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Musculoskeletal > Sarcoma > Flashcards

Sarcoma Flashcards

1
Q

What is sarcoma?

A

Malignant tumour arising from cells of mesenchymal origin
Tumour of connective tissue

Very rare

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2
Q

What cells are of mesenchymal origin?

A 
Bone
Cartilage
Muscle
Synovium
Adipose
Peripheral nerve sheath
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3
Q

What do you call sarcoma of adipose tissue?

A

Liposarcoma

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4
Q

What do you call sarcoma of cartilage tissue?

A

Chondrosarcoma

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5
Q

What do you call sarcoma of bone tissue?

A

Osteosarcoma

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6
Q

What do you call sarcoma of muscle tissue?

A

Myosarcoma

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7
Q

Where are sarcomas commonly found?

A

In the lower extremity, especially the thigh

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8
Q

Where can sarcomas develop?

A

Anywhere in the body where there is connective tissue, i.e. everywhere!

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9
Q

What are the risk factors for sarcoma?

A

Prevalence increases in age, but can happen at any age

Genetics: some conditions increase the risk of sarcoma

Radiation

Lymphoedema

Exposure to certain chemicals:

Infections + immunocompromised

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10
Q

Which genetic conditions increase a persons risk of sarcoma?

A

Li Fraumeni syndrome:
- causes increased risk of several types of cancer

Neurofibromatosis:
- benign tumours form in nerves under skin, increased chance of malignant peripheral nerve sheath tumour

Retinoblastoma:
- childhood inherited eye cancer, 13% of these children develop sarcoma within 50 yrs

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11
Q

What is Li Fraumeni syndrome?

A

Causes increased risk of several types of cancer in families:

  • brain
  • breast
  • kidney
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12
Q

What is neurofibromatosis?

A

Formation of benign tumours in nerves just under skin

This increases the risk of developing malignant peripheral nerve sheath tumour

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13
Q

What is retinoblastoma?

A

Cancer of the retina, affects children

13% of them will get sarcoma by age 50

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14
Q

Which chemicals are linked with an increased risk of sarcoma?

A

Vinyl chloride (make plastic)
Dioxins (make pesticide)
Chlorophenols (make antiseptic)

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15
Q

Which infections are linked with the development of sarcoma?

A

Herpes virus 8 causes Kaposi’s sarcoma

Also Kaposi’s sarcoma has links to AIDS

EBV is linked with leiomyosarcoma

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16
Q

What is leiomyosarcoma?

A

Cancer of smooth muscle

17
Q

What is angiosarcoma?

A

Cancer of the inner lining of blood vessels

18
Q

How do deep sarcomas present?

A

Slow growing, enlarging mass
Painless
Pressure effects
Weight loss, malaise, rigors

19
Q

What is the proper name for cutaneous sarcoma?

A

Dermatofibrosarcoma

20
Q

How do dermatofibrosarcomas present?

A

Slow growing

Red brown nodule

21
Q

Who gets dermatofibrosarcomas ?

A

Males more often than females

Peak age about 35 years

22
Q

Metastasis is common in dermatofibrosarcoma.

True or false?

A

False

Metastasis is rare but recurrence is common

23
Q

How would you treat a dermatofibrosarcoma?

A

Wide excision!

24
Q

What is malignant fibrous histiocytoma?

A

Cancer of the histiocytes in soft tissue and bone

25
Q

What are histiocytes?

A

Cells that are part of the mononuclear phagocyte system

26
Q

What is Kaposi’s sarcoma?

A

Cancer that arises from the blood vessels

Commonly affects limbs

27
Q

What is Ewing’s sarcoma?

A

A small round tumour of the bone, commonly the pelvis, femur, ribs

28
Q

Who gets Ewing’s sarcoma?

A

Teenagers and young adults

29
Q

Who gets Kaposi’s sarcoma?

A

Immunocompromised people, those with HIV/AIDs

30
Q

When should you refer a suspected sarcoma to a specialist centre?

A

If it is superficial but more the 5cm

If it is deep regardless of size

If you are unsure

31
Q

Investigation of a sarcoma?

A

Palpate:

  • hard or soft
  • fixed or moveable
  • pain

Imaging:

  • angiography to check if its near blood vessels
  • Chest CT: sarcomas often spread to chest

Biopsy:
- check what type, what stage

32
Q

Where do sarcomas commonly metastasise to?

A

Lung

33
Q

Management of sarcoma?

A

Depends on type

Surgery
Chemo
Radiotherapy

34
Q

What are the potential problems with surgical excision of sarcoma?

A

Sarcomas are surrounded by a pseudocapsule

If you disturb this, the cancer will release seeds and spread

It is like breaking a pomegranate, the seeds will spread

Musculoskeletal (15 decks)

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