Bone Neoplasms

Question 1

3 most common types of bone neoplasms

Answer 1

1. osteosarcoma - most common primary bone cancer in children and young adults, tumor produces immature bone cells
2. Ewing’s sarcoma - second most common cancer in kids (15-25)
   affects long bones

3. Chondrosarcoma
20-60 year olds
trunk and proximal limbs
tumor produces cartilaginous matrix
chemo not effective

Question 2

general info on osteosarcoma

Answer 2

Affects 10-20 yo and > 65 yo

> 40 yo, cases are frequently asst w/ Paget’s disease of bone

risk factor - radiation therapy

Question 3

signs and sxs of osteosarcoma

Answer 3

Presenting complaint usually pain in a long bone
Femur, tibia, humerus (unilateral)

pain worse at night and w/ activity

fever, wt loss, fatigue, gut feeling this is not growing pains

Question 4

osteosarcoma diagnostic studies

Answer 4

1. w/ any pain get XRAY
   *sunburst pattern and codman’s triangle *
   may look normal beside STS
2. MRI
3. CT scan chest
4. Bone scan- evaluates whole skeleton, shows mets, radioactive dye that lights up area of bone turnover

Question 5

what makes the definitive diagnosis for osteosarcoma

Answer 5

bone biopsy

Question 6

tx of osteosarcoma

Answer 6

1. surgical excision (limb salvage) or amputation

2. adjuvant chemo prior to surgery, surgery, chemo after surgery

Question 7

general info on chondrosarcoma

Answer 7

second most common type of primary bone cancer

develops in cartilage

20-60 year olds (>50)

Slow growing, resistant to chemo

Question 8

signs and sxs of chondrosarcoma

Answer 8

slow growing mass on affected bone

pain worse at night, pain not relieved w/ rest, pain may be present and then increase gradually over tme

Question 9

diagnostic tests for chondrosarcoma

Answer 9

1. Xrays
   Fusiform, lucent defect w/
   scalloping of inner cortex and periosteal reaction
2. CT scan
3. MRI

Question 10

treatment of chondrosarcoma

Answer 10

surgery

since this is a slow growing cancer, chemo is NOT effective
relatively radioresistant

Question 11

general ewing’s sarcoma

Answer 11

develops in almost any bone or soft tissue, communal flat or long bone

minor trauma may be initiating event that calls attention to bone lesion

pain worse at night, aggravated w/ exercise

deep mass, firm

Question 12

ewing’s sarcoma x-ray

Answer 12

moth eaten pattern
cells destroy cortex
onion skin

then get MRI and bone biopsy

Question 13

treatment for ewing’s sarcoma

Answer 13

chemotherapy, surgery, chemotherapy

Question 14

what cancer is resistant to chemo?

Answer 14

chondrosarcoma

Question 15

What other types of cancers are associate w/ bone metastasis?

Answer 15

70% breast
60% prostate
RCC
Lung
Thyroid
Stomach
Intestinal

Question 16

name some common sides of bone metastasis

Answer 16

pelvis
spine
ribs
upper arms and thighs

have good blood supply