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35 Cards in this Set
- Front
- Back
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What is the role of computedtomography (CT), magnetic resonance imaging (MRI), and technetium (Tc) bone scan in evaluating bony lesions?
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CT:determines amount of bone destruction and soft tissue
MRI: determines lesion extent,edema, and presence of soft tissue extension Tc bone scan: determines total number of lesions |
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What is the imaging study of choice for evaluation of a soft tissue mass?
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MRI with contrast
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What is the classic MRI appearance of malignant tumor on T1? T2?
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Low T1
High T2 |
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Quick review: what is the typical MRI appearance of a hemangioma on T1? T2?
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High T1
High T2 |
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What does rim enhancement suggest?
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Mass is likely a cyst
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What if the entire mass enhances?
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Mass is likely a tumor
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If the mass is indeterminate in appearance (benign versus malignant),
what is the next study? |
Needle or open biopsy
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What does a positron emission tomography (PET) scanner measure?
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Fluorodeoxyglucose (FDC)
accumulation |
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This is an indirect measure of what?
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Glucose utilization rate
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Why does a suspected hematoma require careful follow-up?
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May be clinically difficult to differentiate hematoma and
developing sarcoma Must follow patient regularly until mass has resolved |
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From what tissue line do sarcomas originate?
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Mesenchyme
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In general, what is the significance of sarcoma size?
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>5 cm is more likely to metastasize
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What is the signiticance of sarcoma location?
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If sarcoma is below the deep fascia, the prognosis is poorer
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In general, which study is ordered to evaluate for sarcomatous metastases?
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CT chest
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What studies are ordered to evaluate for liposarcoma metastases?
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CT chest/abdomen/pelvis
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Complete staging of osteosarcoma requires what two imaging studies?
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CT chest
Bone scan |
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What additional test is routinely performed for Ewing sarcoma?
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Bone marrow biopsy
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What additional test is routinely performed for rhabdomyosarcoma? Why?
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Local node biopsy
One of four sarcomas that metastasizes to lymph nodes |
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What are the three stages of benign tumors?
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Latent
Active Aggressive |
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In the Enneking staging of malignant tumors, what do I and ll refer to?
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Whether the tumor is low grade (I) or high grade (II)
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What is the significance of grade?
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High-grade tumors are more likely to metastasize
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What is the 5-year survival rate for high-grade sarcomas?
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50%
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What do A, B, and C refer to?
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Whether the tumor is intracompartmental (A),
extracompartmental (B), or metastatic (C) |
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What other system is commonly tumors?
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American joint Committee on Cancer employed to stage malignant (AJCC) system
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What is the major difference in this system?
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Includes a classification for "skip" metastases
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What are the four key prognostic factors for malignant tumors in descending order of importance?
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Stage (includes grade and metastases)
Whether metastases are present Grade Size greater than or less than 8 cm |
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For what can flow cytometry be used?
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To quantify the amount of abnormal DNA present
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What are Mirel's four criteria?
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Site
Pain Lesion type Size |
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What is the clinical application of Mirel's score?
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To predict the likelihood that a metastatic bony lesion will go on to fracture
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How are lesions scored based on site?
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1: upper limb
2: lower limb 3: trochanteric |
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How are lesions scored based on pain?
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1: mild
2: moderate 3: pain with activity |
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How are lesions scored based on type of lesion?
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1: blastic
2: mixed 3: lytic |
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How are lesions scored based on size?
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1: < 1/3 diameter
2: 1/3 to 1/3 diameter 3: > 2/3 diameter |
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What was the mean score for the population that went on to fracture?
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10
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What was the mean score for the nonfracture population?
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7
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