LECTURE 7 - finished Flashcards
List some tissues that can be the tissue of origin of bone tumours
- Bone
- Cartilage
- Fibrous tissues
- Marrow
- Blood vessels
- Nerves
Compare benign and malignant tumours in relation to commonness and age groups they affect:
Benign tumors are:
• Relatively more common
• Common in the young
Malignant tumors are:
• Comparatively rarer
• Twice as common in adults
What are the most common benign tumours?
- Giant-cell tumour
- Osteochondroma
- Chondroma
What are the most common malignant tumours?
- Chondrosarcoma
- Ewing’s sarcoma
- Osteosarcoma
Define sarcoma
Sarcoma = malignant tumour arising from connective tissues
List in order, the most frequent bone tumours per age group
Young people Benign tumours (mostly)
2nd decade
• Osteosarcoma
4th-6th decade
• Chondrosarcoma; Fibrosarcoma
> 6th decade
• Myeloma
> 7th decade
• Metastatic tumours
When do tumours start causing ssx?
When their growth occurs in a confined space
When their growth is rapid
When pain sensitive structures are impinged e.g. spinal nerves
List 5 typical manifestations of Bone tumours and elaborate on each
Bony Mans Penises Swell Near Prostitutes Houses
Pain
- common
- non-specific
- secondary to
- rapid expansion and stretching of surrounding
tissues
- pressure on surrounding tissues
- central haemorrhage (thin walls)
- tumour degeneration (outgrows blood supply)
- stress #'s
Swelling/lump
- indicative of superficial site OR advanced growth
Neurological ssx eg paresthesia, numbness
- pressure or stretching on peripheral nerve
- progressive dysfunction may indicate invasion by an
invasive tumour
Pathological #
- remember that fractures in the elderly usually occur in
the cortico-cancellous junction, so all fractures mid-
shaft should be treated with suspicion.
Hx of trauma/chronic bone disease
- trauma can initiate pathological changes
What should we be examining when assessing for bone tumours?
JOSS
Joint examination
- effusion
- reduced ROM
Overlying skin
- swollen
- warm
- inflamed
Swelling or lumps
- site and tissue of origin
- delineation from surrounding tissue
- mobility
- consistency
- tenderness
Spinal lesions
- painful muscle spasm
- back stiffness
What do benign tumours typically look like on plain film xray?
Well defined
Resemble bony outgrowths
Resemble cysts
What do cysts look like on plain film xray?
They look sclerotic with well defined margins, indicating that they are slow growing, possibly benign
** if they have a hazy, diffuse (soft) margins, this indicates osteoclastic bone resorption
What are ominous signs on plain film xray of bone tumours?
X boy toy Ollie said I Dont PMS
bone Invasion bone Destruction Periosteal bone formation Spread into soft tissue Multiple lesions
In relation to bone tumours, what are MRI’s useful for?
Assessing bone tumour
- spread into nearby tissues
- within bone
What are some lab test results that might indicate a bone tumour?
FBE (anaemia, malignancy)
ESR increased = malignancy
Serum alkaline phosphatase is increased in malignancy
Serum protein electrophoresis (increased abnormal globins means multiple myeloma)
Urine protein electrophoresis (increased bence jones = multple myeloma)
What are the 2 main ways of performing a bone biopsy?
Percutaneously using a large bore needle
Via surgical exposure (open biopsy)
