Tumours Flashcards
6 features to consider for plain radiograph bony lesions?
- Lytic vs sclerotic
- Zone of transition
- Periosteal reaction
- Cortical destruction / ST invasion
- Location
- Patient age
Indications for biopsy of ST/ bone lesions?
- ST lesions >5cm deep to fascia overlying bone/ neuromuscular structures
- Solitary bone lesions in patients with a hx of cancer
- Aggressive lesions
- Unclear dx in asymptomatic patient
Open incisional biopsy principles?
- Incision - longitudinal in extremities - placed in region where future surgery will possibly take place
- Approach - Do not expose NV structures.
Meticulous haemostasis - Biopsy through involved compartment - do not open other compartments
- If using drain - take out through incision
What are the 2 staging systems in orthopaedic tumours?
- Enneking (MSTS)
2. AJCC (TNM Staging)
What is the Enneking staging system based on? 3
Histo grade
Site (intra/extracompartmental)
Mets
In the TNM staging for BONE what is the size cut off between T1 and T2
<8cm and >8cm
In the TNM staging for ST TUMOURS what is the size cut off between T1 and T2?
5cm
With which 2 conditions does chemo improve Px/ outcomes?
- Osteosarcoma
2. Ewings (Neo-adjuvant- tu shrinkage)
For what lesions is radiotherapy considered? (4)
Myxoid liposarcoma
Multiple Myeloma
Lymphoma
Mets
For what 2 lesions is radiotherapy not used?
Osteosarcoma
Chondrosarcoma
Name the 4 benign cartilaginous tumours?
- Chondroblastoma
- Osteochondroma
- Enchondroma
- Chondromyxoid fibroma
Name the 2 benign osteoid tumours?
Osteoid Osteoma
Osteoblastoma - spine
Name the 2 ‘tumour like’ lesions?
Fibrous dysplasia
Eosinophilic granuloma
What are the 2 reactive lesions?
- UBC
2. ABC
What lesion is associated with a USP6 up regulation?
ABC
What is the benign/locally aggressive meta-epiphyseal tumour of unknown origin called?
Giant cell tumour
What are the 2 malignant tumours of unknown origin?
Ewings
Adamantinoma
Where are enchondromas commonly found?
Feet and hands