Tumours and soft tissue swellings Flashcards
bony outgrowth on surface of bone (eg knee)
ostechondroma
are osteochondromas benig or malignant
benign
where in the bone do ostechondromas occur
in which direction do they grow
metaphysis
grows away from epiphysis
where in the bone do enchondromas occur
metaphysis
which bones do osteochondromas occur in
long bones
which bones do enchondromas occur in
short bones
lucent lesion with patchy sclerosis
in small bones of hands and feet
enchondroma
fluid filled neoplasm in long bones
simple bone cyst
how do most benign bone tumours present to hospital
incidental finding on xray after fracture
treatment of benign bone tumours
curettage to remove it
what is an aneurysmal bone cyst filled with
blood
which type of benign bone tumour causes cortical expansion = destruction
aneurysmal bone cyst
are giant cell tumours of the bone benign or malignant
benign
bone with ‘soap bubble’ appearance on xray
giant cell tumour of bone
shephards crook deformity
weakened proximal femur in fibrous dysplasia
intense pain in bone
sclerotic halo on xray
in vertebrae or proximal femur
benign growth
osteoid osteoma
sclerotic halo on xray
bone pain on exercise
low grade fever
brodies abscess
aetiology of most malignant bone tumours
malignancy
treatment of malignant bone tumour
surgery with 3-4cm circumference (+/- joint replacement, stabilisation)
osteosarcoma in elderly, what must you check for
pagets
is osteosarcoma benign or malignant
malignant
which age group does sarcoma usually present in
young
most common malignant bone cancer
osteosarcoma
treatment of osteosarcoma
palliative chemo
what does a chondrsarcoma produce
cartilage
which age group gets chondrosarcoma
45 year olds
where do chondrosarcomas present
pelvis/proximal femur
most common bone cancer in teenagers/kids (genetic problem)
ewings sarcoma
xray appearance of ewings sarcoma
‘onion skin’
microscopic appearance of ewings sarcoma
small round blue cell tumours
overproduction of plasma cells = collection of abnormal plasma cells in bone marrow
myeloma
in myeloma are the plasma cells normal
no
what do the abnormal plasma cells produce in multiple myeloma
paraprotein (abnormal antibodies)
which major organ can the paraproteins get deposited in, in myeloma
which causes
kidneys = renal dysfunction
bone pain back pain weakness fatigue weight loss renal failure anaemia recurrent infections proteinuria
multiple myeloma
investigations for multiple myeloma (4)
head xray - for sclerotic lesions
bloods - electrophoresis for abnormal proteins
urine - for bence jones proteins
bone marrow biopsy
treatment of multiple myeloma (2)
chemo (radiotherapy if 1 lesion but usually multiple)
stem cell transplant
cancers that commonly metastases to the bone (6(3Bs+3)
Breast
Bronchi (lung)
Bowel
renal
thyroid
prostate
generally, how does bone cancer look on xray
‘patchy’
is pagets disease a neoplastic disease
no lol
which cell activity is increased in pagets
osteoclasts AND osteoblasts (negative feedback, increased osteoclasts results in increased osteoblasts)
what is the result of increased osteoclasts AND increased osteoblasts in pagets disease
thickened, brittle, mis-shapen bones
easily fractured
aetiology of pagets (3)
genetics
environmental trigger
viral infection
presentation of pagets (4)
pain, ‘shin splints’
enlarged bones (bigger head)
increased metabolism
fractures
investigation findings in pagets
increased alk phos (ALP) from osteoblasts
normal Ca+
treatment of pagets
bisphosphonates - inhibits osteoclasts = prevent disease progression
what is a lipoma
where is it
benign tumour in fat
what is a leiomyoma
benign tumour in smooth muscle
what is a chondroma
where is it
benign tumour in cartilage (eg enchondroma)
what is a rhabdomyoma
where is it
benign tumour in skeletal muscle
what is a neuroma/schwannoma
where is it
benign tumour in nerves
what is a haemangioma/angiolipoma
benign tumour in blood vessels
if a soft tissue tumour is malignant what is in its name
sarcoma
diagnosis of a soft tissue tumour as being malignant not benign
biopsy
what is bursitis
inflammation of burse (small fluid filled sac around a joint to prevent friction)
what is a sebaceous cyst filled with
what does this look like when it pops
keratin
‘cheesy’
where do you get sebaceous cysts
anywhere apart from palms and soles
treatment of sebaceous cyst
excision
what is an abscess
collection of neutrophils, infective organisms etc
treatment of abscess (1 NOT)
incision and drainage
NOT antibiotics (they can only reach edges of abscess so wont remove all of it)
ossification in muscle after injury
myositis ossificans (heterotopic ossification)
is myositic ossifcans painful
no
how does myositis ossifcans present
not painful
soft lump at site of injury that grows hard
treatment of myositis ossifcans
surgery to remove abnormal bone
nodular fasciitis
rapid growth of lesion after trauma
osteochondirits
inflammation of cartilage/bone at joint
osteochondritis dissecans
inflammation of cartilage/bone at joint with bone fragmentation
(hence the dissecans)
risk factor for osteochondiritis
exercise - increased bleeding and oedema
is osteomalacia a neoplastic disease
no lol
what is osteomalacia (generally)
softening of bone everywhere from hypocalcaemia and low phosphate
aetiology of osteomalacia
abnormal vitD deficiency malnutrition malabsorption lack of sunlight hypophosphataemia chronic kidney disease
how does osteomalacia present in kids
rickets
which kidney condition may present as osteomalacia
CKD
how does multiple myeloma cause renal failure (2)
amyloidosis - deposition of amyloid in kidneys
bone destruction = hypercalcaemia = increased renal stones
what is amyloid
abnormally folded proteins
how does amyloidosis causing renal failure present in investigations (which investigation and result)
congo red staining - investigation
‘apple green birefringence’
