptoms can include pain that: Is in the area of the tumor , dull or achy Gets worse with activity, Wakes us at night Other symptoms related to malignant bone tumors include: Fevers ,Night sweats Swelling around a bone , Limping Fatigue Weight loss BY yordanos L 36

37. Risk factors Genetics . Children with familial retinoblastoma , which is a type of eye cancer, have an increased risk of developing osteosarcoma. ... Previous radiation therapy. ... Chemotherapy for another cancer. ... Benign tumors or other bone conditions. BY Yordanos L) 37

38. Diagnosis of malignant bone tumors B ones through imaging tests such as: X-rays. These show tumors and how big they are. CT scans. A computer uses X-rays to make more detailed pictures. Bone scans . A technician injects a different radioactive material into our vein. It collects in our bones, where a scanner can see it . BY Yordanos L) 38

39. cont... It might also do blood tests to look for two enzymes that can be signs of blood cancer. MRI scans . These use a strong magnet to show inside our body. Biopsy can confirm a diagnosis. PET scans . A technician injects radioactive glucose (sugar) into our vein. A scanner then spots cancer cells, which use more glucose than regular cells. BY yordanos .L 39

40. Common Management of malignant bone tumor Limb salvage surgery . Your doctor removes the part of the bone with cancer but not nearby muscles, tendons, or other tissues. They put a metallic implant in place of the bone. Amputation. If a tumor is large or reaches our nerves and blood vessels, our doctor might remove the limb. You may get a prosthetic limb afterward . BY Yordanos L) 40

41. Cont.… Radiation therapy . This kills cancer cells and shrinks tumors with strong X-rays. Doctors often use it along with surgery. Chemotherapy . This kills tumor cells with cancer drugs. Your doctor might use it before surgery, after surgery, or for metastatic cancer. Targeted therapy . This drug treatment targets certain genetic, protein, or other changes in or around cancer. BY yordanos L 41

42. Prevention Early detection offers the best chance To identify risk factors BY yordanos L 42

43. complication The major skeletal complications associated with bone metastases include; Cancer-induced pain, Hyperkalemia, pathological bone fracture , disability. metastatic epidural spinal cord compression and other organs. ,cancer cachexia then death. BY Yordanos L 43

44. Nursing care plan Imbalanced nutrition , less than body requirement, related to sever pain Anxiety related to impending surgery and diagnosis of cancer Pain related to tumor mass BY Yordnos L 44

45. Nursing management Maintaining optimal nutrition Providing emotional support Relieving pain Monitoring and managing complication BY Yordanos L 45

46. Summary Bone cancer treatments can cause problems over time with our heart, lungs, brain, hearing, bones, or fertility. Your recovery from bone cancer depends on its type and stage. Overall, more than 78% of people who have it live at least 5 years after diagnosis. T hey have a major impact on the life of patients and their families . By yordanos L 46

47. References 1.http ://seer.cancer.gov/csr/1975_2008/results_single/sect_01_table.01.pdf 2. http://www.registri-tumori.it/cms/?q=sede_osso 3. Hauben EI, Arends J, Vandenbroucke JP, et al. Multiple primary malignancies in osteosarcoma patients. Incidence and predictive value of osteosarcoma subtype for cancer syndromes related with osteosarcoma. Eur J Hum Genet. 2003;11:611–8. [PubMed] [Google Scholar] By yordanos L 47

48. cont.… 4. Hameetman L, Bovée JV, Taminiau AH, et al. Multiple osteochondromas: clinicopathological and genetic spectrum and suggestions for clinical management. Hered Cancer Clin Pract. 2004;2:161–73. [PMC free article] [PubMed] [Google Scholar BY Yordanos L) 48

49. Thank you!!! 49 BY yordanos .L