Bone and Soft Tissue Tumours Flashcards Preview

Musculo-skeletal > Bone and Soft Tissue Tumours > Flashcards

Flashcards in Bone and Soft Tissue Tumours Deck (27)
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1
Q

What is sarcoma and how does it spread?

A
  • Malignant tumour arising from the connective tissue

- Spreads along the fascial planes and haematogenous spread to the lungs

2
Q

Which tumours form bone?

A
  • Benign: osteoid osteoma and osteoblastoma

- Malignant: osteosarcoma

3
Q

Which tumours form cartilage?

A
  • Benign: enchondroma and osteochondroma

- Malignant: chondrosarcoma

4
Q

Which tumours are fibrous tissue tumours?

A
  • Benign: fibroma

- Malignant: fibrosarcoma an malignant histiocytoma

5
Q

Name the vascular tissue tumours

A
  • Benign: haemangioma and aneurysmal bone cyst

- Malignant: angiosarcoma

6
Q

Name the adipose tissue tumours

A
  • Benign: lipoma

- Malignant: liposarcoma

7
Q

Name the marrow tissue tumours

A

Ewing’s sarcoma, lymphoma and myeloma (all malignant)

8
Q

What are the suspicious signs of a soft tissue tumour?

A
  • Deep tumours of any size
  • Subcutaneous tumours > 5cm
  • Rapid growth, hard, craggy and tender
9
Q

What is the most common bony tumour in patients over 50?

A

Metastasis

10
Q

What is the commonest primary malignant tumour in younger patients?

A

Osteosarcoma

11
Q

What is the commonest primary malignant tumour in older patients?

A

Myeloma

12
Q

How do bone and soft tissue tumours present?

A
  • Pain (bony pain if bone tumour)
  • Mass
  • Incidental finding on XR
13
Q

What is the pain like in bony tumours?

A
  • Activity related

- Progressive pain at night and at rest

14
Q

What investigations can be done?

A
  • X-rays
  • CT
  • Isotope bone scan
  • MRI
  • Angiography
  • PET
  • Biopsy
  • Bloods
15
Q

What will an inactive tumour look like on x-ray?

A
  • Clear margins
  • Surrounding rim of reactive bone
  • Corticol expansion can occur with aggressive benign lesions
16
Q

What will an aggressive tumour look like on x-ray?

A
  • Less well defined transition zone between lesion and normal bone
  • Cortical destruction
  • Periosteal reactive new bone growth
  • Codman’s triangle, onion skinning or sunburst pattern
17
Q

What are the cardinal features of malignant primary bone tumours?

A
  • Increasing and unexplained pain
  • Deep seated boring nature
  • Night pain
  • Difficulty weight bearing
  • Deep swelling
18
Q

Give three examples of malignant primary bone tumours

A
  • Osteosarcoma
  • Ewings sarcoma
  • Chondrosarcoma
19
Q

What are the clinical features of bone tumours?

A
  • Pain (worse at night and unrelated to exercise)
  • Loss of function (limp, reduced joint movement and stiff back)
  • Swelling
  • Pathological fracture
  • Joint effusion
  • Deformity
  • Neurovascular effects
  • Systemic effects of neoplasia
20
Q

What investigation should be done for bone tumours?

A

MRI

21
Q

What are the treatment options for malignant bone cancers?

A
  • Chemo
  • Surgery
  • Radiotherapy
22
Q

What are the common sites for metastases to go in the bone?

A

Vertebrae > proximal femur > pelvis > ribs > sternum > skull

23
Q

Which tumours commonly metastasise to the bone?

A
  • Lung
  • Breast
  • Prostate
  • Kidney
  • Thyroid
  • GI
  • Melanoma
24
Q

How can pathological fractures be prevented?

A
  • Early chemo
  • Prophylactic internal fixation
  • +/- use of bone cement
25
Q

Which scoring system is used to assess fracture risk?

A

Mirel’s Scoring system

26
Q

How do soft tissue tumours present?

A
  • Painless
  • Mass deep to the deep fascia
  • Mass > 5cm
  • Fixed, hard or indurated mass
  • Any recurrent mass
27
Q

How should soft tissue tumours be investigated?

A

MRI