Malignancy

Question 1

Are prostate cancer mets scleroitic or lytic?

Answer 1

Sclerotic

Question 2

Are breast cancer mets sclerotic or lytic?

Answer 2

Lytic

Question 3

What cells do chondrosarcomas originate from?

Answer 3

Chondrocytes

Question 4

What cells do liposarcomas originate from?

Answer 4

Adipocytes

Question 5

What cells do leiomyosarcomas originate from?

Answer 5

Smooth muscle

Question 6

What is an ewings sarcoma?

Answer 6

A malignant blue cells tumour that arises in the bone or soft tissue.
Most commonly occurs in teenagers and young adults.
Most common near the femoral diaphysis.

Question 7

What is an osteosarcoma?

Answer 7

Tumour from mesenchyma cells makes up 20% of primary bone tumours. Peak age 15 - 30 and more common in males.

Question 8

What cancers commonly metastasise to bone?

Answer 8

Lung 
Prostate
Renal
Thyroid 
Bowel

Question 9

Are secondary bone tumours more common in the central or peripheral skeleton?

Answer 9

Central

Question 10

Which form of imaging can pick up metastatic bone lesions fastest?

Answer 10

MRI

Question 11

What imaging do you do if you suspect a malignant bone tumour?

Answer 11

MRI

Question 12

What is an enchondroma? How does it present, what does it look like and what treatment is required?

Answer 12

A benign bone lesion of cartilage origin formed from aberrhant cartilage within bone. Found in the metaphysis of long bones (femur or humerus)

Usually asymptomatic

X Ray shows a well demarcated calcifying lesion in the metaphysis of the bone

Usually no treatment is required but serial X Rays may be required to make sure the lesion is not growing rapidly.

Question 13

What is an osteochondroma? How does it present, what does it look like and what treatment is required?

Answer 13

The most common benign bone lesion found in adults and children. Develops from cartilage remaining on the surface of the cortex.

Appears on X Ray as a bone lesion that is continuous with the cortex of the bone capped with hyaline cartilage

Most are asymptomatic or present as a swelling.

Usually no treatment is needed

Question 14

What is an osteoid osteoma? How does it present, what does it look like and what treatment is required?

Answer 14

Painful but self limiting benign bone lesion

Caused by osteoblast in the cortex of bone usually in the tibia, spine or femur.

Presents with intense pain, particulary at night

X ray shows a radiolucent nidus surrounded by a dense area of reactive bone.

CT guided ablation and NSAIDs

Question 15

What is fibrous dysplasia? How does it present, what does it look like and what treatment is required?

Answer 15

Developmental abnormality of bone which resents with pain, swelling, deformity or fracture.

Typical ground glass appearance

No treatment.

Question 16

What does the X Ray of chondrosarcoma show?

Answer 16

Lytic lesion with corticol destruction and central calcification
CT/MRI may be required

Question 17

What does the X Ray of osteosarcoma show?

Answer 17

Ill defined lesion
Sclerotic or lytic areas
Corticol destruction

Biopsy needed
CT/MRI for staging