Neoplastic Bone Tumours Flashcards
What should you do as a GP if you suspect a patient to have a primary bone tumour
Refer URGENTLY to specialist centre
How do you perform a bone biopsy
Needle - using Hamshidi needle under US/CT guidance
Open biopsy only if inaccessible/sclerotic lesion
what is a benign condition that mimics bone tumour
Fibrous dysplasia
Who is fibrous dysplasia more common in
female, young (<30)
Where does fibrous dysplasia occur (which bone / how many bones)
any bone, more commonly mono-ostotic
WGHat is the appearance of fibrous dysplasia on X ray
soap bubble osteolysis
What is poly ostotic disease associated with
McCune Albright Sundrome (includes endocrine problems and cafe au lait spots)
What are the three types of cartilagenous bone tumour
osteochondroma
Enchondroma
Chondroblastoma
What are the three types of bone forming bone tumour
osteoid osteoma
Osteoblastoma
Osteoma
Where do osteochondromas occur
AT THE ENDS OF LONG BONES (as this is a cartilaginous tumour!)
What are osteochondromas like
cartilaginous sufrace THICK over normal bone
WHAT occurs in Enchondroma
cartilagenous proliferation WITHIN the bone
Where do Enchondroma occur (which bones)
hands / feet
What does an X ray Enchondroma show
popcorn calcification
what does Enchondroma histology show
well circumcised proliferation of cartilage
What does an Enchondroma show macroscopically
may erode through cortex of bone
Does NOT burst through cartilaginous surface
what occurs in giant cell tumour
BORDERLINE MALIGNANCY:
- benign features: well demarcated, does not come through articular surface of bone
- malignant feature: lots of BLEEDING
where do giant cell tumours occur
end of long bones (around the knee)
What is a giant cell tumour composed of
giant osteoclast cells
What is the appearance of a giant cell tumour on X ray
lytic
what is the histology of a giant cell tumour
spindle / ovoid cells
Explain the three types of malignant bone tumour
osteosarcoma - forms bone
chondrosarcoma - forms cartilage
Ewing’s - mesenchymal (small round cell), undifferentiated
where does Osteosarcoma occur
end of long bones
What does an osteosarcoma look like on x ray
lytic, permeative, metaphysical elevated periosteum (Codman's triangle)
