referat osteosarcoma
DESCRIPTION
Referat OsteosarcomaTRANSCRIPT
![Page 1: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/1.jpg)
REFERAT “OSTEOSARCOMA”
Oleh:Ellen TrisnawatiEzzat Fajria Atsa
Ekawati ErprismanHafshah Sumayyah
Luthfah Aini
Pembimbing:dr. Nursanti , Sp. Rad
![Page 2: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/2.jpg)
PENDAHULUAN
• Osteosarkoma disebut juga osteogenik sarkoma adalah suatu neoplasma ganas yang berasal dari sel primitif (poorly differentiated cells) di daerah metafise tulang panjang pada anak-anak.
• Radiografi diperlukan untuk mengetahui lokasi dari lesi. Gambaran radiologinya adanya gambaran berupa sunburst atau sunray, radial spicules dan codman’s triangle, serta tanda-tanda lain dari kerusakan tulang.
![Page 3: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/3.jpg)
Epidemiologi
• Osteosarkoma 22% dari seluruh jenis tumor tulang.
• Kanker tulang ( osteosarkoma ) lebih sering menyerang kelompok usia 15 – 25 tahun (pada usia pertumbuhan).
• Etiologi masih belum jelas.• Lokasi osteosarkoma paling sering pada
metafisis, dimana area ini merupakan area pertumbuhan dari tulang panjang.
![Page 4: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/4.jpg)
Tumor Frequency %
Telangiectatic 3.5-11
Parosteal 3-4
Periosteal 1-2
Gnathic 6-9
Small cell 1
Intraosseous, low grade <1
Surface, high grade <1
Secondary 5-7
![Page 5: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/5.jpg)
Patofisiologi
![Page 6: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/6.jpg)
Gejala Klinis
• Nyeri dan/ atau pembengkakan ekstremitas yang terkena.
• Fraktur patologik.• Pembengkakan pada atau di atas tulang atau
persendian serta pergerakan yang terbata.• Teraba massa tulang dan peningkatan suhu kulit
di atas massa serta adanya pelebaran vena• Gejala-gejala penyakit metastatik meliputi nyeri
dada, batuk, demam, berat badan menurun dan malaise.
![Page 7: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/7.jpg)
Predileksi Osteosarcoma
![Page 8: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/8.jpg)
Klasifikasi
![Page 9: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/9.jpg)
Klasifikasi
• Osteosarkoma klasik.• Osteosarkoma hemoragi atau telangektasis• Parosteal osteosarkoma.• Periosteal osteosarkoma.• Osteosarkoma sekunder• Osteosarkoma intrameduler derajat rendah.• Osteosarkoma akibat radiasi.• Multifokal osteosarkoma.
![Page 10: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/10.jpg)
Stadium
![Page 11: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/11.jpg)
![Page 12: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/12.jpg)
Pemeriksaan Penunjang
• Laboratorium• Radiografi X-Ray, Ct-Scan, MRI, Ultrasound,
Nuclear Medicine• Patologi anatomi
![Page 13: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/13.jpg)
X-Ray
Perubahan periosteal berupa Codman triangles (white arrow) dan masa jaringan lunak yang luas (black arrow).
![Page 14: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/14.jpg)
X- Ray Osteosarcoma
Sunburst appearance pada osteosarkoma di femur distal
![Page 15: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/15.jpg)
Epitheloid Osteosarcoma
Telangiektasi Osteosarcoma
![Page 16: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/16.jpg)
Osteoblastoma like -
Condroblastoma like -
![Page 17: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/17.jpg)
Giant cell rich osteosarcoma
Osteosarcoma (fibrohistiocytic variant)
![Page 18: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/18.jpg)
Low-grade central osteosarcoma
Gnathic- Osteosarcoma
![Page 19: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/19.jpg)
Parosteal osteosarcoma
Multifocal osteosarcoma
Multifokal osteosarcoma
![Page 20: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/20.jpg)
Periosteal osteosarcoma
![Page 21: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/21.jpg)
Intracortical osteosarcoma.
High-grade surface osteosarcoma
![Page 22: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/22.jpg)
MRI
Gambaran MRI menunjukkan kortikal destruksi dan adanya massa jaringan lunak.
![Page 23: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/23.jpg)
Patologi Anatomi
Classic osteosarcoma in which there is abundant production of osteoid and bone matrix in a lacy pattern into which the malignant cells are incorporated. Because these sections usually are decalcified, the terms osteoid and immature bone are interchangeable, especially if the imaging studies do not reveal the precise biopsy site (H&E, ×250).
![Page 24: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/24.jpg)
Diagnosa banding
• 1. EwingÕs sarcoma• 2. Osteomyelitis• 3. Osteoblastoma• 4. Giant cell tumor• 5. Aneurysmal bone cyst• 6. Fibrous dysplasia
![Page 25: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/25.jpg)
Penatalaksanaan
• Kemoterapi• Pembedahan
![Page 26: Referat Osteosarcoma](https://reader030.vdocuments.site/reader030/viewer/2022012316/55cf9a28550346d033a0abe6/html5/thumbnails/26.jpg)
Daftar Pustaka– Salter, Robert B. Textbook of disorders and injuries of the musculoskeletal
system. 3rd ed.; 1999.p.400-3. Lippincott Williams & Wilkins : Philadeiphia.– Skinner, Harry B. Current diagnosis & treatment in orthopaedics. Lange
Medical Book. 3rd ed. 2003.p.312-8. McGraw-Hill : NewYork– Gebhardt, Mark C, Hornicek, Francis J. Osteosarcoma. Orthopaedic
knowledge update musculoskeletal tumors. American Academy of Orthopaedic Surgeons. 2002.p.175-82. 1st ed. McGraw-Hill: New York
– Reksoprodjo, Soelarto. Kumpulan kuliah ilmu bedah. 2008. Edisi 2. Hal.522-533. Binarupa Aksara : Tangerang.
– Tersedia di www.medicastore.com. Diakses 7 Juni 2010.– Tsuji Y, Kusuzaki K, Kanemitsu K, et al. Calcaneal osteosarcoma associated with
werner syndrome. The Journal of Bone and Joint Surgery 2000;82:9-12.– Bechler JR, Robertson WW, Meadows AT, Womer RB. Osteosarcoma as a
second malignant neoplasmin children. J Bone Joint Surg Am1992. 74:1079-83.