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Charis & Ellie vs MSK part 1 > Primary Malignant Bone Tumours > Flashcards

Primary Malignant Bone Tumours Flashcards

1
Q

What are primary malignant bone tumours commonly misdiagnosed as?

A

Muscular Pains

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2
Q

Presentation of primary malignant bone tumours?

A

-Red flags
-Unexplained persistent pain
(Warrant investigation wit atleast an x-ray)

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3
Q

What will an x-ray show for primary malignant bone tumours?

A

Substantial ill-defined bony swelling

  • Aggressive & destructive signs
  • Cortical destruction
  • Periosteal reaction: raised periosteum producing bone
  • New bone formation: sclerosis
  • Extension into surrounding soft tissue envelope
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4
Q

What is the most common primary malignant tumour producing bone?

A

Osteosarcoma

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5
Q

Who gets osteosarcoma?

A

Younger- adolescence, early adulthood

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6
Q

Areas affected by osteosarcoma?

A
  • 60% of bones around the knee

- Other= proximal femur, proximal humerus, pelvis

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7
Q

Common methods of spreading of osteosarcoma?

A

Haematogenous
Lymphatic
-10% have pulmonary mets at diagnosis

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8
Q

Treatment of osteosarcoma?

A
  • Not radiosensitive

- Adjuvant chemotherapy can prolong survival

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9
Q

What is chondrosarcoma?

A

Cartilage producing primary bone tumour

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10
Q

What age group is susceptible to chondrosarcoma?

A

Older age group

-45y

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11
Q

Features of chondrosarcoma?

A

Large

Slow to metastasize

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12
Q

Areas affected by chondrosarcoma?

A

Pelvis

Proximal femur

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13
Q

What does the prognosis of chondrosarcoma depend on?

A

Histological grading

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14
Q

Treatment of chondrosarcoma?

A

Not radiosensitive

Unresponsive to adjuvant chemotherapy

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15
Q

What is fibrosarcoma & malignant fibrous histiocytoma?

A

Fibrous malignant primary bone tumours

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16
Q

Who is more likely to get fibrosarcoma & malignant fibrous histiocytoma.

A

adolescents & young adults

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17
Q

What is Ewing’s sarcoma?

A

Malignant tumour of primitative cells in the marrow

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18
Q

What is the most prevalent primary bone tumour?

A

Ewing’s sarcoma

19
Q

Prognosis of Ewing’s sarcoma?

A

Poor prognosis

20
Q

Age range for Ewing’s sarcoma?

A

10-20 years

21
Q

Symptoms of Ewing’s sarcoma?

A

Fever
Raised inflammatory markers
Warm swelling

22
Q

What can Ewing’s sarcoma be misdiagnosed as?

A

Osteomyelitis

23
Q

Treatment of Ewing’s Sarcoma?

A

Radiosensitive

Chemosensitive

24
Q

Staging investigations of Primary bone tumours?

A

-Bone scan
-CT chest
-MRI & CT
Biopsy

25
Q

What do MRI & CT scans show of primary bone tumours?

A

Determine local extent of the tumour & muscle, nerve and vessel involvement

26
Q

What does a biopsy tell you about primary bone tumours?

A

Histological diagnosis & grading prior to definitive surgery

27
Q

Aim of surgery for Primary bone tumours

A

Remove tumour & surrounding tissue

28
Q

Types of surgery for primary bone tumours?

A
  • Limb salvage surgery (since adjuvant chemo)
  • Wide margin of 2-4cm bone removed and cut off normal muscle around
  • Biopsy tract also removed with tumour
  • Joint involved needs reconstruction
29
Q

What is lymphoma?

A

Cancer of round cells of the lymphocytic system/macrophages

30
Q

Primary bone tumour from the marrow is?

A

Non-hodgkins lymphoma

31
Q

Treatment of non-hodgkins lymphoma?

A

Surgical resection

32
Q

Where non-hodgkins affects?

A

Pelvis

Femur

33
Q

Where can lymphoma metastasize to?

A

Bone (20%)

34
Q

Presentation of lymphoma?

A
  • Lymphadenopathy

- Splenomegaly

35
Q

Treatment of lymphoma?

A

Radio or chemotherapy

36
Q

Prognosis of lymphoma?

A

Less than 2 years

37
Q

What is myeloma?

A

Malignant B cell proliferation

38
Q

Where does myeloma arise from?

A

Arises from the bone marrow

39
Q

What is a solitary lesion of myeloma?

A

Plasmacytoma

40
Q

What is multiple myeloma?

A

Multiple osteolytic lesions throughout the whole skeleton

41
Q

Presentation of myeloma?

A
  • Weakness
  • Back pain
  • Bone pain
  • Fatigue
  • Weight loss
  • May have marrow suppression-> anaemia, recurrent infection
  • May present with pathologic fracture
42
Q

Likely age range for myeloma?

A

45-56 years

43
Q

Investigations for myeloma?

A
  • Plasma protein electrophoresis (high paraprotein levels)
  • Early morning urine collection (Bence Jones protein array)
  • Lytic lesions
  • Skeletal survey of x-rays
44
Q

Treatment of myeloma?

A
  • Plasmacytoma- radiotherapy

- Multiple myeloma: chemotherapy (5years < 30%)

Charis & Ellie vs MSK part 1 (108 decks)

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