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ABOS Part 1 > Oncology > Flashcards

Oncology Flashcards

1
Q

Mnemonic for vertebral plana

A

MELT

M - metastasis, multiple myeloma
E - Eosinophilic granuloma (LCH)
L - Lymphoma, leukemia
T - Trauma, Tuberculosis

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2
Q

Mnemonic for sarcomas with lymph node mets

A

SCARE

S - Synovial Sarcoma
C - Clear cell sarcoma
A - Angiosarcoma
R - Rhabdomyosarcoma
E - Epitheloid sarcoma

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3
Q

Mnemonic for diaphyseal bone tumors

A

A, E, I, O, U, and Y

A - adamantonoma
E - eosinophilic granuloma (LCH)
I - infection
O - osteoid osteoma, osteoblastoma
U - uings (Ewings)
Y - fibrous dYsplasia, lYmphoma, mYeloma

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4
Q

Mnemonic blue cell tumors

A

LERNM

L - lymphoma (adult)
E - ewings (<30)
R - rhabdomyosarcoma (<30)
N - neuroblastoma (<30)
M - myeloma (adult)

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5
Q

Tumor markers for lymphoma

A

CD 45+
LCA (leukocyte common antigen)

Patients age >30

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6
Q

These tumors are treated with chemotherapy > surgery > chemotherapy

A

Ewing sarcoma (sometimes radiation therapy, too)

Osteosarcoma

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7
Q

These tumors are treated with radiation + surgery

A

Soft tissue sarcomas

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8
Q

These tumors are treated with limb salvage / wide resection

A

Chondrosarcoma
Adamantinoma
Chordoma
Parosteal osteosarcoma

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9
Q

These tumors are treated with ORIF (+ radiation)

A

Metastases
Lymphoma
Myeloma

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10
Q

These tumors are treated with intralesional resection

A

- Giant cell tumor (Epiphyseal, adult)
- ABC (fluid fluid levels)
- NOF (lytic and sclerotic rim, incidental finding)
- LCH (lytic, child)
- Osteoblastoma (diaphyseal)
- Chondroblastoma (Epiphyseal, child)

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11
Q

These tumors are treated with radio frequency ablation

A

Osteoid osteoma

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12
Q

Epiphyseal tumors

A

Chondroblastoma (child)
Giant cell (adult)
Clear cell sarcoma (femoral head)

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13
Q

Tumors located in flat bones

A

Chondrosarcoma (pelvis, scapula) (adult)
Fibrous dysplasia
Hemangioma
Pagets
Ewing sarcoma (child)

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14
Q

Mnemonic for metastatic tumors

A

BLT and Kosher Pickle

B - breast (mammogram)
L - lung (CXR, CT chest)
T - thyroid (ultrasound)

K - kidney (CT abdomen)
P - prostate (PSA)

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15
Q

A

Adamantinoma

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16
Q

A

Eosinophilic granuloma (LCH)

“Punched out” lytic lesion
Diaphyseal

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17
Q

A

Fibrous dysplasia

“Ground glass appearance”

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18
Q

A

Osteoid osteoma
Age <30
Size <2 cm
Diurnal pain relieved by NSAIDS
Prostaglandin E2 is released by tumor and causes inflammation/pain
Lesion modus best seen on CT
Path: woven central bone with mature outer lamellar like bone
TREATMENT:
- NSAIDS
- CT guided radio frequency ablation (90c 6 min) (contraindicated in spine and subcu location)
- noninvasive high frequency MRI ultrasound

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19
Q

A

Parosteal osteosarcoma
Stuck on bone appearance
Just need wide excision, uniquely it does not need chemo

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20
Q

Lab associated with what cancer?
11;22/EWS FLI-1

A

Ewing Sarcoma

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21
Q

Lab is associated with what cancer?
X;18/SSX1-SYT

A

Synovial Sarcoma

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22
Q

Lab is associated with what cancer?
P53 and Rb

A

Osteosarcoma

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23
Q

Side effect of Doxorubicin (Adriamycin)?

A

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24
Q

Order of evaluation for cancer patient.

