Cancer & the Skeleton

Question 1

What does -oma mean?

Answer 1

Benign CT

Question 2

What does -sarcoma mean?

Answer 2

Malignant CT

Question 3

What terminology is given to smooth vs skeletal muscle?

Answer 3

Smooth = leiomyo

Skeletal = rabdo

Question 4

What are the signs and symptoms of skeletal cancer?

Answer 4

Pain, lump, fracture, systemic symptoms, neurological, hypercalcaemic

Question 5

Outline the investigations regarding skeletal cancer

Answer 5

• Radiologic = plain radiograph, US, MRI, CT (mets), isotope scan, biopsy
• Bloods = FBC, U&E, Ca2+, clotting, LFTs, bone profile
• Special = tumour markers (PSA), urine electrophoresis, urine bence jones protein

Question 6

If present how will cancer appear on a plain radiograph?

Answer 6

• Bone forming
• bone destroying
• A combination

Question 7

What is an osteosarcoma?

Answer 7

• Malignant growth arising from long bones (most common near the knee)
• Pain, swelling, lump, fast growing, stretched skin over area

Question 8

What is a chondrosarcoma?

Answer 8

• Malignant growth from cartilage in the femur, humerus, ribs, pelvis
• Most common after 40
• Grayish-white lobulated mass

Question 9

What is Ewing’s sarcoma?

Answer 9

• Malignant neoplasm of undifferentiated cells arising within the bone marrow cavity
• Lower limb rather than upper

Question 10

Which primary bone tumours most commonly occur in the paediatric population

Answer 10

• aneurysmal bone cyst

- Ewing’s sarcoma

Question 11

Which tumours commonly metastasise to bone?

Answer 11

Prostate, breast, kidney, lung, thyroid

Question 12

Which lesions are typically blastic vs lytic?

Answer 12

• blastic = prostate

- lytic = breast, lung, thyroid, kidney

Question 13

Describe the typical radiological appearance of tumours affecting bone

Answer 13

• X-rays,
• CT/MR
• radionucleotide bone scanning

Blastic = bone forming
Lytic = holes