Tumor Board Discussion 19.07.24 of AIIMS Bhopal

tumour board discussion of AIIMS Bhopal on 19th July 2024, where a case is discussed in which a female meets with an accident and for 1 year doesn't take any treatment for the swelling in the head which developed after the accident. The patient is diagnosed as pagets disease on bone scan and blood work up but when operated, the post op biopsy showed as telangiectatic osteosarcoma

1. Tumor Board Discussion 19 / 07 /202 4

2. Age- 62Y Sex- Fem ale CR number- 2392 12400893917

3. c /o pain and swelling over left temporo-occipital region x 1year Consulted Gen Surgery Department in AIIMS Bhopal

4. Patient was apparently alright one year back when she had a motor vehicle accident in which there was injury to the head. Patient had severe pain but was not a/w vomiting, Loss of consciousness or seizures. Over the course of next one month patient had swelling over left temporo-occipital region, a/w moderate pain – not a/w discharge.

5. Patient did not seek medical attention immediately and took pain medications on and off. In AIIMS Bhopal further workup was done.

6. Blood Work up (22/6/24) Phosphate – 2.23 Total Calcium – 7.01 ALP – 1011.5 Albumin – 3.88

7. MRI Brain (26/06/24) There is diffuse thickening of inner and outer table of calvaria and widening of diploic spaces. Multiple patchy areas of sclerosis within the calvaria giving rise to cotton wool appearance. There is a well defined large expansile predominantly cystic lesion with multiple fluid – fluid levels and enhancing soft tissue component in parieto-occipital calvaria of size 7.9x8x8.3 cm with extra and intracranial extension.

8. Patient underwent near total excision of mass on 30/06/24.

9. Post op Biopsy s/o Telangiectatic osteosarcoma

10. Post op NCCT Brain

11. Further plan of management