bone and soft tissue tumours Flashcards

Question

low grade

Answer 1

well differentited few mitoses moderate cytological atypia < 25% risk for metastases

Answer 2

stage II poorly differentiated high mitotic rate high cell /matrix ratio

Answer 3

``` IA and IIA contained within well defined anatomical compartments (barriers to tumour growth) cortical bone articular cartilage fascial septa joint capsule IB & IIB extend beyond compartment of origin III lesion has metastasised regardless of size or histological grade ```

Answer 4

``` pain- not related to exercise deep boring ache, worse at night loss of function swelling pathological fracture joint effusion stiff back ```

Answer 5

warmth+ venous congestion pressure effects near end of long bone

Answer 6

70% survival rate 5 year less well defined for adult soft tissue not used for cartilaginous/ low grade adjuvant therapy

Answer 7

``` wide surgical margins marginal with adjuvant osteoarticular allograft endoprosthetic reconstruction rotaionoplasty ```

Answer 8

intralesional marginal wide radical

Answer 9

will survival be affectd short long term morbidity function of limb compared to prosthesis recurrence

Answer 10

cell position in cell cycle tissue oxygenation DNA damage repair inability to undergo apoptosis

Answer 11

multiple myeloma lymphoma ewings metastic carcinoma

Answer 12

reduce local recurrence of soft tissue sarcome pre operatively to reduce tumour volume complications: skin, osteonecrosis, sarcoma- 10 yrs

Answer 13

autosomal dominant cartilage capped bony outgrowths typically near physes of long bones sessile/ pedunculated periochondrol covering similiar to growth plate benign bone tumour

Answer 14

deep tumours subcu > 5cm rapid growth, hard craggy, non tender but associated with deep ache ie worse at night previously excised swellings recurring

Answer 15

breast commonly goes to bone melanoma commonly goes to lung order of frequency: vertebrae> proximal femur> pelvis> ribs> sternum> skull

Answer 16

``` LUNG- smoker, CXR, sputum cytology BREAST- commonest Prostate- osteosclerotic Kidney- solitary, vascular, angiography &embolise, IVP and US Thyroid- esp follicular Ca GI tract- FOB, endoscopy Melanoma- examine ```

Answer 17

local invasion of normal stromal cells by primary tumour -increased local pressure + dissection by tumour cells along lines of least resistance -tumour cells invade local lymphatics& vessels point of embolisation Tumour emboli normally destoyed by killer cells, vascular turbulence surviving tumour emboli embedded and adherent to distant capillary bed of preffered organ

Answer 18

red marrow bones only eg vertebrae, ribs | rare distal to knee elbow usually suqamous Ca lung

Answer 19

breast prostate renal-> plexus-> bone

Answer 20

``` nausea vomiting anorexia lethargy confusion coma ```

Answer 21

prophylactic internal fixation | mirel's scoring system

Answer 22

high failure rate | never rush to fix fracture check if metastatic

Answer 23

bone tumours: unexplained pain hard fixed swelling ``` Soft tissue tumours: swelling > 5 cm any swelling deep to deep fascia may be painless recurring swelling ```