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Bone tumours Flashcards

1
Q

Types of benign bone tumours

A

Neoplastic, Developmental, Traumatic, Infections and Inflammatory

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2
Q

Which benign tumour is the most common?

A

Osteochondroma

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3
Q

What are the risk of malignant transformation for an osteochondroma?

A

1%

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4
Q

What is an osteochondroma?

A

bony outgrowth with a cartilaginous cap with local pain

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5
Q

Why do multiple osteochondromas occur?

A

due to an autosomal dominant hereditary disorder

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6
Q

What is an enchondroma?

A

an intermedullary and usually metaphyseal cartilaginous tumour

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7
Q

When do enchondromas occur?

A

when normal enchondral ossification fails

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8
Q

What do enchondromas look like on X-ray?

A

lucent but become patchy sclerotic when they mineralize

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9
Q

what are the symptoms of an enchondroma?

A

asymptomatic but can weaken bone

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10
Q

What bones do enchondromas occur in?

A

femur, humerus, tibia and small bones

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11
Q

how do you treat an enchondroma?

A

curettage and filled with bone graft

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12
Q

what is a simple bone cyst?

A

a single cavity, fluid filled cyst

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13
Q

Why do simple bone cysts occur?

A

when there is a growth defect in physis

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14
Q

what bones do simple bone cysts occur in?

A

humerous, femur, talus and calcaneus

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15
Q

what are the symptoms of simple bone cysts?

A

asymptomatic but can cause weakness

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16
Q

who gets simple bone cysts?

A

children or young adults

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17
Q

how do you treat a simple bone cyst?

A

curettage and bone graft

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18
Q

what is an aneurysmal bone cyst?

A

multiple gaps in bone filled with blood or serum

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19
Q

why do aneurysmal bone cysts form?

A

small arteriovenous malformation

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20
Q

where do aneurysmal bone cysts occur?

A

metaphysis of long bones, flat bones and vertebral bodies

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21
Q

what causes aneurysmal bone cysts to become locally aggressive?

A

cortical expansion and destruction

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22
Q

what are the symptoms of aneurysmal bone cysts?

A

pain and weakened bone

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23
Q

How do you treat an aneurysmal bone cyst?

A

curettage and bone graft or bone cement

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24
Q

where do you find a giant cell tumour?

A

can be in the metaphysis, epiphysis or in subchondral bone in the knee, distal radius, long bones, pelvis and spine

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25
Q

how do giant cell tumours appear on an X-ray?

A

multi-nucleate giant cells with a soap bubble appearance

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26
Q

How likely is a metastasis to lung for a giant cell tumour?

A

5%

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27
Q

How do you treat a giant cell tumour?

A

intralesional excision with phenol/ bone cement or liquid nitrogen and some times you replace a joint

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28
Q

when does fibrous dysplasia occur?

A

in adolescence

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29
Q

what causes fibrous dysplasia?

A

genetic mutation

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30
Q

what is fibrous dysplasia?

A

lesions of fibrous tissue in immature bone

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31
Q

what types of fibrous dysplasia are there?

A

monostoic and polystoic

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32
Q

what causes angular deformities in fibrous dysplasia?

A

defective mineralisation

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33
Q

which tumour causes angular deformities?

A

fibrous dysplasia

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34
Q

which tumour causes a shepherd’s crook deformity?

A

fibrous dysplasia?

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35
Q

how do you treat fibrous dysplasia?

A

bisphosphates reduce pain, internal fixation and cortical bone grafts

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36
Q

what is an osteoid osteoma?

A

small nidus of immature bone surrounded by an intense sclerotic halo

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37
Q

when do osteoid osteomas occur?

A

adolescence

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38
Q

where do osteoid osteomas occur?

A

proximal femur, diaphysis of long bone and vertebrae

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39
Q

what are the symptoms of osteoid osteomas?

A

intense constant pain that’s worse at night

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40
Q

how would you treat pain from osteoid osteomas?

A

NSAIDs

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41
Q

how do you treat osteoid osteomas?

A

may resolve but may require CT guided radiofrequency ablation or en bloc excision

42
Q

what is Brodie’s abscess?

A

lytic lesion of bone that’s a brown tumour

43
Q

what causes Brodie’s abscess?

