Bone and Soft Tissue Tumours | Dr Thomas Hilton | Bone Tumour Specialist | Cape Town

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Bone and Soft Tissue Tumours

Dr Thomas Hilton specialises in diagnosing and treating bone and soft tissue tumours, including rare and complex cases. His expertise ensures that patients with benign or malignant tumours receive advanced, personalised care using state-of-the-art techniques.

Understanding Bone and Soft Tissue Tumours

Primary bone tumours originate in the bone and can be either cancerous (malignant) or non-cancerous (benign). Malignant tumours are rare but aggressive, requiring detailed evaluation and specialist care.

Examples of malignant primary bone tumours:

Osteosarcoma: Often occurs in the long bones, commonly affecting teenagers and young adults.
Ewing sarcoma: A rare tumour often found in children and young adults, involving bones and surrounding tissues.
Chondrosarcoma: Typically develops in cartilage-producing cells, affecting older adults.

Key points:

Symptoms may include bone pain, swelling, or fractures.
Diagnosis involves imaging (X-rays, MRI) and biopsy.
Treatment is tailored to the tumour type and may include surgery, chemotherapy, or radiation therapy.

Benign bone tumours are non-cancerous growths that do not spread but can still cause significant symptoms or complications.

Examples include:

Osteochondroma: A common tumour in adolescents, usually painless but may cause joint irritation.
Giant cell tumour: Can weaken bones, increasing the risk of fractures.
Enchondroma: Typically found in the hands and can cause deformities or fractures.

Key points:

Benign tumours are often detected incidentally on imaging.
Treatment depends on symptoms, size, and location, ranging from monitoring to surgical removal.

Soft tissue sarcomas are rare cancers that develop in muscles, fat, nerves, or blood vessels.

Key points:

They can occur anywhere in the body, most commonly in the limbs or trunk.
Early symptoms may include a painless lump that grows over time.
Diagnosis requires imaging and biopsy, often involving a multidisciplinary team (MDT).
Treatment may include surgery, chemotherapy, or radiation therapy, depending on the stage and type of sarcoma.

Metastatic bone disease occurs when cancer from another part of the body spreads to the bones.

Key points:

Commonly associated with cancers like breast, prostate, lung, and kidney.
Symptoms include bone pain, fractures, and reduced mobility.
Treatment focuses on stabilising the bones, relieving symptoms, and improving quality of life through surgery, radiation therapy, or medications.

Treatments and Procedures

Tumour excision involves surgically removing the tumour and a margin of healthy tissue to minimise recurrence.

Key points:

Suitable for benign and malignant tumours.
The approach depends on the tumour’s size, location, and type.
May involve additional reconstruction to restore function.

Rotationplasty is a unique limb salvage procedure primarily performed in children, often after tumour removal around the knee. It involves removing the tumour-affected area and reattaching the lower leg rotated 180 degrees, allowing the ankle to function as a knee joint.

Key points:

Provides an alternative to amputation in cases of tumours or severe trauma.
Commonly performed for osteosarcoma around the knee in children.
Allows for the use of a prosthetic limb with better functionality and control.
Requires careful planning to ensure alignment and mobility.

This approach addresses deep infections in joint replacements through a carefully planned stepwise process. The infected implant is removed, and a temporary spacer containing antibiotics is placed to control the infection. Once the infection resolves, a new permanent prosthesis is implanted.

Key points:

Typically involves two or more surgeries to ensure infection control and implant success.
Temporary antibiotic spacers maintain joint space and deliver localised infection treatment.
Final reconstruction restores joint function and mobility.
Commonly used for hip or knee replacements complicated by infection.

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