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Flashcards in Tumour Deck (329)
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181

What percentage response to chemo is a good prognostic indicator?

>98%

182

Where do neurofibrosarcoma's arise?

From a peripheral nerve or from a neurofibroma (malignant transformation)

183

What must you do to gain adequate margins when resecting a chordoma?

Sacrifice the nerve roots

184

You suspect soft tissue sarcoma but MRI is indeterminant.

Your core biopsy comes back as hematoma only

Next step?

Open biopsy

CANNOT resect this tumour if you suspect soft tissue sarcoma as many of the core's come back as hematoma

185

Recurrence of chondrosarcoma is directly related to what?

Increased telomerase activity

186

In synovial chondromatsis, is the cartilage normal?

No - metaplastic

187

Benign bone lesion in spine is usually what?

Osteoblastoma

188

Does radiation have a role in treatment of Ewing's sarcoma?

Yes, if wide resection is technically difficult or if a Tumor was inadequatly resected based on pathology

189

Synovial sarcoma is a misnomer. What percentage of these tumours actually arise is a major joint?

10%

190

At what age does metastases become more common than primary bone malignancy?

40

191

Diagnosis?

Chondroblastoma

classic:

chondroid matrix

epiphyseal crossing into metaphysis

lots of surrounding edema

dDx: clear cell chondrosarc

192

 

How can you differentiate schwannoma from neurofibroma on MRI?

 

Schwannoma is eccentric and separate from nerve.

 

Neurofibroma is central with the nerve runnign through it.

193

What is the most important factor in preventing local recurrence of a tumour?

adequacy of surgical margin

194

Treatmet for symptomatic, large NOFs

curettage & bone graft

195

This patient is having leg pain unresponsive to conservative mangaement.

Diagnosis?

Treatment?

Paget's disease

Treatment with metaphyseal osteotomy with plate fixation

(Metaphyseal > diaphyseal, plate > IMN - Parvizi)

196

3 Manifestations of fibrous dysplasia

McCune Albright

Mazabraud

Osteofibrous dysplasia

 

197

Treatment of lymphoma

Multiagent chemotherapy ± local radiation

± surgical fixation for instability/pathologic fractures

198

Accuracy of core biopsy done in the office?

80%

199

What is the classification system for GCT?

Campanacci:

I: Intramedullary lesion confined to bone

II: Thinned, expanded lesion

III: Cortical breach

200

Name 3 reasons why prophylactic fixation is better than fixing an actual pathologic fracture

Shorter OR time

Less morbidity

Quicker recovery

201

You diagnose myxoid liposarcoma.  How do you stage?

CT chest, abdo, pelvis

(not just CT chest)

Myxoid liposarcoma specifically has the tendency to spread to areas other than lungs

202

2 differentiating factors from myositis ossificans and tumour

Calcifies from outside - in (vs. tumour - inside out)

Intramuscular origin

203

What Tumor has characteristic fluid levels on MRI?

ABC

204

Most common site for bony mets

Most common site for pathologic fracture secondary to mets to bone

Most common site: thoracic spine

Most common site of pathologic fracture due to mets: proximal femur

205

Treatment algorithm for soft tissue sarcoma

Radiation + wide excision

Whether you do pre-vs. post op radiation is controversial with pros and cons

206

Risk of metasteses with Liposarcoma by grade?

  • Low grade (well differentiated) =
  • High (undifferentiated) = 50%

207

Cell type of synovial sarcoma

Usually biphasic with spindle cells (fibrous) & epithelial cells

NOT SYNOVIAL CELLS

208

 

Lifetime risk of malignant transformation for multiple hereditory exostosis?

 

10%

209

Name the radio-resistant tumours

(TUMOR)

Thyroid 

Undifferentiated soft tissue tumour & chondrosarcoma (Except mesenchymal and dedifferentiated??)

Melanoma 

Osteosarcoma 

RCC 

210

What is the most common solid tumour of childhood?

Is it malignant or benign?

Neuroblastoma

Malignant