Benign (but locally aggressive) MSK tumours Flashcards
What are the 3 main benign but locally aggressive MSK tumours ?
- Giant cell tumour
- Osteoblastoma
- Chordoma
Describe the epidemiology of giant cell tumours
- > common in women
- Affects people aged 25-40
- Affects epiphysis of lone bones often around the knee
Describe the radiological appearance of giant cell tumours
- Radiolucent with increasing density towards periphery.
- Destruction of medullary cavity and adjacent cortex
- May expand into soft tissue.
Describe the histopathological appearance of giant cell tumours
Multinucleated giant cells in a sea of round to oval mononuclear cells
Describe the epidemiology of osteoblastomas
- Affects the metaphysis or diaphysis of long bones and spine
- Usually in there 10-30s
Describe the ragiological appearance of osteoblastomas
Appear as a radio-lucent defect with a central density due to ossification. The lesion is well circumscribed and may have a surrounding sclerosis
Describe the histopathology of osteoblastomas
Classic finding is irregular spicules (needle-like structures) of mineralised bone and eosinophilic osteoid rimmed by osteoblasts
Describe the treatment of osteoblastomas
Biopsy to diagnose
Then surgical resection by either:
- Curettage
- Intralesional excision
- En bloc resection
Describe the epidemiology of chordomas
- Occurs in adults 40+
- Affects the sacrum, skull base and spine
Describe the radiological appearance of chordomas
- Appear as a solitary mid-line lesion with bony destruction
- Often accompanying soft-tissue mass
Describe the histopathology of chordomas
Appear as soft, blue-grey lobulated tumours
Describe the treatment of chordomas
- Wide surgical excision is desirable but rarley fessible due to location
- Radiation used if complete ressection not possible
- Chemo for late stages
