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Flashcards in Tumour Deck (329)
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151

What mutation is characteristic of fibrous dysphasia?

G-Protein mutation

152

Treamtent of leiomyosarcoma?

Surgical resection and CHEMO

Although effet is variable, some studies show better outcomes with surgical resection + chemo.  No role for radiation except if you can't get margins

This is one of the exceptions of regular ST sarcoma treamtent of surgery and radiation

Recall: synovial sarcoma may be respnsive to chemo also, but in that one you use RTx

153

Knee pain and this picture.  Previous aspiration showed hematoma.

Diagnosis & management?

PVNS

clue: affects both sides of the joint and causes OA like destruction (cysts)

Debridement ± radiation

154

What % of plexiform neurifibroma's transform into neurifibrosarcoma?

10%

155

Post-op radiation after prophylactic surgery for impending pathologic fracture has what 3 goals

Decrease pain

slow progression

treat remaining tumour burden not removed at surgery

156

Recurrence for PVNS?

30-50% - high

Therfore for treatment, may start with minimally invasive (arthorscopi) but make patient aware you may have to open later on

157

Diagnosis & treatment?

Synovial chondromatosis

(calcified stippling affecting both sides of joint)

Treatment:

Arthroscopic debridement (symptomatic treatment)

158

Why do you take out a retroperitoneal lipoma?

It has a higher chance of being a liposarcoma

159

Dosing side effects of wound healing post external beam radiation

<45 Gray: usually leads to uncompliated tissue healing

45-55 Gray: tissue heals but with problems

>60 Gray: tissue will likely not heal

160

Jaffe-Companacci syndrome

Congenital syndrome of:

multiple NOFs

cafe-au-lait pigmentation

mental retardation

heart, eyes, gonads involved

161

What tumour is associated with Dupuytrens, Ledderhose and Garrods?

What other inherited condition is it associated with?

Extra-abdominal desmoid tumour

familial adenomtaous polypsis (FAP)

162

Indications for non-excisional bx

>5cm

deep to fascia

surrounds NV structure and NOT a lipoma

overlies bone

Hx of "treated" carcinoma

unclear diagnosis

163

What are Birbeck granules diagnostic of?

Eosinophilic granuloma

164

You should embolize mets from which lesions?

RCC

Thyroid

Hepatocellular carcinoma

165

Local recurrence rate of chordoma?

50% (very high)

Proton-photon beams may help decrease this

166

Inheritance pattern of enchonromatosis (Ollier's/Maffuci)?

No inheritance pattern

MHE is AD though

167

What primary bone malignancies are more likely in patients over 40?

Plasmocytoma (solitary myeloma)

Primary lymphoma of bone

Chondrosarcoma

MFH

168

Genearlly, what do soft tissue sarcomas look like on MRI?

Dark on T1

Bright on T2

169

Management of pathologic fracture through enchondroma?

Cast with delayed curettage until after healing

170

dDx for Benign Active lesion (6)

Fibrous dysplasia

UBC

EG

Osteoid osteoma

Chondroblastoma

Painful enchondroma

171

GCT location mainly?

Prox tibia, distal femur, proximal humerus, distal radius

 

I.e. Where a lot of growth occurs

172

Poor prognostic indicators for Ewing's (5)

spine and pelvic tumors

tumors greater than 100cm3

< 90% necrosis with chemotherapy

elevated lactic dehydrogenase levels

p53 mutation in addition to t(11:22) translocation

173

Diagnosis & Treatment?

Schwannoma

Classic "String Sign" (Soap on a rope)

Marginal excision

Try not to damage nerve to preserve function

174

Best cure rate of SCC?

Moh's microsurery

175

t(12;16)(q13;p11.2) (CHOP transcripton factor)

Myxoid liposarcoma

176

Treatment for solitary plasmacytoma

External beam irradiation alone

± surgical stabilization

177

What is the approach to neoadjuvant chemotherapy for pre-operative malignant bone tumour?

Multiagent chemotherapy:

1. Methotrexate

2. cisplatin

3. Doxorubicin

4. Ifosfamide

178

Most common complication of TKA & THA in Paget's popuation?

TKA: malalignment

THA: excessive bleeding

Therefore, treat medically before elective hip/knee surgery to decrease bleeding risk

179

What is the most common subungla malignancy?

SCC

180

GNAS mutation is associate with what condition?

Polyostotic fibrous dysplasia

Mcune Albright syndrome