Pathology Flashcards
Osteochondroma
Bony outgrowth with cartilaginous cap, may result in local pain.
Osteochondroma Issues
1% chance of becoming metastatic, any increase in growth may require excision.
Enchondroma
Intra medullary cartilaginous tumour due to failure of enchondral ossification.
Enchondroma issues
Pathological fractures due to area of weakness- bone grafting is usual response.
Simple bone cyst
Single cavity benign fluid filled cyst, often incidental finding , usually on long bones.
Simple bone cyst issue
Pathological fractures due to weakening of the bone, bone grafting +/- stabilisation.
Aneurysmal Bone cyst
Lots of chambers filled with blood or serum, affects long and flat bones.
Aneurysmal Bone cyst issues
Locally aggressive causing cortical destruction and pain, pathological fractures
Aneurysmal Bone Cyst treatment
Bone grafts or cement
Giant Cell tumour
Tend to occur in epiphysis especially around the knee but can occur in other long bones pelvis and spine.
Giant cell tumour appearance
On Xray look for soap bubble apearance
Giant Cell Tumour issues
Locally destroying cortex, associated with pain and pathological fractures
Giant Cell risk
5% can metastasise to the lung, metastatic tumour is still considered benign.
Giant cell tumour treatment
Intralesional excision, phenol bone cement and liquid nitrogen used to remove tumour and prevent recurrence.
Fibrous Dysplasia
occurs in adolescence, lesions of fibrous tissue and immature bone.
Fibrous dysplasia in one bone
Monostotic
Fibrous dysplasia in several bones
Polyostotic
Fibrous dysplasia issues
Wider bones with thin cortices, angular deformities are common. All lead to pathological fractures.
Fibrous dysplasia treatment
Bisphosphonates to reduce pain
Internal fixation and bone grafts used to stabilise.
Fibrous dysplasia excision
Simple intralesional excision has a very high recurrence rate.
Osteoid osteoma
Is a small nidus of immature bone surrounded by sclerotic halo, occur in adolescence.
Common site for osteoid osteoma?
Proximal femur, diaphysis of long bones and vertebrae.
Clinical features of osteoid osteoma?
Intense constant pain worse at night.
Massively reduced by NSAIDs
Identification of osteoid osteoma?
Xray may reveal however bone san and CT used to confirm.
Osteoid osteoma treatment.
May be self resolving, CT guided radio frequency ablation or en bloc excision.
Are primary or secondary bone tumours more common?
Secondary bone tumours are more common.
Most common primary bone tumours?
Osteosarcoma
Osteosarcoma
Malignant tumour producing bone, affects younger age groups .
Common site for Osteosarcoma
Usually bones around the knee, proximal femur humerus and pelvis.
Osteosarcoma metastatic spread
Usually haematogenous but can be lymphatic.
Osteosarcoma treatment
They are not radiosensitive , chemotherapy can prolong survival, surgery is curative.
Chondrosarcoma
Cartilage producing primary bone tumour, less common and less aggressive that osteosarcoma,
Chondrosarcoma occurence
Older age group 45years, pelvis or proximal femur.
Chondrosarcoma treatment
Very large and slow to metastasise, however radiotherapy and chemotherapy is as of yet ineffective.
Fibrosarcoma
Fibrous malignant bone tumours occurring in abnormal bone. Tends to affect young adults.
Ewings Sarcoma
Malignant tumour of primary cells within the marrow.
Ewings occurence
2nd most prevalent with the poorest prognosis.
Affects ages between 10 and 20.
Clinical appearance of Ewings sarcomma
Fever raised inflammatory markers and warm swelling.
What is Ewings sarcoma easily mistaken with?
Osteomyelitis
Treatment for Ewings sarcomma
it tends to be radio and chemo sensitive.
Metastatic bone tumours
Brest, prostate, lung, renal, thyroid
Breast metastatic disease
Blastic or sclerotic, mean survival is around 24-26 months
Prostate metastatic disease
Sclerotic, pathological fractures likely, 45% one year survival.
Lung metastatic disease
Lytic disease, mean survival is 6 months
Renal metastatic disease
Large vascular lytic metastases, large risk of bleeding, one isolated tumour surgery is curative.
Lipoma
Common benign tumour of the fat
Angiosarcoma
Malignant tumour of blood vessels
Fibrosarcoma
Fibrous tissue
Liposarcoma
From fat
Rhabdomyosarcoma
Skeletal muscle
Synovial Sarcoma
synovial lining of joints
ganglion cyst
herniation of joint capsule
well defined and firm
excision if causing discomfort or for cosmesis
Bursitis
Inflammation of fluid filled sac preventing friction between tendons bones and muscles.
