musculoskeletal tumors soft tissue tumors painless lump benignmalignant soft tissue tumors in...

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