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MSK > Benign and Malignant Bone Tumours > Flashcards

Benign and Malignant Bone Tumours Flashcards

1
Q

Osteochondroma

A

Most common benign tumour

Bony outgrowth on the external surface of bone which is surrounded by a cartilaginous cap

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2
Q

Osteochondroma Common Sites

A

Epiphysis of long bones

Most commonly around the knee

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3
Q

Osteochondroma Symptoms

A

Asymptomatic

Local Pain

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4
Q

osteochondroma Treatment

A

If growing in size or producing pain

- Excisional Biopsy

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5
Q

Osteochondroma Associations

A

Multiple osteotomy may be associated with an underlying genetic disorder
Small risk of malignancy

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6
Q

Enchondroma

A

Intramedullary metaphysical cartilaginous tumour

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7
Q

Enchondroma Common Sites

A

Small tubular bones of hands and feet

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8
Q

Enchondroma Symptoms

A

Asymptomatic

Can weaken bones leading to pathological fracture

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9
Q

Enchondroma Appearance on Imaging

A

Usually Lucent but may undergo mineralisation to give a sclerotic appearance

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10
Q

Enchondroma Treatment

A

Curettage

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11
Q

Simple Bone Cyst

A

Unicystic Solitary Fluid Filled Neoplasm

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12
Q

Simple Bone Cyst Aetiology

A

Growth defect in physis

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13
Q

Simple Bone Cyst Common Sites

A

metaphysical in long bones
Talus
Calcaneus

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14
Q

Simple Bone Cyst Symptoms

A

Asymptomatic

Can lead to weakness and pathological feature

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15
Q

Simple Bone Cyst Treatment

A

Curettage
Bone Grafting
Stabilisation may be required

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16
Q

Aneurysmal Bone Cyst

A

Lesion of bone containing many blood/ serum filled chambers

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17
Q

Aneurysmal Bone Cyst Aetiology

A

Small Atriovenous Malformations

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18
Q

Aneurysmal Bone Cyst Common Sites

A

metaphysis of long bones
Flat bones
Vertebral bodies

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19
Q

Aneurysmal Bone Cyst Symptoms

A

Pain
- Due to cortical expansion and bone destruction

Pathological feature
- Due to bone weakness

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20
Q

Aneurysmal Bone Cyst Treatment

A

Curettage
Grafting
Bone cement

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21
Q

Giant Cell Tumour Common Sites

A

metaphysis
Epiphysis
Around the knee

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22
Q

Giant Cell Tumours Symptoms

A

pain
- as locally destructive to cortex

Pathological fracture

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23
Q

Giant Cell Tumours Aetiology

A

Translocation between chromosome 1 and 2

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24
Q

Giant Cell Tumours Appearance soon Imaging

A

‘Soap Bubble’

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25
Q

Giant Cell Tumours Associations

A

Can metastasis to lungs

- benign pulmonary Ct

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26
Q

Giant Cell Tumour Treatment

A

Intralesional excision
- Use off phenol, bone cement or. liquid nitrogen to destroy any remaining tumour

Aggressive forms may need joint replacement

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27
Q

Fibrous Dysplasia

A

A disease of bone resulting from a genetic mutation that causes lesion of fibrous tissue and immature bone

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28
Q

Fibrous dysplasia epidemiology

A

Adolescents

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29
Q

Fibrous Dysplasia Common Sites

A

Head and neck

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30
Q

Fibrous Dysplasia Aetiology

A

Genetic mutation causes abnormalities in proteins involved in the G-protein signalling pathway

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31
Q

Fibrous Dysplasia Symptoms

A

Endocrine Symptoms

Stress fractures
- Due to angular deformities

Shepherd’s Crook Deformities
- Due to extensive involvement of the proximal femur

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32
Q

Fibrous Dysplasia Treatment

A

Biphosphonates

Stabilisation of pathological fractures

  • internal fixation
  • cortical bone grafting

NO intralesional excision due to high recurrence rate

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33
Q

Osteoid Osteoma

A

Small nidus of immature bone surrounded by an intense sclerotic halo which secretes prostaglandins

