Bone tumours

• What are the most common bone tumour in children and young adults?

  primary benign bone tumours
• What are the most common bone tumours in older adults ?

  multiple myeloma and metastasis from other sites
• What are more common: sarcomas or carcinomas?

  Carcinomas
• What does osteolytic mean?

  - Direct erosion of bone

  - Stimulation of osteoclasts by cytokines
• What do you seen in a metastatic tumour of the bone?

  Osteolytic and osteosclerotic
• What are some complications of metastatic tumours?

  Pain

  Pathologic fracture

  Replacement of the bone marrow

  Hypercalcaemia

  Nerve and spinal compression
• What is a myeloma?

  Primary malignant proliferation of plasma cells in the marrow
• What are 2 types of myelomas?

  Solitary plasmacytoma or multiple myeloma
• Primary bone tumours are more common in?

  Children and young adults
• Primary malignant tumours are more common in?

  Older individuals
• Accurate diagnosis of primary bone tumours depend on?

  Accurate diagnosis depend on clinical, radiologic and pathologic examination of the lesion
• What are some benign bone forming tumours?

  - Osteoma

  - Osteoid-osteoma
• What is a locally aggressive bone tumour?

  Osteoblastoma
• What is a malignant bone tumour?

  Osteosarcoma
• What is an osteoma?

  Benign bone forming tumour
• Where are osteoma usually found?

  Often craniofacial in location
• Are ostéomes true neoplasms?

  Probably hamartomatous or reactive growth and not true neoplasm
• What are osteomas associated with?

  Gardner syndrome- multiple osteomas
• Who do osteoid osteomas usually affect?

  Young age (second decade)

  Male 3:1 female
• What is osteoid osteoma painful?

  Painful due to presence of high intra-lesional prostaglandin levels
• What is pain of osteoid osteoma relieved by?

  Aspirin
• How big are osteoid osteomas?


  Small size (<2cm)
• Where are osteoid osteomas usually found?

  Cortex of femur or tubeia-diaphysis
• What do nidus consist of?

  vascular spaces surrounded by sclerotic bone
• What is the therapy for osteoid osteoma?

  Complete resection of nidus
• What is an osteoblastoma?

  Benign bone forming tumour

  - Can be locally aggressive (local recurrence)
• Who does osteoblastoma affect the most?

  Young age
• What is the most common location of osteoblastoma?

  Vertebral column
• How big are osteoblastomas?

  > 2 cm
• Is pain relieved by aspirin in osteoblastoma?


  No
• What is the therapy of osteoblastoma?

  Curettage/resection
• What is an osteosarcoma?

  Malignant bone forming tumour
• Who does osteosarcoma most commonly affect?

  Bimodal age distribution

  - Young - <20 years

  - Second peak in elderly
• Most osteosarcomas arise in?

  the metaphysis of a long bone, classically around the knee (distal femur or proximal tibia)
• What are the risk factors of osteosarcoma?

  - Genetic predisposition (deletions and mutations in cell cycle

  regulators including Rb, p16 and p53)

  - Radiation exposure

  - Paget's disease
• what are the clinical features of osteosarcoma?

  Tenderness and/or pain of the affected region with or without a palpable mass

  Pathological fracture

  Distant metastasis (lung)
• How do osteosarcomas spread?

  Within the medullary cavity

  Through the periosteum

  Across epiphyseal plate Haematogenous
• What do osteosarcomas look under imaging ?

  - Destructive mass with

  - "Sunburst"appearance

  - Codman's triangle (lifting of the periosteum)
• There needs to be a biopsy in which cells on osteosarcoma?

  • Biopsy Pleomorphic cells that produce osteoid
• How are people usually treated for osteosarcoma?

  treated with pre-operative chemotherapy and surgical resection