Orbital osteosarcoma
Introduction
Introduction to orbital osteosarcoma Osteosarcoma, also known as osteosarcoma, is the most common primary high-grade malignancy. Occurs in the metaphysis of long bones, the most common near the knee joint, rare in the tibia, but it is more commonly used as a kind of tibia after radiotherapy (especially after radiotherapy in patients with retinoblastoma) Secondary tumors. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: eyeballs
Cause
Causes of orbital osteosarcoma
Cause:
The etiology of the patient has not been known. The tendency of periorbital osteochondral sarcoma after radiotherapy in patients with retinoblastoma suggests that it is related to radioactive irradiation.
Pathogenesis
Osteogenic sarcoma may be derived from interstitial cells with bone differentiation ability, and there are more opportunities for osteosarcoma in bone Paget disease and bone fiber dysplasia.
Pathological examination: The gross specimen is brown-red, colorless, soft in texture, and may have bone fiber-like structure. The lesion is often not enveloped and quite strong, depending on the amount of new bone that has formed. Microscopically, there are malignant spindle-shaped cells with too deep stained nucleus and numerous mitotic patterns, and bone and new bone formation are obvious.
Prevention
Orbital osteosarcoma prevention
First, we must dare to face the reality. I know more about the life experience of "Cancer Shouxing" who suffers from long-term survival after cancer. I can see more and more popular science books that encourage people to fight disease and bad luck, and they will continue to add strength and enhance their spiritual security.
Second, work under the premise of the ability to do tai chi, qigong, walk and do some housework, watch TV programs, listen to the radio, chat with people, etc., will make the mood naturally easy and pleasant.
Third, as long as you can clearly understand that long-term extreme anxiety will disturb the psychological balance, leading to severe insomnia, affecting normal appetite and other various beneficial desires, causing physiological functions and energy metabolism disorders in the body. As long as you are optimistic about the reality and maintain a healthy and healthy state of mind, you will be able to gain tremendous strength and courage. It is beneficial to promote the recovery and improve the quality of life by defeating the pessimistic and disappointing "self".
Fourth, the prevention of osteosarcoma includes letting it become a thing in the past, without having to repent forever, and eagerly awaiting the future. The psychological balance can make you endless anti-cancer vitality and cherish your mental health.
Complication
Orbital osteosarcoma complications Complications
In rare cases, patients with osteosarcoma are associated with chronic bone diseases such as Paget's disease or dysplasia of bone fibers.
Symptom
Symptoms of orbital osteosarcoma Common symptoms Aging and relaxing eye bags and pain in the back of the eye... Peripheral venous reflux disorder Periorbital edema Retinal edema Eyeball transposition Conjunctival hyperemia Eyeball
Osteosarcoma, which occurs clinically in the long bones of the extremities, generally has three major symptoms of pain, swelling and dysfunction, with the most significant pain. When the soft tissue is invaded, the lumps may appear locally, and the skin may be irritated, and the skin temperature rises. The osteosarcoma of the eyelids is painful. The growth of the eye can push the eyeball displacement, which is difficult to distinguish from other tumors. The patients with orbital osteosarcoma have rapid onset, unilateral progressive eyeballs, eyeball displacement, pain, periorbital numbness, eyelids Edema and conjunctival hyperemia, when the tumor originates from the ethmoid or frontal bone, secondary to a sturdy, occluded and often visible mass that shifts the eye downward or laterally, while the tumor from the sphenoid wing produces only The eyeball is prominent and there is no lumps that can be reached.
The development of the disease course prompts the malignant lesion of the eyelid. The X-ray film shows obvious bone destruction or ossified plaque, and the outline is unclear. The CT scan has great value in the diagnosis of orbital osteosarcoma, which can show the bone change and the lesion invasion range. And soft tissue secondary changes, CT has more osteolytic changes and the characteristics of the coexistence of the tumor, B-mode ultrasound examination within the echo is uneven, irregular shape, may be accompanied by sound and shadow, CDI shows color blood flow within the lesion.
Examine
Examination of orbital osteosarcoma
Pathological examination: the gross specimen is brown-red, colorless, soft texture, which may have bone fiber-like structure, the lesion often has no capsule and is quite strong, depending on the amount of new bone formed, visible under the microscope The malignant spindle-shaped cells with too deep stained nucleus and numerous mitotic patterns have obvious bone and new bone formation. In many cases, the tumor stroma contains cartilage and fibroid-like components and numerous blood vessels, and the thin-walled sinusoidal space is in its cavity. It may contain cells. Osteogenic sarcoma may be derived from stromal cells with bone differentiation ability. There are more opportunities for osteosarcoma in bone Paget's disease and bone fiber dysplasia. The reason is unknown.
Pathologically, the main components of osteosarcoma are neoplastic osteoblasts, neoplastic bone-like tissue and tumor bone. Tumor cartilage and fibrosarcoma-like structures can be seen in some tumors. Osteogenic osteosarcoma is osteogenesis and hard as ivory. The osteolytic osteosarcoma is soft and prone to bleeding, and between the two types is a mixed osteosarcoma.
X-ray inspection
Orbital osteogenic osteosarcoma is characterized by localized osteosclerosis of the humerus, uneven density of the hardened area, accompanied by bone destruction, with patchy tumor bones visible, normal trabecular bone structure disappears, and cortical bone defects Incomplete, the edge of the lesion is clear, soft tissue mass is formed around the lesion, and there are also ivory-like, cotton-like tumor bone, needle-shaped tumor bone rare, osteolytic osteosarcoma tibia showing irregular osteolytic destruction, tumor bone Less, low density, no clear boundary between the damaged area and normal bone, no obvious swelling and deformation of the cortical bone, and rare periosteal reaction. The mixed osteosarcoma has both X-ray changes of osteogenic and osteolytic osteosarcoma.
2. CT scan
Long osteosarcoma can be clearly diagnosed by X-ray film, but the sacral osteosarcoma lacks characteristics. Typical tumor bone and periosteal reaction rarely occur, and it is difficult to distinguish other tumors of the tibia. It is difficult to diagnose X-ray suspicious bone destruction in the early stage of the disease. When determined, CT thin-layer scanning can confirm the presence or absence of bone destruction and clarify the extent of surrounding soft tissue infiltration. The typical manifestation of osteosarcoma is bone destruction of the humerus, bone structure disappears, and there may be flaky high-density tumor bone. The soft tissue mass is clear, the tumor can be invaded into the skull, the frontal lobe brain tissue is compressed, and the growth of the eyeball is invaded into the eyeball. The adjacent extraocular muscles often show unclear; the invading the maxillary sinus and even the upper alveolar bone.
3.MRI
The orbital bone is an irregular bone. The osteosarcoma of the humerus lacks the typical manifestation of long bone. It is generally characterized by local humeral deformation, and the normal bone signal disappears. According to the type of tumor pathology, the MRI signals are different, and the T1-weighted image is presented. The non-uniformity is low signal, the T2-weighted image has a high heterogeneity signal, the tumor edge is irregular, and the boundary with the normal bone is unclear, indicating that the tumor is invasively growing.
Diagnosis
Diagnosis and differentiation of orbital osteosarcoma
The identification of chondrosarcoma (chondrosarcoma) is that the disease extends from the sinus to the eyelids. In the early stage, it is often characterized by nasal symptoms. Later, the eyeballs will protrude, shift, and the imaging lesions will involve the sinus. The histological examination can clearly identify .
