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MSK > Bone & Soft Tissue Tumours > Flashcards

Bone & Soft Tissue Tumours Flashcards

1
Q

What are the important clinical features of bone tumours?

A

1) Pain
2) Deep seated mass
3) Swelling
4) Loss of function
5) Pathological fracture

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2
Q

What are the important clinical features of soft tissue tumours?

A

1) Painless
2) Mass is found deep to deep fascia
3) The mass is >5cm
4) A fixed or hard mass
5) Tumours shown up on MRI

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3
Q

What are the key features of malignant bone tumours which differentiate them from benign bone tumours?

A
  • Increasing pain
  • Unexplained pain
  • Deep-seated boring nature
  • Night pain
  • Difficulty weight-bearing
  • Deep swelling
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4
Q

What investigations are carried out in bone and soft tissue tumours and what are the most likely findings?

A

1) Plain radiographs - for bone lesions and calcification
2) CT - assessing ossification and calcification
3) Isotope bone scans - staging skeletal metastasis
4) MRI - modality of choice in bone tumours

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5
Q

How are aggressive and inactive tumours differentiated on plain radiographs?

A

Inactive:

  • Clear margins surrounding rim of the reactive bone

Aggressive:

  • Poorly defined zone of transition between lesion and normal bone
  • Cortical destruction = malignancy
  • Onion-skin appearance
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6
Q

What are sarcomas?

A

Malignant tumours arising from connective tissue

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7
Q

How do sacromas usually spread throughout the body and to which area of the body do they usually metastasise to?

A

Blood

Lungs

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8
Q

How common are primary benign tumours of the bone compared to primary malignant tumours?

A

Benign bone tumours much more common than malignant bone tumours

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9
Q

Which are more common: primary malignant bone tumours or secondary malignant bone tumours?

A

Secondary malignant tumours

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10
Q

What is the most common malignant ‘bone-forming’ tumour?

A

Osteosarcoma

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11
Q

What is the most common malignant ‘cartilage-forming’ tumour?

A

Chondrosarcoma

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12
Q

What is the most common malignant tumour of fibrous tissue?

A

Fibrosarcoma

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13
Q

With which term are cartilage-forming tumours associated?

A

Chondro

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14
Q

What are the most common malignant tumours of bone marrow?

A

1 - Ewings sarcoma

2 - Lymphoma

3 - Myeloma

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15
Q

What is the most common vascular tissue primary tumour?

A

Angiosarcoma

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16
Q

What is the most common malignant tumour of adipose tissue?

A

Liposarcoma

17
Q

What are the top 3 most common bone tumours in the UK?

A

Osteosarcoma

Chondrosarcoma

Ewings sarcoma

18
Q

In which age group are osteosarcomas most commonly found?

A

Teens-young adults

19
Q

In which age group are myelomas most commonly found?

A

Older patients

20
Q

What are the features of bone pain associated with bone tumours?

A

1 - Has been progressively getting worse

2 - Pain continues when resting

3 - Deep boring aching pain

4 - Pain worse at night

21
Q

What imaging techniques can be used to investigate bone pain?

A

X-rays

CT

Isotope bone scan

MRI

22
Q

What is the imaging modality of choice when investigating suspected bone tumours?

A

MRI

23
Q

After imaging, clinical examination and history taking what final investigation will clarify if the tumour is benign or malignant?

A

Biopsy

24
Q

What are the red-flag features for primary bone tumours?

A

1 - Increasing pain

2 - Pain worse at night

3 - Deep-boring aching pain

4 - Deep-seated mass/swelling

5 - Unexplained pain/pain continues at rest

6 - Difficulty weight bearing

25
Q

What are the most common sites for osteosarcomas?

A

1 - Distal femur

2 - Immediately below knee

3 - Proximal humerus

26
Q

What are the clinical features of malignant bone tumours?

A

1 - Pain

2 - Swelling

3 - Loss of function

4 - Pathological fracture

27
Q

What features of bone tumours are MRI’s good at highlighting?

A

1 - Extent of tumour

2 - Soft-tissue involvement

3 - Joint involvement

28
Q

What are the main treatment options for bone tumours?

A

1 - Chemotherapy

2 - Surgery

3 - Radiotherapy

29
Q

What are the suspicious signs of soft tissue tumours?

A

1 - Very deep

2 - Tumours > 5cm

3 - Rapid growth, hard and craggy

30
Q

What are the most common primary tumours that metastasise to bone?

A

1 - Lung

2 - Breast

3 - Prostate

4 - Kidney

31
Q

How can pathological fractures be prevented in patients with bone tumours?

A

1 - Early chemo

2 - Prophylactic fixing of susceptible bones

3 - Bone cement

32
Q

What scoring system is used to assess risk of pathological fractures?

A

Mirels

33
Q

What are the components of Mirel’s scoring system?

A

1 - Site

2 - Pain

3 - Lesion

4 - Size

MSK (31 decks)

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