Enneking Staging

  • Purpose
    • Allow prognosis
    • Guide surgical management
    • Guide adjunctive therapies
  • A compartment is a anatomically confining space which will resist tumour spread beyonds its boundaries
    • Intracompartmental
    • Intraosseous
    • Intra fascial compartments
    • Superficial to deep fascia
    • Parosseous
    • Extracompartmental
    • Extension beyond above
      • Pelvis
      • Popliteal fossae
      • Cubital fossa
      • Axilla

Musculoskeletal Tumour Society

  • Grade
  • Site
  • Metastasis
  • Grade
    • G0
      • benign
      • encapsulated or reactive bone
    • Stage
      • I latent
      • II active
      • III aggressive
    • GI
      • low grade malignant
        • pseudocapsule
        • microsat in reactive zone
    • GII
      • high grade malignant
        • microsatellites
        • skip mets beyond reactive zone
        • permiative margin
        • Codmans triangle
  • Site
    • TO intracapsular
    • TI extracapsular but intracompartmental
    • TII extracapsular & extracompartmental
    • Compartment = anatomic structure forming barrier to extension bone, cartilage or capsule
  • Metastasis
    • MO no mets
    • MI skip, regional or distant mets
  • Skip Metatasis
    • nodule of tumour separated from primary lesion by an intervening zone of normal non-reactive tissue are not the same as satellites found in the reactive zon

Benign

  • Stage I
    • Latent
    • G0,T0,M0
  • Stage II
    • Active
    • G0,T0,M0
  • Stage III
    • Aggressive
    • G0,T1 or II, MI or II
    • e.g. giant cell

Malignant

  • 1A Low Grade Intracompartmental
  • 1B Low Grade Extracompartmental
  • 2A High Grade Intracompartmental
  • 2B High Grade Extracompartmental
  • 3 Metastasis