A

History and physical
Local staging (XR, MRI, CT, labs)
Systemic staging (CT CAP, whole body PET/bone scan)
Biopsy (always stage before biopsy or treatment)

***have a diagnosis before you treat!

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25
Q

Metaphyseal tumors

A

Osteosarcoma
Chondrosarcoma
Metastases

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26
Q

Spine tumors
Anterior elements (2)
Posterior elements (3)

A

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27
Q

Tumors commonly found in the sacrum?

A

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28
Q

Tumors commonly see in tibia?

A

Chondromyxoid fibroma (shark bite lesion)
Non-ossifying fibroma (sclerotic lytic lesion)
Adamantinoma (soap bubble appearance)

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29
Q

CD 45+ , LCA (leukocyte common antigen) are associated with…

A

Lymphoma

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30
Q

Name the cancer….
Vimentin positive
CD 99+
Path with small round blue cells and pseudo rosettes

A

Ewing sarcoma

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31
Q

Name the cancer…
Desmin positive
t(2;13)
PAD-FKHR

A

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32
Q

CD 20+ is associated with this cancer…

A

Myeloma

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33
Q

Name the cancer…
S-100

A

Schwannoma
MPNST

34
Q

Name the cancer…
Beta catenin membrane marker

A

Fibromatosis

35
Q

Name the cancer…
Loss of INI 1 (integrate interactor 1)

A

Epitheloid sarcoma
(Often presents with no healing cutaneous ulcer)

36
Q

Name the cancer…
USP6

A

Aneurysmal bone cyst

37
Q

Name the cancer…
t(12;16)/TLS-CHOP

A

Myxoid liposarcoma

(Requires whole body MRI)
Can metastasize to bone

38
Q

Patients with neurofibromatosis type 1 are at risk of developing…

A

Malignant peripheral nerve sheath tumors

39
Q

Chemotherapy agents for osteosarcoma

A

Doxorubicin, Cisplatin, Methotrexate (high dose)

40
Q

Chondroblastoma

A

Epiphyseal
<30 years
Chicken wire calcification
Round cells with fried egg appearance
Can be locally aggressive and has potential to metastasize to lungs.
Treatment is curretage and bone grafting

41
Q

What 3 benign aggressive tumors require CT chest screening for rule out malignancy?

A

Giant cell tumor of bone
Solitary fibrous tumor
Chondroblastoma

42
Q

Steps for incompletely excised tumor/whoops surgery?

A

Reimage
Radiate
Re-excise

43
Q

Factors associated with worse prognosis for soft tissue sarcomas…

A

Size >5 cm
High grade
Deep to fascia
Fungating
Torso worse than extremity
Extensive necrosis

44
Q

MDM2 is associated with…

A

Liposarcoma or atypical lipomatous tumors

MDM2 is not present in lipomas

45
Q

Fibrosarcoma

A

Soft tissue tumor
CT chest to rule out malignancy
Pathology: Herringbone pattern
Treatment radiation + wide excision

46
Q

Malignant peripheral nerve sheath tumor

A

Associated with NF1 gene on chromosome 17.
S100+
Path: whirling spindle cells
Treatment: radiation + wide excision

47
Q

Angiosarcoma

A

Associated with chronic venous stasis or trauma with chronic lymphedema.
Subcutaneous tissue
+lymph node spread (SCARE)
Can also occur after radiation treatment
Path: see image
Treatment: wide excision

48
Q

Rhandomyosarcoma

A

Kids
Metastatic lymph node spread (SCARE)
Path: Desmin +
t(2;13)/PAX-FKHR
Treatment: neoadjuvant chemotherapy, wide excision, +/- radiation at margins

49
Q

Epithelioid sarcomas are know. For being found in this location…
Path…

A

Hand and forearm
Loss of IN1
Spread to lymph nodes (SCARE)

50
Q

Fibromatosis tumor patients should also have this done..

