What mutation is characteristic of fibrous dysphasia?
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
Knee pain and this picture. Previous aspiration showed hematoma.
Diagnosis & management?
clue: affects both sides of the joint and causes OA like destruction (cysts)
Debridement ± radiation
What % of plexiform neurifibroma's transform into neurifibrosarcoma?
Post-op radiation after prophylactic surgery for impending pathologic fracture has what 3 goals
treat remaining tumour burden not removed at surgery
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
Diagnosis & treatment?
(calcified stippling affecting both sides of joint)
Arthroscopic debridement (symptomatic treatment)
Why do you take out a retroperitoneal lipoma?
It has a higher chance of being a liposarcoma
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
Congenital syndrome of:
heart, eyes, gonads involved
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)
Indications for non-excisional bx
deep to fascia
surrounds NV structure and NOT a lipoma
Hx of "treated" carcinoma
What are Birbeck granules diagnostic of?
You should embolize mets from which lesions?
Local recurrence rate of chordoma?
50% (very high)
Proton-photon beams may help decrease this
Inheritance pattern of enchonromatosis (Ollier's/Maffuci)?
No inheritance pattern
MHE is AD though
What primary bone malignancies are more likely in patients over 40?
Plasmocytoma (solitary myeloma)
Primary lymphoma of bone
Genearlly, what do soft tissue sarcomas look like on MRI?
Dark on T1
Bright on T2
Management of pathologic fracture through enchondroma?
Cast with delayed curettage until after healing
dDx for Benign Active lesion (6)
GCT location mainly?
Prox tibia, distal femur, proximal humerus, distal radius
I.e. Where a lot of growth occurs
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
Diagnosis & Treatment?
Classic "String Sign" (Soap on a rope)
Try not to damage nerve to preserve function
Best cure rate of SCC?
t(12;16)(q13;p11.2) (CHOP transcripton factor)
Treatment for solitary plasmacytoma
External beam irradiation alone
± surgical stabilization
What is the approach to neoadjuvant chemotherapy for pre-operative malignant bone tumour?
Most common complication of TKA & THA in Paget's popuation?
THA: excessive bleeding
Therefore, treat medically before elective hip/knee surgery to decrease bleeding risk
What is the most common subungla malignancy?
GNAS mutation is associate with what condition?
Polyostotic fibrous dysplasia
Mcune Albright syndrome