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MSK tumour pathology Flashcards

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1
Q

How common are skeletal tumours?

A

Uncommon

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2
Q

What are the categories of tumour which can affect the skeleton?

A 
Myeloma (plasma cells)
Metastases
Benign 
Benign but locally destructive
Malignant
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3
Q

What are the benign tumours affecting the skeleton?

A

Osteochondroma (exostosis)
Chondroma/enchondroma
Osteoid osteoma
Chondroblastoma

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4
Q

What is an osteochondroma?

A

Cartilage capped bony outgrowth on the external surface of the bone

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5
Q

How will an osteochondroma appear on imaging?

A

The bony outgrowth will be continuous with the normal bone

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6
Q

Which age group is affected by osteochondromas?

A

Young

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7
Q

Are males or females more affected by osteochondroma?

A

Equal distribution

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8
Q

Where on the bone do osteochondromas tend to develop?

A

Near epiphysis of long bones

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9
Q

When might an osteochondroma cause problems?

A

Can cause local pain or irritation

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10
Q

What is an (en)chondroma?

A

Hyaline cartilage tumour arising within the medullary cavity of bones

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11
Q

Which bones develop (en)chondromas?

A

Hands

Feet

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12
Q

In which two conditions might you see more than one (en)chondroma?

A

Ollier’s disease

Mafucci’s syndrome

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13
Q

Who gets (en)chondromas?

A

Young adult men

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14
Q

What are the enchondromas associated with in Mafucci’s syndrome?

A

Angiomas

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15
Q

What is Ollier’s disease?

A

Rare developmental disorder

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16
Q

Is ollier’s disease hereditory?

A

No

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17
Q

Where do the (en)chondromas arise in ollier’s disease?

A

Metaphyses
Diaphyses

Unilateral

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18
Q

What is the risk with Ollier’s disease?

A

Malignant transformation possible

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19
Q

What is the risk with Mafucci’s syndrome? How does this compare to ollier’s syndome?

A

Malignant transformation much higher than in ollier’s syndrome

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20
Q

Small peripheral bone lesions are less likely to be benign than large axial lesions. T/F

A

False - small peripheral lesions are more likely to be benign

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21
Q

Who gets osteoid osteoma?

A

Children and young adults

More common in males

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22
Q

Where are osteoid osteomas typically found?

A

Femur
Tibia
Hands & feet
Spine

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23
Q

Which cells do osteoid osteomas arise from?

A

Osteoblasts

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24
Q

How do osteoid osteomas typically appear on imaging?

A

Central vascular osteoid core
Peripheral sclerosis
Cortex of bone

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25
How does osteoid osteoma present?
``` Pain worse at night Dull/achey Relieved with aspirin/NSAIDs +/- spinal scoliosis +/- soft tissue swelling ```
26
How are osteoid osteomas managed?
Self resolving within 3 years | Pain relief
27
Who gets chondroblastomas?
Teens
28
How common is chondroblastoma?
Rare
29
Chondroblastomas are benign. T/F
True - can be locally aggressive
30
Where in bones and in which bones do chondroblastomas present?
Epiphysis | Long bones
31
How doe chondroblastomas appear on imaging?
Well circumscribed osteolytic sphere | +/- extension from epiphysis
32
What type of calcification is characteristically seen with chondroblastomas?
Chicken wire
33
How are most benign bone tumours treated?
Biopsy and curettage + liquid nitrogen
34
List the three benign but locally aggressive bone tumours
Giant cell tumour Osteoblastoma Chordoma
35
Which cells do giant cell tumours arise from?
Osteoclasts
36
Which age groups get giant cell tumours?
25-40 y/o
37
Which sex is more prone to giant cell tumours?
Females
38
Which bones do giant cell tumours typically arise on?
Long bones | Very common around knee (distal femur)
39
How do giant cell tumours typically appear on imaging?
Dense around the periphery Destroyed medullary cavity Destroyed cortex +/- soft tissue expansion Nb - "soap bubble" appearance buzzword
40
What type of cells can be seen on histology of a giant cell tumour?
Multi-nucleated giant cells
41
Is an osteoblastoma single or multiple?
Single
42
Where and on which bones can an osteoblastoma be found?
Metaphysis Diaphysis Long bones
43
How does an osteoblastoma appear on imaging?
Central density Well circumscribed +/- peripheral sclerosis
44
How might an osteoblastoma present?
Pain Swelling Tenderness
45
How are benign but locally aggressive bone lesions treated?
Surgical excision
46
How common is chordoma?
Rare
47
Which cells do chordomas arise from?
Notochord embyrological remnants
48
Which age group presents with chordomas?
>40 y/o
49
Which sex is more commonly affected by chordomas?
Females
50
On which bones are chordomas found?
Sacrococcygeal Base of skull (midline)
51
How do chordomas present on imaging?
Midline lesions Bony lysis +/- soft tissue mass +/- focal calcifications
52
How are chordomas treated?
Difficult to resect Radiation Chemotherapy for late stage
53
List the three most common malignant tumours of the bone?
Osteosarcoma Chondrosarcoma Ewing's sarcoma
54
What is the commonest primary malignant bone tumour?
Osteosarcoma
55
Which type of cells do osteosarcomas arise from?
Osteoblasts
56
Which age groups are affected by osteosarcomas?
Young adults
57
Which sex is affected by osteosarcoma?
Male more commonly
58
Where and on which bones are osteosarcomas typically found?
Epiphysis Long bones (distal femur, proximal tibia and humerus)
59
Osteosarcoma is fast growing. T/F
True
60
What are the three subtypes of osteosarcoma?
Osteoblastic Chondroblastic Fibroblastic
61
How is osteosarcoma treated?
Biopsy, CT, bone scan Chemo pre and post op Surgical resection
62
Which type of cells do chondroblastomas arise from?
Chondrocytes
63
Chondroblastomas are commonly found within the pelvis. T/F
True
64
How are chondroblastomas treated?
Excision
65
What type of tumour is Ewing's sarcoma?
Peripheral primitive neuroectodermal tumour (PPNT)
66
Where and in which bones does Ewing's sarcoma arise?
Metaphysis Diaphysis Femur Tibia Humerus
67
Which age group is affected by Ewing's sarcoma?
Teens
68
Which sex is more commonly affected by Ewing's sarcoma?
Males
69
How is Ewing's sarcoma treated?
Surgery Radiotherapy Chemotherapy
70
Which cancers commonly metastasise to bone?
``` Renal Thyroid Prostate Breast Lung (small cell) ```
71
Bone metastases are osteosclerotic. T/F
Osteolytic EXCEPT from prostate cancer
72
What is multiple myeloma?
Malignant cancer of plasma cells
73
Who gets multiple myeloma?
Old people
74
What is a common complication of multiple myeloma?
Kidney failure | and death
75
How does multiple myeloma appear on imaging?
Punched out | "Pepper pots"

Year 2 (72 decks)

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