Bone Tumours Flashcards
Primary tumours are more common than secondary tumours in the bone. T/F?
False - the opposite is true
What is the most common type of primary bone tumour?
Myeloma
The majority of patient’s with terminal cancer will have bony metastases. T/F?
True
From which sites do bony metastases commonly arise?
Metastatic carcinoma of the bronchus, breast, prostate, kidney or thyroid
In childhood, which cancers can commonly metastasise to the bone?
Neuroblastoma
Rhabdomyosarcomas
Which bones are the most common site of metastasis?
Bones with a good blood supply e.g. long bones and vertebrae
Metastasis to the bones can be asymptomatic. T/F?
True
What are the potential signs and symptoms of bony metastases?
Bone pain Bone destruction Pathological frcatures Hypercalcaemia Spinal changes - vertebral collapses, spinal cord compression, nerve root compression, back pain
What imaging modality is used to assess for bony metastases?
PET CT
The majority of bone metastasis are lytic rather than sclerotic. T/F?
True
Lytic lesions in bone due to metastasis are caused by direct action of the tumour cells. T/F?
False - the tumour cells release cytokines which stimulate osteoclast activity
What drugs can be used to inhibit the destruction of bone by metastases?
Bisphosphonates
Metastases from which sites commonly cause sclerotic metastases in the bone?
Prostatic carinoma
Breast Carcinoma
Carcinoid tumour
Solitary bone metastases are typically metastases from which types of tumour?
renal and thyroid carcinomas
Surgery is viable treatment option with solitary bone metastases. T/F?
True
What is myeloma?
A monoclonal proliferation of the plasma cells which can be solitary (palsmacutoma) or multiple myeloma
What are the clinical effects of myeloma?
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
What complications can result from renal impairment as a result of myeloma?
Hyperclacaemia
Amyloidosis
Give examples of. benign primary bone tumours?
Osteoid osteoma
Chondroma
Giant cell tumours
Give examples of malignant primary bone tumours?
Myeloma
Osteosarconma
Chondrosarcoma
Ewing’s tumour
What is an osteoid osteomalacia?
A small, benign osteoblastic proliferation
At what age are osteoid osteomas commonly seen?
Adolescence but can occur at any age
Primary bone tumours are more common in men than women. T/F?
True
Which bones are commonly affected by osteoid osteomas?
Long bones
Vertebrae
When will pain be worst in osteoid osteoma?
Night time
What will be caused by junta-articular osteoid osteomas?
Symapthetic synovitis
What is an osteosarcoma?
A malignant tumour whose cells derived from osteoid or bone
What is the peak age of incidence for osteosarcomas?
10-15 years
At which site are osteosarcomas commonly found?
Knee - in metaphysis of long bones
Osteosarcomas can result in early metastasis, particularly to which organ?
Lung
What forms of osteosarcoma have the best prognosis?
Parosteal, periosteal or low grade central osteosarcoma
What forms of osteosarcoma have a normal prognosis?
Osteoblastic Chondroblastic Fibroblastic Telangiectatic Small cell Sclerotic
What forms of osteosarcoma have the worst prognosis?
Paget’s disease
Multifocal osteosarcoma
Post-irradiation
In which group of people is Paget’s disease most common?
Elderly and anglo-saxon origin
What is Paget’s disease?
A disorder of excessive bone turnover where there is increased eosteoclast activity, increased bone formation and structurally weak bone
Which bones are particularly affected by Paget’s disease?
Vertebrae
Pelvis
Skull
Femur
What symptoms / signs can be caused by Paget’s disease?
Bone pain Deformity - bowing of long bones Pathological fracture OA Deafness Spinal cord compression High cardiac output leading to cardiac failure Paget's sarcoma
Paget’s sarcoma is usually sclerotic. T/F?
False - it is usually lytic
Give examples fo cartilaginous tumours?
Enchondromas
Osteocartilaginous exostosis
Chondrosarcomas
What is an enchondroma?
Lobulated mass of cartilage within the medulla
Enchondromas are common and can occur at any age. T/F?
True
Which sites are most often affected by an enchondroma?
Hands
Feet
Long bones
What are the features of enchondroma in the hands?
Swelling
Pathological fracture
What is osteocartilaginous exostosis?
Benign outgrowth fo cartilage with endochonraal ossification which is probably derived from the growth plate.
What is a chondrosarcoma?
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.
What age groups are particularly affected by chondrosarcomas?
Middle aged and elderly
At which sites are chondrosarcomas commonly seen?
Axial skeleton Pelvis Ribs Shoulder girdle Proximal femur Humerus
At what age is the peak incidence of Ewing’s sarcoma?
5-15 years
In Ewing’s sarcoma there is early metastasis to the…?
Lung
Bone marrow
Bone
