Tumor clinical correlations

Question 1

What are 3 common benign bone tumors?

Answer 1

• non-ossifying fibroma
• osteochondroma
• osteoid osteoma

Question 2

What is the common treatment for an osteoid osteoma?

Answer 2

• en bloc resection
• local curettage (break up with injected saline)
• observation and symptom treatment (tumors will “burn out” on their own)

Question 3

What is multiple myeloma?

Answer 3

• most common primary malignant bone tumor in adults
• a “bone marrow” tumor **systemic illness
• consists of malignant plasma cells (make abnormal immunoglobulins that aren’t good at fighting infection)
• kappa and lamda light chain proteins hurt liver
• pathological fractures common (esp spine)

Question 4

How do you treat multiple myeloma?

Answer 4

• chemotherapy
• stem cell transplant
• treat pathologic fractures/other systemic symptoms

Question 5

What are “mets”?

Answer 5

• Metastatic carcinoma (destructive bone lesions in adults)
• commonly metastasized from BLT-KG (breast, lung, thyroid, kidney, GI)
• not always found after a known primary
  *

Question 6

What are neurilemomas?

Answer 6

• “schwannoma”
• develops from peripheral schwann cell
• slow growing tumors
• M=F, ages 20-60
• nerve preservation by marginal resection

Question 7

What are some key symptoms seen on xray?

Answer 7

• soft tissue planes
• mineralization
• bony reaction or destruction

Question 8

What make MRI unique?

Answer 8

• superior soft tissue contrast
• multi-planar images without loss of clarity
• use of multiple squences and Gadalinium helps differentiate tumor from necrosis and edema
• MRA for evaluating surrounding vessels

Question 9

When is CT a helpful tool for soft tissue lesions?

Answer 9

• staging evaluation for patients with known or suspected soft tissue sarcomas
• evaluation of lungs, retroperitoneum, and lymph nodes
• detection of calcification or ossification
• visualization and guidance of percutaneous biopsies

Question 10

When is ultrasound a helpful tool for soft tissue lesions?

Answer 10

• frequently used to guide biopsy
• helpful in characterizing suspected vascular lesions
• assists in localizing lesions adjacent to vascular structures

Question 11

What is a bone scan?

Answer 11

• baseline study and further study if metastases are suspected
• not used as much for soft tissue sarcomas (use PET instead)

Question 12

What is a PET scan?

Answer 12

• positron emission tomography
• based on rate of glucose metabolism by tumors
• inject radioactive glucose; FDG
  
  • once in cells, it becomes phosphorylated and trapped in the cells **easily detected