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  • Chondrosarcoma
  • Ewing (or Ewing’s) sarcoma
  • Osteosarcoma

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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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  • 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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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 correlation4

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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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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
    • Nausea
    • Vomiting
    • Diarrhea
    • Alopecia
    • Mouth sores
    • Conjunctivitis
    • Ulcers
    • Leukopenia
    • Anemia
    • Thrombocytopenia
    • Headaches
    • Dizziness
    • Menstrual irregularities
    • Infertility
    • Peripheral neuropathies

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Functional Implications

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  • Loss of independence with ADLs, self-care, and locomotion in home ...

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