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Orthopaedics > Bone + Soft Tissue Tumours > Flashcards

Bone + Soft Tissue Tumours Flashcards

1
Q

What is the most common benign bone tumour?

A

Osteochondroma

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2
Q

What is an osteochondroma and who gets them?

A

Bony outgrowth on the external surface with a cartilaginous cap
Age 10-20

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3
Q

What does an osteochondroma look like on xray?

A

Pedunculated bony outgrowth

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4
Q

What is the management of an osteochondroma?

A

Only needs to be excised if growing or painful

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5
Q

What is an enchondroma?

A

Intramedullary, metaphyseal, cartilaginous tumour

Caused by failure of normal endochondral ossification at growth plate

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6
Q

What does an enchondroma look like on xray?

A

Lucent oval + intact cortex

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7
Q

What is the management for an enchondroma?

A

If risk of impending fracture –> curettage + filled with bone graft

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8
Q

What is another name for osteoclastomas?

A

Giant cell tumours

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9
Q

What are osteoclastomas?

A

Giant cell tumour of epiphysis of long bones

–> pain, swelling and limitation of joint movement

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10
Q

What do osteoclastomas look like on xray?

A

Eccentric lytic area giving a ‘soap bubble’ appearance

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11
Q

What is the management of osteoclastomas/giant cell tumours?

A

Surgical resection

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12
Q

What are osteoid osteomas and how do they present?

A

Small tumours at metaphysis of long bones
Males ages 10-20
Localised progressive pain, worse at night

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13
Q

What do osteoid osteomas look like on xray?

A

Small lucent nidus surrounded by halo of reactive bone

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14
Q

What is the management of osteoid osteomas?

A

Conservative with NSAIDs for bone pain or

Surgical resection

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15
Q

What is a simple bone cyst?

A

Benign, fluid filled cyst

Metaphyseal in long bones, talus or calcaneus

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16
Q

What is an aneurysmal bone cyst and how is it managed?

A

Cyst containing multiple chambers filled with blood or serum
Locally aggressive causing cortical expansion + destruction
Painful + risk of fracture
–> curettage + grafting/bone cement

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17
Q

Which cancers commonly metastasise to bone?

A 
Prostate 
Breast
Kidney
Thyroid
Lung 
(PbKTL)
18
Q

What is the general management of bony mets?

A

Palliative usually

Can prophylactically nail long bones at risk of fracture

19
Q

What type of bony lesions does prostate cancer cause?

20
Q

What type of bony lesions does breast cancer cause?

A

Can be sclerotic or lytic

21
Q

What type of bony lesions does lung cancer cause?

22
Q

What type of bony lesions does renal cancer cause?

A

Large, vascular, lytic ‘blow out’ lesions

23
Q

How do primary bone cancers present?

A

Often misdiagnosed as muscular pain (present late)
Bone pain, worse at night/unexplained persistent pain
May be ill-defined bony swelling

24
Q

What is the most common cause of malignant bone tumour?

A

Metastases from other cancers

25
Q

What is the most common primary bone cancer?

A

Osteosarcoma

26
Q

What age is osteosarcoma most commonly seen?

A

Age 10-14 or

> 65 due to Paget’s disease

27
Q

What is the clinical presentation of osteosarcoma?

A

Localised constant pain + tender soft tissue mass

Most commonly at metaphysis of distal femur or proximal tibia

28
Q

What does osteosarcoma look like on xray?

A

Medullary and cortical bone destruction
+ significant periosteal reactions
–> Codman’s triangle or ‘sunburst’ pattern

29
Q

What is the management of osteosarcoma?

A

Biopsy to confirm

Aggressive surgical resection + chemotherapy

30
Q

What is a chondrosarcoma?

A

Cartilage producing tumour of axial skeleton (pelvis, shoulders, ribs) –> painful enlarging mass
Less aggressive than osteosarcoma

31
Q

What age group most commonly get chondrosarcomas?

32
Q

What do chondrosarcomas look like on xray?

A

Lytic lesions with calcification, cortical remodelling + endosteal scalloping

33
Q

What is Ewing’s sarcoma?

A

Paediatric malignancy with poor prognosis

Arise from primitive poorly differentiated neuroectodermal cells in diaphysis of long bones

34
Q

What is the clinical presentation of Ewing’s sarcoma?

A

Painful, enlarging, tender, warm mass

–> often mistaken for osteomyelitis

35
Q

What does Ewing’s sarcoma look like on xray?

A

Lytic lesion + periosteal reaction –> onion skin

36
Q

How can lymphoma affect bone?

A 
Primary bone tumour from marrow --> Non Hodgkins
Or lymphoma (any type) can metastasise to bone
37
Q

Which other cancer might present with bone lesions?

38
Q

What is the most common soft tissue tumour?

39
Q

What is a lipoma?

A

Benign proliferation of subcutaneous fat
–> soft fatty lump under skin
Dos not need excised

40
Q

What is a ganglion cyst?

A

Lump near a joint capsule or tendon sheath
Not a true cyst - no epithelial lining
Well defined, firm, transilluminate

41
Q

Where are some common sites for ganglion cysts?

A

Due to arthritis/joint damage:

  • wrist
  • Baker’s cyst in knee
  • Mucous cyst of DIP joint

Orthopaedics (18 decks)

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