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Repetition > Bone Tumours > Flashcards

Bone Tumours Flashcards

1
Q

Commonest benign bone tumour?

A

Osteochondroma

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2
Q

X-ray appearance of osteochondroma?

A

Bony spur with cartilaginous cap

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3
Q

X-ray appearance of osteoid osteoma?

A

Sclerotic halo around immature bone

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4
Q

Characteristic pain in osteoid osteoma?

A

Severe, worse at night, relieved by NSAIDs

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5
Q

Which (benign) tumour has a 1% risk of malignant transformation?

A

Osteochondroma

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6
Q

Commonest site of osteochondroma?

A

Knee

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7
Q

Benign tumour that classically affects small tubular bones of the hands and feet?

A

Enchondroma

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8
Q

Scenario: fractured clavicle in an 8 year old due to FOOSH. On x-ray, there is a lucent lesion in the middle 1/3 of the clavicle with a smooth edge where it meets the more normal looking bone. There is mild expansion of the cortex.

What’s caused this pathological fracture?

A

Simple bone cyst

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9
Q

Treatment of a simple bone cyst?

A

Curettage and bone graft

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10
Q

What’s an aneursymal bone cyst filled with?

A

Blood / plasma

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11
Q

What is fibrous dysplasia?

A

Normal bone and marrow is replaced with fibrous tissue - the resultant bone is weak and prone to expansion.

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12
Q

What cellular abnormality occurs to cause fibrous dysplasia?

A

problem in G protein signalling

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13
Q

What causes shepherd crooks deformity?

which condition, and which bone is affected

A

Proximal femur involvement in fibrous dysplasia

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14
Q

Treatment of fibrous dysplasia?

A

Bisphosphonates plus internal fixation of pathological fractures

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15
Q

Other conditions can present with a lytic bone lesion.

These presentations include Brodie’s abscess and Brown’s tumour - what conditions are these lesions related to?

A

Brodie’s abscess = subacute osteomyelitis

Brown’s tumour = hyperparathyroidism

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16
Q

Buzzword / classic sign for giant cell tumour on x-ray?

A

Soap bubble appearance

17
Q

Where can giant cell tumour spread to?

A

Lungs, causing benign pulmonary giant cell tumour

18
Q

What’s the chromosomal translocation associated with giant cell tumours?

A

Translocation between chromosome 1 and 2

19
Q

Most commonly location for a giant cell tumour?

A

Knee and distal radius.

Tends to be metaphyseal and epiphyseal. They are locally destructive to the cortex

20
Q

Histology of giant cell tumours?

A

many multi-nucleated giant cells

21
Q

What’s the difference between pain in osteoblastoma and osteoid osteoma?

A

Osteoblastoma isn’t worse at night

Note both conditions are clinically and histologically similar, though osteoblastoma is larger

22
Q

Where does chondroma develop from (embryologically)?

A

Notochord (which forms the spinal cord in foetuses)

23
Q

What age group is usually affected by chondoma?

Which bone is affected?

A

40-60 year olds

Any part of the spine (tumour develops from notochord)

24
Q

x-ray appearance of an aneursymal bone cyst?

A

Multiple chambers visible

25
Q

Commonest malignant bone tumour?

A

Osteosarcoma

26
Q

Is osteosarcoma radiosensitive?

Is it chemosensitive?

A

Not radiosensitive

Chemo can prolong survival

27
Q

Age group most commonly affected by osteosarcoma?

A

Younger people

28
Q

What age group is most affected by chondrosarcoma?

A

Older people

29
Q

Which is more likely to metastasise - osteosarcoma or chondrosarcoma?

A

Osteosarcoma (usually blood spread)

Chrondrosarcoma is less aggressive and slow to metastasise but NOT radio or chemo sensitive

30
Q

Which bone tumour appears with “popcorn calcification” on x-ray?

A

Chondrosarcoma

31
Q

Ewings sarcoma is associated with which chromosomal translocation?

A

t11;22

32
Q

Is Ewing’s sarcoma benign or malignant?

A

Malignant

33
Q

Ewing’s sarcoma radiology appearance?

A

Onion skin pattern

34
Q

How does Ewing’s sarcoma present? What is it sometimes misdiagnosed as?

A

May be misdiagnosed as osteomyelitis

Presents with fever, raised inflammatory markers and warm swelling

35
Q

Treatment of Ewing’s sarcoma?

A

Surgery, plus or minus chemo and radiotherapy

pre-op chemo may improve survival

36
Q

Which types of cancer are most likely to spread to bone?

A 
Breast
Prostate
Lung 
Renal
Thyroid
37
Q

Features suggestive of benign neoplasm?

A 
Small
Fluctuation in size 
Cystic lesions
Well defined 
Fluid filled
Soft / fatty lesions
Transluminable
38
Q

Features suggesting malignancy?

A 
Big lesions (>5cm)
Rapid growth
Solid lesions
Poorly defined
Irregular surface
Associated lymphadenopathy 
Systemic upset (weight loss, fatigue)

Repetition (17 decks)

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