Oncology Flashcards
risk factors for bone cancer
majority idiopathic
previous radiotherapy
pagets
genetic; li fraumeni- p53, retinoblastoma
presentation
worse at night
swelling over joint
palpable mass
perisistent increasign pain usually not with movement
differentials
osteomyelitis / multiple myeloma / metabolic bone disease (e.g. renal osteodystrophy) / pathological fracture
diagnostic tetss
CT
MRI
bone scan
treatment
neoadjuvant; chemo, radio
surgery amputation
osteosarcoma overview
Most common primary sarcoma of bone
Affects children/young adults, 2nd peak in elderly (Pagets)
Usually around distal femur/proximal tibia
Treatment: chemotherapy & limb salvage
ewings overview
Young people 5-25 years of age
2nd commonest malignant bone tumour in children
Usually found in diaphysis of long bones, again distal femur/prox tibia
Treatment chemotherapy with limb salvage+/- adjuvant radiation
chondrosarcoma overview
Malignancy of chondrocytes
Majority arise de novo
Few arise from benign lesions (enchondroma & osteochondroma 1%)
Older patients 40-75y
Commonest in pelvis, proximal and distal femur
May be slow-growing /aggressive – this correlates with survival
osteoid osteoma overview
Central nodule of woven bone with osteoblastic rim
Pain worse at night, relieved by aspirin
Usually resolve spontaneously
Can treat with radiofrequency ablation
Painful, benign tumour of long bones
Young people aged 5-25 years
most common benign bone tumour
osteochondroma
Benign lesion formed from abnormal cartilage
Solitary or multiple (hereditary multiple exostoses, HME)
Common in adolescents / young adults
Can be caused by trauma
classifying lesions on age
1- neuroblastoma
1-10- ewings sarcoma
10-30- osteosarcoma/ewings
30-40- fibrosarcoma/ lymphoma
40+- metastatic carcinoma/ multiple myeloma
can an xray always diagnose
no as lesions may not show up on xray until >50 cortical bone lost
