Term
| Musculoskeletal neoplasms are divided into what 2 categories? |
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Definition
Primary tumor
Secondary tumor |
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Term
| The tumor is initiated locally. Incidence of malignant MS tumor estimated in US: Bone and joint - 2810; cause of death - 1490. Soft tissue including heart - 10980; cause of death - 3920 |
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Definition
| Primary Tumor (MS Neoplasm) |
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Term
| Where the tumor is metastasized to the skeletal system from other origin. Leading metastases include tumors originating from the lung, prostate, and breast |
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Definition
| Secondary Tumor (MS neoplasm) |
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Term
| Are primary MS tumors malignant or benign? |
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Definition
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Term
| Includes tumors orginating from bone or soft tissue such as muscle, cartilage, nerve, collagen, adipose, lymph or blood vessel, or skin |
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Definition
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Term
| Well differentiated. Slow growing. Rarely invasive. Large fibrous defects in WB bones may cause pathologic fractures |
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Definition
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Term
| Capable of spreading or invading local tissues and destroying adjacent tissues. Malignant bone tumors metastasize to distant sites, often to the lungs followed by the liver and other bone sites thru the bloodstream. |
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Definition
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Term
| What are some general clinical manifestations for MS neoplasms? |
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Definition
-Pain: constant, at night, not relieved by changes in position. Severity is various in nature, stage, location, and rate of growth
-Swelling or mass: size, location, mobility, tenderness, and texture
-Pathologic fracture: Increased incidence of fracture due to bone destruction in bone neoplasms
-Function limitations |
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Term
| The most common benign bone lesion; poses no significant health concern |
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Definition
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Term
| Small, oval sclerotic lesion in bone. Clinically asymptomatic, care must be taken not to alarm the client about this finding as a tumor |
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Definition
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Term
| A benign, painful vascular osteoblastic tumor (comprises 11% of all benign bone tumors) |
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Definition
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Term
| Small lesion, usually less than 1.0 cm in diameter, tumor is not progressive. Affects adolescents and young adults; mostly found in men under the age of 25; it is rare in patients over the age of 40 |
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Definition
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Term
| Often located in the cortex of the long bones, most common site is the proximal femure, and diaphysis of long bones; less often in the foot and spine. Cause is unknown |
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Definition
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Term
| What are the clincial manifestations of osteoid osteoma? |
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Definition
| Well localized dull aching pain, worse at night; characteristically, pain is alleviated with aspirin or other NSAIDs; substances which cause vasodilation such as alcohol may precipitate an acute pain crisis. The tumor can lead to joint pain and dysfunction, often misdiagnosed as an overuse syndrome initially |
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Term
| How can Osteoid Osteoma be diagnosed? |
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Definition
-X-ray radiograph: radiolucent lesion (lesion is uncalcified) within the area of sclerosis (as the result of reactive bone formation)
-Bone scan, CT, MRI |
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Term
| How can osteoid osteoma be managed? |
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Definition
Symptomatic: surgical excision
Post-sx activity restrictions or WB limitation to reduce the risk of fracture |
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Term
| An uncommon benign tumor of osteoblasts with areas of osteoid and calcified tissue; comprising 1-2% of all benign bone tumors |
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Definition
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Term
| Larger lesion than that in osteoid osteoma; have a tendency to expand |
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Definition
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Term
| Often found in the spine (pedicles), sacrum, flat bones, and long bones (near joint). Occurring most frequently in pspine of a young person under 30 |
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Definition
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Term
| Wat are the clinical manifestations of osteoblastomas? |
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Definition
| Localized pain (not as severe as osteoid osteoma), relieved by aspirin; an aggressive lesion can expand to joints or soft tissue, resulting in dysfunction, soft tissue swelling, or mass formation; large lesion in long bone may cause pathologic fracture |
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Term
| How can osteoblastoma be diagnosed? |
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Definition
-X-ray radiograph: well defined radiolucent in the central portion and a thin, sclerotic border (as the result of reactive bone formation)
-CT or MRI |
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Term
| How can osteoblastomas be managed? |
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Definition
-Surgical curettage (scraping to remove the lesion tissue)
-Excision
-Post-sx activity restrictions or WB limitation to reduce the risk of fracture |
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Term
| The most common bone sarcoma; extremely malignant; chiefly affects the ends of long bones, comprising 35% of all malignant bone tumors |
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Definition
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Term
| Most often affects males age 10-25 years old; first frequency peak is during adolescent growth spurts, and a smaller peak in ages over 50 years old |
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Definition
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Term
