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Basic Orthopaedic Sciences > Tumours > Flashcards

Tumours Flashcards

1
Q

6 features to consider for plain radiograph bony lesions?

A
  1. Lytic vs sclerotic
  2. Zone of transition
  3. Periosteal reaction
  4. Cortical destruction / ST invasion
  5. Location
  6. Patient age
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2
Q

Indications for biopsy of ST/ bone lesions?

A
  1. ST lesions >5cm deep to fascia overlying bone/ neuromuscular structures
  2. Solitary bone lesions in patients with a hx of cancer
  3. Aggressive lesions
  4. Unclear dx in asymptomatic patient
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3
Q

Open incisional biopsy principles?

A
  1. Incision - longitudinal in extremities - placed in region where future surgery will possibly take place
  2. Approach - Do not expose NV structures.
    Meticulous haemostasis
  3. Biopsy through involved compartment - do not open other compartments
  4. If using drain - take out through incision
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4
Q

What are the 2 staging systems in orthopaedic tumours?

A
  1. Enneking (MSTS)

2. AJCC (TNM Staging)

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5
Q

What is the Enneking staging system based on? 3

A

Histo grade
Site (intra/extracompartmental)
Mets

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6
Q

In the TNM staging for BONE what is the size cut off between T1 and T2

A

<8cm and >8cm

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7
Q

In the TNM staging for ST TUMOURS what is the size cut off between T1 and T2?

A

5cm

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8
Q

With which 2 conditions does chemo improve Px/ outcomes?

A
  1. Osteosarcoma

2. Ewings (Neo-adjuvant- tu shrinkage)

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9
Q

For what lesions is radiotherapy considered? (4)

A

Myxoid liposarcoma
Multiple Myeloma
Lymphoma
Mets

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10
Q

For what 2 lesions is radiotherapy not used?

A

Osteosarcoma

Chondrosarcoma

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11
Q

Name the 4 benign cartilaginous tumours?

A
  1. Chondroblastoma
  2. Osteochondroma
  3. Enchondroma
  4. Chondromyxoid fibroma
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12
Q

Name the 2 benign osteoid tumours?

A

Osteoid Osteoma

Osteoblastoma - spine

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13
Q

Name the 2 ‘tumour like’ lesions?

A

Fibrous dysplasia

Eosinophilic granuloma

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14
Q

What are the 2 reactive lesions?

A
  1. UBC

2. ABC

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15
Q

What lesion is associated with a USP6 up regulation?

A

ABC

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16
Q

What is the benign/locally aggressive meta-epiphyseal tumour of unknown origin called?

A

Giant cell tumour

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17
Q

What are the 2 malignant tumours of unknown origin?

A

Ewings

Adamantinoma

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18
Q

Where are enchondromas commonly found?

A

Feet and hands

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19
Q

What are the 2 subtypes of chondrosarcoma?

A

Clear cell

Mesenchymal

20
Q

Which of the malignant tumours has a popcorn type appearance?

A

Chondrosarcoma

21
Q

Which tumours is characterised by nocturnal pain relieved by Aspirin/NSAIDs

22
Q

What are the 4 types of osteosarcoma?

A
  1. Parosteal
  2. Periosteal
  3. Telangiectatic
  4. Intramedullary
23
Q

Which lytic lesion commonly extends from the metaphysis into the epiphysis (junta-articular)

24
Q

Which lesion is associated with a t11:22 translocation and is found in young patients? 5-25yo

A

Ewings sarcoma

25
Q

Which lesion is always located in the mid tibia?

A

Adamantinoma

26
Q

Which lesion develops from a failure of production of lamellar bone and a GNAS mutation?

A

Fibrous Dysplasia

27
Q

What is Eosinophilic granuloma otherwise known as?

A

Histiocytosis X

Langerhans cell histocytosis

28
Q

Which lesion is known as the “great mimicker”?

A

EG

Self limiting benign histolytic lesions

29
Q

Which lesion is associated with Hand-Schuller-Christian Dx and Letterer-Side disease?

30
Q

2 Indications for surgery for benign bony tumours?

A

Thinning of >50% of cortex

Mass effect

31
Q

What is marginal excision?

A

Resection through the reactive zone - outside the tumour pseudocapsule

32
Q

What is wide excision?

A

Resection outside of the reactive zone

33
Q

What does radical excision involve?

A

En bloc excision of entire compartment

34
Q

What does a mutation in the EXT1 2 &3 genes cause?

A

Multiple Hereditary Exostosis

Loss of regulation of Ihh protein

35
Q

What lesion is commonly found in the epiphysis of bones with OPEN growth plates/

A

Chrondoblastoma

36
Q

Patients carrying the retinoblastoma tumour suppressor gene are predisposed to which tumour?

A

Intramedullary Osteosarcoma

37
Q

What ST tumour is due to an over expression of CSF1 gene?

38
Q

Where is PVNS most commonly found?

39
Q

Where does a leiomyosarcoma originate from?

A

?Blood vessels

40
Q

What is the most common ST sarcoma in children

A

Rhabdomyosarcoma

41
Q

Which lesion is histiologically the same as a GCT of the tendon sheath?

42
Q

What 4 factors are in Mirels criteria?

A 
Site
Pain 
Lesion
Size
>8 = prophylactic fixation
43
Q

What are the synovial tumours? 3

A
  1. PVNS
  2. Synovial chondromatosis
  3. Synovial Sarcoma
44
Q

Most common ST sarcoma in YOUNG ADULTS?

A

Synovial Sarcoma

45
Q

Cold bone scan = which mets?

A

Renal
MM
Thyroid

Basic Orthopaedic Sciences (25 decks)

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