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Excessive Decks > [34] Bone Tumours > Flashcards

[34] Bone Tumours Flashcards

1
Q

What are the most common bone tumours?

A

Bone mets

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2
Q

Which cancers commonly metastasise to bone?

A 
Bronchus
Thyroid
Breast
Kidney
Prostate
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3
Q

How do bony mets appear on x-rays?

A

They are usually radiolucent, apart from prostate which is sclerotic

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4
Q

Where do bony mets usually occur?

A

Axial skeleton

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5
Q

Why do bony mets usually occur in the axial skeleton?

A

Because it contains red marrow

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6
Q

How do bony mets present?

A

Pain or pathological fractures

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7
Q

How are pathological fractures caused by bony mets managed?

A

Internal fixation

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8
Q

How is pain caused by bony mets managed?

A

Radiotherapy

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9
Q

Give 4 tumour-like non-neoplastic conditions of bone

A

Fibrous dysplasia
Simple bone cyst
Aneurysmal bone cyst
Fibrous cortical defect and non-ossifying fibroma

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10
Q

When does fibrous dysplasia present?

A

0-30

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11
Q

Which gender is fibrous dysplasia more common in?

A

Females

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12
Q

What increases the risk of fibrous dysplasia?

A

Fractures

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13
Q

What does McCune Albright’s syndrome consist of?

A

Polyostotic fibrous dysplasia
Precocious puberty in females
Cafe-au-lait spots

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14
Q

What bones does fibrous dysplasia affect?

A

Long bones
Ribs
Skulls

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15
Q

What is meant by fibrous dysplasia being mono-ostotic?

A

Usually only one bone is involved

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16
Q

How might fibrous dysplasia appear on x-ray?

A

‘Ground glass’ lytic lesions

Shepherds crook deformity of proximal femur

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17
Q

When do simple bone cysts present?

A

<20

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18
Q

What happens to the site of a simple bone cyst?

A

The lump migrates down the shaft from original growth plate site

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19
Q

Where do simple bone cysts affect?

A

Proximal metaphysis of humerus or femur

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20
Q

How do simple bone cysts appear on x-ray?

A

Well-defined lytic lesion

Cortex can fall into the cyst, causing a ‘fallen fragment’

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21
Q

When do aneurysmal bone cysts present?

A

<30 years

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22
Q

How do aneurysmal bone cysts present?

A

Pain

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23
Q

What is seen on MRI in aneurysmal bone cysts?

A

Multiple fluid cysts

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24
Q

Who do fibrous cortical defects and non-ossifying fibromas present in?

A

Children

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25
Q

What is the prognosis of fibrous cortical defects and non-ossifying fibromas?

A

Non-painful, benign, and spontaneously regress

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26
Q

Where do fibrous cortical defects and non-ossifying fibromas affect?

A

Distal femur

Proximal tibia

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27
Q

Are fibrous cortical defects and non-ossifying fibromas single or multiple?

A

Often multiple

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28
Q

Give 3 benign cartilaginous neoplasms of bone

A

Osteochondroma
Enchodroma/chondromas
Chondroblastoma

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29
Q

When does osteochondroma present?

A

10-20 years old

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30
Q

What is the male to female ratio of osteochondroma?

A

M:F = 3:1

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31
Q

What might osteochondroma be related to?

A

Previous trauma

32
Q

Where does osteochondroma affect?

A

Knee

33
Q

What may be seen on x-ray in osteochondroma?

A

Cartilage-capped bony outgrowth

34
Q

When do endochondroma/chondromas present?

A

10-40 years

35
Q

What is Ollier disease?

A

Multiple endochondromas

36
Q

What is Maffucci Syn?

A

Condition with endochondromatosis and multiple soft-tissue haemangiomas

37
Q

What is the risk with multiple enchondromas?

A

Risk of malignant transformation

38
Q

Where do enchondromas/chondromas affect?

A

Hands and feet

39
Q

What will be found on x-ray in enchondromas/chondromas?

A

O sign

Endosteal scalloping

40
Q

What is O sign?

A

Oval lucencies with radiodense rim

41
Q

When do chondroblastomas present?

A

10-20

42
Q

What is the male to female ratio of chondroblastoma?

A

M:F = 2:1

43
Q

Where do chondroblastomas affect?

A

Epiphysis

Knee

44
Q

How do chondroblastomas appear on x-ray?

A

Radiolucent with sclerotic border

45
Q

Give a malignant cartilaginous neoplasm

A

Chondrosarcoma

46
Q

When do chondrosarcoma present?

A

> 40

47
Q

How do chondrosarcomas present?

A

Pain and lump

48
Q

What do chondrosarcomas arise from?

A

De novo or from chondromas

49
Q

What is the prognosis of chondrosarcomas?

A

70% at 5 years

50
Q

Where are chondrosarcomas located?

A

Pelvis

Axial skeleton

51
Q

How do chondrosarcomas appear on x-ray?

A

Lytic lesion

Fluffy ‘popcorn calcification’

52
Q

Give 4 benign bone-forming neoplasms

A

Osteoma
Osteoid osteoma
Osteoblastoma
Giant cell tumour/osteoclastoma

53
Q

How does osteoma present?

A

Lump

54
Q

Are osteomas solitary or multiple?

A

Usually solitary, but may be multiple

55
Q

Where are osteomas found?

A

Skull

Facial bones

56
Q

What is the male to female ratio of osteoid osteoma?

A

M:F = 2:1

57
Q

When do osteoid osteomas present?

A

Teens and 20s

58
Q

How does osteoid osteoma present?

A

Severe noctural pain relieved by aspirin

59
Q

How do osteoid osteomas appear on bone scan?

A

Hot

60
Q

Where are osteoid osteomas found?

A

Lower limb

Diaphyseal cortex

61
Q

How do osteoid osteomas appear on x-ray?

A

Lytic lesions with central nidus and sclerotic rim

62
Q

How do osteoblastomas present?

A

Pain unresponsive to aspirin

63
Q

Where are osteoblastomas found?

A

Spine

64
Q

When do giant cell tumours/osteoclastomas present?

A

20-40, after fusion of growth plate

65
Q

Where are giant cell tumours/osteoclastomas found?

A

Knee

On a boundary with joint surface

66
Q

How do giant cell tumours/osteoclastomas present?

A

Soap bubble appearance - solitary, expansile, lytic lesion

67
Q

Give two malignant bone-forming neoplasms

A

Osteosarcomas

Ewing’s sarcoma

68
Q

Who do osteosarcomas present in?

A

Adolescents

69
Q

What is the male to female ratio of osteosarcoma?

A

M:F = 2:1

70
Q

How do osteosarcomas present?

A

Pain
Warmth
Briut

71
Q

What might osteosarcomas arise secondary to?

A

Paget’s or irritation

72
Q

Where are osteosarcomas found?

A

Knee

Metaphysis

73
Q

What will be found on x-ray with osteosarcoma?

A

Periosteal elevation, with sunburst appearance and Codman’s triangle

?? dunno lol

74
Q

When does Erwing’s sarcoma present?

A

<20

75
Q

How does Erwing’s sarcoma present?

A

Painful, warm, enlarging mass

Systemic features, including fever, increased ESR, anaemia, increased WCC

76
Q

Where is Erwing’s sarcoma found?

A

Long bone diaphysis

77
Q

How does Erwing’s sarcoma present on x-ray?

A

Lytic tumour

Onion-skin periosteal reaction

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