Primary And Secondary Bone Tumours

Question 1

Primary

Answer 1

Osteosarcoma
- most common 1’ bone malignancy
- associated with Paget’s
- 15-19 year old patient
- mets to LUNG
- X-RAY = sunburnt appearance of bone
Ewing sarcoma
- from mesenchymal stem cell
- 15 year old
- RARE
Chondrosarcoma
- cartilage cancer
Fibrosarcoma

Question 2

Secondary (BLT KP)

Answer 2

Breast
Lung
Prostate - osteoSCLEROTIC
Thyroid
RCC

Question 3

Symptoms

Answer 3

Local (dependant on tumour) - severe pain, worse at night = wake up in the middle of the night
Systemic - wt loss, fatigue, fever, malaise

Question 4

Diagnosis

Answer 4

Skeletal isotope scan (shows changes before x ray)
X-RAY = osteolysis (osteosclerosis = prostatic mets)
Increased ALP, ESR/CRP
Hypercalcaemia of malignancy

Question 5

Treatment

Answer 5

Chemo
Bisphosphonates