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Year 2 > MSK tumour pathology > Flashcards

MSK tumour pathology Flashcards

1
Q

How common are skeletal tumours?

A

Uncommon

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2
Q

What are the categories of tumour which can affect the skeleton?

A 
Myeloma (plasma cells)
Metastases
Benign 
Benign but locally destructive
Malignant
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3
Q

What are the benign tumours affecting the skeleton?

A

Osteochondroma (exostosis)
Chondroma/enchondroma
Osteoid osteoma
Chondroblastoma

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4
Q

What is an osteochondroma?

A

Cartilage capped bony outgrowth on the external surface of the bone

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5
Q

How will an osteochondroma appear on imaging?

A

The bony outgrowth will be continuous with the normal bone

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6
Q

Which age group is affected by osteochondromas?

A

Young

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7
Q

Are males or females more affected by osteochondroma?

A

Equal distribution

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8
Q

Where on the bone do osteochondromas tend to develop?

A

Near epiphysis of long bones

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9
Q

When might an osteochondroma cause problems?

A

Can cause local pain or irritation

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10
Q

What is an (en)chondroma?

A

Hyaline cartilage tumour arising within the medullary cavity of bones

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11
Q

Which bones develop (en)chondromas?

A

Hands

Feet

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12
Q

In which two conditions might you see more than one (en)chondroma?

A

Ollier’s disease

Mafucci’s syndrome

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13
Q

Who gets (en)chondromas?

A

Young adult men

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14
Q

What are the enchondromas associated with in Mafucci’s syndrome?

A

Angiomas

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15
Q

What is Ollier’s disease?

A

Rare developmental disorder

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16
Q

Is ollier’s disease hereditory?

A

No

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17
Q

Where do the (en)chondromas arise in ollier’s disease?

A

Metaphyses
Diaphyses

Unilateral

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18
Q

What is the risk with Ollier’s disease?

A

Malignant transformation possible

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19
Q

What is the risk with Mafucci’s syndrome? How does this compare to ollier’s syndome?

A

Malignant transformation much higher than in ollier’s syndrome

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20
Q

Small peripheral bone lesions are less likely to be benign than large axial lesions. T/F

A

False - small peripheral lesions are more likely to be benign

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21
Q

Who gets osteoid osteoma?

A

Children and young adults

More common in males

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22
Q

Where are osteoid osteomas typically found?

A

Femur
Tibia
Hands & feet
Spine

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23
Q

Which cells do osteoid osteomas arise from?

A

Osteoblasts

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24
Q

How do osteoid osteomas typically appear on imaging?

A

Central vascular osteoid core
Peripheral sclerosis
Cortex of bone

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25
Q

How does osteoid osteoma present?

A 
Pain worse at night
Dull/achey
Relieved with aspirin/NSAIDs
\+/- spinal scoliosis 
\+/- soft tissue swelling
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26
Q

How are osteoid osteomas managed?

A

Self resolving within 3 years

Pain relief

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27
Q

Who gets chondroblastomas?

A

Teens

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28
Q

How common is chondroblastoma?

A

Rare

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29
Q

Chondroblastomas are benign. T/F

A

True - can be locally aggressive

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30
Q

Where in bones and in which bones do chondroblastomas present?

A

Epiphysis

Long bones

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31
Q

How doe chondroblastomas appear on imaging?

A

Well circumscribed osteolytic sphere

+/- extension from epiphysis

32
Q

What type of calcification is characteristically seen with chondroblastomas?

A

Chicken wire

33
Q

How are most benign bone tumours treated?

A

Biopsy and curettage + liquid nitrogen

34
Q

List the three benign but locally aggressive bone tumours

A

Giant cell tumour
Osteoblastoma
Chordoma

35
Q

Which cells do giant cell tumours arise from?

A

Osteoclasts

36
Q

Which age groups get giant cell tumours?

A

25-40 y/o

37
Q

Which sex is more prone to giant cell tumours?

