Week 1 Pathology - Bone Tumours Flashcards
Describe an osteochondroma.
Is it ever painful?
Bone outgrowth with cartilaginous cap
My have local pain
2 benign tumours which have the potential to metastatise?
osteochondroma = #1 common and 1% mets risk
giant cells tumours also - 5% mets to the lungs
which benign tumour forms in incomplete ossification?
Enchondroma - an intermedullary tumour.
what benign tumours causes cortical expansion with pain?
aneurysmal cyst
what benign tumour looks like a soap bubble on xray ?
giant cell tumour
name 2 benign tumours that teens get
- fibrous dysplasia
2. osteid osteoma
name 3 malignant tumours that teens get
in order of most common
- osteosarcoma
2 ewings sarcoma - fibrosarcome
name the malignant tumour that is slow to metastatsise and occurs in people aged 45 on average
chondrosarcoma
describe the metastatic spread of osteosarcoma - where does it commonly go quickly, and how?
haematogenous spread to the lungs - sadly, 10% of patients already have this on Dx
15 year old Shannon has constant pain in her proximal femur which gets worse at night. Taking ibuprofen can help the pain. she has a benign tumour - which one?
a type of benign bone tumour - osteoid osteoma
may resolve, or need ablated / excised.
16 year old Paige has Pagets. what malignant tumour is she at risk of getting?
Fibrosarcoma
14 year old Flora is getting stress fractures in her proximal femur. she has fibrous dysplasia - what is seen on x ray?
Flora has fibrous dysplasia
on xray the bone would look wide, with thin cortices
If the involvement of the proximal femur is hella extensive - Flora may have a shephards crook deformity.
how will you treat Flora? (FD)
1 drug
2 surgical strategies
biphosphates
internal fixation
bone grafts
what malignant bone tumour may mimic osteomyelitis? what features??
Ewings sarcoma
fever, raised markers, heat and swelling
what malignant bone tumour mostly affects the hip areas = the proximal femur and the pelvis?
what age are they on average?
Chondrosarcoma
45
Macrophage cancer can be a primary bone tumour of marrow, or may be due to metastasis to the bone. what is the primary version called?
where does it normally occur?
what is the Tx?
Non hodgkins lymphoma
Hip area - pelvis or femur
Surgery
Systemic involvement of metastatic lymphoma (2)
Treatment?
prognosis? expected survival time?
Splenomegaly / lymphadenopathy
Chemo / radio
serious - less than 2 year survival
what is multiple myeloma?
multiple osteolytic lesions of myeloma - a B cell cancer
what is the effect of bone marrow suppression in myeloma?
anaemia and recurrent infection
B cell cancers…..
Tx of a plasmacytoma?
Tx of multiple myeloma?
- radiotherapy - only 1 lesion so you can direct radiotherapy specifically to it.
- chemotherapy
name the malignant bone tumour…
1- produces bone
-2 produces cartilage
- 3 occurs in abnormal bone
- osteosarcoma
- chondrosarcoma
- fibrosarcoma
name the malignant bone tumour….
- macrophage cancer
- B cell cancer (antibodies)
- primitive cells of bone marrow
lymphoma
myeloma
Ewings sarcoma
what is fibrous dysplasia?
what is a fibrosarcoma?
FD is a benign bone tumour. Genetic. Lesions of fibrous tissue and immature bone. 1 or more bones Defective mineralization = angular deformities. Bone is wider with thinned cortices.
Fibrosarcoma is a malignant tumour that occurs in abnormal bone eg Pagets
describe an osteoid osteoma
include who gets them and 3 common sites
small nidus of immature bone surrounded by an intense sclerotic halo. Teens. Common sites include the proximal femur, the diaphysis of long bones and the vertebrae
Giant cell tumours are locally aggressive. where do they normally start – spread?
normally start in the epiphysis and invade into the subchondral bone around the joint.
they destroy the cortex
giant cell tumours normally occur in the knee, but where else (3) ??
what is the normal treatment?
severe cases ?
other long bones, the pelvis and the spine
intralesional excision with use of phenol / bone cement / liquid nitrogen to destroy remaining tumour material and reduce the risk of recurrence
severe = cortical destruction = joint replacement
