1. Musculoskeletal tumors
AIDS
Soft tissue tumors
Genetics
BENIGN
Malignant
Sarcoma
5700/Yr. USA

2. Soft tissue tumors Benign Malignant Painless lump in
Orthopedic practice
Connective tissues
Blood vessels
Clinically very similar to benign tumors
1% of adult malignancies
Benign
Malignant
Painless lump

3. Painless mass Malignant Benign 5 Cm. Size Location Mobility
Consistency
Microcirculatory status
X.Ray
Bone scan
C.T scan
M.R.I
Needle Bx.
Incisional Bx.
Excisional Bx.
5 Cm.

4. Surgical staging Benign Malignant Latent Intracompartmental I A Active
I-a:Local wide resection
Latent
Intracompartmental
Low grade I
I-b:Wide amputation A
Active
II-a:Local radical resection
High grade II
Aggressive
II-b:Radical amputation
Extracompartmental ?!
Chemotherapy B
With metastasis
III

5. Penetrating&infiltrating
Latent
Stopping growth
Lipoma
Simple excision
Active
Continuous growth
Fibroma
Marginal excision
Aggressive
Penetrating&infiltrating
Desmoid fibromatosis
Local wide or radical

6. High grade Low grade With metastasis ?! Chemotherapy
I-a:Local wide resection
II-a:Local radical resection
High grade
Low grade
I-b:Wide amputation
II-b:Radical amputation
With metastasis ?!
Chemotherapy

7. 1% of adult malignancies
Induction
Malignant tumors Of
Soft tissues
Never excisional
Chemotherapy
Needle or incisional
Bx.
1% of adult malignancies
Clinically very similar to benign tumors
MRI
Local wide resection
Local radical resection

8. eg. Rhabdomyosarcoma Neurofibroma Liposarcoma Fibroma Synovial srcoma
Lipoma
Fibrosarcoma
Hemangioma
Malignant fibrous histiocytosis
Desmoid fibromatosis

9. Interstitial tissue of a
Neurofibroma
Soft&circumscribed
Rounded
Slightly tender
Skin or deeper tissues
Interstitial tissue of a
periferal nerve
Solitary or Multiple
Spinal canal

10. Firm,Round, painless nodule
Fibroma
Uncommon in extremities
Never in deep tissues
Firm,Round, painless nodule
Usually connected with a fascia or apponeurotic structure

11. Fat&Connective tissue
Lipoma
Common
Almost any part
Usually subcutaneous
Soft,often large,lobulated,with thin capsule
Fat&Connective tissue
Local excision

12. Arterovenous malformation
75-90%
Hemangioma
7 Yr.
True Neoplasia
Birth
Cavernous
Capillary
Compressible
Hamartoma
Cosmetic
Thrombosis
Arterovenous malformation
Limb growth
Recurrence
Head & Neck
Wide resection
Surgery
Radiotherapy
Amputation

13. Desmoid fibromatosis
Young adult
Rare
Hard slow growing
Musculo-apponeurotic
Trunk&shoulder
Bx.”Fibro sarcoma
No metastasis
Local recurrence
Multicentric?!

14. Malignant fibrous histiocytosis Local recurrence&metastasis
Commonest in olders
Local recurrence&metastasis

15. Fibrosarcoma
Localized
Firm
Round mass
Deeper tissues
Neurofibromatosis
Pseudocapsule
Infiltrating
Early lung metastasis

16. Lung Lymph node Synovial srcoma Solid whitish fleshy mass
Insidious , but involving
Young or middle age adult
Wide resection AMPUTATION

17. Pleomorphic&Round cell
Liposarcoma
Rec
Met
Common
Deep tissues
Lobulated mass
Buttock&Thigh
Enormous size
Prognosis ?!!
Mixoid tissue
Radical excision
Pleomorphic&Round cell
Amputation

18. Children & young adults
Rhabdomyosarcoma
Rare
Children & young adults
Trunk
Lower limbs
Rapid growth
Early metastasis
lung