Bone tumours Flashcards

1
Q

What is the most common bone tumour?

A

Metastatic by ~25x

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2
Q

Where are the common sites for metastatic bone disease in order?

A
Vertebrae
Proximal femur and pelvis 
Ribs
Sternum
Skull
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3
Q

What are the most common cancers for bone mets, in order?

A

PRostate
Breast
Lung

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4
Q

What are the common cancers that met to the bones?

A
Prostate, breast, lung= most common
Kidney
Thyroid
GI
Melanoma
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5
Q

What is the presentation of bone mets?

A
Increasing bone pain- dull ace, worse at night
Pathological fracture
Spinal cord compression
Hypercalcaemia
Anaemia
Decreased mobility
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6
Q

What investigations are done for bone mets?

A

XR
CT/MRI, isotope bone scan
Fracture risk

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7
Q

What is sued for fracture risk in bone mets?

A

Mirel’s score

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8
Q

What Mirel’s score indicated high fracture risk?

A

> 8

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9
Q

What would a high Mirel’s score indicate?

A

Prophylactic fixation

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10
Q

What is the management of bone mets?

A

Radiotherapy
Surgery- prophylactic fixation, eradication
Analgesia

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11
Q

Wat is the prognosis with bone mets?

A

Poor prognostic indicator

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12
Q

Who is osteosarcoma usually seen in?

A

10-20yo

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13
Q

What are the most common sites for osteosarcoma?

A

Femur= most common

Tibia, humerus

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14
Q

What is the presentation of osteosarcoma?

A

Persistent bone pain, worse at night
Bone swelling, palpable mass
Restricted joint movement

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15
Q

What does unexplained bone pain/swelling indicate?

A

Urgent XR within 48 hours

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16
Q

What is the appearance of osteosarcoma on XR?

A

Destruction of normal bone and fluffy appearance

Periosteal rection –> sunburst appearance

17
Q

What blood results are seen in osteosarcoma?

A

Elevated ALP

18
Q

What is the management of osteosarcoma?

A

Surgical resection, often with amputation

Adjuvant chemo

19
Q

Who is Ewing sarcoma seen in?

A

M>F

10-20yo

20
Q

What is the presentation of Ewing sarcoma?

A

Persistent bone pain, worse at night
Bone welling, palpable mass
Restricted joint movement

21
Q

What is seen on XR with Ewing sarcoma?

A

Onion skin periosteal reaction

Wide zone of transition

22
Q

What is seen on CT with Ewing sarcoma?

A

Moth eaten destructive radiolucencies

23
Q

What is the management of Ewing sarcoma?

A

Chemo and surgery/radiotherapy