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
What is the underlying cause of Ewing sarcoma?
Genetic mutation: translocation of chromosomal segments
26
Where does Ewing sarcoma usually occur?
Long bones of limbs
27
What is the cell lineage of Ewing sarcoma?
Mesoderm > Reticulum > Blood cell precursors > Ewing sarcoma
28
How does Ewing sarcoma manifest clinically?
Similar symptoms of osteomyelits
29
How is Ewing sarcoma diagnosed?
PAS stain to detect glycogen
30
What is the prognosis for Ewing sarcoma?
Good, 5-year survival rate for a localized disease is 75%
31
What is the term for a malignant tumour of cartilage?
Chondrosarcoma
32
What demographics does chondrosarcoma usually affect?
Males Older adults (40-70 yrs)
33
What is one way that chondrosarcoma is different from osteosarcoma?
Slower growing
34
Where does chondrosarcoma usually occur?
Spongy bone of spine and pelvis
35
What are 2 ways chondrosarcoma lead to local destruction of bone?
1. Stimulates osteoclasts to resorb bone 2. Enlargement of tumour causes erosion of bone cortex and soft tissue impingement
36
What is the cell lineage of chondrosarcoma?
Mesoderm > Fibroblasts > Chondroblasts > Chondrosarcoma
37
What are 3 unique characteristics of the appearance of chondrosarcoma?
1. Primitive cartilage cells 2. Lobules of hyaline cartilage enlarging bone 3. Calcification with no new bone
38
What is the term for a malignant tumour composed of fibroblasts, collagen, and osteoclast-like cells?
Fibrosarcoma
39
Where does fibrosarcoma usually occur?
Metaphyses of femur or tibia
40
What is the cell lineage of fibrosarcoma?
Mesoderm > Fibroblasts > Fibrosarcoma
41
What is the most common type of bone tumour?
Secondary bone tumour
42
Depending on the primary cancer, what are 3 characteristics that secondary bone tumours may exhibit?
1. Osteolytic (increased risk of fracture) 2. Bone forming (high density areas of bone) 3. Mixed