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Flashcards in Metastatic disease Deck (54)
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1

what is the most common sinister complication of any malignancy and often leads to progression of disease and eventually death

metastasis

2

what is the MC malignant tumor of the skeleton

metastatic bone tumors

3

__% of all malignant tumors are metastatic in origin

__% are primary malignant tumors

70%

30%

4

most malignant tumors of bone are metastases from primary extraskeletal areas such as

breast
lung
prostate
kidney
thyroid
bowel

5

primary __ may also metastasize

sarcomas

6

with exception of the following tumors __ and __, almost all tumors have reported incidence of mets to the spine

CNS

basal cell carcinoma in the skin

7

metastatic bone tumors usually spread via what

hematogenous route

others include lymphatics or by direct extension

8

which bones are predisposed to developing osseous metastases

bones rich in red marrow aka axial skeleton, skull, and proximal extremities


involvement distal to elbow and knee are rare

9

what is drop metastases

how does it spread

intracranial lesions that lead to extramedullary metastasis

spread via CSF to spinal cord

10

what kind of enhancement is needed to view leptomeningeal metastasis spread by drop metastasis

sugar coating enhancement

11

metastasis to the skeleton is as common as to the __ and __

liver and lung

12

cancers of the __ __ __ __ account for 80% of all metastatic cancers to bone

breast
prostate
lung
kidney

13

what is responsible for 70% of all bony metastasis

what does this increase risk for

female breast cancer

increase risk of pathological compression fracture

14

what results in 60% of all skeletal metastases

what results in 25% of all skeletal metastases

prostate carcinoma

lung carcinoma

15

metastasis usually occurs when in life

over the age of 40

16

metastatic osseous lesions in children < 5 years old are usually due to

neuroblastoma

17

metastatic osseous lesions in people 10-20 years old are usually due to

ewings sarcoma
and
osteosarcoma

18

metastatic osseous lesions in people 20-35 years old are usually due to

hodgkins lymphoma

19

what are clinical features of metastatic bone tumors

pain
recent weight loss
cachectic
anemia and fever in advanced stages
pathological fracture
insidious onset of pain with bouts of remission and exacerbation
persistent and nocturnal pain
may not have pain or symptoms

20

its not unusual to find osseous metastases __ years after treatment of a primary tumor

10-15 years

(common in mastectomies for breast cancer)

21

what are some lab markings that may indicate metastatic bone tumors

increased ESR

increased serum Ca if lytic mets - otherwise normal

increased alk phos if blastic mets

PSA and acid phosphatase - increased if prostate capsule rupture

22

what do you do if patient has prostate cancer and bone pain

perform bone scan irrespective of PSA value

23

what is an example of direct extension of metastatic bone tumors

uterine carcinoma spread to pelvis via direct extension via surgery

24

how do metastatic bone tumors spread via hematogenous spread

tumor cells enter THIN WALLED VEINS

arterial walls are thick and resistant to tumor emboli entering

25

what are the most common hematogenous spread metastatic tumors

lungs
liver
axial skeleton

26

how do metastatic bone tumors spread via lymphatic spread

not common due to lack of lymphatic channels in bone marrow

tumor cells can be filtered and trapped to begin to grow in lymph nodes in the body

27

what is implantation or seeding metastasis

spread through fluids in a body cavity

ex - malignant cells rupture from the primary tumor and are released into the thoracic or peritoneal cavity - drop mets is also an example

28

some tumors form large quantities of fluid called

can this be taken away

ascites

yes but fluid rapidly returns

29

does ascites always indicate cancer or tumor

no, there must be evidence of malignant cells

30

what is the clinical presentation of ascites

where doe bowels displace

xray findings

central displacement of the loops of the bowl - displacement of bowels out of the pelvis

uniform grayness of the abdomen

loss of definition of the edge of the liver and spleen