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Musculoskeletal > Bone Tumours > Flashcards

Bone Tumours Flashcards

1
Q

Primary tumours are more common than secondary tumours in the bone. T/F?

A

False - the opposite is true

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2
Q

What is the most common type of primary bone tumour?

A

Myeloma

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3
Q

The majority of patient’s with terminal cancer will have bony metastases. T/F?

A

True

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4
Q

From which sites do bony metastases commonly arise?

A

Metastatic carcinoma of the bronchus, breast, prostate, kidney or thyroid

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5
Q

In childhood, which cancers can commonly metastasise to the bone?

A

Neuroblastoma

Rhabdomyosarcomas

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6
Q

Which bones are the most common site of metastasis?

A

Bones with a good blood supply e.g. long bones and vertebrae

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7
Q

Metastasis to the bones can be asymptomatic. T/F?

A

True

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8
Q

What are the potential signs and symptoms of bony metastases?

A 
Bone pain
Bone destruction
Pathological frcatures
Hypercalcaemia
Spinal changes - vertebral collapses, spinal cord compression, nerve root compression, back pain
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9
Q

What imaging modality is used to assess for bony metastases?

A

PET CT

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10
Q

The majority of bone metastasis are lytic rather than sclerotic. T/F?

A

True

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11
Q

Lytic lesions in bone due to metastasis are caused by direct action of the tumour cells. T/F?

A

False - the tumour cells release cytokines which stimulate osteoclast activity

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12
Q

What drugs can be used to inhibit the destruction of bone by metastases?

A

Bisphosphonates

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13
Q

Metastases from which sites commonly cause sclerotic metastases in the bone?

A

Prostatic carinoma
Breast Carcinoma
Carcinoid tumour

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14
Q

Solitary bone metastases are typically metastases from which types of tumour?

A

renal and thyroid carcinomas

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15
Q

Surgery is viable treatment option with solitary bone metastases. T/F?

A

True

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16
Q

What is myeloma?

A

A monoclonal proliferation of the plasma cells which can be solitary (palsmacutoma) or multiple myeloma

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17
Q

What are the clinical effects of myeloma?

A

Bone lesions - punched out lytic foci, generalised osteopenia
Marrow replacement resulting in anaemia, leucopenia (causing recurrent infections) and thrombocytopenia (causing haemorrhage)
ESR >100
Presence of pence jones proteins in urine

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18
Q

What complications can result from renal impairment as a result of myeloma?

A

Hyperclacaemia

Amyloidosis

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19
Q

Give examples of. benign primary bone tumours?

A

Osteoid osteoma
Chondroma
Giant cell tumours

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20
Q

Give examples of malignant primary bone tumours?

A

Myeloma
Osteosarconma
Chondrosarcoma
Ewing’s tumour

21
Q

What is an osteoid osteomalacia?

A

A small, benign osteoblastic proliferation

22
Q

At what age are osteoid osteomas commonly seen?

A

Adolescence but can occur at any age

23
Q

Primary bone tumours are more common in men than women. T/F?

A

True

24
Q

Which bones are commonly affected by osteoid osteomas?

A

Long bones

Vertebrae

25
Q

When will pain be worst in osteoid osteoma?

A

Night time

26
Q

What will be caused by junta-articular osteoid osteomas?

A

Symapthetic synovitis

27
Q

What is an osteosarcoma?

A

A malignant tumour whose cells derived from osteoid or bone

28
Q

What is the peak age of incidence for osteosarcomas?

A

10-15 years

29
Q

At which site are osteosarcomas commonly found?

A

Knee - in metaphysis of long bones

30
Q

Osteosarcomas can result in early metastasis, particularly to which organ?

A

Lung

31
Q

What forms of osteosarcoma have the best prognosis?

A

Parosteal, periosteal or low grade central osteosarcoma

32
Q

What forms of osteosarcoma have a normal prognosis?

A 
Osteoblastic
Chondroblastic
Fibroblastic
Telangiectatic
Small cell
Sclerotic
33
Q

What forms of osteosarcoma have the worst prognosis?

A

Paget’s disease
Multifocal osteosarcoma
Post-irradiation

34
Q

In which group of people is Paget’s disease most common?

A

Elderly and anglo-saxon origin

35
Q

What is Paget’s disease?

A

A disorder of excessive bone turnover where there is increased eosteoclast activity, increased bone formation and structurally weak bone

36
Q

Which bones are particularly affected by Paget’s disease?

A

Vertebrae
Pelvis
Skull
Femur

37
Q

What symptoms / signs can be caused by Paget’s disease?

A 
Bone pain
Deformity - bowing of long bones
Pathological fracture
OA
Deafness
Spinal cord compression
High cardiac output leading to cardiac failure
Paget's sarcoma
38
Q

Paget’s sarcoma is usually sclerotic. T/F?

A

False - it is usually lytic

39
Q

Give examples fo cartilaginous tumours?

A

Enchondromas
Osteocartilaginous exostosis
Chondrosarcomas

40
Q

What is an enchondroma?

A

Lobulated mass of cartilage within the medulla

41
Q

Enchondromas are common and can occur at any age. T/F?

A

True

42
Q

Which sites are most often affected by an enchondroma?

A

Hands
Feet
Long bones

43
Q

What are the features of enchondroma in the hands?

A

Swelling

Pathological fracture

44
Q

What is osteocartilaginous exostosis?

A

Benign outgrowth fo cartilage with endochonraal ossification which is probably derived from the growth plate.

45
Q

What is a chondrosarcoma?

A

A tumour of the central medullary canal or peripheral bone survive which can be a primary tumour or from a pre-existing enchondroma or exostosis.

46
Q

What age groups are particularly affected by chondrosarcomas?

A

Middle aged and elderly

47
Q

At which sites are chondrosarcomas commonly seen?

A 
Axial skeleton
Pelvis
Ribs
Shoulder girdle
Proximal femur
Humerus
48
Q

At what age is the peak incidence of Ewing’s sarcoma?

A

5-15 years

49
Q

In Ewing’s sarcoma there is early metastasis to the…?

A

Lung
Bone marrow
Bone

Musculoskeletal (11 decks)

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