1. NEOPLASMA OBJECTIVES:
To explain biocellular activity and pathology of bone tumor
To understand the clinical and prevalence of bone tumor
To assess bone tumor based on multidiciplin
Should be able early detection of bone tumor
To explain the principle and moran of bone tumor management
Objektif pembelajaran neoplasma…………..

2. NEOPLASMA
BENIGN
BONE TUMOR
MALIGNANT
BONE TUMOR

3. NEOPLASMA ETIOLOGY GENETIC RADIATION CHEMISTRY TRAUMA
CHRONIC LYMPHEDEMA
INFECTION

4. BONE TUMOR BASED ON AGE OSTEOMIELITIS Simple bone cyst Ewing sarcoma
Metastasis
Metastatic neuro-blastoma
Aneurysmal bone cyst
Giant cell tumor
Multiple myeloma
Nonossifying fibroma
Osteosarcoma
Fibrosarcoma
Eosinophilic granu-loma
Malignant fibrous histiocytoma
Osteomyelitis
Chordoma
Enchondroma
Chondroblastoma
Chondromyxoid-fibroma
Osteoblastoma
Fibrous dysplasia
Osteofibrous dysplasia

5. BONE TUMOR Asal Jaringan Benign/Jinak Malignant/Ganas 1. Kartilago
Khondroblastoma
(umur 8 sampai maturitas, jarang, lokasi di epifisis)
Khondromixoid fibroma
(adolescent, eccentric, metafisis, tibia)
Enkhondroma
(dewasa muda, jari, dan metakarpal, speckled calcification)
Osteokhondroma
(Anak-anak atau teneeger, cartilaginous cap on bony stalk)
Khondrosarcoma
(>40, lokasi pusat metafisis, kalsifikasi
Fibrosarcoma/ malignant fibrous histiocytoma
(dewasa tua, metafisis,litik)
Osteosarcoma
(dekade kedua, metafisis, tulang panjang, mixed blastic dan lityc area)
Osteosarcoma sekunder
(asal peny. Paget atau irradiasi tulang)
Catatan: asal tulang, kartilago, dan jaringan fibrosa

6. BONE TUMOR Asal Jaringan Benign/Jinak Malignant/Ganas 2. Tulang
Osteoid osteoma
(anank-anak-anak dan teneeger, nyeri di malam hari dan dengan dosis kecil NSAIDs)
Osteoblastoma
(anak-anak, dewasa muda, jarang, tulang belakang)

7. BONE TUMOR Asal Jaringan Benign/Jinak Malignant/Ganas
3. Elemen sumsum tulang/bone marrow
Eosinophilic granuloma
(anak-anak muda, “hole in bone”)
Ewing sarcoma
(dekade kedua, dapat distimulasi oleh OSTEOMIELITIS, litic)
Leukemia
(anak-anak muda, anggota gerak, tulang belakang)
Multiple myeloma atau plasmacytoma
(umur > 40, tulang belakang dan pelvis)

8. BONE TUMOR Asal Jaringan Benign/Jinak Malignant/Ganas
4. Jaringan fibrosa
Nonossifying fibroma
(anak-anak dan teneeger, metaphysis eccentric)
Fibrous dysplasia
(umur 6 sampai maturitas, diaphyseal, bony deformity, limb shortening)

9. BONE TUMOR Asal Jaringan Benign/Jinak Malignant/Ganas
5. Tissue of uncer-tain origin
Aneurysmal bone cyst
(anak-anak dan teneeger, metafisis, expansile)
Giant cell tumor
(dewasa muda, epifisis dan metafisis, eccentric dan lytic)
Simple bone cyst
(anak-anak dan teneeger, metafisis, lytic)

10. SYMPTOM AND SIGN OF BONE TUMOR
IDENTIFICATION OF SYMPTOM AND SYMPTOM: Deep aching pain, pathologic fracture (osteoid osteoma) or keluhan benjolan.
AGE PATIENT > 40: Metastasis tumor (paru-paru, payudara, prostat, tiroid, and kidney
TUMOR IDENTIFICATION: Pain, location, mobilization, ROM decreasing, limping, body weight decreasing, and adenopathy.
RADIOGRAPHS DESCRIPTION: Circumcribed/uncircumscribed, periostela elevation, Codman triangle, calcification/blastic or lytic, eccentric/central

11. HOW TO DIFFERENTIATE BENIGN AND MALIGNANT BONE TUMOR
INTERMEDIATE
SLOW
SPEED UP
LOCAL INVASSIVE
CAPSULLATED
INFILTRATIF
A LITTLE BIT METASTASIS
GOOD PROGNOSIS
HEMATOGEN/LYMPHOGEN
BASAL CELL CARCINOMA
BAD PROGNOSIS

12. BONE TUMOR DIAGNOSIS BONE TUMOR COMPLAINT
PHYSICAL EXAMINATION: LOOK, FEEL, AND MOVE
INVESTIGATION: RADIOGRAPHS AND LABORATORIES DATA, FNAB (Fine Needle Aspiration Biaopsy)

13. EARLY DETECTION OF BONE TUMOR

14. BENIGN POPULASI HOSPITAL OBSEVATION RISK FACTOR EARLY DETECTION
MALIGNANT
BENIGN
HOSPITAL
OBSEVATION
RISK
FACTOR
Armis

15. A B History Physic. Exam. Add. Exam: lab,& X-ray Tumor suspected
Observation
Surgery
Non-surgery:
Drugs
Chemotherapy
Terapi radiasi
History
Physic. Exam.
Add. Exam: lab,& X-ray
Tumor suspected
Expert/Hosp.
(oncologic team)
BIOPSI
ASPIRASI
DIAGNOSIS
BENIGNA
MALIGNA
Second. tumor
THERAPY
Primary tumor
Additional Examination
Refer
History, physical exam., lab. & X-ray reevaluation
Armis 2004 A B