Abstract | Primarni maligni tumori kostiju su rijetki tumori koji čine manje od 1% svih malignih bolesti. Neki od najčešćih tumora su multipli mijelom, osteosarkom, hondrosarkom i Ewingov sarkom. Osteosarkomi i Ewingov sarkomi su tipični maligniteti adolescenata i mladih, dok se mijelom i hondrosarkom češće javljaju u starijih pacijenata.
Sama etiologija ovih tumora je nepoznata, iako se izloženost zračenju, kemoterapija i nasljedni sindromi spominju kao mogući etiološki čimbenici.
Benigni tumori kostiju su, s druge strane, relativno česti te su, dok ne dođe do ozljede, asimptomatski. Najčešće se javljaju u mlađoj životnoj dobi te su osteohondromi, gigantocelularni tumori, osteoblastomi i osteoid osteomi najčešći predstavnici.
U ovom diplomskom radu bit će predstavljena najnovija klasifikacija Svjetske zdravstvene organizacije za koštane tumore te ukratko opisane specifičnosti pojedinačnih tumora kako bi se, u konačnici, mogle predstaviti radiološke karakteristike i osobitosti koštanih tumora kao i najnovije terapijske metode.
Poseban naglasak stavljen je na razlikovanje benignih i malignih koštanih tumora pomoću određenih radioloških značajki- izgled rubova, periostalna reakcija, kortikalna ekspanzija i širenje u meka tkiva. Uz to, će biti spomenuti klasifikacijski sustavi za određivanje stadija tumora kostiju kao i njihova učestalost ovisno o dobi i lokaciji. Također će biti iznesene i radiološke osobitosti pojedinih benignih i malignih koštanih tumora te određene patognomične nalaze. Nadalje će slijediti rasprava o terapiji koštanih tumora.
U konačnici će se raspravljati o kurativnim i palijativnim metodama interventne radiologije- cementoplastici, alkoholnu ablaciji, termalnu ablaciji, te različitim indikacijama i kontraindikacijama za iste. |
Abstract (english) | Primary malignant bone tumors are rare tumors that account for less than 1% of all malignant tumors. Some of the most common types are multiple myeloma, osteosarcoma, chondrosarcoma, and Ewing sarcoma. Osteosarcoma and Ewing sarcoma can be seen more often in adolescents and young adults, while multiple myeloma and chondrosarcoma are more common in older patients.
The etiology of these tumors is unknown; however radiation exposure, chemotherapy and syndromes are considered to be possible ethological factors.
Benign bone tumors are, on the other hand, relatively common, and remain asymptomatic until their presence is indicated by an injury. They are more common in young age and the most common types are: osteochondromas, giant cell tumors, osteoblastomas and osteoid osteomas.
In this final paper the newest World Health Organization Classification that concerns bone tumors will be presented and a short description of distinct features of individual tumors will be provided to, finally, discuss radiological characteristics and features of bone tumors, as well as the newest therapy methods.
Special emphasis is placed on differentiating between benign and malignant bone lesions with the help of specific radiological findings – margins, periosteal reaction, cortical expansion, and expansion into soft tissues. Additionally, the newest staging systems and their incidence regarding age and location will be presented. Next, specific radiological findings of benign and malignant bone tumors as well as pathognomonic findings will be presented. Furthermore, therapy of bone tumors will also be shortly discussed.
In the end, several curative and palliative methods of interventional radiology will be talked about- cementoplasty, alcohol ablation and thermal ablation, as well as indications and contraindication for the same. |