Bone and soft tissue cancer Flashcards
Osteosarcoma epidemiology
commonest primary bone malignancy
adolescent males
mutation of the Rb gene significantly increases risk of osteosarcoma
Osteosarcoma features
presents with a warm, painful swelling and most commonly at the knee.
40% occuring in the femur, 20% in the tibia, and 10% in the humerus
Osteosarcoma X-ray shows
periosteal reaction with codman’s triangle (from periosteal elevation) and a sunburst appearance
Ewing’s Sarcoma features
small round blue cell tumour
children and adolescents
pelvis and long bones.
severe pain, warm, enlarging mass along long bone diaphysis. systemic symptoms
associated with t(11;22) translocation which results in an EWS-FLI1 gene product
Ewing’s Sarcoma xray shows
onion skin periosteal reaction
Chondrosarcoma features
cartilaginous malignancy
older patients (>40) with pain and a lump. Many of these arise from previous chondromas that have undergone malignant change. most commonly affects the axial skeleton
Chondrosarcoma xray shows
lytic lesion with ‘fluffy popcorn calcification’.
Osteoma features
benign ‘overgrowth’ of bone, most typically occuring on the skull
associated with Gardner’s syndrome (a variant of familial adenomatous polyposis, FAP)
Osteochondroma (exotosis) features
most common benign bone tumour
more in males, usually diagnosed in patients aged < 20 years
cartilage-capped bony projection on the external surface of a bone
Giant cell tumour
tumour of multinucleated giant cells within a fibrous stroma
peak incidence: 20-40 years
occurs most frequently in the epiphyses of long bones
Giant cell tumour xray shows
‘double bubble’ or ‘soap bubble’ appearance
Tumours that metastasise to bone may
“lead kettle” spelt PBKTL
P: prostate
B: breast
K: kidney
T: thyroid
L: lung
