Benign Bone Tumours Flashcards

1
Q

What is an osteochondroma?

A

Bony outgrowth on external surface with a cartilaginous cap

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2
Q

Presentation of osteochondroma?

A

No problems apart from local pain

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3
Q

Risk of osteochondroma?

A

1% risk of malignant transformation

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4
Q

How is multiple osteochondromata inherited?

A

Autosomal dominant hereditary disorder

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5
Q

What is enchondroma?

A

Intramedullary & usually metaphyseal cartilaginous tumour

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6
Q

What failure is associated with enchondroma?

A

Failure of normal enchondral ossification at the growth plate

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7
Q

Symptoms of enchondroma?

A

Usually asymptomatic

-can weaken bone (pathological fracture)

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8
Q

Where are enchondromas usually?

A

Femur
Humerus
Tibia
Small bones of Hand & Feet

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9
Q

What does an enchondroma lesion usually look like?

A

Usually lucent but can undergo mineralization- Patchy sclerotic appearance

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10
Q

Treatment of enchondroma?

A

Fracture healed and risk of impending fracture- curettage & filled with bone graft

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11
Q

What is curettage?

A

Bone scraped out

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12
Q

What is simple bone cyst?

A

Single cavity, benign fluid filled cyst

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13
Q

What is the probable cause of a simple bone cyst?

A

Probably a growth defect from the physis

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14
Q

Presentation of simple bone cyst?

A

Can be asymptomatic & an incidental finding on x-ray

-Can cause weakness resulting in pathological fracture

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15
Q

Treatment of a simple bone cyst?

A

Curettage and bone grafting +/- stabilization

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16
Q

Another term for simple bone cyst?

A

Unicameral bone cyst

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17
Q

What is an aneurysmal bone cyst?

A

Lots of blood/serum filled chambers

18
Q

What are aneurysmal bone cysts due to?

A

Small arteriovenous malformation

19
Q

Where do aneurysmal bone cysts appear?

A

In metaphyses of many different long bones, flat bones

(Ribs, skulls) and vertebral bodies

20
Q

Presentation of aneurysmal bone cysts?

A

Locally aggressive

  • Cortical expansion & destruction
  • Painful, pathological fracture
21
Q

Treatment of aneurysmal bone cysts?

A

Curettage & grafting/bone cement

22
Q

Where do giant cell tumours affect?

A

Metaphyseal region
-Involve epiphysis & can extend to the subchondral bone adjacent to the joint

-Knee, distal radius, also other long bones: pelvis, spine

23
Q

Presentation of giant cell tumour?

A
  • Painful

- May cause pathological fracture

24
Q

What does a giant cell tumour look like on x-ray?

A

Soap bubble appearance

25
Q

Where do 5% of giant cell tumours metastasize to?

A

The lung

26
Q

What type of cell do giant cell tumours consist of?

A

Multi-nucleate giant cells

27
Q

Treatment of giant cell tumours?

A

Intralesional excision with phenol, bone cement or liquid nitrogen
-Destroy remaining tumour material & reduce risk of recurrence

28
Q

Treatment of very aggressive lesions with cortical destruction?

A

May need replacement

29
Q

When does fibrous dysplasia present?

A

Adolescence

30
Q

What causes fibrous dysplasia?

A

Genetic mutation

31
Q

What is fibrous dysplasia?

A

Scar Lesions in fibrous tissue & immature bone

32
Q

Meaning of monostotic?

A

Affects 1 bone

33
Q

Meaning of polyostotic?

A

Affects more than one bones

34
Q

Presentation of fibrous dysplasia?

A
  • Angular deformities
  • Wider bone
  • Thickened cortices
  • Stress fractures can occur
  • Shepherd’s crook deformity (proximal femur)
35
Q

Treatment of fibrous dysplasia?

A
  • Biphosphonates may reduce pain
  • Pathologic fractures should be stabilized with internal fixation & cortical bone grafts
  • Simple intralesional excision has a high recurrence rate
36
Q

What is osteoid osteoma?

A

Small nidus of immature bone surrounded by an intense sclerotic halo

37
Q

When does osteoid osteoma present?

A

Adolescence

38
Q

Common sites of osteoid osteoma?

A

Proximal femur
Diaphysis of long bones
Vertebrae

39
Q

Clinical features of osteoid osteoma?

A

Intense constant pain (worse at night due to intense inflammatory response)

40
Q

Treatment of osteoid osteoma?

A

May resolve spontaneously over time

Some cases require CT quidded radiofrequency ablation/ en bloc excision