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Bone Path 2 > 3e. Other Primary Neoplasms > Flashcards

3e. Other Primary Neoplasms Flashcards

1
Q

What is a Fibrosarcoma (FS)?

A

A RARE sarcoma in which the predominant cell type is a malignant fibroblast.

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2
Q

MC age group for FS?

A

4-83…but not usually common in kids

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3
Q

FS usually occurs where?

A

Major long bones (50% at knee)

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4
Q

What is the average length of time of symptoms in FS before diagnosis?

A

2 years! Pain and swelling

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5
Q

FS Plain film findings?

A
  • Highly destructive, expanding, lytic lesion
  • HUGE soft tissue mass
  • Usually NO periosteal reaction
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6
Q

FS Prognosis?

A

Poor prognosis, mets late to lung, liver, lymph, and brain

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7
Q

Treatment of choice?

A

AMPUTATION

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8
Q

What is Malignant Fibrous Histiocytoma (MFH)?

A
  • MC soft tissue sarcoma in adults
  • Indistinguishable from Fibrosarcoma
  • Primitive mesenchymal cells
  • Mets to lungs
  • Painless, solid mass
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9
Q

Where is MFH more common?

A

Lower extremity (50%)

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10
Q

What is a Chordoma?

A

Rare, notochordal remnant neoplasm

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11
Q

Where do Chordoma’s usually happen?

A

Spinal column (85% sacrococcygeal or spheno-occipital)

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12
Q

Age range of Chordoma?

A

Any age, but 40-70 MC

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13
Q

MC in lads or lasses?

A

Lads

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14
Q

T or F: Metastasis is uncommon in Chordoma’s

A

T

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15
Q

What are symptoms from a Chordoma usually from?

A

Mass effect

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16
Q

Other than the Sacrococcygeal, what other places commonly have Chordoma’s?

A

Clivus, Vertebra (especially C2).

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17
Q

What is the only primary malignancy to cross IVD?

A

Chordoma

18
Q

Prognosis for Chordoma?

A

It varies, many of the lesions can be difficult to resect (spinal column)

19
Q

Plain film findings for Chordoma?

A
  • Lytic destruction
  • Cortical expansion (may increase AP diameter of sacrum)
  • Calcification in 50%
  • Soft tissue mass common
  • Ddx: lytic mets, chondrosarcoma, GCT, ABC, plasmacytoma
20
Q

What is Non-Hodgkins Lymphoma (NHL)?

A

A rare extranodal lymphoma, initially appearing as a solitary bone lesion

21
Q

Age range for NHL? (not the hockey league)

A

20-50

22
Q

…NHL is more common in guys, okay?

A

Why did you flip this card over?

23
Q

Prognosis for NHL?

A

Better than most bone primary malignancies

24
Q

Pain pattern for NHL?

A
  • Local, intermittent pain

- Dull aching, not relieved by rest

25
Q

Are most patients with NHL healthy or unhealthy?

A

Generally healthy, but over 50% will have symptoms in a year (palpable mass or swelling)

26
Q

Plain film findings for NHL?

A
  • Permeative destruction
  • Minimal periosteal response
  • Pathological Fx is very common
  • Femur, tibia, and humerus MC affected
  • Could have soft tissue mass
27
Q

What is Hodgkins Lymphoma of Bone (HLB)?

A
  • Usually secondary to systemic Hodgkin’s (10-20% of patient’s with Hodgkin’s)
  • Rarely primary in bone
28
Q

MC symptom of HLB?

A
  • Pain
29
Q

Prognosis of HLB?

A

Treatment and prognosis related to stage of systemic disease

30
Q

What is Hodgkin’s Lymphoma (HL)?

A

A type of lymphoma, which is generally believed to result from white blood cells of the lymphocyte kind

31
Q

Where is HL MC?

A

In the vertebral body (“ivory vertebrae”, anterior scalloping possible)

32
Q

Are sclerotic or lytic HL lesions MC?

A

Lytic (especially in tubular bones)

33
Q

Periosteal response in HL?

A

Possible exuberant periosteal response

34
Q

What is Synovial Sarcoma (SS)?

A

An uncommon soft tissue sarcoma

35
Q

MC age range for SS?

A

30-50

36
Q

Where is SS MC?

A

Knee, hip, and ankle

37
Q

SS Plain film findings?

A
  • Fine granular calcification in 1/3rd

- Secondary bone destruction in 10-20%

38
Q

SS Prognosis?

A

Moderately good

39
Q

Most useful imaging for SS?

A

MRI

40
Q

Treatment for SS?

A

Excision and/or radiation

Bone Path 2 (10 decks)

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