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ABOS Part 1 > Oncology > Flashcards

Oncology Flashcards

1
Q

Mnemonic for vertebral plana

A

MELT

M - metastasis, multiple myeloma
E - Eosinophilic granuloma (LCH)
L - Lymphoma, leukemia
T - Trauma, Tuberculosis

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2
Q

Mnemonic for sarcomas with lymph node mets

A

SCARE

S - Synovial Sarcoma
C - Clear cell sarcoma
A - Angiosarcoma
R - Rhabdomyosarcoma
E - Epitheloid sarcoma

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3
Q

Mnemonic for diaphyseal bone tumors

A

A, E, I, O, U, and Y

A - adamantonoma
E - eosinophilic granuloma (LCH)
I - infection
O - osteoid osteoma, osteoblastoma
U - uings (Ewings)
Y - fibrous dYsplasia, lYmphoma, mYeloma

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4
Q

Mnemonic blue cell tumors

A

LERNM

L - lymphoma (adult)
E - ewings (<30)
R - rhabdomyosarcoma (<30)
N - neuroblastoma (<30)
M - myeloma (adult)

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5
Q

Tumor markers for lymphoma

A

CD 45+
LCA (leukocyte common antigen)

Patients age >30

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6
Q

These tumors are treated with chemotherapy > surgery > chemotherapy

A

Ewing sarcoma (sometimes radiation therapy, too)

Osteosarcoma

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7
Q

These tumors are treated with radiation + surgery

A

Soft tissue sarcomas

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8
Q

These tumors are treated with limb salvage / wide resection

A

Chondrosarcoma
Adamantinoma
Chordoma
Parosteal osteosarcoma

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9
Q

These tumors are treated with ORIF (+ radiation)

A

Metastases
Lymphoma
Myeloma

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10
Q

These tumors are treated with intralesional resection

A

- Giant cell tumor (Epiphyseal, adult)
- ABC (fluid fluid levels)
- NOF (lytic and sclerotic rim, incidental finding)
- LCH (lytic, child)
- Osteoblastoma (diaphyseal)
- Chondroblastoma (Epiphyseal, child)

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11
Q

These tumors are treated with radio frequency ablation

A

Osteoid osteoma

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12
Q

Epiphyseal tumors

A

Chondroblastoma (child)
Giant cell (adult)
Clear cell sarcoma (femoral head)

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13
Q

Tumors located in flat bones

A

Chondrosarcoma (pelvis, scapula) (adult)
Fibrous dysplasia
Hemangioma
Pagets
Ewing sarcoma (child)

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14
Q

Mnemonic for metastatic tumors

A

BLT and Kosher Pickle

B - breast (mammogram)
L - lung (CXR, CT chest)
T - thyroid (ultrasound)

K - kidney (CT abdomen)
P - prostate (PSA)

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15
Q

A

Adamantinoma

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16
Q

A

Eosinophilic granuloma (LCH)

“Punched out” lytic lesion
Diaphyseal

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17
Q

A

Fibrous dysplasia

“Ground glass appearance”

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18
Q

A

Osteoid osteoma
Age <30
Size <2 cm
Diurnal pain relieved by NSAIDS
Prostaglandin E2 is released by tumor and causes inflammation/pain
Lesion modus best seen on CT
Path: woven central bone with mature outer lamellar like bone
TREATMENT:
- NSAIDS
- CT guided radio frequency ablation (90c 6 min) (contraindicated in spine and subcu location)
- noninvasive high frequency MRI ultrasound

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19
Q

A

Parosteal osteosarcoma
Stuck on bone appearance
Just need wide excision, uniquely it does not need chemo

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20
Q

Lab associated with what cancer?
11;22/EWS FLI-1

A

Ewing Sarcoma

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21
Q

Lab is associated with what cancer?
X;18/SSX1-SYT

A

Synovial Sarcoma

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22
Q

Lab is associated with what cancer?
P53 and Rb

A

Osteosarcoma

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23
Q

Side effect of Doxorubicin (Adriamycin)?

A

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24
Q

Order of evaluation for cancer patient.

A

History and physical
Local staging (XR, MRI, CT, labs)
Systemic staging (CT CAP, whole body PET/bone scan)
Biopsy (always stage before biopsy or treatment)

