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MSK > bone tumours > Flashcards

bone tumours Flashcards

1
Q

what is the most common type of benign bone tumour?

A

osteochondroma

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2
Q

what is an osteochondroma?

A
  • the most common benign bone tumour

- a bony outgrowth of the external surface of bone which is surrounded by a cartilaginous cap

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3
Q

what age group do osteochondromas typically affect?

A

10-30

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4
Q

where do osteochondromas typically occur?

A

the epiphysis of the long bones (most commonly around the knee)

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5
Q

what is multiple osteochondroma?

A

-autosomal dominant condition due to mutations in ETX1 and ETX2 genes

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6
Q

what is the treatment for osteochondroma?

A

-excisional biopsy

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7
Q

how does osteochondroma usually present?

A
  • can be asymptomatic

- can cause localised pain/swelling

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8
Q

are enchondromas benign or malignant?

A

benign

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9
Q

what are enchondromas?

A

-benign, intramedullary, cartilaginous bone tumours that are most often found in the metaphysis (the area between the diaphysis and epiyphysis)

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10
Q

how do enchondromas typically present?

A
  • can be asymptomatic

- usually weaken bone and cause pathological fractures

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11
Q

where are enchondromas typically found?

A
  • long bones

- small bones of hands and feet

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12
Q

how do enchondromas appear on an Xray?

A
  • usually appear lucent

- can appear as patchy sclerotic lesions

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13
Q

what is the management for enchondroma?

A

-curettage and bone graft

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14
Q

what disease causes multiple enchondromas?

A

Maffucci’s disease

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15
Q

what diseases cause enchondromas?

A

Ollier’s disease

Maffucci’s disease

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16
Q

what is a simple bone cyst?

A

-a benign single cavity, fluid-filled cyst in the bone

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17
Q

where are simple bone cysts commonly found?

A
  • metaphysis of long bones

- talus and calcanus of foot

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18
Q

what causes a simple bone cyst?

A

-growth defect in the physis (growth plate)

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19
Q

what is the investigations for simple bone cyst?

A

-may be an incidental finding on an Xray

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20
Q

what is the treatment for a simple bone cyst?

A

-curettage and bone grafting with or without stabilisation

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21
Q

what is an aneurysmal bone cyst?

A
  • a benign bone cyst

- lesions of bone containing may blood/serum filled chambers

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22
Q

what causes aneurysmal bone cysts?

A

-small arteriovenous malformation

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23
Q

where do aneurysmal bone cysts typically occur?

A

in metaphysis of long bones, flat bones (skull and ribs) and vertebral bodies

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24
Q

how do aneurysmal bone cysts present and why?

A

very painful as they cause cortical expansion and destruction

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25
Q

what is the treatment for aneurysmal bone cysts?

A

-curettage, bone grafting and may need to use bone cement

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26
Q

what is an osteoid osteoma?

A
  • benign bone tumour

- small nidus of immature bone surrounded by intense sclerotic halo that secretes prostaglandins

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27
Q

who is more commonly affected by an osteoid osteoma?

A

-adolescents

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28
Q

where do osteoid osteoma commonly occur?

A
  • proximal femur
  • vertebra
  • diaphysis of long bones
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29
Q

how does osteoid osteomapresent?

A

-constant, dull pain, worse at night that is greatly relieved by NSAIDs

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30
Q

what is used to confirm the diagnosis of an osteoid osteoma?

A
  • CT scan

- bone scan

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31
Q

what treatment is given for osteoid osteoma?

A
  • NSAIDs for pain relief

- can be self resolving, if not then CT radiofrequency ablation may be used

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32
Q

what is a giant cell tumour?

A

-a rare, aggressive but benign tumour

33
Q

where do giant cell tumours usually occur?

A
  • most commonly around the knee and in distal radius

- can also occur in other long bones, the pelvis and spine

34
Q

how do giant cell tumours present?

A
  • occur as physis has fused and are locally destructive so destroy the cortex
  • painful
  • can cause pathological fractures

occur in:

  • typically distal radius and knee
  • long bones
  • pelvis
  • spine
35
Q

what investigations are done for giant cell tumours?

A

Xray= will show a soap bubble appearance

Bone biopsy= will show large multinucleated giant cells

35
Q

what investigations are done for giant cell tumours?

A

Xray= will show a soap bubble appearance

Bone biopsy= will show large multinucleated giant cells

36
Q

what is the treatment for giant cell tumours?

A
  • intra lesional excision

- may need joint replacement for very aggressive tumours

37
Q

what is fibrous dysplasia?

A

-a benign bone condition that causes normal bone to be replaced with fibrous tissue

38
Q

what causes fibrous dysplasia?

A

-a genetic condition

39
Q

what parts of the body does fibrous dysplasia tend to affect?

