Download Free Medical Referral and Assessment For Suspected Soft Tissue and Bone Sarcomas PowerPoint Presentation

Referral and Assessment For Suspected Soft Tissue and Bone Sarcomas PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical PowerPoint presentation titled "Referral & Assessment for Suspected Soft Tissue & Bone Sarcomas" by Amit Kumar.

This medical PowerPoint presentation is about soft tissue or bone sarcoma and the requirement for prompt referral and assessment for treatment. When a patient is suspected to have a soft tissue or bone sarcoma, a prompt and thorough referral and assessment is necessary for accurate diagnosis and effective treatment.

Tags : Soft Tissue sarcoma, Bone Sarcoma, Orthopaedic Surgery, Orthopaedic Surgery PowerPoint presentation

Published on : Jun 23, 2023 | Views : 1309 | Downloads : 0

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Referral & Assessment for Suspected Soft Tissue & Bone Sarcomas Amit Kumar 12th October 2019 Greater Manchester Cancer
Slide 2-

Aims Greater Manchester Cancer Increase awareness of MSK tumours Appropriately manage a patient with a concerning lump / suspected bone tumour
Slide 3-

Objectives Greater Manchester Cancer Background Symptoms & Signs Clinical assessment Initial Management Referral Criteria
Slide 4-

Must Read Greater Manchester Cancer NICE Sarcoma Guidelines Familiarity with 2WW local referral form Sarcoma UK Bone Cancer Research UK
Slide 5-

Introduction Greater Manchester Cancer A rare type of cancer arising from mesenchymal/connective tissue Soft Tissue, Bone or GIST 1% of all primary cancer Approx 5300 per year (15/day) 100 different sub-types. 5 year survival rate for sarcoma is 55%
Slide 6-

Sarcoma Greater Manchester Cancer 40-60 years, young adults, children No significant aetiology Associations: HIV / Kaposis, Neurofibromatosis, other cancers – 2nd hit hypothesis 50% extremities: LL > UL Other: Retroperitoneal, Chest, Gynae, Breast
Slide 7-

World Health Organization classification of tumours Tumours are classified by differentiation and biological behaviour. Adipocytic tumours Fibroblastic/myofibroblastic tumours So-called fibrohistiocytic tumours Smooth-muscle tumours Skeletal muscle tumours Vascular tumours Chondro-osseous tumours Gastrointestinal stromal tumours Nerve sheath tumours Tumours of uncertain differentiation Undifferentiated/unclassified sarcomas.
Slide 8-

Common Sarcomas Soft Tissue Leiomyosarcoma Fibroblastic Sarcoma Liposarcoma Rhabdomyosarcoma Malignant peripheral nerve sheath tumour Angiosarcoma Synovial sarcoma GIST Kaposi’s Bone Ewings Osteosarcoma Chondrosarcoma Chordoma Greater Manchester Cancer
Slide 9-

Greater Manchester Cancer
Slide 10-

Greater Manchester Cancer
Slide 11-

Approach to Patient with a lump History: How long Painful Increasing in size Bigger than 5cm? Previous surgery/Rxt Discharge or skin changes FHx – other cancers: melanoma, lymphoma, lung Ask what has been done: other GP, hospital, private Greater Manchester Cancer
Slide 12-

Symptoms & Signs Symptoms Pain Stiffness Local effects Non weight bearing Vague symptoms Signs Noticeable lump Joint swelling Skin changes Fungating tumour Greater Manchester Cancer
Slide 13-

Clinical Examination
Slide 14-

Greater Manchester Cancer Clinical Examination Look: skin changes, naevi, neurofibromas, multiple lumps Feel/Move: Location – limb, trunk, areas of lymph nodes? Soft or hard Mobile or adherent to deeper structures Size >5cm? Pain Joint function Neurological symptoms
Slide 15-

Greater Manchester Cancer Investigations Basic Work up: Ultrasound: Will rule out most benign MRI (Tumour protocol) Limb Xray CXR Baseline Bloods Bone Profile/Calcium
Slide 16-

Greater Manchester Cancer WHOOPS Do NOT not biopsy Do NOT excise without imaging and discussion If in-advertent incision – biopsy and close
Slide 17-

2WW Referral Criteria Greater Manchester Cancer Lump increasing in size, deep, bigger than 5cm Painful, fungating, previous surgery, Rxt Bone changes on Xray
Slide 18-

2WW Referral Form Greater Manchester Cancer
Slide 19-

Greater Manchester Cancer Sarcoma Service Clinical assessment Imaging Biopsy: Core biospy. No role for FNA Histopathology MDT review locally Regional MDT Management Plan
Slide 20-

Greater Manchester Cancer Treatment Surgical Excision: Marginal, Wide, Amputation Pre or Post op Radiotherapy Chemotherapy Palliative treatment
Slide 21-

Greater Manchester Cancer Pitfalls in patient pathway Delayed referral – biggest cause of litigation Patients referred to non-tumour specialists Poor knowledge of tumours and clinical skills WHOOPS Where are the scans? Urgent? 2WW? Beware the persistent haematoma Not taking a history
Slide 22-

Sarcoma Clinic GP Referral Specialist Referral Soft Tissue Mass/Bone lesion Diagnostic Clinic USS + Bx GMOSS MDT MRI / CT Return to referrer Refer to other specialty GMOSS Greater Manchester & Oswestry Sarcoma Service Soft Tissue & Bone Guidelines Arrange Surgery Sarcoma Diagnostic Triage/MDM
Slide 23-

Current Patient Pathway Greater Manchester Cancer Clinic and/or MDT < 2 weeks Biopsy < 2 weeks Results and MDT 2-3 weeks Back to Clinic Total = Min 6 weeks
Slide 24-

NHS England Greater Manchester Cancer
Slide 25-

Doctor, I have got a lump, what do I do with it? Greater Manchester Cancer History: how long, is it getting bigger and painful Examine to see is it soft, hard, mobile and deep; joint swelling – Xrays? Refer to local sarcoma service if meets criteria Discuss/refer if concerned Its not a pathway for: Unknown malignancy, get seen quicker, small benign proven lumps
Slide 26-

Thank you Greater Manchester Cancer