December 7, 2015 - MSK Oncology Flashcards Preview

COURSE 2 > December 7, 2015 - MSK Oncology > Flashcards

Flashcards in December 7, 2015 - MSK Oncology Deck (17):
1

Incidence of Sarcoma

Rare.

Makes up about 1% of all cancers.

2

Presentation of Bone Sarcoma

Wide range of presentations.

Might present with corresponding pain to the aggressiveness of the neoplasm, night pains, or pains that are not alleviated by rest. Swelling or masses can present too.

 

Rarely asymptomatic

3

Red Flags for Bone Malignancy

Night pain or resting pain

Bone pain with soft tissue mass

Low energy bone fractures

Constitutional symptoms (sometimes)

4

When to Order X-Ray

If you ever suspect anything for MSK, order an X-Ray. It is low radiation and can give you valuable information.

Radiographs should be part of the orthopedic physical exam. If you deny your patient an X-Ray, you deny them a full MSK workup.

5

Big 3 Primary Bone Sarcomas

Osteosarcoma

Chondrosarcoma

Ewing Sarcoma

 

All have a peak incidence between 10-20 years old when the bones are rapidly growing, and then risk drops off until much later in life.

6

Bone Sarcoma Presentation

Bone pain

Joint pain

Limp

Localized swelling

Fracture (10-15%)

 

15-20% will present with metastatic disease.

7

Steps for Suspected Osteosarcoma

Protected weightbearing

Local imaging: MRI

Systemic imaging: bone scan & CT chest

Urgent referral to an oncology center

8

Chondrosarcoma

Second most common primary bone sarcoma

Cartilage forming bone tumor

Peak incidence is 40-70 years old

More likely to present in the pelvis

 

Not chemo or radiation sensitive; purely surgical.

9

Steps for Suspected Chondrosarcoma

Protected weightbearing

Local imaging: MRI

Systemic imaging: bone scan & CT chest

Urgent referral to an oncology center

 

Three different grades (1, 2, 3)

10

Ewing Sarcoma

Third most common primary bone sarcoma

Cellular proliferation within bone

Pediatric disease with peak incidence of 10-20 years

Most likely to present in pelvis or diaphysis of long bones

 

Chemo and radiation sensitive.

11

Steps for Suspected Ewing Sarcoma

Protected weightbearing

Local imaging: MRI

Systemic imaging: bone scan, CT chest, and bone marrow aspirate

Urgent referral to an oncology center

12

Chemo and Radiation Sensitivities

Osteosarcoma - chemo sensitive

Chondrosarcoma - not sensitive to any

Ewings Sarcoma - radiation sensitive

13

Skeletal Maturity Girls vs Boys

Girls - 14 years

Boys - 16 years

14

Benign Bone Tumors

Most bone tumors are benign, the sarcomas are RARE.

Some can cause pain, but many are asymptomatic or are incidental findings.

15

Osteochondromas

Bony outgrowths with a cartilage cap.

Benign

Originate from the physis

Stop growing at maturity

Low malignant transformation

Remove only if symptomatic

16

Enchondromas

Benign intramedullary cartilage tumor

"Nest of cartilage cells"

Most common benign bone tumor

Very common incidental finding

Don't biopsy

17

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