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AU'18 Oral Path II > Bone Neoplasms - part II > Flashcards

Bone Neoplasms - part II Flashcards

1
Q

malignant neoplasms of bone

A
  1. chondrosarcoma
  2. osteosarcoma
  3. metastatic disease
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2
Q

chondrosarcoma

A

malignancy of cartilaginous differentiation

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3
Q

T/F: chondrosarcoma is common

A

false, rare

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4
Q

what is the 2nd most common PRIMARY bone malignancy?

A

chondrosarcoma

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5
Q

who is affected by chondrosarcoma?

A

mostly adult males, 4th-6th decade

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6
Q

where does chondrosarcoma most commonly affect?

A
  1. femur
  2. pelvis
  3. ribs
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7
Q

T/F: teeth involved with chondrosarcoma test nonvital

A

false, VITAL

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8
Q

in what way might chondrosarcoma mimic dental infection?

A
  1. ± pain
  2. swelling
  3. loose teeth
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9
Q

radiographic features of chondrosarcoma

A
  1. poorly defined radiolucency with variable amounts of radiopacity
  2. may see widened PDL in area of tumor
  3. loss of lamina dura
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10
Q

T/F: larger chondrosarcoma lesions may appear unilocular

A

false, multilocular

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11
Q

histopathologic features of chondrosarcoma

A

invasive lobules of atypical cells showing cartilaginous differentiation

  1. hypercellular
  2. binucleation variation size/shape
  3. mitoses
  4. eggshell like chamber with vacuolar space holding chondrocyte
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12
Q

tx for chondrosarcoma

A

radical surgery “one chance for cure”

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13
Q

prognosis of chondrosarcoma depends on what?

A
  1. location

2. histopathologic grade of tumor

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14
Q

prognosis of chondrosarcoma

A

poor

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15
Q

death from chondrosarcoma is usually by what?

A

direct extension of tumor involving vital structures

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16
Q

where does chondrosarcoma often metastasize?

A

lung

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17
Q

T/F: osteosarcoma is uncommon

A

true

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18
Q

what is the most common PRIMARY bone malignancy?

A

osteosarcoma

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19
Q

skeletal distribution of osteosarcoma

A
  1. 8% jaws
  2. 10% humerus
  3. 15% hips/proximal femur
  4. 60% distal femur/knees
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20
Q

T/F: pain is often initial complaint in long bones and jaws in osteosarcoma pts

A

true

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21
Q

clinical features of osteosarcoma in jaws

A
  1. swelling
  2. loose teeth
  3. paresthesia
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22
Q

radiographic features of osteosarcoma

A
  1. mixed radiolucent/radiopaque with ill-defined borders

2. symmetrically widened PDL of teeth in area

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23
Q

what is an uncommon radiographic feature of osteosarcoma in the jaws?

A

“sun-burst” pattern

24
Q

which long bones are commonly affected by osteosarcoma?

A

around the knees

25
T/F: teeth where osteosarcoma tumor is is NONVITAL
false, vital
26
T/F: parosteal osteosarcoma has a better prognosis
true, b/c it's peripheral
27
what does parosteal osteosarcoma resemble clinically?
1. peripheral giant cell granuloma | 2. pyogenic granuloma
28
what does osteosarcoma resemble radiographically?
focal COD
29
how does the apex of the root with a osteosarcoma tumor appear radiographically?
has a spiked appearance
30
histopathologic features of osteosarcoma
1. infiltrating sheets of malignant spindle cells 2. production of osteoid by tumor cells 3. mitotic activity variable 4. osteoblastic, chondroblastic and fibroblastic differentiation can be seen
31
tx of osteosarcoma
historically was radical surgery only but recently... 1. induction chemotherapy 2. surgery to remove tumor
32
T/F: prognosis for osteosarcoma in the jaws is better
true
33
prognosis of osteosarcoma
fair
34
where does osteosarcoma usually metastasize?
lung
35
death due to osteosarcoma is due to what?
uncontrolled disease
36
overall, metastases typically goes where?
to bone
37
the most common form of cancer involving bone?
metastatic disease
38
what is the 2nd most common form of cancer involving bone?
multiple myeloma
39
T/F: metastatic disease occasionally affects the jaw
true
40
T/F: metastatic disease can affect oral soft tissues as well
true
41
metastasis due to metastatic disease below the neck may affect jaws via what?
Batson's paravertebral plexus of veins
42
Batson's plexus
a VALVELESS vertebral venous plexus
43
what may a Batson's plexus allow?
1. retrograde spread of tumor cells | 2. bypassing filtration through the lungs
44
Batson's vertebral plexus connects what?
deep pelvic veins and thoracic veins in the internal vertebral venous plexuses
45
T/F: over half of pts affect by metastatic disease is greater than 50 y.o.
true
46
where does metastatic disease commonly affect?
mandible > maxilla > soft tissue
47
what soft tissues does metastatic disease most commonly affect?
gingiva > tongue
48
clinical features of metastatic disease
1. paresthesia 2. tooth mobility 3. swelling 4. hemorrhage 5. pathologic fracture 6. trismus
49
what should you consider when a tooth socket doesn't heal?
1. granulation tissue 2. lymphoma 3. metastatic disease
50
radiographic features of metastatic disease
1. poorly defined radiolucency 2. less commonly, radiopacity 3. "moth eaten"
51
histopathologic features of metastatic disease
"seeded effect" from scattered clusters of cells
52
metastatic disease has the same pattern histopathologically as what?
primary malignancy
53
what is metastatic disease most common?
1. breast 2. lung 3. colon 4. thyroid 5. prostate 6. kidney 7. melanoma
54
tx of metastatic disease
1. palliation | 2. radiation therapy
55
prognosis of metastatic disease
very poor
56
T/F: most patients with metastatic disease die within one year of the dx
true

AU'18 Oral Path II (31 decks)

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