***have a diagnosis before you treat!

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25
Metaphyseal tumors
Osteosarcoma Chondrosarcoma Metastases
26
Spine tumors Anterior elements (2) Posterior elements (3)
27
Tumors commonly found in the sacrum?
28
Tumors commonly see in tibia?
Chondromyxoid fibroma (shark bite lesion) Non-ossifying fibroma (sclerotic lytic lesion) Adamantinoma (soap bubble appearance)
29
CD 45+ , LCA (leukocyte common antigen) are associated with…
Lymphoma
30
Name the cancer…. Vimentin positive CD 99+ Path with small round blue cells and pseudo rosettes
Ewing sarcoma
31
Name the cancer… Desmin positive t(2;13) PAD-FKHR
32
CD 20+ is associated with this cancer…
Myeloma
33
Name the cancer… S-100
Schwannoma MPNST
34
Name the cancer… Beta catenin membrane marker
Fibromatosis
35
Name the cancer… Loss of INI 1 (integrate interactor 1)
Epitheloid sarcoma (Often presents with no healing cutaneous ulcer)
36
Name the cancer… USP6
Aneurysmal bone cyst
37
Name the cancer… t(12;16)/TLS-CHOP
Myxoid liposarcoma (Requires whole body MRI) Can metastasize to bone
38
Patients with neurofibromatosis type 1 are at risk of developing…
Malignant peripheral nerve sheath tumors
39
Chemotherapy agents for osteosarcoma
Doxorubicin, Cisplatin, Methotrexate (high dose)
40
Chondroblastoma
Epiphyseal <30 years Chicken wire calcification Round cells with fried egg appearance Can be locally aggressive and has potential to metastasize to lungs. Treatment is curretage and bone grafting
41
What 3 benign aggressive tumors require CT chest screening for rule out malignancy?
Giant cell tumor of bone Solitary fibrous tumor Chondroblastoma
42
Steps for incompletely excised tumor/whoops surgery?
Reimage Radiate Re-excise
43
Factors associated with worse prognosis for soft tissue sarcomas…
Size >5 cm High grade Deep to fascia Fungating Torso worse than extremity Extensive necrosis
44
MDM2 is associated with…
Liposarcoma or atypical lipomatous tumors MDM2 is not present in lipomas
45
Fibrosarcoma
Soft tissue tumor CT chest to rule out malignancy Pathology: Herringbone pattern Treatment radiation + wide excision
46
Malignant peripheral nerve sheath tumor
Associated with NF1 gene on chromosome 17. S100+ Path: whirling spindle cells Treatment: radiation + wide excision
47
Angiosarcoma
Associated with chronic venous stasis or trauma with chronic lymphedema. Subcutaneous tissue +lymph node spread (SCARE) Can also occur after radiation treatment Path: see image Treatment: wide excision
48
Rhandomyosarcoma
Kids Metastatic lymph node spread (SCARE) Path: Desmin + t(2;13)/PAX-FKHR Treatment: neoadjuvant chemotherapy, wide excision, +/- radiation at margins
49
Epithelioid sarcomas are know. For being found in this location… Path…
Hand and forearm Loss of IN1 Spread to lymph nodes (SCARE)
50
Fibromatosis tumor patients should also have this done..
Colonoscopy to screen for adenomatous polyposis association
51
Name the cancer…. Nuclear IHC beta catenin + Estrogen receptor +
Fibromatosis
52
Name the cancer…
Hemangioma/AVM
53
Cancer commonly found in the foot…
Clear cell sarcoma Synovial sarcoma
54
Osteoblastoma
Age <30 Diaphyseal lesion, size > 2cm Mixed Lytic/blastic, can grow to be expansile Intermittent pain pattern (not diurnal) Treatment: intralesional curettage and grafting
55
Osteosarcoma
Age <30 Metaphyseal 50% around the knee (next most common is prox humerus) P53, Rb Path: immature bone formation with rimming osteoblasts Treatment: chemo, surgery (wide excision), chemo
56
Periostea’s osteosarcoma treatment
Same as conventional osteosarcoma Chemo, wide excision, chemo
57
This osteosarcoma can mimic ABC…
Telangiectactic osteosarcoma Both can have fluid fluid levels on MRI and occur in young patients. USP6 + with ABCs can help differentiate. Also, ABCs tend to expand the cortex and balloon the bone whereas osteosarcoma do not. ABCs have lakes whereas osteosarcomas are more cellular and have atypical cells/mototic figures.
58
Enchondroma Metaphyseal, calcified arcs and rings Asymptomatic Cartilage origin on histology with some clumps of cellularity. Treatment: observe, unless path fx the curette graft and ORIF
59
Osteochondroma Cartilage cap >2cm are at risk for low grade chondrosarcoma. Can be more concerning in MHE EXT1, EXT2, EXT3 mutations. EXT1 has highest burden of disease and greatest risk of malignant transformation to low grade chondrosarcoma
60
Syndrome characterized by multiple non-ossifying fibromas…
61
This sacral nerve root is most important for retaining bowel and bladder function.
S3
62
Mirels score threshold for surgical fixation of pathologic lesion?
Greater than or equal to 9
63
Myeloma
Age >50 Punched out lesion Round blue cell tumor CD56+, CD45+ Monoclonal Diagnosis’s: SPEP/UPEP with monoclonal Kappa/lambda light chains. Path: small round blue cells, Plasma cells with eccentric clock face nucleus Staging: Cold bone scan, need skeletal survey for burden of disease/staging Treatment: chemo + radiation
64
How do you differentiate osteosarcoma from Ewings sarcoma?
Histology
65
How do you differentiate osteomyelitis from other tumors?
It does not respect fascial or muscular planes. It is not organized. Lots of associated edema.
66
Enchondroma
67
Chondrosarcoma Calcifications + causing bony architecture changes
68
Pathology findings for osteosarcoma?
69
Osteofibrous dysplasia (Soap bubble appearance that is critically based, commonly the tibia)
70
Fibrous dysplasia (Ground glass appearance)
71
What 2 soft tissue sarcoma shave improved survival with chemotherapy?
Rhabdomyosarcoma (child) Synovial sarcoma
72
Treatment of chondrosarcoma… Grade 1 Grade 2 Grade 3
Grade 1: intralesional curettage Grade 2: wide resection Grade 3: wide resection *no chemotherapy or radiation indicated
73
This type of cancer can occur in Paget’s disease…
Osteosarcoma
74
Treatment chondromyxoid fibroma?
Intralesional curettage
75
Chordoma treatment?
Wide excision
76
Fibrous dysplasia genetic association?
GNAS
77
Maffuci syndrome is associated with enchondromas + ….
Hemangiomas
78
t(12;22) translocation
Clear cell sarcoma
79
Ollier and Mafucci syndrome…
80
What is the diagnosis… Polyostotic fibrous dysplasia, cafe au lait spots, precocious puberty.
McCune Albright syndrome

ABOS Part 1 (11 decks)

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