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Things I Get Stuck On > Bone Tumours > Flashcards

Bone Tumours Flashcards

1
Q

List the malignant bone tumours

A 
Osteosarcoma
Chondrosarcoma
Myeloma -1% of all malignancies
Metastases
Ewing's sarcoma
2% of enchondromas
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2
Q

List the non-malignant bone tumours

A 
Osteoblastoma
Osteochondroma
Giant cell tumour
Osteoid osteomas
Most enchondromas
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3
Q

Tissue type of osteosarcomas

A

Pleomorphic osteoid producing osteoblasts

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4
Q

Osteoblastoma cell type

A

Osteoblasts

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5
Q

Osteochondroma cell type

A

Growth plate cells

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6
Q

Chondrosarcoma cell type

A

Chondrocytes

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7
Q

Myeloma cell type

A

Plasma cells of bone marrow

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8
Q

Metastases main cell types

A 
Lung
Prostate
Breast
Thyroid
Renal
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9
Q

Ewing’s sarcoma cell type

A

Neuroectodermal

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10
Q

Giant cell tumour cell type

A

Osteoclasts

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11
Q

Osteoid osteomas cell type

A

Osteoblasts

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12
Q

Enchondroma cell type

A

Cartilage

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13
Q

Main presentations of osteosarcomas

A 
Chronic inflammatory response
Bone pain -worse at night
Pulmonary symptoms if Mets
Fever
Swelling
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14
Q

Osteoblastoma main presentations

A 
Nidus of over 1.5cm
Avascular necrosis
Spinal nerve compression
Slow progressive pain
Not relieved by NSAIDs
Swelling
Muscle
Atrophy
Limp
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15
Q

Osteochondroma main presentations

A

Palpable, non tender, bony lump that is firm and immobile potentially causing spinal nerve compression and avascular necrosis

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16
Q

Chondrosarcoma main presentations

A

Chronic inflammatory response with pulmonary symptoms if Mets are present

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17
Q

Myeloma main presentations

A

Localised bone pain
Pathological fracture
Fatigue
Aneamia

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18
Q

Mets main presentations

A

Chronic inflammatory response with primary cancer symptoms

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19
Q

Ewing’s sarcoma presentation

A

Chronic inflammatory response

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20
Q

Giant cell tumour presentation

A

Pain and swelling

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21
Q

Osteoid osteomas presentation

A

Nidus of less than 1.5cm
Worse pain at night
May block sinuses and nasal cavity with polypatous growth
Pain relieved by NSAIDs

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22
Q

Enchondroma presentation

A

Incidentally found

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23
Q

X ray findings of osteosarcoma

A

Lytic bone lesions
Sunburst spicules
Codman’s triangle - very destructive if this appears

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24
Q

X ray findings of osteoblastomas

A

Eroded ring of surrounding bone
Lytic or mixed lytic-blastic lesion with radiolucent nidus > 2cm
Reactive sclerotic bone

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25
Q

X-ray findings of osteochondroma

A

Lateral bony projection (exostosis) with a hyaline cartilage cap

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26
Q

X-ray findings of chondrosarcoma

A

Lytic patchy lesions that look moth eaten in the medullary cavity
Reactive thickening of the cortex
Popcorn lesions may be seen

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27
Q

X-ray findings of myeloma

A

Punched out lytic lesions in metaphysis

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28
Q

Ewing’s sarcoma X ray findings

A

Onion Skinning

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29
Q

Giant cell tumour X ray findings

A

Multicystic bone lesion (soap bubbles) extending to cartilage through epiphysis

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30
Q

Osteoid osteomas x-ray findings

A

Intensely reactive bone around radiolucent nidus

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31
Q

Enchondroma X ray findings

A

Lobular growing pattern (popcorn lesions) with central calcifications within the bone (stopped)

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32
Q

Main age for osteosarcoma

A

Mainly adolescents but also elderly

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33
Q

Osteoblastoma main age

A

10-30 years

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34
Q

Osteochondroma main age

A

<25 years old

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35
Q

Chondrosarcoma main age

A

Elderly

36
Q

Myeloma main age

A

Over 40s

37
Q

Ewing’s sarcoma main age

A

10-20

38
Q

Giant cell tumour main age

A

30-50

39
Q

Osteoid osteomas main age

A

Less than 25

40
Q

Enchondroma main age

A

20-50

41
Q

Which tumours affect males more than females

A 
Osteoblastoma
Osteochondroma
Chondrosarcoma
Myeloma
Mets
Ewing's
Osteoid osteomas
42
Q

Which tumours affect females more than males

A

Giant cell tumours

43
Q

Which cancers are treated with surgery, radiotherapy and chemotherapy?

