Tumours of unknown origin

Question 1

what is Ewing’s sarcoma

Answer 1

a malignant bone tumour

Question 2

what bones does Ewing’s sarcoma usually affect

Answer 2

diaphysis of long bones(femur) and pelvic bones

Question 3

what are the clinical features of Ewing’s sarcoma

Answer 3

painful enlarged masses, site is swollen, tender and warm

Question 4

what is seen in radiology of Ewing’s sarcoma

Answer 4

destructive lesion that involves the surrounding tissue and reactive bone that gives onion skin appearance

Question 5

what is seen histologically in Ewing’s sarcoma

Answer 5

primitive round cells, no obvious lines of differentiation

Question 6

describe the behaviour of Ewing’s sarcoma

Answer 6

aggressive

Question 7

what treatment is used for Ewing’s sarcoma

Answer 7

neoadjuvant chemotherapy and surgery +/- radiotherapy

Question 8

describe the pathology of Synovial sarcoma

Answer 8

deep seated mass, not of synovial origin

Question 9

where in the body does Synovial sarcoma usually affect

Answer 9

around knee joint, chest wall, head and neck areas

Question 10

what group of people does synovial sarcoma usually affect

Answer 10

patients 20-40 years old

Question 11

what does it mean if synovial sarcoma is biphasic

Answer 11

combines areas of spindle cells and epithelial cells

Question 12

what does it mean if synovial sarcoma is monophasic

Answer 12

only one form(cell type) present, usually spindle cells

Question 13

describe the spread of synovial sarcoma

Answer 13

can metastasise, to lungs or regional lymph nodes

Question 14

describe how synovial sarcoma is treated

Answer 14

treated aggressively, with surgery +/- chemotherapy

Question 15

what area of the body does undifferentiated pleomorphic sarcoma affect

Answer 15

deep soft tissue of extremities, usually thigh

Question 16

describe the usual size of undifferentiated pleomorphic sarcoma

Answer 16

large(10-20cm)

Question 17

describe the pathology of undifferentiated pleomorphic sarcoma

Answer 17

areas of necrosis + haemorrhage, high grade cytology, pleomorphic cells

Question 18

describe the behaviour of undifferentiated pleomorphic sarcoma

Answer 18

aggressive

Question 19

describe what giant cell tumour(osteoclastoma) is

Answer 19

a benign but locally aggressive tumour

Question 20

what age group is giant cell tumour(osteoclastoma) usually seen in

Answer 20

20s to 40s

Question 21

where do giant cell tumours(osteoclastoma) usually arise

Answer 21

in the epiphysis of the femur and tibia

Question 22

what symptoms can giant cell tumours cause

Answer 22

arthritis like symptoms or fracture

Question 23

describe the pathology of giant cell tumours(osteoclastoma)

Answer 23

often destroy cortex and expand into soft tissue, thin shell of reactive bone, can become cystic

Question 24

what treatment is used for osteoclastoma and for aneurysmal bone cysts

Answer 24

curettage

Question 25

what age group do aneurysmal bone cysts usually affect

Answer 25

can be any age group, usually in first 2 decades

Question 26

what do aneurysmal bone cysts arise from

Answer 26

metaphysis of long bones and posterior elements of vertebral bodies

Question 27

what symptoms do aneurysmal bone cysts cause

Answer 27

pain and swelling

Question 28

what is seen on radiology of aneurysmal bone cysts

Answer 28

eccentric, expansile, lytic lesion with smooth margin and thin shell of bone

Question 29

what is an aneurysmal bone cyst tumour formed of

Answer 29

multiloculated blood filled spaces