Bone and Soft Tissue Tumours Flashcards
What is a sarcoma?
A malignant tumour of connective tissue
How can sarcoma spread?
Fascial planes
Haematogeous spread to lungs
Rarely to regional lymph nodes
Is it more common for a bone primary tumour to be benign or malignant?
Benign
How are malignancies of bone likely to come about in over 50s?
Metastatic spread
What are examples of benign bone tumours?
Osteoid osteoma, osteoblastoma
What are examples of benign cartilage tumours?
Enchondroma
Osteochondroma
What is a malignant bone tumour called?
Osteosarcoma
What a malignant cartilage tumour called?
Chondrosarcoma
What is a benign fibrous tissue tumour called?
Fibroma
What are examples of malignant fibrous tissue tumours?
Fibrosarcoma
Malignant fibrous histiocytoma
What are examples of benign vascular tissue tumours?
Haemangioma
Aneurysmal bone cyst
What is a malignant vascular tissue tumour called?
Angiosarcoma
What is a benign adipose tissue tumour called?
Lipoma
What is a malignant adipose tissue tumour called?
Liposarcoma
What are examples of malignant marrow tissue tumours?
Ewing’s sarcoma
Lymphoma
Myeloma
What is the main symptom of a primary bone symptom?
PAIN
What are features of pain in bone tumours?
Activity related
Progressive pain at rest and at night
What should be done when examining a tumour?
General health of patient Measurement of mass Location of tumour Shape of tumour Consistency Mobility Tenderness Local temperature Neuro-vascular deficits
What investigations can be done for tumours?
X-rays
Calcifications
Myositis ossificans
Phleboliths in haemangioma
What is isotope bone scan used for?
Staging for skeletal metastasis
What are multiple lesions on an isotope bone scan a sign of?
Osteochondroma
Enchondroma
Fibrous dysplasia
Histiocytosis
What is MRI specific for?
Lipoma
Haemangioma
Haematoma
Pigmented VilloNodular Synovitis
What are cardinal features of malignant primary bone tumours?
Increasing pain Unexplained pain Deep-seated boring nature Night pain Difficulty weight bearing Deep swelling
What are clinical features of osteosarcoma?
Pain Loss of function Swelling Pathological fracture Joint effusion Deformity Neurovascular effects Systemic effects of neoplasia
What loss of function is a result of osteosarcoma?
Limp
Reduced joint movement
Stiff back
How is Ewing’s sarcoma treated?
Chemotherapy
Surgery
Radiotherapy
What should you do with patient’s with a suspected malignant soft tissue tumour?
Refer to specialist tumour centre
What are signs that would make you suspicious of a soft tissue tumour being malignant?
Deep to fascia Subctuaneous tumours >5cm Rapid growth Hard Craggy Non-tender
7 commonest primary cancers metastasising to bone?
Lung Breast Prostate Kidney Thyroid GI tract Melanoma
What scoring system is used to assess fracture risk assessment?
Mirel’s scoring system
How is the site scored in Mirel’s scoring system?
Upper limb - 1
Lower limb - 2
Peritrochanter - 3
How is pain scored in Mirel’s scoring system?
Mild - 1
Moderate - 2
Functional - 3
How is lesion scored in Mirel’s scoring system?
Blastic - 1
Mixed - 2
Lytic - 3
What is scored in Mirel’s scoring system?
Site
Pain
Lesion
Size
What score in Mirel’s scoring system is indicative of prophylactic fixation before radiotherapy?
8 or more
