Bone tumours

Question 1

What is osteosarcoma?

Answer 1

Most common primary malignant bone tumour

Question 2

Where does osteosarcoma occur?

Answer 2

in the metaphyseal region of long bones

Question 3

What are examples of long bones?

Answer 3

Femur
Tibia
Humerus

Question 4

How does osteosarcoma present?

Answer 4

• Persistent bone pain- worse at night
• Bone swelling
• Palpable mass

Question 5

When does the bone pain tend to be worse with Osteosarcoma?

Answer 5

At night

Question 6

How is osteosarcoma diagnosed?

Answer 6

X-ray within 48 hours

Question 7

What would you find on an x-ray of someone with osteosarcoma?

Answer 7

• 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

Question 8

What is the fluffy appearance due to?

Answer 8

Destruction of normal bone

Question 9

What other investigation could you do for osteosarcoma?

Answer 9

Blood test

Question 10

What might you find in the blood of someone with osteosarcoma?

Answer 10

• Raised ALP

* Lactate dehydrogenase

Question 11

What indicates a worse prognosis?

Answer 11

A high Lactate dehydrogenase

Question 12

Where does bone cancer metastasise to?

Answer 12

Lungs

Question 13

What can be used to stage osteosarcoma?

Answer 13

• CT/MRI

* Bone scan and bone biopsy

Question 14

What is the management of osteosarcoma?

Answer 14

Resection of the tumour-sometimes require amputation

Question 15

What genetic mutation increases the risk of osteosarcoma?

Answer 15

Mutation of the Rb gene

Question 16

What are predisposing factors for osteosarcoma?

Answer 16

Paget’s disease of the bone

Radiotherapy

Question 17

What is Ewing’s sarcoma?

Answer 17

Malignant tumour that occurs in the diaphysis of the pelvis and long bones

Question 18

Which bones does Ewing’ sarcoma affect?

Answer 18

Pelvis

Femoral diaphysis- most common

Question 19

Who does Ewing’s sarcoma affect?

Answer 19

Boys mainly

Age 10-20

Question 20

How does Ewing’s sarcoma present?

Answer 20

Severe pain

Question 21

What type of tumour does Ewing’s sarcoma cause?

Answer 21

Small round blue cell tumour

Question 22

What would you see on an x-ray of someone with Ewing’s sarcoma?

Answer 22

Onion-skin appearance

Question 23

How is Ewing’s sarcoma diagnosed?

Answer 23

Fine needle aspiration of the lesion

Question 24

What would you find in the aspiration of Ewing’s sarcoma?

Answer 24

Presence of EWS-FLI1 protein