Bone tumours and mets

Question 1

Describe primary tumours of bones and joints?

Answer 1

• Rare
• Peak incidence in chidlhood/adlolescence

Question 2

What are the benign and malignant tumours of Osteoblast?

Answer 2

• Benign
  
  • Osteoid osteoma
• Malignant
  
  • Osteosarcoma

Question 3

What are the benign and malignant tumours of Chondrocyte?

Answer 3

• Benign
  
  • Chondroma
  • Osteochondroma
• Malignant
  
  • Chondrosarcoma

Question 4

What are the benign and malignant tumours of Fibroblast?

Answer 4

• Benign
  
  • Fibroma
• Malignant
  
  • Fibrosarcoma

Question 5

What are the benign and malignant tumours of Bone marrow cells?

Answer 5

• Benign
  
  • Eosinophilic granuloma
• Malignant
  
  • Ewing’s sarcoma .

Question 6

What are the benign and malignant tumours of Endothelial cells?

Answer 6

• Benign
  
  • Haemangioma
• Malignant
  
  • Angiosarcoma

Question 7

What are the benign and malignant tumours of Osteoclast precursors?

Answer 7

• Benign
  
  • Giant cell tumour
• Malignant
  
  • Malignant giant cell tumour

Question 8

Describe Osteosarcoma?

Answer 8

• Most common primary bone tumour
• Mostly patients <30
• Can occur in the elderly in associated with Paget’s disease

Question 9

How does Osteosarcoma present and how is it investigated?

Answer 9

• Local pain and swelling
• X-ray
  
  • Expansion of bone within surround soft tissue
• CT/MRI
  
  • Determines extent of tumour
• Biopsy

Question 10

Describe the management of Osteosarcoma?

Answer 10

• Depends on the histological type
• Surgical removal then chemoradiotherapy

Question 11

Describe the prognosis of osteosarcoma?

Answer 11

• Good prognosis in childhood/adolescence
• Poor prognosis in the elderly

Question 12

Describe Chondrosarcoma?

Answer 12

• Second most common primary bone tumour
• Presents with bone pain and swelling
• Surgical resection is the treatment of choice
  
  • Relatively resistant to chemotherapy and radiotherapy
• Poor prognosis for anaplastic tumours

Question 13

Describe Ewing’s sarcoma?

Answer 13

• Exclusive to those under 40
• Presents as pain and swelling
• Local excision and surgical excision
• Good prognosis if patients present before metastasis

Question 14

Describe some of the potential presentations of metastatic bone disease?

Answer 14

• Local/general progressive bone pain
• Symptoms of spinal cord compression
• Pathological fractures
• Weight loss, anorexia

Question 15

Name the tumour types which commonly metastasise to bone?

Answer 15

• Myeloma
• Bronchus
• Breast
• Prostate
• Kidney
• Thyroid

Question 16

What are the goals of management for metastatic bone disease?

Answer 16

• Pain relief
• Preserve function
• Skeleton stabilisation
• Local tumour symptom control
  
  • Nerve impingement

Question 17

Describe the management of bony mets?

Answer 17

• Surgical intervention if skeletal instability
• IV bisphosphnates
• Hormonal therapy
  
  • May be useful in breast and prostate cancers
• Radiotherapy