Bone tumours Flashcards Preview

Musculoskeletal > Bone tumours > Flashcards

Flashcards in Bone tumours Deck (45):
1

What is the commonest benign bone tumour?

Osteochondroma

2

What is the tumour assocated with osteochondroma?

A bony outgrowth on the external surface with a cartilaginous cap

3

What symtpoms are associated with osteochondroma?

Localised pain

4

When should an osteochondroma be excised and why?

Small chance of turning malignant

Should excise if growing in size or causing pain

5

What is an enchondroma?

An intramedullary and usually metaphyseal cartilaginous tumour

6

What causes enchondroma?

 Failure of normal enchondral ossification at the growth plate

7

Where do enchondroma tend to occur?

Femur

Humerus

Tibia

Small bones of hands and feet

8

What is the appearance of enchondroma on imaging?

Usually lucent but can undergo mineralization with a patchy sclerotic appearance

9

What is a complication of enchondroma?

Asymptomatic but can weaken bone causing pathological fractures

10

What is the treatment avaliable for enchondroma and when is it used?

Once a fracture has healed or if there is a risk of impending fracture they may be scraped out (curettage) and filled with bone graft to strengthen the bone

11

What is a simple bone cyst?

A single cavity benign fluid filled cyst in a bone

12

Where do bone cysts occur?

Proximal humerus and femur

Talus
Calcaneus

13

What is an aneurysmal bone cyst?

A cyst that contains lots of chambers which are filled with blood or serum

14

Where do aneurysmal cysts occur?

The metaphyses of many different long bones, flat bones (ribs, skull) and vertebral bodies

15

What are the characteristics of an aneurysmal cyst?

Locally agressive causing cortical expansion and destruction and is usually painful, with an increased risk of pathological fracture

16

What is the characteristic appearance of a giant cell bone tumour on Xray?

Soap bubble appearance

17

Where do giant cell tumours of bone tend to occur?

Knee

Distal radius

Other long bones

Pelvis

Spine

18

Where in bone do giant cell tumours occur?

Usually metaphyses, but sometimes epiphyses and can spread to subchondral bone

19

What are the characteristics of a giant cell bone tumour?

Locally invasive, destroying cortex

Benign

Can metastasise to lung

Occur after physis has fused

20

What is the treatment for giant cell bone tumour?

Intralesional excision  with  use  of  phenol,  bone  cement  or  liquid nitrogen to destroy remaining  tumour material and reduce the risk of recurrence

21

What is fibrous dysplasia?

A disease of a bone usually occurring in adolescence where a genetic mutation results in lesions of fibrous tissue and immature bone

22

In fibrous dysplasia, what do the bones look like and why?

Defective mineralization may result in angular deformities and the affected bone is wider with thinned cortices

23

What deformity can occur in extensive involvement of the proximal femur in fibrous dysplasia?

Shepard's crook deformity

24

What are the complications of fibrous dysplasia?

Pain

Stress fractures

Deformity of bones e.g. Shepard's crook deformity

25

What does fibrous dysplasia show on bone scan?

Intense increase in uptake during development but the lesion usually becomes inactive

26

How is fibrous dysplasia treated?

Bisphosphonates to reduce pain

Pathological fractures should be stabalised with internal fixation and cortical bone grafts to improve strength

 

 

27

What is an osteoid osteoma?

 A small nidus of immature bone surrounded by an intense sclerotic halo

28

At what age does osteoid osteoma tend to occur?

During adolescence

29

What common sites does osteoid osteoma affect?

 Proximal femur

The disphysis of long bones

Vertebrae

30

What is the predominant clinical feature in osteoid osteoma?

 Intense constant pain, worse at night due to the intense inflammatory response

31

What signs on Xray indicate a malignant bone tumour?

Cortical destruction

Aperiosteal reaction (raised periosteum producing bone),

New bone formation (sclerosis as well as lysis from destruction)

Extension into the surrounding soft tissue envelope

32

What is the most common form of malignant primary bone tumour?

Osteosarcoma

33

Why is osteosarcoma named as it is?

It is a malignant tumour producing bone

34

What age groups are most commonly affected by osteosarcoma?

Adolescents and young adults

35

Where is the most common site of bone involvemnent in osteosarcoma?

60% of tumours involve the knee

36

What sites can osteosarcoma occur at?

Knee

Pelvis

Proximal femur

Proximal humerus

37

What is the usual form of metastatic spread from osteosarcoma?

Usually haematogenous

Sometimes lymphatic

38

What treatment can prolong surivival in osteosarcoma?

Chemotherapy

39

What is a chondrosarcoma?

A cartilage producing primary bone tumour and is less common and less aggressive than osteosarcoma

40

What is the mean age of patient affected by chondrosarcoma?

45

41

What are the characteristics of chondrosarcoma?

Very large

Very slow to metastasise

42

What is Ewing's sarcoma?

 A malignant tumour of endothelial cells in the marrow

43

Which type of malignant bone tumour has the poorest prognosis?

Ewing's sarcoma

44

At what age to most cases of Ewing's sarcoma occur?

10 - 20

45

What is Ewing's sarcoma commonly mistaken for and why?

Osteomyelitis

Fever, raised inflammatory markers and a warm swelling