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Condition/Disorder Synonyms

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  • Chondrosarcoma

  • Ewing (or Ewing's) sarcoma

  • Osteosarcoma

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ICD-9-CM Codes

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  • 170 Malignant neoplasm of bone and articular cartilage

  • 170.0 Malignant neoplasm of bones of skull and face except mandible

  • 170.1 Malignant neoplasm of mandible

  • 170.2 Malignant neoplasm of vertebral column excluding sacrum and coccyx

  • 170.3 Malignant neoplasm of ribs sternum and clavicle

  • 170.4 Malignant neoplasm of scapula and long bones of upper limb

  • 170.5 Malignant neoplasm of short bones of upper limb

  • 170.6 Malignant neoplasm of pelvic bones sacrum and coccyx

  • 170.7 Malignant neoplasm of long bones of lower limb

  • 170.8 Malignant neoplasm of short bones of lower limb

  • 170.9 Malignant neoplasm of bone and articular cartilage site unspecified

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ICD-10-CM Codes

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  • C40.00 Malignant neoplasm of scapula and long bones of unspecified upper limb

  • C40.10 Malignant neoplasm of short bones of unspecified upper limb

  • C40.20 Malignant neoplasm of long bones of unspecified lower limb

  • C40.30 Malignant neoplasm of short bones of unspecified lower limb

  • C41.0 Malignant neoplasm of bones of skull and face

  • C41.1 Malignant neoplasm of mandible

  • C41.2 Malignant neoplasm of vertebral column

  • C41.3 Malignant neoplasm of ribs, sternum and clavicle

  • C41.4 Malignant neoplasm of pelvic bones, sacrum and coccyx

  • C41.9 Malignant neoplasm of bone and articular cartilage, unspecified

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Preferred Practice Patterns

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Key Features

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Description

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  • Considered either osteoclastic or osteoblastic

  • Abnormal growth of cells within the bone

  • Can be either benign or malignant (cancerous)

  • Often spreads to bone from cancerous tumors in other areas

    • Breast

    • Kidney

    • Lung

    • Prostate

    • Thyroid

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Essentials of Diagnosis

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  • Some benign tumors have no symptoms until fracture

  • Malignant tumors

    • Bone pain at site, worse at night

    • Fracture from simple trauma or no trauma at all

    • Mass or swelling at site of tumor

    • Fracture through cortical bone

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General Considerations

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  • Gradual onset of signs and symptoms

  • Distal femur accounts for more than 40% of cases, with proximal tibia, proximal humerus, and mid and proximal femur following in frequency3

  • Clinical correlation 4

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Demographics

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  • 6th most common malignancy in childhood3

  • 3rd most common malignancy among adolescents3

  • Occurs at an earlier age in girls than boys, corresponding to growth spurt3

  • Ewing sarcoma most common in toddlers and young Caucasian males

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Clinical Findings

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Signs and Symptoms

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  • Bone pain: constant, not dependent on position or activity

  • Fractures

  • Swelling, localized

  • Fever3

  • Weight loss3

  • Presence of mass

  • Spontaneous pain from nerve-root irritation

  • Motor weakness

  • Muscle wasting

  • Lower or upper motor-neuron changes

  • Sensory changes

  • Hydrocephalus

  • Papilledema

  • Elevated intracranial pressure

  • Chemotherapy; side effects include ...

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