Bone cancer Flashcards

1
Q

What are 3 histological patterns of bone destruction?

A
  1. Geographic: lesion has a clearly defined margin
  2. Moth-eaten: larger holes of various sizes
  3. Permeative: ill-defined, diffuse, subtle appearance
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2
Q

What is the term for a small benign bone tumour usually seen in male children/adolescents?

A

Osteoid osteoma

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3
Q

Where do osteoid osteomas usually form?

A

Midshaft of femur

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4
Q

What is the cell lineage of an osteoid osteoma?

A

Mesoderm > Fibroblasts > Osteoblasts > Osteoid osteoma

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5
Q

What is the most common symtom of an osteoid osteoma?

A

Localized, increasing, severe pain in the lower leg

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6
Q

How does an osteoid osteoma appear on CT scan?

A

Tumour core (nidus): osteoid tissue containing osteoblasts, osteoclasts, granulation tissue, nest-like appearance

Shell of dense, reactive, new bone

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7
Q

What is the prognosis of osteoid osteoma?

A

Excellent: cannot become malignant

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8
Q

What is the term for a highly malignant tumour of osteoblasts and neoplastic bone?

A

Osteosarcoma

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9
Q

How common is osteosarcoma?

A

Most common type of malignant primary bone tumour

(which is still rare, because primary bone tumours are rare)

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10
Q

What demographics are commonly affected by osteosarcoma?

A

Males

Young people (10-25 yrs)

Old people (>60 yrs)

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11
Q

What comorbidity may predispose an individual to osteosarcoma?

A

Paget’s disease

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12
Q

What are 3 common places where osteosarcoma may be found?

A
  1. Knee
  2. Vertebrae
  3. Pelvis
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13
Q

Why does osteosarcoma increase a patient’s risk for fracture?

A

Tumour destroys bone cortex

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14
Q

What is the cell lineage of an osteosarcoma?

A

Mesoderm > Fibroblasts > Osteoblasts > Osteosarcoma

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15
Q

What is the histological appearance of an osteosarcoma?

A

Pleomorphic cells mixed with new bone

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16
Q

What is the term for a commonly benign tumour of giant osteoclasts causing extensive bone resorption?

A

Giant cell tumour (osteoclastoma)

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17
Q

What demographics are commonly affected by giant cell tumour?

A

Adults (20-40 yrs)

Older women (especially those with Paget’s, radiation exposure)

18
Q

Where does giant cell tumour usually occur?

A

Usually at junction of metaphysis & epiphysis of long bones (near joints—e.g. shoulder, wrist, knee)

19
Q

What happens to the bone cortex as a result of giant cell tumour, and what does this put the patient at risk for?

A

Becomes egg-shell thin due to bone resorption

Can rupture, causing hemorrhage

20
Q

What is the cell lineage of giant cell tumour?

A

Mesoderm > Reticulum > Blood cell precursors > Giant cell tumour

21
Q

What is the histological appearance of a giant cell tumour?

A

Small neoplastic mononuclear cells mixed with giant multinucleated osteoclasts (can have >100 nuclei)

22
Q

What are 2 treatments for giant cell tumour?

A

Curettage and bone grafting

23
Q

What is the prognosis of giant cell tumour?

A

50% are benign and do not recur
30% recur
20% are malignant

24
Q

What is the term for a highly malignant tumour seen in children/young adults, unique as it accumulates glycogen?

A

Ewing sarcoma

25
Q

What is the underlying cause of Ewing sarcoma?

A

Genetic mutation: translocation of chromosomal segments

26
Q

Where does Ewing sarcoma usually occur?

A

Long bones of limbs

27
Q

What is the cell lineage of Ewing sarcoma?

A

Mesoderm > Reticulum > Blood cell precursors > Ewing sarcoma

28
Q

How does Ewing sarcoma manifest clinically?

A

Similar symptoms of osteomyelits

29
Q

How is Ewing sarcoma diagnosed?

A

PAS stain to detect glycogen

30
Q

What is the prognosis for Ewing sarcoma?

A

Good, 5-year survival rate for a localized disease is 75%

31
Q

What is the term for a malignant tumour of cartilage?

A

Chondrosarcoma

32
Q

What demographics does chondrosarcoma usually affect?

A

Males

Older adults (40-70 yrs)

33
Q

What is one way that chondrosarcoma is different from osteosarcoma?

A

Slower growing

34
Q

Where does chondrosarcoma usually occur?

A

Spongy bone of spine and pelvis

35
Q

What are 2 ways chondrosarcoma lead to local destruction of bone?

A
  1. Stimulates osteoclasts to resorb bone
  2. Enlargement of tumour causes erosion of bone cortex and soft tissue impingement
36
Q

What is the cell lineage of chondrosarcoma?

A

Mesoderm > Fibroblasts > Chondroblasts > Chondrosarcoma

37
Q

What are 3 unique characteristics of the appearance of chondrosarcoma?

A
  1. Primitive cartilage cells
  2. Lobules of hyaline cartilage enlarging bone
  3. Calcification with no new bone
38
Q

What is the term for a malignant tumour composed of fibroblasts, collagen, and osteoclast-like cells?

A

Fibrosarcoma

39
Q

Where does fibrosarcoma usually occur?

A

Metaphyses of femur or tibia

40
Q

What is the cell lineage of fibrosarcoma?

A

Mesoderm > Fibroblasts > Fibrosarcoma

41
Q

What is the most common type of bone tumour?

A

Secondary bone tumour

42
Q

Depending on the primary cancer, what are 3 characteristics that secondary bone tumours may exhibit?

A
  1. Osteolytic (increased risk of fracture)
  2. Bone forming (high density areas of bone)
  3. Mixed