Flashcards in Bone and Soft Tissue Tumours Deck (62)
What is a sarcoma?
Malignant tumour that arises from connective tissue
How do sarcomas spread?
-Spread along fascial planes
-Haematogenous spread to lungs
-Rarely to regional lymph nodes (rhabdomyosarcomas, epithelioid sarcomas & synovial sarcomas)
What is a bone tumour in a patient over 50 likely to be?
Bone tumours: Malignant vs benign
-Benign tumours are common
-Malignant tumours are RARE
-Bony secondaries are common
Name some benign bone-forming tumours.
Name a malignant bone forming tumour.
Name some benign cartilage forming tumours.
Name a malignant cartilage forming tumour.
Name a benign fibrous tissue tumour.
Name some malignant fibrous tissue tumours.
-Malignant fibrous histiocytoma (MFH)
Name some benign vascular tissue tumours.
-Aneurysmal bone cyst
Name a malignant vascular tissue tumour.
Name a benign adipose tissue tumour.
Name a malignant adipose tissue tumour.
Name some malignant marrow tissue tumours.
What are the features of giant cell tumours (GCT)?
Benign, locally destructive and can rarely metastasise
Name some benign tumour like lesions.
-Simple bone cyst
-Fibrous cortical defect
What is the incidence of primary bone tumours in the UK?
Per million population per year
-Ewing's sarcoma: 1.5
-Malignant fibrous histiocytoma: <1
What is the commonest primary malignant bone tumour in young patients?
What is the commonest primary malignant bone tumour in older people?
What history do bone tumours present with?
-Abnormal x-ray (incidental)
Describe the pain associated with bone tumours.
-Progressive pain at rest and night
How might benign tumours present?
-Activity related pain if large enough to weaken the bone (can occur in osteoid osteomas)
What should be noted on examination when someone presents with a bony mass?
-Measurements of mass
What investigations should be carried out?
-Plain x-rays (most useful for bone
-Isotope bone scan
-MRI (study of choice)
How do inactive tumours appear on x-ray?
-Surrounding rim of reactive bone
-Cortical expansion can occur with aggressive benign lesions
How do aggressive tumours appear on x-ray?
-Less well defined zone of transition between lesion and normal bone (permeative growth)
-Cortical destruction = malignancy
-Periosteal reactive new bone growth occurs when the lesion destroys the cortex. (Codman’s triangle, onion-skinning or sunburst pattern)
Give examples of what may be seen on x-ray?
-Calcification in synovial sarcoma
-Phleboliths in haemangioma
What is the role of CT in diagnosing bone and soft tissue tumours?
-Assessing ossification and calcification
-Integrity of cortex
-Best for assessing nidus in osteoid osteoma
-Staging - primarily of lungs