A

Females

38
Q

Which bones do giant cell tumours typically arise on?

A

Long bones

Very common around knee (distal femur)

39
Q

How do giant cell tumours typically appear on imaging?

A

Dense around the periphery
Destroyed medullary cavity
Destroyed cortex
+/- soft tissue expansion

Nb - “soap bubble” appearance buzzword

40
Q

What type of cells can be seen on histology of a giant cell tumour?

A

Multi-nucleated giant cells

41
Q

Is an osteoblastoma single or multiple?

A

Single

42
Q

Where and on which bones can an osteoblastoma be found?

A

Metaphysis
Diaphysis

Long bones

43
Q

How does an osteoblastoma appear on imaging?

A

Central density
Well circumscribed
+/- peripheral sclerosis

44
Q

How might an osteoblastoma present?

A

Pain
Swelling
Tenderness

45
Q

How are benign but locally aggressive bone lesions treated?

A

Surgical excision

46
Q

How common is chordoma?

A

Rare

47
Q

Which cells do chordomas arise from?

A

Notochord embyrological remnants

48
Q

Which age group presents with chordomas?

A

> 40 y/o

49
Q

Which sex is more commonly affected by chordomas?

A

Females

50
Q

On which bones are chordomas found?

A

Sacrococcygeal
Base of skull
(midline)

51
Q

How do chordomas present on imaging?

A

Midline lesions
Bony lysis
+/- soft tissue mass
+/- focal calcifications

52
Q

How are chordomas treated?

A

Difficult to resect
Radiation
Chemotherapy for late stage

53
Q

List the three most common malignant tumours of the bone?

A

Osteosarcoma
Chondrosarcoma
Ewing’s sarcoma

54
Q

What is the commonest primary malignant bone tumour?

A

Osteosarcoma

55
Q

Which type of cells do osteosarcomas arise from?

A

Osteoblasts

56
Q

Which age groups are affected by osteosarcomas?

A

Young adults

57
Q

Which sex is affected by osteosarcoma?

A

Male more commonly

58
Q

Where and on which bones are osteosarcomas typically found?

A

Epiphysis

Long bones (distal femur, proximal tibia and humerus)

59
Q

Osteosarcoma is fast growing. T/F

A

True

60
Q

What are the three subtypes of osteosarcoma?

A

Osteoblastic
Chondroblastic
Fibroblastic

61
Q

How is osteosarcoma treated?

A

Biopsy, CT, bone scan
Chemo pre and post op
Surgical resection

62
Q

Which type of cells do chondroblastomas arise from?

A

Chondrocytes

63
Q

Chondroblastomas are commonly found within the pelvis. T/F

A

True

64
Q

How are chondroblastomas treated?

A

Excision

65
Q

What type of tumour is Ewing’s sarcoma?

A

Peripheral primitive neuroectodermal tumour (PPNT)

66
Q

Where and in which bones does Ewing’s sarcoma arise?

A

Metaphysis
Diaphysis

Femur
Tibia
Humerus

67
Q

Which age group is affected by Ewing’s sarcoma?

A

Teens

68
Q

Which sex is more commonly affected by Ewing’s sarcoma?

A

Males

69
Q

How is Ewing’s sarcoma treated?

A

Surgery
Radiotherapy
Chemotherapy

70
Q

Which cancers commonly metastasise to bone?

A 
Renal
Thyroid
Prostate
Breast
Lung (small cell)
71
Q

Bone metastases are osteosclerotic. T/F

A

Osteolytic EXCEPT from prostate cancer

72
Q

What is multiple myeloma?

A

Malignant cancer of plasma cells

73
Q

Who gets multiple myeloma?

A

Old people

74
Q

What is a common complication of multiple myeloma?

A

Kidney failure

and death

75
Q

How does multiple myeloma appear on imaging?

A

Punched out

“Pepper pots”

Year 2 (72 decks)

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