Bone Tumours Flashcards
what is the most common primary tumour of bone marrow?
multiple myeloma
what is multiple myeloma?
a tumour that forms in the white cells of the bone marrow
who is generally affected by multiple myeloma?
elderly patients
what cancers commonly spread to bone?
breast lung prostate renal thyroid
when are primary bone sarcomas more common?
childhood
what are the risk factors for primary bone cancers?
previous radiotherapy
predisposing conditions
genetic conditions
what are the three predisposing conditions for primary bone cancers?
Paget’s disease
fibrous dysplasia
multiple enchondromas
what genetic conditions increase risk of primary bone tumours?
li fraumeni
familial retinoblastoma
what age group is most commonly affected by primary bone tumours?
10-30
how does a primary bone tumour present?
persistent pain
swelling and erythema
palpable mass
pathological fracture
describe the pain associated with primary bone tumours
worse at night
well localised
doesn’t respond well to analgesia
when do primary bone tumours cause pathological fractures?
if they have caused loss of bone
what investigations are done for primary bone tumours?
x-rays
CT
MRI
bone scan
what are the neoadjuvant treatment options for primary bone tumours?
chemotherapy
radiotherapy
hormone therapy
what is the aim of Neo adjuvant therapy in primary bone tumours?
shrink tumour before surgery
reduce risk of metastasis
what surgery can be done for primary bone tumours?
excision and reconstruction
amputation
what adjuvant treatment may be done for primary bone tumours?
chemotherapy
radiotherapy
what is the most common malignant tumour of bone?
osteosarcoma
what age group is affected by osteosarcoma?
children
young adults
what is the second peak of osteosarcoma?
elderly patients with Paget’s
where does osteosarcoma usually affect?
around the knee
how do around a fifth of patients with osteosarcoma present?
with pulmonary metastases
how is osteosarcoma managed?
chemotherapy
limb salvage
who gets Ewing’s sarcoma?
5-25 years old
where is Ewing’s sarcoma usually found?
diaphsysis of long bones
what is the prognosis of Ewing’s sarcoma?
70% if localised
30% if metastatic
how is Ewing’s sarcoma managed?
chemo
limb salvage
+/- radiotherapy
is Ewing’s sarcoma benign or malignant?
malignant
what is chondrosarcoma?
malignancy of chondrocytes
who gets chondrosarcoma?
older patients (40-75)
where is chondrosarcoma commonly found?
pelvis
femur
describe the appearance of chondrosarcoma on x-ray
lytic/blastic lesions with cortical thickening
is osteoid osteoma benign or malignant?
benign
where is osteoid osteoma usually found?
long bones
who gets osteoid osteoma?
young people (5-25)
how does osteoid osteoma present?
pain that is worse at night and relieved by aspirin
when do osteoid osteomas get better?
spontaneously after 6-18 months
what management can be done for osteoid osteoma?
radiofrequency ablation
what is the most common benign bone tumour?
osteochondroma
what is an osteochondroma?
a benign lesion formed from abnormal cartilage
when do multiple osteochondromas occur?
in hereditary multiple exostoses (HME)
who gets osteochondroma?
common in young people
how can osteochondroma be managed?
excised if causing symptoms
what is an enchondroma?
a benign intramedullary cartilage lesion
who gets enchondromas?
20-50 year olds
how does an enchondroma present?
asymptomatic
usually an incidental finding
how is enchondroma managed?
conservative usually
curettage and bone grafting if symptomatic
what does it mean if a lesion is lytic?
loss of bone
what does it mean if a lesion is sclerotic?
gain of bone
