This clinical pathological conference summarizes two patient cases. The first case is a 38-year-old man presenting with left upper arm pain for 3 months. Examinations found a pathological fracture of the left humerus and imaging suggested a primary bone tumor. The second case is a 16-year-old girl who injured her right knee after a fall. Examinations revealed a mass on her right distal femur and imaging showed a malignant bone tumor with pathological fracture of the distal femur. Both patients underwent further testing including biopsies confirming their diagnoses and determining treatment plans.
This clinical pathological conference summarizes two patient cases. The first case is a 38-year-old man presenting with left upper arm pain for 3 months. Examinations found a pathological fracture of the left humerus and imaging suggested a primary bone tumor. The second case is a 16-year-old girl who injured her right knee after a fall. Examinations revealed a mass on her right distal femur and imaging showed a malignant bone tumor with pathological fracture of the distal femur. Both patients underwent further testing including biopsies confirming their diagnoses and determining treatment plans.
This clinical pathological conference summarizes two patient cases. The first case is a 38-year-old man presenting with left upper arm pain for 3 months. Examinations found a pathological fracture of the left humerus and imaging suggested a primary bone tumor. The second case is a 16-year-old girl who injured her right knee after a fall. Examinations revealed a mass on her right distal femur and imaging showed a malignant bone tumor with pathological fracture of the distal femur. Both patients underwent further testing including biopsies confirming their diagnoses and determining treatment plans.
No Name Anamnesis Physical Examination PA + Lab Radiology Assessment Plan
1 Budy Iryawan Chief Complaint : General condition: Good FNAB( 4-4-2018): X ray : Pathological Pathological fracture of 38 y.o Pain on the left upper arm Karnofsky score : 70 Atipic cell suspect fracture left humerus, the left humerus ec 319436 Recent History : Head : no abnormality malignancy litic lesion, suspect peripheral nerve sheath Magelang - Appeared since 3 month before admission, Neck : no abnormality primary bone tumor. tumor after playing volley ball. Eyes : no abnormality PA (19-7-2018): - 6 month before admission pasien felt pain on Nose : no abnormality Borderline peripheral MRI : his left upper arm Ears : no abnormality nerve sheath tumor Massa intramedullary - No history of trauma before. Mouth : no abnormality diafisis, susp Ewing - History of weight loss (+), night pain (+), Loss Chest : no abnormality Lab : 20-6-2018 sarcoma dd lymphoma of of appetite (-). Shoulder: no abnormality Hb : 15,5 g/d bone - history of chronic illness (-) Abdominal: no abnormality Ht : 45 % Past History: Extermities: look at local Leu : 6300 rb/ul CT scan • Significant or repetitive trauma (+) examination Tro : 245 rb/ul Osteomyelitis, with • Steroid use (-) Gluco : 80 mg/dL pathological fracture of • Chronic illness (-) Left Upper Arm region: ALP : 86 u/L diaphysis humerus • Cancer history L : Skin intact, swelling (-), LDH : 318 Family: venectation (-), color of the skin still • Cancer History (-) normal, deformity unclear. F : Tenderness (-), Neurovascular disturbance (-) M : ROM Shoulder and elbow limited due to pain 2. Syahdin Aulia Chief Complaint : General condition: Average FNAB (11-10-2017) X ray Closed pathological 16 y.o Pain on the right knee Karnoffsky Score : 70 Osteosarcoma Mass on metadiaphysis fracture of right distal 309728 Recent History : Head : no abnormality PA (19-7-2018) distal femur, blastic femur due to Tegal Three days before admission, patient was Eyes : no abnormality Osteosarcoma (residif) lesion , with pathological osteosarcoma slipped down in the bathroom, with position her right Nose : no abnormality fracture knee hit the floor first. After the accident, patient felt Ears : no abnormality Lab (9-9-2017) pain over her right knee that aggravated by movement Mouth : no abnormality Hb : 12.6 g/dl MRI (28-6-2018) and unable to bear weight Neck : no abnormality Ht : 39 % Malignant bone tumor Night pain (+), loss of body weight (+), loss of appetite Shoulder : no abnormality Leu : 5200 rb/ul tumor metadiafisis distal (+), dyspnea (-), headache (-), chronic fever (-), Chest : no abnormality Tro : 330 rb/ul femur dextra, feeding mixturition and defecation still normal. Abdominal : no abnormality LED 1 : 52 mm/jam artery from arteri Extermities : look at local LED 2 : 71 mm/jam femoralis and popliteal Past History: examination CRP : (-) dextra, pathological Chemotherapy : 6x in Moewardi Hospital ALP : 387 u/L fracture diafisis distal Significant or repetitive trauma (-) Right thigh region femur dextra Steroid use (-) L : mass over the knee with 42 Lab (06-06-2018) Chronic illness (-) x 17 cm, shiny skin (+), swelling Hb : 10.6 g/dl Cancer history (-) distal (-), ulcer(-) Ht : 32 % F : solid mass, fixated, unclear Leu : 7500 /ul Family: margin, warmer than adjacent skin, Tro: 163 rb/ul Cancer History (-) tenderness (+) knee LED 1 : 35 mm/jam M : ROM knee hard to evaluate LED 2 : 60 mm/jam due to pain CRP : (-) ALP : 159 u/L LDH : 212