Bone and soft tissue tumours Flashcards
What is a common location for a sarcoma to spread to Haematogenously?
Lungs and fascial planes
Name suspicious signs of soft tissue tumours on examination
deep, subcutaneous>5cm, rapidly growing, hard and craggy
commonest primary malignant ‘bone’ tumour in older patient
Myeloma
commonest primary malignant bone tumour in younger patient
Osteosarcoma
What is a Red flag symptom of a bone tumour
Deep ache which is worse at night and at rest, persistent and increasing
What should you look for on examination of the bone mass
measurement, location, shape, consistency, mobility, tenderness, temperature, neurovascular deficits
Cardinal Malignant features of bone tumours are…
unexplained pain of a deep seated and boring nature worse at night, difficulty weight bearing (loss of function), deep swelling, joint effusion, neurovascular effects, fractures
What is the Ix of choice/ most sensitive for a Osteosarcoma?
MRI
On Ix what is found on XR if the tumour is active?
clear margins, surrounding rim of reactive bone, cortical expansion
On Ix what is found on XR if the tumour is inactive?
unclear margins, cortical destruction, periosteum is reactive, onion skinning pattern
On Ix why is an isotope bone scan used?
assessing ossification, cortex integrity, staging primarily for the lungs
On Ix why is CT used?
staging for skeletal metastases
What method can differentiate between benign and malignant?
tissue diagnosis
16f back pain, isotope bone scan shows uptake at the left proximal humerus
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32m #distal tibia, developed anterior knee pain which is deteriorating. # slow to heal, develops fixed flexion deformity of his knee
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23m knee pain deteriorating continuoisly therapy not working
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Osteosarcomas present with what kind of loss of function
limping, reduced joint movement, stiff back (especially in children)
Osteosarcomas present with what kind of swelling features?
warmth over the swelling, generally near the end of long bone and diffuse in malignancy
Effects between the ages of 10-20 and is a very rare form of bone tumor…
Ewigs Sarcoma
Tx of bone tumours are…
Chemo, radiotherapy, surgery
what are the most common sites for secondary bone tumours?
vertebrae> proximal femur, pelvis, ribs, sternum, skull
bone is the 3rd most common site for mets after…
lung and liver
breast tumours most commonly go to…
Bone
melanomas most commonly go to…
Lung
Name the most common primary cancer sites to then metastasize to bone?
Lung, breast, prostate, thyroid, gi tract, melanoma.
how long will a patient with a pathalogical fracutre survive?
50% >6m, 30%>1yr
what are the methods of preventing a pathalogical fracture?
early chemo, prphylactic internal fixation, bone cement, embolisation,
What factors does Mirel’s fracutre scoring system use?
Site, Pain, Lesion, Size.
