Tumours

Question 1

If a mass in the bone medulla is it likely to be mailgant or benign?

Answer 1

• medullary = met +/- malignant

- cortex spreading to the medulla = malignant (osteosarcoma)

Question 2

Shaft or epiphysis mass, malignant or not?

Answer 2

shaft = malignant 
epiphysis = cystic or infection

Question 3

What does the transition zone on an Xray for a benign bone tumour look like?

Answer 3

• narrow
• sharp
• well defined
• may be lytic but if still well defined it’s fine

Question 4

What does the transition zone on an Xray for a malignant tumour look like?

Answer 4

• wide
• ill-defined
• periosteum may be multilayered (onion skin)
• may have a star burst appearance

Question 5

Investigations for ?bone tumours?

Answer 5

• first line Xray

- MRI for staging

Question 6

What tumours metastasise to the bone a) in children, b) in adults?

Answer 6

a) lymphoma, leukaemia, neuroblstoma

b) Breast, liver, kidney, prostate, thyroid