A 
Myeloma (no surgery)
Osteosarcoma
Chondrosarcoma
Mets
Ewing's sarcoma
44
Q

Chemotherapeutic drug for bone tumours

A

Methotrexate

45
Q

Osteochondroma and osteosarcoma treatment

A

Surgery if symptomatic

46
Q

Giant cell tumour treatment

A

Surgically removed with curretage, grafting and may require denosmuab

47
Q

Genetic link for osteosarcoma

A

Retinoblastoma suppressor gene

48
Q

Osteoblastoma genetic link

A

FAP gene

49
Q

Osteochondroma genetic link

A

Autosomal dominant, mutation in EXT gene

Loss of regulation in Indian hedgehog protein

50
Q

Ewing’s sarcoma genetic link

A

t(11:22) translocation

51
Q

Main bones affected by osteosarcoma

A 
| Distal femur
| Proximal tibia
| Proximal humerus
| Proximal femur
↓ Pelvis
52
Q

Main bones affected by osteoblastoma

A

Mandible
Axial
Skull
Facial bones

53
Q

Main bones affected by osteochondroma

A

Distal femur
Proximal tibia
Ilium
Scapula

54
Q

Main bones affected by chondrosarcoma

A

Axial skeleton
Pelvis
Long bones

55
Q

Main bones affected by myeloma

A

Spine and ribs

56
Q

Main bones affected by Ewing’s sarcoma

A 
Femur
Sacrum
Humerus
Tibia
Diaphyses
57
Q

Main bones affected by giant cell tumours

A

Distal femur

Proximal tibia epiphysis

58
Q

Main bones affected by Osteoid osteomas

A

Long bone diaphyses

59
Q

Main bones affected by enchondroma

A

Medullary cavity of long bones

60
Q

Associated diseases of osteosarcomas

A

Retinoblastoma

Paget’s

61
Q

Long term survival of osteosarcomas

A

76%

62
Q

What % of osteosarcomas give pulmonary mets

A

10-20%

63
Q

Most common benign tumour

A

Osteochondroma

64
Q

Chondrosarcoma long term survival rate

A

Slow growing

50-75%

65
Q

Myeloma 5 year and 10 year survival rate

A

30%

11%

66
Q

Myeloma median survival rate

A

3 years

67
Q

Most common primary bone tumour

A

Myeloma

68
Q

5 year survival of Ewing’s sarcoma

A

60-85%

69
Q

Giant cell tumour links

A

Bony trauma

70
Q

% of giant cell tumours that become malignant

A

2%

71
Q

What are Osteoid osteomas surrounded by

A

Sclerotic bone tissue producing prostaglandins

72
Q

Most common hand malignancy

A

Enchondroma

73
Q

Important test for osteosarcoma

A

Raised alkaline phosphatase

74
Q

Important test for myeloma

A

Raised serum creatinine

75
Q

Important test for Ewing’s sarcoma

A

Increased ESR

76
Q

Important test for giant cell tumour

A

Decreased ROM

77
Q

Histology of osteosarcomas

A

Tumour cells show atypia and produce Lacey osteoid

78
Q

Histology of osteoblastoma

A

Similar to osteoid osteomas but with more giant cells

79
Q

Histology of osteochondroma

A

Necrosis in growth plate

80
Q

Histology of myeloma

A

Round plasma cells with eccentric nucleus and prominent nucleolus

81
Q

History of chondrosarcoma

A

Disorganisation with blue collagen balls

82
Q

Histology of Ewing’s sarcoma

A

Small, round, blue cells

83
Q

Histology of giant cell tumour

A

Numerous multinucleated giant cells

Eccentric lytic epiphyseal/metaphyseal lesion that often extends into the distal epiphysis and borders subchondral bone

84
Q

Histology of osteoid osteomas

A

Benign appearance
No growth potential
Central nidus composed of more organised osteoid and lined by osteoblasts

85
Q

Histology of enchondromas

A

Bland

86
Q

End organ damage ‘CRAB’ pneumonic

A

Calcium raised
Renal insufficiency
Aneamia
Bone lesions

Things I Get Stuck On (13 decks)

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