Bone Tumours

Question 1

Presentation of a bone tumour?

Answer 1

1. Asymptomatic Incidental on xray
2. Symptomatic
   Pain nocturnal
   Lump / swelling
   Deformity of growth
   Pathological fracture (can occur with a bone cyst)
   Systemic symptoms: fever, weight loss, fatigue (absent in benign tumours)

Question 2

Three most common genuine bone tumours

Answer 2

1/ Osteosarcoma
> Most common in <20 yrs old and in this group 80% occur in long bones of the extremities (WHO classification of bone tumours)
> Secondary osteosarcoma, occur in older patients with Paget’s disease

2/Chondrosarcoma (occurs more commonly in (>30 years of age)

3/ Ewing’s sarcoma (most common in 10-15 year old age group) (most common = pelvis)

Question 3

The most common epiphyseal tumour in childhood ?

Answer 3

Chondroblastoma

Ref: WHO Classification of Bone Tumours

Question 4

DDx of bone tumours

Answer 4

Bone Forming Tumours
Benign = Osteoid Osteoma (common in adolescents)
Osteoblastoma
Malignant = Osteosaroma

Cartilaginous forming tumours
Benign = Osteochondroma, Enchondroma,
Chondroblastoma
Metastatic = Chondrosarcoma

Fibrous tumours
Benign = Fibrous dysplasia
Metstatic = Fibrosarcoma

Unknown
Benign = Giant Cell tumour
(benign, but can be aggressive, 2% can metastasise)
Malignant = Ewing’s tumour / Giant Cell tumour