Osteosarcoma
小结
定义
病史和体格检查
关键诊断因素
- childhood and adolescence
- worsening pain over weeks to months
- mass/swelling
- male sex
其他诊断因素
- race/ethnicity
- tall stature
- high birthweight
- limp
- history of trauma
- limited range of motion
危险因素
- childhood and adolescence
- Paget disease
- radiation therapy
- Rothmund-Thomson syndrome
- familial retinoblastoma syndrome
- Li-Fraumeni syndrome
- race/ethnicity
- nonfamilial deleterious germline variants
- male sex
- tall stature
- high birthweight
- chemotherapy exposure
诊断性检查
首要检查
- conventional radiographs
- bone biopsy
- MRI
- CT
- CT thorax
- bone scan
- whole body fluorodeoxyglucose (FDG)-PET/CT
- CBC
- serum alkaline phosphatase
- serum lactate dehydrogenase
治疗流程
low-grade disease at presentation
high-grade nonmetastatic disease at presentation
metastatic disease at presentation
relapsed/refractory disease
撰稿人
作者
David Loeb, MD, PhD
Chief
Division of Pediatric Hematology, Oncology, and Marrow & Blood Cell Transplantation
Children's Hospital at Montefiore
Associate Professor, Pediatrics
Associate Professor, Developmental and Molecular Biology
Albert Einstein College of Medicine
Bronx
NY
利益声明
DL declares that he has no competing interests.
鸣谢
Dr David Loeb would like to gratefully acknowledge Dr Luminita Rezeanu and Dr Michael J. Klein, the previous contributors to this topic.
利益声明
LR and MJK declare that they have no competing interests.
同行评议者
Edward Sauter, MD, PhD
Professor of Surgery
Ellis Fischel Cancer Center
University of Missouri
Columbia
MO
利益声明
ES declares that he has no competing interests.
Rachael Windsor, BSc, MBBS, MSc, MRCPCH
Locum Consultant Paediatric Oncologist
University College Hospital
London
UK
利益声明
RW declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours: WHO classification of tumours. 5th ed. vol 3. Lyon, France: IARD Press; 2020
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: bone cancer [internet publication].全文
Strauss SJ, Frezza AM, Abecassis N, et al. Bone sarcomas: ESMO-EURACAN-GENTURIS-ERN PaedCan Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2021 Dec;32(12):1520-36.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Ewing sarcoma
- Chondrosarcoma
- Malignant fibrous histiocytoma
更多 鉴别诊断指南
- NCCN clinical practice guidelines in oncology: bone cancer
- ACR appropriateness criteria: suspected primary bone tumors
更多 指南
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