MS- Skeletal Neoplasia.txt

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MS- Skeletal Neoplasia.txt
2015-04-27 19:08:19
vetmed musculoskeletal neoplasia

vetmed neoplasia
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  1. Skeletal neoplasia that is expansile, compressive, well-differentiated with minimal anaplasia.
    benign skeletal neoplasia
  2. Neoplasm of the periosteum with dense trabecular bone formed; exophytic.
  3. Osteomas usually occur in ___________.
    flat bones
  4. Neoplasm forming hyaline cartilage; usually of flat bones. RARE
  5. Benign neoplasm of fibrous tissue. RARE
  6. Skeletal neoplasm that is invasive with bone lysis and production that is usually rapidly growing with metastatic potential; cells range from poorly differentiated to well-differentiated.
    Malignant skeletal neoplasia
  7. Osteosarcoma is a malignancy of ___________ that may arise from the ____________ or ____________ with __________ mineralization.
    osteoblasts; periosteum; medullary cavity; variable
  8. Chondrosarcoma is a malignancy producing ___________ that is not known to arise from _______________ and is found in regions of ______________ with _____________ mineralization.
    hyaline cartilage; articular hyaline cartilage; bone not near cartilage; patchy
  9. Chondrosarcoma is more common in ____________.
    flat bone
  10. Fibrosarcoma is a malignancy of _____________ with _________mineralization of ______________.
    fibrous tissue; no; connective tissue
  11. Fibrosarcoma in dogs can arise from the ___________________.
    maxillary periosteum
  12. Synovial cell sarcoma is a malignancy of _____________ that usually ____________ the bone on both sides of the __________; there is _______ mineralization. With this type, usually no metastasis.
    fibrocytic synoviocytes; lyses bone; joint space; no
  13. Synovial cell sarcoma that is a malignancy of _____________; is usually malignant.
    histiocytic synoviocytes
  14. Metastatic malignancies to bone are usually _____________.
  15. Lymphoreticular neoplasms of BM are mostly __________ and __________; plasma cell tumors in bone are called __________.
    lytic; multicentric; multiple myeloma
  16. Hematopoietic malignancies are usually not associated with ______________.
    bone lesions
  17. What radiographic views do you use to diagnose osteosarcoma?
    lateral and craniocaudal
  18. What are radiographic signs of osteosarcoma? (4)
    osteolytic (moth-eaten), osteoblastic (proliferative- sunburst pattern), cortical lysis, codmans triangle (lifting of periosteum)
  19. Possible etiologies of osteosarcoma? (6)
    implants, fracture, osteomyelitis, bone infarcts, radiation, genetics
  20. With FNA, neoplastic changes include... (3)
    multinucleated giant cells, "comet cells"-osteoblasts, no/minimal inflammatory cells
  21. Distinguish osteomyelitis from bone neoplasia with _______.
  22. Once you have diagnosed osteosarcoma, your definite next step is to...
    take thoracic radiographs to look for lung metastases
  23. What aspect of osteosarcoma is lethal to our patients?
    metastatic disease
  24. What is the most common chemotherapy for osteosarcoma in dogs?
  25. Delivers radiation much more precisely to the affected area of osteosarcoma; with this method, you must still treat with chemo for micrometastases.
    stereotactic radiation therapy (SRT)
  26. Why is Doxorubicin used less frequently then carboplatin as chemotherapy in dogs with osteosarcoma, even though it is lower cost?
    more potential side effects, such as cardiotoxicity
  27. What is the adjuvant treatment for OSA in dogs?
    thoracic radiographs every 2-3 months to check for macrometastases
  28. Cytotoxic chemotherapy has generally not been effective in treating ___________.
    gross metastatic disease
  29. What is an alternative to limb spare surgery for pain relief?
    palliative radiation therapy
  30. What NSAID is commonly given for pain in dogs with OSA?
  31. Describe OSA in cats.
    metastasis is rare; amputation is often curative
  32. With OSA in dogs, surgery alone is __________, but ___________ is ALWAYS present.
    palliative; micrometastses
  33. What is a contraindication for amputation?
    severe DJD that prevents dog from standing/rising easily
  34. 4 surgical techniques for amputation with canine OSA.
    wide soft tissue and bone margins to ensure complete excision, meticulous hemostasis, avoid incising the tumor, soft tissue padding of bony prominences to prevent pressure sores
  35. What is the preferred method of amputation for forelimb OSA in dogs?
    complete forequarter amputation (most comfortable for dog, most cosmetic, least chance of recurrence)
  36. What are the 3 recognized techniques for hindlimb amputation for dogs with OSA?
    coxofemoral disarticulation (preferred), proximal third of femur osteotomy, hemipelvectomy
  37. What dogs are candidates for proximal third of femur osteotomy?
    tibial tumors and distal sites
  38. Describe a hemipelvectomy.
    acetabulum at minimum is removed, sometimes 1/4 of the pelvis- required for proximal femur tumors
  39. What is the ideal tumor for limb sparing surgery?
    distal radius osteosarcoma
  40. What are the different limb spare techniques?
    allograft, endoprosthesis (metal plate), bone transport osteogenesis (rare), pasteurized tumor allograft (RARE), ulnar transposition (RARE)
  41. What is the paradox of infected allografts?
    surmount a better immune response and live longer
  42. Diaphyseal tumors are almost always...
    metastases, NOT primary bone tumors
  43. Primary bone tumors are almost always in the __________.