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
Commonest malignant bone tumour?
Osteosarcoma
26
Is osteosarcoma radiosensitive? Is it chemosensitive?
Not radiosensitive Chemo can prolong survival
27
Age group most commonly affected by osteosarcoma?
Younger people
28
What age group is most affected by chondrosarcoma?
Older people
29
Which is more likely to metastasise - osteosarcoma or chondrosarcoma?
Osteosarcoma (usually blood spread) Chrondrosarcoma is less aggressive and slow to metastasise but NOT radio or chemo sensitive
30
Which bone tumour appears with "popcorn calcification" on x-ray?
Chondrosarcoma
31
Ewings sarcoma is associated with which chromosomal translocation?
t11;22
32
Is Ewing's sarcoma benign or malignant?
Malignant
33
Ewing's sarcoma radiology appearance?
Onion skin pattern
34
How does Ewing's sarcoma present? What is it sometimes misdiagnosed as?
May be misdiagnosed as osteomyelitis Presents with fever, raised inflammatory markers and warm swelling
35
Treatment of Ewing's sarcoma?
Surgery, plus or minus chemo and radiotherapy | pre-op chemo may improve survival
36
Which types of cancer are most likely to spread to bone?
``` Breast Prostate Lung Renal Thyroid ```
37
Features suggestive of benign neoplasm?
``` Small Fluctuation in size Cystic lesions Well defined Fluid filled Soft / fatty lesions Transluminable ```
38
Features suggesting malignancy?
``` Big lesions (>5cm) Rapid growth Solid lesions Poorly defined Irregular surface Associated lymphadenopathy Systemic upset (weight loss, fatigue) ```