Bone and Soft Tissue Tumours Flashcards Preview

Systems: MSK AB > Bone and Soft Tissue Tumours > Flashcards

Flashcards in Bone and Soft Tissue Tumours Deck (62)
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1

What is a sarcoma?

Malignant tumour that arises from connective tissue

2

How do sarcomas spread?

-Spread along fascial planes
-Haematogenous spread to lungs
-Rarely to regional lymph nodes (rhabdomyosarcomas, epithelioid sarcomas & synovial sarcomas)

3

What is a bone tumour in a patient over 50 likely to be?

Metastatic

4

Bone tumours: Malignant vs benign

-Benign tumours are common
-Malignant tumours are RARE
-Bony secondaries are common

5

Name some benign bone-forming tumours.

-Ostoid osteoma
-Osteoblastoma

6

Name a malignant bone forming tumour.

Osteosarcoma

7

Name some benign cartilage forming tumours.

-Enchondroma
-Osteochondroma

8

Name a malignant cartilage forming tumour.

Chondrosarcoma

9

Name a benign fibrous tissue tumour.

Fibroma

10

Name some malignant fibrous tissue tumours.

-Fibrosarcoma
-Malignant fibrous histiocytoma (MFH)

11

Name some benign vascular tissue tumours.

-Haemangioma
-Aneurysmal bone cyst

12

Name a malignant vascular tissue tumour.

Angiosarcoma

13

Name a benign adipose tissue tumour.

Lipoma

14

Name a malignant adipose tissue tumour.

Liposarcoma

15

Name some malignant marrow tissue tumours.

-Ewing's sarcoma
-Lymphoma
-Myeloma

16

What are the features of giant cell tumours (GCT)?

Benign, locally destructive and can rarely metastasise

17

Name some benign tumour like lesions.

-Simple bone cyst
-Fibrous cortical defect

18

What is the incidence of primary bone tumours in the UK?

Per million population per year
-Osteosarcoma: 3
-Chondrosarcoma: 2
-Ewing's sarcoma: 1.5
-Malignant fibrous histiocytoma: <1

19

What is the commonest primary malignant bone tumour in young patients?

Osteosarcoma

20

What is the commonest primary malignant bone tumour in older people?

Myeloma

21

What history do bone tumours present with?

-PAIN
-Mass
-Abnormal x-ray (incidental)

22

Describe the pain associated with bone tumours.

-Activity related
-Progressive pain at rest and night

23

How might benign tumours present?

-Activity related pain if large enough to weaken the bone (can occur in osteoid osteomas)

24

What should be noted on examination when someone presents with a bony mass?

-General health
-Measurements of mass
-Location
-Shape
-Consistency
-Mobility
-Tenderness
-Local temperature
-Neuro-vascular deficits

25

What investigations should be carried out?

-Plain x-rays (most useful for bone
-CT
-Isotope bone scan
-MRI (study of choice)
-Angiography
-PET
-Biopsy

26

How do inactive tumours appear on x-ray?

-Clear margins
-Surrounding rim of reactive bone
-Cortical expansion can occur with aggressive benign lesions

27

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)

28

Give examples of what may be seen on x-ray?

-Calcification in synovial sarcoma
-Myositis ossificans
-Phleboliths in haemangioma

29

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

30

What role do isotope bone scans play in diagnosing bone and soft tissue tumours?

-Staging for skeletal metastasis
-Multiple lesions - osteochondroma, enchondroma, fibrous dysplasia & histiocytosis
-Frequently negative in Myeloma
-Benign also demonstrate increased uptake