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MSK > bone and soft tissue tumours > Flashcards

bone and soft tissue tumours Flashcards

1
Q

what are sarcomas ?

A

malignant tumours arising from connective tissues
spread along fascial planes
haematogenous spread to lungs
rarely to regional lymph nodes

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2
Q

what are benign bone-forming tumours ?

A

osteoid osteoma

osteoblastoma

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3
Q

what are malignant bone-forming tumours ?

A

osteosarcoma

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4
Q

what are benign cartilage-forming tumours ?

A

enchondroma

osteochondroma

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5
Q

what are malignant cartilage-forming tumours ?

A

chondrosarcoma

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6
Q

what are benign fibrous tissue tumours ?

A

fibroma

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7
Q

what are malignant fibrous tissue tumours ?

A

fibrosarcoma

malignant fibrous histiocytoma

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8
Q

what are benign vascular tissue tumours ?

A

haemangioma

aneurysmal bone cyst

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9
Q

what are malignant vascular tissue tumours ?

A

angiosarcoma

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10
Q

what are benign adipose tumours ?

A

lipoma

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11
Q

what are malignant adipose tissue tumours ?

A

liposarcoma

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12
Q

what are malignant marrow tissue tumours ?

A

Ewing’s sarcoma
lymphoma
myeloma

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13
Q

what are suspicious signs of a soft tissue tumour ?

A

deep - deep to fascia of any size
subcutaneous tumours >5cm
rapid growth, hard, craggy, non-tender

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14
Q

what features of swelling should you beware of ?

A

rapidly growing
hard, fixed, craggy, indistinct margin
non-tender, but deep ache at night
recurred after excision

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15
Q

what is the most common primary malignant bone tumour in young people ?

A

osteosarcoma

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16
Q

what is the most common primary malignant ‘bone’ tumour in old people ?

A

myeloma

17
Q

what is the clinical presentation of a bone tumour ?

A

pain - activity related, progressive at rest and night
mass
abnormal xray

18
Q

what xray findings are suggestive of specific diseases ?

A

calcification - synovial sarcoma
myositis ossificans
phleboliths in haemangioma

19
Q

what xray signs suggest inactive tumour ?

A

clear margins
surrounding rim of reactive bone
cortical expansion can occur with aggressive lesions

20
Q

what xray features suggest aggressive tumour ?

A

less well defined margins
cortical destruction
periosteal reactive new bone growth occurs when the lesion destroys the cortex
onion skinning

21
Q

what conditions can you see multiple lesions on an isotope bone scan ?

A

osteochondroma
enchondroma
fibrous dysplasia
histiocytosis

22
Q

what are cardinal features of malignant primary bones tumours ?

A 
increasing pain
unexplained pain
deep-seating boring nature
night pain
difficulty weight bearing
deep swelling
23
Q

what are clinical features of an osteosarcoma ?

A 
pain - cardinal, worse at night
loss of function- limp, reduced ROM, stiff back
swelling
pathological fracture
joint effusion
deformity
neurovascular effects
systemic effects of neoplasia
24
Q

what is the investigation for osteosarcoma ?

A

MRI
bone scan
xray

25
Q

how do you treat Ewing’s sarcoma ?

A

chemo
surgery
radiotherapy

26
Q

what are the 7 most common cancers which metastasise to bone ?

A 
lung
breast - commonest
prostate
kidney
thyroid
GI 
melanoma
27
Q

what is the survival rate for patients with pathological fractures ?

A

50% survive >6months

30% survive >1year

28
Q

how do you prevent pathological fracture ?

A

early chemo
prophylactic internal fixation
bone cement

29
Q

what is the scoring system for fracture risk and what are the variables ?

A

Mirel’s scoring

site
pain
lesion
size

30
Q

what are score 1 options on fracture risk assessment ?

A

upper limb
mild pain
blastic lesion
<1/3rd

31
Q

what are score 2 options on fracture risk assessment ?

A

lower limb
moderate pain
mixed lesion
1/3-2/3rd

32
Q

what are score 3 options on fracture risk assessment ?

A

peritrochanter
functional pain
lytic lesion
>2/3rd

MSK (29 decks)

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