Cancer And Tumours

Question 1

What type of patient does Ewing sarcoma present in and where?

Answer 1

Children 5-10 years. Long bones.

Question 2

Most likely bone malignancy in patients 10-20 years?

Answer 2

Osteosarcoma

Question 3

What is the most common primary malignant tumour of bone in adults?

Answer 3

Multiple myeloma

Question 4

Name 3 risk factors multiple myeloma

Answer 4

• 90% in >40 age
• males twice as common
. African twice as common

Question 5

Name 5 signs and symptoms of multiple myeloma

Answer 5

• Localized bone pain (cardinal early symptom)
• compression/pathological #
• renal failure, nephritis
• high incidence infections eg pyelonephritis/pneumonia
• systemic: weakness, weight loss, anorexia

Question 6

Name 5 lab blood findings of multiple myeloma

Answer 6

• Anaemia
• thrombocytopenia
• increased ESR
• hypercalcaemia
• increased creatinine

Question 7

Name 3 radiographic findings multiple myeloma

Answer 7

• Multiple “punched out” lytic lesions that are well demarcated, only appear once > 50% destruction
. No surrounding sclerosis (thus punched out - lack osteoblastic activity in myeloma)
• marked bone expansion

Question 8

What is multiple myeloma?

Answer 8

Neoplastic proliferation of plasma cells that commonly results in multiple skeletal lesions, hypercalcaemia, renal insufficiency, anemia. Most common primary malignant tumour of bone in adults.

Question 9

How diagnose multiple myeloma? (2)

Answer 9

• Serum/urine immune electrophoresis (monoclonal gammopathy)

* CT guided biopsy of lytic lesions at multiple bony sites showing monoclonal plasma cells ≥ 10%

Question 10

What is osteosarcoma?

Answer 10

Malignant, aggressive, osteogenic bone tumours commonly found in distal femur or proximal tibia. Second most common primary malignancy in adults

Question 11

Risk factors osteosarcoma? (4)

Answer 11

• Children and young adults, most frequently second decade of life
• history Paget’s disease (elderly)
• prior radiation treatment
• African males

Question 12

Most common sites osteosarcoma? (3)

Answer 12

• Distal femur
• proximal tibia
• proximal humerus

Question 13

What is Ewing’s sarcoma?

Answer 13

Malignant, distinctive small round cell sarcoma occurring mostly in 5-25 years old. Florid periosteal reaction in metaphysis of long bone with diaphyseal extension. metastasis frequent without treatment
Second most common primary malignant bone tumor in children.

Question 14

Radiographic findings Ewing’s sarcoma? (3)

Answer 14

• Moth-eaten appearance
• periosteal lammellated pattern of reaction - “onion skin”
• large associated soft tissue mass appreciated in > 80%

Question 15

Treatment Ewing’s sarcoma?

Answer 15

Radiation, chemo and resection

Question 16

Name 5 cancers that commonly metastasize to bone

Answer 16

• prostate
• breast
• lung
• colon
• kidney