Bone Cancer Flashcards
1
Q
What are types of primary bone malignancies?
A
- Osteosarcoma- most common
- Ewing’s sarcoma
- Chondrosarcoma
2
Q
Who gets osteosarcoma?
A
- Mainly children and adolescents
3
Q
Where does osteosarcoma occur?
A
- Metaphyseal region of long bones prior to epiphyseal closure
- 40% occuring in femur
- 20% in tibia
- 10% in humerus
4
Q
Xray findings in osteosarcoma?
A
- Codman triangle (from periosteal elevation)
- Sunburst pattern
5
Q
What genes are associated with osteosarcoma?
A
- Mutation of Rb gene significantly increases the risk of osteosarcoma
- Hence association with retinoblastoma
6
Q
What other predisposing factors are there for osteosarcoma?
A
- Paget’s disease of the bone
- radiotherapy
7
Q
Presentation of osteosarcoma?
A
- Bone pain- particularly at night
- mass or swelling
- restricted movement in joint
may be mistaken for growing pains in kids
8
Q
Presentation of osteosarcoma?
A
- Bone pain- particularly at night
- mass or swelling
- restricted movement in joint
may be mistaken for growing pains in kids
9
Q
Ddx for osteosarcoma?
A
- Growing pains
- Septic arthritis
- Gout
- Ewings sarcoma
10
Q
Where do sarcomas metastise to?
A
- lungs
11
Q
Investigations of osteosarcoma?
A
- X-ray of the bone/ joint
- CT thorax as it most likely metastises to the lungs
- Biopsy
12
Q
Management of osteosarcoma?
A
- Surgery-removing tumour or limb sparing or partial or full amputation
- Chemotherapy- neoadjuvant in the pelvis, may have adjuvant after
- Immunotherapy e.g. mifamurtide (MEPACT) in children and adolescents and help reduce chance of tumour coming back
- Radiotherapy- not often used
13
Q
What is the histology of Ewing’s sarcoma?
A
- Small round blue cell tumour
14
Q
Who gets Ewing’s sarcoma?
A
- children and adolescents
15
Q
Where does Ewing’s sarcoma affect?
A
- pelvis and long bones
- tends to cause severe pain
