Bone and soft tissue tumours

Question 1

Sarcoma

Answer 1

malignant tumour arising from connective tissues

Question 2

How do sarcomas spread?

Answer 2

along fascial planes
haematogenous to lungs
rarely to regional LN

Question 3

Malignant bone forming tumour

Answer 3

sarcoma

Question 4

cartilage forming malignancy tumours

Answer 4

chondrosarcoma

Question 5

Malignant marrow tissue tumours

Answer 5

Ewings
lymphoma
myeloma

Question 6

commonest primary tumour in younger patient

Answer 6

osteosarcoma

Question 7

commonest primary bone tumour in elderly

Answer 7

myeloma

Question 8

Bone tumours pain

Answer 8

activity related
progressive at rest
night pain

Question 9

When may benign tumours present with activity related pain?

Answer 9

large enough to weaken bone

Question 10

Examinations

Answer 10

measurements of mass 
location 
shape 
consistency 
mobility 
tenderness 
local temperature 
neurovascular deficits

Question 11

Investigations

Answer 11

plain x-rays 
CT
isotope bone scan 
MRI
angiography 
PET
biopsy

Question 12

x-ray findings - aggressive

Answer 12

less well defined zone of transition
cortical destruction
periosteal reactive new bone growth
onion skinning or sunburst pattern

Question 13

cardinal features of primary malignancy bone tumours

Answer 13

increasing unexplained pain 
deep seating boring pain 
night pain 
difficult weight bearing 
deep swelling

Question 14

clinical features of osteosarcoma

Answer 14

pain 
loss of function 
swelling 
pathological fracture 
deformity 
joint effusion

Question 15

swelling of bone tumours

Answer 15

diffuse, near end of long bone
warmth
pressure effects

Question 16

What is MRI good for showing?

Answer 16

intraosseus extent of tumour
skip metastases
joint involvement

Question 17

Soft tissue tumours suspicious signs

Answer 17

deep
>5cm
rapid growth, hard and non tender

Question 18

Soft tissue swelling

Answer 18

rapidly growing

hard, fixed, non tender

Question 19

7 commonest primary tumours metastasising to the bone

Answer 19

breast 
thyroid 
kidneys 
prostate 
lung
melanoma and GI

Question 20

preventing pathological fractures

Answer 20

early chemo and DXT

prophylactic internal fixation

Question 21

fracture risk assessment for pathological fractures

Answer 21

mirels