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Flashcards in Tumour Deck (329)
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91

4 posterior element tumours

ABC

osteoid osteoma

osteoblastoma

osteochondroma

92

What systemic pathology (ie non ortho) do people with Paget's disease get?

high output cardiac failure

due to increased turnover of bone

93

What percentage of vertebral body tumours are malignanet?

75%

94

 

What bone metasteses are not redio sensitive?

 

Which is the most readio-sensitive?

 

1) GI and Renal

 

2) Prostate

95

Classic spine finding in eosinophilic granuloma

Name 1 other classic finding

Vertebra plana aka platyspondia

Multiple punched out/lytic cranial lesions (ask for skull x-ray)

96

Which side of the spine in an osteoid osteoma normally found in?

Concavity of the spine

97

Histology of ewings sarcoma?

Small round blue cells

98

How do you classify UBC?

Active - in continuity with physis

Latent - bony bridge between UBC and physis

99

Most common location of mets in soft tissue sarcoma

Lungs

They can mets to LNs, but lungs are still most common

100

Survival rate of chondrosarcoma

Directly correlates with histological grade:

Grade 1: 90%

Grade 2: 60-70%

Grade 3: 30-50%

De-differentiated: 10%

101

What are the main steps in treatment of malignant bone tumour?

1. Neo adjuvant chemotherapy

2. Re-stage with imaging for response to therapy and operative planning

3. Surgery - limb sparing vs. amputation

4. Post-operative chemotherapy - use pathology to prognosticate

102

Treatment?

Chordoma

Wide resection is standard of care

± radiation if:

positive margins

inoperable tumour

103

What is the most common cause of painful scoliosis in the adolescent population?

osteoid osteoma

104

5 complications with treatment of UBC

recurrence

fracture

embolizatio of injected material

local reaction to injected material

growth disturbances

105

What kind of tumour results from malignant transformation of a chronic OM?

what is the treatment?

SCC

Treat with wide excision/amputation + adjuvant chemo/rads

Prognosis is poor with late diagnosis, good with early

 

106

Patient comes in post-MVC with a pathologic fracture through this.  Dx as ABC.  What is your plan?

Non-operative fracture management

Once healed, then proceed with intralesional curettage

Remember to treat path fractures non-op!

107

4 predisposing genetic factors for intramedullary osteosarcoma

Rb +

p53

Rothmund thomson syndrome

LiFraumeni syndrome

108

60 yo F with constitutional symptoms, pain palpable mass.  (see picture)

Dx & treatment

Lymphoma

Treatment is surgical stabilization, chemo, radiation

*Lymphoma can have a soft tissue mass!

*lymphoma: small round blue cell

109

What do the terms onion skinning and sunburst refer to on radiographs? Which Tumors are each characteristic of?

Types of periosteal reaction

Onion skinning = ewings

Sunburst = osteosarcoma

110

Age range for GCT?

20-40

111

indications for excisional bx

superficial to fascia

Not overlying NV structure

excise AND LEAVE BEHIND FASCIA

112

"Pop corn densities" are useful in differentiating what secondary malignancy from its benign precursor?

Secondary chondrosarcoma from enchondroma.

113

What is the histo of periosteal osteosarcoma

osteoid + chondroblastic matrix

If no osteoid, will be classified as chondrosarcoma

114

 

What tumor shows predilection for the distribution shown in this figure?

 

Giant Cell Tumor

115

Desribe AJCC classification system

Soft soft tissue tumours:

See picture

116

Name 5 signs/symptoms that are concerning for chondrosarcoma, you know, that may be in a stem of a question

Deep Endosteal scalloping (>2/3)

Pain/progressive pain

Night symptoms/constitutional symptoms

Periosteal reaction

Soft tissue extension

Lysis of prior chondroid mineralization

117

Ddx for multiple giant cell containing lesions?

Multifocal GCT

Browns Tumor

118

Management of hypercalcemia

Fluids (200-300mL/hr initially, then maintaining u/o 100-150mL/hr)

Calcitonin

Bisphosphonates

Can use denosumab if refractory to bisphosphonates

LOOP DIURETICS ARE NOW NOT RECOMMENDED

119

dDx for Benign Latent Lesion (3)

Osteochondroma

NOF

Enchondroma

120

Treatment for suspected low-grade chondrosarcoma (instead of enchondroma)

intralesional curettage