Bone and soft tissue tumours Flashcards
Name two types of bone cancers
osteosarcoma
chondrosarcoma
ewing sarcoma
Name two types of soft tissue sarcoma
Rhabdomyosarcoma – originating from skeletal muscle
Leiomyosarcoma – originating from smooth muscle cancer
Liposarcoma – originating from adipose (fat) tissue
Synovial sarcoma – originating from soft tissues around the joints
Angiosarcoma – originating from the blood and lymph vessels
Kaposi’s sarcoma
In which group of patients is kaposi’s sarcoma most commonly seen?
HIV patients
What causes kaposi’s sarcoma?
HSV 8
What are the investigations for bony lumps and persistent pain?
Xray, CT/MRI for metastatic spread, biopsy
What is the initial imaging used for soft tissue lumps?
ultrasound (xray for bony lumps)
What is the most common site of metastasis for sarcoma?
lungs
State three signs and symptoms of bone tumours
pain
swelling
joint swelling and stiffness
limping
fever
generally unwell
weight loss
anaemia
List three investigations for suspicious bone/soft tissue lesions
Xray
Blood tests
CT scan
MRI
Biopsy
Name a blood test for suspicious bone/soft tissue lesion
alk phos
Name a benign bone tumour that typically arises in long bones
osteoid osteoma
Name two benign bone tumours
osteoid osteoma
osteochondroma- cartilage
simple bone cyst
Name two malignant bone tumours
chondrosarcoma
osteosarcoma
Ewing’s sarcoma
What is the most common cause of destructive bone lesion in adults
metastatic cancer
Name a benign bone lesion that can causes pathological fracture
simple cyst
Describe two features of xray of benign bone tumour
narrow zone of transition
centrally located within cortices
Which small bone can be confused with fracture/osteophyte/tophi?
sesamoid- fingers, toes
List two features of malignant bone tumor on xray
sclerotic margins
periosteal reaction
irregular border
soft tissue involvement
Name the imaging for bone malignancy?
NM bone scan- nuclear medicine
Which oral solution is given during bone scan
biphosphonate
How to distinguish between the presentation of osteosarcoma and ewing’s sarcoma in children?
osteosarcoma- painless
ewing’s- painful and surrounding erythema
List two common sites for bone mets
spine
prox femur
humerus
List one red flag for bone pain
night pain
List three primary tumours for secondary bone mets
Breast
Bronchus
Byroid
Bidney
Brostate
List two symptoms of hypercalcaemia
confusion, weakness, nausea, dehydration
List three investigations for bone mets
alk phos
myeloma screen
calcium
FBC
CT chest abdo pelvis
Bone scan
What is mirel’s score?
Mirels’ score is a tool useful in the management of bone tumors, by identifying those patients who would benefit from prophylactic fixation if they have a high enough risk of pathological fracture.
State two non surgical options in the management of secondary bone mets
biphopsphonates
analgesia
chemo
denosumab
