bone tumours

Question 1

what are the 2 categories of bone tumours

Answer 1

primary and secondary

Question 2

what are primary bone tumours

Answer 2

Cancers that originate in the bone.

Question 3

are primary bone tumours more common or secondary

Answer 3

secondary are the most common bone malignancies
primary are rare

Question 4

most common primary bone tumour

Answer 4

osteosarcoma

Question 5

what are secondary bone tumours

Answer 5

Cancers that originate outside of the bone.

Question 6

causes of primary bone tumours

Answer 6

exact causes of primary bone cancers are not fully understood

factors that increase risk:
- genetic factors
- radiation exposure
- bone conditions such as Paget’s disease

Question 7

giv3 4 primary bone tumours

Answer 7

• osteosarcoma
• ewing sarcoma
• fibrosarcoma
• chondrosarcoma

Question 8

what are the 5 secondary tumors that spread to bone

Answer 8

Breast, lung, thyroid, kidney, and prostate

BLT KP

Question 9

what are the common sites for bone metastases in order

Answer 9

1. lungs
2. liver
3. bone

Question 10

presentation of osteosarcoma

Answer 10

Warm, painful swelling, often around the knee

Question 11

most common age of osteosarcoma

Answer 11

15 - 19

Question 12

where does osteosarcoma metastaize

Answer 12

to lung

Question 13

what does x ray of osteosarcoma show

Answer 13

‘sunburst’ appearing bone

Question 14

what causes ewings sarcoma

Answer 14

it originates from mesenchymal stem cells

Question 15

what age does ewings sarcoma present

Answer 15

15 year old
very rare tho

Question 16

presentation of ewings sarcoma

Answer 16

• Systemic symptoms
• Raised inflammatory markers
• Painful, warm, enlarging mass along the long bone diaphysis

Question 17

what age does chondrosarcoma present

Answer 17

older patients

Question 18

presentation of chondrosarcoma

Answer 18

Pain and a lump

Question 19

general symptoms of bone tumours

Answer 19

local:
- severe pain worst at night
- decreased range of motion of long bones
- increased fractures
- Atypical bony or soft tissue swelling/ masses
- Easy Bruising

systemic:
- weight loss
- fatigue
- fever
- malaise

Question 20

investigations for bone tumours

Answer 20

1. X-ray (1st line)
2. Blood tests
3. Biopsy (gold standard)
4. MRI
5. CT
6. Bone scan - skeletal isotope scan

Question 21

what do blood tests for bone tumours find

Answer 21

• increased ALP
• increased ESR/CRP
• hypercalcaemia

Question 22

what do x rays for bone tumours show

Answer 22

osteolysis - process of progressive destruction of bone tissue

Question 23

why is skeletal isotope scan better than x ray for bone tumours

Answer 23

shows bone changes earlier

Question 24

4 treatment options for bone tumours

Answer 24

1. Surgical resection
2. Radiation therapy
3. Systematic chemotherapy
4. biphosphonates