benign Tumors

Question 1

Commonest true benign tumor of bone

Answer 1

Osteoid osteoma

Question 2

Commonest benign tumor of bone

Answer 2

Osteochondroma

Question 3

Therapeutic test

Answer 3

Nagging pain worst at night which decreases on giving NSAIDS
- in osteoid osteoma

Question 4

Osteoid osteoma has

Answer 4

Nidus of tangled arrays of partially mineralized osteoid trabecular surrounded by dense sclerotic bone

Question 5

Location of osteoid osteoma

Answer 5

Diaphysis

- long bones: tibia, femur

Question 6

Age group affected by osteoid osteoma

Answer 6

10-25 years( young adults)

Question 7

Investigation in osteoid osteoma

Answer 7

• X-ray: typical radiolucent nidus (<1 cm diameter) surrounded by zone of dense sclerotic bone tumor
• CT SCAN: confirms diagnosis

Question 8

T/t of osteoid osteoma

Answer 8

• complete excision of nidus along with sclerotic bone

- destroyed by CT localized radio frequency ablation

Question 9

Enneking staging for benign tumor

Answer 9

1. Latent lesion
2. Active lesion
3. Aggressive lesion

Question 10

features of Latent lesion

Answer 10

• intracapsular
• grows slowly and stops
• well defined margin
• no cortical destruction
• no t/t required
  Eg: osteoid osteoma

Question 11

Features of active lesion

Answer 11

-intracapsular
- actively growing
- well defined margin
- May expand and thin the cortex
- extended curettage is the t/t
Eg: aneurysmal bone cyst

Question 12

Features of aggressive lesion

Answer 12

-extracapsular
- tendency to recur
- break through the reactive bone possibly the cortex
- extended curettage and marginal/wide resection is t/t
Eg: symptomatic giant cell tumor

Question 13

Osteochondroma has

Answer 13

-bony stalk with a cartilaginous cap

Question 14

Why osteochondroma is not a true neoplasm?

Answer 14

• as its growth stops with cessation of growth at epiphyseal plate

Question 15

Location of osteochondroma

Answer 15

Metaphyseal area of any bone developing by endochondral ossification

• distal femur, proximal tibia, proximal humerus, distal radius, distal tibia
  Can also occur in flat bones of pelvis

Question 16

Trevor’s disease

Answer 16

Osteochondroma on epiphyseal side of growth plate

Question 17

Classical feature of osteochondroma

Answer 17

• cortex and cancellous bone of osteochondroma are continuous with the cortex and cancellous bone of host

Question 18

Feature suggestive of malignant transformation of osteochondroma

Answer 18

Further enlargement after the end of growth plate

Question 19

Age group for osteochondroma

Answer 19

<20 years of age ( during growth period)

Question 20

Symptoms of osteochondroma

Answer 20

• Painless swelling

- pain once complications like bursitis, malignat change has begun

Question 21

Signs of osteochondroma

Answer 21

• firm, non- tender, palpable swelling fixed to bone around joints
• tenderness and warmth if bursa inflamed
• restricted joint movements
• abnormal cosmetic appearance
• interference of tendon function, growth disturbance

Question 22

Causes of sudden pain in osteochondroma

Answer 22

• fracture
• sarcomatous change
• bursitis of overlying bursa
• impingement of neighboring structures: nerves, vessels

Question 23

Radiological findings in osteochondroma

Answer 23

• mushroom shaped outgrowth of bone at metaphysis either sessile or pedunculated, 2-12 cm in size
• tumor showing cortical and medullary portion continuous with the host bone
• tumor looks smaller than it feels because cartilage cap is not seen on X-ray unless calcified

Question 24

T/t of osteochondroma

Answer 24

• not required unless complications develop
• complete excision including periosteum over the exostosis is done
• excision of osteochondroma should, if possible be postponed until later adolescence due to risk of recurrence and growth arrest

Question 25

Other name of osteochondroma

Answer 25

Exostosis

Question 26

Multiple hereditary exostosis also known as:

Answer 26

- diaphysialaclasia

Question 27

MHE is:

Answer 27

Autosomal dominant disorder where there is failure of bone remodeling and this excess of metaphyseal growth is not resorbed forming multiple irregular cartilage capped exostosis

Question 28

Radiological feature of MHE

Answer 28

- classical trumpet shaped metaphysis and bony projections from it - deformities like bowing of radius, genu valgum, ankle valgum

Question 29

Benign tumor of hyaline cartilage is:

Answer 29

Chondroma

Question 30

Chondroma arising from medullary cavity is:

Answer 30

- asenchondroma

Question 31

Chondroma arising from surface of bone is k/a

Answer 31

Subperiosteal or juxta-cortical chondroma

Question 32

Location of enchondroma

Answer 32

Tubular bones of hand and feet

Question 33

Enchondroma is:

Answer 33

Benign tumor consisting of lobulated mass of cartilage encapsulated by fibrous tissue

Question 34

Types of enchondroma

Answer 34

1. Ollier’s disease (chondrodysplasia) | 2. Maffuccis’s syndrome