Bone tumours

Question 1

what cancers most commonly metastasise to the bone?

Answer 1

breast, lung, thyroid, prostate, renal, skin

Question 2

tumour affects older adults and is not responsive to chemo and radio?

Answer 2

Chondrosarcoma

Question 3

Lytic
Intralesional calcifications
“Endosteal scalloping”
“popcorn sign”

Answer 3

Chondrosarcoma

Question 4

Chondrosarcoma- benign or malignant?

Answer 4

malignant

Question 5

Ewing’s sarcoma- benign or malignant?

Answer 5

malignant

Question 6

Osteosarcoma- benign or malignant?

Answer 6

malignant

Question 7

Osteoid osteoma- benign or malignant?

Answer 7

benign

Question 8

Chondroblastoma- benign or malignant?

Answer 8

benign

Question 9

Osteochrondoma- benign or malignant?

Answer 9

benign

Question 10

Giant cell tumour– benign or malignant?

Answer 10

benign

Question 11

Haemangioma- benign or malignant?

Answer 11

benign

Question 12

Who gets Ewing’ sarcoma?

Answer 12

children and young adults

Question 13

Bone pain, swelling and fever in children. Worry about what?

Answer 13

Ewing’s sarcoma

Question 14

Sarcoma is a tumour of which tissue type?

Answer 14

Mesenchymal (connective tissue)

Question 15

What tumour causes severe dull pain, worse at night and is reliever by NSAIDs? In young males, long bone diaphysis and spine.

Answer 15

Osteoid osteoma

Question 16

Young person. Pain and limping. X-ray shows cartilage, epiphyseal lesion

Answer 16

Chondroblastoma

Question 17

Chondroblastoma rarely metastasise to lung- true or false

Answer 17

true

Question 18

Which tumour is slowing growing, vascular and often an incidental vertebral finding?

Answer 18

Haemangioma (tend to enhance on T1 and T2 MRI)

Question 19

small hidus of immature bone surrounded by an intense sclerotic halo

Answer 19

osteoid osteoma

Question 20

What is the most common benign tumour?

Answer 20

Osteochondroma

Question 21

Which benign tumour is aggressive (non-cancerous) with risk of pathological fracture, cortical expansion and destruction (causing pain)

Answer 21

Aneurysmal bone cyst

Question 22

Which benign tumour may require embolisation, radiotherapy or medical therapy e.g. denosumab or surgery?

Answer 22

Aneurysmal bone cyst

Question 23

which tumour causes “soap bubble appearance on x-ray?

Answer 23

giant cell tumour

Question 24

how do you treat giant cell tumour?

Answer 24

intralesional excision with phenol, bone cement or liquid nitrogen to destroy remaining tumour material and reduce recurrence

Question 25

How may myeloma present?

Answer 25

pain, lethargy, anaemia, infection, renal failure

Question 26

“blown-out appearance” on x-ray

Answer 26

aneurysmal bone cyst

Question 27

“punched out” appearance on x-ray

Answer 27

myeloma

Question 28

Bence-Jones protein

Answer 28

myeloma

Question 29

Ideal treatment for myeloma?

Answer 29

bone marrow transplant and chemotherapy

Question 30

What is the disease process in myeloma?

Answer 30

proliferation of plasma B cells

Question 31

What is the most common primary malignant of the bone?

Answer 31

Osteosarcoma

Question 32

Lytic sclerosis
Codman’s triangle
Sun ray spicles

Answer 32

Osteosarcoma

Question 33

Which tumours do you investigate with biopsy and chest imaging?

Answer 33

Osteosarcoma and Ewing’s sarcoma

Question 34

Lytic, soft tissue reaction, onion skin sign on x-ray

Answer 34

Ewing’s sarcoma