Bone cancers Flashcards
1
Q
Primary
A
- Started in bones, no prior cause
- Rare
- Classified by cell type
- May present with P, tenderness and local swelling
- Rapid growth and ill-defined edge suggestive of malignant growth
2
Q
Secondary
A
- Tend to spread from area of primary tumour (blood flow)
- Metastatic tumours in bone relatively common
- Prostate, breast, lung, thyroid, kidney, colon
- Present with symptoms/signs of a pathological fracture
- Commonly presents with bone P, Lsp, ribs and pelvis common, Csp less common
- Irregular bony lysis/missing pedicel on x-ray
- New presentation of myopathy/neuropathy
3
Q
Malignant disease
A
- Paraneoplastic syndrome
- Hypertrophic pulmonary osteoarthropathy
- Paraneoplastic polyarthritis
4
Q
Types of bone cancer
A
- Osteoid osteoma
- Osteochondroma
- Chordoma
- Chondrosarcoma
5
Q
Osteoid osteoma
A
- Small benign tumour-Osteoid/newly formed bone
- Px <30
- Femur or tibia
- X-ray features
- Bone scan may show inc activity
- Excision
6
Q
Osteochondroma
A
- Most common bone tumour
- Onset in adolescence
- Initial cartilage overgrowth from epiphyseal plate with latter ossification
- Growth after full growth of bones, may indicate malignancy
- bony hard lump
- Well defined on x-ray
- Excision
7
Q
Chondroma
A
- Being or cartilaginous tumour
- Single or multiple
- Long bones of hand or feet
- P and swelling, or fracture
- X-ray area orf medulla rarefaction with calcification
- Older age group
- Excision, replacement with bone graft
8
Q
Chondrosarcoma
A
- May exist in 2 forms
1. Chondroma which subsequently expands, older person presenting with P or pathological fracture
2. Malignant changes in osteochondroma. If growing in pelvic basin may be large before clinically recognised swelling - Wide excision
- Radiotherapy
9
Q
Ewing’s tumour
A
- Rare
- Malignant
- Origin from vascular endothelium in bone marrow
- In teenager in diaphysis of long bones
- Presentation with P/swelling post trauma
- Ill-defined warm and tender lump
- X-ray bone destruction
10
Q
Multiple myeloma
A
- Neoplasm of plasma cells
- Infiltrates bone marrow
- 6-70
- M:F equal
- Bone P- back, shoulder, ribs, long bones rarely
- High ESR
- Bloods, x-rays
- single/multiple chemo
11
Q
Giant cell tumour
A
- Young adults
- Epiphysis fused bones, lower femur, upper tibia, lower radius, upper humerus
- Presents with P, swelling, pathological fracture
- 1/3 benign, 1/3 locally invasive, 1/3 mets
- X-ray- asymmetrically placed, from metaphysis to aub-articular margin, cortex thin/perforated
- Curretage, excision, radiotherapy
12
Q
Osteosarcoma
A
- Tumour of childhood/adolescents/Paget’s
- Arises in metaphysis-knee/prox humerus
- Metastases early to lung/other bone
- P, constant, swelling, tenderness, heat
- > 50% Hx trauma
- X-ray- bone destruction, raised periosteum, new bone formatio
13
Q
Aneurysmal bone cyst
A
- Occurs at any age/any bone
- Ballooning of bone end
- Benign- no malignant transformation
- P accompanies expanding lesion
- X-ray shows well defined radiolucent cyst
- Tumour contains clotted blood surrounded by fibrous fleshy lining
- Treatment curettage/packing
- May recover
14
Q
Hereditary multiple exostosis
A
- Autosomal dominant/variable expression
- Often discovered in childhood
- Apophyseal border enlargement
- Bony shortening/deformity
- Bony growth ceases with parent bone
- Post skeletal maturity- consider malignancy
15
Q
Non ossifying formation
A
- Usually metaphyseal
- Asymptomatic/often incidental
- treatment often unnecessary
