bone tumours Flashcards
this tumour often occurs around the knee and distal radius with a ‘soap bubble’ appearance
giant cell tumour - benign
a single, lucent lesion, often an incidental finding, found most commonly within metaphyseal regions
a simple bone cyst - benign
a tumour extensively involving the proximal femur with cortical thinning and a ‘Shepherd’s crook’ deformity
fibrous dysplasia
adolescent with bony outgrowth on external surface with cartilaginous cap on xray
osteochondroma (benign)
20-50yrs with intramedullary + usually metaphyseal cartilaginous tumour on xray
enchondroma (benign)
most incidental + asymmptomatic
weakens bones - pathological fracture
treatment of enchondromas
conservative
if symptommatic = curettage + bone grafting
osteoid osteoma appearance on xray
small nest of immature (woven) bone surrounded by an intense sclerotic halo
osteoid osteoma presentation
adolescence
intense constant pain - worse at night
–> pain greatly relieved by NSAIDs (aspirin)
HALO (sclerotic)
some resolve, may require CT guided radiofrequency ablation
predisposing condition to primary malignant bone tumours
Paget’s (fast turnover of bone)
fibrous dysplasia (fibrous scars in place of bone)
multiple enchondromas (lots of benign bony tumours throughout skeleton)
list the primary malignant tumours which commonly spread to bone in order of frequency
- breast
- prostate
- lung
- renal cell
- thyroid
treatment of primary bone tumours
neo-adjuvant chemo (given prior to surgery)
–> shink tumour/reduce metastases
surgery - remove tumour + surrounding tissue
chemo+radio
tumour thats large + slow to metastasize in ages 40-75yrs
chondrosarcoma (malignant)
pelvis or proximal femur
unresponsive to chemo
Ewing’s sarcoma
malignant tumour of primitive cells in the marrow - poorest prognosis
10-20yrs
assoc. - fever, inflam markers, warm swelling
what is Ewing’s sarcoma commonly misdiagnosed as?
osteomyelitis
is Ewing’s sensitive to radio + chemo?
yup
