45: Bone Tumors - Carnevale Flashcards Preview

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

what are the 5 questions to ask?

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

what two sites can ALL of the lesions appear in?

around the knee and at the humerus

3

diaphysis tumor ***

ewing sarcoma *** always in the diaphysis

4

metaphysis tumors

chondrosarcoma and osteosarcoma

5

epiphysis tumors

giant cell tumor

6

osteoma

- 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

bone forming tumors

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

8

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

bone tumor (osteoid osteoma/osteoblastoma)

9

painful bone tumor relieved by aspirin ***

osteoid osteoma
- if not relieved by aspirin = osteoblastoma

10

osteoblastoma

- teens-twenties
- vertebral column
- less than 2 cm

11

malignant tumor producing osteoid***

osteosarcoma

12

most common primary malignant tumor of bone

osteosarcoma

13

location osteosarcoma

metaphysis of long bones

14

age osteosarcoma

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

15

codman triangle

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

16

what is key for osteosarcoma diagnosis?

osteoid

17

osteochondroma

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

18

chondroma

- benign tumors of hyaline cartilage
- in medullary cavity = enchondroma
- metaphyses, hands and feet

19

multiple enchondromas

ollier disease

20

chondroma

- young 20-40
- small bones of hand and feet

21

chondrosarcoma is a tumor of the _______ skeleton

- 40-60 (rare in children)
- pelvic bones, axial skeleton **

22

small round blue tumors

ewing sarcoma

23

ewing sarcoma is always from the ...

diaphysis

24

ewing sarcoma EWS vs. primitive neuroectrodermal tumor PNET

- uniform, undifferentiated small round blue cells
- cells form prominent Homer Wright rosettes with central fibrillary cores

25

when does a person get a fibrous cortical defect?

1st two decades of life

26

fibrous dysplasia

- young 10-30
- anywhere
- radiolucent, in diaphysis

27

immature woven bone surrounded by fibroblastic proliferation

fibrous dysplasia

28

giant cell tumor of bone aka

osteoclastoma

29

osteoclastoma

- giant cell tymor of bone
- epiphyses
- 20-55 yo (mature skeleton)

30

bone cell origin

bengin = osteoma, osteoid osteoma
malignant = osteosarcoma