Bone and Soft Tissue Tumors

Question 1

What is the commonest primary malignant bone tumor in younger patients?

Answer 1

Osteosarcoma

Question 2

What is the commonest primary malignant bone tumor in older patients?

Answer 2

Myeloma

Question 3

What is the 3 most important point when examining someone with a suspected bony tumor?

Answer 3

Measure the mass
Location
Temperature - Due to increased blood flow

Question 4

What will the appearance of an inactive benign bony lesion be on an x-ray?

Answer 4

Clear margins
Surrounding rim of reactive bone
Cortical expansion can occur with aggressive benign lesions

Question 5

What will the appearance of an aggressive bony lesion be on an x-ray?

Answer 5

Less-well defined zone of transition between lesion and normal bone.
Cortical destruction - Malignancy.
Periosteal reactive new bone growth occurs when the lesion destroys the cortex.

Question 6

When is an isotope bone scan used?

Answer 6

Staging for skeletal masses

Multiple lesions

Question 7

What is the radiological study of choice for soft tissue and bone tumors?

Answer 7

MRI

Question 8

What are the cardinal features of primary malignant bone tumors?

Answer 8

Increasing pain
Unexplained pain
Deep-seated boring pain
Night pain
Difficulty weight-bearing
Deep swelling

Question 9

What is the scoring system used to risk assess for pathological fractures?

Answer 9

Mirel’s Scoring System

Question 10

What is the most common type of soft tissue tumor?

Answer 10

Lipoma

Question 11

What are suspicious signs with regards to diagnosing a soft tissue tumor?

Answer 11

Any deep swelling
Subcutaneous tumors
Rapid growths which are hard, craggy and non-tender.