Tumours that mets to bone
*all the paired organs
What are the three treatment facets of a MM bone lesion?
With a confirmed diagnosis, the treatment of multiple myeloma involves radiotherapy, bisphosphonates +/- surgical stabilization.
Surgical stabilization is utilized when there is a complete or impending fracture.
CD31 & polyvinyl chloride exposure is a risk for what?
What is the local recurrence rate with ABC?
Name 1 adjunct that may help decrease local recurrence?
25% local recurrence
High speed burr
Less common in older kids
Bloodwork for metastasis with unknown origin?
Survival of Chordoma?
60% 5 year survival
25% long term survival
local extension may be fatal
What kind of biopsy is contraindicated in chordoma?
Maffuccis is characterized by:
A) multiple enchondromas, hemangiomas, lymphangiomas
B) multiple enchondromas in a unilateral distribution
C) auto-dominant transmission, multiple enchondromas and osteochondromas
What does it mean if a Tumor is biphasic?
It contains both epithelial and mesemchymal neoplastic cells
For ewings sarcoma, what blood markers should be added to the typical malignant work up and why?
CBC, esr and crp to differentiate it from osteomyelitis
In ewings esr will be up (but not crp?)
Indications for marginal resection of lipoma (4)
Rapidly growing mass
Deep to fascia or in retroperitoneum
Spindle cell & pleomorphic variants
What term is typically used to describe the following genes: p53 and RB-1
Tumor suppressor genes.
In terms of tumour location, what are apophyses treated like?
THINK: locations for chondroblastoma (GT apophysis, calcaneal apophysis etc...)
3 dDx for anterior tibial liesion
malignant fibrous histiocytoma
What tumor am I?
Estrogen Beta Positive
Locally invasive but benign
Can treat with Tamoxifen
Associated with FAP and Dupuytrens
Extra-Abdominal Desmoid Tumor
Lifetime risk of malignant transformation for solitary enchondroma?
What is special about biphasic sarcomas in terms of metasteses?
They can go to lymph nodes, which is unusual for sarcomas.
Also they metastasize to locations other than the lungs.
Name 2 types of benign periepheral nerve sheath tumours
What's the difference
Scwannoma: only made up of Schwan cells
Neurofibroma: Arises from Schwann cells but also has other cells (fibroblasts etc)
PVNS typically contains which pigment?
Gene associated with primary ABC?
3 Predictors of UNSUCCESSFUL treatment of UBC with steroids
Long standing chronic draining wounds or burn scar are at risk of what?
Transformation into SCC (Marjolin's ulcer)
What Tumor is usually epiphyseal in skeletally immature with chicken wire calcifications?
Also has mononuclear chondroblasts
Name 3 soft tissue tumours that chemo can help with:
Rhabdomyosarcoma (only in paediatric population, not adults)
Common presentations in Chordoma?
bladder & bowel changes are common!
palpable on rectal exam
What staging investigation must you include in epitheliod sarcoma (and certain other soft tissue sacomas)
Sentinel LN biopsy
what germ line mutation & tumour is it associated with
also: breast, colon Ca
Name 4 vertebral body tumours
What is the most common benign radiation induced tumour of bone?
Indications for bone marrow biopsy?
(i.e. what tumors necessitate this)
- Multiple Myeloma