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Flashcards in Malignant tumors Deck (127)
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1

what is another name for multiple myeloma

kahlers disease

2

what is the age range of multiple myeloma

50-70 years old

3

where does multiple myeloma occur

diaphysis of long tubular bones

spine and skull

4

what are some characteristic features of multiple myeloma

what is the hallmark feature

how is this different from mets

punched out lesions** - HALLMARK

earliest - osteoporosis


moth eaten bone
rain drop skull
pancake vertebrae - or vertebrae plana
unexplained osteoporosis compression fractures
spared pedicles

uniform size lesions in MM
non uniform size in mets

5

what are the symptoms of multiple myeloma

what is the cardinal sign

pain is cardinal sign

pain with increased activity (old man with back pain after shoveling snow)

anemia, weight loss, cachexia, renal disease

pain worse with activity or throughout the day - back pain

6

is multiple myeloma visible on bone scan

no !

no osteoblast activity

may be present if pathological fracture is present with MM

7

what is the most common malignant tumor

multiple myeloma

8

what do you see on lab work with multiple myeloma

m spike on serum elctrophoresis - 90%

IgG myeloma - 50%

bence jones protein


9

what is best imaging for multiple myeloma

what is seen on MR

MRI is best - shows marrow infiltration

low signal t1

high signal t2

10

half of the people that get solitary plamocytoma are under the age of

50 years old

11

what is a solitary plamocytoma look like

single multiple myeloma lesion

expansile and soap bubble like

12

what does solitary plamocytoma lead to

what percent of cases does that occur

70% develop multiple myeloma in 5 years time

13

what do multiple myeloma lesions look like

circumscribed osteolytic lesions - uniform in size and shape

osteoporosis

wrinkled vertebrae

pedicle sign- spared pedicles

14

in what occupations does mutiple myeloma occur in

agriculture - pesticides such as DDT

exposure to wood dust
sheet metal
nuclear industry

15

what is the most common malignant tumor

multiple myeloma

16

where do solitary plasmacytoma occur

Mc in mandible, ilium, vertebrae, ribs, proximal femur, scapula

17

what is a central osteosarcoma

what are the different types of central osteosarcoma

what is most common

undifferentiated connective tissue and forms of neoplastic osteoid

sclerotic - 50%
lytic - 25%
mixed - 25%

18

what do the different types of central osteosarcoma look like

lytic - focal metaphyseal lesion, permeative, mottled, wide or poor zone of transition

sclerotic - dense ivory or sclerotic medullary lesion, cumulus cloud appearance

19

where are central osteosarcomas typically located

metaphysis

MC in distal femur

distal femur and proximal tibia - MC around knee

and humerus / shoulder

vertebral body

20

what tumor is known to stop expanding once it reaches the physis or growth plate so it never enters the epiphysis

central osteosarcoma

21

what are general features of central osteosarcoma

metaphysis
stops at physis
wide zone of transition
codmans triangle
spiculated or sunburst periosteal reaction
soft tissue mass
cortical disruption
dense ivory or sclerotic lesion

22

what tumor is known to cause cannonball mets and spontaneous pneumothorax

central osteosarcoma (>5cm) - mutiple ossified pulmonary lesions - indicates sacromatous pulmonary bone growth

pneumo - subpleural nodules excavate leading to rupture in pleural space

cannonball mets - lungs mets via blood

23

what is the age range for central osteosarcoma

10-25 years old

24

what is the 2nd most common malignant bone tumor

central osteosarcoma

25

what are the symptoms of central osteosarcoma

85% of time - insidious pain and swelling that cannot be relieved - becomes more severe and persistent

weight loss, cachexia, and fever are all unusual*



26

how long can it take to diagnose central osteosarcoma

6 months

27

what is increased in the blood when a patient has a central osteosarcoma

alk phos

28

if a patient has pagets disease, what will be increased in malignant transformation

alk phos

29

what does central osteosarcoma look like on bone scan

hot

30

what does central osteosarcoma look like on MRI and CT

will notice soft tissue mass and marrow infiltration