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Bone Tumours Flashcards

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1
Q

List the malignant bone tumours

A 
Osteosarcoma
Chondrosarcoma
Myeloma -1% of all malignancies
Metastases
Ewing's sarcoma
2% of enchondromas
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2
Q

List the non-malignant bone tumours

A 
Osteoblastoma
Osteochondroma
Giant cell tumour
Osteoid osteomas
Most enchondromas
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3
Q

Tissue type of osteosarcomas

A

Pleomorphic osteoid producing osteoblasts

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4
Q

Osteoblastoma cell type

A

Osteoblasts

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5
Q

Osteochondroma cell type

A

Growth plate cells

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6
Q

Chondrosarcoma cell type

A

Chondrocytes

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7
Q

Myeloma cell type

A

Plasma cells of bone marrow

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8
Q

Metastases main cell types

A 
Lung
Prostate
Breast
Thyroid
Renal
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9
Q

Ewing’s sarcoma cell type

A

Neuroectodermal

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10
Q

Giant cell tumour cell type

A

Osteoclasts

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11
Q

Osteoid osteomas cell type

A

Osteoblasts

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12
Q

Enchondroma cell type

A

Cartilage

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13
Q

Main presentations of osteosarcomas

A 
Chronic inflammatory response
Bone pain -worse at night
Pulmonary symptoms if Mets
Fever
Swelling
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14
Q

Osteoblastoma main presentations

A 
Nidus of over 1.5cm
Avascular necrosis
Spinal nerve compression
Slow progressive pain
Not relieved by NSAIDs
Swelling
Muscle
Atrophy
Limp
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15
Q

Osteochondroma main presentations

A

Palpable, non tender, bony lump that is firm and immobile potentially causing spinal nerve compression and avascular necrosis

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16
Q

Chondrosarcoma main presentations

A

Chronic inflammatory response with pulmonary symptoms if Mets are present

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17
Q

Myeloma main presentations

A

Localised bone pain
Pathological fracture
Fatigue
Aneamia

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18
Q

Mets main presentations

A

Chronic inflammatory response with primary cancer symptoms

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19
Q

Ewing’s sarcoma presentation

A

Chronic inflammatory response

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20
Q

Giant cell tumour presentation

A

Pain and swelling

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21
Q

Osteoid osteomas presentation

A

Nidus of less than 1.5cm
Worse pain at night
May block sinuses and nasal cavity with polypatous growth
Pain relieved by NSAIDs

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22
Q

Enchondroma presentation

A

Incidentally found

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23
Q

X ray findings of osteosarcoma

A

Lytic bone lesions
Sunburst spicules
Codman’s triangle - very destructive if this appears

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24
Q

X ray findings of osteoblastomas

A

Eroded ring of surrounding bone
Lytic or mixed lytic-blastic lesion with radiolucent nidus > 2cm
Reactive sclerotic bone