| Rapidly growing tumors from bone-forming cells, causing destructive lesions and abundant sclerosis |
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Definition
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Term
| What are the most common sites for osteosarcoma? |
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Definition
-at the epiphyseal plate
-50% are located in the knee region: distal femur, proximal tibia
-proximal humerus |
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Term
| How can osteosarcoma be secondary? |
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Definition
| Developed from other lesions such as those with Paget's dz, chronic osteomyelitis, osteoblastoma, or a giant cell tumor |
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Term
| What are the clinical manifestations of osteosarcoma? |
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Definition
-Continuous localized pain lasting weeks to months
-Joint pain, tenderness, swelling and limitation of motion; the overlying skin is warm (due to increased vascularity)
-Pathological fractures due to destructive lesion
-Metastases to lungs early (20-25% at the time of diagnosis); 90% metastasize to lung |
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Term
| How can osteosarcoma be diagnosed? |
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Definition
| Clinical presentation, X-ray, CT, MRI |
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Term
| How can osteosarcoma be managed? |
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Definition
-Surgical removal of primary tumor and metastases is essential to cure
-Adjunctive preoperative chemotherapy
-5 year survival rate: 70-80%
-This tumor is relatively resistance to radiation therapy |
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Term
| Slow-growing malignant tumor; second most common solid malignant tumors of bone (after osteosarcoma) |
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Definition
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Term
| What gender and age is most likely to be effected by chondrosarcoma? |
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Definition
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Term
| What are the common sites for chondrosarcoma? |
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Definition
| pelvic and shoulder girdles; proximal and distal femur, proximal humerus and ribs |
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Term
| What are the tumor origins for chondrosarcoma? |
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Definition
-Primary: arise spontaneously in normal bone
-Secondary: malignant change from benign tumors such as osteochondroma or an enchodroma; malignant change from Paget's disease |
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Term
| How can chondrosarcoma be treated? |
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Definition
| Surgical excision; prevent post-operative fracture |
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Term
| Extremely malignant nonosteogenic primary tumor; can arise in bone or soft tissue |
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Definition
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Term
| Rapid growing tumor, composed of cells of neural origin; 95% of tumors derived from a specific genetic translocation between chromosomes 11 and 22; the second most common primary malignant bone tumor in children |
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Definition
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Term
| 80% occur in young people under age 20; rarely occurs in the black population |
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Definition
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Term
| Where are the common sites for Ewing's sarcoma? |
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Definition
| Pelvis and lower extremity (femure, tib/fib, humerus); no preference for a certain part of the bone |
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Term
| What are the clinical manifestations for Ewing's Sarcoma? |
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Definition
-Progressive pain and swelling and palpable mass
-Pain usually first appears after a sports-related injury, and can be intermittent. Both factors may cause delayed dx
-Pathologic fracture in 5-10% cases
-Metastases to lung early (30% at time of dx)
-Young children may present flu-like symptoms including low grade fever, may be misdiagnosed as osteomyelitis |
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Term
| How can Ewing's sarcoma be dx? |
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Definition
-Clinical Presentation
-CT, MRI, Bone scan
-X-ray; lytic lesion with a moth-eaten appearance involving a diffuse area of bone |
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Term
| How can Ewing's sarcoma be managed? |
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Definition
-Cure requires therapy to control both local tumor and metastases
-Surgical removal of primary tumor (may lead to amputation)
-Radiation: this tumor is very responsive to high-dose radiation therapy
-Chemotherapy: Combination with radiation to eradicate distant metastases
-5 year survival rate: 70% |
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Term
| A malignant neoplams derived from skeletal ms |
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Definition
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Term
| What is the most common soft tissue sarcoma in children? |
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Definition
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Term
| In the US: the incidence is 6 cases per 1 million per year in children and adolescents younger than 15 years old |
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Definition
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Term
| What are the most common sites for rhabdomyosarcomas? |
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Definition
28% in head and neck
24% in extremeties
18% in GI tract
11% in trunk
7% in orbit
6% in retroperitoneum |
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Term
| Metastases of this are found predominantly in the lungs, bone marrow, bones, lymph nodes, breasts, and brain |
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Definition
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Term
| Physical findings depend on the location of the tumor. Tumors in superficial locations may be palpable and detected early, but those in deep locations may grow large before causing symptoms |
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Definition
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Term
| Plain radiography (CT, MRI): radiographs of the primary site and of the chest are helpful to determine the presence of calcifications and bone involvement of the primary tumor and to search for metastatic lung lesions. |
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Definition
