Malignant Musculoskeletal Tumours Flashcards
1
Q
Sarcoma
A
Soft tissue malignancy Named after mesodermal origin Rare Rarely spreads to lymph Spreads to lungs Calcification on X Ray MRI and biopsy Require resection
2
Q
Osteosarcoma
A
Most common malignant bone tumour 90% highly malignant
Mesenchymal bone cells
Adolescent males
Long bone metaphysis
3
Q
Osteosarcoma symptoms
A
Night pain Exercise pain Swelling # Fatigue Wt loss Malaise
4
Q
Osteosarcoma X Ray
A
X Ray-> mixed sclerotic/lytic lesion
- permeative
- sunburst
- cod mans triangle
5
Q
Ewigs sarcoma
A
Neuro-ectodermal cells Children Diaphysis Always high grade Warm swelling and systemic upset X Ray-> poorly marinated, extend in to soft tissue -laminated -permeative (moth eaten)
6
Q
Chondrosarcoma
A
Cartilage >40 Variable grade Long bones X Ray-> lytic, intralesionsal calcification, permeative, periosteal reaction
7
Q
Bone malignancy symptoms
A
Localised pain, ache/tenderness, at rest and at night Swelling and redness Lump Pathological # Fever Wt loss Night sweats
8
Q
Bone malignancy X Ray signs
A
Lytic Ground glass-> fibrous dysplasia Irregular zone of transition Codmans triangle-> periosteal elevation Onion skinning Sunday spicules
9
Q
Multiple myeloma definition
A
Malignancy of the plasma cells of bone marrow
Most common bone malignancy in adults
10
Q
Multiple myeloma clinical features
A
Bone pain *back ache Pathological # Spinal cord/nerve root compression Lethargy-anaemia Anorexia Hypocalcemia-> thirst, constipation, nausea like confusion Renal failure Recurrent infection Bleeding/bruising
11
Q
Multiple myeloma investigations bloods
A
Bloods -normocytic, normochromic anaemia -leukopenia -thrombocytopenia -raised ESR -deranged u and e and Cr -increased Ca Serum and urine bence Jones electrophoresis-> paraprotien type
12
Q
Multiple myeloma X Ray
A
Skeletal survey Initially normal Numerous well circumcised lytic bone lesions -punched out -scalloping
13
Q
Multiple myeloma management
A
Incurable Relapsing remitting Asymptomatic->observe Active-> melphalen and prednislone Chemotherapy-> <65y Analgesia and bisphosphonates
