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Khối u: Chẩn đoán, đánh giá, và quản lý

Khối ung thư mô mềm lành tính và điều kiện tumorlike của hệ thống cơ xương là phổ biến. Sacôm ít thường xuyên hơn, với chỉ có 5.000 trường hợp mới được chẩn đoán mỗi năm tại Hoa Kỳ. Sau khi chụp X quang vùng đồng bằng của khu vực bị ảnh hưởng đã được thu được, cộng hưởng từ (MR) | Soft-Tissue Tumors Diagnosis Evaluation and Management Franklin H. Sim MD Frank J. Frassica MD and Deborah A. Frassica MD Abstract Benign soft-tissue neoplasms and tumorlike conditions of the musculoskeletal system are common. Sarcomas are less frequent with only 5 000 new cases diagnosed each year in the United States. After plain radiographs of the affected area have been obtained magnetic resonance MR imaging both T1- and T2-weighted sequences is the best imaging modality for detecting and characterizing the lesion. Although MR imaging is not specific in determining whether lesions are benign or malignant it can be useful in evaluating other characteristics such as size pattern of growth integrity of natural boundaries and homogeneity. Biopsy must be done carefully so as not to adversely affect the outcome. Technical considerations include proper location and orientation of the biopsy incision meticulous hemostasis and frozen-section analysis to ensure that diagnostic material has been obtained. Effective treatment requires close coordination between the surgeon the radiation oncologist the pathologist the plastic surgeon and the diagnostic radiologist. Limb-salvage surgery has resulted in a local control rate greater than 90 . High-grade tumors that are larger than 5 cm in diameter have the worst prognosis. The role of chemotherapy remains controversial and unresolved. J Am Acad Orthop Surg 1994 2 202-211 Benign soft-tissue neoplasms and tumorlike conditions of the musculoskeletal system are common and include entities such as lipomas hemangiomas and giant cell tumors of the tendon sheath. Malignant lesions such as soft-tissue sarcomas are less frequent with only 5 000 new cases each year in the United States. There are many different causes of soft-tissue masses Table 1 . The principal types are 1 soft-tissue tumors and tumorlike conditions 2 bone tumors that have penetrated the bone compartment and formed a soft-tissue mass and 3 surface tumors of bone that .