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rad tumor points
capsule summaries, minus basic info
| Question | Answer |
|---|---|
| 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
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