Bone & Soft Tissue Tumours Flashcards
1
Q
Definition
A
Tumours which originate from the connective tissues and spread along fascial planes
Large and deep swellings = Sarcoma
Bone
- Benign: Osteoma / Osteoblastoma
- Malignant: Osteosarcoma
Cartilage
- Benign: Enchocondroma / Osteochondroma
- Malignant: Chondrosarcoma
Fibrous
- Benign: Fibroma
- Malignant: Fibrosarcoma
Vascular
- Benign: Haemangioma / Aneurmal bone cysts
- Malignant: Angiosarcoma
Adipose
- Benign: Lipoma (not just bone)
- Malignant: Liposarcoma
Marrow
- Benign: None
- Malignant: Ewing’s Sarcoma / Lymphoma
Others
- Benign: Giant Cell Tumours (very disruptive)
- Malignant: Giant cells may metastasise
Tumour-Like Lesions
- Benign: Simple bone cyst
2
Q
Epidemiology
A
Bone: Benign (common) - Occasional cause a fracture Primary (very rare): - Osteosarcoma; 3:1,000,000 / Male>Female - Chondrosarcoma 2:1,000,000 - Ewings 1.5:1,000,000 Secondary (very common)
3
Q
Pathophysiology
A
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4
Q
Etiology/Risk Factors
A
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5
Q
Presentation
A
Pain (very common): - Activity related - Progressive pain at rest & NIGHT Mass: - Mass - Shape - Consistency - Mobility - Tenderness - Temperature change - Sensory loss - Location
Malignant mass signs:
- Rapid growth
- Hard
- Fixed
- Craggy edges
- Non-tender (but deep pain)
Weight loss
General ill health
Previous history!
History of previous cancer check for secondary: 1 - Lung 2 - Breast 3 - Prostrate 4 - Kidney (very vascular, need embossing) 5 - Thyroid 6 - GI 7 - Melanoma
6
Q
Lab Work Up
A
FBC
Liver function
U&Es
Biopsy (histology)
7
Q
Imagining
A
X-Ray (benign are often incidental) - Calcification CT - Ossification - Calcification - Cortex - Staging
Isotope bone scans
- Staging in skeletal metastasis
MRI
- Limits of the disease in and out of bone (anatomical relationships)
8
Q
Complications
A
Heamotolgenous spread to lungs, lymph metastasis is rare
Pathological fracture
9
Q
Differential Diagnosis
A
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10
Q
Treatment
A
Chemotherapy Surgery: - Excision & filler - Amputation Radiotherapy
11
Q
Prognosis
A
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12
Q
Histology
A
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