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MSK > Bone Tumours > Flashcards

Bone Tumours Flashcards

1
Q

What are the five causes of benign bone tumours?

A 
Neoplastic
Infection
Inflammation
Traumatic
Developmental
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2
Q

What are the seven benign bone tumours important to know?

A 
Osteochondroma
Enchondroma
Simple bone cyst
Aneurysmal bone cyst
Osteoclastoma/Giant Cell Tumour
Fibrous dysplasia
Osteoid Osteoma
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3
Q

What is an osteochondroma?

A

Bony outgrowth with a cartilage cap.

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4
Q

Where are osteochondromas commonly found?

A

Metaphysis of long bones.

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5
Q

What age group tend to get osteochondromas?

A

Teenagers

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6
Q

How does an osteochondroma present?

A

Can be painful and very rarely malignant (1%)

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7
Q

What is the most common benign bone tumour?

A

Osteochondroma

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8
Q

What is an enchondroma?

A

Failure of normal ossification of growth plate. Name means within cartilage.

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9
Q

Where are enchondromas found?

A

Metaphysis cartilage of long bones.

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10
Q

How does enchondroma present?

A

Usually asymptomatic but can weaken bone.

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11
Q

How can enchondroma be treated?

A

Excise and replace with bone graft.

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12
Q

What is a simple bone cyst?

A

Single cavity fluid filled cyst.

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13
Q

Where are simple bone cysts found?

A

Metaphysis of long bones

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14
Q

What age group is susceptible to simple bone cysts?

A

5-15

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15
Q

How does a simple bone cyst present?

A

Asymptomatic but can weaken bones.

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16
Q

How can simple bone cysts be treated?

A

Excise and replace with bone graft.

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17
Q

What is an aneurysmal bone cyst?

A

A cyst with lots of chambers filled with blood or serum.

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18
Q

What causes an aneurysmal bone cyst?

A

Malformation of blood vessels.

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19
Q

Where are aneurysmal bone cysts normally found?

A

Metaphysis of long bones, flat bones and vertebral bodies.

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20
Q

How do aneurysmal bone cysts present?

A

Locally aggressive and painful with a risk of fracture.

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21
Q

How do you treat an aneurysmal bone cyst?

A

Excise and replace with bone graft.

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22
Q

What is an osteoclastoma?

A

Giant Cell Tumour with unknown aetiology.

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23
Q

Where do osteoclastomas/GCT present?

A

Epiphysis and subchondral bone.

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24
Q

What age group is affected by osteoclastoma/GCT

A

20-40. Occurs once joints are fused.

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25
Q

How does an osteoclastoma/GCT present?

A

Locally aggressive and looks like ‘Soap bubble’ on XR. Painful and can cause fracture.

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26
Q

How do you treat an osteoclastoma/GCT?

A

Excise then use phenol, bone cement or liquid nitrogen to finish.

27
Q

What is fibrous dysplasia?

A

Lesion of fibrous tissue and immature bone. Can be mono- or polyosteotic.

28
Q

How does fibrous dysplasia present?

A

Angular deformities (‘Shepherds crook’ in femur), thinning of cortex and fractures.

29
Q

How do you treat fibrous dysplasia?

A

Bisphosphonates for pain

Fix fractures and bone graft for strength.

30
Q

What is osteoid osteoma?

A

Nidus of immature bone surrounded by sclerosis.

31
Q

Where is osteoid osteoma normally round?

A

Proximal femur.

32
Q

What age group is osteoid osteoma normally found?

A

Adolescents

33
Q

How does osteoid osteoma normally present?

A

Intense pain worse at night due to inflammatory response.

34
Q

How do you treat osteoid osteoma?

A

NSAIDs for pain

Ablate though can reverse with time.

35
Q

Are malignant bone cancers common compared to those of other organs?

A

No

36
Q

What are the red flags for malignant bone cancer?

A 
Constant pain worse at night.
Weight loss
Fatigue
Loss of appetite 
<25 or >60 YO
37
Q

What signs of a malignant bone tumour may you see on an XR?

A 
Cortical destruction
Raised periosteum
Sclerosis
Lysis
Invasion into soft tissue
38
Q

What is the standard way of treating malignant bone tumours?

A

Excision with 3-4cm margin.

39
Q

What are the six malignant bone tumours we need to know?

A 
Osteosarcoma 
Chondrosarcoma
Fibrosarcoma/Malignant fibrous histiocytoma 
Ewing's Sarcoma
Non-Hodgkin Lymphoma
Myeloma
40
Q

What is an osteosarcoma?

A

A bone producing malignant tumour. Most common malignant bone tumour.

41
Q

What age group are osteosarcomas often seen?

A

10-25

42
Q

Where do osteosarcoms often occur?

A

Bones around knee, femur, humerus and pelvis

43
Q

What does osteosarcoma look like?

A

Large. Can be sclerotic or fleshy. Metastasis through blood.

44
Q

How do you treat osteosarcoms?

A

Excise. Not radio sensitive but is chemosensitive.

45
Q

What is a chondrosarcoma?

A

Cartilage producing bone tumour.

46
Q

What age group is most affected by chondrosarcoma?

A

Middle age. ~45.

47
Q

Where are chondrosarcomas normally found?

A

Pelvis and proximal femur.

48
Q

How do chondrosarcomas normally present?

A

Large painful swellings. Slow to metastasize.

49
Q

How do you treat chondrosarcoma?

A

Excise. Not chemo or radio sensitive.

50
Q

What is a fibrosarcoma/malignant fibrous histiocytoma?

A

Malignant bone tumours of fibrous tissue.

51
Q

Where do fibrosarcoma/malignant fibrous histiocytomas commonly occur?

A

Abnormal bones such as:
Infarcted. fibrous dysplastic or affected by Paget’s disease.
Metaphysis of long bones.

52
Q

What age groups are affected by fibrosarcoma/malignant fibrous histiocytoma?

A

Adolescents and young adults.

53
Q

What are Ewing’s sarcomas?

A

Malignancy of primitive cells in bone marrow. 2nd most common malignant bone tumour and has worst outcome.

54
Q

Where are Ewing’s sarcomas normally found?

A

Starts in medulla but swiftly progresses to cortex.

55
Q

How do Ewing’s sarcomas present?

A

Large soft tissue masses.
Pain and swelling, fever, elevated WCC
Metastasis to lung and other bone

56
Q

How do you treat Ewing’s sarcoma?

A

Excise.

Chemo and radio sensitive.

57
Q

What is a non-Hodgkin lymphoma?

A

Occurs from lymphatics in bone marrow and can metastasis to bone. Very aggressive.

58
Q

What bones are most affected by non-Hodgkin lymphoma?

A

Pelvis and femur

59
Q

How do you treat non-Hodgkin lymphoma?

A

Chemo and radiotherapy.

60
Q

What is myeloma?

A

Tumour of B cells in bone marrow.

Can get mono or polylesions

61
Q

What age group is affected my myeloma?

A

45-65

62
Q

How does myeloma present?

A

Weakness, back pain, fatigue, anaemia and infection

63
Q

What five cancers tend to metastasize to bone?

A 
Prostate carcinoma
Lung carcinoma
Thyroid adenocarcinoma
Breast carcinoma
Kidney cell carcinoma

MSK (17 decks)

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