Bone tumours Flashcards
What is osteosarcoma?
Most common primary malignant bone tumour
Where does osteosarcoma occur?
in the metaphyseal region of long bones
What are examples of long bones?
Femur
Tibia
Humerus
How does osteosarcoma present?
- Persistent bone pain- worse at night
- Bone swelling
- Palpable mass
When does the bone pain tend to be worse with Osteosarcoma?
At night
How is osteosarcoma diagnosed?
X-ray within 48 hours
What would you find on an x-ray of someone with osteosarcoma?
- Sun burst appearance in periosteum
- Fluffy appearance due to destruction of normal bone
- Poorly defined lesions in the bone
- X-ray may show Codman triangle
What is the fluffy appearance due to?
Destruction of normal bone
What other investigation could you do for osteosarcoma?
Blood test
What might you find in the blood of someone with osteosarcoma?
- Raised ALP
* Lactate dehydrogenase
What indicates a worse prognosis?
A high Lactate dehydrogenase
Where does bone cancer metastasise to?
Lungs
What can be used to stage osteosarcoma?
- CT/MRI
* Bone scan and bone biopsy
What is the management of osteosarcoma?
Resection of the tumour-sometimes require amputation
What genetic mutation increases the risk of osteosarcoma?
Mutation of the Rb gene
What are predisposing factors for osteosarcoma?
Paget’s disease of the bone
Radiotherapy
What is Ewing’s sarcoma?
Malignant tumour that occurs in the diaphysis of the pelvis and long bones
Which bones does Ewing’ sarcoma affect?
Pelvis
Femoral diaphysis- most common
Who does Ewing’s sarcoma affect?
Boys mainly
Age 10-20
How does Ewing’s sarcoma present?
Severe pain
What type of tumour does Ewing’s sarcoma cause?
Small round blue cell tumour
What would you see on an x-ray of someone with Ewing’s sarcoma?
Onion-skin appearance
How is Ewing’s sarcoma diagnosed?
Fine needle aspiration of the lesion
What would you find in the aspiration of Ewing’s sarcoma?
Presence of EWS-FLI1 protein
