Bone tumours Flashcards
(53 cards)
top 5 primary tumours that metstasise to bone
breast
prostate
lung
kidney
thyroid
common non-malignant tumours of bone and soft tisseu 3
enchondromas
osteochondroma
lipoma
how do myeloma and lymohas present 1
usually with MSK pain
red flag syx assoc w MSK malignancy in adults 4
night pain
unremitting pain
non-traumatic joint of limb pain
weight loss
Mx of malignant secondary bone lesions 7
Mx-range of oncology options:
-chemo
-radio (internal and external)
-mAB
-bisphosphonates
-surgery
-injecting bone cement into bones
-pain control
IX for secondary bone tumours 2
MRI and PET-CT
common sites of bone metastis that cause pain 4
spine
pelvis
hips
long bones
which primary bone tumour is more common in children
sarcoma
where do osteosarcomas present
in the metaphyseal portion of the bone
common presenation of sarcoma 4
limping child
progressive swelling around the knee
any progressive limb swelling
night pain
most common primary malignant bone tumour
multiple myeloma
-accounts for 45%
hallmark bone manifestation of multiple myeloma 1
multiple punched-oout osteolytic lesions
2nd most common primary malignant bone tumour
osteosarcoma
who gets primary osteosarcomas and where
typically adolescents
-aries in the metaphysis of the long bone (esp the knee)
who gets secondary osteosarcomas and where
typically 10-20yrs w peak in adolescent growth
-arises in bones affected by Pagets disease or post-irridation
difference between primary and secondary osteosarcoma
Primary osteosarcoma, originates in bone cells and is not directly associated with another cancer or disease.
Secondary osteosarcoma also originates in bone cells but is associated with either a skeletal disease or treatment from another condition (typically cancer
x-ray findings in osteosarcoma 2
bone destruction and new bone formation- sunburst pattern [45]
marked periosteal elevation- Codsmans tirangle [46]
(50%. of lesions around the knee)
what other imaging can be used in osteosarcoma diagnosis and why 2
staging MRI- assess for intramedullary spread
HRCT chest (high resolution)
-screen for lung mets
-ESP if raised ALP
treatment for osteosarcoma 2
historically limp amputated
-still has 80% recurrence rates
-try and do limb salvage surgery
neoadjuvant chemo (prior to surgery)
standard therapy is limb salvage surgery and neoadjuvant chemo
predisosing factors for osteosarcoma 3
mutations of Rb gene (hence assoc w retinoblastoma)
Pagets disease of the bone
radiotherapy
define ewings sarcoma
malignant round-cell tumour of long bones (diaphysis) and limb girdles
who gets ewings sarcoma
typically adolescents
what genetic abnormality is commonly seen in ewings sarcoma
T11:22 chromosomal translocation
radiological features of ewings sarcoma 4
bone destruction
new bone formation in concentric layers- ‘onion ring’ sign [47]
soft tissue swelling
periosteal elevation
