Pathology: Benign Bone Tumours Flashcards Preview

RB Y2 MSK 02 - Rheumatology > Pathology: Benign Bone Tumours > Flashcards

Flashcards in Pathology: Benign Bone Tumours Deck (48)
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1
Q

how do a lot of bone tumours present

A

non specifically:

  • pain
  • soft tissue mass
  • compression of adjacent structures
  • acutely with fracture
2
Q

osteochondroma

A

common bony outgrowth on the external surface of bone that is covered in cartilaginous cap

3
Q

location of osteochondroma

A

typically around epiphysis of long bones - most commonly knee

4
Q

treatment of osteochondroma

A

if are growing or causing pain excise as they have a small risk of malignancy

5
Q

CF of osteochondroma

A

do not usually cause problems but can cause localised pain

6
Q

what are multiple osteochondromas associated with

A

genetic disorders

7
Q

enchondroma

A

intramedullary cartilaginous tumour - cartilage that lines the inside of the bones

8
Q

what is the appearance of enchondroma

A

usually lucent but can undergo mineralisation to become PATCHY SCLEROTIC appearance

9
Q

what can an enchondroma result in

A

weakens bone - fracture

10
Q

where do enchondroma usually occur

A

classically small tubular bones of hands and feet usually metaphyseal

11
Q

treatment of enchondroma

A

benign - simply scrape off bone

12
Q

simple bone cyst

A

solitary unicystic fluid filled neoplasm

13
Q

location of simple bone cysts

A

metaphyseal long bones (humerus and femur), and also talus and calcaneus

14
Q

CF of simple bone cyst

A

asymptomatic and therefore an incidental finding on Xray can cause weakness leading to fracture

15
Q

treatment of simple bone cyst

A

curettage and bone grafting

16
Q

aneurysmal bone cyst

A

lots of chambers filled with blood or serum

17
Q

what are aneurysmal bone cyst due to

A

arteriovenous malformation

18
Q

location of aneurysmal bone cyst

A

metaphyses of many different bones

19
Q

features of aneurysmal bone cyst

A

expansile lesion usually locally aggressive and causes cortical expansion and destruction - painful risk of fracture

20
Q

treatment of aneurysmal bone cyst

A

curettage and grafting or use of bone cement

21
Q

giant cell tumours

A

many multi nucleated giant cells

22
Q

what are the giant cells characterised by

A

consistent translocation between chromosome 1 and 2

23
Q

where in the bone are giant cell tumours found

A

metaphyseal and epiphyseal region can extend to subchondral bone adjacent to joint

24
Q

GCT common sites

A

knee and distal radius

25
Q

characteristics of GCT

A

benign but locally aggressive

can metastasise to lungs with benign pulmonary GCT. these have an excellent prognosis

26
Q

CF of GCT

A

cause pain and can cause fracture

27
Q

what is seen onX ray wtih GCT

A

soap bubble appearance

28
Q

treament of GCT

A

intralesional excision with use of phenol, bone cement or liquid nitrogen to destroy tumour material and reduce risk of occurrence

there is a small malignant risk

29
Q

how do you treat very aggressive GCT lesions with cortical destruction

A

joint replacement

30
Q

fibrous dysplasia

A

disease of bone occurring in adolescence where a genetic mutation results in lesions of fibrous tissue develops instead of normal bone and causes immature bone

weakens bone predisposing to fracture

can be monostotic or polystotic

31
Q

common locations of fibrous dysplasia

A

head and neck are frequent

32
Q

aetiology of fibrous dysplasia

A

usually a mutation causing abnormality in G protein signalling

33
Q

what do patients with polystotic fibrous dysplasia often have

A

endocrine disorders (G protein mutations)

34
Q

which genetic condition is fibrous dysplasia associated with

A
  • McCune Albright
  • polystotic fibrous dysplasia
  • also see café au lait macules, hormonal abnormalitites etc
35
Q

features of fibrous dysplasia

A

defective mineralisation results in angular deformities and the affected bone is wider with thinned cortices

stress fractures can occur

36
Q

what happens when the proximal femur is involved in fibrous dysplasia

A

sheperds crook deformity

37
Q

what is used to reduce pain in fibrous dysplasia

A

biphosphonate

38
Q

treatment of fibrous dysplasia caused fractures

A

stabilised with internal fixation and cortical bone grafts

39
Q

osteoid osteoma

A

small nidus of immature bone surrounded by sclerotic halo

40
Q

when do osteoid osteoma most commonly occur

A

adolescence

41
Q

where do osteoid osteoma most commonly occur

A

long bones

42
Q

CF of osteoid osteoma

A

persistent pain that is worse at night and relieved by NSAIDs

43
Q

diagnosis of osteoid osteoma

A

may be seen on X ray bone scan and CT scan can confirm diagnosis

44
Q

treatment of osteoid osteoma

A

may resolve spontaneously CT guided radiofrequency ablation

45
Q

what can also present with a lytic lesion of bone

A

brodies abscess (osteomyelitis) and hyperparathyroidism (Browns tumours)

46
Q

A mostly lucent lesion, with a patchy sclerosis, found within the metaphyseal region of short tubular bones.

A

enchondroma

47
Q

A lucent, multi-loculated cyst found within the medulla of many different bones, often with associated cortical expansion.

A

aneurysmal bone cyst

48
Q

A bony spur, originating the in metaphyseal regions of long bones, growing away from the epiphysis.

A

osteochondroma