๐ท๐๐๐๐๐๐ ๐ฉ๐๐๐ ๐ป๐๐๐๐๐ Flashcards
What is a primary bone tumour?
These are tumours that develop from the bone cells and divide uncontrollably
What are the risk factors for Primary bone tumour?
- Genetic disorders e.g Li-Fraumeni Syndrome
- Paget disease
- Radiation
- Bone marrow transplant
- Retinoblastoma
What are primary bone tumors?
Tumors that develop from bone cells when they divide uncontrollably; constitute 0.1% of bone tumors.
What are the major risk factors for primary bone tumors?
Li-Fraumeni syndrome, Paget disease, Radiation, Bone marrow transplant, Retinoblastoma.
What is the basic clinical classification of bone tumors?
Benign bone tumors, Malignant bone tumors.
What are the three main classification approaches for bone tumors?
Clinical (benign vs malignant), Histological (based on cell origin), Radiological (extent of spread).
What is osteoid osteoma?
A benign bone lesion that occurs especially at night, small but very painful, relieved by anti-inflammatory medication.
Which age group is most commonly affected by osteoid osteoma?
Children and adolescents.
What are the typical characteristics of osteoblastoma?
Larger and more aggressive than osteoid osteoma, commonly occurs in the spine, presents as dull pain not relieved by aspirin.
What is osteoclastoma (giant cell tumor)?
An uncommon benign tumor characterized by the presence of multinucleated giant cells.
What are the defining features of osteoma/exostosis?
A new piece of bone usually growing on another piece of bone, typically at D1-D11, causing pain and swelling.
What is primary osteosarcoma?
Arises in the absence of underlying bone disease.
What is the most common location for primary osteosarcoma?
Distal femur, followed by proximal tibia and proximal humerus.
What is secondary osteosarcoma?
Occurs on a background of some predisposing influence like Pagetโs disease or fibrous dysplasia.
What are the characteristic features of chondroblastoma?
A benign cartilage-producing tumor in children, most common around the knee.
What type of pain is associated with chondroblastoma?
Pain is often severe and associated with inflammation and joint effusion.
Where does chondroblastoma originate from?
The epiphyseal plate.
What is chondrosarcoma?
A malignant tumor with cartilage differentiation, arising from pre-existing lesions.
What are the common presenting symptoms of chondrosarcoma?
Pain and/or swelling.
What is the age distribution of osteochondroma?
Bimodal prevalence: ages 10-15 and 40-50.
What is an osteochondroma?
A benign cartilage-capped bony projection, grows away from the joint toward the diaphyseal region.
Can osteochondromas be multiple?
Yes, they are usually solitary, but some patients have multiple exostoses.
What is enchondroma?
Benign cartilage within the intramedullary cavity of the bone.
Where are enchondromas most commonly found?
80% in hands and feet; most common bone tumor in the hand.
What is the T classification in bone tumor staging?
T for tumor stage โ nodal involvement stage.
What is the M classification in bone tumor staging?
M for metastasis.
List the types of benign bone tumors
Osteoid osteoma, Osteoma, Osteoblastoma, Osteoclastoma, Chondroma, Chondroblastoma.
List the types of malignant bone tumors
Osteosarcoma, Chondrosarcoma, Fibrosarcoma, Ewingโs sarcoma, Lymphoma, Reticular cell sarcoma.
What type of cells can primary bone tumors originate from?
Osteocyte, Osteoblast, Osteoclast, Chondrocyte/Chondroblast, Fibrocyte, Fat cell, Muscle cell, Red blood cells.
Where is chondroblastoma most commonly found?
Around the knee.
What is the typical presentation of osteoid osteoma?
Pain worse at night, relieved by anti-inflammatory medication.
Which bone tumor commonly presents with a pathologic fracture?
Osteoclastoma (giant cell tumor).
What are the key characteristics of Ewingโs sarcoma?
A malignant round cell sarcoma of bone with characteristic 11:22 translocation; one of few tumors that arise from the diaphysis.
What are the typical presenting symptoms of Ewingโs sarcoma?
Pain, hill mass, and bone systemic symptoms including fever and anemia.
What is the radiological appearance of Ewingโs sarcoma?
Shows onion-skin periosteal reaction.
What percentage of bone tumors are secondary (metastatic)?
About 93% of bone tumors arise from a different source and metastasize to the bone.
List the most common primary cancers that metastasize to bone.
Lung, breast, kidney, prostate, thyroid.
How do carcinomas typically spread to bone?
Through the hematogenous route.
What are the three stages of benign tumors?
Latent: asymptomatic & discovered incidentally (e.g., osteochondroma); Active: present with mild symptoms & continue to grow (e.g., osteoid osteoma); Aggressive: grows rapidly (e.g., giant cell tumor).
What is the grading system for malignant tumors?
Low grade (1A: intracompartmental, 1B: extracompartmental); High grade (2A: intracompartmental, 2B: extracompartmental); Any grade (3: metastases).
What is the typical sequence of clinical features in benign tumors?
Mass appears first, followed by pathological fracture, then pain.
What is the typical sequence of clinical features in malignant tumors?
Pain is usually the first symptom, then mass is noticed, followed by pathological fracture.
List the main imaging investigations for bone tumors.
X-ray, CT scan/MRI, PET scan, scintigraphy, angiography, biopsy.
What are the main treatment options for bone tumors?
Radiotherapy, chemotherapy, amputation, excision, and reconstruction (for benign tumors).
How are high-grade malignant bone tumors classified?
2A (intracompartmental) and 2B (extracompartmental).
What does grade 3 indicate in bone tumor staging?
Presence of metastases, regardless of the original tumor grade.
What is the importance of compartmental classification in bone tumors?
Helps determine tumor extent and surgical approach; classified as intra- or extra-compartmental.
