25. Primary bone tumors Flashcards Preview

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Flashcards in 25. Primary bone tumors Deck (88)
1

giant cell tumor - age and sex

20-40
no sex differences

2

giant cell tumor - area of the bone

epipheseal end of long bones

3

giant cell tumor - area of the body

epiphesial end of long bones --> often around kne: distal femoral and proximal tibia

4

giant cells tumor is AKA

osteoclastoma

5

giant cell tumor - histology

multinucleated giant cells and stromal cells

6

giant cell tumor - apperance on X- ray

Soap bubble

7

giant cell tumor - behaviour

locally agressive benign tumor ( may recur )

8

MC benign tumor of the bone

osteochondroma

9

osteochondroma - age and sex

under 25 ( male )

10

osteochondroma consists of

mature boney exostosis with cartilaginous ( chondroid ) cap

11

osteochondroma rarely transforms to

chondrosarcoma

12

osteochondroma - area of bone

metaphysis

13

soap bubble appearance in X-ray - bone tumor ?

giant cell tumor

14

osteochondroma - sex

male

15

malignant tumor of cartilage

chondrosarcoma

16

giant cell tumor - behaviour

locally agressive benign tumor ( may recur )

17

x-ray apperance of osteochondroma

an exostosis of the bone

18

osteosarcoma - area of bone

metaphysis

19

osteochondroma rarely transforms to

chondrosarcoma

20

chondroma usually arises in the

medulla of small bones of the hands and feet ( metaphysis )

21

chondrosarcoma usually arises in

medulla of pelvis or central skeleton ( metaphysis)

22

osteochondroma to chondrosarcoma ( frequency )

rare

23

osteosarcoma - presents as a

pathologic fracture or bone pain with swelling

24

MC primary malignant bone tumor

multiple myeloma

25

osteosarcoma - age

bimodal distribution --> 10-20 (MC) and >65

26

osteosarcoma - predisposing factors

1. Paget disease
2. bone infracts
3. radiation
4. Familiar retinoblastoma
5. Li- Fraumeni syndrome ( germline p53 mutation )

27

osteosarcoma - area of bone

metaphysis ody

28

osteosarcoma - area of the b

(metaphysis) often around knee ( distal femoral and proximal tibia)

29

osteosarcoma - malignant proliferation of

osteoblasts

30

osteosarcoma is also called

osteogenic sarcoma

31

behaviour of osteosarcoma

aggressive

32

Ewing sarcoma - genetics

translocation t (11:22) --> fusion protein EWS - FLI 1

33

osteosarcoma - treatment

surgical en bloc resection ( with limb salvage ) and chemotherapy

34

osteosarcoma - codman triangle on x-ray is produced from

elevation of periosteum

35

Ewing sarcoma - x ray

onion skin periosteal reaction in bone

36

Ewing sarcoma - area of the body

1. long bones
2. pelvis
3. scapula
4. ribs

37

Ewing sarcoma - histology

anaplastic small blue cell

38

Ewing sarcoma in biopsy can be confused by

1. lymphoma
2. chronic osteomyelitis

39

primary bone tumors - round cell lesions

1. Ewing sarcoma
2. Multiple Myeloma

40

Ewing sarcoma - behaviour

extremely aggressive with early metastasis 9 but responsive to chemotherapy )

41

Ewing sarcoma - age and sex

boys under 15

42

Ewing sarcoma protein

EWS - FLI 1

43

primary bone tumors of epiphysis

giant cell tumor

44

primary bone tumors of metaphysis

1. osteosarcoma
2. osteochondroma
3. simple bone cyst

45

primary bone tumors of diaphysis

1. fibrous dysplasia
2. osteoid osteoma
3. Ewing sarcoma
4. Multiple myeloma
5. osteoblastoma

46

chondrosarcom a - frequency

rare

47

chondrosarcoma - age and sex

men 30-60

48

chondrosarcoma - apperance of the mass

expansile glistering mass with medullary cavity

49

osteoma - area of the

surface of the facial bones

50

osteoid osteoma is a benign tumor derived from

osteoblasts

51

osteoid osteoma appearance y a rim

osteoid surrounded by a rim of reactive bone ( CENTRAL NIDUS)

52

osteoid osteoma - age and sex

males

53

osteoid osteoma - area bone

cortex diaphysis

54

osteoid osteoma - x ray

bony mass smaller than 2 cm with radiolucent core

55

osteoid is the

unmineralized, organic portion of the none matrix tha forms prior to the maturarion of bone tissue

