Bone tumours + SCC

Question 1

Pathology of osteosclerosis

Answer 1

Abnormal diffuse/ patchy hardening of bone

Increased bone density due to impaired bone resorption

Question 2

Types of acquired osteosclerosis

Answer 2

Pagets
Osteogenic bone mets 
Myelofibrosis 
Chronic osteomyelitis 
High vit D
Hypoparathyroidism
Schnitzler syndrome

Question 3

Types of inherited osteosclerosis

Answer 3

Osteopetrosis

Osteopoikilosis

Question 4

S+S of osteosclerosis

Answer 4

Asymptomatic
Generalised bone pain
Pathological fractures

Question 5

Investigations for ?bone pathology

Answer 5

X ray

Question 6

Management of osteosclerosis

Answer 6

Calcium
Phosphate
Vit D

Question 7

Pathology of Ewings sarcoma

Answer 7

Malignant bone tumour

Small, round blue-stained cells

Question 8

S+S of Ewings sarcoma

Answer 8

Pelvis, femur, clavicle, humerus, ribs, spine affected
Intense pain, worse at night, worse with exercise
Soft mass attached to bone
Systemic symptoms
Lung mets

Question 9

Investigations + results for ?Ewings Sarcoma

Answer 9

X ray = permeative process, bone looks moth eaten. Periosteal reaction giving onion skin appearance
MRI for precise tumor size + location
PET for mets

Question 10

Management of Ewings sarcoma

Answer 10

Chemo

Surgery

Question 11

Pathology of giant cell tumor of bone

Answer 11

Benign, express RANKL
Increased osteoclast number
Causes bone destruction

Question 12

S+S of giant cell tumor of bone

Answer 12

Commonly around knee
Pain + swelling
Restricted ROM
Pathological fractures

Question 13

Investigations + results for giant cell tumor of bone

Answer 13

X ray = lucent mass, cortical thinning/ destruction, pathological fractures
Nucelar medicine = donut sign

Question 14

Pathology of osteoblastoma

Answer 14

Benign bone tissue forming tumor

Lots of osteoids + osteoblasts

Question 15

S+S of osteoblastoma

Answer 15

Commonly affects posterior spine + long bones 
Dull pain 
Not responsive to salicylates 
SCC
Swelling, tenderness + reduced ROM

Question 16

Investigations + results for osteoblastoma

Answer 16

X ray = well defined lucent mass, adjacent sclerosis, inner calcification
Biopsy

Question 17

What is the difference between histology for osteoblastoma + sarcoma?

Answer 17

Osteoblastoma:
Reduced mitotic activity 
Reduced cell atypia 
No cartilagenous matrix 
Does not imbue surrounding bone

Question 18

Pathology of osteosarcoma

Answer 18

Malignant bone tissue forming tumour

Growth plates with mutation prone cells

Question 19

Complications of osteosarcoma

Answer 19

Bone marrow represssion

Cortical bone breakage

Question 20

S+S of osteosarcoma

Answer 20

Appears in long bones, usually around knee
Pain worse on movement
Growing palpable mass

Question 21

X ray findings for osteosarcoma

Answer 21

Soft tissue mass with different calcification range
Bone destruction
Codman triangle