Bone and soft tissue tumours

Question 1

What is sarcoma?

Answer 1

Malignant tumours arising from connective tissue

Question 2

Benign bone forming tumours

Answer 2

osteoid osteoma

osteoblastoma

Question 3

Malignant bone forming tumours

Answer 3

osteosarcoma

Question 4

Benign cartilage forming tumours

Answer 4

endochroma

osteochroma

Question 5

Malignant cartilage forming tumours

Answer 5

chondrosarcoma

Question 6

Benign fibrous tissue tumours

Answer 6

fibrosarcoma

Question 7

Malignant fibrous tissue tumours

Answer 7

fibrosarcoma

malignant fibrous histiocytoma

Question 8

Benign vascular tissue tumours

Answer 8

haemangioma

aneurysmal bone cyst

Question 9

benign adipose tissue tumours

Answer 9

lipoma

Question 10

malignant adipose tissue tumours

Answer 10

liposarcoma

Question 11

Malignant tissue tumours

Answer 11

Ewing’s sarcoma
Lymphoma
Myeloma

Question 12

Clinical features of bone tumours

Answer 12

Pain

Activity related or progressive pain at rest and night

Question 13

Bone tumour investigations?

Answer 13

Plain x-rays (calcification and Myositis ossificans)
CT (assessing ossification and calcification, staging)
Isotope bone scans (skeletal metastasis)
MRI (size, extent, anatomical relationships. Non specific benign vs malignant)
Biopsy(complete work up prior)

Question 14

Cardinal features of malignant primary bone tumours

Answer 14

Increasing pain
Unexplained pain
Deep-seated boring nature of ache
Night pain
Difficulty weight bearing
Deep swellign

Question 15

Osteosarcoma clinical Features

Answer 15

pain
loss of function 
swelling
pathological fracture
joint effusion
deformity
neurovascular effects
systemic effects of neoplasia

Question 16

Osteosarcoma investigations

Answer 16

MRI scan - investigation of choice
Good for showing intraosseus and extraosseus soft tissue extent of tumour, joint involvement, skip mets and epiphyseal extension
Determines resection margins

Question 17

Treatment of bone tumours

Answer 17

Chemotherapy
Surgery
Radiotherapy

Question 18

Suspicious signs of soft tissue tumours

Answer 18

Deep tumours of any sizr
Subcutaenous tumours >5cm
Rapid growth, hard, craggy, non tender

Question 19

7 commonest cancers that metastasise to bone

Answer 19

Lung, prostate, kidney, thyroid, GI tract, melanoma, breast