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Flashcards in Pediatric Tumors Deck (49)
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1

Signs/Symptoms of Bone Tumors & Bone Tumor-like Lesions

Persistent skeletal pain & swelling
Limitation of motion
Spontaneous fracture
Proceed with clinical, radiographic, lab & biopsy exam

2

Examples of Osteoblastic Connective Tissue Tumors

Osteoid osteoma
Osteosarcoma

3

Examples of Cartilage Tumors

Enchondromas
Chondromyxoid fibromas
Chondrosarcomas

4

Examples of Bone Tumors

Giant cell
Chondroblastomas
Ewing's sarcoma

5

Things to Beware of

Night pain
Constant pain
Unusual symptoms
No improvement with conservative management
General symptoms
X-ray findings with lytic or blastic bone changes, soft tissue calcification or periosteal reaction
Unexplained mass

6

Evaluation of Pediatric Tumors

Physical exam
X-rays
Possible: bone scan, CT/MRI, chest x-rays/CT for high risk lesions
Consider: labs, consults/referrals

7

Biopsy of Tumor

Ideal if "ultimate" surgeon performing

8

Treatment of Clearly Benign Tumors

Observation vs. excision/curettage

9

Treatment of Possibly Malignant Tumors

Consider referral to regional cancer center

10

Who is all part of the team at regional cancer centers?

Pathologists
Radiologists
Surgeons
Oncologists
Radiation therapists

11

Classification of Tumors

Bony vs. soft tissue
Benign vs. malignant
Primary vs. metastatic

12

Epidemiology of Osteosarcoma

2nd most common primary bone tumor
High risk mets
Male = Female
Appendicular

13

X-ray Findings in Osteosarcoma

Mixed lytic/sclerotic lesions with cortical destruction

14

Epidemiology of Ewing's

Highly anapestic
Long bone diaphyses

15

X-ray Findings in Ewing's

Lytic, moth-eaten, indistinct margins, "onion skin"

16

Prognosis of Ewing's with Pre-op Chemotherapy

Survival rate: 80-90%

17

Types of Resection with Soft Tissue Tumors

Intra-lesional
Marginal
Wide
Radical

18

Describe Soft Tissue Tumors

Small, superficial cystic lesions: benign/observed
Large, deep solid tumors: studies/biopsy

19

Different Classes with Soft Tissue Tumors

Fibrous
Lipomatous
Smooth muscle
Striated muscle
Vascular
Synovial
Neurologic

20

Determinants of Staging of Soft Tissue Tumors

Tumor grade
Location
Extension
Mets

21

What is the most common cause of bone tumors?

Metastatic disease

22

What cancers primarily have mets in the bones?

Breast
Lung
Prostate
Kidney

23

Most Common Bones for Metastatic Disease

Spine
Ribs
Pelvis
Proximal limb girdles

24

Common Pitfalls with Metastatic Bone Disease

Assume metastatic
Inadequate workup, planning, or fixation
Not knowing when to refer

25

Treatment of Metastatic Bone Disease

Fracture risk
Function
Palliation

26

Benign Bone Tumors

Osteochondroma
Osteoid osteoma
Bone cyst
Non-ossifying fibroma

27

What is the most common of benign primary bone tumors?

Osteochondroma

28

Most Common Location of Osteochondroma

Knee
Proximal humerus

29

Gender Distribution of Osteochondroma

Males > females
2:1

30

When does Osteochondroma generally occur?

2nd & 3rd decades