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12 Cards in this Set
- Front
- Back
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Chondrosarcoma
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Definition: Malignant neoplasm of hyaline cartilage
P.C.T: Chondrocytes C.M.: Late presentation, M>F, 20% of malignant bone tumours, pelvis and long tubular bones Rx: Staging, surgery (wide resection), reconstruction |
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Ewing sarcoma
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Definition: Primitive malignant small cell neoplasm
P.C.T.: unknown (mesenchymal stem cell?) C.M.: 6-8% malignant bone tumours, <20, M>F, soft tissue mass, cortex intact, fever, decreased ROM, pain (>night), weight loss Rx: Staging, chemo + surgery +/- radiation, 70-80% cure |
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Fibrous dysplasia
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Definition: benign medullary fibro-osseous lesion in 1+ bones
P.C.T.: unknown C.M.: Cafe-au-lait spots, bone expanded with thin cortex, all ages, M=F, long bones, easily fractured, pain (dull ache) Rx: nothing if asymptomatic, bisphosphonates (for pain), surgery for mechanical problem (scrape out tumour, osteotomy) |
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Giant cell tumour
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Definition: Benign, locally aggressive neoplasm of sheets of neoplastic mononuclear cells with interspersed reactive osteoclast-type giant cells
PCT: mononuclear cells and osteoclasts CM: 20% of benign bone tumours, 20-45, F>M, ends of long bones, hemorrhagic, cortical destruction, pain (progressve), decreased ROM, stiffness of joint Rx: Surgical resection and filling with cement |
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Langerhans cell histiocytosis
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Definition: neoplastic proliferation of Langerhans cells
PCT: Langerhans cells CM, <5 common, M>F, "punch-out" hole in bone, no soft tissue involvement, pain (constant, >activity), weight loss, frequent urination, periosteal rxn Rx:biopsy and leave to heal if isolated, steroids or mild chemo for systemic disease, radiation for active bone lesions |
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Multiple myeloma
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Definition: malignant plasma cell neoplasm that produces immunoglobulin (IgG or IgA)
PCT: plasma cells CM: >60, M=F, osteopenia, no periosteal rxn, no soft tissue mass, erosion of cortex, pain (progressive, >activity/mvmt, <rest), tired, cachectic Rx: Staging (immunoelectrophoresis,etc), manage complications (anemia, hypercalcemia, renal dysfunction), chemo, radiation for symptomatic lesions, surgery for fracture risk, not curable |
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Osteochondroma
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Definition: benign cartilage-capped projection arising from bone surface, continuous with marrow cavity
PCT: Osteoblasts and chondrocytes CM: most common benign bone tumour, M>F, sporadic or hereditary, <25, mechanical problems, shortened bone, fractures, bursa formation, secondary osteoarthritis, stiffness, longstanding/progressive, pain (minimal), decreased ROM, non-tender Rx: observation, surgical resection at base if symptomatic |
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Osteoid osteoma
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Definition: benign bone-forming tumour that is <2cm, limited growth potential and disproportionate pain
PCT: Osteoblasts CM: pain (only at night,relieved with anti-inflammatories), no soft tissue mass, cortex>medullary cavity, <20, M>F, periosteal rxn, Rx: Observe (often resolves), anti-inflammatories for pain, radio-frequency ablation, surgery(rare) |
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Osteosarcoma (Terry Fox)
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Definition: primary intramedullary high grade malignant tumour with neoplastic production of osteoid
PCT: Osteoblasts, chondrocytes, fibroblasts CM: extensive soft tissue involvement, periosteal reaction, intact cortex, bimodal, M>F, long bones, pain (progressive, constant, not relieved by pain killers), effusion/swelling, decreased ROM Rx: staging, chemo, surgical resection (wide margins) and reconstruction, 70% cure |
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Metastaic lung cancer (90% of bone tumours)
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Definition: malignant neoplasm originating from lungs
PCT: lung cells CM: 3rd most common site of metastasis, 40-60, smoking is a risk factor, metabolic abnormalities from other mets (ex-diabetes insipidous) Rx: find primary, manage metabolic abnormalities, chemotherapy (primary tumour), radiotherapy (bone met), surgery to prevent fracture, low cure rate |
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Enchondroma
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Definition: benign intramedullary neoplasm composed of hyaline cartilage
PCT: chondrocyte CM:Solitary or multiple (enchondromatosis), pain (progressive, >night, NC with activity), no soft tissue mass, no periosteal reaction Rx:Observation, treat associated fractures |
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Work-up for pathologic fracture/metastatic bone lesion
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Diagnosis: xray, biopsy
Staging (if malignant):CT, bone scan, bone marrow aspirate, etc Treatment: Pain meds, anti-inflammatories, treat associated symptoms, surgery, radiation, chemo |
