Bone tumors Flashcards
When is the bone malignancy metastatic and when is it primary?
1) Metastatic in adult age group
2) Primary in pediatric age group
Describe bone tumor
- It is the growth of abnormal cells in the bone that does not fulfill a function
- It forms 0.2% of human tumor burden
- Primary malignant bone tumors makes 1% of all malignant tumors
What are the different classification of bone tumors?
- Based on the tissue of origin:
1) Bone
2) Cartilage
3) Fibrous tissue
4) Bone marrow
5) Blood vessels
6) Mixed
7) Uncertain origin
How do we diagnose bone cancer?
1) History
2) Physical examination
3) Investigations (Series of plain X-rays, biopsy, etc)
How do we evaluate bone neoplasm?
1) Age
2) Sex
3) Morphology of the tumor (border, bone destruction, periosteal reaction, matrix, soft tissue mass)
4) Single or multiple
5) Location of the tumor (which bone & where in the bone)
How do we evaluate bone cancer?
1) Gait (for example limping is caused by a compression to the common peronial nerve)
2) Observe mass, swelling or any deformity
3) Palpate (tender, cold, warm, fluctuant)
4) NV exam
5) Lymph node examination
6) Abdominal exam for masses
What causes the pain in bone tumors?
1) Weakening of the bone (due to imminent fracture, pathological fracture, bone destruction)
2) Exerting local pressure on the periosteum, surround soft tissue, or nerves
How to evaluate a lump/swelling?
1) Site
2) Size
3) Shape
4) Skin cover
5) Recent changes
6) Mobility
7) Tenderness
What is meant by effusion?
It is the collection of fluid in the joint, and its clinical presentation (limitation of movement)
- It is one of the clinical pictures of bone tumors
What are some of the signs that the tumor has metastasized?
1) Pathological fracture
2) Spinal instability
3) Spinal cord compression (bowel & bladder dysfunction)
4) Metastatic organ function (dyspnea to lung metastasis)
What characterizes a pathological fracture?
1) Large lytic lesions
2) Weak bone (with varying densities in the site of fracture)
3) Sclerotic borders
What are the bone tumors characterized for children and young adults?
1) Primary osteosarcoma
2) Ewing’s sarcoma
Is chondrosarcomas common in children and middle age patients?
NO
What is the commonest skeletal malignancy in ppl over 40?
Metastatic cancer
- Multiple myeloma
- Chondrosarcoma
What is meant by giant cell tumor?
- Locally aggressive lesions in the epiphysis
- It has a lucrative structure
- Occurs exclusively in skeletally mature patients (20-50 yrs, with closed epiphysis)
What pathologies can give all types of X-rays (Well-defined, ill-defined, & sclerotic)?
Bone Infection
What is the importance of the location of the tumor?
Some tumors almost exclusively occurs at specific sites
1) Central or eccentric
2) Cortex or medulla
3) Epiphysis, metaphysis or diaphysis
In which location is chondroblastoma most common?
1) <30 years epiphysis