Tumour Flashcards
Lifetime risk of malignant transformation for solitary osteochondroma?
1%
Two important differences between Maffucis and Olliers?
Maffucis has hemangiomas
Maffucis has higher risk of secondary malignant transformation (100% vs. 30%)
Which type of liposarcoma does not require adjuvant radiotherapy?
Well differentiated liposarcoma
Operative
-
marginal resection without radiotherapy
- indications
- well-differentiated liposarcoma
- outcomes
- low risk of local recurrence, metastasis extremely rare
- dedifferentiation risk of 2% in extremities and 20% in retroperitoneal lesions
- indications
-
wide surgical resection with adjuvant radiotherapy
- indications
- intermediate grade liposarcomas
- high grade liposarcomas
- outcomes
- radiation decreases local recurrence
- chemotherapy may be beneficial in selected patients
- myxoid liposarcomas with >10% round cells have high likelihood of metastasis
- indications
Can you do limb salvage in osteosarcoma in a patient with a pathologic fracture?
Yes
However increased rates of local recurrence and decreased survival overall in these patients
Adult Patient with osteochondrama has acute onset of pain at the location of lesion. What do you suspect?
Sarcomatous transformation
Treamtent for osteosclerotic myeloma
Chemo + radio+ plasmapheresis
Generally no surgery needed
(This is a form of MM associated with POEMS)
What is the multidrug resistance gene (MDR)
Pumps chemo out of cancer cells
Present in 25% of primaries
50% of mets
Very poor prognostic indicator
What primary is very vascular, requiring embolization of lesions primary to ORIF?
RCC
Thyroid
What does GCT look like on MRI?
Dark on T1 and T2
Ddx for lytic lesion in greater than 40 year old
- Mets
- MM
- Lymphoma
- Metabolic (browns Tumor)
- Sarcoma
Diagnosis?

Melorheostosis
Periosteal formation of new bone
Looks like dripping candle wax
Benign but painful
Symptomatic treatment ± excision
Name these translocations!!
- t(2;13)
- t(11;22)
- t(X;18)
- t(12:16)
- Alveolar rhabdomyosarcoma; t(2;13)
- Ewings Sarcoma; t(11;22)
- Synovial sarcoma; t(X;18)
- Myxoid liposarcoma; t(12:16)
Who gets Ewing’s sarcoma?
White males aged 10-20
What blood markers can be used to measure bone turnover?
ALP, LDH
What is stone man’s disease?
Fibrodysplasia ossificans progressiva
Hallmarks:
- Progressive and EXTENSIVE heterotopic ossification (muscles, fascia, tendons, ligaments, joint capsules)
- Congenital malformation of the great toe
Mutation in ACVR1 gene (activin A type I receptor)
Enchondromatosis is characterized by: (3 things)
A) multiple enchondromas, hemangiomas, lymphangiomas
B) multiple enchondromas in a unilateral distribution
C) auto-dominant transmission, multiple enchondromas and osteochondromas
Poor prognostic indicators in Multiple myeloma (9)
Renal failure (worst)
hypercalcemia
Stage
Type (plasmacytoma has best prognosis)
chromosome 13 deletion or translocation (t4;14), 4(14;16)
circulating plasma cells
increased beta 2 microgloblulin (indicates elevated tumor burden)
decreased serum albumin
increased marrow microvessels
Surveillance of soft-tissue & osteosarcoma?
(They are the same)
Physical exam, CXR, CT Chest
1-2 years: 3 months
3-5 years: 6 months
5-10 years: yearly
Common locations of ABC?
Femur > tibia > spine
What part of an osteochondroma is usually the site for secondary malignant transformation?
Cartilage cap
risk of malignant transformation is
- <1% with solitary osteochondroma
- ~5-10% with MHE develop secondary chondrosarcoma
- cartilage cap >2cm is associated with increased chance of malignancy
- mean age of diagnosis, 31yrs
- seldom in 1st decade or after 5th decade of life
Name the tumours associated with NF1
Wilm’s tumour
Optic glioma - part of dx criteria
Neurofibroma
Neuofibrosarcoma
Astrocytoma
meningioma
melanoma
leukemia
rhabdoyosarcoma
pheochromocytoma
carcinoma
pancreatic endocrine tumors
Describe FU for solitary enchondroma with no concerning features:
serial x-rays
q3-6 months for 1-2 years, then annually
What is the incidence of post radiation sarcoma in an area previously radiated to treat malignancy?
13%
(more common if also had chemo)
Episyphyseal lesions?
Chondroblastoma, infection, GCT































