45: Bone Tumors - Carnevale Flashcards Preview

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Flashcards in 45: Bone Tumors - Carnevale Deck (35)
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1
Q

what are the 5 questions to ask?

A
  1. what is the lesion’s pattern of growth?
  2. are the cells of the lesion producing anything?
  3. what do the cells of the lesion look like?
  4. based on cellular features and imaging studies, is the lesion more likely benign or malignant?
  5. does the anatomical diagnosis correlate with the clinical picture and the radiographic appearance of the lesion? – if it doesn’t carefully reconsider all of the information for the case!
2
Q

what two sites can ALL of the lesions appear in?

A

around the knee and at the humerus

3
Q

diaphysis tumor ***

A

ewing sarcoma *** always in the diaphysis

4
Q

metaphysis tumors

A

chondrosarcoma and osteosarcoma

5
Q

epiphysis tumors

A

giant cell tumor

6
Q

osteoma

A
  • benign tumor mature bone
  • asymptomatic
  • 40-50 yo
  • cortical bones of SKULL and FACE
  • well-delimited odule
  • prognosis: good, slow-growing, not invasive, no malignant
7
Q

bone forming tumors

A
  • osteoid osteoma and osteoblastoma
  • benign neoplasms with identical histology
  • differ in size, origin, x-ray and symptoms
8
Q

x:ray - central area of tumor (nidus) usually radiolucent, surrounded by rim of sclerotic bone

A

bone tumor (osteoid osteoma/osteoblastoma)

9
Q

painful bone tumor relieved by aspirin ***

A

osteoid osteoma

- if not relieved by aspirin = osteoblastoma

10
Q

osteoblastoma

A
  • teens-twenties
  • vertebral column
  • less than 2 cm
11
Q

malignant tumor producing osteoid***

A

osteosarcoma

12
Q

most common primary malignant tumor of bone

A

osteosarcoma

13
Q

location osteosarcoma

A

metaphysis of long bones

14
Q

age osteosarcoma

A
  • under 20
  • small peak in elderly with predisposing conditons (secondary osteosarcoma)
  • 20% with pulmonary mets at time of diagnosis
15
Q

codman triangle

A

elevation of periosteum to produce an angle b/w surface of involved bone - osteosarcoma

16
Q

what is key for osteosarcoma diagnosis?

A

osteoid

17
Q

osteochondroma

A
  • young 10-30 male 3x female
  • metaphysis near epiphyseal plate
  • polypoid growth/ mushroom shaped
18
Q

chondroma

A
  • benign tumors of hyaline cartilage
  • in medullary cavity = enchondroma
  • metaphyses, hands and feet
19
Q

multiple enchondromas

A

ollier disease

20
Q

chondroma

A
  • young 20-40

- small bones of hand and feet

21
Q

chondrosarcoma is a tumor of the _______ skeleton

A
  • 40-60 (rare in children)

- pelvic bones, axial skeleton **

22
Q

small round blue tumors

A

ewing sarcoma

23
Q

ewing sarcoma is always from the …

A

diaphysis

24
Q

ewing sarcoma EWS vs. primitive neuroectrodermal tumor PNET

A
  • uniform, undifferentiated small round blue cells

- cells form prominent Homer Wright rosettes with central fibrillary cores

25
Q

when does a person get a fibrous cortical defect?

A

1st two decades of life

26
Q

fibrous dysplasia

A
  • young 10-30
  • anywhere
  • radiolucent, in diaphysis
27
Q

immature woven bone surrounded by fibroblastic proliferation

A

fibrous dysplasia

28
Q

giant cell tumor of bone aka

A

osteoclastoma

29
Q

osteoclastoma

A
  • giant cell tymor of bone
  • epiphyses
  • 20-55 yo (mature skeleton)
30
Q

bone cell origin

A
bengin = osteoma, osteoid osteoma
malignant = osteosarcoma
31
Q

cartilage cell of origin

A
bengin = chondroma
malignant = chondrosarcma
32
Q

osteoclasts cell of origin

A

bengin 90% giant cell tumor, 10% malignant

33
Q

malignant undifferentiatied

A

ewing sarcoma

34
Q

metatstatic tumors to bone are at least _____________ than primary bone tumors

A

20 X more common

- most lesions are osteolytic

35
Q

lytic metastatic bone cancer =
blastic =
majority are mixed

A

lytic - thyroid, lung, gi , kidney, melanoma

blastic - prostate, breast