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MSK > O: Bone Tumours > Flashcards

O: Bone Tumours Flashcards

1
Q

what are the 3 main malignant cancers of bone?

A

osteosarcoma, Ewing’s sarcoma and chondrosarcoma

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2
Q

what is osteosarcoma?

A

formation of abnormal bone

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3
Q

epi of osteosarcoma?

A

most common malignant bone cancer, affects young

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4
Q

red flag symptoms of any malignant bone cancer?

A

persistent and inc pain, not associated with movement, worse at night

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5
Q

where is the most common presentation of osteosarcoma?

A

distal femur/ proximal tibia

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6
Q

what Is Ewing’s sarcoma?

A

caused by proliferation of endothelial cells in bone marrow

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7
Q

epi of Ewing’s sarcoma?

A

5-25yo, 2nd commonest bone cancer in kids

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8
Q

where are 50% of Ewing’s found?

A

diaphysis of long bones

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9
Q

is Osteosarcoma presents in elderly, what is the most likely cause?

A

Paget’s disease

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10
Q

what may Ewing’s sarcoma presentation mimic?

A

septic arthritis- pain associated with fever

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11
Q

what are some ix markers of Ewing’s sarcoma?

A

bloods- raised inflammatory markers: ESR, CRP

imaging: sunburst appearance

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12
Q

why is surgery a difficult option to consider with Ewing’s?

A

bone marrow involvement is extensive so amputation often insufficient

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13
Q

what is chondrosarcoma?

A

malignancy of chondrocytes

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14
Q

epi for chondrosarcoma?

A

40-75yo

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15
Q

common sites for chondrosarcoma?

A

pelvis/ distal femur

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16
Q

common imaging finding for chondrosarcoma?

A

blastic lesions with reactive cortical thickening

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17
Q

___ % of all child cancers are bone cancer?

A

10%

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18
Q

main risk factors for bone cancers?

A

previous injuries, conditions (Paget’s), genetic (p53), familial retinoblastoma

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19
Q

what may cancer present with?

A

fractures due to abnormal bone

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20
Q

main ix for malignant bone cancers?

A

bloods, radiographs (AP & lateral, MRI/CT, bone scan)

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21
Q

what part of bone looks like popcorn on scan if cancer present?

A

matrix

22
Q

tx for bone cancer?

A

neoadjuvant chemo, surgery (limb salvage resection & reconstruction, amputation), adjuvant therapy

23
Q

what rx is given for symptomatic relief with bone cancer?

A

bisphosphonates

24
Q

which of the 3 malignant bone cancers has the worst prognosis?

A

Ewing’s sarcoma, although chondrosarcoma is slow growing and so often is caught late

25
Q

name the acronym for 2y cancer spread to bone?

A

BLT with Kosher Pickle

breast, lung, thyroid, kidney, prostate

26
Q

sites commonly affected by 2y spread to bone?

A

vertebrae, pelvis, ribs, femurs, skull

27
Q

what are the 2 pathophysiological processes of bone mets?

A

can be bone loss or bone formation

28
Q

what are common ix carried out for 2y cancer to bone?

A

x-ray, if -ve but high clinical suspicion do CT/MRI

bloods: inc serum alk phos

29
Q

why are x-rays not always the best ix for bone cancer?

A

lesions not visible unless >50% of bone cortex destroyed

30
Q

10-20% of patients with 2y bone cancer have ___________?

A

hypercalcaemia

31
Q

what are the 3 main benign diseases of bone?

A

Osteoid Osteoma, osteochondroma, endochondroma

32
Q

what is osteoid osteoma?

A

painful benign tumour of long bones

33
Q

epi for osteoid osteoma?

A

5-25yo

34
Q

s/s of osteoid osteoma?

A

pain worse at night, pain

35
Q

ix finding for osteoid osteoma?

A

central nodule of woven bone with osteoblastic rim (halo)

36
Q

mx for osteoid osteoma?

A

spontaneous resolution, radio frequency ablation

37
Q

what is osteochondroma?

A

benign lesion formed by abnormal cartilage

38
Q

which of the 3 is the most common benign bone tumour?

A

osteochondroma

39
Q

what are the 2 types of osteochondroma?

A

solitary and multiple hereditary exostosis

40
Q

aetiology for solitary osteochondroma?

A

salter harris fracture, surgery, radiotherapy

41
Q

aetiology for multiple hereditary exostosis osteochondroma?

A

mutation of EXT 1,2,3 genes

42
Q

where is a common site for ostechondromas?

A

knee- may be palpable mass

43
Q

MHE ostechondroma may also present with…

A

jt pain and deformity of limb

44
Q

ix for osteochondroma?

A

x-rays and MRI for cartilage cap

45
Q

tx for osteochondroma?

A

syonvectomy, observe/ surgically excise

46
Q

what is main complication of osteochondroma?

A

formation of loose bodies within joint

47
Q

which of the 3 benign cancers are most likely to undergo malignant transformation and when to be worried about this?

A

osteochondroma- specifically MHE. consider this is lesion is rapidly inc in size/ systemic symptoms

48
Q

what is endochondroma?

A

benign intramedullary lesion

49
Q

endochondroma is __ most common benign tumour and is mainly found in __- __ year olds

A

2nd, 20-50yo

50
Q

T/F: endochondroma often presents with acute symptoms

A

F: it is often an incidental finding

51
Q

what is mx for endochondroma?

A

symptomatic: curettage and bone grafting
asymptomatic: conservative mx

MSK (26 decks)

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