benign tumours Flashcards
what is osteochondroma
bony outgrowth with a cartilaginous cap on the external surface
what is does osteochondroma usually affect
long bones near the growth plates in those aged 10-30
what is the most common type of benign bone tumour
osteochondroma
what is the cause of osteochondroma
idiopathic
multiple osteochondroma = autosomal dominant disorder
what are the symptoms of osteochondroma
usually asymptomatic
pain
what is the risk of malignant transformation
small (1%)
what is the treatment of osteochondroma
if lesion is growing in size or causing pain it may require excision biopsy
what is Enchondroma, where do they occur
intramedullary and usually metaphyseal cartilaginous tumour
femur, humerus, tibia, small bones of the hands and feet
describe an Enchondroma
lucent lesion but can undergo mineralisation with a patchy sclerotic appearance
what are the causes of Enchondroma
failure of normal Enchondromal ossification at the growth plates
as part of a syndrome
what syndromes can cause Enchondroma
Ollier’s
Maffuci
what is Ollier’s syndrome
rare, non-hereditary sporadic disorder where Enchondromas develop close to growth [late cartilage
what is Maffuci’s syndrome
sporadic disease characterised by the presence of multiple Enchondromas associated with cavernous haemangiomas and pleobolith (small calcifications within a vein)
what are the symptoms of Enchondroma
asymptomatic
weekend bone may result in pathological fracture
what is a simple bone cyst, what is it also known as
single cavity, fluid filled cyst within the bone
aka unicameral bone cyst
where do simple bone cysts occur
the metaphyseal in long bones (usually the proximal humerus and femur)
can also occur in the talus or calcaneus
what causes simple bone cyst
growth defect from the physis
what are the symptoms of simple bone cyst
asymptomatic
can cause weakness resulting in pathological fracture
what is an aneurysmal bone cyst
many chambers filled with blood or serum within the bone
where do aneurysmal bone cysts occur
in the metaphyses of many long bones, flat bones, and vertebral bodies
what is the cause of aneurysmal bone cyst
small, arteriovenous malformation
describe the actions of an aneurysmal bone cyst and what this causes
locally aggressive causing cortical expansion and destruction resulting in pain
what are the symptoms of an aneurysmal bone cyst
pain
pathological fracture
where do a giant cell tumours occur
around the knee and in the distal radius
can occur in long bones, pelvis, and spine
when do giant cell tumours occur
after the physis has fused
what are the symptoms of giant cell tumours (GCT)
pain
pathological fracture
5% metasise to the lung causing benign pulmonary GCT
what are the investigations of giant cell tumours, what can be seen in them
x-ray = soap bubble (BUZZWORD)
what is the treatment of giant cell tumours
intralesional excision + phenol/bone cement/liquid nitrogen (kills remaining tumour material to prevent recurrence)
what are the types of giant cell tumours, what do they affect
pigmented villonodular synovitis (PNVS) = large joints
giant cell tumour of tendon sheath (GCTS) = digits
describe pigmented villonodular synovitis (PNVS)
destructive and diffuse so are difficult to excise and often reoccur
describe giant cell tumour of tendon sheath
small nodules that are easily excised by occasionally reoccur
what is fibrous dysplasia and what causes it
lesions od fibrous tissue and immature bone due to genetic mutation
when does fibrous dysplasia occur, and what does it affect
usually in adolescence
can affect one bone (monostoic) or multiple (polystoic)
what are the symptoms of fibrous dysplasia
defective mineralisation causes angular deformities
stress fractures
shepherd crook deformity
describe the bone in fibrous dysplasia
wider but with thinned cortices
soap bubble appearance is a buzzword for what condition
Giant cell tumour
what is the investigation for fibrous dysplasia
bone scans = intense increase in uptake during development before lesion becomes inactive
what is the treatment of fibrous dysplasia
bisphopshates = reduce pain
shepherds crook deformity is a buzzword for what condition
fibrous dysplasia
what is an osteoid osteoma
a small nidus of immature bone surrounded by sclerotic halo
where do osteoid osteomas occur
proximal femur
diaphysis of long bones
vertebrae
when do osteoid osteomas occur
adolescence
what are the symptoms of osteoid osteomas
constant, intense pain worse at night
what are the investigations of osteoid osteomas
X-ray
Boen scan = intense local uptake
CT
what is the treatment of osteoid osteomas
NSAIDs = pain relief
may spontaneously resolve
CT guided radio frequency ablation
what is a brodies abscess
subacute osteomyelitis which is contained to a localised area and walled off by fibrous and granulation tissue
what is the cause of a brodies abscess
staph aureus
what can a brodies abscess present with
lytic lesion of bone
what is a brown tumour
a bone lesion which arises in setting of excess osteoclast activity. it is not a true neoplasm but may mimic it
where does a brodies abscess commonly affect
maxilla and mandible
what is the cause of a brodies abscess
hyperparathyroidism
what is the treatment of abscesses
antibiotics + drainage
what is a bursitis
inflammation of the bursa
what is a bursa, what is its function
a small fluid filled sac lined by synovium around a joint
prevents friction between tendons, bones, muscles and skin
what are the causes of bursitis
repeated pressure or trauma
bacterial infection
what is the treatment of bursitis
the swelling will usually subside on it’s own but a thickened burial sac may remain
excision may be required but can cause problems with scarring
describe a ganglion cyst, where do they occur
occurs around a synovial joint or tendon sheath.
well-defined, readily transilluminate and may be firm
no epithelial lining (not a true cysts)
what is the cause of a ganglion cyst
herniation or out-pouching of a weak portion a joint capsule or tendon sheath
what cause the weakness which allows a ganglion cyst to occur
developmental e.g. juvenile baker cyst
underlying joint damage/arthritis with a build up of pressure within the joint e.g. adult baker cyst
describe the histology of a ganglion cyst
space within mixed material
may have secondary inflammatory changes
what is the treatment for ganglion cysts
excision if causing discomfort or for cosmesis
what is the most common benign soft tissue tumour
lipoma
what is a lipoma
neoplastic proliferation of fat which usually occurs in the subcutaneous fat but can occur in the middle
describe the histology of a lipoma
resembles normal fat
nuclei are small and at the edge
describe a angiolipoma
usually multiple and peripheral
vascular with fibrin thrombi
painful