A
  • femur
  • tibia
  • humerus
  • pelvis
  • skull
  • ribs
40
Q

how does fibrous dysplasia present?

A
  • bone curvature
  • bone deformity
  • bone fractures
  • bone pain
  • swelling
41
Q

what investigations are done for fibrous dysplasia?

A

bone scan

42
Q

what is the treatment for fibrous dysplasia?

A
  • biphosphonates to relieve pain

- internal fractures stabilised

43
Q

what is Brodie’s abscess?

A

-a benign and subacute form of osteomyelitis that is contained to a localised area and walled off by fibrous and granulation tissue

44
Q

what causes Brodie’s abscess?

A

-staph aureus

45
Q

what investigations can be done for Brodie’s abscess?

A

Xray will show lytic lesion of bone

46
Q

what is Brown tumour?

A

-a benign focal bone lesion caused by increased osteoclastic activity, fibroblastic proliferation and found in patients with uncontrolled hyperparathyroidism

47
Q

what disease is linked with Brown Tumour?

A

-hyperparathyroidism

48
Q

where do Brown tumours commonly present?

A
  • maxilla

- mandible

48
Q

where do Brown tumours commonly present?

A
  • maxilla

- mandible

49
Q

how do Brown’s tumours present on an Xray?

A

-as a lytic lesion of bone

50
Q

what is the most common malignant bone tumour?

A

-osteosarcoma

51
Q

what is an osteosarcoma?

A
  • it is the most common malignant bone tumour
  • bone producing tumour
  • every malignant tumour that produces bone is classed an an osteosarcoma until proven otherwise
52
Q

who is typically affected by osteosarcoma?

A

<20

53
Q

where do osteosarcomas typically present?

A

> 50% occur in the knee

54
Q

where do osteosarcomas typically metastases to?

A

the lung

55
Q

how do osteosarcomas typically spread?

A
  • mainly through the blood

- also can spread through lymphatics

56
Q

how does osteosarcoma present?

A
  • constant pain
  • weight loss
  • worse at night
  • fatigue
57
Q

what is a chondrosarcoma?

A
  • a malignant cartilage producing tumour

- it is not as aggressive or common as osteosarcoma

58
Q

who does chondrosarcoma usually affect?

A

-the average age is 45 years

59
Q

where does chondrosarcoma usually occur?

A
  • pelvis

- proximal femur

60
Q

how does chondrosarcoma usually present?

A
  • constant pain
  • swelling
  • fracture due to weakened bone
  • if pressing on spinal cord they may experience weakness, numbness or incontinence (urination or defecation)
61
Q

what is the treatment for chondrosarcoma and why?

A
  • surgery
  • as they are very large and slow to metastasise
  • they also do not respond to radiotherapy or adjuvent chemotherapy
62
Q

what is the second most common malignant bone tumour?

A

Ewings sarcoma

63
Q

which malignant bone tumour has the worst prognosis?

A

Ewing’s sarcoma

64
Q

what is Ewing’s sarcoma?

A
  • the second most common malignant bone tumour
  • bone tumour with the worst prognosis
  • small round blue cell tumour
65
Q

what causes Ewing’s sarcoma?

A

translocation mutation between. chromosome 11 and 22

66
Q

where does Ewings sarcoma typically present?

A

long bones

-most commonly in femur

67
Q

how does Ewings sarcoma present on an Xray?

A

-it looks like onion skin

68
Q

what is the treatment for Ewing’s sarcoma?

A
  • suregery to remove the tumous

- radiotherapy and chemotherapy

69
Q

what is a lymphoma?

A

-a malignant tumour of the round cells of lymphatic system and macrophages

70
Q

how do lymphomas present?

A
  • night sweats
  • unexplained weight loss
  • fever
  • lymphadenopathy
  • fatigue
71
Q

what is the treatment for lymphoma?

A

primary: surgery
metastatic: chemotherapy or radiotherapy

72
Q

what is the survival rate for lymphoma?

A

usually <2 years

73
Q

what is a myeloma?

A

-a malignant bone tumour caused by clonal proliferation of abnormal plasma cells which arise from bone marrow

74
Q

what would you call a myeloma that presents as a solitary lesion and what would you call a myeloma that presents as multiple lesions?

A

solitary: plasmacytoma
multiple: multiple myeloma

75
Q

how does myeloma present?

A
  • weakness
  • backpain
  • fatigue
  • weight loss
  • anaemia
76
Q

what is the treatment for myeloma?

A

plasmacytoma:
-surgery

multiple myeloma:
-chemotherapy

77
Q

what investigations are done for myeloma?

A

Plasma protein electrophesis:
-showing high levels of paraprotein

Early morning urine collection for Bence Jones protein assay

MSK (64 decks)

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