A

sub acute osteomyelitis and hyperparathyroidism

44
Q

Benign or malignant: osteochondroma

A

Benign

45
Q

Benign or malignant: enchondroma

A

Benign

46
Q

Benign or malignant: simple bone cyst

A

Benign

47
Q

Benign or malignant: aneurysmal bone cyst

A

Benign

48
Q

Benign or malignant: giant cell tumour

A

Benign

49
Q

Benign or malignant: fibrous dysplasia

A

Benign

50
Q

Benign or malignant: osteoid osteoma

A

Benign

51
Q

Benign or malignant: brodie’s abscess

A

Benign

52
Q

Benign or malignant: osteosarcoma

A

Malignant

53
Q

Benign or malignant: chondrosarcoma

A

Malignant

54
Q

Benign or malignant: fibrosarcoma

A

Malignant

55
Q

Benign or malignant: Ewing’s sarcoma

A

Malignant

56
Q

Benign or malignant: lymphoma

A

Malignant

57
Q

Benign or malignant: myeloma

A

Malignant

58
Q

are malignant primaries rare or common?

A

rare

59
Q

what age group do malignant tumours occur?

A

young patients

60
Q

what are red flags for malignant tumours?

A

persistent unexplained pain

61
Q

what does a malignant tumour look like?

A

substantial, ill-defined bony swelling

62
Q

what does a malignant tumour look like on X-ray?

A

aggressive and destructive- cortical destruction, periosteal reaction and new bone formation and extension into surrounding soft tissue

63
Q

what is an osteosarcoma?

A

malignant tumour producing bone

64
Q

When do osteosarcomas usually occur?

A

adolescence and early adulthood

65
Q

where do osteosarcomas most commonly affect?

A

around the knee

66
Q

how do osteosarcomas spread?

A

haematogenously or lymphatically

67
Q

how would you prolong survival in a patient with an osteosarcoma?

A

chemo

68
Q

what is a chondrosarcoma?

A

cartilage producing primary that’s less aggressive than an osteosarcoma

69
Q

what age group does a chondrosarcoma usually affect?

A

45 year olds

70
Q

where does a chondrosarcoma affect?

A

pelvis or proximal femur

71
Q

is a chondrosarcoma responsive to chemo or radio therapy?

A

no

72
Q

is a chondrosarcoma quick or slow to metastasize?

A

slow

73
Q

what is another name for Fibrosarcoma?

A

malignant fibrous histiocytoma

74
Q

is a fibrosarcoma a primary or secondary tumour?

A

primary

75
Q

where does a fibrosarcoma occur?

A

in abnormal bone

76
Q

who gets a fibrosarcoma?

A

adolescence or young adults

77
Q

Where do Ewing’s sarcomas occur?

A

primitive cells in the marrow

78
Q

who does Ewing’s sarcoma usually affect?

A

10-20 years old

79
Q

what condition often gets misdiagnosed as osteomyelitis?

A

Ewing’s sarcoma

80
Q

Is Ewing’s sarcoma radio and chemo sensitive?

A

yes

81
Q

Where does a non-Hodkins lymphoma metastasise from?

A

marrow or lymph to bone

82
Q

where does a primary lymphoma usually affect?

A

pelvis or the femur

83
Q

what is the survival mean for a lymphoma?

A

2 years

84
Q

what is a myeloma?

A

malignant B cell proliferation

85
Q

what is a single lesion of myeloma called?

A

plasmacytoma

86
Q

what are multiple lesions of myeloma called?

A

multiple myeloma

87
Q

what age group is most affected by myeloma?

A

45-65

88
Q

what symptoms present in a myeloma?

A

weakness, backpain, fatigue, weight loss, anaemia and recurrent infection

89
Q

how is a myeloma diagnosed?

A

by plasma protein electrophoresis and early morning urine collection for Bence Jones assay

90
Q

are myelomas always detected on a bone scan?

A

no

91
Q

what is the 5 year survival rate?

A

<30%

92
Q

What type of lesion is a breast met?

A

blastic or lytic

93
Q

What is the survival for a breast met to the bone?

A

24-26 months

94
Q

what type of lesion is a prostate met?

A

sclerotic

95
Q

what is the survival for a prostate met to the bone?

A

45% at 1 year

96
Q

What type of lesion is a lung met?

A

Lytic

97
Q

what is the survival for a lung met to the bone?

A

6 months on average

98
Q

what type of lesion is a renal cell carcinoma met?

A

large lytic blow out

99
Q

what is the survival for a renal CC met to the bone

A

12-18 months

100
Q

break

A

break

Cortext (25 decks)

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