1. Re-written By: Daniel Habashi Surgical Treatment Of Neglected Cases Of Malignant Bone Tumors

2. Bone Tumors Primary malignant bone tumors are rare – only 6/mln/year Although rare, they are highly aggressive They all present with non-mechanical pain (like a toothache) followed later by swelling Delays in diagnosis are common Metastases are blood-borne and usually arise first in the lungs

3. Clinical Presentation Pain Swelling Oathological fracture

4. Radiological Features Bone destruction New bone formation Soft tissue swelling Periosteal elevation – CODMANS TRIANGLE

5. Aim of Surgery Surgical resection with margins Limited indications for amputation or disarticulation (amputation through the joint) Basically this means that when you have a tumor of the long- bone, you must remove the tumor as a whole, with a margin of 7-10cm. So at times it’s required to remove the whole bone

6. Enneking’s Criteria Histological subtype Grade Anatomical setting (intra or extra compartmental)