Clinico-Morphological Pattern of Musculoskeletal Tumours among Patients Seen At Muhimbili Orthopaedic Institute, From January 2013 to December 2014

Abstract

Musculoskeletal tumours are relatively rare, with low incidence compared to other tumours. Their geographic distribution varies greatly around the world, in Asia; the annual distribution of musculoskeletal tumour was 624 against 8,805 cases of colorectal cancer and 6532 cases of lung cancer in 2008 – 2012. In USA, the annual distribution of bone was 0.2% and soft tissue tumours was 0.7% against 18.3% of digestive system cancers, 14.5% of breast cancer, 13.9% of respiratory system cancers and 7.9% of urinary system in 2006 – 2010 Objective: The aim of this study is to determine the clinico-morphological pattern of musculoskeletal tumours, seen at Muhimbili Orthopaedic Institute, from January 2013 to December 2014. Study design: A retrospective hospital based descriptive study of patients with musculoskeletal tumors seen at MOI from January 2013 to December 2014. Materials and methods: Data was collected retrospectively from musculoskeletal registry of MOI, notes from patients’ files and histopathology reports of biopsies from patients clinically diagnosed with musculoskeletal lesions from January 2013 to December 2014.The histopathology results of specimen sent to CPL were correlated with clinical findings for diagnosis of patients. Musculoskeletal tumours were diagnosed by, incisional, excisional or tru-cut biopsy. The malignant and metastatic tumours in additional were diagnosed radiological. Data was collected on age, sex, anatomical site, and histo-pathologic type from 210 patients. On the basis of histopathology reports, the tumours were classified as benign bone tumours, primary malignant bone tumours, secondary bone tumours (metastasis), benign and malignant soft tissue tumours (STT) and tumour like lesions. Description statistics were performed using SPSS software version 20.0 for windows (SPSS Inc., Chicago, IL, USA). Frequency and percentage of the mentioned variables were calculated. Results: Data of a total from 210 patients with musculoskeletal tumours was collected and 181 analysed. The total number of male was 99 with an age range from 8 – 85 years and median age of 25 years. The total number of female was 82 with an age range from 3 – 75 years and median age 28.5 years. Primary malignant bone tumours, (osteosarcoma, chondrosarcomaand Ewing’s sarcoma) were seen in 54 (29.8%) of cases, demonstrated higher predilections for male 31 (57. 4%). Generally, benign tumours, demonstrated slightly higher predilections for male 25 (53.2%). Whereas osteochondroma and chondroma among the benign bone tumours, demonstrated higher predilection for male, giant cell tumour 21 (44.6%) the most common benign bone tumour showed higher predilection for female 12 (57.1%) Secondary malignant bone tumours 32 (17.6%), the carcinoma from breast, prostate, lung and thyroid demonstrated higher predilections for female 13 (68.4%). Secondary malignant tumours and are seen mainly in elderly patients > 50yrs of age. Both Benign and malignant soft tissue tumours 48 (26.5%), demonstrated higher predilections for male 28 (58.3%). From the study, the most common site of the musculoskeletal tumours is the femur 39 (21.5%), followed by the tibia 28 (15.5%) and humerus 26 Conclusion: Among 181 musculoskeletal tumours analysed, 99 cases were male with an age range from 8 – 85 years and median age of 25 years and 82 cases were female with an age range from 3 – 75 years and median age 28.5 years. From this study, musculoskeletal tumour have shown slightly male predilection at a M;F ratio of 1.2:1 The most affected age was the 11 – 20year age group. The frequent histological types were osteosarcoma 47 (21.6%), Metastases 32 (17.7%), Giant cell tumours 21 (11.6%), osteochondroma 10 (5.5%) and Synovial sarcoma 10 (5.5%). The commonest sites for musculoskeletal tumours are femur, tibia and humerus, the bones sites with highest growth rate. Recommendation: This study throws some light on the existing musculoskeletal tumour burden at MOI. A long period and multicentre study is needed to throw more light on the burden of disease nationwide.