A

Colonoscopy to screen for adenomatous polyposis association

51
Q

Name the cancer….
Nuclear IHC beta catenin +
Estrogen receptor +

A

Fibromatosis

52
Q

Name the cancer…

A

Hemangioma/AVM

53
Q

Cancer commonly found in the foot…

A

Clear cell sarcoma
Synovial sarcoma

54
Q

Osteoblastoma

A

Age <30
Diaphyseal lesion, size > 2cm
Mixed Lytic/blastic, can grow to be expansile
Intermittent pain pattern (not diurnal)
Treatment: intralesional curettage and grafting

55
Q

Osteosarcoma

A

Age <30
Metaphyseal
50% around the knee (next most common is prox humerus)
P53, Rb
Path: immature bone formation with rimming osteoblasts
Treatment: chemo, surgery (wide excision), chemo

56
Q

Periostea’s osteosarcoma treatment

A

Same as conventional osteosarcoma
Chemo, wide excision, chemo

57
Q

This osteosarcoma can mimic ABC…

A

Telangiectactic osteosarcoma

Both can have fluid fluid levels on MRI and occur in young patients.
USP6 + with ABCs can help differentiate. Also, ABCs tend to expand the cortex and balloon the bone whereas osteosarcoma do not. ABCs have lakes whereas osteosarcomas are more cellular and have atypical cells/mototic figures.

58
Q

A

Enchondroma
Metaphyseal, calcified arcs and rings
Asymptomatic
Cartilage origin on histology with some clumps of cellularity.
Treatment: observe, unless path fx the curette graft and ORIF

59
Q

A

Osteochondroma

Cartilage cap >2cm are at risk for low grade chondrosarcoma.

Can be more concerning in MHE
EXT1, EXT2, EXT3 mutations. EXT1 has highest burden of disease and greatest risk of malignant transformation to low grade chondrosarcoma

60
Q

Syndrome characterized by multiple non-ossifying fibromas…

A

61
Q

This sacral nerve root is most important for retaining bowel and bladder function.

A

S3

62
Q

Mirels score threshold for surgical fixation of pathologic lesion?

A

Greater than or equal to 9

63
Q

Myeloma

A

Age >50
Punched out lesion
Round blue cell tumor
CD56+, CD45+
Monoclonal
Diagnosis’s: SPEP/UPEP with monoclonal Kappa/lambda light chains.
Path: small round blue cells, Plasma cells with eccentric clock face nucleus
Staging: Cold bone scan, need skeletal survey for burden of disease/staging
Treatment: chemo + radiation

64
Q

How do you differentiate osteosarcoma from Ewings sarcoma?

A

Histology

65
Q

How do you differentiate osteomyelitis from other tumors?

A

It does not respect fascial or muscular planes. It is not organized. Lots of associated edema.

66
Q

A

Enchondroma

67
Q

A

Chondrosarcoma

Calcifications + causing bony architecture changes

68
Q

Pathology findings for osteosarcoma?

A

69
Q

A

Osteofibrous dysplasia
(Soap bubble appearance that is critically based, commonly the tibia)

70
Q

A

Fibrous dysplasia
(Ground glass appearance)

71
Q

What 2 soft tissue sarcoma shave improved survival with chemotherapy?

A

Rhabdomyosarcoma (child)
Synovial sarcoma

72
Q

Treatment of chondrosarcoma…
Grade 1
Grade 2
Grade 3

A

Grade 1: intralesional curettage
Grade 2: wide resection
Grade 3: wide resection

*no chemotherapy or radiation indicated

73
Q

This type of cancer can occur in Paget’s disease…

A

Osteosarcoma

74
Q

Treatment chondromyxoid fibroma?

A

Intralesional curettage

75
Q

Chordoma treatment?

A

Wide excision

76
Q

Fibrous dysplasia genetic association?

A

GNAS

77
Q

Maffuci syndrome is associated with enchondromas + ….

A

Hemangiomas

78
Q

t(12;22) translocation

A

Clear cell sarcoma

79
Q

Ollier and Mafucci syndrome…

A

80
Q

What is the diagnosis…
Polyostotic fibrous dysplasia, cafe au lait spots, precocious puberty.

A

McCune Albright syndrome

ABOS Part 1 (11 decks)

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