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rad tumor points

capsule summaries, minus basic info

QuestionAnswer
Common causes of solitary vertebral collapse mets, plasmacytoma, compression fracture, Paget’s, infection
Common causes of solitary ivory vertebra osteoblastic mets, Hodgkin’s lymphoma, Paget’s
What are the most common malignant tumor of the skeleton? metastatic bone tumors
What types of malignant tumors generally do not spread to bone? basal cell carcinoma, CNS tumors
What is the most life-threatening complication of any malignancy? metastasis
What percentage of all malignant tumors are metastatic? 70%
What percentage of Pts with malignancies have osseous metastasis? 20-35%
What 4 primary cancers account for 80% of all osseous mets? breast, prostate, lung, kidney.
Is alkaline phosphatase eleveated in osteoblastic or osteolytic mets? osteoblastic
By what 3 routes do cancers metastasize? hematogenous, direct extension, lymphatic channels.
Plain film xray requires what % of bone loss before mets can be visually detected? 30%
What % of osseous mets are in the axial skeleton? 80%
Blow-out lesions of mets are associated with which 2 types of primary cancers? renal, thyroid
A neoplastic weakening of the vertebral endplates results in what radiographic feature of mets? schmorl’s nodes
What is a blind vertebra? bilateral pedicle destruction from mets
What is the most common cause of the extrapleural sign? rib mets
A solitary lesion resembling multiple myeloma plasmacytoma
What is another name for multiple myeloma? Kahler’s Dz
What is the most common primary malignant bone tumor? Multiple myeloma
What 5 sites are commonly involved in MM? spine, pelvis, skull, ribs, scapula.
What percentage of MM Pts’ labs show Bence Jones Proteinuria? 40%
What % of MM Pts have secondary amyloidosis? 15%
what is the most common site for non-medullary plasmacytoma? nasopharynx
what might be the only early radiographic sign of MM? gross osteoporosis
what are 3 buzzwords associated with MM’s radiographic features? raindrop skull, vertebra plana, punched-out lesions.
How does MM usually appear on bone scan? Cold
What percentage of plasmacytomas develop into MM? 70%
What is the 2nd most common primary malignant bone tumor? osteosarcoma
What are the most common sites for osteosarcoma? knee, shoulder.
What is the only consistent lab finding in osteosarcoma? raised alkaline phosphatase
What is the most common metastatic pattern of osteosarcoma? cannonball metastasis to lungs.
What is the cumulus cloud appearance? roughened and irregular margins of the eccentric, lobulated mass associated with osteosarcoma.
What is the 3rd most common primary malignant bone tumor? chondrosarcoma
What are the 3 most common sites of chondrosarcoma? Prox humerus/femur, pelvis
Although chondrosarcomas present in a mature population, <2% present here. epiphyseal
Where do chondrosarcomas metastasize to? lungs
What is the fourth most common primary malignant bone tumor? Ewing’s sarcoma
Signs and symptoms of Ewing’s sarcoma may mimic what condition? infection
What is the only primary bone tumor which mimics the symptoms of infection? Ewing’s sarcoma
What are the most common locations for Ewing’s? long bones of lower extremities, inominates (pelvis)
Where does Ewing’s metastasize to? bone
What percentage of ewing’s present with pathological fractures? 5%
What % of malignant bone tumors are fibrosarcomas? 2%
What fraction of fibrosarcomas initially present with pathological fracture? 1/3
Where is the classic location for fibrosarcoma? metaphyseal, in the knee.
What is the only primary malignant bone tumor in which sequestration is found? fibrosarcoma
What type of primary malignant bone tumor is unique in it’s selective lymphatic spread? fibrosarcoma
Which primary malignant bone tumor produces the largest soft tissue mass? fibrosarcoma
What are the most common preexisting beinign conditions to undergo change to secondary fibrosarcoma? Paget’s, fibrous dysplasia, osteomyelitis, postradiation, and bone infarct.
Is GCT benign or malignant? malignant
What are the most common sites of GCT? knee, wrist, shoulder
What is the most common benign bone tumor? osteochondroma
A bony exostosis with a hyaline cap osteochondroma
What is the most common clinical presentation of osteochondroma? Painless hard mass near a joint.
Where are osteochondromas located? Any growing physis
What is the cortical appearance of osteochondroma? blends imperceptibly with the host bone.
What type of tumor may cause cauliflower spine? osteochondroma
What is the most common benign bone tumor of the spine? hemangioma
What is the classic radiographic feature of hemangioma? courdoroy cloth appearance
What percentage of hemangiomas present in the spine and skull? 75%
Where in the spine do hemangiomas present? vertebral bodies of thoracolumbar junction
Rapidly increasing acute local pain is what kind of tumor? ABC
Osteosarcoma shows a clear predilection for what age and sex? males less than 25 years old.
Coathanger exostosis describes what type of tumor? pedunculated osteochondroma
List the most common primary malignant bone tumors in order. MM, osteosarcoma, chondrosarcoma, Ewing’s Sarcoma
What is the most common malignant bone tumor? mets
Subarticular radiolucency related to Paget’s Dz is called blade of grass appearance
Neurofibromatosis is also called Von Recklinghausen's Disease
Osteoid osteoma is located in the _____, whereas osteoma is located in the ______ long bones and spine, skull and sinuses
Which 2 conditions are pain worse at night relieved by aspirin? osteoid osteoma, brodie’s abscess
What is the difference between osteoid osteoma and brodie’s abscess? size, brodies abscess will be more than 2 cm in diameter
Which 3 conditions have a lucent nidus? Osteoblastoma, osteoid osteoma and brodie’s abscess
Is ABC neoplastic? no
Sinus and vision problems, headaches and exopthalmos are all symptoms of what tumor? Osteoma
What is subungual exostosis? osteochondroma at the distal end of the terminal phalanx of a toe or finger causing a Y-shaped distal phalanx
Non-hodkins, Ewing’s, and multiple myeloma have what in common? they are all round cell tumors.
Differentiate between MM and Lytic mets in the skull lytic lesions are more apt to be of varying sizes, MM of uniform size
Lytic phase of Paget’s Dz may demonstrate what finding in the vertebra? vertebra plana
What are the 4 stages of pagets? 1 osteolytic/destructive/monophasic, 2 combined/biphasic, 3 sclerotic or ivory, 4 malignant degeneration
Rugger jersey spine occurs in hyperparathyroid
Osteoma has a predilection for: adult females
Most common primary malignant bone tumor in the hand is? chondrosarcoma
Osteoblastic mets should contain the following Ddx: Paget’s Dz, osteomyelitis, fibrous dysplasia
Brown tumor is a feature of what condition? hyperparathyroidism
Osteoporosis circumscripta is AKA for Paget’s Dz
Marie Strumpel’s is AKA for Ankylosing Spondylitis
Large Coast-of-Maine café-au-lait spots are typical of what process? fibrous dysplasia
Cancers of the breast, prostate, lung and kidney account for what % of skeletal mets in the spine? 80%
Created by: stigmatamarty