Flashcards in bone neoplasms Deck (19):
What is an osteoma? Where do they arise With what are they associated?
benign tumor of the bone that usually arises on the surface of the facial bone. associated with gardner's syndrome (familial adenomatous polyposis plus fibromatosis in the retroperitonium. fibromatosis is a non-neoplastic prolif of fibroblasts that grows and destroys local structure)
What is an osteoid osteoma? Who gets these? Where do they arise?
benign tumor of osteoblasts (osteoid) surrounded by a rim of reactive bone (osteoma). seen in young adults under 25, esp. young men. arise in the cortex of long bones, esp. the diaphysis (long shaft of bone)
Presentation of osteoid osteoma. imaging?
bone pain that resolves with aspirin. imaging shows a bony mass with a radiolucent core (this is osteoid)
What is an osteoblastoma?
similar to osteoid osteoma, but arises in vertebrae, is greater than 2 cm, and presents as bone pain that doesn't respond to aspirin
What is osteochondroma? Where does it arise? Complications?
tumor of bone with overlying cartilage cap. most common benign tumor of bone, seen in males under 25. arises from a lateral projection of the growth plate. bone is continuous with the marrow space. can transform to a chondrosarcoma (rare)
What is an osteosarcoma? Who gets it?
malignant proliferation of osteoblasts. peak incidence in teens, second (less common) peak in elderly >65.
risk factors for osteosarcoma
familial retinoblastoma (incr. risk of bilateral retinoblastoma and osteosarcoma), Paget disease, radiation, Li-Fraumeni, bone infarcts
Where do osteosarcomas arise? presentation?
metaphysis of long bones, usually distal femur or proximal tibia (knee region). presents as a pathologic fracture or bone pain with swelling.
What does the imaging show in an osteosarcoma? Biopsy?
destructive mass with a sunburst appearance and lifting of the periosteum off the bone. creates an angle called "codman's angle"
biopsy shows pleomorphic cells that produce osteoid
treat with en bloc resection and chemo
What is a giant cell tumor? Who gets it? Where
tumor of multinucleated giant cells and stromal cells seen in young adults (20-40). arises in the epiphysis of long bones, esp. distal femur or proximal tibia.
clinical features of giant cell tumor and appearance of x ray
soap bubble appearance (reactive bone formation circling the tumor). locally aggressive and may recur
What is a ewing sarcoma? Who gets it, and where?
maliogant proliferation of poorly differentiated cells from the NEUROECTODERM. arises in the diaphysis of long bones, usually in male kids.
Ewing sarcoma: x ra appearance, biopsy, clinical course, translocation
onion skin onx-ray, small round blue cells that resemble lymphocytes on biopsy (may be confused with lymphoma. 11,22 translocation is characteristic. often appears with mets but is responsive to chemo
What is a chondroma? Where does it arise?
benign tumor of cartilage that arises in the medulla of small bones of hands and feet.
What is a chondrosarcoma? Where does it arise?
malignant cartilage forming tumor that arises in the medulla of the pelvis or central skeleton (or humerus, tibia, femur)
What is a typical metastaic tumor to bone? How does it present?
more common than primary tumors. usually result in osteolytic lesions. However, prostate cancer classically produces osteoblastic lesions.
What is osteitis fibrosa cystica
brown tumors d/t fibrous replacement of bone with subperiosteal thickening
what is osteitis fibrosa cystica from primary hyperparathyroidism? lab findings/
idiopathic or parathyroid hyperplasia, adenoma, or carcinoma.
incr. serum Ca, decr. phosphate, incr. ALP, incr. PTH