Bone Tumours Flashcards

1
Q

what is an osteoma?

A

benign overgrowth of bone
most typically on skull

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2
Q

what is osteoma a/w?

A

gardner’s syndrome (variant of FAP)

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3
Q

what is an osteochondroma?

A

most common benign bone tumour
cartilage-capped bony projection on the external surface of a bone

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4
Q

who is osteochondroma more common in?

A

males
usually <20y

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5
Q

what is another term for osteochondroma?

A

exotosis

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6
Q

what is a giant cell tumour?

A

tumour of multinucleated giant cells within a fibrous stoma

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7
Q

peak incidence of giant cell tumour?

A

20-40y

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8
Q

what do giant cell tumour affect?

A

frequently in epiphyses of long bones

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9
Q

what do x-rays show in giant cell tumours?

A

double bubble or soap bubble appearance

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10
Q

list the benign bone tumours

A

osteochondroma
osteoma
giant cell tumour

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11
Q

list the malignant tumours

A

osteosarcoma
ewing’s sarcoma
chondrosarcoma

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12
Q

what is an osteosarcoma?

A

most common primary malignant bone tumour

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13
Q

who do osteosarcomas occur in?

A

children and adolescents
mostly males

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14
Q

where do osteosarcomas often occur?

A

metaphyseal region of long bones before epiphyseal closure

40% femur (distal)
20% tibia (proximal)
10% humerus

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15
Q

what do x-rays show in osteosarcoma?

A

periosteal reaction with codman’s triangle
sunburst appearance

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16
Q

mutation in what gene increases risk of osteosarcoma?

A

rb gene
hence a/w retinoblastoma

17
Q

what are other predispoing factors to osteosarcoma (other than rb gene)?

A

paget’s
radiotherapy

18
Q

what is ewing’s sarcoma?

A

small round blue cell tumour
tends to cause severe pain

19
Q

who does ewing’s sarcoma mostly affect?

A

children and adolescents

20
Q

where does ewing’s sarcoma commonly occur?

A

diaphysis of pelvis and long bones

21
Q

what is ewing’s sarcoma a/w?

A

t(11;122) translocation
results in EWS-FLI1 protein (i.e. the gene product) - can be detected on fine needle aspiration

22
Q

what does x-ray of ewing’s sarcoma show?

A

onion skin periosteal reaction

23
Q

what is chondrosarcoma?

A

malignant tumour of cartilage

24
Q

what does chondrosarcoma affect?

A

most commonly, axial skeleton

25
who does chondrosarcoma affect?
more common in middle age (>40)
26
what is used to score predict risk of fracture with secondary bone tumours?
mirel scoring
27
what do secondary bone tumours look like on x-ray?
appearance depends on primary - prostate -> sclerotic - breast -> lytic
28
bone profile for secondary bone tumours?
elevated ca and ALP
29
mx for secondary bone tumours?
radiotherapy prophylactic fixation analgesia
30
how does osteosarcoma present?
warm painful swelling most commonly at knee
31
how does ewing's sarcoma present?
systemic symptoms - fever, anaemia bloods - raised ESR, WCC
32
how does chondrosarcoma present?
pain a lump
33
what does x-ray of chondrosarcoma show?
lytic lesion with 'fluffy popcorn calcification'