56

osteoid osteoma - presentation

NIght - time bone pain that resolve with aspirin

57

osteoclastoma - bone tumor

giant cell tumor

58

multinucleated giant cells - bone tumor

giant cell ( osteoclastoma)

59

anaplastic small blue cells - bone tumor

Ewing sarcoma

60

fibrous dysplasia - area of the bone

diaphysis

61

bone tumor with bimodal age distribution ( and which ages )

osteosarcoma
10-20 (mC)
>65

62

onion skin on x ray - bone tumor

Ewing sarcoma

63

osteoblastoma - area of the body

vertebrae

64

osteoblastoma presents as

bone pain that does not respond to aspitin

65

osteoblastoma vs osteoid osteoma - according size

similar but osteoblastoma larger ( >2cm )

66

osteoblastoma vs osteoid osteoma on presentation

osteoblastoma - bone pain that does respond to aspirin
osteoid osteoma --> bone pain tha resolves with aspirin

67

age and sex of - giant cell tumor, osteochondroma
osteosarcoma, Ewing sarcoma, chondrosarcoma, osteoid osteoma

giant cell tumor : 20-40 9 no sex differences
osteochondroma: under 25 (male)
osteosarcoma: bimodal 10-20 (MC) and >65
Ewing sarcoma,boys under 15
chondrosarcoma: men 30-60
osteoid osteoma : under 25

68

osteosarcoma x-ray

1. Codman triangle ( from elevation of periosteum )
2. Sunburst pattern

69

2 MC primary malignant bone tumors

1. MM
2. osteosarcoma

70

• Giant cell tumors have a peak incidence in patients in what age range and occur at what anatomic location?

20–40 years of age; epiphyseal end of long bones

71

• A 25-y/o man has an aggressive bone tumor of the distal femur. Histology shows spindle-shaped cells/multinucleated giant cells. Diagnosis?

Giant cell tumor, or osteoclastoma

72

• A 22-year-old male has bone pain. He is found to have a benign tumor with cartilaginous cap. What's the most likely diagnosis?

Osteochondroma (with a cartilaginous [chonroid] cap)

73

• At what age do men usually develop osteochondromas?

At ages younger than 25 years

74

• Osteochondromas rarely transform into which type of malignancy?

Chondrosarcoma

75

• What bone tumor appears histologically as mature bone with a cartilaginous cap?

Osteochondroma (exostosis)

76

• What is the second most common primary malignant bone tumor after multiple myeloma?

Osteosarcoma

77

• At what ages do osteosarcomas peak?

10̵20 years old (primary), >65 years of age (secondary) (bimodal distribution

78

• Where in the body are osteosarcomas most commonly found?

In the metaphysis of the long bones, especially around the knee

79

• Name some predisposing factors for osteosarcoma.

Paget disease of bone, bone infarcts, radiation, familial retinoblastoma, Li-Fraumeni syndrome (germline 53 mutation)

80

• Patients of what sex and age are predisposed to Ewing sarcoma?

Boys younger than 15 years of age

81

• What is the prognosis of patients with untreated Ewing sarcoma? How does their prognosis change with treatment?

If caught early, it responds well to chemotherapy (Ewing sarcoma is an aggressive cancer with early metastases

82

• A boy with an aggressive bone tumor has an X-ray that shows periosteal "onion skinning." What will genetic analysis of the tumor show?

t(11;22) = translocation (11 + 22 = 33, Patrick Ewing's jersey number) (seen in Ewing sarcoma)

83

• Where is Ewing sarcoma most commonly found?

The diaphysis of long bones, pelvis, scapula, and ribs

84

• Osteosarcomas, which are ___ (benign/malignant) tumors, are typically found in the ____ of long bones.

Malignant, metaphysis

85

• A 25-year-old man has a soap-bubble appearance (see image) on X-ray of his femur. On what part of the femur was X-ray most likely taken?

The epiphyseal end of the femur near the knee (this person most likely has a giant cell tumor [osteoclastoma])

86

• Which primary bone tumor(s) is/are commonly found in the metaphysis of a bone?

Osteochondroma (exostosis), osteosarcoma, simple bone cysts

87

• Which primary bone tumor(s) is/are commonly found in the diaphysis of a bone?

Round cell lesions (e.g., Ewing sarcoma, multiple myeloma), osteoid osteoma, fibrous dysplasia

88

• Which primary bone tumor(s) is/are commonly found in the metaphysis of a bone?

Giant cell tumors

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