Bone-Forming Tumors

Question 1

What patients will get Osteoid Osteomas?

Answer 1

Young men

Question 2

Describe the symptoms of Osteoid Osteomas

Answer 2

Pain that is WORSE AT NIGHT

Question 3

What can differentiate Osteoid Osteomas from Osteoblastomas besides size?

Answer 3

Osteoid Osteomas respond to Aspirin and NSAIDS

– Osteoblastomas do NOT

Question 4

What size are Osteoid Osteomas?

Answer 4

Less than 2 cm

Question 5

Where are Osteoid Osteomas located?

Answer 5

Femur or tibia

Question 6

How do Osteoid Osteomas look?

Answer 6

Central nidus of woven bone surrounded by osteoblasts

Question 7

A central nidus of woven bone surrounded by osteoblasts on the femur or tibia is likely?

Answer 7

Osteoid Osteoma

Question 8

Is there a bone reaction with Osteoid Osteomas?

Answer 8

Yes, thick rind of reactive cortical bone

Question 9

What size are Osteoblastomas?

Answer 9

Greater than 2 cm

Question 10

Where are Osteoblastomas usually located?

Answer 10

Posterior spine

Question 11

Describe the pain with Osteoblastomas

Answer 11

Achey pain

Question 12

Do Osteoblastomas respond to Aspirin/NSAIDs?

Answer 12

NO

– Osteoid Osteomas do

Question 13

Is there a bony reaction with Osteoblastomas?

Answer 13

NO

Question 14

What is the most common primary malignant bone tumor?

Answer 14

Osteosarcoma

Question 15

Malignant mesenchymal cells produce bone matrix

Answer 15

Osteosarcoma

Question 16

Describe the pain/location for Osteosarcomas

Answer 16

Painful enlarging mass at the KNEE

Question 17

A painful enlarging mass presents at the knee

Answer 17

Osteosarcoma

Question 18

Osteosarcomas have bimodal presenting ages. What are they?

Answer 18

1. Less than 20 yo males

2. Older males with pagets or prior radiation

Question 19

If an older male presents with an Osteosarcoma, what is likely in his history?

Answer 19

Pagets or PRIOR RADIATION

Question 20

What is an aggressive x-ray sign of an Osteosarcoma?

Answer 20

Codman Triangle

Question 21

What is the Codman Triangle and what is it seen with?

Answer 21

• Seen with Osteosarcomas

= Elevation of periosteum when bone breaks through the cortex

Question 22

Patients with Osteosarcomas usually have acquired genetic abnormalities of tumor suppressor genes. What are the most common mutations?

Answer 22

RB gene!!

– Also TP53 –> Li-Fraumeni Syndrome

Question 23

What is the histological description of Osteosarcomas?

Answer 23

Bizarre giant tumor cells including abnormal tri-polar forms

– lace like!

Question 24

What is the histological description of Osteosarcomas?

Answer 24

Bizarre giant tumor cells including abnormal tri-polar forms

– lace like!

Question 25

Osteosarcomas will spread through the medullary canal and replace the marrow while destroying the cortex. Where else can they spread?

Answer 25

Soft tissue spread

Question 26

If an Osteosarcoma produces cartilage it is called?

Answer 26

Chondroblastic Osteosarcoma

Question 27

What are all patients assumed to have at the time of diagnosis of an Osteosarcoma?

Answer 27

Occult malignancies

Question 28

What gene is usually mutated with Osteosarcomas?

Answer 28

RB gene

Question 29

Where are Osteosarcomas usually located?

Answer 29

Knee