Bone Tumours Flashcards
Where do osteosarcomas commonly metastasise?
Lung (blood-borne)
What are the radiological features of osteosarcoma?
Mixed Lytic + sclerotic zones in the metaphysics.
What is the common management of osteosarcoma?
Surgical resection+/- chemo for lung mets
Which area of bone do osteosarcomas affect?
Metaphyseal ends of long bones (distal femur + proximal tibia most common)
Which population does chondrosarcoma usually affect?
Middle aged + Elderly
Which area of bone do chrondrosarcomas affect?
Medulla or Juxtacortical
Pelvis, ribs, proximal humerus or proximal femur
Are chondrosarcomas fast or slow growing?
Slow growing, seldom metastasise
What are the x-ray features of chondrosarcomas?
Prominent end-steal scalloping and cortical thickening
Are radiotherapy/chemotherapy effective in chondrosarcoma?
No
Which population does ewing sarcoma affect?
Children
Which area of bone does ewing sarcoma affect?
Diaphysis of long bones (femur + flat bones of pelvis)
What are the radiological features of ewing sarcoma?
Lytic lesions with periosteal reactions
‘Onion’ skin appearance
How are ewings sarcomas managed?
Resection + neoadjuvant chemo
What is the characteristic clinical feature of osteoid osteomas?
Pain at night relieved by NSAIDs
What are the radiological features of osteoid osteomal??
Lucent area surrounded by reactive sclerosis.
usually <2cm
Which area of bone does osteoid osteoma affect?
shaft of long bones
Who does osteoid osteoma affect?
Males, 10-25yrs
Who does osteochondroma affect?
Males, 2nd decade
What are the clinical features of osteochondroma?
Asymptomatic, slow growing
What are the radiological features of osteochondroma?
Pedunculated bony outgrowth from metaphysics
How are osteoid osteomas typically managed?
Conservatively
How are osteochondromas typically managed?
Conservatively
Who are affected by chondromas?
30-50 yrs
Which part of the bone is affected by chondroma?
Metaphysis of long bones of hands, feet, humerus, femur, tibia
How do chondromas usually present?
Incidental
What are the radiological features of chondroma?
Elongated, oval, lytic areas
How are chondromas managed?
Asymptomatic - conservative
Symptomatic - surgical
Which diseases are chondromas associated with?
Olliers disease
Maffuci syndrome
What are the features of giant cell tumours (osteoclastomas)?
Pain
Benign but locally aggressive
What are the radiological features of giant cell tumours?
‘Soap bubble’ appearance
Eccentric lytic areas
How are giant cell tumours managed?
Surgical resection
small risk transformation to osteosarcoma
Which part of bone do giant cell tumours present?
Epiphysis of long bones
50% around knee
Who is affected by giant cell tumours?
20-40 years
How do bone cysts usually present?
Adolescent boys
Asymptomatic or pathological Fracture
What are the radiological features of bone cysts?
Ovoid radiolucent area
What staging system is used for primary bone tumours?
Enneking staging
What are the most common primary site of bone metastasis?
Renal Thyroid Prostate Lung Breast
What scoring system is used to stratify fracture risk in metastatic bone lesions?
Mirel scoring system
what is the most common soft tissue sarcoma of childhood?
Rhabdomyosarcoma
Pagets disease causes what x-ray findings
Cortical thickening
which cell type is implicated in osteopetrosis?
osteoclasts
