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Tri 6 - Tumors > 8. Skeletal Metastasis > Flashcards

8. Skeletal Metastasis Flashcards

1
Q

almost all tumors have reported incidences of metastases to bone except tumors of

A

central nervous

system and basal cell carcinoma of the skin

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2
Q

Leptomeningeal Metastasis from primary Medulloblastoma of brain

A

Drop Metastasis

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3
Q

“sugar coating” enhancement

A

Drop Metastasis

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4
Q

4-year-old with medulloblastoma

presents with

A

morning vomiting and ataxia

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5
Q

responsible for ~70% of all bony metastases

A

Female breast cancer

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6
Q

results in ~60% of skeletal metastases

A

Prostate carcinoma

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7
Q

Metastatic osseous lesions in children <5 yo are usually due to

A

neuroblastoma

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8
Q

Metastatic Bone Tumors between 10-20 yo

A

Ewing’s and Osteosarcoma

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9
Q

Metastatic Bone Tumors Between 20 and 35 yo

A

Hodgkin’s lymphoma

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10
Q

May have increased serum calcium in

A

extensive lytic

metastasis

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11
Q

Blastic metastasis will increase

A

alkaline phosphatase

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12
Q

PSA and/or acid phosphatase will elevate if what is disrupted?

A

prostate

capsule

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13
Q

drop metastasis in CSF is an example of what type of mets?

A

Implantation or Seeding Metastasis

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14
Q

Valveless epidural vertebral veins that function as a venous lake or pool

A

Batson’s Venous Plexus

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15
Q

provides the
pathophysiological basis for early metastasis of
prostate cancer to pelvis, lumbar spine, and
remainder of axial skeleton

A

Prostatic venous plexus may drain directly into

vertebral venous plexus

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16
Q

Approximately 90% of patients present with Spinal metastasis present with

A

bone and/or back pain followed by radicular pain

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17
Q

most ominous symptom in patients with metastatic disease to the spine

A

Bone pain at night

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18
Q

Destruction due to osteoclast stimulating cytokines secreted by tumor cells.

A

Lytic Metastasis

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19
Q

Contrast is inserted into the thecal sac (subarachnoid space) via fluoroscopic
control

A

MYELOGRAPHY

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20
Q

Osteoid reacts to tumor cells by laying down nonneoplastic bone as a futile attempt at bone repair

A

Blastic Metastasis

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21
Q

Bone Scan will detect what percent of metabolic activity alteration?

A

3-5%

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22
Q

Radiation emitting substance, with low radiation dose a convenient half life for clinical use, is taken up and concentrated in
regions of high metabolic activity in bone

A

99mTc-MDP

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23
Q

bone scan with be positive how long before you see disease on plain film?

A

18 months

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24
Q

Useful for cortical bone involvement and presence of soft

tissue mass formation

A

Computed Tomography (CT, CAT):

25
Q

Better than CT for detecting bone lesions and assessment of

soft tissue mass formation

A

MRI

26
Q

Replacement of fatty bone marrow by tumor cells results in

A

loss of normal bright signal intensity on T1 weighted images

27
Q

75% of metastatic bone tumors are

A

lytic

28
Q

Motheaten or permeative pattern is classic in metastatic bone tumors and occurs mc with

A

breast and lung carcinoma metastasis

29
Q

Primary tumors of thyroid and kidney may

produce

A

blow-out metastatic patterns

30
Q

favors primary tumors

A
  • Periosteal reactions
  • Soft tissue mass
  • Long lesions >6cm
  • Most tumors that expand bone
  • usually solitary, whereas metastatic lesions are usually multiple
31
Q

Earliest and most subtle sign of metastasis to vertebral body is

A

focal osteoporosis compared to adjacent bodies

32
Q

due to disc herniation into vertebral body from destruction and weakening of
vertebral body

A

Malignant Schmorl’s Nodes

33
Q

Regarding neural arch, the _____ is mc involved by metastasis

A

pedicle

winking owl sign

34
Q

Bilateral pedicle destruction, known as

A

Blind Vertebra

35
Q

When a single vertebral body is involved with a diffuse homogeneous radiopacity

A

Ivory Vertebra

36
Q

3 mc causes of ivory vertebra

A

Blastic Metastasis, Paget’s Disease, and Hodgkin’s Lymphoma

37
Q

mc cause of extrapleural sign is

A

rib metastasis

38
Q

Blow out rib lesions are from

A

thyroid and renal metastasis

39
Q

description of the extrapleural Sign

A
  1. Smooth contour
  2. Convex towards lung
  3. Edges taper
40
Q

Predilection for distal phalanx of finger to be affected by metastasis from

A

primary bronchogenic carcinoma

41
Q

Periosteal Reactions are very rare in metastatic lesions, with
the exception of

A

neuroblastoma

42
Q

Complications of bone metastasis

A
  • pathologic fracture
  • Damage to physis
  • Extradural compression of spinal cord
  • AVN
43
Q

mc complication of bone metastasis is

A

pathologic fracture

44
Q

Greater chance for pathologic fracture when > 50% of the

A

cortex is destroyed

45
Q

Soft tissue masses typically accompany metastatic disease to small bones such as ribs, and is usually due to

A

hemorrhage

46
Q

ribs are commonly affected by

A

expansion

47
Q

Presence of sclerosis in a lytic lesion may be a sign of

A

healing

48
Q

what seem to be most reliable to measure

response to therapy?

A

Bone scans

49
Q

Second mc abdominal neoplasm in childhood

Wilm’s is mc

A

neuroblastoma

(75% arise in adrenal gland)

50
Q

Adrenal neuroblastomas are highly fatal and mc prior to age

A

5

51
Q

neuroblastomas have a ________ of calcification in 2/3 of cases

A

Granular pattern

52
Q
  • Typically osteolytic and fairly symmetric
  • Vertebral compression fractures with widening of paravertebral
    stripe
A

Neuroblastoma

53
Q
  • Lytic lesions
  • Widening of sutures
  • Sunburst periosteal reaction
  • Metastatic lesions to brain produce plaques on brain that may
    widen sutures
A

pathognomonic Skull changes from a neuroblastoma

54
Q

most common pediatric malignancy in infancy

A

Neuroblastoma

55
Q

Hypertrophic Osteoarthropathy (HOA) may occur secondary to

A

pulmonary lesions

56
Q

in children cyanotic congenital heart disease is a potential

cause of

A

Hypertrophic Osteoarthropathy (HOA)

57
Q
  • Clubbing of Fingers
  • Periostitis in the distal tibial diaphyses
  • “Double stripe or
    railroad track” appearance
A

Pulmonary
Hypertrophic
Osteoarthropathy

58
Q

periosteal proliferation and right upper lobe perihilar mass

A

Pulmonary Hypertrophic Osteoarthropathy

Tri 6 - Tumors (12 decks)

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