Bone Tumours Flashcards
1
Q
A
2
Q
What is this?
Describe what you see?
A
- Compact bone
- Osteocytes are the white cells
- Haversian systems surround the osteocytes
3
Q
What is this?
Describe what you see
A
- Cancellous bone
- arranged in trabeculae
- white spaces are marrow cavity
4
Q
What type of bone is seen in childhood fractures and bone tumours?
A
Woven bone
5
Q
What type of cells form woven bone?
A
Osteoblasts
6
Q
How common are secondary bone tumours?
A
Very common
7
Q
How common are bone myelomas?
A
Most common primary bone tumour
8
Q
How common are primary bone tumours?
A
Rare
9
Q
What type of cancers metastasise to bone?
A
- Lung (bronchus)
- Breast
- Prostate
- Kidney
- Thyroid (follicular)
10
Q
What are the childhood cancers which metastasise to bone?
A
- Neuroblastoma
- Rhabdomyosarcoma
11
Q
What are the effects of cancer metastasis to bone?
A
- Asymptomatic
- Bone pain
- Hypercalcaemia
- Pathological fracture of long bones
12
Q
What are the effects of cancer metastasising to the spine?
A
- Back pain
- Vertebral collapse
- Spinal cord compression
13
Q
Describe PET CT?
A
- Anatomical detail can be achieved alongside functional data
- e.g. this is a metastatic deposit in femur
14
Q
What are the different types of bone mets?
A
- Lytic (majority)
- Sclerotic
15
Q
What is this?
A
- X-ray of lytic bone metastasis
- Translucent area on pelvis
16
Q
What is the mechanism of bone destruction caused by bony mets?
A
- Osteoclasts
- Stimulated by cytokines released from tumour cells
- Inhibited by bisphophonates
17
Q
Waht is pictured here?
A
- Sclerotic bone mets
- Opacification of left pubis
- Likely to be from prostate cancer
18
Q
What can sclerotic bone mets be caused by?
A
- Carcinoid tumour
- Breast carcinoma
- Prostatic carcinoma
19
Q
How do sclerotic metastasis form on bone?
A
Reactive bone formation induced by tumour cells
20
Q
Describe solitary bone mets?
A
- Renal and thyroid carcinomas
- Long survival
- Surgical removal
21
Q
Describe Myeloma?
A
- Most common malignant primary bone tumour
- Monoclonal proliferation of plasma cells
- Solitary or multiple myeloma
22
Q
What is another name for a solitary myeloma?
A
Plasmacytoma
23
Q
What are the clinical effects of myeloma?
A
- Bone lesions
- Punched out lytic foci
- Osteopenia
- Marrow replacement
- Anaemia
- Infectious
- Immunoglobulin excess
- ESR > 100
- Bence Jones protein in urine
24
Q
What is this?
A
- ‘Pepper pot’ skull
- Punched out foci
- Classical feature of myeloma
25
Describe histoloy of plasma cells?
* Eccentric nucleus
* Clock face
* Clear area on cytoplasm
26
What is pictured here?
* Histology of meyloma
* Lots and lots of plasma cells
27
What are the Benign Primary Bone tumours?
* Chondroma
* Giant cell tumour
* Osteoid osteoma
28
What are the Malignant Primary Bone tumours?
* Osteosarcoma
* Ewing's tumour
* Chondrosarcoma
29
Describe Osteoid Osteoma?
* Osteoblastic prolfieration
* Spine and long bones
* Pain, worse at night
* Relieved by aspirin
30
What is pictured here?
Classical radiological appearance of Osteoid Osteoma
31
Describe Osteosarcoma?
* Metaphysis of long bones
* Around the knee
* Early lung metastasis
32
Classical
Classical presentation of (left) Osteosarcoma
33
What is the prognosis of Osteosarcoma?
50-60% 5 year suvival now than chemotherapy has been developed
34
What are the worse prognosis variants of osteosarcoma?
* Paget's disease
* Multifocal osteosarcoma
* Post-irradiation osteosarcoma
35
What is this?
* Bad osteosarcoma on x-ray
* humerus
36
Describe Paget's disease?
* Disorder of excessive bone turnover
* Structurally weak bone
37
Who does Paget's disease commonly affect?
What bones does Paget's disease commonly affect?
Elderly, anglo-saxon
* Skull
* Pelvis
* Femur
* Vertebrra
38
Describe the clinical manifestations of Paget's disease?
* Bone pain
* Deformity of long bones
* Pathological fractures
* Osteoarthritis
* Deafness
* Spinal cord compression
* Cardiac failure due to high CO
* Paget's sarcoma
39
Describe Paget's sarcoma?
* Second osteosarcoma peak in elderly
* Lytic
* Long bones
* Very poor prognosis due to early metastases to lung and bone
40
Name the bone forming tumours?
* Osteoid osteoma (benign)
* Osteocarcoma (malignant)
41
Name the cartilaginous tumours?
* Enchondroma (benign)
* Osteocartilaginous exostosis (benign)
* Chondrosarcoma (malignant)
42
Describe Enchondroma?
* Lobulated cartilage within medulla
* Hands, feet, long bones
* Low cellularity
* Surrounded by plates of lamellar bone
43
What are the symptoms of Enchondroma affected the long bones?
Asymptomatic
44
What are the symptoms of Enchondroma affected the hands?
* Swelling
* Pathological fracture
45
Describe Osteocartilaginous exostosis?
* Cartilage with endochondral ossification
* Cartilage cap
* Derived from growth plate
46
Describe Multiple-diaphyseal aclasis?
* Autosomal dominant
* Multiple osteocartilaginous exostosis
47
Osteocartilaginous exostosis
48
Describe Chondrosarcoma?
* Malignant cartilage tumour
* Primary or secondary to beign cartilage tumour
* Withhin medullary canal or on bone surface
49
Where do Chondrosarcomas tend to affect?
* Ribs
* Pelvis
* Shoulder girdle
50
* Chondrosarcoma
* chalky calcifications
51
Describe Ewing's sarcoma?
* Tends to be in children
* Long bones, flat bones
* Early metastasis to lung, bone, marrow
* 50-60% 5 year survival
52
Name the genetic abnormality involved in Ewings sarcoma?
11:22 translocation