34
Q

Osteoid Osteoma Epidemiology

A

Adolescents

35
Q

osteoid osteoma common sites

A

Proximal femur
Diaphysis of long bones
Vertebrae

36
Q

osteoid Osteoma Symptoms

A

Constant pain

- worse at night

37
Q

Osteoid Osteoma Investigations

A

Bone Scan

CT

38
Q

Osteoid Osteoma Treatment

A

NSAIDs

Excision

39
Q

Brodies Abscess

A

Intraosseous abscess as a result of subacute osteomyelitis

40
Q

Brodies Abscess Aetiology

A

Staph Aureus Infection

41
Q

Brodies Abscess Appearance on Imaging

A

Lytic Lesion

42
Q

Brodies Abscess Symptoms

A

Localized pain

  • Night time
  • Relieved by NSAIDs
43
Q

Brodies Abscess Common Sites

A

Metaphysis of long bones

44
Q

Brodies Abscess Treatment

A

Surgical Exacuation and curettage

- Under antibiotic cover

45
Q

Brown Tumours Aetiology

A

Hyperparathyroidism

46
Q

Brown Tumours Appearance on Imaging

A

Lytic Lesion

47
Q

Brown Tumours Treatment

A

Treatment of parathyroidism

48
Q

osteosarcoma

A

Most common primary malignant bone tumour

Malignant bone tumour that produces bone

49
Q

osteosarcoma Associations

A

Retinoblastoma gene

50
Q

Osteosarcoma Epidemiology

A

Younger patients

51
Q

Osteosarcoma common sites

A

Knee

metastases common

  • through haematogenous sprea
  • 10% have pulmonary metastases at time of diagnosis
52
Q

Osteosarcoma Symptoms

A

Constant. pain worse at night
Loss of appetitie
Weight loss
Fatigue

53
Q

Osteosarcoma treatment

A

Chemotherapy

- Palliative/ prolonging

54
Q

Chondrosarcoma

A

Cartilage producing primary bone tumour

55
Q

Chondrosarcoma epidemiology

A

Older patients (~45)

56
Q

Chondrosarcoma Symptoms

A

Back or thigh pain
Sciatica
Bladder symptoms
Unilateral Oedema

57
Q

Chondrosarcoma Common Sites

A

Proximal femur

Pelvis
- Very large and slow to metastasise

58
Q

Ewing’s sarcoma

A

Primary bone tumour of uncertain origin

Small round blue cell tumour

59
Q

Ewing’s sarcoma Epidemiology

A

-Teenagers

60
Q

Ewing’s sarcoma Aetiology

A

Associated with translocation between chromosomes 11 and 22 involving the Ewing sarcoma gene moon C22

61
Q

Ewing’s sarcoma Common Sites

A

Long bones

- Femur

62
Q

Ewing’s sarcoma Symptoms

A

Fever
Raised inflammatory markers
Warm swelling in affected area

63
Q

Ewing sarcoma on X-ray

A

Onion Skin

64
Q

Ewing sarcoma Treatment

A

Chemotherapy

Radiotherapy

65
Q

Lymphoma

A

Cancer of round cells of the lymphocytic system and macrophages which can occur as a primary bone tumour from bone marrow or the lymphoma may metastasise to bone

66
Q

Primary lymphoma of bone

A

Non-Hodgkin’s lymphoma

Affects pelvis or femur

Surgical resection

67
Q

Metastatic Lymphoma

A

lymphadenopathy
Splenomegaly

Treatment: Chemotherapy and radiotherapy

68
Q

Myeloma

A

Malignant clonal proliferation of abnormal plasma cells which arise from bone marrow

69
Q

Myeloma Types

A

Solitary Lesion
- Plasmacytoma

Multiple Lesions
-0 Multiple Myeloma

70
Q

Myeloma Epidemiology

A

Aged 45-65

71
Q

Myeloma Symptoms

A 
Weakness
Back pain 
Bone pain 
Weight loss 
Fatigue 
Anaemia
72
Q

myeloma Diagnosis

A

Plasma Protein Electrophoresis

Early morning urine collection for Bence Protein Assay

73
Q

Myeloma appearance on imaging

A

no metastases may be seen on bone scan as there is not usually an osteoblastic response to the osteoclastic activity

74
Q

Myeloma Treatment

A

Plasmacytoma
- Radiotherapy

Multiple Myeloma
- Chemotherapy

75
Q

Primary Bone Tumour Mets

A 
Vertebrae
Pelvis
Ribs
Skull 
Humerus 
Long bones of lower limb
76
Q

Mets from other sites

A

Breast
Prostate
Lung
Renal

77
Q

breast metastases

A

Sclerotic or lytic

78
Q

Prostate metastases

A

Sclerotic
Pathological features more likely to heal due to high osteoblast activity
Hormonal therapy and radiotherapy can reduce chance of mets

79
Q

Lung metastases

A

Lytic

80
Q

Renal Metastases

A

Large vascular lytic ‘blow out’ mets
Surgery or biopsy may cause severe bleeding
1 bony met may be treated with nephrectomy.

MSK (35 decks)

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