Flashcards in MSK tumour pathology Deck (75):
How common are skeletal tumours?
What are the categories of tumour which can affect the skeleton?
Myeloma (plasma cells)
Benign but locally destructive
What are the benign tumours affecting the skeleton?
What is an osteochondroma?
Cartilage capped bony outgrowth on the external surface of the bone
How will an osteochondroma appear on imaging?
The bony outgrowth will be continuous with the normal bone
Which age group is affected by osteochondromas?
Are males or females more affected by osteochondroma?
Where on the bone do osteochondromas tend to develop?
Near epiphysis of long bones
When might an osteochondroma cause problems?
Can cause local pain or irritation
What is an (en)chondroma?
Hyaline cartilage tumour arising within the medullary cavity of bones
Which bones develop (en)chondromas?
In which two conditions might you see more than one (en)chondroma?
Who gets (en)chondromas?
Young adult men
What are the enchondromas associated with in Mafucci's syndrome?
What is Ollier's disease?
Rare developmental disorder
Is ollier's disease hereditory?
Where do the (en)chondromas arise in ollier's disease?
What is the risk with Ollier's disease?
Malignant transformation possible
What is the risk with Mafucci's syndrome? How does this compare to ollier's syndome?
Malignant transformation much higher than in ollier's syndrome
Small peripheral bone lesions are less likely to be benign than large axial lesions. T/F
False - small peripheral lesions are more likely to be benign
Who gets osteoid osteoma?
Children and young adults
More common in males
Where are osteoid osteomas typically found?
Hands & feet
Which cells do osteoid osteomas arise from?
How do osteoid osteomas typically appear on imaging?
Central vascular osteoid core
Cortex of bone
How does osteoid osteoma present?
Pain worse at night
Relieved with aspirin/NSAIDs
+/- spinal scoliosis
+/- soft tissue swelling
How are osteoid osteomas managed?
Self resolving within 3 years
Who gets chondroblastomas?
How common is chondroblastoma?
Chondroblastomas are benign. T/F
True - can be locally aggressive
Where in bones and in which bones do chondroblastomas present?
How doe chondroblastomas appear on imaging?
Well circumscribed osteolytic sphere
+/- extension from epiphysis
What type of calcification is characteristically seen with chondroblastomas?
How are most benign bone tumours treated?
Biopsy and curettage + liquid nitrogen
List the three benign but locally aggressive bone tumours
Giant cell tumour
Which cells do giant cell tumours arise from?
Which age groups get giant cell tumours?
Which sex is more prone to giant cell tumours?
Which bones do giant cell tumours typically arise on?
Very common around knee (distal femur)
How do giant cell tumours typically appear on imaging?
Dense around the periphery
Destroyed medullary cavity
+/- soft tissue expansion
Nb - "soap bubble" appearance buzzword
What type of cells can be seen on histology of a giant cell tumour?
Multi-nucleated giant cells
Is an osteoblastoma single or multiple?
Where and on which bones can an osteoblastoma be found?
How does an osteoblastoma appear on imaging?
+/- peripheral sclerosis
How might an osteoblastoma present?
How are benign but locally aggressive bone lesions treated?
How common is chordoma?
Which cells do chordomas arise from?
Notochord embyrological remnants
Which age group presents with chordomas?
Which sex is more commonly affected by chordomas?
On which bones are chordomas found?
Base of skull
How do chordomas present on imaging?
+/- soft tissue mass
+/- focal calcifications
How are chordomas treated?
Difficult to resect
Chemotherapy for late stage
List the three most common malignant tumours of the bone?
What is the commonest primary malignant bone tumour?
Which type of cells do osteosarcomas arise from?
Which age groups are affected by osteosarcomas?
Which sex is affected by osteosarcoma?
Male more commonly
Where and on which bones are osteosarcomas typically found?
Long bones (distal femur, proximal tibia and humerus)
Osteosarcoma is fast growing. T/F
What are the three subtypes of osteosarcoma?
How is osteosarcoma treated?
Biopsy, CT, bone scan
Chemo pre and post op
Which type of cells do chondroblastomas arise from?
Chondroblastomas are commonly found within the pelvis. T/F
How are chondroblastomas treated?
What type of tumour is Ewing's sarcoma?
Peripheral primitive neuroectodermal tumour (PPNT)
Where and in which bones does Ewing's sarcoma arise?
Which age group is affected by Ewing's sarcoma?
Which sex is more commonly affected by Ewing's sarcoma?
How is Ewing's sarcoma treated?
Which cancers commonly metastasise to bone?
Lung (small cell)
Bone metastases are osteosclerotic. T/F
Osteolytic EXCEPT from prostate cancer
What is multiple myeloma?
Malignant cancer of plasma cells
Who gets multiple myeloma?
What is a common complication of multiple myeloma?