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Term
| What is the treatment for RMS? |
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Definition
| A combo of sx, chemo, and radiation |
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Term
| A common benign tumor found in both men and women |
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Definition
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Term
| The most common primary benign tumor of bone |
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Definition
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Term
| Ectopic hyaline cartilage rests in intramedullary bones |
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Definition
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Term
| Resulted from aberrant epiphyseal development |
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Definition
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Term
| Where are the common sites of enchondroma? |
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Definition
| Hands and feet (phalanges, metacarpals, metatarsals) |
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Term
| usually asymptomatic; may eventually develop a firm swelling; pathologic stress fracture may occur, which may cause pain |
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Definition
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Term
| Consists of a pedicle of normal bone covered with a rim of proliferating cartilage cells; formed by outgrowth of bone with a cartilagenous cap (from the metaphysic region of long bones and extends away from nearest epiphysis); usually cease growth at skeletal maturity |
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Definition
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Term
| How can enchondroma be treated? |
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Definition
| Curettage with or without bone graft |
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Term
| Where is osteochondroma commonly found? |
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Definition
| Metaphyses of long bones, especially the distal femure, proximal tibia and humerus |
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Term
| What are the clinical manifestations for osteochondroma? |
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Definition
-a hard mass may be palpated in some pts
-usually not a painful lesion; but may interfere with the function of surrounding soft tissues such as tendons, nerves, or bursae
-Bursitis may be the initial symptom |
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Term
| How can osteochondroma be treated? |
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Definition
-Observation: usually cease growth at skeletal maturity
-Surgical excision: if function if affected or pain develops
-Need to follow up due to high risk of malignant change to chondrosarcoma: rare |
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Term
| Common osseous anomaly, a benign lesion; found in the femur, skull, humerus, and tibia; affects adolescents and young adults |
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Definition
| Fibrous lesions (fibrous dysplasia of bone) |
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Term
| A disturbance in which bone undergoing physiologic lysis is replaced by abnormal fibrous tissue, resulting in asymmetric distortion and expansion of bone; may be confined to a single bone (monostotic fibrous dysplasia) or involve multiple bones (polyostotic fribrous dysplasia) |
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Definition
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Term
| Lesions vary from small fibrous corical defects to larger fibrous dysplasias. Clinical manifestation is usually asymptomatic, and pathologic fracture may be the initial symptom. |
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Definition
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Term
| How can fibrous lesions be treated? |
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Definition
| Surgery; pathologic fracture prevention and rehab |
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Term
| A malignant neoplasm that originates in bone marrow and involves chiefly the skeleton. Occurs more frequently in men |
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Definition
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Term
| Characterized by numerous diffuse foci or nodular accumulations of abnormal or malignant plasma cells in themarrow of various bones and abnormal proteins in the serum and urine |
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Definition
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Term
| What are the clinical manifestations of multiple myeloma? |
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Definition
| Deep bone pain; associated with anemia, hemorrhage, recurrent infections, and weakness; radiographs: osteopenia and punched-out areas of bone with sclerotic border |
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Term
| What is the prognosis for multiple myeloma? |
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Definition
| poor; most die within 1-3 years after diagnosis |
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Term
| Secondary tumors of bone originated from other organs. Tumors commonly originated (75)% from: lung, breast, prostate, kidney cancers, and thyroid |
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Definition
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Term
| Where are the common bone sites of the metastasis? |
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Definition
-Lung: metastasizes early
-Breast: pelvis, ribs, vertebrae, and proximal femur
-Prostate: pelvis, vertebrae, ribs, and proximal femur
-Kidney: metastasizes to vertebrae, pelvis, and proximal femur in 40% of cases
-Thyroid: metastasizes to skull, ribs, sternum, and spine. Women are at 3X more risk than men for thyroid bone metastasis |
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Term
| The most common source of skeletal metastasis in men; metastasize to bone in >50% of cases. Therapists should be alert for this as a possible cause of lumba, spine, and hip pain in men over 50 |
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Definition
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Term
| How are metastatic tumors clinically manifested? |
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Definition
-Pain is most common symptom; sharp, severe, worse at night; transient or intermittent in the early course but constant in advanced cancer
-General systematic symptoms of cancer
-Pathologic fractures |
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Term
| How can metastatic tumors be managed by PTs? |
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Definition
-Early detection: recognize the cancer may mimic MS complaints
-Preoperative tx
-Rehab after pathologic fractures or post-op |
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