Bone Sarcoma Flashcards
What are the 3 main types of bone sarcoma?
Osteosarcoma= most common form of bone cancer
Chondrosarcoma= cancer originating from cartilage
Ewing Sarcoma= bone and soft tissue cancer mostly affecting children and young adults
What is osteosarcoma?
When does it typically present?
What other condition increases the risk?
How does it present?
Malignant bone tumour producing osteoid
2 peaks of presentation:
- 10-20 years
- >40 years when associated with Paget’s disease
Paget’s disease is a risk factor
Persistant bone pain-
- worse at night i.e. disturbs sleep or wakes them up
- femur/tibia/humerus i.e. effects meta-diaphysis of long bones
Bone swelling
Palpable mass
Restricted joint movements
How is osteosarcoma diagnosed?
What x-ray findings would you expect to find?
Where does osteosarcoma metastasise to?
Xrays
- poorly defined lesions
- periosteal reaction (irritation of lining of bone) i.e. gives sun-burst appearance on xray
- Codman’s triangle =reactive bone formation in the meta-diaphysis
LFTs= raised ALP
CT/MRI
Bone scan
PET scna
Bone biopsy
Mets to lungs
What are the management options for osteosarcoma?
Surgical resection
-often with limb amputation
Adjuvant chemotherapy
What is Ewing sarcoma?
When does it typically present?
How does it present?
Which sites does it affect preferentially?
Intramedullary tumour with secondary effects on periosteum
Children (2nd most common sarcoma in children)
Bone pain
Fever
Weightloss
Bones swelling or soft tissue lumps
Marrow of femur/tibia/humerus/fibula/pelvis/ribs/vertebraw
How would you investigate Ewing sarcoma?
What xray findings would you expect?
Xray
- destructive lytic tumour
- reactive periosteal bone resembling = looks like onion skin
Bloods
-leukocytosis and raised ESR
CT/MRI
Biopsy
What are the management options for Ewing Sarcoma?
Preoperative chemo
Surgery-> resection
Radiation therapy
