Bone tumours

Question 1

Types of benign bone tumours

Answer 1

Neoplastic, Developmental, Traumatic, Infections and Inflammatory

Question 2

Which benign tumour is the most common?

Answer 2

Osteochondroma

Question 3

What are the risk of malignant transformation for an osteochondroma?

Answer 3

1%

Question 4

What is an osteochondroma?

Answer 4

bony outgrowth with a cartilaginous cap with local pain

Question 5

Why do multiple osteochondromas occur?

Answer 5

due to an autosomal dominant hereditary disorder

Question 6

What is an enchondroma?

Answer 6

an intermedullary and usually metaphyseal cartilaginous tumour

Question 7

When do enchondromas occur?

Answer 7

when normal enchondral ossification fails

Question 8

What do enchondromas look like on X-ray?

Answer 8

lucent but become patchy sclerotic when they mineralize

Question 9

what are the symptoms of an enchondroma?

Answer 9

asymptomatic but can weaken bone

Question 10

What bones do enchondromas occur in?

Answer 10

femur, humerus, tibia and small bones

Question 11

how do you treat an enchondroma?

Answer 11

curettage and filled with bone graft

Question 12

what is a simple bone cyst?

Answer 12

a single cavity, fluid filled cyst

Question 13

Why do simple bone cysts occur?

Answer 13

when there is a growth defect in physis

Question 14

what bones do simple bone cysts occur in?

Answer 14

humerous, femur, talus and calcaneus

Question 15

what are the symptoms of simple bone cysts?

Answer 15

asymptomatic but can cause weakness

Question 16

who gets simple bone cysts?

Answer 16

children or young adults

Question 17

how do you treat a simple bone cyst?

Answer 17

curettage and bone graft

Question 18

what is an aneurysmal bone cyst?

Answer 18

multiple gaps in bone filled with blood or serum

Question 19

why do aneurysmal bone cysts form?

Answer 19

small arteriovenous malformation

Question 20

where do aneurysmal bone cysts occur?

Answer 20

metaphysis of long bones, flat bones and vertebral bodies

Question 21

what causes aneurysmal bone cysts to become locally aggressive?

Answer 21

cortical expansion and destruction

Question 22

what are the symptoms of aneurysmal bone cysts?

Answer 22

pain and weakened bone

Question 23

How do you treat an aneurysmal bone cyst?

Answer 23

curettage and bone graft or bone cement

Question 24

where do you find a giant cell tumour?

Answer 24

can be in the metaphysis, epiphysis or in subchondral bone in the knee, distal radius, long bones, pelvis and spine

Question 25

how do giant cell tumours appear on an X-ray?

Answer 25

multi-nucleate giant cells with a soap bubble appearance

Question 26

How likely is a metastasis to lung for a giant cell tumour?

Answer 26

5%

Question 27

How do you treat a giant cell tumour?

Answer 27

intralesional excision with phenol/ bone cement or liquid nitrogen and some times you replace a joint

Question 28

when does fibrous dysplasia occur?

Answer 28

in adolescence

Question 29

what causes fibrous dysplasia?

Answer 29

genetic mutation

Question 30

what is fibrous dysplasia?

Answer 30

lesions of fibrous tissue in immature bone

Question 31

what types of fibrous dysplasia are there?

Answer 31

monostoic and polystoic

Question 32

what causes angular deformities in fibrous dysplasia?

Answer 32

defective mineralisation

Question 33

which tumour causes angular deformities?

Answer 33

fibrous dysplasia

Question 34

which tumour causes a shepherd's crook deformity?

Answer 34

fibrous dysplasia?

Question 35

how do you treat fibrous dysplasia?

Answer 35

bisphosphates reduce pain, internal fixation and cortical bone grafts

Question 36

what is an osteoid osteoma?

Answer 36

small nidus of immature bone surrounded by an intense sclerotic halo

Question 37

when do osteoid osteomas occur?

Answer 37

adolescence

Question 38

where do osteoid osteomas occur?

Answer 38

proximal femur, diaphysis of long bone and vertebrae

Question 39

what are the symptoms of osteoid osteomas?

Answer 39

intense constant pain that's worse at night

Question 40

how would you treat pain from osteoid osteomas?

Answer 40

NSAIDs

Question 41

how do you treat osteoid osteomas?

Answer 41

may resolve but may require CT guided radiofrequency ablation or en bloc excision

Question 42

what is Brodie's abscess?

Answer 42

lytic lesion of bone that's a brown tumour

Question 43

what causes Brodie's abscess?

