Bone and soft tissue tumours

Question 1

Name two types of bone cancers

Answer 1

osteosarcoma
chondrosarcoma
ewing sarcoma

Question 2

Name two types of soft tissue sarcoma

Answer 2

Rhabdomyosarcoma – originating from skeletal muscle
Leiomyosarcoma – originating from smooth muscle cancer
Liposarcoma – originating from adipose (fat) tissue
Synovial sarcoma – originating from soft tissues around the joints
Angiosarcoma – originating from the blood and lymph vessels
Kaposi’s sarcoma

Question 3

In which group of patients is kaposi’s sarcoma most commonly seen?

Answer 3

HIV patients

Question 4

What causes kaposi’s sarcoma?

Answer 4

HSV 8

Question 5

What are the investigations for bony lumps and persistent pain?

Answer 5

Xray, CT/MRI for metastatic spread, biopsy

Question 6

What is the initial imaging used for soft tissue lumps?

Answer 6

ultrasound (xray for bony lumps)

Question 7

What is the most common site of metastasis for sarcoma?

Answer 7

lungs

Question 8

State three signs and symptoms of bone tumours

Answer 8

pain
swelling
joint swelling and stiffness
limping
fever
generally unwell
weight loss
anaemia

Question 9

List three investigations for suspicious bone/soft tissue lesions

Answer 9

Xray
Blood tests
CT scan
MRI
Biopsy

Question 10

Name a blood test for suspicious bone/soft tissue lesion

Answer 10

alk phos

Question 11

Name a benign bone tumour that typically arises in long bones

Answer 11

osteoid osteoma

Question 12

Name two benign bone tumours

Answer 12

osteoid osteoma
osteochondroma- cartilage
simple bone cyst

Question 13

Name two malignant bone tumours

Answer 13

chondrosarcoma
osteosarcoma
Ewing’s sarcoma

Question 14

What is the most common cause of destructive bone lesion in adults

Answer 14

metastatic cancer

Question 15

Name a benign bone lesion that can causes pathological fracture

Answer 15

simple cyst

Question 16

Describe two features of xray of benign bone tumour

Answer 16

narrow zone of transition
centrally located within cortices

Question 17

Which small bone can be confused with fracture/osteophyte/tophi?

Answer 17

sesamoid- fingers, toes

Question 18

List two features of malignant bone tumor on xray

Answer 18

sclerotic margins
periosteal reaction
irregular border
soft tissue involvement

Question 19

Name the imaging for bone malignancy?

Answer 19

NM bone scan- nuclear medicine

Question 20

Which oral solution is given during bone scan

Answer 20

biphosphonate

Question 21

How to distinguish between the presentation of osteosarcoma and ewing’s sarcoma in children?

Answer 21

osteosarcoma- painless
ewing’s- painful and surrounding erythema

Question 22

List two common sites for bone mets

Answer 22

spine
prox femur
humerus

Question 23

List one red flag for bone pain

Answer 23

night pain

Question 24

List three primary tumours for secondary bone mets

Answer 24

Breast
Bronchus
Byroid
Bidney
Brostate

Question 25

List two symptoms of hypercalcaemia

Answer 25

confusion, weakness, nausea, dehydration

Question 26

List three investigations for bone mets

Answer 26

alk phos myeloma screen calcium FBC CT chest abdo pelvis Bone scan

Question 27

What is mirel's score?

Answer 27

Mirels' score is a tool useful in the management of bone tumors, by identifying those patients who would benefit from prophylactic fixation if they have a high enough risk of pathological fracture.

Question 28

State two non surgical options in the management of secondary bone mets

Answer 28

biphopsphonates analgesia chemo denosumab