Bone Tumours Flashcards

1
Q

Name 3 benign and 1 malignant OSTEOBLAST tumour

A

Benign

  • Osteoid osteoma
  • Osteoma
  • Osteoblastoma

Malignant
- Osteosarcoma

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2
Q

Name 3 benign and 1 malignant CHONDROCYTE tumour

A

Chondrocyte (cartilage forming)

Benign

  • Chondroma/enchondromas
  • Osteochondroma
  • Chondroblastoma

Malignant
- Chondreosarcoma

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3
Q

Name 2 malignant BONE MARROW CELL tumour

A
  • Ewing Sarcoma

- Myeloma

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4
Q

Name a benign and malignant Giant Cell/OSTEOCLAST tumour

A

Benign
- Giant cell tumour/Benign Osteoclastoma

Malignant
- Malignant Giant cell tumour/Malignant osteoclastoma

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5
Q

What red flag would indicate bone cancer?

A
  • Pain worse at night
  • Night sweats
  • Atypical bony swelling/masses
  • Weight loss/loss of appetite
  • Pathological fracture
  • Mid thoracic pain
  • Previous malignancy
  • Bone pain in children

Urgent referral in the following cases

  1. Unexplained bone pain in children or young adult
  2. Unexplained bone swelling in children or young adult
  3. Suspicious x-ray
  4. Xray is clear but Sx persists
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6
Q

Rf for BENIGN Bone cysts/Tumours

A
  • 10-20 years
  • male Fx
  • Radiation exposure
  • occupation
  • immune suppression
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7
Q

Sx of benign bone cyst/tumour

A
  • Localised progressive pain
  • Pain worse at night
  • Typically made better with NSAIDs
  • Swelling and tenderness
  • Limping
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8
Q

Chondrosarcoma - what is it? common sites? Ix? Tx?

A

(1. ) 2nd most common primary bone tumour
(2. ) Malignant mass of chondrocytes
(3. ) Common sites = long bones, pelvis, ribs

(4. ) Imaging
- Xray = popcorn calcification
- CT/MRI = large unmineralized soft tissue mass associated with the lesion

(5.) Tx = surgical excision only as it is resistant to chemo and radio

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9
Q

Ewing Sarcoma - what is it? common sites? Sx? Ix? Tx?

A

(1. ) RF = Second most common in Children and young adults, 10-20yrs old, Caucasian
(2. ) Malignant mass of neural crest cells
(3. ) Common sites = long bones, pelvis, ribs, vertebrae
(4. ) Always high grade
(5. ) Signs and Sx = Painful and enlarging mass, tenderness and warmth
(6. ) Imaging = onion ring signs
(7. ) Tx = Combination of chemo and local surgery +/- radio
(8. ) 70% 3-year survival, lung metastasis in 40%

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10
Q

Common 5 cancers that have bone metastases

A

breast, lung, prostate, kidney, thyroid

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11
Q

Osteosarcoma pathophysiology

A
  • Most common malignant primary bone tumour
  • Bone cancer that leads to the formation of new bones (osteoid)
  • Occurs at the end of long bones (metaphysis) surrounding the knee (distal femur or proximal tibia).
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12
Q

Osteosarcoma RF

A
  • More common in children 10-14y or in >65y (typically in those with Paget’s disease)
  • Male
  • Hx of radiotherapy
  • Chemotherapy
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13
Q

Osteosarcoma Presentation

A
  • Local pain and swelling
  • Pain worse at rest and at night
  • Deep boring pain
  • May cause individual to limp
  • Initially mild but progresses to severe pain over weeks to months
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14
Q

Osteosarcoma Examination

A
  • If there is a mass present: firm, tender and warm to touch
  • Antalgic gait
  • Occasionally limited ROM
  • Occasionally there may be an overlying skin ulceration
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15
Q

Osteosarcoma Investigations

A

(1. ) Physical examination
- Localised constant pain and a tender soft tissue mass may be palpable

(2. ) Bloods
- LFT = ALP elevated
- Lactate dehydrogenase (LDH) = elevated

(3. ) X-ray (1st line)
- Medullary and cortical bone destruction (moth eaten appearance)
- Codman’s Triangle - elevation of outer layer of bone from surface
- Sunburst pattern

(4.) Tissue biopsy (diagnostic)

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16
Q

Osteosarcoma Tx and Mx

A
  • 2ww referral: if xray is suggestive of osteosarcoma.
  • Specialist team performs biopsy
  • Aggressive surgical resection
  • Systemic chemotherapy
17
Q

Complications of Osteosarcoma

A
  • Amputation
  • Metastasis
  • Death