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[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
What is the prognosis of fibrous cortical defects and non-ossifying fibromas?
Non-painful, benign, and spontaneously regress
26
Where do fibrous cortical defects and non-ossifying fibromas affect?
Distal femur | Proximal tibia
27
Are fibrous cortical defects and non-ossifying fibromas single or multiple?
Often multiple
28
Give 3 benign cartilaginous neoplasms of bone
Osteochondroma Enchodroma/chondromas Chondroblastoma
29
When does osteochondroma present?
10-20 years old
30
What is the male to female ratio of osteochondroma?
M:F = 3:1
31
What might osteochondroma be related to?
Previous trauma
32
Where does osteochondroma affect?
Knee
33
What may be seen on x-ray in osteochondroma?
Cartilage-capped bony outgrowth
34
When do endochondroma/chondromas present?
10-40 years
35
What is Ollier disease?
Multiple endochondromas
36
What is Maffucci Syn?
Condition with endochondromatosis and multiple soft-tissue haemangiomas
37
What is the risk with multiple enchondromas?
Risk of malignant transformation
38
Where do enchondromas/chondromas affect?
Hands and feet
39
What will be found on x-ray in enchondromas/chondromas?
O sign | Endosteal scalloping
40
What is O sign?
Oval lucencies with radiodense rim
41
When do chondroblastomas present?
10-20
42
What is the male to female ratio of chondroblastoma?
M:F = 2:1
43
Where do chondroblastomas affect?
Epiphysis | Knee
44
How do chondroblastomas appear on x-ray?
Radiolucent with sclerotic border
45
Give a malignant cartilaginous neoplasm
Chondrosarcoma
46
When do chondrosarcoma present?
>40
47
How do chondrosarcomas present?
Pain and lump
48
What do chondrosarcomas arise from?
De novo or from chondromas
49
What is the prognosis of chondrosarcomas?
70% at 5 years
50
Where are chondrosarcomas located?
Pelvis | Axial skeleton
51
How do chondrosarcomas appear on x-ray?
Lytic lesion | Fluffy 'popcorn calcification'
52
Give 4 benign bone-forming neoplasms
Osteoma Osteoid osteoma Osteoblastoma Giant cell tumour/osteoclastoma
53
How does osteoma present?
Lump
54
Are osteomas solitary or multiple?
Usually solitary, but may be multiple
55
Where are osteomas found?
Skull | Facial bones
56
What is the male to female ratio of osteoid osteoma?
M:F = 2:1
57
When do osteoid osteomas present?
Teens and 20s
58
How does osteoid osteoma present?
Severe noctural pain relieved by aspirin
59
How do osteoid osteomas appear on bone scan?
Hot
60
Where are osteoid osteomas found?
Lower limb | Diaphyseal cortex
61
How do osteoid osteomas appear on x-ray?
Lytic lesions with central nidus and sclerotic rim
62
How do osteoblastomas present?
Pain unresponsive to aspirin
63
Where are osteoblastomas found?
Spine
64
When do giant cell tumours/osteoclastomas present?
20-40, after fusion of growth plate
65
Where are giant cell tumours/osteoclastomas found?
Knee | On a boundary with joint surface
66
How do giant cell tumours/osteoclastomas present?
Soap bubble appearance - solitary, expansile, lytic lesion
67
Give two malignant bone-forming neoplasms
Osteosarcomas | Ewing's sarcoma
68
Who do osteosarcomas present in?
Adolescents
69
What is the male to female ratio of osteosarcoma?
M:F = 2:1
70
How do osteosarcomas present?
Pain Warmth Briut
71
What might osteosarcomas arise secondary to?
Paget's or irritation
72
Where are osteosarcomas found?
Knee | Metaphysis
73
What will be found on x-ray with osteosarcoma?
Periosteal elevation, with sunburst appearance and Codman's triangle ?? dunno lol
74
When does Erwing's sarcoma present?
<20
75
How does Erwing's sarcoma present?
Painful, warm, enlarging mass | Systemic features, including fever, increased ESR, anaemia, increased WCC
76
Where is Erwing's sarcoma found?
Long bone diaphysis
77
How does Erwing's sarcoma present on x-ray?
Lytic tumour | Onion-skin periosteal reaction

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