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25
X-ray findings of osteochondroma
Lateral bony projection (exostosis) with a hyaline cartilage cap
26
X-ray findings of chondrosarcoma
Lytic patchy lesions that look moth eaten in the medullary cavity Reactive thickening of the cortex Popcorn lesions may be seen
27
X-ray findings of myeloma
Punched out lytic lesions in metaphysis
28
Ewing's sarcoma X ray findings
Onion Skinning
29
Giant cell tumour X ray findings
Multicystic bone lesion (soap bubbles) extending to cartilage through epiphysis
30
Osteoid osteomas x-ray findings
Intensely reactive bone around radiolucent nidus
31
Enchondroma X ray findings
Lobular growing pattern (popcorn lesions) with central calcifications within the bone (stopped)
32
Main age for osteosarcoma
Mainly adolescents but also elderly
33
Osteoblastoma main age
10-30 years
34
Osteochondroma main age
<25 years old
35
Chondrosarcoma main age
Elderly
36
Myeloma main age
Over 40s
37
Ewing's sarcoma main age
10-20
38
Giant cell tumour main age
30-50
39
Osteoid osteomas main age
Less than 25
40
Enchondroma main age
20-50
41
Which tumours affect males more than females
``` Osteoblastoma Osteochondroma Chondrosarcoma Myeloma Mets Ewing's Osteoid osteomas ```
42
Which tumours affect females more than males
Giant cell tumours
43
Which cancers are treated with surgery, radiotherapy and chemotherapy?
``` Myeloma (no surgery) Osteosarcoma Chondrosarcoma Mets Ewing's sarcoma ```
44
Chemotherapeutic drug for bone tumours
Methotrexate
45
Osteochondroma and osteosarcoma treatment
Surgery if symptomatic
46
Giant cell tumour treatment
Surgically removed with curretage, grafting and may require denosmuab
47
Genetic link for osteosarcoma
Retinoblastoma suppressor gene
48
Osteoblastoma genetic link
FAP gene
49
Osteochondroma genetic link
Autosomal dominant, mutation in EXT gene | Loss of regulation in Indian hedgehog protein
50
Ewing's sarcoma genetic link
t(11:22) translocation
51
Main bones affected by osteosarcoma
``` | Distal femur | Proximal tibia | Proximal humerus | Proximal femur ↓ Pelvis ```
52
Main bones affected by osteoblastoma
Mandible Axial Skull Facial bones
53
Main bones affected by osteochondroma
Distal femur Proximal tibia Ilium Scapula
54
Main bones affected by chondrosarcoma
Axial skeleton Pelvis Long bones
55
Main bones affected by myeloma
Spine and ribs
56
Main bones affected by Ewing's sarcoma
``` Femur Sacrum Humerus Tibia Diaphyses ```
57
Main bones affected by giant cell tumours
Distal femur | Proximal tibia epiphysis
58
Main bones affected by Osteoid osteomas
Long bone diaphyses
59
Main bones affected by enchondroma
Medullary cavity of long bones
60
Associated diseases of osteosarcomas
Retinoblastoma | Paget's
61
Long term survival of osteosarcomas
76%
62
What % of osteosarcomas give pulmonary mets
10-20%
63
Most common benign tumour
Osteochondroma
64
Chondrosarcoma long term survival rate
Slow growing | 50-75%
65
Myeloma 5 year and 10 year survival rate
30% | 11%
66
Myeloma median survival rate
3 years
67
Most common primary bone tumour
Myeloma
68
5 year survival of Ewing's sarcoma
60-85%
69
Giant cell tumour links
Bony trauma
70
% of giant cell tumours that become malignant
2%
71
What are Osteoid osteomas surrounded by
Sclerotic bone tissue producing prostaglandins
72
Most common hand malignancy
Enchondroma
73
Important test for osteosarcoma
Raised alkaline phosphatase
74
Important test for myeloma
Raised serum creatinine
75
Important test for Ewing's sarcoma
Increased ESR
76
Important test for giant cell tumour
Decreased ROM
77
Histology of osteosarcomas
Tumour cells show atypia and produce Lacey osteoid
78
Histology of osteoblastoma
Similar to osteoid osteomas but with more giant cells
79
Histology of osteochondroma
Necrosis in growth plate
80
Histology of myeloma
Round plasma cells with eccentric nucleus and prominent nucleolus
81
History of chondrosarcoma
Disorganisation with blue collagen balls
82
Histology of Ewing's sarcoma
Small, round, blue cells
83
Histology of giant cell tumour
Numerous multinucleated giant cells | Eccentric lytic epiphyseal/metaphyseal lesion that often extends into the distal epiphysis and borders subchondral bone
84
Histology of osteoid osteomas
Benign appearance No growth potential Central nidus composed of more organised osteoid and lined by osteoblasts
85
Histology of enchondromas
Bland
86
End organ damage 'CRAB' pneumonic
Calcium raised Renal insufficiency Aneamia Bone lesions

Things I Get Stuck On (13 decks)

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