Answer 43

sub acute osteomyelitis and hyperparathyroidism

Question 44

Benign or malignant: osteochondroma

Answer 44

Benign

Question 45

Benign or malignant: enchondroma

Answer 45

Benign

Question 46

Benign or malignant: simple bone cyst

Answer 46

Benign

Question 47

Benign or malignant: aneurysmal bone cyst

Answer 47

Benign

Question 48

Benign or malignant: giant cell tumour

Answer 48

Benign

Question 49

Benign or malignant: fibrous dysplasia

Answer 49

Benign

Question 50

Benign or malignant: osteoid osteoma

Answer 50

Benign

Question 51

Benign or malignant: brodie's abscess

Answer 51

Benign

Question 52

Benign or malignant: osteosarcoma

Answer 52

Malignant

Question 53

Benign or malignant: chondrosarcoma

Answer 53

Malignant

Question 54

Benign or malignant: fibrosarcoma

Answer 54

Malignant

Question 55

Benign or malignant: Ewing's sarcoma

Answer 55

Malignant

Question 56

Benign or malignant: lymphoma

Answer 56

Malignant

Question 57

Benign or malignant: myeloma

Answer 57

Malignant

Question 58

are malignant primaries rare or common?

Answer 58

rare

Question 59

what age group do malignant tumours occur?

Answer 59

young patients

Question 60

what are red flags for malignant tumours?

Answer 60

persistent unexplained pain

Question 61

what does a malignant tumour look like?

Answer 61

substantial, ill-defined bony swelling

Question 62

what does a malignant tumour look like on X-ray?

Answer 62

aggressive and destructive- cortical destruction, periosteal reaction and new bone formation and extension into surrounding soft tissue

Question 63

what is an osteosarcoma?

Answer 63

malignant tumour producing bone

Question 64

When do osteosarcomas usually occur?

Answer 64

adolescence and early adulthood

Question 65

where do osteosarcomas most commonly affect?

Answer 65

around the knee

Question 66

how do osteosarcomas spread?

Answer 66

haematogenously or lymphatically

Question 67

how would you prolong survival in a patient with an osteosarcoma?

Answer 67

chemo

Question 68

what is a chondrosarcoma?

Answer 68

cartilage producing primary that's less aggressive than an osteosarcoma

Question 69

what age group does a chondrosarcoma usually affect?

Answer 69

45 year olds

Question 70

where does a chondrosarcoma affect?

Answer 70

pelvis or proximal femur

Question 71

is a chondrosarcoma responsive to chemo or radio therapy?

Answer 71

no

Question 72

is a chondrosarcoma quick or slow to metastasize?

Answer 72

slow

Question 73

what is another name for Fibrosarcoma?

Answer 73

malignant fibrous histiocytoma

Question 74

is a fibrosarcoma a primary or secondary tumour?

Answer 74

primary

Question 75

where does a fibrosarcoma occur?

Answer 75

in abnormal bone

Question 76

who gets a fibrosarcoma?

Answer 76

adolescence or young adults

Question 77

Where do Ewing's sarcomas occur?

Answer 77

primitive cells in the marrow

Question 78

who does Ewing's sarcoma usually affect?

Answer 78

10-20 years old

Question 79

what condition often gets misdiagnosed as osteomyelitis?

Answer 79

Ewing's sarcoma

Question 80

Is Ewing's sarcoma radio and chemo sensitive?

Answer 80

yes

Question 81

Where does a non-Hodkins lymphoma metastasise from?

Answer 81

marrow or lymph to bone

Question 82

where does a primary lymphoma usually affect?

Answer 82

pelvis or the femur

Question 83

what is the survival mean for a lymphoma?

Answer 83

2 years

Question 84

what is a myeloma?

Answer 84

malignant B cell proliferation

Question 85

what is a single lesion of myeloma called?

Answer 85

plasmacytoma

Question 86

what are multiple lesions of myeloma called?

Answer 86

multiple myeloma

Question 87

what age group is most affected by myeloma?

Answer 87

45-65

Question 88

what symptoms present in a myeloma?

Answer 88

weakness, backpain, fatigue, weight loss, anaemia and recurrent infection

Question 89

how is a myeloma diagnosed?

Answer 89

by plasma protein electrophoresis and early morning urine collection for Bence Jones assay

Question 90

are myelomas always detected on a bone scan?

Answer 90

no

Question 91

what is the 5 year survival rate?

Answer 91

<30%

Question 92

What type of lesion is a breast met?

Answer 92

blastic or lytic

Question 93

What is the survival for a breast met to the bone?

Answer 93

24-26 months

Question 94

what type of lesion is a prostate met?

Answer 94

sclerotic

Question 95

what is the survival for a prostate met to the bone?

Answer 95

45% at 1 year

Question 96

What type of lesion is a lung met?

Answer 96

Lytic

Question 97

what is the survival for a lung met to the bone?

Answer 97

6 months on average

Question 98

what type of lesion is a renal cell carcinoma met?

Answer 98

large lytic blow out

Question 99

what is the survival for a renal CC met to the bone

Answer 99

12-18 months

Question 100

break

Answer 100

break