Chondrosarcoma diagnostic study of choice: Difference between revisions
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=== Study of choice === | === Study of choice === | ||
*Biopsy is the gold standard test for the diagnosis of chondrosarcoma. | |||
'''Technique''' | |||
*Open | |||
*Closed | |||
The | ===Open Technique=== | ||
*The tumor is surgically exposed and biospy of the tumor is taken. | |||
'''Incision''' | |||
*Longitudinal incision in the extremities is taken. | |||
*It should allow for extension of the incision for definitive management | |||
'''Approach''' | |||
* | *Never expose neurovascular structures. | ||
* | *During the biopsy, all tissue exposed is considered contaminated with tumor. | ||
*Meticulous hemostasis to be carried out. | |||
*Post-surgery hematomas are considered contaminated with tumor. | |||
*Always deflate the tourniquet prior to wound closure. | |||
'''Biopsy''' | |||
*Perform through the involved compartment of the tumor. | |||
*For bone lesions with a soft tissue mass, perform the biopsy using the soft tissue mass. | |||
'''Closure'' | |||
*If drain is kept, remove the drain out of the skin in line with surgical incision. | |||
*This helps in excising the drain site with definitive surgical extensile incision. | |||
===Closed Technique=== | |||
==== | |||
===== Diagnostic results ===== | ===== Diagnostic results ===== | ||
Line 71: | Line 43: | ||
===== Sequence of Diagnostic Studies ===== | ===== Sequence of Diagnostic Studies ===== | ||
The various investigations must be performed in the following order: | The various investigations must be performed in the following order: | ||
* | *X-ray | ||
* | *MRI | ||
*Biopsy | |||
===Enneking (MSTS) Staging System=== | ===Enneking (MSTS) Staging System=== |
Revision as of 15:16, 23 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Diagnostic Study of Choice
Study of choice
- Biopsy is the gold standard test for the diagnosis of chondrosarcoma.
Technique
- Open
- Closed
Open Technique
- The tumor is surgically exposed and biospy of the tumor is taken.
Incision
- Longitudinal incision in the extremities is taken.
- It should allow for extension of the incision for definitive management
Approach
- Never expose neurovascular structures.
- During the biopsy, all tissue exposed is considered contaminated with tumor.
- Meticulous hemostasis to be carried out.
- Post-surgery hematomas are considered contaminated with tumor.
- Always deflate the tourniquet prior to wound closure.
Biopsy
- Perform through the involved compartment of the tumor.
- For bone lesions with a soft tissue mass, perform the biopsy using the soft tissue mass.
'Closure
- If drain is kept, remove the drain out of the skin in line with surgical incision.
- This helps in excising the drain site with definitive surgical extensile incision.
Closed Technique
Diagnostic results
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
- [Finding 1]
- [Finding 2]
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
- X-ray
- MRI
- Biopsy
Enneking (MSTS) Staging System
- The Enneking surgical staging system (also known as the MSTS system) for malignant musculoskeletal tumors based on histological and radiographic characteristics of the tumor host margin.[1][2]
- It is widely accepted and routinely used staging system.
Stages | Grade | Site | Metastasis |
---|---|---|---|
IA | G1: Low grade | T1: Intracompartmental | M0: No metastasis |
IB | G1: Low grade | T2: Extracompartmental | M0: No metastasis |
IIA | G2: High grade | T1: Intracompartmental | M0: No metastasis |
IIB | G2: High grade | T2: Extracompartmental | M0: No metastasis |
III | G1 or G2 | T1 or T2 | M1: Regional or distant metastasis |
References
- ↑ Jawad MU, Scully SP (2010). "In brief: classifications in brief: enneking classification: benign and malignant tumors of the musculoskeletal system". Clin Orthop Relat Res. 468 (7): 2000–2. doi:10.1007/s11999-010-1315-7. PMC 2882012. PMID 20333492.
- ↑ Peabody, Terrance (2014). Orthopaedic oncology : primary and metastatic tumors of the skeletal system. Cham: Springer. ISBN 9783319073224.